scholarly journals Use of 1-MNA to Improve Exercise Tolerance and Fatigue in Patients After COVID-19

2021 ◽  
Author(s):  
Michal Chudzik ◽  
Joanna Kapusta ◽  
Monika Burzynska
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Phase 1 ◽  
Chronic Fatigue ◽  
Walk Test ◽  
Fatigue Syndrome ◽  
Improve Exercise Tolerance ◽  
Severe Fatigue ◽  
Phase 0 ◽  
6 Minute Walk Test ◽  
Minute Walk

Abstract Background: Coronavirus disease 2019 (COVID-19) is a serious respiratory disease that results from infection with a newly discovered coronavirus (SARS-COV-2). Unfortunately, COVID-19 is not only a short-term infection but that patients (pts) recovering from SARS-CoV2 infection complain of persisting symptoms including: fatigue, diffuse myalgia and weakness, which may lead to chronic fatigue syndrome. There is currently no evidence that nutritional supplements and/or physical exercise can assist in the recovery of pts with chronic fatigue syndrome. 1-Methylnicotinamide (1-MNA) is an endogenic substance that is produced in the liver when nicotinic acid is metabolized. 1-MNA demonstrates anti-inflammatory and anti-thrombotic properties. Therefore, we investigated whether 1-MNA supplements could improve exercise tolerance and decrease fatigue among patients recovering from SARS-CoV-2. Methods: The study population was composed of pts after COVID-19, expressing subjective feelings of limited tolerance to exercise. The selected pts were randomized into two groups: GrM0 without supplementation; GrM1 with 1-MNA supplementation. At the beginning of the study (Phase 0), in both groups, a 6-minute walk test (6MWT) was carried out and fa-tigue assessment with Fatigue Severity Scale (FSS) was performed. After 1 month (Phase 1), a follow up FSS and 6MWT once more were performed in both groups. Results: A significant improvement in the mean distance covered in the 6MWT was noted among the pts in GrM1, compared to those in GrM0. We also noted that in GrM1 the 6MWT distance was significantly higher after 1 month of supplementation with 1-MNA, compared to the beginning of the study (515.18 m in Phase 0 vs 557.8m in Phase 1; p = 0.000034). In GrM1, significantly more pts improved their distance in the 6MWT (23 out of 25 pts, equal to 92%), by a mean of 47 meters, compared to GrM0 (15 of 25 pts, equal to 60%) (p = 0.0061). After one month, significantly more patients in the group without 1-MNA had severe fatigue (FSS ≥ 4) compared to the group with supplementation (GrM1 = 5 pts (20%) vs GrM0 = 14pts (56%); p = 0.008). Conclusions: 1-MNA supplementation significantly improved physical performance in a 6-minute walk test and reduced the percentage of patients with severe fatigue after COVID-19. The comprehensive action of 1-MNA, including anti-inflammatory and anticoagulant effects, as well as activation of the SIRT1 enzyme, may be beneficial for the recovery of patients with persistent symptoms of fatigue and low tolerance to exercise after COVID-19. Keywords: COVID-19, MNA, chronic fatigue syndrome, post-COVID syndrome

Prevalence of ADHD in chronic fatigue syndrome

2011 ◽  
Vol 26 (S2) ◽  
pp. 1574-1574
Author(s):  
N. Sáez Francàs ◽  
J. Alegre ◽  
N. Calvo Piñero ◽  
J.A. Ramos Quiroga ◽  
E. Ruiz ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Rating Scale ◽  
Chronic Fatigue ◽  
Diagnostic Interview ◽  
Initial Sample ◽  
Hyperactivity Disorder ◽  
Fatigue Syndrome ◽  
Severe Fatigue ◽  
Severe Psychopathology ◽  
The Relationship

IntroductionChronic Fatigue Syndrome (CFS) is characterized by severe fatigue associated with pain, sleep disturbance, attentional impairment and headaches. Evidence points towards a prominent role for Central Nervous System in its pathogenesis, and alterations in serotoninergic and dopaminergic neurotransmission have been described.Attention-deficit Hyperactivity Disorder (ADHD) courses with inattention, impulsivity, and hyperactivity. It affects children and persists into adulthood in 50% of patients. Dopamine transporter abnormalities lead to impaired neurotransmission of catecholaminergic frontal-subcortical-cerebellar circuits.ObjectivesTo describe the prevalence of ADHD in a sample of CFS patients, and the clinical implications of the association.AimsTo study the relationship between CFS and ADHD.MethodsThe initial sample consisted of 142 patients, of whom 9 were excluded because of severe psychopathology or incomplete evaluation. All the patients (age 49 ± 87; 94,7 women) received CFS diagnoses according to Fukuda criteria. ADHD was assessed with a diagnostic interview (CAADID), ADHD Rating Scale and the scale WURS, for childhood diagnose. The scales FIS-40, HAD, STAI and Pluthik Risk of Suicide (RS) were administrated.Results38 patients (28,8%) were diagnosed of childhood ADHD (4 combined, 22 hyperactive-impulsive, 12 inattentive) and persisted into adulthood in 28 (21,1%; 5 combined, 4 hyperactive-impulsive, 19 inattentive). There were no differences in Fukuda criteria profile and FIS-40 between groups. ADHD patients scored higher in HAD-Anxiety (9,88 ± 4,82 vs. 12,57 ± 3,49; p = 0,007), HAD-Depression (9,69 ± 4,84 vs. 12,04 ± 4,53; p = 0,023), STAI-E (30,55 ± 14,53 vs. 38,41 ± 11,35; p = 0,012), and RS (6,13 ± 3,48 vs. 8,49 ± 3,07; p = 0,002).ConclusionsADHD is frequent in CFS patients and it is associated with more severe clinical profile.

scholarly journals Chronic fatigue syndrome in the routine hematology practice

2020 ◽  
Vol 11 (4) ◽  
pp. 47-54
Author(s):  
Vsevolod G. V.G.Potapenko ◽  
Marina F. Ballyuzek
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Clinical Signs ◽  
Chronic Fatigue ◽  
Deficiency Anemia ◽  
Fatigue Syndrome ◽  
Severe Fatigue ◽  
Iron Deficient ◽  
Initial Symptoms ◽  
Median Level ◽  
The Difference

Purpose. Presentation of clinical signs and laboratory profiles of the patients with chronic fatigue syndrome, and comparison of their symptoms with those of the patients with iron deficiency anemia. Materials and methods. Retrospective analysis of the patients symptoms referred to the hematologist outpatient clinic during the period between January 2016 and December 2018. Results. There were 560 patients(162 males and 398 females) referred for a primary consultation by a hematologist. Median age was 52.5 (1894) years. The unexplained fatigue was reported by 27 (4.8%) patients (1 male and 26 females), median age 41 (2466) years. Diagnosis chronic fatigue syndrome (CFS) was confirmed based on the criteria in 17 (63%) patients. 10 patients (47%) with symptoms partially meeting the criteria were diagnosed idiopathic fatigue syndrome (SIF). Half of the patients connected the onset of the diseases with emotional trauma (family issues etc.). The prevailing complaints (30%) were represented by: prolonged fatigue, mild memory impairment and distraction, arthralgia and insomnia. The most frequent reason to see a hematologist was fatigue and borderline changes in the blood tests. Five patients with CFS and 2 patients with SIF were known to have previously diagnosed iron deficient anemia (IDA). Median level of hemoglobin in the patients with severe fatigue and IDA was 10.7 (8.411.7) g/dl. Median follow up duration was 28 (640) months. In the observed group (n = 23) 17% of the patients (n = 4) showed spontaneous improvement. The rest of the patients had reported no changes. The comparison group (n = 64) included the patients with IDA. Most of them (n = 38) did not report fatigue as their initial symptoms (median level of hemoglobin was 9.35 (5.511.9) g/dl). Twenty six patients reported fatigue; median level of hemoglobin was 8.15 (5.911.7) g/dl. The difference between the hemoglobin levels in two groups was significant (р 0.05). However, there was no correlation between the level of hemoglobin and fatigue in the patients with CFS and SIF. The correlation was found in the patients with CFS and SIF between fatigue and patients perception. Conclusion. The main symptoms accompanying CFS are fatigue and other non-specific symptoms which are often related to patients emotional status. Considering CFS as a differential diagnosis when dealing with fatigue is essential.

scholarly journals Understanding Muscle Dysfunction in Chronic Fatigue Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Gina Rutherford ◽  
Philip Manning ◽  
Julia L. Newton
Keyword(s):  
Skeletal Muscle ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Muscle Dysfunction ◽  
Biochemical Abnormality ◽  
Fatigue Syndrome ◽  
Acid Clearance ◽  
Severe Fatigue ◽  
Show Evidence ◽  
Accompanying Symptoms

Introduction. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a debilitating disorder of unknown aetiology, characterised by severe disabling fatigue in the absence of alternative diagnosis. Historically, there has been a tendency to draw psychological explanations for the origin of fatigue; however, this model is at odds with findings that fatigue and accompanying symptoms may be explained by central and peripheral pathophysiological mechanisms, including effects of the immune, oxidative, mitochondrial, and neuronal pathways. For example, patient descriptions of their fatigue regularly cite difficulty in maintaining muscle activity due to perceived lack of energy. This narrative review examined the literature for evidence of biochemical dysfunction in CFS/ME at the skeletal muscle level.Methods.Literature was examined following searches of PUB MED, MEDLINE, and Google Scholar, using key words such as CFS/ME, immune, autoimmune, mitochondria, muscle, and acidosis.Results. Studies show evidence for skeletal muscle biochemical abnormality in CFS/ME patients, particularly in relation to bioenergetic dysfunction.Discussion.Bioenergetic muscle dysfunction is evident in CFS/ME, with a tendency towards an overutilisation of the lactate dehydrogenase pathway following low-level exercise, in addition to slowed acid clearance after exercise. Potentially, these abnormalities may lead to the perception of severe fatigue in CFS/ME.

scholarly journals Fatigue Scales and Chronic Fatigue Syndrome: Issues of Sensitivity and Specificity

2011 ◽  
Vol 31 (1) ◽  
Author(s):  
Leonard Jason ◽  
Jason Meredyth Evans ◽  
Molly Brown ◽  
Nicole Porter ◽  
Abigail Brown ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
Chronic Fatigue ◽  
Roc Curve Analysis ◽  
Fatigue Syndrome ◽  
Specificity And Sensitivity ◽  
Severe Fatigue ◽  
Fatigue Severity ◽  
Extreme Care

<p>Few studies have explored issues of sensitivity and specificity for using the fatigue construct to identify patients meeting chronic fatigue syndrome (CFS) criteria. In this article, we examine the sensitivity and specificity of several fatigue scales that have attempted to define severe fatigue within CFS. Using Receiver Operating Characteristic (ROC) curve analysis, we found most scales and sub-scales had either significant specificity and/or sensitivity problems. However, the post-exertional subscale of the ME/CFS Fatigue Types Questionnaire (Jason, Jessen, et al., 2009) was the most promising in terms of specificity and sensitivity. Among the more traditional fatigue scales, Krupp, LaRocca, Muir-Nash, and Steinberg’s (1989) Fatigue Severity Scale had the best ability to differentiate CFS from healthy controls. Selecting questions, scales and cut off points to measure fatigue must be done with extreme care in order to successfully identify CFS cases.</p>

Subjective Reduction in Symptoms of Chronic Fatigue Syndrome Following Long-Term Treatment with a Porcine Liver Extract: A Phase 1 Trial

1994 ◽  
Vol 18 (Supplement_1) ◽  
pp. S114-S114
Author(s):  
Thomas Steinbach ◽  
William Hermann ◽  
Carl Lawyer ◽  
David Montefiore ◽  
Sudhakar Wagle ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Liver Extract ◽  
Phase 1 ◽  
Chronic Fatigue ◽  
Term Treatment ◽  
Porcine Liver ◽  
Fatigue Syndrome ◽  
Long Term Treatment ◽  
Subjective Reduction

scholarly journals The course of severe chronic fatigue syndrome in childhood

2000 ◽  
Vol 93 (3) ◽  
pp. 129-134 ◽  
Author(s):  
L Rangel ◽  
M E Garralda ◽  
M Levin ◽  
H Roberts
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Bed Rest ◽  
Chronic Fatigue ◽  
Prognostic Indicators ◽  
Illness Onset ◽  
Fatigue Syndrome ◽  
School Absence ◽  
Duration Of Illness ◽  
Severe Fatigue ◽  
Recovery Assessment

Summary Little has been reported on prognostic indicators in children with chronic fatigue syndrome (CFS). We used interviews with children and parents, a mean of 45.5 months after illness onset, to follow up 25 cases of CFS referred to tertiary paediatric psychiatric clinics. At its worst, the illness had been markedly handicapping (prolonged bed-rest and school absence in two-thirds); mean time out of school was one academic year. Two-thirds, however, had recovered and resumed normal activities—mean duration of illness to recovery/assessment 38 months—and none had developed other medical conditions. Recovery was associated with specific physical triggers to the illness, with start of illness in the autumn school term and with higher socioeconomic status. Severe fatigue states in children can cause serious and longlasting handicap but most children recover.

scholarly journals Idiopathic combined adrenocorticotropin and growth hormone deficiency mimicking chronic fatigue syndrome

2021 ◽  
Vol 14 (10) ◽  
pp. e244861
Author(s):  
Kazuki Tokumasu ◽  
Kanako Ochi ◽  
Fumio Otsuka
Keyword(s):  
Growth Hormone ◽  
Chronic Fatigue Syndrome ◽  
Gh Deficiency ◽  
Chronic Fatigue ◽  
Hormone Deficiency ◽  
Fatigue Syndrome ◽  
General Fatigue ◽  
Severe Fatigue ◽  
Anterior Pituitary Function ◽  
Combined Deficiency

A 42-year-old man who had suffered from severe fatigue for 5 years was diagnosed as having chronic fatigue syndrome (CFS) and fibromyalgia. Endocrinological workup using combined anterior pituitary function tests showed that the patient had adrenocorticotropin hormone (ACTH) deficiency, with a normal pituitary MRI. Treatment with a physiologic dose of oral hydrocortisone replacement physically ameliorated his general fatigue. A secondary workup using a growth hormone-releasing peptide-2 test revealed that he also had growth hormone (GH) deficiency, and GH replacement therapy was started. His muscle pain and depression were improved by the therapy. Here, we present a rare case of combined deficiency of ACTH and GH in a middle-aged man with severe general fatigue. This case report aims to raise awareness of combined deficiency of ACTH and GH as a differential diagnosis of CFS and its mimics.

Abstract 15652: Cell Therapy in Heart Failure With Preserved Ejection Fraction (CELLpEF)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Bojan VRTOVEC ◽  
Sabina Frljak ◽  
Gregor Poglajen ◽  
Gregor Zemljic ◽  
Andraz Cerar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cell Therapy ◽  
Phase 1 ◽  
Preserved Ejection Fraction ◽  
Walk Test ◽  
Phase 2 ◽  
Systolic Strain ◽  
Test Distance ◽  
6 Minute Walk Test ◽  
Minute Walk

Introduction: Previous studies have demonstrated that cell therapy may improve diastolic parameters in heart failure. Hypothesis: We sought to investigate the effects of transendocardial CD34 + cell therapy in patients with heart failure with preserved ejection fraction (HFpEF). Methods: In a prospective crossover study, we enrolled 30 patients with HFpEF (LVEF>50%, E/e'>15, NT-proBNP >300 pg/ml). In Phase 1, patients were treated with stable medical therapy for 6 months. Thereafter, all patients underwent transendocardial CD34 + cell transplantation. They received bone marrow stimulation with filgrastim (10 mcg/kg, 5 days); CD34 + cells were collected by apheresis. We performed electroanatomical mapping of the left ventricle, and injected the cells transendocardialy in the areas of local diastolic dysfunction (80 million CD34 + cells divided into 20 injections). Patients were followed for 6 months after the procedure (Phase 2). Results: Our cohort included 23 male and 7 female patients aged 62±10 years, with LVEF of 58.7±7.3%, creatinine of 93±35 μmol/L, and bilirubin of 14.3±6.8 μmol/L. In Phase 1 (medical therapy), we found no change in E/e' (from 18.0±3.5 to 17.4±3.0, P=0.97), global systolic strain (from -12.5±2.4% to -12.8±2.6%, P=0.77), NT-proBNP levels (from 1463±1247 pg/mL to 1298±931 pg/mL, P=0.31), or 6-minute walk test distance (from 391±75 m to 402±93 m, P=0.42). In contrast, in Phase 2 (cell therapy), we found a significant improvement in E/e' (from 17.4±3.0 to 11.9±2.6, P=<0.0001), a decrease in NT-proBNP levels (from 1298±931 pg/ml to 887±809 pg/ml, P=0.02), and an improvement in 6-minute walk test distance (from 402±93 m to 438±72 m, P=0.02). Although global systolic strain did not change significantly in Phase 2 (from -12.8±2.6% to -13.8±2.7%, P=0.36), we found a significant improvement of local systolic strain in myocardial segments that were injected with stem cells (-3.4±6.8%, P=0.005). Conclusion: In patients with HFpEF, transendocardial CD34 + cell therapy appears to be associated with improved left ventricular diastolic parameters, better exercise capacity, a decrease in NT-proBNP levels, and improved local systolic strain at cell injection sites.

scholarly journals The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Current Evidence and Potential Therapeutic Applications

2021 ◽  
Vol 10 (21) ◽  
pp. 5077
Author(s):  
Angelica Varesi ◽  
Undine-Sophie Deumer ◽  
Sanjana Ananth ◽  
Giovanni Ricevuti
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Gut Microbiota ◽  
Therapeutic Potential ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Current Evidence ◽  
Fatigue Syndrome ◽  
Severe Fatigue ◽  
Irritable Bowel

The well-known symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) are chronic pain, cognitive dysfunction, post-exertional malaise and severe fatigue. Another class of symptoms commonly reported in the context of ME/CFS are gastrointestinal (GI) problems. These may occur due to comorbidities such as Crohn’s disease or irritable bowel syndrome (IBS), or as a symptom of ME/CFS itself due to an interruption of the complex interplay between the gut microbiota (GM) and the host GI tract. An altered composition and overall decrease in diversity of GM has been observed in ME/CFS cases compared to controls. In this review, we reflect on genetics, infections, and other influences that may factor into the alterations seen in the GM of ME/CFS individuals, we discuss consequences arising from these changes, and we contemplate the therapeutic potential of treating the gut to alleviate ME/CFS symptoms holistically.

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