BACKGROUND Reports of mild hypocortisolism in chronic fatigue syndrome led us to postulate that low-dose hydrocortisone therapy may be an effective treatment. METHODS In a randomised crossover trial, we screened 218 patients with chronic fatigue. 32 patients met our strict criteria for chronic fatigue syndrome without co-morbid psychiatric disorder. The eligible patients received consecutive ...

All letters are subject to editing and may be shortened. Letters should be sent to the BJGP office by e-mail in the first instance, addressed to [email protected] (please include your postal address). Alternatively, they may be sent by post (please use double spacing and, if possible, include a MS Word or plain text version on an IBM PC-formatted disk). We regret that we cannot notify authors...

Chronic fatigue is an important contributor to impaired health-related quality of life in Ehlers-Danlos syndrome. There is overlap in the symptoms and findings of EDS and chronic fatigue syndrome. A proportion of those with CFS likely have EDS that has not been identified. The evaluation of chronic fatigue in EDS needs to include a careful clinical examination and laboratory testing to exclude ...

The chronic fatigue syndrome is characterised by a fatigue that is disproportionate to the intensity of effort that is undertaken, has persisted for 6 months or longer, and has no obvious cause. Unless there has been a long period of patient- or physician-imposed inactivity, objective data may show little reduction in muscle strength or peak aerobic power, but the affected individual avoids hea...

BACKGROUND Chronic fatigue syndrome (CFS) is a controversial disorder with different case definitions, aetiological models and proposed treatments. An epidemiological approach is likely to bring some clarity to the field. AIM The aim of this article is to review the literature on the epidemiology of fatigue, chronic fatigue and CFS. METHOD A literature search was conducted using the databas...

Numerous studies with fatigue as a prominent feature have been described in the literature since time immemorial. Yet CFS continues to be relegated to the grab bag of vague and poorly understood syndromes that do not fit the traditional allopathic model of illness with specific etiology and pathogenesis. Despite our skepticism (and perhaps ignorance), this condition, with its uncertain etiology...

AIMS To review studies evaluating the treatment of chronic fatigue and chronic fatigue syndrome, to describe predictors of response to treatment and to discuss the role of the occupational health physician. METHODS A literature search was carried out using Medline and PsychInfo. RESULTS Studies evaluating cognitive behaviour therapy, graded exercise therapy, pharmacological interventions (e...

p. 68-69. Fletcher, M.A., Maher, K.J. & Klimas, N.G. 2002. Natural killer cell function in chronic fatigue syndrome. Clinic. & Appl. Immunol. Rev., 2, 129-139. Fletcher, M.A., Zeng, X.R., Barnes, Z., Levis, S. & Klimas, N.G. 2009. Plasma cytokines in women with chronic fatigue syndrome. Jl. Transl. Med., 7:96 doi:10.1186/1479-5876-7-96 Flett, G.L., Besser, A., Hewitt, P.L. & Davis, R.A. 2007. P...

1. Urisman A, Molinaro RJ, Fischer N, Plummer SJ, Casey G, Klein EA, et al. Identifi cation of a novel gammaretrovirus in prostate tumors of patients homozygous for R462Q RNASEL variant. PLoS Pathog. 2006;2:e25. DOI: 10.1371/journal. ppat.0020025 2. Lombardi VC, Ruscetti FW, Das GJ, Pfost MA, Hagen KS, Peterson DL, et al. Detection of an infectious retrovirus, XMRV, in blood cells of patients w...