Perceptions of European ME/CFS experts concerning knowledge and understanding of ME/CFS among primary care physicians in Europe: A report from the European ME/CFS Research Network (EUROMENE)

Background and Objectives: We have conducted a survey of academic and clinical experts who are participants in the European ME/CFS Research Network (EUROMENE) to elicit perceptions of general practitioner (GP) knowledge and understanding of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and suggestions as to how this could be improved. Materials and Methods: A questionnaire was sent to all national representatives and members of the EUROMENE Core Group and Management Committee. Survey responses were collated and then summarized based on the numbers and percentages of respondents selecting each response option, while weighted average responses were calculated for questions with numerical value response options. Free text responses were analysed using thematic analysis. Results: Overall there were 23 responses to the survey from participants across 19 different European countries, with a 95% country-level response rate. Serious concerns were expressed about GPs’ knowledge and understanding of ME/CFS, and, it was felt, about 60% of patients with ME/CFS went undiagnosed as a result. The vast majority of GPs were perceived to lack confidence in either diagnosing or managing the condition. Disbelief, and misleading illness attributions, were perceived to be widespread, and the unavailability of specialist centres to which GPs could refer patients and seek advice and support was frequently commented upon. There was widespread support for more training on ME/CFS at both undergraduate and postgraduate levels. Conclusion: The results of this survey are consistent with the existing scientific literature. ME/CFS experts report that lack of knowledge and understanding of ME/CFS among GPs is a major cause of missed and delayed diagnoses, which renders problematic attempts to determine the incidence and prevalence of the disease, and to measure its economic impact. It also contributes to the burden of disease through mismanagement in its early stages

The role of prevention in reducing the economic impact of ME/CFS in Europe : A report from the socioeconomics working group of the European network on ME/CFS (EUROMENE)

Funding Information: This research received no external funding. EUROMENE receives funding for networking activities from the COST programme (COST Action 15111), via the COST Association. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.This report addresses the extent to which there may be scope for preventive programmes for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and, if so, what economic benefits may accrue from the implementation of such programmes. We consider the economic case for prevention programmes, whether there is scope for preventive programmes for ME/CFS, and what are the health and economic benefits to be derived from the implementation of such programmes. We conclude that there is little scope for primary prevention programmes, given that ME/CFS is attributable to a combination of host and environmental risk factors, with host factors appearing to be most prominent, and that there are few identified modifiable risk factors that could be the focus of such programmes. The exception is in the use of agricultural chemicals, particularly organophosphates, where there is scope for intervention, and where Europe-wide programmes of health education to encourage safe use would be beneficial. There is a need for more research on risk factors for ME/CFS to establish a basis for the development of primary prevention programmes, particularly in respect of occupational risk factors. Secondary prevention offers the greatest scope for intervention, to minimise diagnostic delays associated with prolonged illness, increased severity, and increased costs.publishersversionPeer reviewe

Perceptions of European ME/CFS experts concerning knowledge and understanding of ME/CFS among primary care physicians in Europe : A report from the European ME/CFS research network (EUROMENE)

Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Background and Objectives: We have conducted a survey of academic and clinical experts who are participants in the European ME/CFS Research Network (EUROMENE) to elicit perceptions of general practitioner (GP) knowledge and understanding of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and suggestions as to how this could be improved. Materials and Methods: A questionnaire was sent to all national representatives and members of the EUROMENE Core Group and Management Committee. Survey responses were collated and then summarized based on the numbers and percentages of respondents selecting each response option, while weighted average responses were calculated for questions with numerical value response options. Free text responses were analysed using thematic analysis. Results: Overall there were 23 responses to the survey from participants across 19 different European countries, with a 95% country-level response rate. Serious concerns were expressed about GPs’ knowledge and understanding of ME/CFS, and, it was felt, about 60% of patients with ME/CFS went undiagnosed as a result. The vast majority of GPs were perceived to lack confidence in either diagnosing or managing the condition. Disbelief, and misleading illness attributions, were perceived to be widespread, and the unavailability of specialist centres to which GPs could refer patients and seek advice and support was frequently commented upon. There was widespread support for more training on ME/CFS at both undergraduate and postgraduate levels. Conclusion: The results of this survey are consistent with the existing scientific literature. ME/CFS experts report that lack of knowledge and understanding of ME/CFS among GPs is a major cause of missed and delayed diagnoses, which renders problematic attempts to determine the incidence and prevalence of the disease, and to measure its economic impact. It also contributes to the burden of disease through mismanagement in its early stages.publishersversionPeer reviewe

A Literature Review of GP Knowledge and Understanding of ME/CFS: A Report from the Socioeconomic Working Group of the European Network on ME/CFS (EUROMENE)

Funding Information: EUROMENE receives funding for networking activities from the COST programme (COST Action 15111), via the COST Association. Publisher Copyright: © 2020 by the authors. Licensee MDPI, Basel, Switzerland.Background and Objectives: The socioeconomic working group of the European myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) Research Network (EUROMENE) has con-ducted a review of the literature pertaining to GPs’ knowledge and understanding of ME/CFS; Materials and Methods: A MEDLINE search was carried out. The papers identified were reviewed following the synthesis without meta-analysis (SWiM) methodology, and were classified according to the focus of the enquiry (patients, GPs, database and medical record studies, evaluation of a training programme, and overview papers), and whether they were quantitative or qualitative in nature; Results: Thirty-three papers were identified in the MEDLINE search. The quantitative surveys of GPs demonstrated that a third to a half of all GPs did not accept ME/CFS as a genuine clinical entity and, even when they did, they lacked confidence in diagnosing or managing it. It should be noted, though, that these papers were mostly from the United Kingdom. Patient surveys indicated that a similar proportion of patients was dissatisfied with the primary medical care they had received. These findings were consistent with the findings of the qualitative studies that were examined, and have changed little over several decades; Conclusions: Disbelief and lack of knowledge and understanding of ME/CFS among GPs is widespread, and the resultant diagnostic delays constitute a risk factor for severe and prolonged disease. Failure to diagnose ME/CFS renders problematic attempts to determine its prevalence, and hence its economic impact.publishersversionPeer reviewe

Recommendations for Epidemiological Research in ME/CFS from the EUROMENE Epidemiology Working Group

The European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE) was established after a successful grant application to the European Cooperation is Science and Technology (COST). This network aimed to assess the existing knowledge and/or experience on health care delivery for people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in the European countries and worldwide, and to enhance coordinated research and health care provision in this field. The EUROMENE proposal, was based on the establishment of interrelated working groups (WGs), where the participants contributed with specific knowledge and viewpoints according to their specialties and/or areas of interest. In this paper we outline the work of a multidisciplinary team of researchers, including epidemiologists, clinicians, statisticians, biomedical scientist and heath economists, who set out their recommendations to guide data acquisition for ME/CFS research, aiming to standardise data collection and improve epidemiological research.</jats:p

Perceptions par les parents de la gastro-entérite aiguë infantile

La gastro-entérite aiguë de l'enfant est responsable de décès chaque année en France. Elle entraîne plus de 50000 séjours à l'hôpital, soit plus de 10% des hospitalisations dans cette tranche d'âge. Malgré des recommandations bien codifiées, les pratiques des médecins ne suivent pas parfaitement ces règles, mais elles s'améliorent tout de même. Les connaissances des parents sont globalement mauvaises : les signes jugés les plus inquiétants sont les vomissements et la durée de la diarrhée> 12 heures. 39,5% des parents n'ont pas la notion du risque mortel. L'auto-médication est importante (71%) et les parents donnent spontanément des médicaments, parfois dangereux (lopéramide 20%). 40% des parents connaissent les solutés de réhydratation, mais seulement 7% des parents n'ayant jamais eu de prescription de soluté, connaissent ces solutés. Par contre, la définition de la gastro-entérite est assez bonne : ils citent les symptômes principaux et l'étiologie est supposée virale. Les parents citent les médecins comme première source d'information. Nous avons une possibilité d'action sur leurs connaissances. Nous avons mis en évidence des parents à informer en priorité : ceux ne connaissant pas les solutés de réhydratation, n'ayant pas d'antécédent de gastro-entérite, les CSP moins favorisées, n'ayant qu'un enfant. Les médecins doivent informer de manière préventive les parents sur les signes de gravité de la gastro-entérite aiguë, les risques de déshydratation et expliquer les modalités de la prise des solutés. Idéalement, on devrait trouver des sachets de réhydratation dans tous les foyers ayant de jeunes enfants.NANCY1-SCD Medecine (545472101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Prise en charge médicale de la migraine en Lorraine (résultats d'une enquête auprès de 702 patients se plaignant de céphalées au centre de Médecine Préventive de Nancy)

NANCY1-SCD Medecine (545472101) / SudocPARIS-BIUM (751062103) / SudocNANCY1-Bib. numérique (543959902) / SudocSudocFranceF

Asthme et reflux gastro-oesophagien de l'adulte (analyse d'une série personnelle de 28 cas et revue de la littérature)

NANCY1-SCD Medecine (545472101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Lésions du tractus digestif supérieur par ingestion d'agents caustiques (mise au point à propos d'une étude personnelle de 68 observations)

Potentiellement mortelle, l'ingestion de produit caustique est un acte relativement fréquent en France chez l'adulte. A partir de 68 observations personnelles et en nous appuyant sur la littérature, nous avons analysé les lésions digestives et leurs conséquences en fonction du type de caustique ingéré. L'ingestion de soude, associée ou non à un agent mouillant, d'acide chlorhydrique, d'ammoniaque ou d'essence de Térébenthine provoque, dans la plupart des cas, des lésions sévères du tractus digestif supérieur. Par contre, l'eau de Javel qui est l'agent le plus communément ingéré reste le produit le moins dangereux, surtout sous forme diluée. Afin d'évaluer correctement les lésions caustiques, certaines données sont fondamentales : la nature, le volume, la concentration du(es) produit(s), l'heure d'ingestion, les examens cliniques et endoscopiques. Ces informations permettent d'optimiser les décisions thérapeutiques et de valider ou non le recours à la chirurgie.NANCY1-SCD Medecine (545472101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF