Sleep Apnea

NHLBI on: What Is Sleep Apnea?

Obviously, one big difference in the case presented above is tiredness in sleep apnea versus fatigue in ME/CFS.

What's interesting is that he thought he might have depressions.

The other interesting thing he said was: "Now that I am feeling better [with treatment] I am coming home from work with energy still."

I guess the presentation of cases is a continuum (especially considering the different types of apnea and the unknown causes of apnea) and that therefore some bona fide apnea cases may be misdiagnosed as ME/CFS.

I think sleep apnea is one of the many other conditions that need to be considered as differential diagnosis to ME/CFS. As sleep apnea more often affects men and ME/CFS more often affects women, this should be taken into consideration when trying to make a differential diagnosis.

Orac on Homeopathy and Clinical Trials

Orac on Homeopathy and Clinical Trials:

So ridiculous is homeopathy that I sometimes feel that I and my fellow skeptics are firing Howitzers at an ant when we take so much time and effort to explain why homeopathy is nonsense. On the other hand, it is homeopathy's monumental lack of scientific plausibility that makes it a perfect teaching tool to explain the difference between science-based medicine (SBM) and evidence-based medicine (EBM). Specifically, because clinical trials have unavoidable shortcomings and biases, even at a p=0.05, which would imply only approximately a 5% chance that a given trial's apparently positive results could be due to random chance alone. As John Ioannidis has taught us, in clinical trials as practiced in the real world, the chance is much higher that any given positive trial is a false positive. It also means that, the lower the prior plausibility of a remedy working, the higher the chance of false positive trials. This is exactly what we see in homeopathy, hence the panoply of homeopathy trials showing "positive" results in which the treatment group is barely different from the control and/or the results barely reach statistical significance. With something like homeopathy, which violates the laws of so many sciences, it is relatively easy to make the case that it takes a lot more than a few equivocal clinical trials to show that so much well-established science is wrong. Apparently positive clinical trials of homeopathy are measuring, in essence, the noise inherent in doing clinical trials.

Interview with Ian Lipkin

An interview with Ian Lipkin in the Disco-Mag:

… LCMV, a cause of meningitis in humans, shuts down the ability of the pituitary gland to make growth hormone. The virus doesn’t kill the cell, 
but it suppresses transcription and translation of genes, so the organism as a whole suffers but the individual cell looks OK. My contribution was showing that there were specific effects on neurotransmitters linked to the behavioral manifestations of the 
disease. This became a model for understanding how persistent viral infections affect the central nervous system. …

Haven't read it all yet. Some of the interview questions are a bit "woo", and Ian Lipkin comes off as a bit woo too – but I guess this comes with having an open mind and even Newton studied Alchemy. It is definitely interesting to see were he comes from, what he learned about different diseases and how he learned to see them.

Cytotoxic lymphocyte microRNAs as prospective biomarkers for CFS/ME

Cytotoxic lymphocyte microRNAs as prospective biomarkers for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.
Brenu EW, Ashton KJ, van Driel M, Staines DR, Peterson D, Atkinson GM, Marshall-Gradisnik SM.

Faculty of Health Science and Medicine, Bond University, Australia.

Abstract

BACKGROUND:
Immune dysfunction associated with a disease often has a molecular basis.

A novel group of molecules known as microRNAs (miRNAs) have been associated with suppression of translational processes involved in cellular development and proliferation, protein secretion, apoptosis, immune function and inflammatory processes.

MicroRNAs may be implicated in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME), where immune function is impaired.

The objective of this study was to determine the association between miRNAs in cytotoxic cells and CFS/ME.

METHODS:
Natural Killer (NK) and CD8(+)T cells were preferentially isolated from peripheral blood mononuclear cells from all participants (CFS/ME, n=28; mean age=41.8±9.6years and controls, n=28; mean age=45.3±11.7years), via negative cell enrichment.

Following total RNA extraction and subsequent synthesis of cDNA, reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) was used to determine the expression levels of nineteen miRNAs.

RESULTS:
There was a significant reduction in the expression levels of miR-21, in both the NK and CD8(+)T cells in the CFS/ME sufferers.

Additionally, the expression of miR-17-5p, miR-10a, miR-103, miR-152, miR-146a, miR-106, miR-223 and miR-191 was significantly decreased in NK cells of CFS/ME patients in comparison to the non-fatigued controls.

LIMITATIONS:
The results from these investigations are not yet transferable into the clinical setting, further validatory studies are now required.

CONCLUSIONS:
Collectively these miRNAs have been associated with apoptosis, cell cycle, development and immune function.

Changes in miRNAs in cytotoxic cells may reduce the functional capacity of these cells and disrupt effective cytotoxic activity along with other immune functions in CFS/ME patients.

Via CO-CURE

Orac on the Placebo Effect

Orac on the placebo effect:

Placebo responses only "work" for subjective symptoms. They don't "cure" anything. At best, placebo responses are due to a change in perception of subjective symptoms that leads to their bothering the patient less. Even so, they're variable and unreliable, not something that a doctor would want to hang his hat on when he needs to relieve a patient's symptoms. At worst, placebo effects do not exist. Rather, they're due to artifacts in clinical trials, confirmation biases, and observer effects.

Lactose Intolerance was once considered "psychosomatic"

Recognition of the extent and genetic basis of lactose intolerance is relatively recent. Though its symptoms were described as early as Hippocrates (460-370 B.C.), until the 1960s the prevailing assumption in the medical community was that tolerance was the norm and intolerance either the result of milk allergy, an intestinal pathogen, or else was psychosomatic (it being recognised that some cultures did not practice dairying, and people from those cultures often reacted badly to consuming milk).

The "Psychosomatic" explanation of illness reminds me of the God of the Gaps theological perspective. The medical community must root the psychosomatic school of thought from their ranks, or they make themselves accomplices to this unscientific abuse of patients which is committed by these psycho-babble-quacks.

My Acne is caused by Milk and Dairy

I can now say, with rather high confidence, that my acne was caused by the consumption of (cow-)milk. I used to drink a lot of milk – and had a lot of acne. One and a half years ago I massively reduced my consumption of milk and milk-products, and my acne almost went away. I ceased to eat dairy and my acne went completely away. I reintroduced dairy, and my acne came back, pimples within 6 to 12 hours. It does not rise to the level to be considered proof, but for me, in my case, it is pretty clear.

Over the next months I will try Ghee ("clarified butter", which is almost free of both cow proteins and lactose, and contains almost only fatty acids) to see if this still contributes to my acne or not.