{"id":25318,"date":"2020-04-10T06:38:02","date_gmt":"2020-04-10T06:38:02","guid":{"rendered":"https:\/\/wames.org.uk\/cms-english\/?p=25318"},"modified":"2020-04-10T06:47:21","modified_gmt":"2020-04-10T06:47:21","slug":"chronic-fatigue-syndrome-progress-possibilities","status":"publish","type":"post","link":"https:\/\/wames.org.uk\/cms-english\/chronic-fatigue-syndrome-progress-possibilities\/","title":{"rendered":"Chronic Fatigue Syndrome: progress &#038; possibilities"},"content":{"rendered":"<h3><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/abs\/10.5694\/mja2.50553\" target=\"_blank\" rel=\"noopener noreferrer\">Chronic Fatigue Syndrome: progress and possibilities<\/a>, by <a href=\"https:\/\/www.researchgate.net\/profile\/Carolina_Sandler\" target=\"_blank\" rel=\"noopener noreferrer\">Carolina X Sandler<\/a>, <a href=\"https:\/\/www.me-pedia.org\/wiki\/Andrew_Lloyd\" target=\"_blank\" rel=\"noopener noreferrer\">Andrew R Lloyd<\/a> <span style=\"text-decoration: underline;\">in<\/span> <em>Medical Journal of Australia <\/em>April 5, 2020<\/h3>\n<p>&nbsp;<\/p>\n<p><img data-recalc-dims=\"1\" decoding=\"async\" class=\"size-large wp-image-25392 aligncenter lazyload\" data-src=\"https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-Diagnosis.png?resize=640%2C328&#038;ssl=1\" alt=\"\" width=\"640\" height=\"328\" data-srcset=\"https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-Diagnosis.png?resize=1024%2C524&amp;ssl=1 1024w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-Diagnosis.png?resize=300%2C154&amp;ssl=1 300w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-Diagnosis.png?resize=150%2C77&amp;ssl=1 150w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-Diagnosis.png?resize=768%2C393&amp;ssl=1 768w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-Diagnosis.png?resize=1536%2C786&amp;ssl=1 1536w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-Diagnosis.png?resize=2048%2C1048&amp;ssl=1 2048w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-Diagnosis.png?w=1760&amp;ssl=1 1760w\" data-sizes=\"(max-width: 640px) 100vw, 640px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 640px; --smush-placeholder-aspect-ratio: 640\/328;\" \/><\/p>\n<h3><strong>Review Summary<\/strong><\/h3>\n<ul>\n<li>Chronic fatigue syndrome (CFS) is a prevalent condition affecting<br \/>\nabout one in 100 patients attending primary care.<\/li>\n<li>There is no diagnostic test, validated biomarker, clear<br \/>\npathophysiology or curative treatment.<\/li>\n<li>The core symptom of fatigue affects both physical and cognitive<br \/>\nactivities, and features a prolonged post\u2010activity exacerbation<br \/>\ntriggered by tasks previously achieved without difficulty.<\/li>\n<li>Although several different diagnostic criteria are proposed, for<br \/>\nclinical purposes only three elements are required: recognition of the<br \/>\ntypical fatigue; history and physical examination to exclude other<br \/>\nmedical or psychiatric conditions which may explain the symptoms; and a<br \/>\nrestricted set of laboratory investigations.<\/li>\n<li>Studies of the underlying pathophysiology clearly implicate a range of<br \/>\ndifferent acute infections as a trigger for onset in a significant<br \/>\nminority of cases, but no other medical or psychological factor has been<br \/>\nreproducibly implicated.<\/li>\n<li>There have been numerous small case-control studies seeking to<br \/>\nidentify the biological basis of the condition. These studies have<br \/>\nlargely resolved what the condition is not: ongoing infection,<br \/>\nimmunological disorder, endocrine disorder, primary sleep disorder, or<br \/>\nsimply attributable to a psychiatric condition.<\/li>\n<li>A growing body of evidence suggests CFS arises from functional<br \/>\n(non\u2010structural) changes in the brain, but of uncertain character and<br \/>\nlocation. Further functional neuroimaging studies are needed.<\/li>\n<li>There is clear evidence for a genetic contribution to CFS from family<br \/>\nand twin studies, suggesting that a large scale genome\u2010wide association<br \/>\nstudy is warranted.<\/li>\n<li>Despite the many unknowns in relation to CFS, there is significant<br \/>\nroom for improvement in provision of the diagnosis and supportive care.<br \/>\nThis may be facilitated via clinician education.<\/li>\n<\/ul>\n<p><img data-recalc-dims=\"1\" decoding=\"async\" class=\"size-large wp-image-25391 aligncenter lazyload\" data-src=\"https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-review-image-2020.png?resize=640%2C455&#038;ssl=1\" alt=\"\" width=\"640\" height=\"455\" data-srcset=\"https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-review-image-2020.png?resize=1024%2C728&amp;ssl=1 1024w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-review-image-2020.png?resize=300%2C213&amp;ssl=1 300w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-review-image-2020.png?resize=150%2C107&amp;ssl=1 150w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-review-image-2020.png?resize=768%2C546&amp;ssl=1 768w, https:\/\/i0.wp.com\/wames.org.uk\/cms-english\/wp-content\/uploads\/2020\/04\/Sandler-Lloyd-review-image-2020.png?w=1184&amp;ssl=1 1184w\" data-sizes=\"(max-width: 640px) 100vw, 640px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 640px; --smush-placeholder-aspect-ratio: 640\/455;\" \/><\/p>\n<h3><strong>Introduction<\/strong><\/h3>\n<p>Chronic fatigue syndrome (CFS) is an\u00a0enigmatic clinical entity which challenges patients, health care providers and researchers alike.1 The diagnosis is sometimes avoided by medical practitioners, leaving patients in diagnostic limbo andprone to non-evidence- based labels and potentially harmful treatments. This quandary reflects the lack of a diagnostic test, validated biomarker, clear pathophysiology or curative treatment.<\/p>\n<p>We retrieved publications from MEDLINE, PsycINFO, EMBASE, Cochrane and PubMed databases from 1988 to 2019 to consider aspects of clinical decision making in the diagnosis, assessment of prognosis, and management of CFS; provide an update on understanding of CFS pathophysiology; and identify priorities for improved care of patients with CFS and for future research. This review focuses on adult populations, but the condition also affects children and adolescents (reviewed elsewhere).2<\/p>\n<p><a href=\"https:\/\/sci-hub.tw\/10.5694\/mja2.50553\" target=\"_blank\" rel=\"noopener noreferrer\">Read full paper<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Chronic Fatigue Syndrome: progress and possibilities, by Carolina X Sandler, Andrew R Lloyd in Medical Journal of Australia April 5, 2020 &nbsp; Review Summary Chronic fatigue syndrome (CFS) is a prevalent condition affecting about one in 100 patients attending primary &hellip; <a href=\"https:\/\/wames.org.uk\/cms-english\/chronic-fatigue-syndrome-progress-possibilities\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[4115,4112,5360,107],"class_list":["post-25318","post","type-post","status-publish","format-standard","hentry","category-news","tag-andrew-r-lloyd","tag-carolina-x-sandler","tag-clinical-management","tag-diagnostic-criteria"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5qkYK-6Am","_links":{"self":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/25318","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/comments?post=25318"}],"version-history":[{"count":6,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/25318\/revisions"}],"predecessor-version":[{"id":25395,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/25318\/revisions\/25395"}],"wp:attachment":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/media?parent=25318"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/categories?post=25318"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/tags?post=25318"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}