Post-Infectious Fatigue in Adolescents: Does Physical Activity Make a Difference?

Objectives: To compare adolescents who do and do not recover from acute infectious mononucleosis in terms of fatigue severity and activity levels before, during, and in the two years following infection. Design: Prospective case-control study. Setting: The baseline, 12- and 24-month evaluations occurred in the subjects’ homes. The six-month outpatient visit occurred at Children’s Memorial Hospital in Chicago, Illinois. Participants: 301 adolescents (12-18 years old) with acute infectious mononucleosis. Main Exposures: All participants were evaluated at baseline (during active infection). Six months following infection, 39 of them met criteria for chronic fatigue syndrome. These subjects were matched by sex and tanner stage to 39 randomly selected screened-negative subjects. Both groups were re-evaluated at 12- and 24-month follow-ups. Main Outcome Measures: The Fatigue Severity Scale and the Modifiable Activity Questionnaire. Results: For both groups, physical activity levels declined and sleep increased as a result of having mononucleosis. Compared with their matched controls, adolescents with chronic fatigue syndrome reported significantly higher levels of fatigue at all time points and spent significantly more time sleeping during the day six- and 12- months following infection. The two groups did not differ significantly in terms of physical activity levels before, during, and after infection. There was a consistent trend for decreased physical activity in the chronic fatigue syndrome group. Conclusions: Adolescents with chronic fatigue syndrome appear to be pushing themselves in an attempt to maintain similar activity levels as their peers, but paying for it in terms of fatigue severity and an increased need for sleep, particularly during the day

Additional file 3: Table S3a,b,c and d. of Tracking post-infectious fatigue in clinic using routine Lab tests

Supplemental tables containing summary statistics describing the significance and probability of false discovery for the effects of time and the time x group interaction for each of the clinical markers using a regression-based repeated measures model. (XLSX 48 kb

Additional file 2: Table S2a. of Tracking post-infectious fatigue in clinic using routine Lab tests

Summary of 2-way ANOVA. Significance of time, group and time x group effects of conventional metabolic profiling in blood across 6, 12 and 24 months following diagnosis with IM. False discovery rates (FDR) were based on Storey [36] using the bootstrap (boot) and the polynomial (poly) fit methods to estimate lambda, as well as on by Benjamini and Hochberg [37] (BH). Table S2b. Summary of 2-way ANOVA. Significance of time, group and time x group effects for complete blood count (CBC) profiling in blood across 6, 12 and 24 months following diagnosis with IM. False discovery rates (FDR) were based on Storey [36] using the bootstrap (boot) and the polynomial (poly) fit methods to estimate lambda, as well as on by Benjamini and Hochberg [37] (BH). Table S2c. Summary of 2-way ANOVA. Significance of time, group and time x group effects for conventional differential blood count profiling in blood across 6, 12 and 24 months following diagnosis with IM. False discovery rates (FDR) were based on Storey [36] using the bootstrap (boot) and the polynomial (poly) fit methods to estimate lambda, as well as on by Benjamini and Hochberg [37] (BH). Basophil count was not considered due to a large proportion of missing values. Table S2d. Summary of 2-way ANOVA. Significance of time, group and time x group effects for standard endocrine profiling in blood with urine specific gravity and pH across 6, 12 and 24 months following diagnosis with IM False discovery rates (FDR) were based on Storey [36] using the bootstrap (boot) and the polynomial (poly) fit methods to estimate lambda, as well as on by Benjamini and Hochberg [37] (BH). (DOC 150 kb

Additional file 1: Table S1a. of Tracking post-infectious fatigue in clinic using routine Lab tests

Summary descriptive statistics of clinical assays. Mean and standard deviation () of the conventional complete metabolic profiling in blood at 6, 12 and 24 months following diagnosis with IM. Table S1b. Summary descriptive statistics of clinical assays. Mean and standard deviation () of the conventional complete blood count (CBC) profiling in blood at 6, 12 and 24 months following diagnosis with IM. Table S1c. Summary descriptive statistics of clinical assays. Mean and standard deviation () of the conventional differential blood count profiling in blood at 6, 12 and 24 months following diagnosis with IM. Basophil count was not considered due to a large proportion of missing values. Table S1d. Summary descriptive statistics of clinical assays. Mean and standard deviation () of the conventional endocrine profiling in blood with urine specific gravity and pH at 6, 12 and 24 months following diagnosis with IM. (DOC 149 kb

Developmental morphogenesis of attachment organs in lower vertebrates

Adhesive organs are widespread structures among vertebrate larvae. They allow the larvae to attach to a substrate, so that the time for the development of mouth or motoric apparatus could be prolonged. Similar structures in ascidians, larvaceans and lancelets are known too. Thus, it might be hypothesized that the presence of some type of adhesive gland could indeed represent the ancestral state for chordate larvae. Interestingly, however, whilst in most species these glands take their developmental origin in ectodermal layer, in bichir, a member of a primitive actinopterygian lineage, their origin was suggested to be endodermal already at the beginning of 20th century. Since then, however, the former study has become almost forgotten and even recent analyses do not come with new findings on this topic. Because of the essential importance of study of bichir cement glands for understanding the relationship between these structures among chordates, I have decided to focus on this subject. To obtain appropriate comparative data Xenopus, Weather loach and Ribbed newt embryos were included in this study as well. By using combination of immunohistochemical and histological techniques the endodermal origin of cement glands in bichir was proven and their morphogenesis was described into considerable details. The..

Additional file 1: Tables S1, S2, S3. of Illness progression in chronic fatigue syndrome: a shifting immune baseline

Supplemental tables containing summary statistics of the data collected in each cohort segment, group-wise comparative statistics and normalization constants for each cytokine species. Table S4. contains Spearman correlation and corresponding null probability values for pair-wise correlation of the Multidimensional Fatigue Inventory (MFI) with IL-1ι, IL-6 and IL-8 levels in subjects older than 18 years of age. Table S5 contains the performance of classification based on IL-1ι, IL-6 and IL-8 levels where the relative contribution of each cytokine is adjusted on the basis of duration of illness only as described in Additional file 4: Figure S2. (XLS 51 kb