Journal of Chronic Fatigue Syndrome: Volume 13, Issue 1, 2006

Volume 13, Issue 1, 2006

 * Editorial by Elke Van Hoof, Kenny De Meirleir & Neil McGregor
 * Prevalence of Chronic Fatigue Syndrome and Chronic Fatigue Within Families of CFS Patients"'Abstract - The prevalence of CFS (Chronic Fatigue Syndrome) and chronic fatigue were investigated in family members of CFS patients using a questionnaire-based study. Significant differences were seen between the prevalence of CFS in all groups of family members relative to the published community prevalence of 0.422% (spouses/partners: 3.2%, p < 0.001; offspring: 5.1%, p < .001; parents and siblings: 1.1%, p < 0.02; second and third degree blood relatives 0.8%, p < 0.02). The prevalence of CFS was higher in genetically unrelated household contacts and in nonresident genetic relatives than in the community, indicating that both household contact and genetic relationship are risk factors for CFS.'"
 * Unexplained Prolonged Fatigue in Primary Care"'Abstract - Background: Unexplained prolonged fatigue (UPF) is one of the most common complaints in primary care. UPF is difficult to manage because of its nonspecific nature and unknown mechanism. UPF frequently frustrates health care professionals and has negative impacts on the physician-patient relationship. Although it is nonfatal, fatigue-associated functional impairments and economic consequences are substantial, negatively impacting patients' quality of life. Objectives: To evaluate current knowledge development of UPF and to help focus the direction of future investigations. Methods: A literature review was undertaken with the MEDLINE databases chosen as the primary electronic resources to retrieve the literature. Results: Current understanding of UPF is limited. Lack of consistent scientific language is a major problem. There is no consensus about the case definition of UPF even for the most widely studied chronic fatigue syndrome (CFS). Various sets of classification have been developed, each with similar but not identical criteria. Clinicians are dubious about perceiving fatigue as a clinical entity and ignore the diagnosis criteria. Many more patients are excluded than included from the current classifications and lack appropriate evaluation and treatment. The predisposing factors are not well established with the exception of being female and relatively young. Laboratory testing and immune and endocrine abnormalities are inconsistent in determining the causes. Psychological and social factors play an important but inconclusive role in mediating fatigue status. Conclusions: The high prevalence, persistence, and disability-associated consequences of UPF warrant more attention. Further investigations of the symptoms, psychosocial-based symptom experiences, and a search for effective management are needed.'"
 * Antibodies to Herpes Simplex Types 1 and 2 in Chronic Fatigue Syndrome"'Abstract - Background: It has been suggested that Herpes simplex virus (HSV) could play a role in the aetiology of chronic fatigue syndrome (CFS). An immune system that has been compromised, could account for HSV reactivating or infecting for the first time, and also being insufficiently under control in the body. Another consequence of inadequate control could be that several strains of HSV could simultaneously infect the body. Objectives: To look for the presence of antibodies to HSV-1 and HSV-2 in patients with CSF and in controls. The presence of antibodies to both types of HSV could reflect infection by multiple strains of HSV. Methods: Antibodies to HSV-1 and HSV-2 were measured in sera from 27 CSF patients and 26 age-and sex-matched controls. CFS was diagnosed using the CDC criteria. Results: More CFS patients had antibodies to HSV-1, HSV-2 and both types simultaneously, than did the controls (all p < .019). Conclusions: More CFS patients have antibodies to both HSV-1 and HSV-2 than do controls. The possibility that multiple strains could recombine to form more virulent strains or ones able to cause different forms of illness is discussed.'"
 * Rehabilitation Programs for Individuals with Chronic Fatigue Syndrome: A Review"'Abstract - Over the past two decades, a small but growing number of rehabilitation programs for individuals with chronic fatigue syndrome (CFS) have been initiated. The aims of this paper were to review existing literature on these programs, to compare and contrast findings emerging from inpatient and outpatient programs, and to comment on the rigor and quality of methodologies used in outcomes research in this area. The studies reviewed herein varied widely in case selection criteria, program intensity, length of participation, program content, and outcome variables measured. Moreover, many were limited by selection bias, the absence of valid and reliable measures, and the absence of a control group. These limitations made it difficult to draw definitive conclusions regarding the effectiveness of any single approach to rehabilitation (whether inpatient or outpatient). However, there is some preliminary evidence that both inpatient and outpatient rehabilitation programs may lead to improvements in physical and occupational functioning, decreased perception of symptom severity, improved quality of life, and greater resource acquisition at least for certain subgroups of individuals with CFS that participate in specific types of programs. Taken together, these preliminary findings support the need for additional funding and support for the development of comprehensive rehabilitative program centers that include both inpatient and outpatient programs with follow-up sessions and ongoing evaluation. Recommendations for future program development and outcomes research in this area are discussed.'"
 * Lipid Replacement and Antioxidant Nutritional Therapy for Restoring Mitochondrial Function and Reducing Fatigue in Chronic Fatigue Syndrome and Other Fatiguing Illnesses"'Abstract - Evidence in the literature indicates that diminished mitochondrial function through loss of efficiency in the electron transport chain caused by oxidation occurs during aging and in fatiguing illnesses. Lipid Replacement Therapy (LRT) administered as a nutritional supplement with antioxidants can prevent oxidative membrane damage, and LRT can be used to restore mitochondrial and other cellular membrane functions via delivery of undamaged replacement lipids to cellular organelles. Recent clinical trials using patients with chronic fatigue have shown the benefit of LRT plus antioxidants in restoring mitochondrial electron transport function and reducing moderate to severe chronic fatigue. These studies indicate the benefits of LRT plus antioxidants in reducing fatigue and preventing loss of mitochondrial function, most likely by protecting mitochondrial and other cellular membranes from oxidative and other damage and removing damaged lipids by lipid replacement. In one clinical study we determined if mitochondrial function is reduced in subjects with mild to severe chronic fatigue, and if this can be reversed with NTFactor®, a nutritional supplement that replaces damaged cellular lipids. With the use of the Piper Fatigue Scale, there was a significant time-dependent reduction in overall fatigue in moderately or severely fatigued subjects while on the dietary supplement for 4-8 weeks. Analysis of mitochrondrial function indicated that four and eight weeks of the dietary supplement in moderately or severely fatigued subjects significantly increased mitochondrial function. Similarly, chronic fatigue syndrome patients administered antioxidants plus LRT also show reductions in fatigue. The results indicate that LRT plus antioxidants can significantly reduce moderate to severe chronic fatigue and restore mitochondrial function. Dietary use of unoxidized membrane lipids plus antioxidants is recommended for patients with moderate to severe chronic fatigue.'"
 * Letter to the Editor - Chronic Fatigue Syndrome: Editorial Bias in the British Medical Journal by Giselle Jones & Fiona Godlee.
 * Response to the Letter to the Editor by Bart Stouten, Ellen Goudsmit & Sandra Howes.