Paul Levine

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Source:breasthealthandhealing.org

Paul H. Levine, MD, is a Research Professor in the Department of Epidemiology and Biostatistics and Clinical Professor of Medicine at the George Washington University Medical Center, Washington, DC. His research interests include viral oncology, aggressive breast cancer and chronic fatigue syndrome.

Books[edit | edit source]

Notable studies[edit | edit source]

  • 2001, Neuromyasthenia and Chronic Fatigue Syndrome (CFS) in Northern Nevada/California: A Ten-Year Follow-Up of an Outbreak

    "Abstract - In 1984-87, an outbreak of debilitating fatigue was reported by two physicians in the private practice of internal medicine in Incline Village, Nevada. Follow-up questionnaires were sent in 1995 to the 259 patients in this outbreak. The results were analyzed to determine how many patients met the latest Centers for Disease Control and Prevention (CDC) case definition for Chronic Fatigue Syndrome (CFS), Idiopathic Chronic Fatigue (ICF), or Prolonged Fatigue (PF). Data were analyzed separately for those living in the Lake Tahoe area and those referred from other locales. Of those returning questionnaires (123/259), 41% met the CDC case definition for CFS, 56% met the criteria for inclusion in the subgroup ICF, and 3% experienced PF. In the population-based Lake Tahoe group, symptomatic women were more likely to have CFS than ICF whereas symptomatic men were likely to fit ICF criteria. Also in this group, full recovery was reported more often among Lake Tahoe participants classified as having ICF (43%) than participants classified as having CFS (15%)."[1]

  • 2000, Chronic Fatigue Syndrome and Cancer

    "Abstract - Background: Several studies have indicated a link between chronic fatigue syndrome (CFS) and cancer, most of them based on anecdotal observations. We have attempted to use more population-based data to determine if the reported relationship is meaningful. Two outbreaks of a fatiguing illness which included well documented cases of CFS were evaluated ten years after the reported outbreak for long-term effects, particularly cancer. We found an unusual pattern of cancer which, in view of an increased incidence of brain tumors and non-Hodgkin's lymphoma (NHL) reported in other studies involving CFS, indicates the need for further study. At the present time this link, which is often presumed to be due to immune dysfunction, has not yet been documented. Not all CFS patients have apparent dysregulation of the immune system and a single causative agent is highly unlikely, making the study of two heterogeneous illnesses, CFS and cancer, highly problematic. With the continuing focus on subgroups, however, this area of research may prove to be more productive."[2]

  • 2000, Silicone Breast Implants, Chronic Fatigue Syndrome and Fibromyalgia

    "Abstract - Clinical studies have continued to suggest a relationship between silicone breast implants and chronic fatigue syndrome. Extensive epidemiologic studies, however, indicate that such a relationship is likely to be by chance and the successful lawsuits against producers of silicone breast implants are based on factors other than scientific proof. We present several perspectives on this issue which are probably relevant to other reports of putative etiologic agents for chronic fatigue syndrome."[3]

  • 1999, Prognostic Factors for Persons With Idiopathic Chronic Fatigue[4]
  • 1998, Characteristics of Fatigued Persons Associated with Features of Chronic Fatigue Syndrome

    Abstract - "Background: Characteristics of persons with chronic fatigue syndrome (CFS) have previously been studied by comparing subjects with CFS to subjects with other conditions or no symptoms of fatigue- In the present study of subjects with idiopalhic chronic fatigue we examined the association between the number and severity of the features of CFS with other characteristics of the subjects. Methods: Data were obtained from a registry of persons over the age of 17 with fatigue for at least six months. All subjects in the registry completed an extensive questionnaire that provided information about fatigue, demographic characteristics, medical conditions, life style, sleeping habits, and psychological characteristics. The characteristics of the subjects were tested for an association with the number of CFS symptoms and the severity of individual CFS symptoms that are considered to be of fundamental importance and may identify more homogeneous subjects with chronic fatigue. Results: The number of CFS symptoms had a bell shaped distribution. This number was strongly associated with the severity of fatigue, the response of fatigue to mental and physical activity, and the following subject characteristics: a greater frequency of sinus and respiratory infections, a higher frequency of migraine headaches, a greater number of somatoform symptoms that were not included as criteria for CFS, and not drinking alcohol. These same subject characteristics were generally associated with at least one of the individual CFS symptoms but more weakly. Psychological complaints only had a statistically significant positive association with one feature of CFS, neurocognitive complaints. Conclusions: Persons with fatigue can be usefully characterized by the extent to which they meet the CFS criteria."[5]

  • 1998, Chronic fatigue syndrome comes of age[6]
  • 1997, Chronic Fatigue Syndrome and Disability[7]
  • 1997, Epidemic neuromyesthenia and chronic fatigue syndrome in west Otago, New Zealand. A 10-year follow-up[8]
  • 1997, Epidemiologic Advances in Chronic Fatigue Syndrome[9]
  • 1996, The Elusive Gulf War Syndrome[10]
  • 1995, Epidemiology[11]
  • 1994, A Comparative Review of Systemic and Neurological Symptomatology in 12 Outbreaks Collectively Described as Chronic Fatigue Syndrome, Epidemic Neuromyasthenia, and Myalgic Encephalomyelitis[12]
  • 1992, Clinical, Epidemiologic, and Virologic Studies in Four Clusters of the Chronic Fatigue Syndrome[13] (Abstract - can request full article)

Talks & interviews[edit | edit source]

Online presence[edit | edit source]

  • PubMed

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. ↑ Paula S. Strickland, Paul H. Levine, Daniel L. Peterson, Karen O'Brien & Thomas Fears. (2001). Neuromyasthenia and Chronic Fatigue Syndrome (CFS) in Northern Nevada/California: A Ten-Year Follow-Up of an Outbreak. Journal of Chronic Fatigue Syndrome, Vol. 9, Iss. 1-2, pp. 3-14. http://dx.doi.org/10.1300/J092v09n03_02
  2. ↑ Paul H. Levine, Deborah Pilkington, Paula Strickland & Daniel Peterson. (2000). Chronic Fatigue Syndrome and Cancer. Journal of Chronic Fatigue Syndrome, Vol. 7, Iss. 1, pp. 29-38. http://dx.doi.org/10.1300/J092v07n01_04
  3. ↑ Paul H. Levine, Daniel J. Clauw, Henry N. Claman, Alastair D. Robertson & Lawrence Ketch. (2000). Silicone Breast Implants, Chronic Fatigue Syndrome and Fibromyalgia. Journal of Chronic Fatigue Syndrome, Vol. 7, Iss. 1, pp. 53-73. http://dx.doi.org/10.1300/J092v07n01_06
  4. ↑ Hartz, Arthur J.; Kuhn, Evelyn M.; Bentler, Suzanne E.; Levine, Paul H.; London, Richard (1999), "Prognostic Factors for Persons With Idiopathic Chronic Fatigue", Archives of Family Medicine, 8: 495-501
  5. ↑ Arthur J. Hartz, Evelyn M. Kuhn & Paul H. Levine. (1998). Characteristics of Fatigued Persons Associated with Features of Chronic Fatigue Syndrome. Journal of Chronic Fatigue Syndrome, Vol. 4, Iss. 3, pp. 71-97. http://dx.doi.org/10.1300/J092v04n03_07
  6. ↑ Levine, Paul H. (1998). The American Journal of Medicine, Volume 105, Issue 3, 2S - 6S. http://dx.doi.org/10.1016/S0002-9343(98)00156-9
  7. ↑ Daniel L. Peterson. (1997). Chronic Fatigue Syndrome and Disability. Journal of Chronic Fatigue Syndrome, Vol. 3, Iss. 4, pp 5-7. http://dx.doi.org/10.1300/J092v03n04_02
  8. ↑ Levine PH, Snow PG, Ranum BA, Paul C, Holmes MJ. (1997). Epidemic neuromyesthenia and chronic fatigue syndrome in west Otago, New Zealand. A 10-year follow-up. Archives of Internal Medicine, 157(7), 750-754. doi:10.1001/archinte.157.7.750 http://www.ncbi.nlm.nih.gov/pubmed/9125006
  9. ↑ Levine P. H. (1997). Journal of Psychiatric Research; 31(1): 7-18.
  10. ↑ Paul H. Levine. (1996). The Elusive Gulf War Syndrome. Journal of Chronic Fatigue Syndrome, Vol. 2, Iss. 2-3, pp 55-63. http://dx.doi.org/10.1300/J092v02n02_05
  11. ↑ Paul H. Levine. (1995). Epidemiology. Journal of Chronic Fatigue Syndrome, Vol. 1 , Iss. 3-4, pp 177-180. http://dx.doi.org/10.1300/J092v01n03_26
  12. ↑ Briggs, Nathaniel C.; Levine, Paul H. (1994), "A Comparative Review of Systemic and Neurological Symptomatology in 12 Outbreaks Collectively Described as Chronic Fatigue Syndrome, Epidemic Neuromyasthenia, and Myalgic Encephalomyelitis", Clinical Infectious Diseases, 1994 (18 Suppl 1): S32-42, doi:10.1093/clinids/18.Supplement_1.S32, PMID 8148451
  13. ↑ Levine, Paul H.; Jacobson, Steven; Pocinki, Alan G.; Cheney, Paul; Peterson, Daniel; Connelly, Roger R; Weil, R; Robinson, SM; Ablashi, Dharam V; Salahuddin, Sayeef Z; Pearson, GR; Hoover, R (1992), "Clinical, Epidemiologic, and Virologic Studies in Four Clusters of the Chronic Fatigue Syndrome", Archives of Internal Medicine, 152 (8): 1611-1616, doi:10.1001/archinte.1992.00400200049009

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

chronic fatigue (CF) - Persistent and abnormal fatigue is a symptom, not an illness. It may be caused by depression, multiple sclerosis, fibromyalgia, chronic fatigue syndrome or many other illnesses. The term "chronic fatigue" should never be confused with the disease chronic fatigue syndrome.

somatic symptom disorder A psychiatric term to describe an alleged condition whereby a person's thoughts somehow cause physical symptoms. The actual existence of such a condition is highly controversial, due to a lack of scientific evidence. It is related to other psychiatric terms, such as "psychosomatic", "neurasthenia", and "hysteria". Older terms include "somatization", "somatoform disorder", and "conversion disorder". Such terms refer to a scientifically-unsupported theory that claims that a wide range of physical symptoms can be created by the human mind, a theory which has been criticized as "mind over matter" parapsychology, a pseudoscience.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

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