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Examines the nature and extent of the overlap among unexplained symptoms of clinical conditions (UCCs) and the limitations of previous medical research. Sharing of demographic, clinical and psychosocial features and objective findings in UCCs; Proportion of patients with one unexplained condition meeting criteria for a second unexplained condition; Substantial overlap in UCCs.

Objective: To conduct neurologic, immunologic, and virologic studies in patients with a chronic debilitating illness of acute onset.Design: Cohort study with comparison to matched, healthy control subjects.Patients: We studied 259 patients who sought care in one medical practice; 29% of the patients were regularly bedridden or shut-in.Main Outcome Measures: Detailed medical history, physical examination, conventional hematologic and chemistry testing, magnetic resonance imaging (MRI) studies, lymphocyte phenotyping studies, and assays for active infection of patients' lymphocytes with human herpesvirus type 6 (HHV-6).Main Results: Patients had a higher mean (+/- SD) CD4/CD8 T-cell ratio than matched healthy controls (3.16 +/- 1.5 compared with 2.3 +/- 1.0, respectively; P less than 0.003). Magnetic resonance scans of the brain showed punctate, subcortical areas of high signal intensity consistent with edema or demyelination in 78% of patients (95% CI, 72% to 86%) and in 21% of controls (CI, 11% to 36%) (P less than 10(-9)). Primary cell culture of lymphocytes showed active replication of HHV-6 in 79 of 113 patients (70%; CI, 61% to 78%) and in 8 of 40 controls (20%; CI, 9% to 36%) (P less than 10(-8], a finding confirmed by assays using monoclonal antibodies specific for HHV-6 proteins and by polymerase chain reaction assays specific for HHV-6 DNA.Conclusions: Neurologic symptoms, MRI findings, and lymphocyte phenotyping studies suggest that the patients may have been experiencing a chronic, immunologically mediated inflammatory process of the central nervous system. The active replication of HHV-6 most likely represents reactivation of latent infection, perhaps due to immunologic dysfunction. Our study did not directly address whether HHV-6, a lymphotropic and gliotropic virus, plays a role in producing the symptoms or the immunologic and neurologic dysfunction seen in this illness. Whether the findings in our patients, who came from a relatively small geographic area, will be generalizable to other patients with a similar syndrome remains to be seen. [ABSTRACT FROM AUTHOR]

Investigates the point prevalence of the chronic fatigue syndrome and unexplained debilitating chronic fatigue in a community-based sample of persons. Description of demographic, clinical and psychosocial differences among samples with chronic fatigue and healthy controls; Questionnaire on medical history and fatigue related symptoms as source of evaluation.

Background: Fibromyalgia is a common chronic pain condition for which patients frequently use acupuncture. Objective: To determine whether acupuncture relieves pain in fibromyalgia. Design: Randomized, sham-controlled trial in which participants, data collection staff, and data analysts were blinded to treatment group. Setting: Private acupuncture offices in the greater Seattle, Washington, metropolitan area. Patients: 100 adults with fibromyalgia. Intervention: Twice-weekly treatment for 12 weeks with an acupuncture program that was specifically designed to treat fibromyalgia, or 1 of 3 sham acupuncture treatments: acupuncture for an unrelated condition, needle insertion at nonacupoint locations, or noninsertive simulated acupuncture. Measurements: The primary outcome was subjective pain as measured by a 10-cm visual analogue scale ranging from 0 (no pain) to 10 (worst pain ever). Measurements were obtained at baseline; 1, 4, 8, and 12 weeks of treatment; and 3 and 6 months after completion of treatment. Participant blinding and adverse effects were ascertained by self-report. The primary outcomes were evaluated by pooling the 3 sham-control groups and com- paring them with the group that received acupuncture to treat fibromyalgia. Results: The mean subjective pain rating among patients who received acupuncture for fibromyalgia did not differ from that in the pooled sham acupuncture group (mean between-group difference, 0.5 cm [95% CI, -0.3 cm to 1.2 cm]). Participant blinding was adequate throughout the trial, and no serious adverse effects were noted. Limitations: A prescription of acupuncture at fixed points may differ from acupuncture administered in clinical settings, in which therapy is individualized and often combined with herbal supplementation and other adjunctive measures. A usual-care comparison group was not studied. Conclusion: Acupuncture was no better than sham acupuncture at relieving pain in fibromyalgia. [ABSTRACT FROM AUTHOR]

Provides information on the U.S. National Institutes of Health workshop to improve the reproductivity of results and precision of tests in chronic fatigue syndrome (CFS), held from March 18 to 19, 1991. Symptoms of CFS; Purposes of the workshop; Major criteria to meet the case definition for CFS.