Chronic fatigue syndrome is a medically unexplained ailment characterized by new onset of fatigue accompanied by rheumatological, infectious, and neuropsychiatric symptoms. Because the ailment often begins suddenly with a flu-like presentation, early pathophysiological ideas as to cause included viral infection and immune activation. When early reports identified putative immunological abnormalities in this illness, it was given the name of chronic fatigue and immune dysfunction syndrome, or CFIDS.The purpose of this review is to evaluate the immunological literature to determine if strong evidence to support this notion exists. We collected and reviewed 239 published papers, of which only 72 fulfilled a set of criteria for use in this review. For this review, we developed the following criteria: papers had to be published in the peer review literature; patients had to be from a group with substantial fatigue lasting at least 6 months (the vast majority fulfilled either the 1988 [21] or the 1994 [13] case definition of chronic fatigue syndrome [CFS]); papers had to compare CFS patients to healthy controls; and actual data had to be shown with evidence of testing for statistical significance. So, for example, when a paper reported no difference between patients and controls for some immunological variables but actual data were not included, we did not include it. Also, if a report compared patient data to normative values rather than to the study's own control group, we did not include it.The numbers of immunologically active cells and immunologically active substances such as cytokines reported in the literature have mushroomed in the past decade. To keep this review manageable, we are reporting scientific papers only on those variables for which either consistent or inconsistent abnormalities were reported by more than one group. We did not review papers reporting immunological variables to be within normal limits but have listed those studies in which more than one group found such results in a table. We have chosen not to list those variables reported abnormal in only one study because those results have not yet been replicated. When inconsistent results among laboratories were found for any immunological variable, we reviewed the methods described in those papers in an effort to identify reasons for such discrepancies.Note: when a group published more than one paper and it was apparent that the two studies used many if not all of the patients whose data are in the second paper, we chose to include only the more recent paper or the one with the largest number of subjects. To provide several examples, Tirelli published two papers, the first with 205 subjects and the second with 265 patients (66, 67). When data from one variable appeared in both papers, we included data from only the latter. Our own group has published three papers using different statistical methods and making different comparisons when reviewing lymphocyte populations. Thus, we used the one paper that controlled for multiple comparisons (74)...

No abstract

Adhesive capsulitis or frozen shoulder is a common condition characterized by shoulder pain and stiffness in which conservative methods of treatment such as glucocorticosteroids, anti-inflammatory drugs, and physiotherapy play a significant part. To evaluate the pain relieving effect of short-course pulse prednisolone, this comparison study was planed. Two age and sex-matched groups of patients were studied during three years. Each group consisted of thirty patients suffered from idiopathic Frozen Shoulder. The mean duration from the onset of the disorder to referral to our clinic was five months. Patients' pain on external rotation was qualified using a visual analog scale before and after finishing the treatment. The first group received oral diclofenac (100 mg/day) and physiotherapy. The second group received 500 mg of prednisolone intravenously (i.v.) for three consecutive days at the beginning of treatment in addition to the full treatment regimen of the first group. The pain relieving effects of the two methods of treatment were compared. The mean pain scale for the first group decreased from 7.16 to 4.9 (p < 0.001) and for the second group from 7.10 to 2.96 (p < 0.001) as indicated by Paired sample test. Based on the results of this study, inclusion of 500 mg prednisolone for three days appears to improve the pain-relieving effect of routine conservative treatment of frozen shoulder using NSAIDs and physiotherapy.

Adhesive capsulitis or frozen shoulder is a common condition characterized by shoulder pain and stiffness in which conservative methods of treatment such as glucocorticosteroids, anti-inflammatory drugs, and physiotherapy play a significant part. To evaluate the pain relieving effect of short-course pulse prednisolone, this comparison study was planed. Two age and sex-matched groups of patients were studied during three years. Each group consisted of thirty patients suffered from idiopathic Frozen Shoulder. The mean duration from the onset of the disorder to referral to our clinic was five months. Patients' pain on external rotation was qualified using a visual analog scale before and after finishing the treatment. The first group received oral diclofenac (100 mg/day) and physiotherapy. The second group received 500 mg of prednisolone intravenously (i.v.) for three consecutive days at the beginning of treatment in addition to the full treatment regimen of the first group. The pain relieving effects of the two methods of treatment were compared. The mean pain scale for the first group decreased from 7.16 to 4.9 (p < 0.001) and for the second group from 7.10 to 2.96 (p < 0.001) as indicated by Paired sample test. Based on the results of this study, inclusion of 500 mg prednisolone for three days appears to improve the pain-relieving effect of routine conservative treatment of frozen shoulder using NSAIDs and physiotherapy.