Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 549
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-32455618

RESUMO

AIM: To explore endometriosis-related fatigue (ERF), health-related fitness, sleep quality, and health-related quality of life (HRQoL) in women with endometriosis in comparison with matched controls. METHODS: Twenty-five affected women and twenty-five age and height-matched women without endometriosis were included. ERF was assessed through the Piper Fatigue Scale; health-related fitness was assessed through the Schöber, flamingo, and 6-min walking tests and dynamometry; and body composition was assessed through impedanciometry. Self-perceived physical fitness, sleep quality, and HRQoL were assessed through the International Fitness Scale, the Pittsburgh Sleep Quality Index, and the 12-item Short Form Health Survey, respectively. RESULTS: Affected women exhibited higher levels of ERF than controls, increased fat mass, and physical deconditioning (reduced back strength, lumbar flexibility, body balance, and functional capacity, p-values < 0.050). Moreover, cases also had poorer perceived physical fitness, sleep quality, and HRQoL (p-value < 0.050). Finally, we observed deteriorated health-related fitness, sleep quality, and HRQoL in those women with endometriosis with higher levels of ERF. CONCLUSIONS: This study constitutes the first evidence that women with endometriosis describe a generalized physical deconditioning, even more pronounced in affected women with higher levels of ERF. Further studies assessing the efficacy of rehabilitation interventions to face these physical impairments in women with endometriosis are warranted.


Assuntos
Endometriose , Síndrome de Fadiga Crônica , Adulto , Estudos de Casos e Controles , Endometriose/complicações , Síndrome de Fadiga Crônica/complicações , Feminino , Humanos , Aptidão Física , Qualidade de Vida
2.
PLoS One ; 15(4): e0231136, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32275686

RESUMO

Myalgic encephalomyelitis/ Chronic fatigue syndrome (ME/CFS) has been associated with abnormalities in mitochondrial function. In this study we have analysed previous bioenergetics data in peripheral blood mononuclear cells (PBMCs) using new techniques in order to further elucidate differences between ME/CFS and healthy control cohorts. We stratified our ME/CFS cohort into two individual cohorts representing moderately and severely affected patients in order to determine if disease severity is associated with bioenergetic function in PBMCs. Both ME/CFS cohorts showed reduced mitochondrial function when compared to a healthy control cohort. This shows that disease severity does not correlate with mitochondrial function and even those with a moderate form of the disease show evidence of mitochondrial dysfunction. Equations devised by another research group have enabled us to calculate ATP-linked respiration rates and glycolytic parameters. Parameters of glycolytic function were calculated by taking into account respiratory acidification. This revealed severely affected ME/CFS patients to have higher rates of respiratory acidification and showed the importance of accounting for respiratory acidification when calculating parameters of glycolytic function. Analysis of previously published glycolysis data, after taking into account respiratory acidification, showed severely affected patients have reduced glycolysis compared to moderately affected patients and healthy controls. Rates of ATP-linked respiration were also calculated and shown to be lower in both ME/CFS cohorts. This study shows that severely affected patients have mitochondrial and glycolytic impairments, which sets them apart from moderately affected patients who only have mitochondrial impairment. This may explain why these patients present with a more severe phenotype.


Assuntos
Acidose Respiratória/metabolismo , Metabolismo Energético , Síndrome de Fadiga Crônica/metabolismo , Mitocôndrias/metabolismo , Índice de Gravidade de Doença , Acidose Respiratória/diagnóstico , Acidose Respiratória/etiologia , Estudos de Coortes , Síndrome de Fadiga Crônica/complicações , Síndrome de Fadiga Crônica/diagnóstico , Glicólise , Humanos
4.
J Psychosom Res ; 129: 109893, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31884303

RESUMO

OBJECTIVE: Post-exertional malaise (PEM) is often considered a cardinal symptom of Chronic Fatigue Syndrome (CFS). There is no gold standard diagnostic method for CFS, however, and the Centers for Disease Control (CDC) Fukuda case definition does not require PEM. Research has identified differences in symptom burden between patients according to PEM, but whether it is associated with psychological distress has not been investigated. METHODS: The CDC CFS Inventory, Fatigue Symptom Inventory, Profile of Mood States, Center for Epidemiologic Studies Depression Scale, Perceived Stress Scale, and subscales of the Sickness Impact Profile were administered to 261 patients diagnosed with the Fukuda criteria. PEM status (loPEM/hiPEM) was determined via self-reported post-exertional fatigue severity. Analyses of covariance (ANCOVA), controlling for age and gender, assessed cross-sectional group differences, and cross-sectional linear regressions using the continuous PEM severity predictor paralleled these analyses. RESULTS: hiPEM patients reported greater symptom intensity, frequency, and interference than loPEM counterparts (p's < .001). hiPEM patients also reported greater social disruption, depressive symptoms, and mood disturbance (p's ≤ .011). Groups did not differ in recent negative life experiences, perceived stress, or demographic variables. The results of regression analyses mirrored those of ANCOVAs. CONCLUSION: This study replicates the association between PEM and symptom burden and additionally associates PEM with psychological distress; psychological distress could, however, be a consequence of symptom burden. Differences between hiPEM and loPEM CFS patients highlight the heterogeneity of diagnoses resulting from the Fukuda criteria. It is also possible that PEM identifies particularly distressed patients for whom psychological intervention would be most beneficial.


Assuntos
Síndrome de Fadiga Crônica/complicações , Síndrome de Fadiga Crônica/psicologia , Angústia Psicológica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Perfil de Impacto da Doença
5.
Rev. Hosp. Ital. B. Aires (2004) ; 39(4): 128-134, dic. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1099754

RESUMO

Asociada o no a una enfermedad orgánica, la depresión tiene gran prevalencia en la práctica médica pero es subdiagnosticada. El trastorno del ánimo suele coexistir con variadas quejas somáticas y dolores crónicos, configurando síndromes mixtos con un diagnóstico diferencial complejo. En este artículo se describen distintas presentaciones clínicas de la depresión en medicina general, con énfasis en los estados depresivos atípicos, depresiones enmascaradas muy relevantes por su frecuencia y consecuencias: depresión posquirúrgica, cuadros dolorosos crónicos como cefaleas o lumbago, la fatiga crónica y la fibromialgia. Solo el reconocimiento y diagnóstico de la depresión subyacente posibilitará la implementación de las adecuadas intervenciones terapéuticas. Se revisan también algunas recomendaciones para el uso de antidepresivos en atención primaria y la eventual consulta psiquiátrica. (AU)


Associated or not with an organic disease, depression has a high prevalence in medical practice but is underdiagnosed. The mood disorder usually coexists with varied somatic complaints and chronic pain, forming mixed syndromes with a complex differential diagnosis. This article describes different clinical presentations of depression in general medicine, with emphasis on atypical depressive states, masked depressions very relevant for their frequency and consequences: post-surgical depression, chronic painful conditions such as headaches or lumbago, chronic fatigue and fibromyalgia. Only the recognition and diagnosis of the underlying depression will enable the implementation of appropriate therapeutic interventions. Some recommendations for the use of antidepressant drugs in primary care and the eventual psychiatric consultation are also reviewed. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Atenção Primária à Saúde/tendências , Depressão/diagnóstico , Psiquiatria/tendências , Sinais e Sintomas , Transtornos Somatoformes/diagnóstico , Citalopram/efeitos adversos , Citalopram/uso terapêutico , Fibromialgia/complicações , Síndrome de Fadiga Crônica/complicações , Fluoxetina/efeitos adversos , Fluoxetina/uso terapêutico , Inibidores de Captação de Serotonina/efeitos adversos , Dor Lombar/complicações , Antagonistas Colinérgicos/efeitos adversos , Erros Médicos , Sertralina/efeitos adversos , Sertralina/uso terapêutico , Depressão/classificação , Depressão/complicações , Depressão/terapia , Depressão/epidemiologia , Medicina Geral , Dor Crônica/complicações , Cloridrato de Venlafaxina/efeitos adversos , Cloridrato de Venlafaxina/uso terapêutico , Cloridrato de Duloxetina/efeitos adversos , Cloridrato de Duloxetina/uso terapêutico , Inibidores da Recaptação de Serotonina e Norepinefrina/efeitos adversos , Cefaleia/complicações , Amitriptilina/efeitos adversos , Amitriptilina/uso terapêutico , Antidepressivos/administração & dosagem
6.
Int Rev Neurobiol ; 147: 121-153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31607352

RESUMO

Chronic fatigue syndrome (CFS) is often overlooked, has unclear etiology and no effective cure except some symptomatic treatments. Additionally, most people with CFS do not seek medical attention. Qigong exercise, an ancient Eastern body-mind-spirit practice, has been long practiced in Chinese communities and may powerfully trigger the self-healing process. Using full baseline data (n=1409), the average Hong Kong CFS respondent was found to be female, married, 42.5yo, highly educated and employed full-time, experiencing sleep disturbance (~95%), anxiety (>80%), and depressive symptoms (68%). Here, we summarized our previous studies to evaluate the potential of Qigong as a complementary and alternative therapy for CFS. Two randomized controlled trials were conducted (RCT1 n1=137, RCT2 n2=150). In both trials, extensive online questionnaires allowed individuals with CFS-like illness (i.e., symptoms match CFS, yet without clinical confirmation) to be identified. RCT1 included a 5-week intervention. The intervention in RCT2 was 8weeks. In RCT1 Qigong group had reduced fatigue (P<0.001) and depressive symptoms (P=0.002), and improved telomerase activity (P=0.029). An effective practice regimen was identified (≥3 days/week, at ≥30min/session). Methods were slightly adjusted for RCT2, which replicated RCT1 findings, and further documented improved subjective sleep quality (P=0.008) and adiponectin levels (P<0.05). A significant dose-response relationship was founded. Thus, Qigong exercise should be recognized as a possible standalone therapy and self-management skill in CFS. Strategies are needed to increase motivation for regular practice and to explore its possibility of self-management skill in brain health. Further clarity would come from studies comparing Qigong with other physical exercises.


Assuntos
Síndrome de Fadiga Crônica/terapia , Qigong , Adiponectina/sangue , Adulto , Depressão/complicações , Depressão/terapia , Terapia por Exercício , Síndrome de Fadiga Crônica/sangue , Síndrome de Fadiga Crônica/complicações , Síndrome de Fadiga Crônica/metabolismo , Feminino , Humanos , Masculino , Projetos Piloto , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/terapia , Telomerase/metabolismo , Adulto Jovem
7.
Medicine (Baltimore) ; 98(39): e16720, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574792

RESUMO

BACKGROUND: Although chronic fatigue syndrome (CFS) sometimes referred to as myalgic encephalomyelitis (ME) is a very challenging condition to treat, there is evidence that individual cognitive behavioral therapy (ICBT) can be effective for treatment and management of its symptoms. Furthermore, group cognitive behavioral therapy (GCBT) is emerging as promising treatment for the condition.The aim of the present study was to explore further the effectiveness of GCBT in a routine clinical setting and to investigate associated positive psychological effects related to GCBT. METHODS: In this pragmatic, non-randomized, controlled trial, 28 people acted as their own waiting list control by completing a range of measures 8 weeks prior to taking part in the GCBT. The intervention consisted of 8 consecutive weeks of 2.5-hour sessions. RESULTS: Repeated measures analysis of covariance revealed significant improvements in physical fatigue (F = 28.31, P < .01, effect size d = 0.52), mental fatigue (F = 7.72, P < .01, effect size d = 0.22), and depressive symptoms (Beck depression inventory-fast screen for medical individuals [BDI-FS]: F = 11.43, P < .01, effect size d = 0.30; hospital anxiety and depression scale [HADS-D]: F = 16.72, P < .01, effect size d = 0.38) compared with the waiting list. Improvements in quality of life (F = 7.56, P < .01, effect size d = 0.23), hope (F = 15.15, P < .01, effect size d = 0.36), and optimism (F = 8.17, P < .01, effect size d = 0.23) were also identified, but no change was reported for anxiety levels. Global outcome measures revealed that the majority of the individuals found the treatment beneficial and were satisfied with the results. CONCLUSION: GCBT is a beneficial and cost-effective treatment that individuals find amenable in routine clinical practice for CFS. Additionally we have described important effects emerged on positive psychological dimensions such as hope and optimism potentially enhancing the overall benefit.


Assuntos
Terapia Cognitivo-Comportamental , Síndrome de Fadiga Crônica/psicologia , Síndrome de Fadiga Crônica/terapia , Listas de Espera , Adulto , Ansiedade/complicações , Ansiedade/terapia , Depressão/complicações , Depressão/terapia , Síndrome de Fadiga Crônica/complicações , Feminino , Esperança , Humanos , Masculino , Pessoa de Meia-Idade , Otimismo , Qualidade de Vida
8.
Neuropsychology ; 33(5): 658-669, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31169386

RESUMO

OBJECTIVE: This study aimed to explore the relationship between self-reported cognitive difficulties, objective neuropsychological test performances, and subjective health complaints in chronic fatigue syndrome (CFS) and to examine the degree of impaired cognitive functions. METHOD: A total of 236 consecutively recruited outpatients, 18-62 years of age, completed the tests. Self-administered questionnaires were used for assessing fatigue, pain, depression, anxiety and subjective cognitive complaints (Everyday Memory Questionnaire [EMQ]). Also, neuropsychological tests, that is, Stroop I-IV, California Verbal Learning Test-Second Edition (CVLT-II) learning and delay, Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) Letter Number (L-N) Sequencing, and the Paced Auditory Serial Addition Task were performed to examine whether these objective measures correlated with subjective complaints and were compared with normative data. RESULTS: There was a trend of association (p < .05) between the unadjusted EMQ with Stroop IV (inhibition and shifting attention), the CVLT-II learning and delay (verbal learning and memory), and the WAIS-III L-N Sequencing (working memory), but none were statistically significant at the .001 level. The EMQ was positively associated with fatigue, pain, and depression (p < .001). The PASAT (working memory) was negatively associated with pain (p < .001). Between 21% and 38% of the patients performed below the 1.5-SD cutoff for clinically significant impairment on the Stroop tests. CONCLUSION: The self-reported cognitive performance was not strongly associated with the objective cognitive performances on any domains in patients with CFS. Patients with higher fatigue, pain, and depression levels reported greater subjective cognitive difficulties, as well as higher pain related to lower objective working memory function. The CFS patients had problems mainly in the domains of psychomotor speed and attention measured by the objective neuropsychological tests. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Atenção/fisiologia , Disfunção Cognitiva/fisiopatologia , Depressão/fisiopatologia , Autoavaliação Diagnóstica , Síndrome de Fadiga Crônica/fisiopatologia , Desempenho Psicomotor/fisiologia , Adolescente , Adulto , Disfunção Cognitiva/etiologia , Síndrome de Fadiga Crônica/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Autorrelato , Adulto Jovem
9.
Rev. andal. med. deporte ; 12(2): 131-134, jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184513

RESUMO

The initial focus of overtraining syndrome was physical overexertion with inadequate rest, causing severe chronic fatigue and decreased performance. The pathophysiological knowledge has subsequently evolved, and although the exact mechanisms of overtraining syndrome are unknown, several hypotheses arise. The most prominent of these are: the existence of an immunoneuroendocrine imbalance and dysfunction of the central nervous system and of the neuroendocrine axis. On the other hand, central sensitivity syndrome encompasses nosological entities that share the pathophysiological mechanisms that cause them, that is, an immunoneuroendocrine and mitochondrial dysfunction as well as an oxidative stress imbalance. The most common entities within central sensitivity syndrome are fibromyalgia, tension headache and/or migraine, chronic fatigue syndrome, irritable bowel syndrome, multiple chemical syndrome, electrosensitivity syndrome, irritable bladder syndrome, and restless leg syndrome, among others. The pathophysiological and clinical analogy between overtraining syndrome and central sensitivity syndrome raises the possibility of including overtraining syndrome within central sensitivity syndrome, since a stressful stimulus such as chronic overtraining coupled with unbalanced compensatory systems can generate, at a given time, immunoneuroendocrine sensitization and therefore central sensitivity syndrome


El enfoque inicial del síndrome de sobreentrenamiento ha sido el sobreesfuerzo físico con un descanso no adecuado, que provocaba fatiga crónica severa y disminución en el rendimiento. Posteriormente ha ido evolucionando el conocimiento fisiopatológico, y aunque se desconocen los mecanismos fisiopatológicos exactos del síndrome de sobreentrenamiento, se plantean diversas hipótesis. Las más destacadas son: la existencia de un desbalance inmunoneuroendocrino y disfunción del sistema nervioso central y el eje neuroendocrino. Por su parte el síndrome de sensibilidad central engloba entidades nosológicas que tienen en común las razones fisiopatológicas que las ocasionan, esto es, una disfunción inmunoneuroendocrina, mitocondrial y un desbalance del estrés oxidativo. Las entidades más comunes dentro del síndrome de sensibilidad central suelen ser la fibromialgia, la cefalea tensional y/o migraña, el síndrome de fatiga crónica, el síndrome de intestino irritable, el síndrome químico múltiple, el síndrome de electrosensibilidad, el síndrome de la vejiga irritable, el síndrome de piernas inquietas, entre otros. La analogía fisiopatológica y clínica entre el síndrome de sobreentrenamiento y el síndrome de sensibilidad central, plantea la posibilidad de englobar al síndrome de sobreentrenamiento dentro del síndrome de sensibilidad central, ya que ante la presencia de un estímulo estresante como lo es el sobreentrenamiento crónico, unido a sistemas compensadores desequilibrados, puede generar en un momento determinado una sensibilización


O foco inicial da síndrome do supertreinamento foi o excesso de esforço físico com descanso inadequado, causando fadiga crônica grave e diminuição do desempenho. Posteriormente o conhecimento fisiopatológico evoluiu e, embora os mecanismos exatos da síndrome do supertreinamento sejam desconhecidos, surgem várias hipóteses. Os mais proeminentes são: a existência de um desequilíbrio imunoneuroendócrino e disfunção do sistema nervoso central e do eixo neuroendócrino. Por outro lado, a síndrome da sensibilização central engloba entidades nosológicas que compartilham os mecanismos fisiopatológicos que as causam, ou seja, uma disfunção imunoneuroendócrina e mitocondrial, bem como um desequilíbrio de estresse oxidativo. As entidades mais comuns dentro da síndrome da sensibilização central são fibromialgia, cefaleia e/ou enxaqueca, síndrome de fadiga crônica, síndrome do intestino irritável, síndrome química múltipla, síndrome de eletrosensibilidade, síndrome da bexiga irritável e síndrome das pernas inquietas, entre outros. A analogia fisiopatológica e clínica entre síndrome do supertreinamento e síndrome da sensibilização central levanta a possibilidade de incluir a síndrome do supertreinamento dentro da síndrome da sensibilização central, uma vez que um estímulo estressante, como o supertreinamento crônico, juntamente com sistemas compensatórios desequilibrados, pode gerar, em determinado momento, sensibilização imunoneuroendócrina e, portanto, síndrome da sensibilização central


Assuntos
Humanos , Transtornos Traumáticos Cumulativos/diagnóstico , Sensibilização do Sistema Nervoso Central/fisiologia , Síndrome de Fadiga Crônica/complicações , Traumatismos em Atletas/diagnóstico , Recuperação de Função Fisiológica/fisiologia , Fibromialgia/complicações
10.
J Neuroinflammation ; 16(1): 67, 2019 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-30927920

RESUMO

BACKGROUND: Patients diagnosed with chronic fatigue syndrome (CFS) or fibromyalgia experience chronic pain. Concomitantly, the rat model of CFS exhibits microglial activation in the lumbar spinal cord and pain behavior without peripheral tissue damage and/or inflammation. The present study addressed the mechanism underlying the association between pain and chronic stress using this rat model. METHODS: Chronic or continuous stress-loading (CS) model rats, housed in a cage with a thin level of water (1.5 cm in depth), were used. The von Frey test and pressure pain test were employed to measure pain behavior. The neuronal and microglial activations were immunohistochemically demonstrated with antibodies against ATF3 and Iba1. Electromyography was used to evaluate muscle activity. RESULTS: The expression of ATF3, a marker of neuronal hyperactivity or injury, was first observed in the lumbar dorsal root ganglion (DRG) neurons 2 days after CS initiation. More than 50% of ATF3-positive neurons simultaneously expressed the proprioceptor markers TrkC or VGluT1, whereas the co-expression rates for TrkA, TrkB, IB4, and CGRP were lower than 20%. Retrograde labeling using fluorogold showed that ATF3-positive proprioceptive DRG neurons mainly projected to the soleus. Substantial microglial accumulation was observed in the medial part of the dorsal horn on the fifth CS day. Microglial accumulation was observed around a subset of motor neurons in the dorsal part of the ventral horn on the sixth CS day. The motor neurons surrounded by microglia were ATF3-positive and mainly projected to the soleus. Electromyographic activity in the soleus was two to three times higher in the CS group than in the control group. These results suggest that chronic proprioceptor activation induces the sequential activation of neurons along the spinal reflex arc, and the neuronal activation further activates microglia along the arc. Proprioceptor suppression by ankle joint immobilization significantly suppressed the accumulation of microglia in the spinal cord, as well as the pain behavior. CONCLUSION: Our results indicate that proprioceptor-induced microglial activation may be a key player in the initiation and maintenance of abnormal pain in patients with CFS.


Assuntos
Citocinas/metabolismo , Síndrome de Fadiga Crônica/complicações , Microglia/patologia , Dor/etiologia , Dor/patologia , Distúrbios Somatossensoriais/etiologia , Fator 3 Ativador da Transcrição/genética , Fator 3 Ativador da Transcrição/metabolismo , Animais , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Proteínas de Ligação ao Cálcio/metabolismo , Gânglios Espinais/patologia , Regulação da Expressão Gênica/efeitos dos fármacos , Masculino , Proteínas dos Microfilamentos/metabolismo , Microglia/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Neurônios/metabolismo , Medição da Dor , Ratos , Ratos Sprague-Dawley , Receptores de Fator de Crescimento Neural/genética , Receptores de Fator de Crescimento Neural/metabolismo , Distúrbios Somatossensoriais/patologia , Estilbamidinas/metabolismo , Proteína Vesicular 1 de Transporte de Glutamato/metabolismo
11.
J Psychosom Res ; 121: 37-45, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31006533

RESUMO

OBJECTIVE: After Q fever infection, 1-5% of patients develop chronic Q fever, while about 20% develops Q fever fatigue syndrome (QFS). This study examines whether these two conditions have a long-term impact on psychosocial functioning compared to the general population and patients with type 2 diabetes (DM) and investigate which mediating factors influence outcomes. METHODS: Cross-sectional study was performed, measuring psychosocial functioning including quality of life (depression and satisfaction with life), anxiety, social functioning and relationship satisfaction in patients with proven or probable chronic Q fever or QFS, 5-9 years after acute Q fever infection. Multivariate linear regression was used to analyse differences between groups, correct for confounders and identify relevant mediators (fatigue, physical or cognitive functioning, illness perception). RESULTS: Quality of life and social functioning of chronic Q-fever and QFS patients was significantly lower and anxiety significantly higher compared to DM patients and the general population. The impact was completely mediated by fatigue in both Q fever groups. Physical and cognitive functioning and illness perception partially mediated the impact. CONCLUSIONS: Health care workers need to be aware of the long-term impact of chronic Q fever and QFS on psychosocial functioning of patients in order to provide proper guidance.


Assuntos
Diabetes Mellitus/psicologia , Síndrome de Fadiga Crônica/complicações , Síndrome de Fadiga Crônica/psicologia , Febre Q/complicações , Febre Q/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Qualidade de Vida , Ajustamento Social , Fatores de Tempo
12.
J Psychosom Res ; 121: 93-99, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31006534

RESUMO

OBJECTIVE: To determine which variables predicted long-term outcome after cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS). METHODS: A cohort of 511 CFS patients from four different CBT for CFS studies, i.e. two cohort studies and two RCT's. Before treatment, all patients fulfilled the 2003 US CDC criteria for CFS and treated with CBT, were assessed at long-term follow-up, up to 10 years after end of treatment. We tried to predict fatigue severity and physical functioning at follow-up with demographics, cognitive-behavioral perpetuating factors, and CFS characteristics as predictors in linear regression analyses. Logistic regression analysis was used to explore significant predictors of fatigue scores within normal limits at long-term follow-up. RESULTS: Lower fatigue severity at long-term follow-up was predicted by a shorter duration of CFS symptoms and lower fatigue levels at baseline, and lower frustration in response to fatigue and lower fatigue levels directly post-treatment. Fatigue scores within normal limits at follow-up was predicted by lower fatigue severity and lower levels of frustration in response to fatigue, both assessed directly post-treatment. Better physical functioning at follow-up was predicted by higher sense of control over fatigue, better physical functioning at post-treatment, and being younger at baseline. In some of the additional analysis pain at baseline also predicted physical functioning at follow-up. CONCLUSION: The finding that lower fatigue severity and higher physical functioning at long-term follow-up were positively associated with its outcomes at post-treatment underline the importance of fully maximizing the positive effects of CBT for the sustainment of outcomes. Furthermore, augmenting sense of control and starting treatment sooner after diagnosing CFS could positively influence long-term outcome. Interventions aimed at pain management deserve more attention in research.


Assuntos
Terapia Cognitivo-Comportamental , Síndrome de Fadiga Crônica/terapia , Estudos de Coortes , Síndrome de Fadiga Crônica/complicações , Síndrome de Fadiga Crônica/fisiopatologia , Síndrome de Fadiga Crônica/psicologia , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Dor/complicações , Qualidade de Vida , Fatores de Tempo , Resultado do Tratamento
13.
J Affect Disord ; 250: 380-390, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30877861

RESUMO

BACKGROUND: Both of the modern medicine and the traditional Chinese medicine classify depressive disorder (DD) and chronic fatigue syndrome (CFS) to one type of disease. Unveiling the association between depressive and the fatigue diseases provides a great opportunity to bridge the modern medicine with the traditional Chinese medicine. METHODS: In this work, 295 general participants were recruited to complete Zung Self-Rating Depression Scales and Chalder Fatigue Scales, and meanwhile, to donate plasma and urine samples for 1H NMR-metabolic profiling. Artificial intelligence methods was used to analysis the underlying association between DD and CFS. Principal components analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were used to analyze the metabolic profiles with respect to gender and age. Variable importance in projection and t-test were employed in conjunction with the PLS-DA models to identify the metabolite biomarkers. Considering the asymmetry and complexity of the data, convolutional neural networks (CNN) model, an artificial intelligence method, was built to analyze the data characteristics between each groups. RESULTS: The results showed the gender- and age-related differences for the candidate biomarkers of the DD and the CFS diseases, and indicated the same and different biomarkers of the two diseases. PCA analysis for the data characteristics reflected that DD and CFS was separated completely in plasma metabolite. However, DD and CFS was merged into one group. LIMITATION: Lack of transcriptomic analysis limits the understanding of the association of the DD and the CFS diseases on gene level. CONCLUSION: The unmasked candidate biomarkers provide reliable evidence to explore the commonality and differences of the depressive and the fatigue diseases, and thereby, bridge over the traditional Chinese medicine with the modern medicine.


Assuntos
Inteligência Artificial , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Síndrome de Fadiga Crônica/complicações , Síndrome de Fadiga Crônica/diagnóstico , Adulto , Biomarcadores/sangue , Transtorno Depressivo , Feminino , Perfilação da Expressão Gênica , Humanos , Análise dos Mínimos Quadrados , Espectroscopia de Ressonância Magnética , Masculino , Metabolômica , Pessoa de Meia-Idade , Análise de Componente Principal
14.
BMJ Open ; 9(3): e023955, 2019 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-30850404

RESUMO

OBJECTIVES: The aim of this study was to estimate the prevalence of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and describe illness characteristics in a community population in Poland. DESIGN: cross-sectional study. SETTING: Poland. PARTICIPANTS: Of the cohort of 1400 who self-presented with fatigue only 69 subsequently were confirmed as having CFS/ME using the Fukuda criteria. MAIN OUTCOME MEASURES: Participants completed the following screening symptom assessment tools: Chalder Fatigue Scale, Hospital Anxiety and Depression Scale (HADS), Epworth Sleepiness Scale (ESS), Composite Autonomic Symptom Score 31 (COMPASS 31), Quality of Life Scale (QOLS). Haemodynamic and autonomic parameters were automatically measured at rest with a Task Force Monitor. RESULTS: In 1308, from 1400 (93%) individuals who identified themselves as fatigued, recognised chronic conditions were identified, for example, neurological (n=280, 21.5%), neurodegenerative (n=200, 15%), psychiatric (n=654, 50%) and immunologic (n=174, 13.5%) disorders. The remaining 69 participants (mean age 38.3±8.5) met the Fukuda defintion for CFS/ME and had baseline objective assessment. The majority had experienced symptoms for over 2 years with 37% having symptoms for 2-5 years and 21.7% for more than 10 years. The COMPASS 31 indicated that 50% have symptoms consistent with orthostatic intolerance. About 43/69 (62%) had Epworth sleepiness scores ≥10, ie, consistent with excessive daytime sleepiness, 26/69 (38%) had significant anxiety and 22/69 (32%) depression measured by HADS A & D. Quality of life is significantly impaired in those with Fukuda criteria CFS (QLS score 64±11) with significant negative relationships between quality of life and fatigue (p<0.0001), anxiety (p=0.0009), depression (p<0.0001) and autonomic symptoms (p=0.04). CONCLUSION: This is the first study to summarise illness characteristics of Polish CFS/ME patients. Our study has confirmed that fatigue is a common and under-recognised symptom affecting the Polish population.


Assuntos
Ansiedade/diagnóstico , Depressão/diagnóstico , Síndrome de Fadiga Crônica/epidemiologia , Adulto , Idoso , Ansiedade/epidemiologia , Doença Crônica , Estudos de Coortes , Estudos Transversais , Depressão/epidemiologia , Fadiga , Síndrome de Fadiga Crônica/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Prevalência , Qualidade de Vida , Inquéritos e Questionários
15.
J Transl Med ; 17(1): 55, 2019 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-30795765

RESUMO

BACKGROUND: Similarities in the symptoms of chronic fatigue syndrome (CFS) and inflammatory bowel disease (IBD) have been observed as follows: severe disease activity in IBD correlates with severe fatigue, major psychiatric signs, the common use of medication, and bacterial translocation. One of several hypotheses for explaining the mechanisms underlying CFS suggests a similarity to the impaired intestinal mucosa of IBD. "This study investigated the risk of incident CFS among patients with IBD". METHODS: We conducted a population-based retrospective cohort study by using Taiwan's National Health Insurance Research Database to evaluate the subsequent risk of CFS in patients with IBD, according to demographic characteristics and comorbidities. The exposure cohort comprised 2163 patients with new diagnoses of IBD. Each patient was randomly selected and frequency matching according to gender and age with four participants from the general population who had no history of CFS at the index date (control cohort). Cox proportional hazards regression analysis was conducted to estimate the relationship between IBD and the subsequent risk of CFS. RESULTS: The exposure cohort had a significantly higher overall risk of subsequent CFS than that of the control group [adjusted hazard ratio (Christophi in Inflamm Bowel Dis 18(12):2342-2356, 2012) = 2.25, 95%, confidence interval (Aaron and Buchwald in Ann Intern Med 134(9 Pt 2):868-881, 2001; Farraye et al. in Am J Gastroenterol 112:241, 2017) 1.70-2.99]. Further analysis indicated a significantly higher risk of CFS in patients who were male (HR = 3.23, 95% CI 2.12-4.91), were older than 35 years, and had IBD but without comorbidity status, e.g. Cancers, diabetes, obesity, depression, anxiety, sleep disorder, renal disease (HR = 2.50, 95% CI 1.63-3.84) after adjustment. CONCLUSION: The findings from this population-based retrospective cohort study suggest that IBD, especially Crohn's disease, is associated with an increased risk of subsequent CFS.


Assuntos
Síndrome de Fadiga Crônica/complicações , Síndrome de Fadiga Crônica/epidemiologia , Doenças Inflamatórias Intestinais/complicações , Translocação Bacteriana , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia
16.
Eur J Paediatr Neurol ; 23(1): 70-80, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30455131

RESUMO

BACKGROUND: Fatigue is a disabling, poorly understood symptom in children and adolescents with multiple sclerosis (caMS), for which effective treatments are lacking. In paediatric Chronic Fatigue Syndrome (CFS), effective psychological interventions have been developed based on psychosocial factors associated with fatigue. This study aimed to identify potentially modifiable factors of fatigue in caMS by comparing caMS, adolescents with CFS, healthy adolescents and their parents on measures of fatigue, psychosocial factors, and neurocognitive functioning. METHODS: 175 participants including 30 caMS (15 fatigued, 15 non-fatigued), 30 adolescents with CFS, 30 healthy controls, and their parents were compared on measures of self- and parent-reported fatigue, adolescent and parent cognitive behavioural responses to symptoms, sleep, psychological difficulties, parental distress and objectively measured neurocognitive functioning. RESULTS: Fatigue severity, functional impairment and cognitive behavioural responses to symptoms were equivalent in fatigued caMS and adolescents with CFS, and were significantly higher than in healthy controls and non-fatigued caMS. Neurocognitive functioning was impaired in both caMS groups, but was normal in adolescents with CFS and healthy controls. No between-group differences were identified in adolescent sleep behaviour or psychological difficulties. Parents of all illness groups had more unhelpful cognitions than parents of healthy controls. Psychological distress was elevated in parents of both fatigued groups. CONCLUSIONS: Fifty percent of caMS reported clinically significant fatigue. Similarities between adolescent and parent cognitive behavioural factors in fatigued caMS and adolescents with CFS suggest important potential targets for intervention. Both fatigued and non-fatigued caMS had cognitive difficulties, suggesting that fatigue may need targeted intervention.


Assuntos
Síndrome de Fadiga Crônica/complicações , Fadiga/psicologia , Esclerose Múltipla/complicações , Pais/psicologia , Adolescente , Criança , Síndrome de Fadiga Crônica/psicologia , Feminino , Humanos , Masculino , Esclerose Múltipla/psicologia
17.
Scand J Pain ; 19(1): 183-192, 2019 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-30325737

RESUMO

Background and aims The interaction between the immune system and pain has been thoroughly explored in the recent decades. The release of inflammatory mediators from immune cells has the capability of activating neurons and glial cells, in turn sensitizing the nervous system. Both immune system alterations and pain modulation dysfunctions have been shown in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) following exercise. However, no studies tried to explore whether these two phenomena are linked and can explain exercise-induced symptoms worsening in people with ME/CFS. We hypothesized that exercise-induced changes in descending pain modulation is associated to changes in immune system functions. We used complement system product C4a and elastase activity as indicators of immune system activity. Methods The study design was a secondary analysis of controlled experimental studies. Twenty-two patients with ME/CFS and 22 healthy sedentary controls were enrolled. In experiment 1, subjects performed an aerobic submaximal exercise test; in experiment 2 they underwent a self-paced exercise test. One week of rest period were set between the two exercise tests. Before and after each experiment, subjects underwent clinical assessment, pain thresholds (PPTs) measurement, and blood sampling. Immune system function was assessed measuring complement system C4a products and elastase activity. Results Changes in elastase activity were not associated to changes in PPTs. Associations were observed in the ME/CFS group between changes in PPTs and C4a products, following both types of exercise. After submaximal exercise, the change in C4a products was associated with the change in PPT at the thumb in patients (r=0.669, p=0.001). Similarly, after self-paced exercise the change in C4a products was associated witht the change in PPT at the calf in patients (r=0.429, p=0.047). No such correlations were found in healthy controls. Regression analysis showed that C4a changes after the submaximal exercise significantly predicted the change in PPTs (R2=0.236; p=0.02). Conclusions Moderate associations between exercise-induced changes in PPTs and immune system activity were found only in ME/CFS. The change in the complement system following submaximal exercise might be able to explain part of the change in patient's pain thresholds, providing evidence for a potential link between immune system alteration and dysfunctional endogenous pain modulation. These results have to be taken with caution, as only one out of three measures of PPTs was found associated with C4a changes. We cannot reject the hypothesis that C4a might therefore be a confounding factor, and changes during exercise might be mediated by other mechanism. Implications Immune system changes following exercise might contribute to exercise-induced symptoms worsening in patients with ME/CFS. However, the role of the complement system is questionable.


Assuntos
Complemento C4a/imunologia , Exercício Físico , Síndrome de Fadiga Crônica/imunologia , Hiperalgesia/imunologia , Dor/imunologia , Elastase Pancreática/imunologia , Adulto , Teste de Esforço , Síndrome de Fadiga Crônica/complicações , Feminino , Humanos , Hiperalgesia/etiologia , Dor/complicações , Limiar da Dor
18.
Scand J Pain ; 19(1): 61-72, 2019 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-30325738

RESUMO

Background and aims Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is challenging to live with, often accompanied by pervasive fatigue and pain, accompanied by decreased quality of life (QoL) as well as anxiety and/or depression. Associations between higher pain, lower QoL and higher anxiety and depression have been shown in patients with various chronic pain disorders. Few studies have however examined such associations in a sample of patients with ME/CFS. The aims of the current study were to examine the impact of pain levels and compare levels of pain, health related QoL, anxiety and depression between patients with ME/CFS and healthy controls. In addition, the study aimed and to examine these relationships within the patient group only. Methods This is a cross-sectional questionnaire based study comparing 87 well-diagnosed patients with ME/CFS with 94 healthy controls. The De Paul Symptom Questionnaire (DSQ), the Medical Outcomes Study Short-Form Surveys (SF-36) and the Hospital Anxiety and Depression Scale (HADS) were used to examine and compare pain, physical function, QoL, anxiety and depression in patients and healthy controls. Further the pain variables were divided into pain total, pain intensity and a pain frequency score for analyses of the above mentioned variables within the patient group only. Results Significantly higher levels of pain, anxiety and depression, and lower levels of QoL were found in the patient group compared with healthy controls. For the patient group alone, pain was significantly associated with lower QoL in terms of physical functioning, bodily pain, general health functioning, vitality and social functioning capacity. In this patient sample, only frequency of joint pain showed significant difference in psychological variables such as depression and anxiety - depression combined. Conclusions ME/CFS patients differ significantly from healthy controls in pain, health related QoL, anxiety and depression. Pain is significantly associated with reduced QoL and overall a lower level of functioning. The relation between pain and anxiety and depression appears less clear. Implications Pain is for many ME/CFS patients associated with reduced physical functioning and reduced QoL. A thorough pain assessment can therefore be essential for clinicians, and subsequent medical pain treatment combined with good pain coping skills may increase functioning level and QoL for these patients. The link between joint pain and psychological factors should also be focused in clinical practice in terms of mapping and counseling. Pain should be further examined to understand the importance it may have for functioning level as reduced function is a main criteria when diagnosing the patients.


Assuntos
Síndrome de Fadiga Crônica/complicações , Síndrome de Fadiga Crônica/psicologia , Dor/psicologia , Qualidade de Vida , Adulto , Ansiedade/etiologia , Ansiedade/psicologia , Estudos Transversais , Depressão/etiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Dor/etiologia , Medição da Dor , Inquéritos e Questionários
19.
Pain Res Manag ; 2018: 5801510, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30533166

RESUMO

Objective: The aim of the current study was to compare physical activity and sleep duration between patients with chronic fatigue syndrome (CFS), patients with fibromyalgia syndrome (FMS), and controls and to examine the association between physical activity level and sleep duration with symptom severity within these patient groups. Methods: This study used data of LifeLines, a general population cohort in which 1.0% (n=943, 63.7% female, age 44.9 (SD 11.6) years) reported CFS, 3.0% (n=2,714; 91.6% female; age 48.4 (SD 10.7) years) reported FMS, and 95.7% (n=87,532; 57.9% female; age 44.3 (SD 12.4) years) reported neither CFS nor FMS. Physical activity, sleep duration, and symptom severity were assessed by questionnaires and analysed using ANCOVA and regression analyses, adjusted for age, sex, body mass index, smoking, and educational level. Results: Patients with CFS and FMS had significantly lower physical activity scores (8834 ± 5967 and 8813 ± 5549 MET ∗ minutes) than controls (9541 ± 5533; p < 0.001). Patients with CFS had the longest sleep duration (466 ± 86 minutes) compared to patients with FMS and controls (450 ± 67 and 446 ± 56; p < 0.001). A linear association between physical activity, sleep duration, and symptom severity was only found in controls, in whom higher physical total activity scores and longer sleep duration were associated with a lower symptom severity. In contrast, quadratic associations were found in all groups: both relatively low and high physical activity scores and relatively short and long sleep duration were associated with higher symptom severity in CFS, FMS, and controls. Conclusion: This study indicates that patients with CFS or FMS sleep longer and are less physically active than controls on average. Both low and high levels of physical activity and short and long sleep duration are associated with higher symptom severity, suggesting the importance of patient-tailored treatment.


Assuntos
Exercício Físico/fisiologia , Síndrome de Fadiga Crônica/complicações , Fibromialgia/complicações , Transtornos do Sono-Vigília/etiologia , Sono/fisiologia , Adulto , Análise de Variância , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Inquéritos e Questionários
20.
Int J Mol Sci ; 19(11)2018 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-30373189

RESUMO

Gulf War Illness (GWI) is a chronic multisymptom illness characterized by fatigue, musculoskeletal pain, and gastrointestinal and cognitive dysfunction believed to stem from chemical exposures during the 1990⁻1991 Persian Gulf War. There are currently no treatments; however, previous studies have predicted a putative multi-intervention treatment composed of inhibiting Th1 immune cytokines followed by inhibition of the glucocorticoid receptor (GCR) to treat GWI. These predictions suggest the use of specific monoclonal antibodies or suramin to target interleukin-2 and tumor necrosis factor α , followed by mifepristone to inhibit the GCR. In addition to this putative treatment strategy, there exist a variety of medications that target GWI symptomatology. As pharmaceuticals are promiscuous molecules, binding to multiple sites beyond their intended targets, leading to off-target interactions, it is key to ensure that none of these medications interfere with the proposed treatment avenue. Here, we used the drug docking programs AutoDock 4.2, AutoDock Vina, and Schrödinger's Glide to assess the potential off-target immune and hormone interactions of 43 FDA-approved drugs commonly used to treat GWI symptoms in order to determine their putative polypharmacology and minimize adverse drug effects in a combined pharmaceutical treatment. Several of these FDA-approved drugs were predicted to be novel binders of immune and hormonal targets, suggesting caution for their use in the proposed GWI treatment strategy symptoms.


Assuntos
Disfunção Cognitiva/tratamento farmacológico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Síndrome de Fadiga Crônica/tratamento farmacológico , Gastroenteropatias/tratamento farmacológico , Dor Musculoesquelética/tratamento farmacológico , Polifarmacologia , Disfunção Cognitiva/complicações , Disfunção Cognitiva/metabolismo , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/metabolismo , Síndrome de Fadiga Crônica/complicações , Síndrome de Fadiga Crônica/metabolismo , Gastroenteropatias/complicações , Gastroenteropatias/metabolismo , Guerra do Golfo , Humanos , Simulação de Acoplamento Molecular , Terapia de Alvo Molecular/métodos , Dor Musculoesquelética/complicações , Dor Musculoesquelética/metabolismo , Software
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA