From Pediatrics, February 2016.
Chronic Fatigue Syndrome at Age 16 Years
Simon M. Collin, PhD(a,b), Tom Norris, PhD(a,b), Roberto Nuevo, PhD(a,b), Kate Tilling, PhD(a), Carol Joinson, PhD(a,b), Jonathan A.C. Sterne, PhD(a), and Esther Crawley, BMBCh, PhD(a,b)
a) School of Social & Community Medicine
b) Centre for Child & Adolescent Health, University of Bristol, Bristol, United Kingdom
Dr Collin analyzed the data, wrote the first draft, and revised the manuscript; Drs Norris and Nuevo provided methodologic input, analyzed the data, and revised the manuscript; Drs Tilling, Joinson, and Sterne provided methodologic input, interpreted the results, and revised the manuscript; and Dr Crawley conceived the study, interpreted the results, and revised the manuscript. All authors approved the final version of the manuscript as submitted.
In the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, chronic disabling fatigue lasting <–6 months affected 1.3% of 13-year-olds, was equally common in boys and girls, and became more prevalent with increasing family adversity. METHODS ALSPAC data were used to estimate the prevalence of chronic fatigue syndrome (CFS) at age 16 years, defined by parental report of unexplained disabling fatigue last <–6 months. We investigated gender and a composite 14-item family adversity index as risk factors. School absence data were obtained from the National Pupil Database. Multiple imputation was used to address bias caused by missing data. RESULTS The prevalence of CFS was 1.86% (95% confidence interval [CI]: 1.47 to 2.24). After excluding children with high levels of depressive symptoms, the prevalence was 0.60% 995% CI: 0.37 to 0.84). Authorized school absences were much higher (mean difference: 35.6 [95% CI: 26.4 to 44.9] half-day sessions per academic year) and reported depressive symptoms were much more likely (odds ratio [OR]: 11.00 [95% CI: 11.0 [95% CI: 5.92 to 20.4]) in children with CFS than in those without CFS. Female gender (OR: 1.95 [95% CI: 1.33 to 2.86]) and family adversity (OR: 1:20 [95% CI:1.01 to 1.42] per unit family,y adversity index} were also associated with CFS. CONCLUSIONS CFS affectd 1.96% of 16-year-olds in a UK birth cohort and was positively associated with higher family adversity. Gender was a risk factor at age 16 years but not at age 13 years or in 16-year-olds with high levels of depressive symptoms.
From Scientific Reports, 13 January 2016 (open access).
Support for the Microgenderome: Associations in a Human Clinical Population
Amy Wallis(1), Henry Butt(2), Michelle Ball(1), Donald P. Lewis(3), Dorothy Bruck(1)
1) Psychology Department, Victoria University, Victoria, Australia
2) Bioscreen (Aust) Pty Ltd, Victoria, Australia
3) CFS Discovery Clinic, Donvale, Victoria, Australia
The ‘microgenderome’ provides a paradigm shift that highlights the role of sex differences in the host-microbiota interaction relevant for autoimmune and neuro-immune conditions.
Analysis of cross-sectional self-report and faecal microbial data from 274 patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) suggests that commensal gut microorganisms may play both protective and deleterious roles in symptom expression.
Results revealed significant sex-specific interactions between Firmicutes (Clostridium, Streptococcus, Lactobacillus and Enterococcus) and ME/CFS symptoms (including neurological, immune and mood symptoms), regardless of compositional similarity in microbial levels across the sexes.
Extending animal studies, we provide support for the microgenderome in a human clinical population. Applied and mechanistic research needs to consider sex-interactions when examining the composition and function of human microbiota.
From BMC Complementary and Alternative Medicine, 22 January 2016 (full text available).
Use of complementary and alternative medicine in patients with health complaints attributed to former dental amalgam fillings
Agnete E. Kristoffersen(1), Frauke Musial(1), Harald J. Hamre(2), Lars Björkman(3), Trine Stub(1), Anita Salamonsen(1) and Terje Alræk(1)
1) The National Research Center in Complementary and Alternative Medicine, (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway
2) Institute for Applied Epistemology and Medical Methodology at the University of Witten-Herdecke
3) Dental Biomaterials Adverse Reaction Unit, Uni Research Health
The dental filling material amalgam is generally well tolerated. However, a small proportion of dental patients experience health complaints which they attribute to amalgam. The symptom pattern is often similar to patients with medically unexplained physical symptoms (MUPS) and the health complaints may persist after amalgam removal. Among patients with MUPS, the use of complementary and alternative medicine (CAM) seems to be high. The aim of this survey was to describe the prevalence and range of CAM use among people with health complaints attributed to dental amalgam fillings in which the health problems persist after the removal of all amalgam fillings. Specific attention was paid to (1) self-reported effects of CAM, (2) differences in CAM use dependent on self-reported health, and (3) gender differences in self-reported CAM use.
A survey was distributed to all members of The Norwegian dental patient association (NDPA) (n = 999), the response rate was 36.4 %. The anonymous questionnaire asked for socio-demographic data, health complaints related to former amalgam fillings, subjectively perceived health status, symptoms, and experience with therapeutic interventions, mostly from the spectrum of CAM. Only participants who had all their fillings removed, which was the vast majority, were analysed.
A total of 88.9 % of included respondents had used at least one CAM modality, with a higher proportion of men (95.7 %) compared to women (86.2 %, p = 0.015). The most frequently used therapies were dietary supplements, vitamins and minerals recommended by a therapist (used by 66.7 %) followed by self-prescribed dietary supplements, vitamins and minerals (59.0 %), homeopathy (54.0 %), acupuncture (48.8 %) and special diets (47.5 %). Use of CAM was similar for participants reporting normal to good health compared to participants reporting poor health. For all but two CAM modalities, the self-reported treatment effect was better in the group reporting normal to good health compared to the group reporting poor health.
CAM was widely used by participants in our study, a finding similar to findings from studies of MUPS patients. To date, health problems associated with the use of dental amalgam is not an accepted diagnosis in the healthcare system. Consequently, people suffering from such complaints experience a lack of adequate treatment and support within conventional health care, which might have contributed to the high number of CAM users in this study.