Tag: Netherlands

Normal carnitine levels in patients with chronic fatigue syndrome

Abstract:

BACKGROUND: Patients with chronic fatigue syndrome (CFS) complain of muscle pain and impaired exercise tolerance. Previous studies show that this is due to systemic carnitine deficiency. We investigated the hypothesis that carnitine deficiency plays an important role in CFS in female CFS patients and compared their results with neighbourhood controls.

METHODS: The level of total carnitine, free carnitine, acylcarnitine and carnitine esters were measured in 25 female CFS patients and 25 healthy matched neighbourhood controls in a blinded fashion.

RESULTS: The previously reported decreased level of acylcarnitine in CFS patients was not confirmed. There were also no significant differences in levels of total carnitine, free carnitine and 20 carnitine esters between CFS patients and controls.

CONCLUSIONS: The present study demonstrates that serum carnitine deficiency does not contribute to or causes the symptoms in many CFS patients.

 

Source: Soetekouw PM, Wevers RA, Vreken P, Elving LD, Janssen AJ, van der Veen Y, Bleijenberg G, van der Meer JW. Normal carnitine levels in patients with chronic fatigue syndrome. Neth J Med. 2000 Jul;57(1):20-4. http://www.ncbi.nlm.nih.gov/pubmed/10862998

 

Chronic Fatigue Syndrome and Primary Fibromyalgia Syndrome as recognized by GPs

Abstract:

BACKGROUND: Prevalence studies on Chronic Fatigue Syndrome (CFS) are rare. Because of the similarity in symptoms, the prevalence of Primary Fibromyalgia Syndrome (PFS) was investigated at the same time.

OBJECTIVES: To determine the prevalence of CFS and PFS as recognized by GPs in The Netherlands and to inform them of the existence of CFS.

METHODS: A postal questionnaire was sent to all GPs.

RESULTS: The questionnaire was returned by 60% of the GPs. Seventy-three per cent reported one or more CFS patients and 83% one or more PFS patients in their practice.

CONCLUSION: The estimated prevalence of CFS as recognized by GPs of 112 (PFS 157) patients per 100,000 is a minimum estimate.

 

Source: Bazelmans E, Vercoulen JH, Swanink CM, Fennis JF, Galama JM, van Weel C, van der Meer JW, Bleijenberg G. Chronic Fatigue Syndrome and Primary Fibromyalgia Syndrome as recognized by GPs. Fam Pract. 1999 Dec;16(6):602-4. http://fampra.oxfordjournals.org/content/16/6/602.long (Full article)

 

Prevalence of chronic fatigue syndrome in 4 family practices in Leiden

Abstract:

OBJECTIVE: To determine the prevalence of chronic fatigue syndrome (CFS) in general practice.

DESIGN: Descriptive.

SETTING: General practice and primary health care centres in Leyden region, the Netherlands.

METHOD: RNUH-LEO is a computerized database which contains the anonymous patient information of one general practice (with two practitioners) and four primary health care centres. The fourteen participating general practitioners were asked what International Classification of Primary Care (ICPC) code they used to indicate a patient with chronic fatigue or with CFS. With these codes and with the code for depression patients were selected from the database. It then was determined whether these patients met the criteria of CFS by Holmes et al.

RESULTS: The general practitioners used 10 codes. Including the code for depression a total of 601 patients were preselected from a total of 23,000 patients in the database. Based on the information from the patients’ records in the database, 42 of the preselected patients were selected who might fulfill the Holmes’ criteria of CFS. According to the patients’ own general practitioner, 25 of the 42 patients would fulfil the Holmes’ criteria. The men:women ratio was 1:5. The prevalence of CFS in the population surveyed was estimated to be at least 1.1 per 1,000 patients.

 

Source: Versluis RG, de Waal MW, Opmeer C, Petri H, Springer MP. Prevalence of chronic fatigue syndrome in 4 family practices in Leiden. Ned Tijdschr Geneeskd. 1997 Aug 2;141(31):1523-6. [Article in Dutch] http://www.ncbi.nlm.nih.gov/pubmed/9543740

 

Prevalence of chronic fatigue syndrome and primary fibromyalgia syndrome in The Netherlands

Erratum in: Ned Tijdschr Geneeskd 1997 Sep 13;141(37):2686.

 

Abstract:

OBJECTIVE: To determine the prevalence of chronic fatigue syndrome (CFS) and of primary fibromyalgia syndrome (PFS) in the Netherlands.

DESIGN: Questionnaire.

SETTING: Department of Medical Psychology, University Hospital Nijmegen, the Netherlands.

METHOD: A questionnaire was mailed to all the 6657 general practitioners in the Netherlands in order to inform them of the existence of CFS and to ask them if they had any CFS or PFS patients in their practices.

RESULTS: Sixty percent (n = 4027) of the general practitioners returned the questionnaire. Of all the general practitioners, 27% said they had no CFS patients, 23% said they had 1 CFS patient, while 21% had 2 CFS patients, and 29% said they had 3 or more CFS patients in their practice. Concerning PFS the results were 17% (no PFS patients), 18%, 18% and 47%, respectively. With a mean practice of 2486 patients per general practice, the estimated prevalence of CFS was 112 per 100,000 and that of PFS 157 per 100,000 persons. Of the CFS patients 81% were women and 55% were 25-44 years old; for PFS these figures were 87% and 48% respectively.

CONCLUSION: Extrapolation of the study results indicates that there are at least 17,000 CFS patients and 24,000 PFS patients in the Netherlands. The found prevalence is probably an under-estimation.

 

Source: Bazelmans E, Vercoulen JH, Galama JM, van Weel C, van der Meer JW, Bleijenberg G. Prevalence of chronic fatigue syndrome and primary fibromyalgia syndrome in The Netherlands. Ned Tijdschr Geneeskd. 1997 Aug 2;141(31):1520-3. [Article in Dutch] http://www.ncbi.nlm.nih.gov/pubmed/9543739

 

Indications for management in long-term, physically unexplained fatigue symptoms

Abstract:

In meetings arranged by the minister of Public Health, Welfare and Sports between general practitioners and specialists concerning chronic fatigue syndrome (CFS), suggestions for the diagnosis, treatment and assistance and support of patients with protracted physically unexplained fatiguesymptoms, were established in the light of current scientific insight.

The term ‘CFS’ is applicable in cases of fatigue complaints, of at least 6 months’ standing, reported by the patient himself and evaluated medically, for which no physical explanation has been found and which cause considerable disabilities in professional social and/or personal functioning.

The management depends on the duration of the illness. A distinction is made between an acute phase (up to one month after the first consultation; the policy is mostly expectative), a subacute phase (until 6 months after the onset of the complaints and disabilities; the management is aimed at making the patient accept the condition and persuading him or her to make an effort to promote health) and a chronic phase (from 6 months after the onset of the complaints and disabilities; the management is aimed at health-promoting behaviour and cognitions). Further (laboratory) examinations are useful only if the symptoms have not disappeared after one month (this is the case in approximately 20% of the patients); such examinations may be useful in older patients earlier.

It is important that the CFS patient learns to realize that it is useless to continue to spend energy on searching for causes and possible therapies, but that he should try to promote his own health, for instance by means of a quantified programme of activities linked to a time schedule (instead of to a level of fatigue).

Comment in:

Chronic fatigue syndrome. Ned Tijdschr Geneeskd. 1997

Chronic fatigue syndrome. Ned Tijdschr Geneeskd. 1997

 

Source: van der Meer JW, Rijken PM, Bleijenberg G, Thomas S, Hinloopen RJ, Bensing JM. Indications for management in long-term, physically unexplained fatigue symptoms.Ned Tijdschr Geneeskd. 1997 Aug 2;141(31):1516-9. [Article in Dutch] http://www.ncbi.nlm.nih.gov/pubmed/9543738

Chronic fatigue syndrome in young persons

Abstract:

The prevalence of chronic fatigue syndrome (CFS) in teenagers is 10-20 per 100,000 inhabitants in the Netherlands. The natural course of the disorder is not favourable according to the literature.

Proposed criteria for the diagnosis ‘CFS’ in adolescence are: absence of a physical explanation for the complaints, a disabling fatigue for at least six months and prolonged school absenteeism or severe motor and social disabilities. Exclusion criterion should be a psychiatric disorder.

Factors that attribute to the persistence of fatigue are somatic attributions, illness enhancing cognitions and behaviour of parents as well as physical inactivity. The role of the physician and the role of parents can enhance the problems.

The treatment should focus on decreasing the somatic attributions, on reinforcement by the parents of healthy adolescent behaviour, on the gradual increase of physical activity and on decreasing attention (including medical attention) for the somatic complaints.

 

Source: de Jong LW, Prins JB, Fiselier TJ, Weemaes CM, Meijer-van den Bergh EM, Bleijenberg G. Chronic fatigue syndrome in young persons. Ned Tijdschr Geneeskd. 1997 Aug 2;141(31):1513-6.[Article in Dutch] http://www.ncbi.nlm.nih.gov/pubmed/9543737

 

Attributions and chronic fatigue

Abstract:

It was recently suggested that chronic fatigue is merely a question of attribution. Attribution clearly contributes to the course of chronic fatigue syndrome (CFS) but is not its sole determinant. The presence of strong somatic attributions appears to be one of the perpetuating factors in CFS but not the only one.

Many CFS patients present a self-diagnosis, e.g. myalgic encephalomyelitis. Communication problems between patient and doctor easily arise because of different attributions of the complaints. At the start of fatigue somatic attributions are of less importance than later on in the course of the complaints. In this process an iatrogenic factor might be involved. On the other hand doctors are able to influence these attributions actively in a favourable direction.

Comment in:

Chronic fatigue syndrome. Ned Tijdschr Geneeskd. 1997

Chronic fatigue syndrome. Ned Tijdschr Geneeskd. 1997

 

Source: Bleijenberg G. Attributions and chronic fatigue. Ned Tijdschr Geneeskd. 1997 Aug 2;141(31):1510-2. [Article in Dutch] http://www.ncbi.nlm.nih.gov/pubmed/9543736

 

Chronic fatigue syndrome

Abstract:

Chronic fatigue syndrome is a controversial disease entity. Opinions range from non-disease via psychiatric disorder to a somatic disturbance. Somatic pathogenetic hypotheses include persisting infections, intoxications, metabolic or immunologic disturbances, nervous system diseases and endocrine pathology. None of these hypotheses has been substantiated as yet. Psychological factors are important in the course of the disorder and can be used in the therapeutic approach of patients with chronic fatigue syndrome.

 

Source: van der Meer JW. Chronic fatigue syndrome. Ned Tijdschr Geneeskd. 1997 Aug 2;141(31):1507-9. [Article in Dutch] http://www.ncbi.nlm.nih.gov/pubmed/9543735

 

Chronic fatigue–‘tired with 23 i’s’

 

Abstract:

Two patients, a woman aged 32 years and a man aged 49, presented with severe chronic fatigue. The woman had chronic fatigue syndrome; she recovered slowly. The man suffered from a pituitary adenoma producing follicle stimulating hormone; he recovered after transsphenoidal hypophysectomy.

In patients with chronic fatigue, the history and a thorough physical examination to exclude underlying illness are very important; secondary symptom criteria must not be overemphasized (as is the case with the Holmes and Fukuda criteria), chronic fatigue syndrome should not be diagnosed if the condition has a shorter duration than 6 months, but it should be diagnosed if the clinical picture is compatible.

The prognosis is not poor: in patients with a median disease duration of 4.5 years, 20% show significant improvement over an 18-month period.

Comment in:

Chronic fatigue syndrome. Ned Tijdschr Geneeskd. 1997

Chronic fatigue syndrome. Ned Tijdschr Geneeskd. 1997

 

Source: van der Meer JW, Elving LD. Chronic fatigue–‘tired with 23 i’s’. Ned Tijdschr Geneeskd. 1997 Aug 2;141(31):1505-7. [Article in Dutch] http://www.ncbi.nlm.nih.gov/pubmed/9543734