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[Zac]

Source: http://www.meassocia....org.uk/?p=7173

From The Journal of Internal Medicine, July 2011 (manuscript accepted 15 July 2011 and published online on 20 July 2011)

Myalgic Encephalomyelitis: International Consensus Criteria

Abstract

The label “chronic fatigue syndrome” (CFS) has persisted for many years because of lack of knowledge of the etiological agents and of the disease process. In view of more recent research and clinical experience that strongly point to widespread inflammation and multisystemic neuropathology, it is more appropriate and correct to use the term “myalgic encephalomyelitis”(ME) because it indicates an underlying pathophysiology. It is also consistent with the neurological classification of ME in the World Health Organization’s International Classification of Diseases (ICD G93.3). Consequently, an International Consensus Panel consisting of clinicians, researchers, teaching faculty and an independent patient advocate was formed with the purpose of developing criteria based on current knowledge. Thirteen countries and a wide range of specialties were represented. Collectively, members have approximately 400 years of both clinical and teaching experience, authored hundreds of peer reviewed publications, diagnosed or treated approximately 50,000 ME patients, and several members coauthored previous criteria. The expertise and experience of the panel members as well as PubMed and other medical sources were utilized in a progression of suggestions/drafts/reviews/revisions. The authors, free of any sponsoring organization, achieved 100% consensus through a Delphi type process.

The scope of this paper is limited to criteria of ME and their application. Accordingly, the criteria reflect the complex symptomatology. Operational notes enhance clarity and specificity by providing guidance in the expression and interpretation of symptoms. Clinical and research application guidelines promote optimal recognition of ME by primary physicians and other health care providers, improve consistency of diagnoses in adult and paediatric patients internationally, and facilitate clearer identification of patients for research studies.

Introduction

Myalgic encephalomyelitis (ME), also referred to in the literature as chronic fatigue syndrome (CFS), is a complex disease involving profound dysregulation of the central nervous system (CNS) [1-3] and immune system [4-8], dysfunction of cellular energy metabolism and ion transport [9-11], and cardiovascular abnormalities [12-14]. The underlying pathophysiology produces measurable abnormalities in physical and cognitive function and provides a basis for understanding the symptomology. Thus, the development of International Consensus Criteria that incorporate current knowledge should advance the understanding of ME by health practitioners, and benefit both the physician and patient in the clinical setting as well as clinical researchers.

The problem with broadly inclusive criteria [15, 16] is that they do not select homogeneous sets of patients. The Centers for Disease Control prevalence estimates increased tenfold from 0.24% using the Fukuda criteria [17] to 2.54% using the Reeves empirical criteria [16]. Jason et al. [18] suggest there are flaws in Reeves’ methodology because it is possible to meet the empirical criteria for ME without having any physical symptoms and it does not discriminate ME/CFS patients from those with Major Depressive Disorder. Patient sets that include people who do not have the disease lead to biased research findings, inappropriate treatments, and waste scarce research funds [19].

Some symptoms of the Fukuda criteria overlap with depression whereas the Canadian Consensus Criteria [20] differentiate ME patients from those who are depressed and identify patients who are more physically debilitated and have greater physical and cognitive functional impairments [21].




Read more: http://www.meassocia....org.uk/?p=7173

[enrica2010]

Sarebbero il consenso canadese "aggiornato"?
ottimo!
Tra i dottori menzionati all'inizio dell'abstract c'è pure la dott.ssa Nicoletta Carlo Stella di Pavia (come medico indipendente); mentre, alla fine, nella lista di medici il primo è Tirelli :
speriamo che l'Italia si smuova e, finalmente, si accettino dei criteri per fare diagnosi!

[Zac]

Tirelli è nella Bibliografia, non nei collaboratori del Consensum.
Non dimentichiamoci però che è in un gruppo Europeo, stimoliamo quindi la sua associazione per passare dai pensieri alle azioni, ai fatti, la Carlo Stella può ben far poco, se non visitare i pazienti e scoprire troppe errate diagnosi

[enrica2010]

Capito ...!
ma dài, qualcosa in pochi anni si smuoverà!vuoi che continuino a negare la possibilità di fare diagnosi e le evidenze dei test!ieri leggevo il "Nightingale" di Hyde; quei test sono davvero i migliori, quelli cercati da un esperto col cuore in mano, dopo 20 anni di studi..