A New Decade of ME Research: The 11th Invest in ME International ME Conference 2016
Mark Berry presents the first in a series of articles on the 11th Invest in ME International ME Conference in London ...
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comparison of Q fever fatigue syndrome and CFS

Discussion in 'Latest ME/CFS Research' started by msf, Aug 17, 2015.

  1. msf

    msf Senior Member

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    http://www.ncbi.nlm.nih.gov/pubmed/26272528

    This seems like bad news, but it may just turn out to be good news, if this trial takes place:

    http://www.biomedcentral.com/1471-2334/13/157

    In their desperation to prove that Q fever fatigue syndrome is all in the patients´ heads, and can be treated effectively with CBT, they may have made a fatal error - including a biomedical treatment as a comparison. The hope has to be that if they (as they should) find that the biomedical approach is more effective in Q fever fatigue syndrome (which they are likely to find out is just Q fever), they will realise that it may be more effective in CFS too.
     
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  2. A.B.

    A.B. Senior Member

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    I'm not sure what to expect. It's possible that Q fever fatigue syndrome isn't due to an infection with coxiella burnetii.

    In this case CBT could prove to be a stronger placebo than a sugar pill (especially if patients have already tried doxycycline and don't expect much from it).
     
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  3. msf

    msf Senior Member

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  4. msf

    msf Senior Member

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    Possible, but on the available evidence, unlikely.

    Good point about the doxy, they would have already had a short course for the Q fever.
     
  5. Ecoclimber

    Ecoclimber Senior Member

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    I see no comparison between the two diseases to be alarmed about this trial of course in the Netherlands. The epidemiology is different.

    Diagnosis and Management of Q Fever — United States, 2013: Recommendations from CDC and the Q Fever Working Group
    The largest known reported Q fever outbreak involved approximately 4,000 human cases and occurred during 2007–2010 in the Netherlands. This outbreak was linked to dairy goat farms near densely populated areas and presumably involved human exposure via a windborne route.
    Schimmer B, Dijkstra F, Velllema P, et al. Sustained intensive transmission of Q fever in the south of the Netherlands, 2009. Euro Surveill 2009;14:3.
     
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  6. A.B.

    A.B. Senior Member

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    On the other hand a previous study reported improvement in symptoms and decrease in body temperature in Q fever fatigue syndrome patients treated with an antibiotic for 3 months. It was an open label study but the change in temperature and changes in lab test results suggest there was a real improvement.

    http://www.ncbi.nlm.nih.gov/pubmed/14964579
     
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  7. jimells

    jimells Senior Member

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    I see this is yet another study published in the Journal of Psychosomatic Research. I wonder if they have ever published a study that holds up to close scrutiny.

    What does BMI have to do with Q fever or "CFS" or ME? Is it some kind of indirect way of blaming patients for their illness?
     
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  8. alkt

    alkt Senior Member

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    bmi indicates whether a patient is overweight and thus more prone to fatigue at least if they have a sedentry lifestyle . but the b m i has its own problems with validation as a measurement.
     
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  9. Woolie

    Woolie Senior Member

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    I have seen it used as an indirect way of claiming a psychological cause for an illness. This is an article about psychogenic nonepileptic seziures (NES):

    Psychogenic nonepileptic seizures are associated with an increased risk of obesity. Anna Vinter Marquez, , Sarah T. Farias, Michelle Apperson, Suzanne Koopmans, Julie Jorgensen, Alan Shatzel, Taoufik M. Alsaadi
    "What is the relationship between NES, psychiatric disorders, and body weight? It is possible that the psychopathological processes underlying NES also contribute to weight problems. "

    I am sure if these patients were too thin, the evidence would be used in a similar way - it would suggest anxiety, compulsivness, whatever.

    My guess is that these factors are probably socioeconomic. People with Q fever are more likely to live rurally (and probably work manually) than those with MECFS, which come from all walks. Plus, they may have recently given up a very active lifestyle for a sedentary one. People with psychogenic seizures also tend to come from poorer backgrounds than your average patient.
     
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  10. Dolphin

    Dolphin Senior Member

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    I couldn't fit the full title in the title box.

    Bleijenberg and Knoop could be described as CBT-obsessed psychologists who have published a lot on CFS.

    I don't find this paper that exciting but as I've read it, I'll post some comments.

     
    Last edited: Aug 28, 2015
  11. Dolphin

    Dolphin Senior Member

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    From Introduction:
    One might think from that that not many have CFS after Q fever.
    But in this study they found:
    Admittedly these are Q fever fatigue syndrome patients so one can't make a direct comparison. But the introduction says around 1/5 of those with Q fever have QFS:
     
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  12. Dolphin

    Dolphin Senior Member

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    Can't say I'm a fan of this paper but they do seem to do this right to help ensure that one isn't comparing QFS patients with QFS patients:

     
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  13. Dolphin

    Dolphin Senior Member

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    Ferritin and haemochromatosis

     
  14. Dolphin

    Dolphin Senior Member

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    They divided physical activity into two types both of which are seen as abnormal i.e. everyone by definition was going to have an abnormal activity pattern:
     
  15. Dolphin

    Dolphin Senior Member

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    67 is around pretty standard for CFS patients in these Dutch studies.

    I think a control group had 93 or so by comparison.
     
  16. Dolphin

    Dolphin Senior Member

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    (they don't seem to control for gender)

    But there was no statistical difference in terms of BDI scores >= 4 (26% vs 31%).

    They say the following on this which is a little conciliatory/similar
     
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  17. Dolphin

    Dolphin Senior Member

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    Perhaps not surprising with people like Bleijenberg and Knoop writing it: they push for CBT for QFS even though the evidence they produced doesn't point in that direction:
     
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  18. alex3619

    alex3619 Senior Member

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    Its not really a blame thing at this point, I think. Its more they are fishing for associations. They will then create a story that uses those associations in its explanation ... that is the next step.

    We already know that some biomedical treatments give results much better than CBT/GET, yet they are not claimed as cures. Antivirals do this for subsets with measurable viral titres. Ampligen does this in responders. Ditto Rituximab, though this particular one might turn out to be a cure for a subset. This does not stop the march of babble. They know this.

    One thing to watch out for are inappropriate comparison arms in a trial. They did this in PACE with adaptive pacing, a therapy nobody has used except for them in that one trial. It relies on the confusion with regular pacing to have an impact on people reading the paper or articles about the paper.
     
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  19. jimm

    jimm

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    kejimel conveniently cherry picks evidence to back up his views, check out his preliminary data it using now outdated data on CBT used in fatigue illness and conveniently ignoring the body of work from the Q fever research group done by the now sadly deceased Prof Marmion. Marmion et al had already done lots of preliminary studies finding underlying problems
    one such paper is here:
    http://qjmed.oxfordjournals.org/content/103/11/847
     
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