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A V Plioplys

Publications and source records attributed to A V Plioplys.

At least 19 recordsLinked to original sources
PubMed1999

A community-based study of chronic fatigue syndrome.

BACKGROUND: Most previous estimates of the prevalence of chronic fatigue syndrome (CFS) have derived largely from treated populations, and have been biased by differential access to health care treatment linked with sex, ethnic identification, and socioeconomic status. OBJECTIVE: To assess the point prevalence of CFS in an ethnically diverse random community sample. DESIGN AND PARTICIPANTS: A sample of 28,673 adults in Chicago, Ill, was screened by telephone, and those with CFS-like symptoms were medically evaluated. MAIN OUTCOME MEASURES AND ANALYSES: Self-report questionnaires, psychiatric evaluations, and complete medical examinations with laboratory testing were used to diagnose patients with CFS. Univariate and multivariate statistical techniques were used to delineate the overall rate of CFS in this population, and its relative prevalence was subcategorized by sex, ethnic identification, age, and socioeconomic status. RESULTS: There was a 65.1% completion rate for the telephone interviews during the first phase of the study. Findings indicated that CFS occurs in about 0.42% (95% confidence interval, 0.29%-0.56%) of this random community-based sample. The highest levels of CFS were consistently found among women, minority groups, and persons with lower levels of education and occupational status. CONCLUSIONS: Chronic fatigue syndrome is a common chronic health condition, especially for women, occurring across ethnic groups. Earlier findings suggesting that CFS is a syndrome primarily affecting white, middle-class patients were not supported by our findings.

Adult↗
PubMed1998

Estimating the prevalence of chronic fatigue syndrome among nurses.

The present study assessed the prevalence of chronic fatigue syndrome (CFS) in a sample of nurses. There is a paucity of studies on the prevalence of CFS in healthcare professionals. Two samples of nurses were recruited through mailed questionnaires. Data were collected on demographic characteristics and symptoms. In addition from the sample, those nurses with CFS-like symptoms were more comprehensively evaluated using a structured clinical interview and reviewing their medical records. A physician review team estimated the prevalence of CFS to be 1,088 per 100,000. These findings suggest that nurses might represent a high-risk group for this illness, possibly due to occupational stressors such as exposure to viruses in the work setting, stressful shift work that is disruptive to biologic rhythms, or to other possible stressors in the work settings (e.g., accidents).

Fatigue Syndrome, Chronic↗
PubMed1998

Survival rates among children with severe neurologic disabilities.

BACKGROUND: This study was done to determine survival rates in subpopulations of severely neurologically disabled children who reside in pediatric skilled nursing facilities and to compare these survival rates with those in previously published studies. METHODS: Data were collected at three pediatric skilled nursing facilities over the 1986 to 1996 decade. The total study population numbered 447. We studied in detail six groups of the most severely disabled children and correlated their survival rates with clinical parameters and the presence of other significant diseases. RESULTS: The survival rates in our six groups of severely disabled children were significantly better than those previously reported. In group 1, our 8-year survival rate was 66%, as compared with 5% in the previous study. In group 2, our 8-year survival rate was 89%, versus 22% in the previous study. We obtained better survival rates in all six groups studied, irrespective of the analysis including children less than 1 year old, between 1 year and 15 years old, or more than 15 years old. The most significant determinant for reduced survival was the presence of other significant diseases. Those with other significant diseases had a 10-year survival rate of 45%, whereas those who were relatively healthy had a survival rate of 90%. Patients who received gastrostomy tube feedings had a better 10-year survival rate than those fed by nasogastric tube (78% vs 41%). This difference was independent of the presence of other significant medical diseases. CONCLUSIONS: Our results show substantially better survival rates than those previously reported. These improved results are most likely related to much more intense medical management of severely disabled children in skilled nursing facilities than at home or in other residential settings. Our study also showed a significantly better survival rate for those fed by gastrostomy tube as compared with nasogastric tube.

Adolescent↗
PubMed1998

Intravenous immunoglobulin treatment of children with autism.

Since autism has been associated with immunologic abnormalities suggesting an autoimmune cause of autistic symptoms in a subset of patients, this study was undertaken to investigate whether intravenous immunoglobulin (i.v.Ig) would improve autistic symptoms. Ten autistic children with immunologic abnormalities, demonstrated on blood tests, were enrolled in this study. Their ages ranged from 4 to 17 years, with two girls and eight boys. Eight children (1 female and 7 male) historically had undergone autistic regression. Intravenous immunoglobulin, 200 to 400 mg/kg, was administered every 6 weeks for an intended treatment program of four infusions. In five children, there was no detectable change in behavior during the treatment program. In four children, there was a mild improvement noted in attention span and hyperactivity. In none of these children did the parents feel that the improvement was sufficient to warrant further continuation of the infusions beyond the termination of the program. Only in one child was there a very significant improvement, with almost total amelioration of autistic symptoms over the time period of the four infusions. Once the treatment program was completed, this child gradually deteriorated over a 5-month time period and fully reverted to his previous autistic state. In this treatment program, five children had no response to intravenous immunoglobulin. In the four children who showed mild improvements, those improvements may simply have been due to nonspecific effects of physician intervention and parental expectation (ie, placebo effect). However, in one child there was a very significant amelioration of autistic symptoms. There were no distinguishing historic or laboratory features in this child who improved. Given a positive response rate of only 10% in this study, along with the high economic costs of the immunologic evaluations and the intravenous immunoglobulin treatments, the use of intravenous immunoglobulin to treat autistic children should be undertaken only with great caution, and only under formal research protocols.

Adolescent↗
PubMed1997

Meeting the frustrations of chronic fatigue syndrome.

Patients face long-term disability, a variable prognosis, and too often, skeptical or misinformed doctors. Physicians lack laboratory markers or definitive treatment. Nevertheless, the diagnosis can be made with confidence by applying established diagnostic criteria- and selected laboratory studies to exclude other disorders-while symptomatic medication can provide support until recovery begins.

Adult↗
PubMed1997

Amantadine and L-carnitine treatment of Chronic Fatigue Syndrome.

Carnitine is essential for mitochondrial energy production. Disturbance in mitochondrial function may contribute to or cause the fatigue seen in Chronic Fatigue Syndrome (CFS) patients. Previous investigations have reported decreased carnitine levels in CFS. Orally administered L-carnitine is an effective medicine in treating the fatigue seen in a number of chronic neurologic diseases. Amantadine is one of the most effective medicines for treating the fatigue seen in multiple sclerosis patients. Isolated reports suggest that it may also be effective in treating CFS patients. Formal investigations of the use of L-carnitine and amantadine for treating CFS have not been previously reported. We treated 30 CFS patients in a crossover design comparing L-carnitine and amantadine. Each medicine was given for 2 months, with a 2-week washout period between medicines. L-Carnitine or amantadine was alternately assigned as fist medicine. Amantadine was poorly tolerated by the CFS patients. Only 15 were able to complete 8 weeks of treatment, the others had to stop taking the medicine due to side effects. In those individuals who completed 8 weeks of treatment, there was no statistically significant difference in any of the clinical parameters that were followed. However, with L-carnitine we found statistically significant clinical improvement in 12 of the 18 studied parameters after 8 weeks of treatment. None of the clinical parameters showed any deterioration. The greatest improvement took place between 4 and 8 weeks of L-carnitine treatment. Only 1 patient was unable to complete 8 weeks of treatment due to diarrhea. L-Carnitine is a safe and very well tolerated medicine which improves the clinical status of CFS patients. In this study we also analyzed clinical and laboratory correlates of CFS symptomatology and improvement parameters.

Amantadine↗
PubMed1997

Antimuscle and anti-CNS circulating antibodies in chronic fatigue syndrome.

Chronic fatigue syndrome (CFS) patients suffer from disabling physical and mental fatigue. Circulating autoimmune antibodies may produce symptoms of muscular fatigue by reacting with acetylcholine receptors or calcium binding channels. They can also produce mental status changes by reacting with central nervous system (CNS) antigens. We thoroughly investigated the presence of circulating antimuscle and anti-CNS antibodies in 10 CFS patients and 10 controls. We were unable to detect any pathogenic antibodies.

Adult↗
PubMed1995

Estimating rates of chronic fatigue syndrome from a community-based sample: a pilot study.

Most of the Chronic Fatigue Syndrome (CFS) epidemiological studies have relied on physicians who refer patients having at least six months of chronic fatigue and other symptoms. However, there are a number of potential problems when using this method to derive prevalence statistics. For example, some individuals with CFS might not have the economic resources to access medical care. Other individuals with CFS might be reluctant to use medical personnel, particularly if they have encountered physicians skeptical of the authenticity of their illness. In addition, physicians that are skeptical of the existence of CFS might not identify cases. In the present pilot study, a random community sample (N = 1,031) was interviewed by telephone in order to identify and comprehensively evaluate individuals with symptoms of CFS and those who self-report having CFS. Different definitions of CFS were employed, and higher rates (0.2%) of CFS were found than in previous studies. Methodological benefits in using more rigorous epidemiological methods when estimating CFS prevalence rates are discussed.

Adolescent↗
PubMed1995

Deficiency of a neuronal growth-sustaining factor in fibroblasts of patients with Alzheimer's disease.

A previous report has shown a deficiency of a cholinergic differentiating factor in spent culture media in which Alzheimer's disease (AD) patient fibroblasts were grown (Kessler, 1987). We used a similar approach to investigate whether AD fibroblast-conditioned medium demonstrated central nervous system (CNS) neuronal growth sustaining properties. For these investigations we used cultured fetal murine telencephalic vesicle neurons. Control fibroblast-conditioned medium produced statistically significant neuronal survival as compared to AD fibroblast-conditioned medium or to nonconditioned medium. There was no statistically significant difference between AD fibroblast-conditioned medium and nonconditioned medium results. These results suggest that there may be a deficiency in AD of a CNS neuronal growth-sustaining factor.

Aged↗
PubMed1995

Chronic fatigue syndrome (myalgic encephalopathy).

Chronic fatigue syndrome is associated with many misconceptions. In this review, we attempt to summarize various pathogenic hypotheses for this disease and discuss new lines of insight into causes and treatments of this baffling and most frustrating condition.

Adult↗
PubMed1995

Serum levels of carnitine in chronic fatigue syndrome: clinical correlates.

Carnitine is essential for mitochondrial energy production. Disturbance in mitochondrial function may contribute to or cause the fatigue seen in chronic fatigue syndrome (CFS) patients. One previous investigation has reported decreased acylcarnitine levels in 38 CFS patients. We investigated 35 CFS patients (27 females and 8 males); our results indicate that CFS patients have statistically significantly lower serum total carnitine, free carnitine and acylcarnitine levels, not only lower acylcarnitine levels as previously reported. We also found a statistically significant correlation between serum levels of total and free carnitine and clinical symptomatology. Higher serum carnitine levels correlated with better functional capacity. These findings may be indicative of mitochondrial dysfunction, which may contribute to or cause symptoms of fatigue in CFS patients.

Adolescent↗
PubMed1995

Electron-microscopic investigation of muscle mitochondria in chronic fatigue syndrome.

Patients with chronic fatigue syndrome (CFS) suffer from disabling physical and mental fatigue. Abnormalities in mitochondrial function can lead to fatigue and weakness. Ultrastructural mitochondrial abnormalities have been reported to be present in CFS patients. We obtained percutaneous needle muscle biopsies from 15 CFS patients and 15 age- and sex-matched controls. We investigated previously reported ultrastructural abnormalites in CFS: subsarcolemmal mitochondrial aggregates, intermyofibrillar mitochondrial aggregates, mitochondrial circumference, area, pleomorphism and the presence of compartmentalization of the inner mitochondrial membrane. All of the steps of tissue processing, electron microscopy and data abstracting and analysis were performed in a totally blinded fashion. All of our data were rigorously quantified. We found no difference in any of these studied parameters between CFS patients and controls. Although there is no ultrastructural mitochondrial abnormality in CFS patients, other lines of evidence suggest the presence of a possible functional mitochondrial abnormality.

Adolescent↗
PubMed1994

Lymphocyte function in autism and Rett syndrome.

Peripheral blood lymphocytes from 17 patients with autism were separated on a Ficoll-Hypaque density gradient. Patients had normal numbers of T and B cells and T cell subsets. Although CD4:CD8 ratios were normal for the whole group (2.09 +/- 0.97), 6 patients had elevated ratios (> 2.2) and 5 had decreased ratios (< 1.5). Mitogen-induced proliferation (concanavalin-A and phytohemagglutinin) was normal as was the autologous mixed lymphocyte reaction for the whole group. There was an abnormally increased percentage of DR+ (activated) T lymphocytes in 11 patients. With increasing age percentage of DR+ lymphocytes decreased. No patient had interleukin-2 (IL-2) receptor+ cells. Similar investigations performed on blood samples from 8 girls with Rett syndrome produced normal results. 11 of 17 autistic patients had an abnormally increased percentage of DR+ but not IL-2 receptor+ lymphocytes suggesting 'incomplete' activation, a finding which is seen in autoimmune diseases. The decrease in activated cells with increasing age suggests that there may be an autoimmune process which is more active earlier in life in a subset of autistics.

Adolescent↗