Primer for doctors and researchers/he

== פריימר לרופאים וחוקרים ==

== תסמונת עייפות כרונית (CFS) ידועה גם בשם מיאלגי אנצפלומיאליטיס (ME) או ME/CFS. יש מספר רבות של הגדרות קליניות , וזה שיוצר בלבול אצל רופאים, חוקרים ומטופלים.

חשוב לציין עייפות כרונית (ללא ה"תסמונת") אינה מחלה בפני עצמה, אלא סימפטום של מחלות וטיפולים תרופתיים רבים. זה אינו להחלפה להשם CFS, ME או ME/CFS.

“מהו ME/CFS מאת Open Medicine Foundation – “OMF. Linda Tannenbaum לינדה טננבאום, מייסדת ומנכ"לית/נשיאה, מדברת על ME/CFS וכיצד OMF מובילה מחקר (2018) תסמיני העיקרים של ME/CFS הם: עייפות כרונית (CF); חולשה לאחר מאמץ (PEM);

בעיות שינה/שינה לא מרעננות;

ופגיעה קוגניטיבית/ערפל מוחי ו/או אי סבילות אורתוסטטית (OI).[1][2] אדם עם ME יסבול גם מתסמינים אחרים.[3] יש עוד קריטריון בשם מחלת אי-סבילות במאמץ מערכתית' (SEID), הקריטריון הזה מאפשרים למטופל להיות מאובחן עם תסמיני הליבה המינימליים [4][2].

הקריטריוני הקנדית (CCC) דורשים את תסמיני העיקרים יחד עם תסמינים נוירולוגיים, אוטונומיים, נוירואנדוקריניים וחיסונים נוספים.[5]

הקריטריוני הקונצנזוס הבינלאומיים (ICC) משמשים לאבחון אנצפלומיאליטיס מיאלגי (ME) המצריך את תסמיני העיקרים והפרעות נוירולוגיות, חיסוניות/מערכת העיכול/גניטורינארית, וחילוף חומרים אנרגטי/הובלת יונים לאבחון.[6] למרות שהקריטריונים של פוקודה FUKUDA [7] ואוקספורד OXFORD [8] שימשו לאבחון CFS, הם קריטריונים רחבים מידאי, ויכולים לגרום לאבחון שגוי .[9][10][7][11][12] היו דיווחים בתקשורת על ספורטאים שאובחנו עם מיאלגי אנצפלומיאליטיס (ME) או תסמונת עייפות כרונית (CFS) שהחלימו מהר יחסית לאחר מנוחה, תוספי תזונה ושינויי תזונה;[13][14][15][ 16] יתכן הייתה להם אימון יתר (שיש לה סימפטום של CF) ולא ME או CFS.[17] חלק מהאנשים עם אנמיה, אלרגיות, עייפות כרונית אידיופטית או מחלות מעייפות אחרות מאובחנים בטעות עם CFS.[5] השם ME/CFS נמצאים בשימוש הרבה, על ידי רופאים ארגוני חולים וחולים.

פיברומילגיה ותסמונת עייפות כרוני לא אותו דבר "המצב שקצת חופף עם ME/CFS זה פיברומיאלגיה."[18][19] רק בארץ מספר רופים טענונים כי ME/CFS ופיברומיאלגיה הם גרסאות של אותה מחלה, אבל בחוץ לארץ אומרים אחרת. בנג'מין נטלסון, (MD) היציג נתונים שמראים שVO שתי המחלות שונים עם תהליכים פתופיזיולוגיים שונים המובילים לטיפולים שונים.[20] לצערינו קיים גישה פסיכיאטרית עם ME/CFS, אך זה משתנה. בשלב זה אין טיפולים תרופתיים מאושרים. טיפול בפעילות גופנית מדורגת (GET) וטיפול קוגניטיבי התנהגותי (CBT) השתמשו בבריטניה עד 2021. אתר המרכז לבקרת מחלות ומניעתן (CDC) קובע כי "ME/CFS היא מחלה ביולוגית, לא הפרעה פסיכולוגית" ומשפיעה על מערכות גוף מרובות.[21] ה-CDC מזהה את סימפטום ההיכר של PEM שהוא החמרה בתסמינים לאחר פעילות גופנית או נפשית[1] ואומר כי ME/CFS היא "מחלה משבית ומורכבת."[22]

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References

1. ↑ Jump up to:1.01.11.2 "Symptoms of ME/CFS | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)". Centers for Disease Control and Prevention. January 18, 2019. Retrieved January 22, 2019. 2. ↑ Jump up to:2.02.12.22.32.4 "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness | Clinicians' Guide" (PDF). National Academies. 2015. pp. 9–10. 3. ↑ Jump up to:3.03.13.23.3 "What is ME/CFS?". Open Medicine Foundation. Retrieved August 23, 2018. 4. ↑ Jump up to:4.04.1 "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness - Diagnostic Algorithm". nationalacademies.org. 2015. 5. ↑ Jump up to:5.05.15.25.35.4 Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003). "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF). Journal of Chronic Fatigue Syndrome. 11 (2): 7-115. doi:10.1300/J092v11n01_02. 6. ↑ Jump up to:6.06.16.2 Carruthers, Bruce M.; van de Sande, Marjorie I.; De Meirleir, Kenny L.; Klimas, Nancy G.; Broderick, Gordon; Mitchell, Terry; Staines, Donald; Powles, A. C. Peter; Speight, Nigel; Vallings, Rosamund; Bateman, Lucinda; Baumgarten-Austrheim, Barbara; Bell, David; Carlo-Stella, Nicoletta; Chia, John; Darragh, Austin; Jo, Daehyun; Lewis, Donald; Light, Alan; Marshall-Gradisnik, Sonya; Mena, Ismael; Mikovits, Judy; Miwa, Kunihisa; Murovska, Modra; Pall, Martin; Stevens, Staci (August 22, 2011). "Myalgic encephalomyelitis: International Consensus Criteria". Journal of Internal Medicine. 270 (4): 327–338. doi:10.1111/j.1365-2796.2011.02428.x. ISSN 0954-6820. PMC 3427890. PMID 21777306. 7. ↑ Jump up to:7.07.1 Fukuda, K.; Straus, S. E.; Hickie, I.; Sharpe, M. C.; Dobbins, J. G.; Komaroff, A. (December 15, 1994). "The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group" (PDF). Annals of Internal Medicine. American College of Physicians. 121 (12): 953–959. doi:10.7326/0003-4819-121-12-199412150-00009. ISSN 0003-4819. PMID 7978722. 8. Jump up↑ Sharpe, M C; Archard, L C; Banatvala, J E; Borysiewicz, L K; Clare, A W; David, A; Edwards, R H; Hawton, K E; Lambert, H P (February 1991). "A report--chronic fatigue syndrome: guidelines for research". Journal of the Royal Society of Medicine. 84 (2): 118–121. ISSN 0141-0768. PMC 1293107. PMID 1999813. 9. Jump up↑ Chronic Fatigue Versus Chronic Fatigue Syndrome - About.com Health - By: Carol Eustice 10. Jump up↑ "What Does a True ME Definition Look Like?". MEadvocacy.org. Retrieved January 25, 2019. 11. Jump up↑ US NIH Report Calls for UK Definition of ME/CFS to be Scrapped - The Argus Report By: Penny Swift 12. Jump up↑ Spotila, Jennie; Dimmock, Mary (August 16, 2016). "AHRQ Evidence Review Changes Its Conclusions". occupyme.net. Retrieved January 25, 2019. 13. ↑ Jump up to:13.013.1 Tanner, Claudia (2018). "Marathon runner forced to quit work after developing ME claims diet change gave him his life back". iNews. 14. ↑ Jump up to:14.014.1 Broadbent, Rick (December 2, 2017). "Muslim fighter with ME who left an arranged marriage to win world". The Times. ISSN 0140-0460. Retrieved February 28, 2019. 15. ↑ Jump up to:15.015.1 Park, Andy; O'Halloran, Clare. "Committee reviews 'potentially harmful and old fashioned' chronic fatigue treatments". ABC News. 6mins 18s. 16. ↑ Jump up to:16.016.1 Broadbent, Rick (February 27, 2019). "Nathan Douglas: London 2012 was the darkest period of my life". The Times. ISSN 0140-0460. Retrieved February 28, 2019. 17. ↑ Jump up to:17.017.1 Spence, Vance. "Snippets | A presentation by MERGE Chairman Dr Vance Spence on 12 November 2005 at the Oak Tree Court Conference Centre, Coventry, at the invitation of the Warwickshire Network for ME". Irish M.E. Association. 18. Jump up↑ "Overlapping Conditions - American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society". American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society. Retrieved August 12, 2018. 19. Jump up↑ Jason, Leonard; Taylor, R.R.; Kennedy, C.L.; Song, S; Johnson, D; Torres, S.R. (January 1, 2001). "Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness". Medicine and Psychiatry. 4: 29–34. 20. Jump up↑ Natelson, Benjamin H. (February 19, 2019). "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Fibromyalgia: Definitions, Similarities, and Differences". Clinical Therapeutics. 41 (4): 612. doi:10.1016/j.clinthera.2018.12.016. ISSN 0149-2918. PMID 30795933. 21. ↑ Jump up to:21.021.121.221.321.4 "Etiology and Pathophysiology | Presentation and Clinical Course | Healthcare Providers | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". Centers for Disease Control and Prevention. July 10, 2018. Retrieved September 7, 2018. 22. ↑ Jump up to:22.022.122.2 "What is ME/CFS? | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)". Centers for Disease Control and Prevention. January 18, 2019. Retrieved April 12, 2019. 23. ↑ Jump up to:23.023.1 Chu, Lily; Valencia, Ian J.; Garvert, Donn W.; Montoya, Jose G. (January 14, 2019). "Onset patterns and course of myalgic encephalomyelitis/chronic fatigue syndrome". Frontiers in Pediatrics. doi:10.3389/fped.2019.00012

[[Link title]]

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.

post-exertional malaise (PEM) - A notable exacerbation of symptoms brought on by small physical or cognitive exertions. PEM may be referred to as a "crash" or "collapse" and can last for days or weeks. Symptoms can include cognitive impairments, muscle pain, trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, and others.

orthostatic intolerance (OI) - The development of symptoms when standing upright, where symptoms are relieved upon reclining. Patients with orthostatic intolerance have trouble remaining upright for more than a few seconds or a few minutes, depending upon severity. In severe orthostatic intolerance, patients may not be able to sit upright in bed. Orthostatic intolerance is often a sign of dysautonomia. There are different types of orthostatic intolerance, including postural orthostatic tachycardia syndrome (POTS).

systemic exertion intolerance disease (SEID) - A term for ME/CFS that aims to avoid the stigma associated with the term "chronic fatigue syndrome", while emphasizing the defining characteristic of post-exertional malaise (PEM). SEID was defined as part of the diagnostic criteria put together by the Institute of Medicine (IOM) report of 10 February 2015.

Canadian Consensus Criteria (CCC) - A set of diagnostic criteria used to diagnose ME/CFS, developed by a group of practicing ME/CFS clinicians in 2003. The CCC is often considered to be the most complex criteria, but possibly the most accurate, with the lowest number of patients meeting the criteria. Led to the development of the International Consensus Criteria (ICC) in 2011.

International Consensus Criteria (ICC) - A set of diagnostic criteria, based on the Canadian Consensus Criteria, that argued for the abandonment of the term "chronic fatigue syndrome" and encouraged the sole use of the term "myalgic encephalomyelitis".

graded exercise therapy (GET) - A gradual increase in exercise or activity, according to a pre-defined plan. Focuses on overcoming the patient's alleged unhelpful illness beliefs that exertion can exacerbate symptoms, rather than on reversing physical deconditioning. Considered controversial, and possibly harmful, in the treatment or management of ME. One of the treatment arms of the controversial PACE trial.

cognitive behavioral therapy (CBT) - A type of psychotherapy geared toward modifying alleged unhealthy thinking, behaviors or illness beliefs. One of the treatment arms used in the controversial PACE trial.

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.

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.

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.

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.

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.

National Institutes of Health (NIH) - A set of biomedical research institutes operated by the U.S. government, under the auspices of the Department of Health and Human Services.

Agency for Healthcare Research and Quality (AHRQ) - Agency for Healthcare Research and Quality is a United States government agency under the U.S. Department of Health and Human Services. Their mission is "to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable. A representative of the Agency for Healthcare Research and Quality sat on the (now disbanded) CFSAC committee as an Ex Officio Member.

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.

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.

etiology The cause of origin, especially of a disease.