原因不明の発熱、脱力感が続く 働き盛りに多発 慢性疲労症候群 Unexplained fever, followed by weakness, multiple symptoms in the prime of life: Chronic Fatigue Syndrome

原因不明の発熱、脱力感が続く　働き盛りに多発　慢性疲労症候群

2013年4月9日

　ある日突然、全身の倦怠（けんたい）感に襲われ、疲労や微熱が続く「慢性疲労症候群」（ＣＦＳ）。働き盛りの二十代～四十代で発症する例が多いが、詳しい原因

は不明で根本的な治療法もない。症状はうつ病と似ていて診断は難しく、病気を知らなかったり、認めなかったりする医師もいて、精神科や内科をたらい回しになる患者もいる。　（細川暁子）

　東京都内の女性（４０）の体に異変が起きたのは二〇〇九年三月。三九度の熱が出て、解熱剤を飲んだが一週間以上も微熱が続いた。頭がボーッとして会話の内容が理解できなかったり、少し動くだけで息切れしたりするように。全身の筋力が低下して、次第に鍋がつかめないほどになった。治療を受けたが、症状は軽減せず、半年後にＣＦＳと診断された。

　女性はシングルマザーで、中学一年の長女（１２）と小学五年の長男（１０）がいる。一〇年八月からは休職中だが、現在も微熱や頭痛が続く。ほとんど寝たきりで、移動には電動車いす。子どもたちが食事作りなど身の回りの世話をしている。漢方薬を服用し、血液循環をよくするマッサージを受けると、少し楽になるという。「思うように動けず、子どもにつらい思いをさせている」

　「ＣＦＳの患者は働き盛りの二十代～四十代に多く、女性の割合が高い」とＣＦＳ治療の第一人者で、関西福祉科学大教授の倉恒弘彦さんは指摘する。患者は全国に三十万人以上と推測する。

　ＣＦＳは激しいだるさや脱力感、微熱が続き、筋肉や関節が痛むのが特徴だ。それが半年以上続き、日常生活に支障が生じていることなどが診断基準で、リンパ節の腫れを根拠にする医師もいる。だが一般的な検査では異常は見つからず、詐病を疑われる場合もある。女性も、症状が急激に悪化して近隣の診療所に駆け込んだ際に、ＣＦＳについて伝えると「（ＣＦＳとは）診断できない。処置できない」と言われたという。

　多くの患者は身体的な症状だけでなく、不眠や思考力、集中力の低下などの症状も訴える。東京・池袋の「池袋内科」の井上幹紀親（みきちか）さんは「うつ病との区別が難しく、病院を渡り歩く患者も多い」と話す。症状としては、内科と精神科にまたがっているため、双方の協力が重要という。

　発症のメカニズムは解明されていないが、患者の血液を調べると、何らかのウイルスが見つかるケースがあり、倉恒さんは免疫との関連性を指摘している。

　患者は血液中の活性酸素が通常より高いことが特徴で、活性酸素を減らす薬を出すこともある。ただし、現状では、それぞれの症状を軽減する対症療法しかない。通常の日常生活に戻れる患者もいるが、十年以上も症状が軽減せず、苦しむ人もいる。

　倉恒さんらが参加する厚生労働省の研究班では、自律神経のバランスを指先の脈拍で調べるなど、新たな診断基準づくりを進めている。倉恒さんは「疲れを感じたら休息し、それでも改善しなければ、まずは専門医に相談を」と話している。

◆福祉サービスの対象外

　ＣＦＳの患者には、重症になると寝たきりで、食事や外出に介助が必要な人もいる。だが、症状が一定せず、身体障害者手帳の取得は難しい。

　四月施行の障害者総合支援法で、障害者手帳を持っていない難病患者も家事介助や補助具支給など、福祉サービスを受けられるようになったが、ＣＦＳは対象外だ。

　東京都練馬区の関町内科クリニックの申偉秀（しんいす）さんは「病名の『疲労』という言葉は実態を正しく表していない。誤解を与え、社会保障を受けられない一因になっているのでは」と指摘する。

　英国やカナダの一部の医師たちは、重症患者は脳などに炎症があることから「筋痛性脳脊髄炎」への病名変更を提唱しているという。申さんも病名変更には賛同し、「重症者には、優先的に福祉サービスを受けられるようにしてほしい」と話す。

http://www.tokyo-np.co.jp/article/living/health/CK2013040902000138.html

Unexplained fever, followed by weakness, multiple symptoms in the prime of life: Chronic Fatigue Syndrome

April 9, 2013

Suddenly one day, she was overcome by a sense of systemic malaise, fatigue followed by low-grade fever -- i.e. "chronic fatigue syndrome" (CFS). While there are many cases developing from one`s twenties to one`s forties, in the prime of life, the exact cause is unknown and there is no simple treatment. Diagnosis is difficult and the symptoms are similar to depression. There are also doctors who do not know or will not acknowledge the disease, and patients get passed around by general practitioners and psychiatrists. (Akiko Hosokawa)

Something happened inside the body of a woman (40) in Tokyo in March of 2009. She broke out in a fever of 39 degrees and hence took anti-fever medication, but a low-grade fever continued to last for more than a week. She fell into a brain fog and could not understand the content of conversations while the slightest of movements left her breathless. Gradually, general muscle strength became so weak, she was not even able to grasp the pots on the stove. She was treated, but there was no alleviation of symptoms, and she was diagnosed with CFS six months later.

She is a single mother, with a daughter (12) in junior high school and a son (10) in elementary school. Since August of 2010 she has been on leave from work but the low-grade fever and headache still continue. She is almost completely bedridden and gets around in an electric wheelchair. Her children prepare her meals and take care of her. She says she feels a little better when taking Chinese medicine and or when receiving a massage to increase blood circulation. "Since I am able to move around as I would like, I think I will be leaving my children with some bitter memories."

"Many CFS patients are in their twenties to forties with a good percentage of these being women," points out CFS leading authority Kansai University of Welfare Sciences Professor KURATSUNE Akihiko. He guesstimates there are over three hundred thousand patients in Japan.

CFS is distinguished by a sense of languor and weakness, followed by a low-grade fever, and muscle and joint pain.  While diagnostic criteria is based on such things as this continuing for more than six months and disrupting daily life, a number of doctors also base it on the patient having swollen lymph nodes. In some cases, when a general examination finds no abnormalities it is suspected the patient is feigning the illness. One women with a sudden worsening of symptoms ran to the local clinic and when she mentioned CFS she was told that "CFS can not be diagnosed or treated."

Many patients also complain of symptoms besides the physical symptoms, such as insomnia and a reduction in concentration and the ability to think. INOUE Michichika of the "Ikebukuro Clinic" in Ikebukuro, Tokyo states, "It is difficult to distinguish between depression, and often patients wander from hospital to hospital." Since the symptoms overlap between psychiatry and internal medicine, it is important to have the cooperation of both here.

While it is not clear what causes the onset of symptoms, when patients' blood is examined, there are cases where some sort of virus is found and KURATSUNE points out that there must be some connection with the immune system.

One distinguishing factor found in patients' blood is a higher than normal presence of reactive oxygen species and sometimes medicines are prescribed which lowers the amount of these.

However, at present, there are only specific treatments available to alleviate each symptom. And while some patients return to a normal everyday life, there are others who suffer for more than ten years without an alleviation of symptoms.

A  study group with the Ministry of Health, Labour and Welfare, in which KURATSUNE is participating, is making advances in diagnostic criteria like checking the pulse from the fingertip to determine autonomic system balance.  Kuratsune states "If you feel tired, take a rest, and if that does not help, then see a specialist."

◆ Outside the Scope of Welfare Services

Some CFS patients whose symptoms become severe end up bedridden and require assistance to eat and to go out. However, if their symptoms are not constant, then it is difficult for them to get disability benefits.

In the Comprehensive Welfare Act for Persons with Disabilities set to take effect in April, patients with intractable diseases who do not have a disability will also be able to receive welfare services such as aid payment and housework assistance. However, CFS is excluded.

Dr. SHIN Isu of the Sekimachi Medical Clinic in Nerima-ku, Tokyo, points out that "The word 'Fatigue' in the disease name does not reflect the actual conditions. It invites misunderstanding and this is one factor as to why these people cannot receive social security benefits."

It is said that some doctors in Canada and the United Kingdom advocate a name change to "Myalgic Encephalomyelitis" because there are such things as inflammation of the brain, etc. in critically ill patients. Dr. Shin also agrees with a name change. He states, "I would like for the critically ill to be able to receive welfare services on a priority basis."

Alarm over vanishing frogs in the Caribbean

By BEN FOX and EZEQUIEL ABIU LOPEZ | Associated Press – Wed, Apr 10, 2013

View Photo

Associated Press/Ricardo Arduengo - In this March 21, 2013 photo, Ana Longo, a researcher with Proyecto Coqui, holds a Coqui or Common Coqui (Eleutherodactylus coqui) at a tropical forest in Patillas, Puerto Rico. A familiar sound is vanishing from the Caribbean night. The bird-like peeps and chirping of frogs are fainter across the region, a decline scientists say appears to be caused by a combination of climate change, a fungus that has been killing amphibians around the world, and habitat loss. It's a global problem, but worrisome in the Caribbean because the island geography means many species exist nowhere else on earth and the loss of frogs, a principal nocturnal predator of mosquitoes, may have severe consequences for humans. (AP Photo/Ricardo Arduengo) 

PATILLAS, Puerto Rico (AP) — A curtain of sound envelops the two researchers as they make their way along the side of a mountain in darkness, occasionally hacking their way with a machete to reach the mouth of a small cave.

Peeps, tweets and staccato whistles fill the air, a pulsing undercurrent in the tropical night. To the untrained ear, it's just a mishmash of noise. To experts tracking a decline in amphibianswith growing alarm, it's like a symphony in which some of the players haven't been showing up.

In parts of Puerto Rico, for example, there are places where researchers used to hear four species at once and they are now hearing one or two, a subtle but important change.

"You are not hearing what you were before," said Alberto Lopez, part of a husband-and-wife team of biologists trying to gauge the health of frogs on the island.

Scientists report that many types of amphibians, especially frogs, are in a steep global decline likely caused by a mix of habitat loss, climate change, pollution and a virulent fungus. The downward spiral is striking particularly hard in the Caribbean, where a majority of species are now losing a fragile hold in the ecosystem.

Without new conservation measures, there could be a massive die-off of Caribbean frogs within 15 years, warned Adrell Nunez, an amphibian expert with the Santo Domingo Zoo in the Dominican Republic. "There are species that we literally know nothing about" that could be lost, he said.

Researchers such as Lopez and his wife, Ana Longo Berrios, have been fanning out across the Caribbean and returning with new and troubling evidence of the decline. In some places, especially inHaiti, where severe deforestation is added to the mix of problems, extinctions are possible.

It is part of a grim picture overall. The International Union for the Conservation of Nature has found that 32 percent of the world's amphibian species are threatened or extinct, including more than 200 alone in both Mexico and Colombia.

"Everywhere we are seeing declines and it's severe," said Jan Zegarra, a biologist based in Puerto Rico for the U.S. Fish and Wildlife Service.

Frogs may be less charismatic than some other troubled species, but their role in the environment is important. They are consumed by birds and snakes and they in turn are major predators of mosquitoes. Their absence could lead to a rise in malaria and dengue, not to mention discomfort.

There are also less tangible reasons for protection. The coqui, the common name for a genus that includes 17 species in Puerto Rico, including three believed to be already extinct, is important to the cultural heritage of the island; it's considered a symbol of the island, seen in everything from indigenous petroglyphs to coffee mugs sold to tourists at the airport. Frogs, which breathe and process toxins through their skin, are considered a promising area for pharmaceutical research and a bio-indicator that can tell scientists about what's going on in the environment.

"We are just starting to understand the ripple down effects and the repercussions of losing amphibians," said Jamie Voyles, a biologist at New Mexico Tech in Albuquerque and one of the principal investigators of Project Atelopus, an effort to study and protect frogs of an endangered genus in Panama.

Rafael Joglar, a biologist at the University of Puerto Rico, has noted the diminishing nighttime calls in decades of research on the island and not just from the three species believe to have gone extinct. "Many of the other species that were common when I was a younger student ... are now disappearing and are actually very rare."

In percentage terms, the worst situation for frogs is the Caribbean, where more than 80 percent of species are threatened or extinct in the Dominican Republic, Cuba and Jamaica and more than 90 percent in Haiti, according to the International Union for the Conservation of Nature. In Puerto Rico, it's around 70 percent.

"The frogs in the Caribbean are in very bad shape," Joglar said.

One major reason the Caribbean is so vulnerable is that many species are found only within a small habitat on just one island. Take, for example, the coqui guajon, or rock frog, which was the focus of attention by Lopez and Longo on a recent night. About the size of a golf ball, it is what's known as a habitat specialist, found only in caves of a certain kind of volcanic rock along streams in southeastern Puerto Rico.

There are 17 known spots designated by the U.S. Fish and Wildlife Service as critical habitat for the rock frog, all of them on private land. Longo and Lopez, working for a research and public education initiative called Proyecto Coqui, have been trying to determine the health of the populations on those isolated patches.

"That's why it's such a vulnerable species," Lopez said. "If something happens to the habitat, people can't just grab them and put them in another place on the island because this habitat is only found on the southeast of the island."

In densely populated Haiti, the degradation of the environment has been so severe that only a handful of species are known for certain to still be viable in the country and even they are in trouble, said S. Blair Hedges, a biology professor at Pennsylvania State University who has studied frogs in the Caribbean since the 1980s.

"I'm really certain that some species are going over the edge, are disappearing," Hedges said.

Frogs have been under siege around the world from a fungus called Batrachochytrium dendrobatidis, known for short as "Bd," which has been known to be weakening and killing amphibians since the late 1990s though much about it remains under scientific study, Voyles said. Its effects, however, are dramatic.

"When I first went to Panama the sounds at night were incredible and now it's just silent," she said. "It's hard to communicate the absence of that incredible cacophony of beautiful sounds. It's very striking how much we have lost."

Among research efforts on the fungus is one by Lopez and Longo, who have been catching frogs in the forest, checking them for Bd and ticks, and then releasing them back into the night. They have started finding the fungus in the coqui guajon and are still trying to determine how it will affect the population.

After three weeks on the winding back roads of Puerto Rico, politely knocking on people's doors to ask if they could root around on their land for frogs, the researchers were relieved to find plentiful specimens. But they were also dismayed to confirm that one place designated as critical habitat had not a single coqui guajon left.

"To our surprise, the habitat is there, but no frogs, no frogs at all," he said.

_____

Associated Press writer Trenton Daniel contributed from Port-au-Prince, Haiti; Lopez reported from the Dominican Republic; Fox reported from Puerto Rico.

http://news.yahoo.com/alarm-over-vanishing-frogs-caribbean-183246905.html

Electromagn Biol Med. 2010 Jun;29(1-2):31-5. doi: 10.3109/15368371003685363.

Mobile phone mast effects on common frog (Rana temporaria) tadpoles: the city turned into a laboratory.

Balmori A.

C/Navarra, Valladolid, Spain. abalmori@ono.com

Abstract

An experiment has been made exposing eggs and tadpoles of the common frog (Rana temporaria) to electromagnetic radiation from several mobile (cell) phone antennae located at a distance of 140 meters. The experiment lasted two months, from the egg phase until an advanced phase of tadpole prior to metamorphosis. Measurements of electric field intensity (radiofrequencies and microwaves) in V/m obtained with three different devices were 1.8 to 3.5 V/m. In the exposed group (n = 70), low coordination of movements, an asynchronous growth, resulting in both big and small tadpoles, and a high mortality (90%) was observed. Regarding the control group (n = 70) under the same conditions but inside a Faraday cage, the coordination of movements was normal, the development was synchronous, and a mortality of 4.2% was obtained. These results indicate that radiation emitted by phone masts in a real situation may affect the development and may cause an increase in mortality of exposed tadpoles. This research may have huge implications for the natural world, which is now exposed to high microwave radiation levels from a multitude of phone masts.

http://www.ncbi.nlm.nih.gov/pubmed/20560769

Source

Parents hope photo of son's last text before dying serves as warning to others who text and drive

Parents hope photo of son's last text before dying serves as warning to others who text and drive

Police hold a picture of Alexander Heit's phone and the last text he was composing before he crashed. 

Posted: 04/11/2013

Last Updated: 28 minutes ago

GREELEY, Colo. - Alexander Heit's final text cut off in mid-sentence.

Before he could send it, police say the 22-year-old University of Northern Colorado student drifted into oncoming traffic, jerked the steering wheel and went off the road, rolling his car.

Heit died shortly after the April 3 crash in Greeley, but his parents and police are hoping the photo of the mundane text on his iPhone will serve as a stark reminder to drivers that no text is worth it.

The photo, obtained by 7NEWS, shows Heit was responding to a friend by typing "Sounds good my man, seeya soon" followed by a few random letters. That was the exact moment he crashed.

“I can’t bear the thought of anyone else having to go through something like this,” mother Sharon Heit wrote in a statement released by Greeley Police. “Please, vow to never, NEVER text and drive. In a split second you could ruin your future, injure or kill others, and tear a hole in the heart of everyone who loves you.”

Heit, who is originally from Boulder, had a spotless driving record and was not speeding. Sharon Heit said her son was a good student who was kind, well liked and funny.

Copyright 2013 Scripps Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

http://www.thedenverchannel.com/news/local-news/parents-hope-photo-of-fatal-text-serves-as-warning-to-others-who-text-and-drive

Texting While Driving: How Dangerous is it?

Unprotected Text: We investigate if sending messages on your phone while driving is more LOL than OMFG.

JULY 2009

    

PHOTOGRAPHY BY AARON KILEY

http://bcove.me/0ce9s6w4

Cell phones promote serious social, psychological issues

WASHINGTON, April 7. 2013-“It’s getting harder to differentiate between schizophrenics and people talking on the cell phone. It brings me up short to walk by somebody who appears to be talking to themselves.” Bob Newhart.

What started out as a means of adult communication has become a teen status symbol and a new age addiction, and it is not a drug: It’s a cell phone. Recent research at Baylor University finds the link between materialism and IT devices are creating a generation of learned compulsive behavior. With four billion cell phones in use today, that’s a substantial amount of compulsion.

Read more: http://communities.washingtontimes.com/neighborhood/steps-authentic-happiness-positive-psychology/2013/apr/7/cell-phones-promote-serious-socio-psychological-is/

Mystery of massive rise in those quitting workforce on disability

Mystery of massive rise in those quitting workforce on disability

03 APRIL 2013

OVER the past few years an extraordinary development has occurred in Ireland, which has gone broadly unnoticed. Tens of thousands of people have left the labour force due to disability. This has occurred despite the fact that the workforce, in general, has become younger and healthier on most measures and despite the fact that there have been significant positive steps towards reducing discrimination against disabled people in the workforce.

However, if you drill down into the numbers, the number of people now registered as disabled or citing a disability as the reason they can't find work has gone through the roof.

What is happening?

These people are not included in the unemployed and they are, in effect, invisible from the statistics.

At the outset let me be clear: I do not know why this is happening. As a general rule, you would expect the proportion of those people who state in surveys that they are disabled would progress in line with growth in the general population.

A huge jump in disability – whether physical or emotional – might come if a country experienced a war or a natural catastrophe like Chernobyl. But nothing like this this has happened here, thankfully.

Yet, since 2006, there has been a 37.7pc increase in the number of people who have left the labour force citing a condition that substantially limits one or more basic physical activities.

This is not people who have been unfortunate enough to be born with a disability, but people who have developed a disabling condition. This means 55,000 people – bigger than Waterford, the country's fifth largest city. Between 2002 and 2006, the same figure only increased by 1pc which is less than 2,000 people.

So what has happened from 2006 to 2012 to cause 53,000 extra people to leave the labour force due to physical disability?

Meanwhile, the number of people leaving the labour force citing a psychological or emotional condition has risen even more dramatically – 88,000 people are now diagnosed with an emotional or psychological condition that is bad enough that they can't work. This is a 27,000 rise from the same figure in 2006.

What has happened in the past few years to explain this dramatic increase?

If we look at the chart – taken from CSO data – which plots the growth in the number of people not working due to disability and the growth in the labour force itself, we see a massive deviation. This began in the late 1990s and has continued throughout the past dozen years.

In all cases, these people drop off the economic and social radar screen and politically only become an issue when something like the cut in the carer's allowance becomes a big budgetary issue.

People on disability don't show up in any of the places we usually look to see how the economy is doing. But the story of these programmes – who goes on them, and why, and what happens after that – is, to a large extent, an undocumented one.

The question for us is whether our population has become dramatically more unhealthy in the past few years or whether the State has recognised conditions which up until now were not regarded as conditions deemed to make people unfit for work.

These are not frivolous questions because if the answer is the former – that the Irish workforce is becoming more unhealthy – it has enormous implications for the effectiveness of the health system, the ongoing nutrition of the people and the emotional or psychological stability of the nation.

On most metrics, the evidence is that Irish people have become progressively healthier over the past two decades.

In addition, having spent so much money on the health system over the past few years, there are legitimate reasons to ask, if health budgets have gone up, why has the workforce become less healthy?

If, on the other hand, the dramatic rise in people being unfit for work is due to the increase in the diagnosis of heretofore unrecognised conditions that are sufficiently debilitating to prevent people looking for work, the dilemma is what to do to help these people improve their quality of life.

For example, once you are diagnosed with an emotional condition, is that it?

Do you remain out of the workforce indefinitely or are there programmes to treat your emotional and mental health so that you can look for a job again?

Of course, there is also the possibility that some people are seeking to have a condition diagnosed in order to stay on benefits indefinitely and to avoid their long-term benefits becoming conditional on having to go out looking for work.

What is clear from the point of view of society is that people who are unfit for work because they develop an emotional, psychological or physical ailment are an economic resource that needs to be nurtured. It isn't enough to give them a cheque every week and forget about them.

If it becomes clear that some cases are not legitimate and are due to fabricated or exaggerated ailments, then life will be more difficult for people who really are disabled because taxpayers will come to think of all people who are stressed, bullied, immobile or injured as faking it.

Discussions on these issues tend to descend very easily into one side screaming "welfare fraud" and the other screaming "legitimate need". These set pieces rarely produce anything other than reinforcing initial prejudices. However, a reasoned discussion as to why an increasing number of the Irish workforce are deemed unfit to work would seem like a sensible conversation to have.

www.davidmcwilliams.ie

http://www.independent.ie/opinion/columnists/david-mcwilliams/mystery-of-massive-rise-in-those-quitting-workforce-on-disability-29170473.html