This paper presents a critical review of the most frequently used case definitions in CFS. There are currently five case definitions of CFS; however, the most prominent and widely used of these definitions is the 1994 Centre for Disease Control and Prevention Case Definitions. However, the pre-eminence of this definition over the others has never been substantiated and it has been widely criticized for its lack of specificity. Furthermore, none of the above case definitions have produced evidence to demonstrate their accuracy or precision at defining cases of CFS. A summary description of the symptom profile included in each of the case definitions is provided. The inconsistencies that have emerged in CFS research as a consequence of differing approaches to case definition are also highlighted and discussed.

The aim of this article is to provide a comprehensive and updated review of the key neuropsychiatric and neuropsychological complaints associated with chronic fatigue syndrome (CFS). Neuropsychiatric and neuropsychological difficulties are common in CFS and are linked primarily to disorders of mood, affect and behaviour. The neuropsychiatric complaint most frequently encountered amongst CFS patients is depression and in particular major depressive disorder (MDD). Despite decades of research, the precise aetiological relationship between CFS and MDD remains poorly understood. This has resulted in the development of a number of interesting and polarised hypotheses regarding the aetiological nature of CFS. Recent scientific advances have however begun to unravel a number of interesting inflammatory and immunological explanations that suggest CFS and MDD are distinct yet interrelated conditions. The possibility that the overlap between CFS and MDD might be explained in terms of shared oxidative and nitrosative (IO&NS) pathways is an area of intense research interest and is reviewed in detail in this article. The overlap between CFS and MDD is further differentiated by variations in HPA axis activity between the two disorders. Important immunological differences between MDD and CFS are also reviewed with particular emphasis on antiviral RNase L pathways in CFS. In addition to the presence of neuropsychiatric complaints, CFS is also associated with neuropsychological symptoms such as impaired attention, memory and reaction time. The key neuropsychological problems reported by CFS patients are also included in the review in an effort to understand the significance of cognitive impairment in CFS.

Chronic Fatigue Syndrome (CFS) is a severe, systemic, acquired illness that presents with overpowering tiredness that cannot be relieved by rest and is deteriorated through physical and mental activity. Due to the window of prevalence (20-40 years), some women diagnosed with CFS become pregnant. Given that CFS targets women in their reproductive years, responsibility is placed upon midwives to educate, support and provide families with advice. To equip midwives with knowledge about CFS, the objectives of this paper are to provide an overview of: (1) How CFS impacts on reproductive health, (2) The effects of pregnancy on CFS symptoms, (3) CFS related pregnancy complications, (4) Intrapartum management of women with CFS, and (5) Postpartum recovery of women with CFS. To date, only a handful of studies have explored relationships between CFS, childbearing and associated complications. Greater understandings of CSF interactions with physical, psychological and social reproductive processes are required.

BACKGROUND: As age increases, prevalence of type 2 diabetes in the U.S. rises dramatically as the population approaches and enters Medicare eligibility (CDC). Although ensuring category access, CMS formulary guidelines for Medicare Part D (MPD) coverage do not take into account the effects of cost-sharing burden on patient compliance. Literature demonstrates that patient adherence is reduced with higher copayment costs and consequently, the beneficial clinical impacts may likely be unrealized for many patients. OBJECTIVES: To investigate access to diabetic medications for MPD patients compared to commercially covered lives. Exploring copay differentials amongst these populations, insight is gained on how MPD differs from commercial access to diabetes medications. METHODS: Analysis of the Walters Kluwer Pharma Solutions Source Longitudinal Patient Database, sampling of 26.7 million commercial lives and 5 million Medicare Part D lives in 2009. Low Income Subsidy covered lives were excluded. RESULTS: Average drug copayment for metformin and sulfonylurea for commercial and MPD patients

In a nutshellVarious nutrition links have been proposed for CFS. The most likely to have some validity are an imbalance of LCPFA, or of amino acids and the neurotransmitters synthesised from them. There may be some antioxidant stress involved as well.Unfortunately, the body of clinical trial evidence does not add up to any firm conclusion, despite the popularity of nutritional treatments amongst CFS patients.