Anthony Pinching Quotes

[Valentijn]

Anthony Pinching is a immunologist who ran the Royal Cornwall Hospital's ME/CFS clinic. He was a member of BACME, and played a prominent role in getting BPS-style clinics established around Great Britain. He was also a professor at a Cornwall medical college.

Whether infections act simply as a trigger in predisposed individuals or have a specific role in the continuing illness is unclear. There is no consistent evidence of abnormal viral persistence, but non-specific immunological changes, resembling those in acute infections, may persist and be relevant.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

Patients with a history of depression can subsequently develop CFS. However, studies on the clinical features and laboratory findings suggest that they are distinct. Similarly, CFS can usually be distinguished on symptom pattern from somatisation disorder
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

The two widely used sets of criteria for CFS, Centers for Disease Control (CDC)1 and Oxford2 are primarily designed for surveillance and research, and are probably too narrow for clinical use by virtue of exclusions.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

While fatigue may not always be the dominant feature, it is always present, and its characteristics are valuable at diagnosis.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

Diagnosis of CFS rests on the characteristic clinical history. There are no validated laboratory or other tests to confirm it.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

The clinical features may suggest a wide range of differential diagnoses. . . . These can generally be excluded on clinical grounds and simple screening tests. However, over investigation can also be harmful and counterproductive to the managements of these patients, raising inappropriate concerns and causing them to seek abnormal test results to validate their illness.Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

It is helpful to establish with the patient a way of thinking about the illness providing reasonable explanations for distressing symptoms and disability, while not undermining the patient’s ability to recover. This is easier if patients feel they have been listenedd to and believed, and realise that clinicians will be alert to development of new symptoms or signs, rather than dismissing them as part of CFS.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

There is no established drug treatment for CFS, though many have been tried and continue to be studied. Patients may need guidance about claims in the popular press and from other practitioners.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

Many patients attempt too high a level of activity until they relapse, leading to cycles of over and underactivity. Others overcompensate and avoid activity, fearing relapse, but then develop symptoms of deconditioning (cardiovascular and muscular unfitness) or excessive awareness of physiological changes.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

The benefits of graded exercise have been shown by randomised controlled trials.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

Adjustment to the illness, and a behavioural response limiting its impact while maximising the extent and rate of recovery is crucial. As with other illnesses, cognitive behavioural therapy,
tailored to the patient’s needs, can substantially reduce secondary distress and optimise rehabilitation.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

Cognitive behavioural therapy and simple advice (eg. avoiding caffeine and alcohol) can help both sleep and pain management.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

Postural dizziness can improve as cardiovascular fitness improves, and does not require drug treatment.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

Some patients find that certain foods increase gut and other symptoms, but they may need guidance about some more radical dietary interventions suggested by other practitioners.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

There is no clear evidence that dietary supplements with vitamins and minerals, although widely promoted, are necessary or beneficial for most patients.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

Strategies should be geared towards long-term recovery and avoid short-term tactics that inhibit it, such as over or underactivity.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

The essence of treatment is activity management and graded rehabilitation.
Pinching, A. J. (2000) Chronic fatigue syndrome. Prescribers’ Journal, 40, 99–106.

 

[MeSci]

Agree with some; disagree with others.

It seems a tragic omission in view of his specialism (immunology) and public status, that he never apparently picked up on the likelihood of autoimmunity.

I liked him when I had a consultation with him, finding him patient and respectful. My only complaint would be his apparent dismissal of my chemical sensitvity as psychological in origin, although he did not explcitly say so.

 

[peggy-sue]

Why can't "fatigue" be properly described for what it is?

a simple "inability to achieve aerobic metabolism".