TGI Friday! Our weekly round-up of recently published research abstracts | 29 November 2013

From Panminerva Medical, a journal of internal medicine. 2013 Nov 14. [Epub ahead of print].

Improved management of primary chronic fatigue syndrome with the supplement French oak wood extract (Robuvit®): a pilot, registry evaluation

Belcaro G, Cornelli U, Luzzi R, Cesarone MR, Dugall M, Feragalli B, Hu S, Pellegrini L, Ippolito E.
Irvine3 Circulation/Vascular Labs and San Val. Epidemiology Department of Biomedical Sciences, Chieti‑Pescara University, Pescara, Italy – cardres@abol.it.

Abstract

AIM

The aim of this supplement study was to evaluate French oak wood extract (Robuvit®, Horphag Research Ltd) used as a supplement in association with a defined management plan for chronic fatigue syndrome (CFS) in healthy subjects with CFS, a condition that has, so far, no specific treatment or management standards.

METHODS

Robuvit® is a new proprietary and exclusive extract of oak wood with important antoxidant actions. The dosage of the supplementation was 200 mg/day for at least 6 months. The CFS questionnaire and the Brief Mood Introspection Scale (BMIS) questionnaire were used to evaluate mood variations associated with CFS patients. The CFS form includes an analogue scale to record the variations of single symptoms with a score range of 0-10. At inclusion into the registry study, at least 5 symptoms were present. All subjects (age range 35-44; BMI range 24-26) with CFS were tested for oxidative stress: 61 out of 91 subjects had an increased value of oxidative stress. The BMIS scale evaluating mood changes in time was also used. The evaluation was repeated at 3 and 6 months.

RESULTS

Out of 91 eligible subjects with CFS, 48 subjects (31 with increased oxidative stress) were accepted as part of the supplement registry study using Robuvit; 43 (30 with increased oxidative stress) were accepted as controls using only the management plan. In the Robuvit® group there were 3 drop outs; also 3 controls were lost. Oxidative stress was increased in 64.58% of subjects that used Robuvit and in 69.7% of controls. The average values of oxidative stress were expressed for the whole group. The average follow up was 199.3;9.2 days in the Robuvit group and 202.2;5.5 in the control group with a minimum of 6 months.

Considering variations in oxidative stress, there was no significant average change in controls, but a significant decrease from the initial values was observed in Robuvit subjects after 3 and 6 months. The CFS questionnaire variations in score indicated that there was a significant improvement for most symptoms after 3 and 6 months in the Robuvit group. Positive variations were also present in controls, indicating the positive effect of an increased attention to CFS. The improvement in signs/symptoms was significantly more valuable in subjects using the oak wood extract considering the main 8 symptoms and the accessory symptoms.

Considering the BMIS variations, the totals for positive and negative items were significantly more favourable for Robuvit subjects. Overall mood evaluation in the oak wood extract group improved from an inclusion average of -6.93;2.1 to +4.32;2.6 at 6 months; in contrast it changed from -6.5;2.5 to -3.4;1.5 in controls. No side effects were observed during the supplementation with Robuvit. The compliance was optimal with 93% of the capsules correctly used.

CONCLUSION

This promising pilot supplement registry study indicates a new opportunity of management for these difficult and often neglected patients. Correlation between oxidative stress and CFS have to be better explored.


From Arthritis Care and Research, official journal of the American College of Rheumatology, May 2013.

Fibromyalgia Prevalence, Somatic Symptom Reporting, and the Dimensionality of Polysymptomatic Distress: Results From a Survey of the General Population

Frederick Wolfe(1,*), Elmar Brähler(2), Andreas Hinz(2), Winfried Häuser(3,†)
1) National Data Bank for Rheumatic Diseases and University of Kansas School of Medicine, Wichita
2) Universität Leipzig, Leipzig, Germany
3) Technische Universität München, Munich, and Klinikum Saarbrücken, Saarbrücken, Germany
†) Dr. Häuser has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Daiichi Sankyo and Abbott Germany.

Email: Frederick Wolfe (fwolfe@arthritis-research.org)

Abstract

OBJECTIVE

To evaluate fibromyalgia in the general population with emphasis on prevalence, dimensionality, and somatic symptom severity.

METHODS

We studied 2,445 subjects randomly selected from the German general population in 2012 using the American College of Rheumatology 2010 preliminary diagnostic criteria for fibromyalgia, as modified for survey research, and the polysymptomatic distress scale (PSD). Anxiety, depression, and somatic symptom severity were assessed with the Patient Health Questionnaire (PHQ) series, and measures of symptoms and quality of life were assessed with the European Organization for Research and Treatment of Cancer questionnaire.

RESULTS

The prevalence of fibromyalgia was 2.1% (95% confidence interval [95% CI] 1.6, 2.7), with 2.4% (95% CI 1.5, 3.2) in women and 1.8% (95% CI 1.1, 2.6) in men, but the difference was not statistically significant. Prevalence rose with age. Fibromyalgia subjects had markedly abnormal scores for all covariates. We found smooth, nondisordered relationships between PSD and all predictors, providing additional evidence against the hypothesis that fibromyalgia is a discrete disorder and in support of a dimensional or spectrum disorder. There was a strong correlation (r = 0.790) between the PSD and the PHQ somatic symptom severity scale; 38.5% of persons with fibromyalgia satisfied the proposed Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for a physical symptom disorder.

CONCLUSION

The modified 2010 diagnostic criteria do not result in high levels of fibromyalgia. PSD and fibromyalgia are strongly related to somatic symptom severity. There is evidence in support of fibromyalgia as a dimensional or continuum disorder. This has important ramifications for neurobiologic and epidemiology research, and for clinical diagnosis, treatment, and ascertainment of disability.


From the Universal Journal of Public Health, November 2013 Gull text here www.hrpub.org/download/20131107/UJPH4-17600991.pdf

Coverage of CFS within U.S. Medical Schools

T. Mark Peterson, Thomas W. Peterson, Sarah Emerson, Eric Regalbuto, Meredyth A. Evans, Leonard A. Jason.
Center for Community Research, DePaul University, Chicago, 60614, Illinois, United States *Corresponding Author: mevans24@depaul.edu

Abstract

Little is known about the extent to which chronic fatigue syndrome (CFS) is covered within medical schools in the United States (U.S.) The current study is an exploration of the extent that CFS is covered in the areas of treatment, research, and curricula in U.S. Medical Schools.

Surveys were sent to personnel at 132 accredited U.S. medical schools and a total of 71 schools responded. The extent of coverage across the three domains was extremely limited. Only 29.6% of schools met the clinical criterion, 28.2% met the curricula criterion, and 15% met the research criterion. Only four of the 71 (5.6%) responding schools met criteria for all three domains.

While the current study is preliminary, it points to significant gaps in the coverage of CFS among medical institutions, which is likely impacting the ability of physicians to fully acknowledge, understand, effectively treat, and find a cure for CFS.

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