Prevalence of clinically significant functional fatigue or weakness in specialty outpatient clinics of Pune, India.

Disorders of fatigue are important in clinical practice but inadequately studied in developing countries. Questions about their consistency and variation across cultures also require attention. The standard professional diagnostic formulations of these disorders, namely, chronic fatigue syndrome and neurasthenia, are not used widely in India, perhaps due to lack of research and poor appreciation of their clinical significance. Recognising patients with clinically significant functional fatigue or weakness often seek help from various care-givers, prevalence of this condition was studied in four specialty clinics of Sassoon Hospital, Pune. An operationally defined set of criteria was used to create a screening instrument. Trained research assistants surveyed 1,874 consecutive patients from psychiatry, medicine, dermatology, and ayurved clinics. Data were entered and analysed to compute the rates of this condition, compare them across clinics and between sexes, and to compute rates adjusted for age, sex, and the clinic attended. Overall prevalence was 5.02% with higher rates in the dermatology and ayurved clinics than in psychiatry and medicine clinics. The female preponderance (63.83%) was notable (p < 0.001). Mean age of patients with this condition was similar across clinics. Logistic regression showed female sex (OR 2.19, 95% CI 1.41 to 3.40) and dermatology clinic (OR 1.70, 1.02 to 2.85) to be significant predictors of CS-FoW. Female preponderance indicates the need for studies with gender focus. Clinical and cultural epidemiological studies informing psychiatrists as well as other physicians are necessary. Need for counselling for majority of these patients calls for appropriate changes in healthcare delivery.

Nuevas enfermedades ¿del alma?: reflexiones psicosomáticas a propósito de algunas analogías estructurales entre síndrome de fatiga crónica, fibromialgia y sensitividad química múltiple / New maladies - of the soul?: reflections concerning some structural analogies among chronic fatigue syndrome fibromyalgie and multiple chemical sensitivities

Introducción. En los últimos años se ha observado la expansión de una serie de cuadros clínicos situados en la frontera entre el soma y la psique. Entre ellos cabe destacar el síndrome de fatiga crónica (CFS), la fibromialgia (FM) y la enfermedad medioambiental sensitividad química múltiple (MCS). En la actualidad, no hay un consenso científico a propósito de etiología, patogénesis y tratamiento de las afecciones nombradas, lo que ha impedido que se formula una respuesta clínica adecuada a dichas molestias. Dada la mencionada falta de homogeneización de criterios los autores proponen someter a dichas enfermedades a un análisis crítico desde un punto de vista comparativo. CFS, FM y MCS, pensadas desde una perspectiva interdisciplinaria, más que genuinas enfermedades orgánicas parecen ser el resultado sobredeterminado de la confluencia simultánea de múltiples factores psicosociales. Recuperando el concepto de somatización, por un lado, y el de angustia, por el otro, los autores proponen un enfoque psicosomático de CFS, FM y MCS, basado en sus respectivas analogías estructurales.

Introduction. Recent years have seen an increase in several illnesses located on the border between body and mind. Chronic fatigue syndrome (CFS), fibromyalgia (FM) and multiple chemical sensitivities (MCS) are particularly prominent members of this group. There is currently no scientific consensus on the etiology, pathogenesis and medical treatment of these maladies, and, consequently, no adequate clinical response has been formulated. Considering the lack of homogeneous criteria, the authors carry out a critical analysis from a comparative point of view. CFS, FM and CFS, seen from an interdisciplinary perspective, seem to be more the result of the simultaneous confluence of multiple psychosocial factors than genuine organic diseases. Using the concepts of somatization and anxiety, the authors propose a complementary psychosomatic approach based on the structural analogies of CFS, FM and MCS.

Prevalence of Chronic Fatigue and Chronic Fatigue Syndrome in Korea: Community-Based Primary Care Study

There have been many epidemiological and clinical researches on chronic fatigue (CF) and chronic fatigue syndrome (CFS) since the 1990s, but such studies have been quite limited in Korea. The aim of this study was to investigate the point prevalence of CF and CFS in patients who visited community-based eight primary care clinics in Korea. The study subjects were 1,648 patients aged 18 yr and over who visited one of eight primary care clinics in Korea between the 7th and 17th of May 2001. The physicians determined the status of the subjects through fatigue-related questionnaires, medical history, physical examination, and laboratory tests. The subjects were categorized into no fatigue, prolonged fatigue, CF and then CF were further classified to medically explained CF (Physical CF and Psychological CF) and medically unexplained CF (CFS and idiopathic chronic fatigue). The point prevalence of CF and CFS were 8.4% (95% CI 7.1-9.7%) and 0.6% (95% CI 0.2-1.0%). Medically explained CF was 80.5% of CF, of which 57.1% had psychological causes. The clinical characteristics of CFS were distinguished from explained CF. CF was common but CFS was rare in community-based primary care settings in Korea.

Síndrome de fatiga crónica / Chronic fatigue syndrome

The Chronic Fatigue Syndrome is a disease that originates in the 18th Century of unknown etiology. The chronic fatigue is a common complain with an estimate prevalence of 24. In 1988 the Chronic Fatigue Syndrome was define by the experts due to an increase in the recognition of the disease. Is a disease that possess similar characteristics to other conditions for which the diagnosis is one of exclusion. Cases has been reported around the world been most common in women between 20-50 years of age. The treatment is mostly supportive

Evaluación retrospectiva de anticuerpos heterofilos y específicos contra el virus Epstein-Barr en pacientes con sospecha de mononucleosis infecciosa / Retrospective analysis of heterophile and specific antibodies to Epstein-Barr virus in patients with clinical diagnosis of infectious mononucleosis

Se realizó un estudio comparativo, retrospectivo entre las técnicas de Paul Bunnel Davidsohn y la de inmunofluorescencia para la pesquisa de anticuerpos específicos contra el virus de Epstein-Barr. Se analizaron 44 sueros de pacientes (18 hombres y 26 mujeres) menores de 30 años, enviados al Instituto de Salud Pública con el diagnóstico de mononucleosis infecciosa. Se detectaron 11 casos (+) para MNI, 9 de los cuales coincidieron por ambas técnicas. Un caso fue (+) solo por IFI y otro solo por PBD. Los (+) por IFI presentaron: IgG VCA (+), IgM VCA (+) y EBNA (-), los Ac anti early demostraron ser inespecíficos en el diagnóstico de esta enfermedad. Este trabajo demuestra que el PBD sigue siendo una buena alternativa para el diagnóstico de MNI y que bastaría realizar IgM VCA y EBNA para efectuar este mismo diagnóstico por la técnica de IFI. La detección de Ac específicos debiera realizarse de rutina en niños menores y cuando se desee conocer el estado inmune de un individuo al VEB