ME/CFS Primer for Clinical Practitioners – a milestone in diagnosis and treatment from the IACFS/ME   (25 votes) ProHealth.com • May 17, 2012 Tweet previous article next article More than two years in the making, to support the informed diagnosis & management of millions afflicted with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) On May 15, 2012… the International Association for CFS/ME (IACFS/ME) released for public sharing ME/CFS: A Primer for Clinical Practitioners © 2012 IACFS/ME. See the printable PDF… of the 40-page primer on the IACFS/ME website. The IACFS/ME asks the community’s help… in seeing that news of the Primer reaches as many physicians and other healthcare professionals as possible. For practitioners who access it, they suggest a donation of $15 or another amount to help continue the work of the IACFS/ME. Notable features include… • An ME/CFS Clinical Diagnostic Criteria Worksheet (pages 12 and 13). References include the revised Canadian ME/CFS Case Definition. • Attention to special groups, including severely affected, pediatric ME/CFS, and pregnancy, and to post-exertional malaise/activity management. (See full topic listing, below.) Members of the IACFS/ME Primer Writing Committee… dedicated more than 2 years to development and vetting of this document. The 11 members are: Fred Friedberg, PhD (chair and IACFS/ME president); Lucinda Bateman, MD; Alison Bested, MD; Todd Davenport, DPT; Kenneth J Friedman, PhD; Alan Gurwitt, MD; Leonard Jason, PhD; Charles W. Lapp, MD; Staci Stevens, MA; Rosemary Underhill, MB; Rosamund Vallings, MB. In a brief forward for clinician users… Harvard physician Anthony Komaroff, MD, suggests: “In this Primer, the collected wisdom of many experienced clinicians and clinician-scientists has been gathered. Here, you’ll find advice on how to diagnose ME/CFS, and on therapies that appear to be beneficial, although not curative. I think you will find it useful.” Topics as listed in the Table of Contents… 1. Introduction and Overview (6-7) • Nomenclature • Epidemiology • Diagnosis • Presentation and Course of Illness • The health practitioner's role in diagnosis and management 2. Etiology (8) • Predisposing factors • Precipitating and causal factors 3. Pathophysiology (8-11) • Immune system abnormalities • Neuroendocrine dysregulation • Brain abnormalities • Cognitive impairment • Autonomic/cardiovascular disturbances • Mitochondrial/energy production abnormalities • Gene studies 4. Clinical Diagnosis (11-16) • Patient history • Physical examination • Diagnostic Worksheet • Laboratory tests • Differential diagnosis • Distinguishing ME/CFS from depression and anxiety disorders • Exclusionary medical conditions • Co-existing medical conditions 5. Management/Treatment (17-26) • Approach to treatment • Sleep • Pain • Fatigue and post-exertional malaise • Managing post-exertional symptoms, Pacing and the Energy Envelope • Activity and exercise • Cognitive problems • Depression, anxiety and distress • Cognitive behavioral therapy • Management of related conditions • Orthostatic intolerance and Cardiovascular symptoms • Gastrointestinal problems • Urinary symptoms • Allergies • Multiple chemical sensitivities • Infections and immunological factors • Dietary management • Alternative and complementary approaches • Follow-up 6. Clinical concerns (26-29) • Low functioning patients • Pregnancy • Gynecological problems • Pediatric ME/CFS • Immunizations • Blood and tissue donation • Recommendations prior to surgery 7. References (29) Appendix 35-40 A 1994 International research case definition (Fukuda et al) worksheet B Pediatric case definition worksheet C Functional capacity scale D Activity log E Recommendations prior to surgery

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