Journal of Chronic Fatigue Syndrome: Volume 10, Issue 1, 2002

Volume 10, Issue 1, 2002

 * Editorial by Roberto Patarca-Montero
 * Differences in Baseline Nasal Secretions Between Chronic Fatigue Syndrome (CFS) and Control Subjects"'Abstract - Objective: To assess potential mechanism(s) for the rhinitis found in Chronic Fatigue Syndrome (CFS) subjects. Methods: The concentrations of mucus constituents were measured in basal nasal lavage fluids of 103 CFS and 92 non-CFS control subjects. Subjects were further characterized by their Rhinitis Score and allergy skin test results into nonallergic and allergic rhinitis, atopic, and negative subgroups to determine if differences were related to atopy. Other questionnaires of irritant sensitivity and medicine use were completed. Results: Mucin polysaccharide (p = 0.043, ANOVA), free hemoglobin (p = 0.0044), mucin/total protein (p = 0.039) and hemoglobin/total protein (p = 0.043) were higher in CFS than controls. CFS subjects with positive Rhinitis Scores (p = 0.023) or skin tests (p = 0.047) had higher mucin levels than those with negative values. For all subjects, increased mucin was correlated with total protein (Pearson's r2 = 0.188) and inhaled corticosteroid use (r2 = 0.091), while hemoglobin was correlated with total protein (r2 = 0.082) and elevated Tobacco Scores (r2 = 0.061). Other correlations with demographic, medication, or questionnaire responses gave r2 < 0.05. Conclusions: CFS subjects have a higher level of complaints in many systems including the nose. They appear to have an irritant (nonallergic) rhinitis with increased mucin production and mucosal friability (epistaxis of hemoglobin). Nasal and systemic drugs do not explain these significant baseline changes.'"
 * Quality of Life of Patients with Chronic Fatigue Syndrome"'Abstract - The purpose of this study was to compare quality of life between patients with Chronic Fatigue Syndrome (CFS; n = 73) and healthy controls (n = 147), using a broad and generic quality of life assessment instrument, the World Health Organization Quality of Life assessment (WHOQOL-100). Participants were assessed on the WHOQOL-100, a self-assessment instrument designed for quantifying 24 facets relating to quality of life. These facets are grouped into six larger domains: physical health, psychological health, level of independence, social relationships, environment, and spirituality. The WHOQOL-100 also includes one facet examining overall quality of life and general health perceptions. Analyses revealed that the CFS group reported significantly lower levels of quality of life than the control group on overall quality of life and general health perceptions and on 22 out of the 24 facets of quality of life. Compared to earlier studies that used health-status scales or rather limited quality of life measures, this study generated a more complete picture of the problems of patients with CFS. The results suggest that the impact of CFS on the patients' lives is very profound. CFS has a quality-of-life burden that affects a wide range of factors inherent to quality of life. Questions that must be addressed by future research are considered.'"
 * Chronic Fatigue Syndrome in Psychiatric Patients: Exposure to Potentially Toxic Substances"'Abstract - Several investigators have suggested that environmental chemicals or “pollutants” play a significant role in the pathogenesis of chronic fatigue syndrome (CFS). This study compares the reported exposures to environmental chemicals and other potentially toxic environmental factors of psychiatric patients with CFS and two sets of controls from the same practice who did not meet the criteria for CFS. All comparisons found that CFS patients reported significantly more exposures to potentially toxic substances than any of the control groups. The extensive scientific literature on chemical intolerance and sensitization to generally non-toxic levels of potentially toxic substances, and its possible relevance to the investigation of CFS, is discussed.'"
 * Can General Practitioners Manage Chronic Fatigue Syndrome?: A Controlled Trial"'Abstract - Background: Chronic Fatigue Syndrome/Myalgic En-cephalomyeltis (CFS/ME) is now recognised as a condition that results in substantial disability with a prevalence of around 0.6%. Aim: The study aimed to test the hypotheses that general practitioners could (a) diagnose and (b) treat patients with the Chronic Fatigue Syndrome (CFS). Method: All practices in two health authorities were contacted with a 35% uptake. Fifty percent of practices then entered a patient into the study. Practices were randomised to either intervention or control groups, and were encouraged to recruit patients. It was intended that the intervention practices would introduce a form of brief cognitive behavioural therapy. Control practices were invited to manage their patients as usual, which often included referral to secondary care. Results: The study suffered from both poor recruitment and high drop out. However, we were able to show that this intervention had no effect on the illness of the patients enrolled, and that patients with CFS remained highly disabled over the 12 month study period, whatever their treatment. Conclusion: The study suggests that general practitioners in this study were unable to effectively treat the condition. This accords with the Royal Colleges' report (1996), that the only evidence for effective treatment thus far has come from specialist units. The study suggests that general practitioners are unable to provide a management programme of this nature, and possibly effective treatment programmes for CFS in primary care.'"
 * Myalgic Enchephalomyelitis: Guidelines for Doctors