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Part A: Terms most often encountered in relation to CFS A anti-inflammatory: Agents that reduce inflammation without directly antagonizing the agent that caused it. antidepressants: Pharmaceutical agents used to treat clinical depression. anxiety disorders: Also known as anxiety neurosis or anxiety reaction. A condition that can be caused by both psychologic and physiologic factors. It can take two general forms: (1) acute anxiety (panic disorder), marked by repeated occurrences of intense self-limited anxiety lasting usually a few minutes to an hour, or (2) chronic anxiety, characterized by less intense reactions of much longer duration (days, weeks, or months). B Borrelia: A genus of bacteria with numerous species that cause disease in humans. The diseases associated with these organisms are typically relapsing fevers. C case definition: In the example of CFS, a combination of symptoms, signs, and physiologic characteristics that serve to distinguish a case of chronic fatigue syndrome from other disease states. case-control study: An epidemiologic study that examines selected patients who have a defined disease (cases) with persons without the disease (controls). chronic: Of long duration, denoting a disease of slow progress and long continuance. chronic fatigue and immune dysfunction syndrome (CFIDS): A synonym for chronic fatigue syndrome used by some patients and physicians. It should be stressed, however, that no immune dysfunction or aberration has been persuasively linked to chronic fatigue syndrome. coenzyme: A substance that enhances or is necessary for the action of enzymes. They are generally much smaller than enzymes themselves. connective tissue disorder: A variety of inflammatory diseases of connective tissue, the most common of which is rheumatoid arthritis. Much, if not all, of this disease is now attributed to autoimmune processes. connective tissue: The supporting tissues of the body, such as tendons, ligaments, bone, and cartilage. control: A device used to verify or regulate a scientific experiment or study. A case-control study serves as a useful example. Since patients with a specific illness are examined for various characteristics, a group of healthy individuals who otherwise have as much in common with the patients as possible must be examined in parallel for the same characteristics. cross-sectional study: In epidemiology, a study in which participants are examined at only a single time for characteristics of a disease. cytokine: Proteins manufactured by cells of various lineages that, when secreted, drive specific responses (e.g., proliferation, growth, or maturation) in other susceptible cells. cytomegalovirus (CMV): One of the eight known types of human herpesviruses, also known as human herpesvirus 5 (HHV-5). It belongs to the beta subfamily of herpesviruses. CMV can cause severe disease in patients with immune deficiency and in newborns when the virus is transmitted in utero.
D
E epidemiology: The branch of medical science that deals with the incidence, distribution, and control of disease in a population. Epstein-Barr virus (EBV): One of the eight known types of human herpesviruses, also known as human herpesvirus 4 (HHV-4). It belongs to the gamma subfamily of herpesviruses. It commonly causes acute mononucleosis, and less commonly chronic mononucleosis. It some populations EBV is causally associated with life-threatening malignancies (Burkitt's lymphoma, nasopharyngial carcinoma). etiology: Causal association of a disease with an agent. The study of the cause of diseases. F H human herpesvirus 6: A virus of the herpesvirus beta-subfamily,
discovered in 1985, that infects more than 95% of people by the age of
2 years. It has been causally associated with roseola, mononucleosis-like
illness, inflammation of lymph glands. There is also suggestive evidence
for a role in multiple sclerosis.
I
imaging tests: Any of a variety of methods for observing the internal anatomy of the body, ranging from simple x-rays to complex three-dimensional scanning techniques using nuclear magnetic resonance, positron emission, and other techniques. immune globulin: A crude preparation of antibody molecules collected from pooled multiple blood donations, used as a means for passively transferring antimicrobial resistance to susceptible individuals. immune suppressants: Agents that block or restrict the activity of one or more components of the immune system, usually leading to increased susceptibility to infectious disease. L lymphocyte: Small white blood cells that are uniform in appearance, but very diverse in function. Collectively, they are responsible for antibody production, direct cell-mediated killing of virus-infected cells and tumor cells, and for the regulation of virtually every other component of the mammalian immune system. M malaise: A feeling of general discomfort or uneasiness, an out-of-sorts feeling, often the first indication of an infection or other disease. myalgic encephalomyelitis: A synonym for chronic fatigue syndrome in common usage in the United Kingdom and Canada.
natural killer cell (NK): A lymphocyte which, unlike other lymphocytes, does not require specific activation by foreign antigen. They are considered to play a "front line" role in controlling infection, curbing infection until a specific, coordinated immune response can be mounted. N neuromyasthenia: Muscular weakness, usually of emotional origin. neuropsychiatric: Relating to organic and functional diseases of the nervous system. P R retrovirus: A family of RNA viruses that have the unique characteristic
of producing an enzyme that makes a DNA copy of its genetic information
from an RNA template (the opposite of what normally takes place). The
most widely recognized of these viruses is HIV, the causative agent in
AIDS. Another virus from this family (HTLV-1) has been associated with
T cell leukemia. Initial reports of an association of an HTLV-II-like
retrovirus with CFS could not be confirmed in subsequent studies.
S single photon emission computed tomography (SPECT) scan: An imaging technique that measures the emission of photons of a given energy from radioactive tracers introduced into the body. As with other forms of computer-assisted tomography, the technique produces a series of cross-sectional images of internal anatomy. systemic lupus erythematosus: An inflammatory disease of connective tissue occurring predominantly in women (90%). It is considered to be an autoimmune disease. T titer: The concentration of a substance in a solution, or the strength of such a substance detected by titration. In the current context, the term is most likely to refer to antibody titer, which is a measure of the concentration of specific antibodies to selected microbes that are circulating in an individual's bloodstream. V
Part B: Scientific terms encountered in this document
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amino acid: A family of modified organic acids that serve as building blocks for the synthesis of proteins.
amylase: An enzyme that breaks down complex carbohydrates such as starch.
anaphylactic shock: An allergic reaction marked by contraction of smooth muscle and dilation of blood vessels. If not checked rapidly by an injection of epinephrine, the reaction can be lethal.
anorexia nervosa: A personality disorder manifested by extreme aversion to food, usually occurring in young women.
anterograde: Moving forward.
antinuclear antibody: Anti-self antibodies directed against the DNA. It is one indicator for the autoimmune disorder systemic lupus erythematosis (SLE).
asthma: A disease marked by recurrent attacks of distressed breathing. It is most often due to allergic reactions to plant or animal substances or to food products.
autoimmune disease: Disorders in which the body mounts a destructive immune response against its own tissues.
axillary lymph nodes: Lymphoid organs located near the shoulder joint.
B
bile duct: Tubular structures responsible for conducting bile (a substance
that aids in digestion) from the liver to the intestine.
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biliary obstruction: Blockage or clogging of a bile duct.
bilirubin: A red pigment formed from hemoglobin during normal and abnormal destruction of red blood cells in the body.
bulimia nervosa: A disorder marked by morbidly increased appetite, often alternating with periods of anorexia.
C
cervical lymph nodes: Lymphoid organs located in the neck.
cholangitis: Inflammation of the bile duct.
cholecystitis: Inflammation of the gall bladder.
cirrhosis: Progressive disease of the liver, characterized by liver cell damage, scarring of the liver, and abnormal liver architecture and function.
cluster investigation: An epidemiologic investigation mounted to determine if there has been an unexpected increase in the number or prevalence of cases of illness. The increase can be with respect to a particular interval in time, a particular location, or both.
co-morbid: Two or more disease conditions that occur simultaneously within the same person. A diagnosis of CFS requires that certain other conditions that may also cause fatigue, such as cancer, are not present.
creatinine: A component of urine, and the final breakdown product of creatine, which is an important molecule for building energy reserves, for example, in muscle cells.
D
diabetes mellitus: A metabolic disease in which carbohydrate utilization
is reduced and fat and protein utilization is enhanced. It is caused by
insulin deficiency.
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diabetic acidosis: A condition in diabetic patients in which the levels of alkali are reduced relative to the level of acids.
diabetic ketoacidosis: A form of acidosis in diabetic patients caused by the enhanced production of ketone bodies.
diabetic nephrosclerosis: A condition in diabetic patients marked by hardening of the kidney from overgrowth and contraction of the connective tissue of the organ.
delusional disorders: A psychiatric disorder characterized by states of heightened self-awareness and a tendency toward paranoia.
dementias: A physically caused permanent or progressive decline in intellectual function that interferes with the patient's normal social or economic activity.
diuretics: Agents that promote the excretion of and/or increase the amount of urine.
E
electrolytes: Substances that dissociate in water to form a cation
(positively charged ion) and and anion (negatively charged ion). Charged
ions are central to a variety of important processes in the body, including
muscle contraction and nerve impulse conduction.
enzyme: Specialized proteins that act as catalysts for virtually all necessary chemical reactions that take place within the body. Like all catalysts, enzymes unchanged by the reactions they promote, and will initiate many reactions until they are degraded (usually by another enzyme).
eosinophil: A white cell of the category known as granulocytes. These cells contain numerous dense granules in their cytoplasm that comprise a battery of highly active digestive chemicals and toxins. Their chief role is thought to be in combatting large parasites, although occasionally their activity may be triggered by other agents, potentially leading to damage of normal tissues (see eosinophilia myalgia syndrome).
eosinophilia myalgia syndrome (EMS): A disease caused by marked promotion of eosinophil activity, resulting in a symptom complex of severe pain, inflammation of the tendons, fluid build-up in the muscles, and skin rash. The disorder has been linked to a contaminant of some commercial preparations of the amino acid L-tryptophan.
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G
gamma (g) glutamyl transferase: One of a family of enzymes involved
in transporting amino acids from the exterior to the cytoplasm of a cell.
High serum levels of this enzyme serve as an indicator for liver disease.
globulin: A family of proteins found in abundance in plasma. They include the gamma globulins, which in turn include the various antibody molecules produced by the immune system.
glomerulonephritis: Kidney disease characterized by bilateral inflammatory changes in the glomeruli (tufts of capillary loops associated with the nephrons, the functional units of the kidney). The disorder is not caused by infection. It is considered an autoimmune disease.
glucose: A simple sugar which is actively transferred into the blood following the digestive breakdown of starch and other carbohydrates in the gut.
H
hematologic: Having to do with the blood.
hemoglobin: The red, oxygen-carrying protein found in red blood cells.
hepatitis B virus: A small DNA virus capable of causing both acute and chronic liver disease, possibly by eliciting tissue damage by the immune system. The virus may also be a risk factor for hepatic carcinoma. It is often transmitted through sexual activity or through exposure to contaminated blood.
hepatitis C virus: An RNA virus related to the pestiviruses and flaviviruses. It is capable of causing both acute and chronic liver disease. As with hepatitis B, the liver damage resulting from this infection may be the result of immune reactivity against virus-infected liver cells.
hyperthyroidism: A condition marked by excessive secretory activity of the thyroid gland.
hypoparathyroidism: A condition caused by the reduction or absence of secretions of the parathyroid gland.
hypothyroidism: Diminished production of thyroid hormone, leading to thyroid insufficiency.
I
iatrogenic: Related to an abnormal state or condition produced in
a patient through inadvertant or erroneous treatment.
insomnia: Inability to sleep even in the absence of external impediments, during the period when sleep should normally occur.
L
lactate dehydrogenase: An enzyme important to the process of glucose
combustion in the body, and an important mechanism for cellular energy
production.
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lactate: An ester of lactic acid produced during non-respiratory glucose combustion. It may accumulate during some disease conditions, leading to lactate acidosis.
Lyme disease: A tick-transmitted inflammatory disorder that begins with a characteristic skin rash, and may be followed weeks to months later by neurologic, cardiac, or joint abnormalities.
lymphotrophic: Denoting a virus that tends to bind to and infects one or more subsets of lymphocytes.
M
malabsorption syndrome: Syndromes resulting from impaired absorption
of nutrients from the bowel.
multiple chemical sensitivity disorder: A controversial diagnosis of an allergy-like sensitivity to an unusually broad range and number of substances. This condition has not been subjected to rigorous scientific scrutiny, and there is considerable doubt as to whether or not it actually exists.
multiple sclerosis: A slowly progressive central nervous system disease characterized by disseminated patches of demyelination in the brain and spinal cord.
myoglobin: The oxygen-transporting protein of muscle, resembling blood hemoglobin in function.
N
narcolepsy: A sudden, uncontrollable disposition to sleep occurring
at irregular intervals, with or without obvious predisposing or exciting
cause.
neurotransmitters: Substances produced in neurons that promote or inhibit the conduction of nerve impulses, such as epinephrine, norepinephrine, dopamine, serotonin, and gamma-aminobutyrate.
O
osmolality: Osmotic concentration. An indicator of fluid balance in
the bodies tissues.
P
pathognomonic: Characteristic or indicative of a disease, denoting
especially one or more typical symptoms.
pathophysiologic: Characteristic derangement of function seen in disease.
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period prevalence: The number of existing cases of an illness during a period or interval, divided by the average population.
pituitary: Also known as the hypophysis, a gland at the base of the brain with two functionally distinct lobes involved in regulating growth, metabolism, and maturation.
plasma: The fluid portion of the blood, rich in soluble proteins with a wide range of functions.
pulmonary: Relating to the lungs.
R
renal: Relating to the kidneys.
roseola: Also known as roseola infantum, exanthem subitem, and pseudorubella. An acute disease of infants or very young children caused by HHV-6 and characterized by high fever and a skin rash.
rubella: Also known as German measles, an acute disease marked by skin rash and swollen lymph nodes, but generally without fever. It is caused by an RNA virus of the togavirus family.
S
sarcoidosis: A systemic disease involving the lungs, lymph nodes,
skin, liver, spleen, eyes, phalangial bones, and parotid glands, characterized
by granular nodules. Its cause is not known.
schizophrenia: The most common type of psychosis, characterized by extensive withdrawal of the individual's interest from other people and the outside world and the investment of it in his/her own self.
sequelae: Morbid conditions following as a consequence of a disease.
sinusitus: Inflammation of the lining membrane of any sinus, especially of one of the paranasal sinuses.
sleep apnea: A group of potentially lethal disorders in which breathing recurrently stops during sleep for long enough to cause measurable blood deoxygenation.
subacute: A zone between acute and chronic, denoting the course of a disease.
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syphillis: An acute and chronic disease caused by the bacteria Treponema pallidum, transmitted by direct contact, usually through sexual intercourse.
T
thyroid-stimulating hormone: A hormone of the anterior pituitary gland
that stimulates and regulates the development and secretory activity of
the thyroid gland.
thyroid: A two-lobed structure located in front of and on either side of the trachea, producing the hormone thryoxin; of or relating to the thyroid gland.
thyrotoxicosis: Poisoning from hyperthyroidism.
tumor: An abnormal mass of tissue that grows more rapidly than normal, and continues to grow after the stimuli which initiated the new growth cease.
U
urea: The chief product of nitrogen metabolism in mammals, excreted
in the urine. Carbonyl diamide.
V
vitamin D deficiency: (ricketts and osteomalacia) In children, the
condition prevents normal bone development; in adults, a lack of vitamin
D causes demineralization of bone, particularly in the spine, pelvis,
and lower extremities.
vitamin D intoxication: A disorder marked by weight loss, nausea, vomiting, and impaired renal function.
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