Tag: review

Epstein-Barr virus infection and associated diseases in children. I. Pathogenesis, epidemiology and clinical aspects

Abstract:

Epstein-Barr virus (EBV), an ubiquitous human B lymphotropic virus, is the cause of infectious mononucleosis. Moreover, EBV infection can be followed by lymphoproliferative diseases in patients with inherited and acquired immunodeficiencies.

Primary EBV infection may be a threat to all children after marrow or organ transplantation or those receiving chronic immunosuppressive treatment for various other reasons. The virus has been also implicated in the pathogenesis of different malignant tumours such as Burkitt lymphoma, nasopharyngeal carcinoma, Hodgkin disease and some T-cell lymphomas.

This review focuses on various aspects of virus-host interactions, immune mechanisms of the host, and the still experimental therapeutic approaches in EBV-associated diseases.

 

Source: Schuster V, Kreth HW. Epstein-Barr virus infection and associated diseases in children. I. Pathogenesis, epidemiology and clinical aspects. Eur J Pediatr. 1992 Oct;151(10):718-25. http://www.ncbi.nlm.nih.gov/pubmed/1330572

 

Culture and somatic experience: the social course of illness in neurasthenia and chronic fatigue syndrome

Abstract:

An anthropological view of culture and somatic experience is presented through elaboration of the notion that illness has a social course. Contemporary anthropology locates culture in local worlds of interpersonal experience. The flow of events and processes in these local worlds influences the waxing and waning of symptoms in a dialectic involving body and society over time.

Conversely, symptoms serve as a medium for the negotiation of interpersonal experience, forming a series of illness-related changes in sufferers’ local worlds. Thus, somatic experience is both created by and creates culture throughout the social course of illness. Findings from empirical research on neurasthenia in China, and chronic fatigue syndrome (CFS) in the United States, corroborate this formulation. Attributions of illness onset to social sources, the symbolic linking of symptoms to life context, and the alleviation of distress with improvement in circumstances point to the sociosomatic mediation of sickness.

Transformations occasioned by illness in the lives of neurasthenic and CFS patients confirm the significance of bodily distress as a vehicle for the negotiation of change in interpersonal worlds. An indication of some of the challenges anthropological thinking poses for psychosomatic medicine concludes the discussion.

 

Source: Ware NC, Kleinman A. Culture and somatic experience: the social course of illness in neurasthenia and chronic fatigue syndrome. Psychosom Med. 1992 Sep-Oct;54(5):546-60. http://www.ncbi.nlm.nih.gov/pubmed/1438658

 

The chronic fatigue syndrome

Introduction

Waging war requires ….. energy, which in the end, depletes the operator and concerns the relationship between energy and stress. When the operators are human beings, it may happen that a stage is reached such that the demands being made exceed their resources to cope ….. the symptoms of such resultant stress have been given a variety of labels – shellshock, lack of moral fibre, twitch, war neurosis, battle fatigue and now post-traumatic stress disorder ……’. This is a paraphrased account of Norman Dixon’s penetrating assessment of post-Gulf War battle stress in The Times Saturday Review of the 26 January 1991. It would apply equally to the chronic fatigue syndrome (CFS), which also has a variety of labels including the post-viral fatigue syndrome, myalgic encephalomyelitis, Royal Free disease, fibromyalgia, epidemic neuromyaesthenia, yuppy ‘flu disease, chronic Epstein-Barr virus syndrome and Iceland disease. The major clinical feature is of incapacitating fatigue, often accompanied by widespread myalgia and low-spiritedness.

You can read the rest if this article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2399560/pdf/postmedj00068-0012.pdf

 

Source: James DG1, Brook MG, Bannister BA. The chronic fatigue syndrome. Postgrad Med J. 1992 Aug;68(802):611-4. http://www.ncbi.nlm.nih.gov/pubmed/1448399

 

Chronic fatigue syndrome

Abstract:

The chronic fatigue syndrome (CFS) is a poorly understood condition with nonspecific signs and symptoms, especially debilitating fatigue. Most patients can pinpoint the onset of their illness and usually describe a flu-like state. The search for an etiologic agent has focused on a number of viruses such as Epstein-Barr, enteroviruses, retroviruses, and human herpesvirus-6.

Evidence supports persistent viral infection in a small percentage of CFS patients. Immunologic abnormalities do exist in CFS, which indicate the presence of immune activation in CFS patients.

Although abnormal muscle biopsies have been found in some patients with CFS, strength and endurance appear normal, but perception of exertion may be abnormal. Patients with chronic fatigue have a high incidence of premorbid and concurrent psychiatric disorders, and on physical examination many often have reproducible tender points similar to fibromyalgic patients. Clinical evaluation should rule out other potential causes of fatigue, but elaborate diagnostic tests are seldom required.

Presently, no specific treatment exists for CFS. A cognitive behavioral approach with or without the use of tricyclics has been advocated. Patients should be encouraged to maintain functional status and should not be discouraged from exercise. Several medications have been tried but with no definite clinical benefit.

 

Source: Winters EG, Quinet RJ. Chronic fatigue syndrome. J La State Med Soc. 1992 Jun;144(6):260-70. http://www.ncbi.nlm.nih.gov/pubmed/1619343

 

Chronic fatigue syndrome. Recent advances in diagnosis and treatment

Abstract:

Chronic fatigue syndrome is a chronic debilitating illness that is marked in the majority of cases by sudden onset of fatigue and flulike symptoms. Symptoms subsequently relapse and remit and may persist for years. Physical examination typically reveals relatively minor, nonspecific abnormalities in an apparently well patient. Although immunologic abnormalities are associated with chronic fatigue syndrome, tests for these features are expensive, nonspecific, and generally reserved for research purposes. The diagnosis is made on the basis of new onset of severe fatigue, a characteristic pattern of symptoms, and exclusion of other illnesses. Treatment is aimed at alleviating symptoms and helping patients adjust to the debilitating and chronic nature of the illness.

 

Source: Bell DS. Chronic fatigue syndrome. Recent advances in diagnosis and treatment. Postgrad Med. 1992 May 1;91(6):245-52. http://www.ncbi.nlm.nih.gov/pubmed/1579531

 

Chronic fatigue syndrome

Abstract:

Chronic Fatigue Syndrome appears to represent a spectrum of disorders in which a variety of pathophysiological mechanisms may operate. While the initiating event in the majority of patients is a pyrexial illness, possibly due to enterovirus infection, evidence of persisting infection or inflammatory changes in muscle and/or brain remain unconvincing.

CFS patients display a definite reduced aerobic work capacity compared to normal control subjects, but this may reflect a state of deconditioning resulting from prolonged physical inactivity. They also have an altered perception of their level of exertion and premorbid fitness.

The characteristic fluctuation in symptoms, with periods of relapses and partial remissions, may indicate that some central disorder of sensory perception is operational. It may be that a primary sleep disorder results in a reduced sensory threshold for afferent stimuli from muscle. This could well account for many of the subjective symptoms which patients experience. Much more research is clearly necessary if we are to achieve a better understanding of this distressing and at present enigmatic disorder.

 

Source: McCluskey DR, Riley MS. Chronic fatigue syndrome. Compr Ther. 1992 Apr;18(4):13-6. http://www.ncbi.nlm.nih.gov/pubmed/1628478

 

Chronic fatigue syndrome

Abstract:

Chronic fatigue syndrome (CFS), which is characterized by devastating fatigue, mild fever, lymphadenopathy, headache, myalgia, insomnia and neuropsychiatric disorders, now has drawn much attentions from many physicians, researchers and even peoples in general society world wide. The pathogenesis of CFS is still remains to be clarified and clinico-pathological difference between CFS and mood disorder is controversial. In this paper, CFS would be reviewed in detail.

 

Source: Matsuda J. Chronic fatigue syndrome. Nihon Rinsho. 1992 Apr;50(4):887-91. [Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/1619775

 

Fibromyalgia, chronic fatigue, and myofascial pain syndromes

Abstract:

During the past year many studies have been published on fibromyalgia and chronic fatigue syndromes. Randomized clinical trials using current operational diagnostic criteria were reported, but no single therapy has been highly effective in either condition. The working case definition of chronic fatigue syndrome has been criticized and suggestions for a new case definition have been made. Further understanding of the overlap of these three common disorders will also require that uniform diagnostic criteria be tested in chronic fatigue syndrome and myofascial pain syndrome.

 

Source: Goldenberg DL. Fibromyalgia, chronic fatigue, and myofascial pain syndromes. Curr Opin Rheumatol. 1992 Apr;4(2):247-57. http://www.ncbi.nlm.nih.gov/pubmed/1581154

 

Chronic tiredness and idiopathic chronic fatigue–a connection?

Abstract:

Evidence is adduced to support the proposal that pathological fatigue is a consequence of impaired capillary blood flow resulting in inadequate oxygen delivery, which is in accordance with physiological concepts of fatigue. Case reports are presented.

Comment in: Chronic fatigue syndrome. [N J Med. 1992]

 

Source: Simpson LO. Chronic tiredness and idiopathic chronic fatigue–a connection? N J Med. 1992 Mar;89(3):211-6. http://www.ncbi.nlm.nih.gov/pubmed/1574202

 

Chronic fatigue syndrome

Abstract:

Fatigue is one of the most common complaints among patients seen in the primary care setting. Chronic fatigue syndrome, which has recently been called chronic fatigue immune dysfunction syndrome, is distinctive, with an abrupt onset of symptoms that wax and wane for at least six months.

Usually there is low-grade fever, pharyngitis and tender, but not enlarged, lymph nodes. The fatigue can be disabling and is often made worse by physical activity. Some patients with this disorder have also been found to have highly characteristic immunologic abnormalities.

Treatment can be rewarding and is based on patient education and support, exercise and symptomatic therapies for abnormal sleep patterns, musculoskeletal pain and other symptoms.

 

Source: Calabrese L, Danao T, Camara E, Wilke W. Chronic fatigue syndrome. Am Fam Physician. 1992 Mar;45(3):1205-13. http://www.ncbi.nlm.nih.gov/pubmed/1543105