Me research uk database of Research Publications 2009 - 29


Wells DL.


School of Psychology, Queen's University Belfast, Northern Ireland, United Kingdom. d.wells@qub.ac.uk
Associations between pet ownership and self-reported health status in people suffering from chronic fatigue syndrome.
J Altern Complement Med. 2009 Apr;15(4):407-13.
OBJECTIVE: This study explored the association between pet ownership and self-reported health in people suffering from chronic fatigue syndrome (CFS). METHODS: One hundred and ninety-three (193) people with medically diagnosed CFS completed a postal survey designed to collect information on illness severity, physical and psychologic health, and pet ownership practices. RESULTS: Most of the participants were female (72.0%), over 45 years of age (57.1%) and married (41.1%) with no children (63.1%). Pets were owned by 58.3% of the sample, with dogs and cats being the most commonly kept types of companion animal. The general health of the participants was discovered to be poor, as assessed by scores on the Chalder Fatigue Questionnaire (CFQ), General Health Questionnaire-12 (GHQ-12), and Short-Form-36 (SF-36) health survey. Pet ownership was not significantly associated with scores on the CFQ, GHQ-12, or SF-36 scales, although pet owners considered their animals to offer them a range of health benefits, notably those associated with mental well-being. CONCLUSIONS: Overall, findings suggest no statistically significant association between pet ownership and self-reported health in people with CFS. Nonetheless, people suffering from this condition believe that their pets have the potential to enhance quality of life. Although animals should not be regarded as a panacea for people with long-term conditions such as CFS, they may, nonetheless, serve a valuable, and currently underutilized, role in promoting well-being, whether in their own right, or in conjunction with more traditional forms of therapy.

Wessely S.


Department of Psychological Medicine, Institute of Psychiatry, King's College London, London SE5 9RJ, UK. s.wessely@iop.kcl.ac.uk
Surgery for the treatment of psychiatric illness: the need to test untested theories.
J R Soc Med. 2009 Oct;102(10):445-51.

Weston S, Townsend S.


Shropshire Enablement Team.
Using a DVD to help people with chronic fatigue syndrome learn the technique of pacing.
Nurs Times. 2009 Nov 17-23;105(45):26-7.
The Shropshire Enablement Team, a specialist community rehabilitation team, has produced a DVD and booklet on pacing for people with chronic fatigue syndrome/ME. Pacing is a technique for managing fatigue, and involves achieving the correct balance between rest and activity. This article explains the benefits of pacing, and how the DVD and booklet have enabled the team to better support clients.

Wormser GP, Schwartz I.


Division of Infectious Diseases, Department of Medicine, York Medical College, Munger Pavilion Room 245, Valhalla, NY 10595, USA. gary_wormser@nymc.edu
Antibiotic treatment of animals infected with Borrelia burgdorferi.
Clin Microbiol Rev. 2009 Jul;22(3):387-95.
Despite resolution of the objective manifestations of Lyme disease after antibiotic treatment, a minority of patients have fatigue, musculoskeletal pain, and/or difficulties with concentration or short-term memory of uncertain etiology; these are called post-Lyme disease symptoms or, in more severe cases, post-Lyme disease syndrome or "chronic Lyme disease." Several recent studies in which Borrelia burgdorferi-infected animals were treated with antibiotic therapy have demonstrated the presence of PCR positivity for B. burgdorferi DNA in the absence of culture positivity. In mice that were treated with antibiotic therapy, residual spirochetes could be taken up by ticks during a blood meal and could be transmitted to SCID mice. These spirochetes are attenuated; their presence is not associated with either inflammation or disease. In this review the methodology and findings of these studies are critically analyzed, and the significance of the results with regard to human Lyme disease is evaluated, with special emphasis on whether these studies provide useful insights into post-Lyme disease syndrome. A serious methodological concern is the failure to consider the pharmacokinetic-pharmacodynamic properties of the antibiotic in choosing the dosage regimen used. We conclude that there is no scientific evidence to support the hypothesis that such spirochetes, should they exist in humans, are the cause of post-Lyme disease syndrome.

Wormser GP, Shapiro ED.


Division of Infectious Diseases, Department of Medicine, New York Medical College, Munger Pavilion Room 245, Valhalla, NY 10595, USA. gary_wormser@nymc.edu
Implications of gender in chronic Lyme disease.
J Womens Health (Larchmt). 2009 Jun;18(6):831-4.
BACKGROUND: "Post-Lyme disease syndrome" refers to prolonged subjective symptoms after antibiotic treatment and resolution of an objective manifestation of Borrelia burgdorferi infection (Lyme disease). "Chronic Lyme disease" is a vaguely defined term that has been applied to patients with unexplained prolonged subjective symptoms, whether or not there was or is evidence of B. burgdorferi infection. OBJECTIVE: To determine if the population of patients with chronic Lyme disease differs from the populations of patients with either Lyme disease or post-Lyme disease syndrome by examining the gender of patients with these diagnoses. Methods: Data on gender were compiled in this cross-sectional study based on a systematic review of published studies of antibiotic treatment in United States patients with post-Lyme disease syndrome (n = 184) or chronic Lyme disease (n = 490), and on cases of adults with Lyme disease reported to the Centers for Disease Control and Prevention from 2003 to 2005 (n = 43,282). RESULTS: Patients with chronic Lyme disease were significantly more likely to be female than were patients diagnosed with either Lyme disease (odds ratio [OR] 2.42, 95% confidence interval [CI] 1.98-2.94, p < 0.0001) or with post-Lyme disease syndrome (OR 2.32, 95% CI 1.62-3.34, p < 0.0001). CONCLUSIONS: Patients with chronic Lyme disease differ with regard to gender from those with either B. burgdorferi infection or post-Lyme disease syndrome. This finding suggests that illnesses with a female preponderance, such as fibromyalgia, chronic fatigue syndrome, or depression, may be misdiagnosed as chronic Lyme disease.

Wu J, Ding HS, Ye DT.


Graduate School at Shenzhen, Tsinghua University, Shenzhen 518055, China. wuj@sz.tsinghua.edu.cn
[Evaluating fatigue resistance effect of health food by near-infrared tissue oximeter] [Article in Chinese]
Guang Pu Xue Yu Guang Pu Fen Xi. 2009 Sep;29(9):2357-60.
Currently, chronic fatigue syndrome (CFS) seriously affects people's normal living and work. In the present paper, the physiological parameters, such as tissue oxygenation saturation and heart rate, were used to evaluate the subjects' fatigue degree, and the fatigue resistance capsule and coffee were taken as a measure to adjust the fatigue. Human tissue oxygen saturation (rSO2) can be monitored noninvasively and in real time by near infrared spectroscopy (NIRS) based on spatially-resolved spectroscopy. Aiming at those brainworkers who need to work in an office for a long time; two static experiments were designed to evaluate the fatigue degree of the subjects who either take the fatigue resistance capsules/coffee or not. The rSO2 and heart rate (HR) of the subjects in the experiment group and contrast group were measured respectively for fatigue evaluation. This work particularly analyzed the changes in rSO2 in these two groups. The results show that the rSO2 of subjects in the experiment group evidently increased compared to that in the contrast group when the subjects took the fatigue resistance capsule or coffee, thereby show that the health food can reduce the fatigue to a certain extent.

Wyller VB, Eriksen HR, Malterud K.


Division of Paediatrics, Rikshospitalet University Hospital, Oslo, Norway. brwylle@online.no.
Can sustained arousal explain the Chronic Fatigue Syndrome?
Behav Brain Funct. 2009 Feb 23;5:10.
ABSTRACT: We present an integrative model of disease mechanisms in the Chronic Fatigue Syndrome (CFS), unifying empirical findings from different research traditions. Based upon the Cognitive activation theory of stress (CATS), we argue that new data on cardiovascular and thermoregulatory regulation indicate a state of permanent arousal responses - sustained arousal - in this condition. We suggest that sustained arousal can originate from different precipitating factors (infections, psychosocial challenges) interacting with predisposing factors (genetic traits, personality) and learned expectancies (classical and operant conditioning). Furthermore, sustained arousal may explain documented alterations by establishing vicious circles within immunology (Th2 (humoral) vs Th1 (cellular) predominance), endocrinology (attenuated HPA axis), skeletal muscle function (attenuated cortical activation, increased oxidative stress) and cognition (impaired memory and information processing). Finally, we propose a causal link between sustained arousal and the experience of fatigue. The model of sustained arousal embraces all main findings concerning CFS disease mechanisms within one theoretical framework.

Yan S, Li HZ, Zhang XY, Li HJ.


Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China.
[Retrospective analysis of the combined therapy of terazosin with chlormezanone for chronic prostatitis/chronic pelvic pain syndrome] [Article in Chinese]
Zhonghua Nan Ke Xue. 2009 Aug;15(8):717-20.
OBJECTIVE: To investigate the efficacy and safety of the alpha1-receptor inhibitor terazosin combined with chlormezanone in the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: A total of 168 CPPS patients, aged 20 -50 (mean 32.9) years and with the disease course of 3 months to 7 years (mean 17 months), were equally randomized into a terazosin group (n = 58), a chlormezanone group (n = 38) and a terazosin + chlormezanone (T + C) group (n = 72), and treated accordingly for 4 weeks. All the patients were scored on NIH-CPSI (National Institute of Health-Chronic Prostatitis Symptom Index) after the treatment and the therapeutic effects were compared among the three groups. RESULTS: Of the total number of patients, 159 completed the treatment and were evaluated, including 55 of the terazosin group, 35 of the chlormezanone group and 69 of the T + C group. After the treatment, the NIH-CPSI scores of the three groups decreased from 24.05 +/- 3.02 to 16.15 +/- 3.25 (mean 7.90), from 23.43 +/- 3.58 to 17.51 +/- 3.08 (mean 5.92), and from 23.93 +/- 3.30 to 15.01 +/- 3.08 (mean 8.92), respectively, with statistically significant differences from pretreatment (P < 0.05) as well as between the combined therapy group and the other two (P < 0.05). The adverse events included postural hypotension (17.1% in the terazosin group and 15.4% in the T + C group), dysspermatism (3.4% in the terazosin group only), lassitude, fatigue and anorexia (18.5% in the chlormezanone group and 12.6% in the T + C group). Nine of the patients failed to accomplish the treatment because of adverse events, 3 (5.2%) in the terazosin group, 3 (7.9%) in the chlormezanone group and 3 (12.6%) in the T + C group. CONCLUSION: Both terazosin and chlormezanone can relieve the symptoms in CP/CPPS patients and improve their life quality, but their combined use may produce a better efficacy than either terazosin or chlormezanone used alone.

Zhang L, Goudh J, Christmas D, Mattey D, Richards S, Main J, Enlander D, Honeybourne D, Ayres J, Nutt DJ, Kerr J.


St George's University of London, United Kingdom;
Microbial infections in eight genomic subtypes of Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (CFS/ME).
J Clin Pathol. 2009 Dec 2. [Epub ahead of print]
We have previously reported genomic subtypes of CFS/ME based on expression of 88 human genes. In this study we attempted to reproduce these findings, determine specificity of this signature to CFS/ME, and test for associations between CFS/ME subtype and infection. We determined expression levels of 88 human genes in blood of 61 new patients with idiopathic CFS/ME (according to Fukuda criteria), 6 patients with Q-fever associated CFS/ME form the Birmingham Q-fever outbreak (according to Fukuda criteria), 14 patients with endogenous depression (according to DSM-IV criteria) and 18 normal blood donors. In patients with CFS/ME differential expression was confirmed for all 88 genes. Q-CFS/ME patients had similar patterns of gene expression to idiopathic CFS/ME. Gene expression in endogenous depression patients was similar to that in the normal controls, except for upregulation of five genes (APP, CREBBP, GNAS, PDCD2, PDCD6). Clustering of combined gene data in CFS/ME patients for this and our previous study (n=117 CFS/ME patients) revealed genomic subtypes with distinct differences in SF-36 scores, clinical phenotypes, severity and geographical distribution. Antibody testing for Epstein-Barr virus (EBV), enterovirus, Coxiella burnetii and parvovirus B19 revealed subtype-specific relationships for EBV and enterovirus, the two most common infectious triggers of CFS/ME.

Ziemssen T.


MS Center, Neurological University Clinic, Dresden, Germany. Tjalf.Ziemssen@uniklinikum-dresden.de
Multiple sclerosis beyond EDSS: depression and fatigue.
J Neurol Sci. 2009 Feb 1;277 Suppl 1:S37-41.
Depression and fatigue are common symptoms of multiple sclerosis and are the primary determinants of impaired quality of life in this demyelinating neurological disease. The twelve-month prevalence of major depression in patients with multiple sclerosis is around 15%. Untreated depression is associated with suicidal ideation, impaired cognitive function and poor adherence to immunomodulatory treatment. For these reasons, systematic screening and management of depressive symptoms is recommended for all patients with multiple sclerosis. There is some evidence that interferon-beta treatment may exacerbate depressive symptoms and a switch to glatiramer acetate can be envisaged in patients treated with an interferon-beta in whom depressive symptoms become an issue. Fatigue is present in over three-quarters of patients with multiple sclerosis. It is considered the most debilitating symptom of the disease and is a major reason for work absenteeism. There is growing evidence that immunomodulatory treatments, in particular glatiramer acetate, improve fatigue symptoms in patients with multiple sclerosis.
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