Sharon Song

CHRONIC FATIGUE SYNDROME Sociodemographic Subtypes in a Community-Based Sample

Most chronic fatigue syndrome (CFS) studies are based on information about patients from primary or tertiary care settings. These patients might not be typical of patients in the general population. This investigation involved examinations of individuals with CFS from a community-based study. A random sample of 18,675 in Chicago was inter-viewed by telephone. Individuals with chronic fatigue and at least four minor symptoms associated with CFS were given medical and psychiatric examinations. A group of physicians then diagnosed individuals with CFS, who were then subclassified based on three sociodemographic categories—gender, ethnicity, and work status. Sociodemographic subgroups were analyzed amid symptom severity, functional disability, coping, optimism, perceived stress, and psychiatric comorbidity. Women, minorities, and nonworking individuals with CFS reported greater levels of functional disability, symptom severity, and poorer psychosocial functioning than men, Caucasians, and working individuals, suggesting sociodemographic characteristics may be associated with poorer outcomes in urban, community-based samples of CFS individuals.

Chronic fatigue syndrome: occupation, medical utilization, and subtypes in a community-based sample.

Most studies of chronic fatigue syndrome (CFS) have been based on patients recruited from primary or tertiary care settings. Patients from such settings might not be typical of patients in the general population. The present investigation involved examining individuals with CFS from a community-based study. A random sample of 18,675 respondents in Chicago was first interviewed by telephone. A group of individuals with chronic fatigue accompanied by at least four minor symptoms associated with CFS were given medical and psychiatric examinations. From this sample, a physician review group diagnosed individuals with CFS. Those diagnosed with CFS were subclassified based on a variety of categories, including duration of illness, mode of illness onset, and presence or absence of a stressful life event directly preceding onset. In addition, we examined medical utilization among those diagnosed with CFS, as well as whether individuals with CFS were disproportionately represented in health care professions. Important differences emerged on measures of sociodemographics, symptoms, and functional disability. The implications of these findings and others are discussed.

The Relationship Between Ethnicity and Fatigue in a Community-Based Sample

Estimates of fatigue severity vary according to whether participants are recruited from hospital-based tertiary care clinics, primary medical care, or community-based samples. Sampling methodology is a central issue in epidemiological research because differences in utilization and differential access to health care among participants of varying sociodemographic backgrounds have biased earlier prevalence and severity estimates of fatigue. Most existing studies do not employ randomly selected representative samples and do not examine ethnic and other sociodemographic differences. Findings presented herein derive from a community-based study of fatigue severity and prevalence in an ethnically and socioeconomically diverse sample of 28,673 households in Chicago. The study examined sociodemographic differences in fatigue across African American, White, Latino, and Asian American samples according to age, gender, socioeconomic status, marital status, and parental status. Latinos who were female, Latinos who were older, and Latinos of higher socioeconomic status reported the highest relative severity of fatigue. The implications of these findings are discussed.

A population-based study of chronic fatigue syndrome (CFS) experienced in differing patient groups: An effort to replicate Vercoulen et al.'s model of CFS

Background: Vercoulen et al.s (1998) model characterizes patients with chronic fatigue syndrome (CFS) as having insufficient motivation for physical activity or recovery, lacking an internal locus of control, and maintaining a self-defeating preoccupation with symptoms. However, this model has only been tested in a poorly specified group using a single comparison sample. Aims: To investigate whether Vercoulen et al.s model provides an adequate description of CFS in a community-based sample. Method: A community-based sample recruited through telephone interviewing (N = 28,763) produced five groups (CFS, CF-psychiatrically-explained symptoms, CF-medically-unexplained symptoms, CF-substance misuse, and idiopathic CF). The data were analysed using path analysis with the endogenous (dependent) variables, fatigue severity, physical activity, and impairment, were ratio-level measurements and consisted of at least four values. The exogenous (independent) variables except for causal attribution of fatigue were also ratio-level measurements. Results: The current investigation found that the Vercoulen et al. model adequately represented chronic fatigue secondary to psychiatric conditions but not CFS. Conclusions: This finding points to important differences between CFS and psychiatrically-explained chronic fatigue which may have an impact on the development of therapy as well as explanatory models. Declaration of interest: Financial support for this article was provided by the National Institutes of Allergies and Infectious Diseases grant number AI36295. There are no financial relationships that pose a conflict of interest.

Chronic Fatigue Syndrome: Symptom Subtypes in a Community Based Sample

ABSTRACT Most studies of Chronic Fatigue Syndrome (CFS) have been based on patients recruited from primary or tertiary care settings. Patients from such settings might not be typical of patients in the general population. The present investigation involved examining individuals with CFS from a community-based study. A random sample of 18,675 respondents in Chicago were first interviewed by telephone. A group of individuals with chronic fatigue accompanied by at least four Fukuda et al. (1994) symptoms associated with CFS were given medical and psychiatric examinations. From this sample, a physician review group diagnosed individuals with CFS. Those diagnosed with CFS were subclassified based on frequency of symptoms. Important differences emerged on measures of sociodemographics and disability. The implications of these findings and others are discussed.

Fatigue Severity among African Americans: Gender and Age Interactions

The present study investigated the relationship between fatigue, age, and gender in a multiculturally and socioeconomically diverse community-based urban sample. The impact of age and gender on fatigue severity was examined in a group of 3,692 African Americans and then compared to results from 9,717 Caucasians and 3,450 Latinos. Findings indicated that for African Americans, there was a significant gender by age interaction. African American women had significantly higher rates of fatigue when compared to African American men. Older African American men had significantly higher rates of fatigue than younger African American men. However, there was no significant difference in the levels of fatigue reported by younger and older African American women. An age and gender interaction was also present for the Caucasian sample but not for the Latino sample. Findings suggest that age and gender are important in predicting the severity of fatigue in an African American sample.

Expression of midkine in ameloblastomas and its correlation with clinicopathologic parameters

OBJECTIVE Midkine (MK) is a heparin-binding growth factor that is overexpressed in various human cancers. The aim of this study was to investigate the expression of MK in ameloblastomas and correlate the results with clinicopathologic parameters. STUDY DESIGN Cases of ameloblastoma seen between 1999 and 2010 were identified. Clinical information was collected regarding age, gender, race, and location of tumor. Cases were classified as solid/multicystic, unicystic, and peripheral. The expression of midkine was assessed using immunohistochemistry. A significant difference was considered present at P < 0.05. RESULTS A total of 34 cases of ameloblastoma and 4 cases of ameloblastic carcinomas were identified. MK was expressed in 67% of lesions (23.5% weak expression; 14.7% moderate expression; 29.4% strong expression). A significant difference was seen between solid/multicystic and unicystic lesions. CONCLUSIONS MK is expressed in the majority of ameloblastomas, suggesting a role of the protein in the tumors development, progression, and behavior.