Wikis
| Chronic fatigue syndrome | |
|---|---|
| Classification and external resources | |
| ICD-10 | G93.3 |
| ICD-9 | 780.71 |
| DiseasesDB | 1645 |
| MedlinePlus | 001244 |
| eMedicine | med/3392 ped/2795 |
| MeSH | D015673 |
Contents |
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I would like to start this new wikibook as part of a
interdisciplinary bachelorthesis project. This project consist of
making a interdisciplinary thesis by two persons of the Liberal
Arts & Sciences Study at the University of Utrecht. I'm doing
my project together with Niels van Miltenburg who will approach our
subject from the perspective of a philosopher an I, Rik van Velzen,
will take a biological approach.
Although CFS has multiple etiologies and treatmeant differ from a wide range of various drug treatments to behavioral therapies (Cognitive Behavioral Therapy[[1]], Behavioral Interventions[2], Counselling, etc.), cfs seem to have some clear biochemical characteristics. For example Dr. De Meirleir was able to predict with an accuracy of 99% [3] which blood samples where from CFS patients by measuring the 37/80 kDa RNase L ratio.[4]
Type of Book: Textbook/Thesis
Difficulty level: Intermediate/advanced level for University
student
Disciplines: (neuro)Biology, philosophy, psychology
Aim of the book: Next to creating a book on Chronic Fatigue Syndrom
(CFS) and reflecting on medical/therapeutical approaches of
psychosomatica (CFS in this specific case) the aim of this book is
to support in writing the bachelor thesis for Niels/Rik's project.
--rik 17:43, 2 December 2006 (UTC)
| This section is not yet finished. Any help on this section is welcome |
Chronic Fatigue Syndrome (CFS)[5], which is also
known as myalgic encephalomyelitis (ME), post-viral fatigue
syndrome (PVFS), and various other names, is a syndrome (or group
of syndromes) of unknown and possibly multiple [[6]], affecting the central nervous system
(CNS), immune, and many other systems and organs. There is no
simple diagnostic test; CFS is a diagnosis of exclusion, although
recent research indicates biological hallmarks of the syndrome, and
a diagnostic test is predicted soon.
It is important to be aware that the disease Myalgic Encephalomyelitis, which has had a World Health Organisational classification since 1969, is not the same illness as the subsequently-named 'Chronic Fatigue Syndrome' definitions, although they are sometimes treated as similar [7]. In addition, experts such as Dr Byron Hyde [8] have argued that the various 'CFS' definitions have no practical usefulness, as they are so broad that they clearly encompass those suffering from a range of illnesses, and the concept of 'CFS' should thus be abandoned as in practice it functions to divert attention from fully testing and treating patients for whatever they suffer from, in addition to leading to treatment which is possibly harmful for patients as it is not suitable for their particular illness [9].
In contrast to many of the 'CFS' definitions, Myalgic Encephalomyelitis is not a diagnosis of exclusion [10]. Lack of knowledge of this has led both to people being incorrectly diagnosed with the illness, and also to the stigma that sufferers are complaining of an invisible disease, and must hence have a psychosomatic illness.
Adding to the confusion, some research ostensibly done on 'CFS' population samples has in fact been done on sufferers of M.E., and some research ostensibly done on M.E. has in fact been done using test subjects diagnosed with one of the types of CFS which are quite different from M.E. (for instance the Fukuda criteria), or with those who simply have some sort of fatigue, due to the mistaken belief that M.E. is synonymous with 'chronic fatigue'[11][12](nb some definitions of CFS, such as the 1991 Oxford criteria, are quite synonymous with chronic fatigue and others are not, for instance the Australian CFS definition[13]).
It should not necessarily be concluded that those diagnosed with "Chronic Fatigue Syndrome" have, in contrast to those with M.E., a psychosomatic disorder or problems. Part of the problem of the extremely broad criteria of some CFS definitions is that they can incorporate both those whose fatigue is primarily related to depression and emotional stressors in their lives, and those who have fatigue and other physical symptoms which are caused by undiagnosed physical disorders or diseases. Thus the definition CFS is, as Dr Byron Hyde has written, unhelpful to those with M.E., and unhelpful to those who have been diagnosed with 'CFS'. Dr Hyde advocates that the concept of 'CFS' should be abandoned, as in practice it leads to stigmatizing those with physically-caused illnesses as psychosomatic or hypochondriacs, and is often used as an excuse not to conduct proper testing and treatment of the genuinely ill (by doctors who assume the diagnosis of 'CFS' means that there is no point in conducting more than rudimentary physical tests).
| This section is not yet finished. Any help on this section is welcome |
From Highlights from Dr. Kenny De Meirleir's Lecture:
Some psychiatrists advocate that no tests or lab work be
done on ME/CFS patients because testing will reinforce delusion of
physically illness. Given the wealth of confirmed biochemical
abnormalities, such rationale is ludicrous. Dr. De Meirleir
stressed that tests must be done in order to eliminate the cause. A
"clean-up" of all the consequences of the problem must also be
undertaken. Therapies and the orders of treatment vary according to
the patient's unique test profile. Treatment includes:
1. Restoring immune competence
2. Removing microorganisms
3. Restoring hormonal balance
4. Restoring intestinal flora
5. Decreasing prostaglandins and protein kinase activity
6. Removing heavy metals and toxic chemicals
| This section is not yet finished. Any help on this section is welcome |
Dr. De Meirleir is a world renowned researcher and professor of
Physiology and Internal Medicin at Free University of Brussels in
Belgium. In Highlights from Dr Kenny De Meirleir's
Lecture[14]
Van de Sande states that numerous infectious agents can trigger
ME/CFS. Infectious agents that invade cells release RNA
(ribonucleic acid) or DNA (deoxyribonucleic acid) when they
reproduce. Normally when a virus infects a cell, an enzyme called
RNase L (Ribonulease L) is activated and cuts the RNA of the
infectious agent so it cannot replicate itself and cuts the RNA of
the infected cell, which triggers the cell's death and removal.
Then the RNase L molecule "switches off" and remains inactive so
that it doesn't damage healthy cells.
Abnormality in RNase L molecule in ME/CFS
Patients
The normal weight of the RNase L molecule is 80 kilo Daltons (kDa).
In ME/CFS patients the RNase L molecule is being cut and weighs 37
kDa. The low molecular weight (LMW) of the RNase L molecule can
discriminate ME/CFS Patients from healthy people and other
illnessses such as fibromyalgia, multiple sclerosis, cancer, AIDS
and depression. The Center for Disease Control (USA) sent 100 blood
samples to Dr. De Meirleir who was able to identify with an
accuracy of 99%, using the test for LMW RNase L, which blood
samples came from ME/CFS patients. {|- style="color: red" |NEEDS
REFERENCE|}
Abnormal RNase L molecule causes chronic dysfunction of the
immune system
The damaged RNase L molecule is not able to kill infectious agents
and it keeps damaged cells alive. The body is unable to "switch
off" these abnormal RNase L fragments and they also continue to cut
the RNA of normal cells. Destructive RNase L fragments are six
times more active than normal and consume approximately 70% of the
cells' energy (ATP). Un-"switched off" Rnase L fragments destroy
normal protein synthesis, enzyme production and other vital
cellular functions. They inhibit respiratory muscles and cause
hyperventilation, metabolic alkalosis, sleep diturbances and
fatigue. Furthermore there is sodium retention, low magnesium
levels and dramatically low levels of potassium. Natural killer
cells, which protect against viruses and intracellular infections,
are also being damaged. Thus, the immune system is in a state of
chronic dysfunction.
| This section is not yet finished. Any help on this section is welcome |
Van de Sande points out that these findings confirm an organic
origin of ME/CFS and validate diagnosis of ME/CFS.
This idea of there being an organic origin (instead of a mental)
suggest a sepparation between mental and physical phenomena which,
as we would like to argue in this wikibook, might be a false view
and we would like to argue that there is no difference between
mental and physical phenomenon. Instead of trying to find
treatments on medical or mental bases we should work towards a
holistic approach. Problem only is that "mental" phenomenon work as
complex non-linear systems for which we can't easily point out
which physical constitutions causes which mental phenomenon and
vice versa. With reviewing some recent developments in the research
on Embodiment we would like to get a better idea how the mental and
the physical interact.
Bibliography:
Cromby, Between constructionism and Neuroscience, the
societal Co-constructionism and Neuroscience, Theory and
Psychology, Vol 14(6), 2004.
Cromby, Embodied Subjectivity in Chronic Fatigue Syndrome: a
phenomenological analysis, (in press).
Hermans, The Dialogical Self as a society of Mind, Theory
and psychology, Vol 12(2), 2002.
Lewis, The dialocial brain: Contributions of emotional
neurobiology to understanding the dialogical self', Theory and
psychology, Vol 12(2), 2002.
Lysaker & Lysaker, Narrative structure in Psychosis:
Schizophrenia and Disruptions in the Dialogical Self, Theory
and psychology, Vol. 12(2), 2002.
Franssen & Van Geelen, Silence and the dialogical self:
Considerations on Polyphony and Authorship, ??,
University Utrecht/University Medical Center, 2006.
Varela & Thompson, Radical embodiment: neural dynamics and
consciousness, TRENDS in cognitive sciences, Vol. 5 No. 10
October 2001.
--rik 17:15, 2 December 2006 (UTC)
Here are sentences from other pages on Chronic fatigue syndrome, which are similar to those in the above article.
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