OK. Lets start with Mats Reimer's critique of the ICC ME and Norway's adoption of it as the criteria of choice:
16 January 2012:
http://translate.googleusercontent....mecfs/&usg=ALkJrhhhwK357Ym3wvWBx9drL_tB7sWWZg
New criteria for ME / CFS
The Directorate of Health emphasizes the ME criteria I think is really good lobbying from representatives of patients for the whole world will not have CFS associated with somatization, or psyche.
Mats Reimer, pediatrician and blogs, Gothenburg
It was with surprise I read that the Health Directorate will now define chronic fatigue syndrome (CFS) for new international consensus criteria. It has translated the article "Myalgic Encephalomyelitis: International Consensus Criteria" into Norwegian.
Consensus sounds good, but this article does not represent a broad consensus among the most active in the research field. It is rather those who argue that CFS is a purely neuro-immune disease, which has been agreed internally by omitting the researchers from the Netherlands and Britain, and perhaps Oslo, with some success working for a biopsychosocial model.
The authors acknowledge standpoint already in the title, which they rather use the term CFS myalgic encephalomyelitis - despite the fact that encephalitis or myelitis has never been demonstrated. In the new criteria they have removed the requirement that symptoms must have been present for six months, and they claim that "no other illnesses have criteria where there is a time requirement of six months to get a diagnosis."
This is not true, whoever leafed in the DSM-4, found that a number of diagnoses have such a requirement for symptoms for at least six months.
CRITERIA. Main criterion is, of course, a disabling fatigue that the authors call "exercise-induced neuro-immune energy failure." They believe that this criterion can be met despite a very average level of activity, if the person was twice energetic to begin with. "An outstanding athlete, for example, a 50 percent reduction in the level of activity before disease onset, but still be more active than a sedentary person."
In addition to the main criterion to ME patients have three neurological symptoms, three immunological / GI / urogenital symptoms and a symptom of a lack of energy production. As neurological symptoms include impaired concentration, difficulty making decisions, difficulty remembering, unsteadiness, pain, altered sleep patterns and several other very common subjective symptoms.
Immune symptoms. Among the "immunological" counting symptoms sore throat, sinusitis, enlarged lymph nodes in the neck and frequent viral infections. Redness of the pharynx and the tonsils are considered as "indicative of immune activation." Hypersensitivity to foods, medicines, smell or chemicals may also be viewed as immunologically. Nausea or bloating are examples of valid gastrointestinal symptoms, and urogenital symptoms include increased urination urgency, frequent urination and nocturia.
By disruption of energy production and transportation counts circulation problems (orthostatic intolerance, palpitations, lightheadedness / dizziness), breathing problems, temperature deviations (low body temperature, sweating episodes, fever, feeling without fever, cold extremities) and to the end 'intolerance to extreme temperatures. " Who has not?
I think almost all general practitioners have seen most bisymptomene in various combinations in patients who are afraid of the symptoms caused by disease, or who are experiencing these very common problems such as difficult to live with. I will in no way trivialize CFS patients real suffering with severe fatigue - I mean just that most of the other symptoms required for diagnosis of ME is very unspecific.
Unconventional. The 26 authors who have agreed, are clinicians, researchers, and a patient. Several of them are retired, some have weird theories and use highly unconventional methods. Kenny Kenny from Belgium believes that CFS is often due to "dysbiosis" in the gut, and treat with antibiotics followed by probiotics. Lillestrom Health Clinic recently went bankrupt since the Board of Health to stop misuse of antibiotics, but it is possible that Kenny is still treating patients in Norway with this method.
John Chia, a specialist in infectious diseases from California, believes that enteroviruses cause CFS. He has healed her son CFS with interferon and herbal preparations. He recommends Equilibrant, a dietary supplement with vitamins and various herbs such as liquorice, shit-take mushrooms and leaves from the olive tree. The Irish professor emeritus Austin Darragh, among much else invented a machine (Vi-Aqua), which is claimed to produce water electromagnetic energy for better crops.
In bad company. Martin Pall, professor emeritus of biochemistry, said to have found a new disease paradigm with the common background of chronic fatigue syndrome, tinnitus, schizophrenia, asthma, and numerous other disorders. Few researchers seem to believe in his theories.
Judy Mikovits is the most famous of the authors. Her discovery that the CFS would be caused by a virus called XMRV, received enormous attention as the results were published in Science. His career came to an abrupt end when she recently was fired and was convicted of theft from his former employer, and Science has retracted the article because XMRV proved to be an artifact.
The Directorate of Health emphasizes the ME criteria I think is really good lobbying by representatives of CFS patients for the whole world will not have CFS associated with somatization, or psyche, and perhaps also one of the authors are Barbara Baumgarten, Austin, chief physician at the ME Centre in Oslo. With some of these authors, she has been in bad company.
Chronicle and debate, Current Medicine 01/2012
What follows is a little harder to follow but that's probably due to Google translation:
28 February 2012:
http://translate.google.com/transla...o/nyheter/helsedirektoratet-avviser-me-press/
Directorate of Health rejects the ME pressure - Health Directorate's emphasis on the international consensus criteria for CFS has been an independent assessment, said the directorate.
The various criteria for the diagnosis of the disease CSF / ME has long been the subject of debate:
Lobbying
The Swedish pediatrician Mats Reimer said in a blog Posts Today's Medicine in the Health Directorate has been subject to lobbying by representatives of the CFS patients.
Reimer writes that he is amazed that the Directorate of Health to define chronic fatigue syndrome (CFS) for new international consensus criteria.
The Directorate of Health emphasizes the ME criteria I think is really good lobbying by representatives of CFS patients for the whole world will not have CFS associated with somatization, or psyche, writes Reimer.
Executive Director Cecilie Daae in the Health Directorate said that the international consensus criteria have been prepared by an independent international expert group.
No part of this
Health Directorate has not had any role in this but have been informed about the work underway by the groups for Norwegian representative, said Daae to Today's Medicine.
National Health Services Research Centre undertook in 2008 a systematic review which, among other things, the various diagnostic systems that have been used or applied were reviewed and vurdert.
I total of 12 diagnostic systems were discussed, but the consensus criteria from 2011 currently being discussed, is not among these 12.
This paper from 2011 does not contain any recommendations for diagnosis, but concludes that there is a need to identify research on validation and applicability, said Daae.
Directorate of Health is in the final stages of preparing a circular to GPs and health and care services in the municipalities and specialist services.
The circular, various diagnostic systems are presented and discussed, including the knowledge base they are based on and evaluation of the applicability in clinical practice, she said.
Development of good diagnostic criteria and applicable diagnostic systems are central to ensuring patients appropriate and timely diagnosis and treatment. Different systems have different focus and provides the opportunity for both under-and over-diagnosis.
Daae shows that one in international research makes use of the so-called Fukuda criteria, Canada-criteria and criteria developed by NICE.
