Myalgic encephalomyelitis/chronic fatigue Syndrome (ME/CFS) : Investigating care practices pointed out to disparities in diagnosis and treatment across European Union

ME/CFS is a chronic, complex, multisystem disease that often limits the health and functioning of the affected patients. Diagnosing patients with ME/CFS is a challenge, and many different case definitions exist and are used in clinical practice and research. Even after diagnosis, medical treatment is very challenging. Symptom relief and coping may affect how patients live with their disease and their quality of life. There is no consensus on which diagnostic criteria should be used and which treatment strategies can be recommended for patients. The purpose of the current project was to map the landscape of the Euromene countries in respect of national guidelines and recommendations for case definition, diagnosis and clinical approaches for ME/CFS patients. A 23 items questionnaire was sent out by email to the members of Euromene. The form contained questions on existing guidelines for case definitions, treatment/management of the disease, tests and questionnaires applied, and the prioritization of information for data sampling in research. We obtained information from 17 countries. Five countries reported having national guidelines for diagnosis, and five countries reported having guidelines for clinical approaches. For diagnostic purposes, the Fukuda criteria were most often recommended, and also the Canadian Consensus criteria, the International Consensus Criteria and the Oxford criteria were used. A mix of diagnostic criteria was applied within those countries having no guidelines. Many different questionnaires and tests were used for symptom registration and diagnostic investigation. For symptom relief, pain and anti-depressive medication were most often recommended. Cognitive Behavioral Therapy and Graded Exercise treatment were often recommended as disease management and rehabilitative/palliative strategies. The lack of consistency in recommendations across European countries urges the development of regulations, guidance and standards. The results of this study will contribute to the harmonization of diagnostic criteria and treatment for ME/CFS in Europe

Ovo em pó na alimentação de leitões recém-desmamados Spray-dried egg for wealing pigs

Foram realizados dois experimentos para determinar a composição química, os coeficientes de digestibilidade de nutrientes e os valores de energia e proteína digestíveis do ovo em pó (OP) e avaliar o desempenho e os componentes sangüíneos e plasmáticos de leitões alimentados com dietas contendo OP. No Experimento I, foram utilizados oito leitões em um ensaio de digestibilidade. Os animais foram distribuídos em dois tratamentos e quatro repetições, sendo uma ração referência e uma teste (70% da ração referência + 30% de OP). Utilizou-se a metodologia da coleta parcial de fezes (0,5% de Cr2O3). Os coeficientes de digestibilidade aparente do OP foram de 80,81; 87,14; 82,00 e 70,55%, respectivamente, para a matéria seca, energia bruta, proteína bruta e extrato etéreo. A partir dos coeficientes de digestibilidade determinados e os valores de proteína bruta (56,53%) e energia bruta (5.897 kcal/kg), foram calculados os valores de 43,90% de proteína digestível e 5.140 kcal/kg de energia digestível para o OP. No Experimento II, foram utilizados 90 animais desmamados com 24 dias e 5,6 kg. Os tratamentos consistiram de cinco rações isonutritivas com níveis crescentes (0, 25, 50, 75 e 100%) de substituição protéica do plasma sangüíneo (PS) da dieta pelo OP. O delineamento experimental foi o de blocos casualizados, com nove repetições por tratamento. Não houve diferença entre os tratamentos para as variáveis de desempenho na fase de 1-14 dias pós-desmame. Para a fase de 15-28 dias e para o período total, foi observada redução linear do GDP e CDR, com o aumento do nível de inclusão da proteína do OP. Para as variáveis dos componentes plasmáticos e sangüíneos não foram observadas diferenças significativas entre os tratamentos. Em função dos resultados obtidos, não foi viável a substituição do plasma sangüíneo pelo ovo em pó nas dietas de leitões durante a fase de creche.<br>Two experiments were carried out to determine the chemical composition, nutrients digestibility and digestible energy and protein of spray-dried egg (OP) and to study the performance and plasma and blood components of weanling pigs fed diets containing OP. In the Experiment I, eight pigs were used for digestibility assay. The animals were assigned to two treatments and four replications/treatment. The treatments consisted of a basal diet and test diet (70% of basal diet + 30% of OP). The method was the partial faeces collection (0.5% Cr2O3). The apparent digestibility coefficients of dry matter, gross energy, crude protein and crude fat were, respectively, 80.81, 87.14, 82.00, and 70.55%. From the results of apparent digestibility coeficients and the values of crude protein (56.53%) and gross energy (5,897 kcal/kg), values of 43.90% of digestible protein and 5,140 kcal/kg of digestible energy for OP were calculated. In the Experiment II, ninety pigs were weaned at 24 days of age with 5.6 kg live weight. The treatments consisted of five dietary levels of 0, 25, 50, 75 and 100%, as a replacement of plasma (PS) protein for OP protein. Pigs were alloted to a randomized block design with nine replications per treatment. No treatment effects were observed on performance for 1-14 day post-weaning phase. For the 15-28 d phase and for the total period, linear reductions of GDP and CDR were observed, as the dietary OP levels increased. No treatment effects were observed on plasma and blood components by the inclusion of spray-dried egg. It was not recommended to replace the PS by OP in nursery diets

Myalgic encephalomyelitis/chronic fatigue Syndrome (ME/CFS): Investigating care practices pointed out to disparities in diagnosis and treatment across European Union

ME/CFS is a chronic, complex, multisystem disease that often limits the health and functioning of the affected patients. Diagnosing patients with ME/CFS is a challenge, and many different case definitions exist and are used in clinical practice and research. Even after diagnosis, medical treatment is very challenging. Symptom relief and coping may affect how patients live with their disease and their quality of life. There is no consensus on which diagnostic criteria should be used and which treatment strategies can be recommended for patients. The purpose of the current project was to map the landscape of the Euromene countries in respect of national guidelines and recommendations for case definition, diagnosis and clinical approaches for ME/CFS patients. A 23 items questionnaire was sent out by email to the members of Euromene. The form contained questions on existing guidelines for case definitions, treatment/management of the disease, tests and questionnaires applied, and the prioritization of information for data sampling in research. We obtained information from 17 countries. Five countries reported having national guidelines for diagnosis, and five countries reported having guidelines for clinical approaches. For diagnostic purposes, the Fukuda criteria were most often recommended, and also the Canadian Consensus criteria, the International Consensus Criteria and the Oxford criteria were used. A mix of diagnostic criteria was applied within those countries having no guidelines. Many different questionnaires and tests were used for symptom registration and diagnostic investigation. For symptom relief, pain and anti-depressive medication were most often recommended. Cognitive Behavioral Therapy and Graded Exercise treatment were often recommended as disease management and rehabilitative/palliative strategies. The lack of consistency in recommendations across European countries urges the development of regulations, guidance and standards. The results of this study will contribute to the harmonization of diagnostic criteria and treatment for ME/CFS in Europe. Copyright: © 2019 Strand et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Myalgic encephalomyelitis/chronic fatigue Syndrome (ME/CFS) : Investigating care practices pointed out to disparities in diagnosis and treatment across European Union

ME/CFS is a chronic, complex, multisystem disease that often limits the health and functioning of the affected patients. Diagnosing patients with ME/CFS is a challenge, and many different case definitions exist and are used in clinical practice and research. Even after diagnosis, medical treatment is very challenging. Symptom relief and coping may affect how patients live with their disease and their quality of life. There is no consensus on which diagnostic criteria should be used and which treatment strategies can be recommended for patients. The purpose of the current project was to map the landscape of the Euromene countries in respect of national guidelines and recommendations for case definition, diagnosis and clinical approaches for ME/CFS patients. A 23 items questionnaire was sent out by email to the members of Euromene. The form contained questions on existing guidelines for case definitions, treatment/management of the disease, tests and questionnaires applied, and the prioritization of information for data sampling in research. We obtained information from 17 countries. Five countries reported having national guidelines for diagnosis, and five countries reported having guidelines for clinical approaches. For diagnostic purposes, the Fukuda criteria were most often recommended, and also the Canadian Consensus criteria, the International Consensus Criteria and the Oxford criteria were used. A mix of diagnostic criteria was applied within those countries having no guidelines. Many different questionnaires and tests were used for symptom registration and diagnostic investigation. For symptom relief, pain and anti-depressive medication were most often recommended. Cognitive Behavioral Therapy and Graded Exercise treatment were often recommended as disease management and rehabilitative/palliative strategies. The lack of consistency in recommendations across European countries urges the development of regulations, guidance and standards. The results of this study will contribute to the harmonization of diagnostic criteria and treatment for ME/CFS in Europe