Vol 4-1 Research Article

Predictors for Developing Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome following Infectious Mononucleosis

Leonard A Jason1*, Joseph Cotler1, Mohammed F Islam1, Jacob Furst2, Ben Z Katz3

1Center for Community Research, DePaul University, Chicago, IL 60614, USA. Emails: Leonard Jason: ljason@depaul.edu; Joseph Cotler: joey.cotler@gmail.com; Mohammed Islam: mfislam87@gmail.com;

2The College of Computing and Digital Media, DePaul University, Chicago, IL 60614, USA. Email: Jacob Furst:   jfurst@cdm.depaul.edu;

3Northwestern University Feinberg School of Medicine, Department of Pediatrics, Chicago, 60611 USA. Email: Ben Z Katz:   bkatz@northwestern.edu;

Background: About 10% of individuals who contract infectious mononucleosis (IM) have symptoms 6 months later that meet criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).  Our study for the first time examined whether it is possible to predict who will develop ME/CFS following IM.

Methods: We have reported on a prospectively recruited cohort of 4,501 college students, of which 238 (5.3%) developed IM.  Those who developed IM were followed-up at six months to determine whether they recovered or met criteria for ME/CFS. The present study focuses on 48 students who after six months had a diagnosis of ME/CFS, and a matched control group of 58 students who had no further symptoms after their IM. All of these 106 students  had data at baseline (at least 6 weeks prior to the development of IM), when experiencing IM, and 6 months following IM. Of those who did not recover from IM, there were two groups: 30 were classified as ME/CFS and 18 were classified as severe ME/CFS. We measured the results of 7 questionnaires, physical examination findings, the severity of mononucleosis and cytokine analyses at baseline (pre-illness) and at the time of IM.  We examined predictors (e.g., pre-illness variables as well as variables at onset of IM) of  those who developed ME/CFS and severe ME/CFS following IM.

Results: From analyses using receiver operating characteristic statistics, the students who had had severe gastrointestinal symptoms of stomach pain, bloating, and an irritable bowel at baseline  and who also had abnormally low levels of the immune markers IL-13 and/or IL-5 at baseline, as well as severe gastrointestinal symptoms when then contracted IM,  were found to have a nearly 80% chance of having severe ME/CFS persisting six months following IM.

Conclusions: Our findings are consistent with emerging literature that gastrointestinal distress and autonomic symptoms, along with several immune markers, may be implicated in the development of severe ME/CFS.

DOI: 10.29245/2767-5122/2021/1.1129 View / Download Pdf
Vol 3-2 Research Article

The Effects of Caloric Restriction and/or Intermittent Fasting on Bone Health

Connor A. Hernon1,2, Abduallah Elsayed3, Raphael M. Vicente4, Ariane Zamarioli4, Melissa A. Kacena3,5,6, Jonathan W. Lowery1,2,3,5,6

1Division of Biomedical Science, Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA

2Bone & Muscle Research Group, Marian University, Indianapolis, Indiana USA

3Department of Orthopaedic Surgery, Indiana University School of Medicine, Indiana, USA

4Department of Orthopaedics and Anaesthesiology, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil

5Richard L. Roudebush VA Medical Center, IN, USA

6Indiana Center for Musculoskeletal Health, School of Medicine, Indiana University, Indianapolis, Indiana, USA

This mini-review summarizes the available information regarding the impact of caloric restriction (CR) and/or intermittent fasting (IF) on bone health. CR and IF are dietary interventions used in rehabilitative healthcare for augmenting weight loss and also proposed for recovery of conditions such as stroke and heart failure. CR restricts the total number of calories rather than different food groups or periods of eating. In contrast, IF severely restricts caloric intake for a period of time followed by a period of ad libitum intake. Here, we discuss the available information regarding the impact of these rehabilitation diets on bone metabolism, highlighting areas of consistency and discrepancy and suggesting future areas of study to advance the understanding of CR and/or IF on bone health.

DOI: 10.29245/2767-5122/2021/2.1128 View / Download Pdf
Vol 3-2 Research Article

Validation of the Comprehensive Arm Prosthesis and Rehabilitation Outcomes Questionnaire

Kerstin S. Baun1, Nathan T. Kearns2, Jennifer K. Peterson1, John M. Miguelez1

1Clinical Services, Advanced Arm Dynamics, Redondo Beach, CA, USA

2Department of Psychology, University of North Texas, Denton, TX, USA

Purpose: To develop and psychometrically evaluate the Comprehensive Arm Prosthesis and Rehabilitation Outcomes Questionnaire (CAPROQ), a 28-item, self-report measure of three key facets associated with successful rehabilitation (perceived function, satisfaction, and pain) designed specifically for the adult upper limb loss (ULL) population.

Materials and Methods: Using a national sample of adult ULL patients (N=240), factor structure, internal consistency, convergent/concurrent validity, and known group validity of the total CAPROQ score and three subscale scores were evaluated.

Results: Confirmatory factor analysis indicated adequate-to-strong factor loading on each subscale: satisfaction (.623-.913), perceived function (.572-.860) and pain (.422-.834).  Internal consistencies for the total measure and measure subscales were good-to-excellent (.89-.95) and convergent validity indicated moderate-to-strong statistically significant associations between the CAPROQ subscales and relevant measures. Concurrent validity showed moderate associations between CAPROQ total score, prosthetic wear time, and psychosocial adjustment scores. Known group validity indicated significant differences on CAPROQ total score between initial and definitive fitting stages (p=.012).

Conclusion: Psychometric evaluation indicated that the CAPROQ and CAPROQ subscales were structurally sound, internally consistent, and demonstrated convergent validity with currently used assessments of perceived functioning, satisfaction, and pain.  CAPROQ is needed for guiding individual patient care, improving care models and future prosthesis selection and development.

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