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Review of ME/CFS: an evidence-based approach to diagnosis and management by clinicians.

Kyla

ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ
Messages
721
Location
Canada
http://www.ncbi.nlm.nih.gov/pubmed/26613325

Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians.
Bested AC, Marshall LM.
Abstract
This review was written from the viewpoint of the treating clinician to educate health care professionals and the public about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). It includes: the clinical definition of ME/CFS with emphasis on how to diagnose ME/CFS; the etiology, pathophysiology, management approach, long-term prognosis and economic cost of ME/CFS. After reading this review, you will be better able to diagnose and treat your patients with ME/CFS using the tools and information provided. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, chronic medical condition characterized by symptom clusters that include: pathological fatigue and malaise that is worse after exertion, cognitive dysfunction, immune dysfunction, unrefreshing sleep, pain, autonomic dysfunction, neuroendocrine and immune symptoms. ME/CFS is common, often severely disabling and costly. The Institute of Medicine (IOM) reviewed the ME/CFS literature and estimates that between 836,000 and 2.5 million Americans have ME/CFS at a cost of between 17 and 24 billion dollars annually in the US. The IOM suggested a new name for ME/CFS and called it Systemic Exertion Intolerance Disease (SEID). SEID's diagnostic criteria are less specific and do not exclude psychiatric disorders in the criteria. The 2010 Canadian Community Health Survey discovered that 29% of patients with ME/CFS had unmet health care needs and 20% had food insecurity - lack of access to sufficient healthy foods. ME/CFS can be severely disabling and cause patients to be bedridden. Yet most patients (80%) struggle to get a diagnosis because doctors have not been taught how to diagnose or treat ME/CFS in medical schools or in their post-graduate educational training. Consequently, the patients with ME/CFS suffer. They are not diagnosed with ME/CFS and are not treated accordingly. Instead of compassionate care from their doctors, they are often ridiculed by the very people from whom they seek help. The precise etiology of ME/CFS remains unknown, but recent advances and research discoveries are beginning to shed light on the enigma of this disease including the following contributors: infectious, genetic, immune, cognitive including sleep, metabolic and biochemical abnormalities. Management of patients with ME/CFS is supportive symptomatic treatment with a patient centered care approach that begins with the symptoms that are most troublesome for the patient. Pacing of activities with strategic rest periods is, in our opinion, the most important coping strategy patients can learn to better manage their illness and stop their post-exertional fatigue and malaise. Pacing allows patients to regain the ability to plan activities and begin to make slow incremental improvements in functionality.

PMID:

26613325

[PubMed - as supplied by publisher]
 

Kyla

ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ
Messages
721
Location
Canada
Oops. I think this may already have another thread.
Not sure how to delete
 

Kati

Patient in training
Messages
5,497
Management of patients with ME/CFS is supportive symptomatic treatment with a patient centered care approach

Supportive symptomatic treatment. This is basically palliative care/behavioral medicine. Got orthostatic intolerance? here, try this electrolyte drink... (We don't do IV here because the government doesn't think you are worthy of them)

Cognitive dysfunction? Try meditation. And so on.

'patient centered care approach'? What does that even mean? Institutions that are self-proclaimed as patient-centered care are quickly retreating back when the patient actually asks for science-based treatments, and access to off-labeled treatments.

Essentially all that is described here is education program which is the other way to say CBT and pacing to regain abilities to plan activities and begin to make slow incremental improvement to functionality is the other way to say 'rehab' or GET.

Nothing new here, extremely conservative.

Published in 'Environmental medicine'. Why branding this disease as an environmental disease? Global warming anyone? we caught this from our environment? Then why is HIV/AIDs not an environemntal disease? MS? Alzeimer? Cancer?