Microsoft word - abnormalities, tests, potential drugs me-cfs - april 21 2013 10 pm.docx
Date: April 21, 2013 Working Summary Myalgic Encephalomyelitis (ME/CFS) Table of Biological Abnormalities, Clinical/LabTests and Drugs with Potential for Repurposing
* A PATIENT-DRIVEN EFFORT * A WORK-IN-PROGRESS *
FDA has determined that ME and CFS is a serious disease or set of diseases for which there are no approved drug
treatments. The following table, compiled by patients, lists the clinical abnormalities found in ME/CFS patients, examples of
clinical abnormalities (symptoms and abnormal test results) that an ME/CFS patient might experience, examples of the
clinical/lab tests that patients have had to confirm the abnormalities (i.e. potential diagnostic biomarkers), and examples of the
kinds of drugs that patients have been prescribed off-label by doctors or used in clinical trials for ME/CFS, and thus have
potential for repurposing for ME/CFS patients.
BIOLOGICAL
EXAMPLES2
CLINICAL/LAB TESTS3
DRUGS WITH POTENTIAL FOR
Neurological and Memory loss, processing speed, Spect scans, fMRI, Romberg Deplin, Cerefolin-NAC, Cognex, hyperacusis, vertigo, vestibular test, CANTAB and other anti-seizure medication, Adderall, injuries, seizures, ataxia, neurocognitive tests, Lamictal, selegiline, Neurontin, expressive dysphasia, dyslexia, Computerized Dynamic SInemet, Ceftriaxone IV, Ketamine IV, absence seizures, disorientation, Posturography, qEEG, Cialis, Provigil, Aricept, piracetam, visual disturbances neurotransmitter levels (photophobia, diploplia, blurred vision), auditory processing dysfunction, tinnitus, parathesias, cranial nerve & sensory neuropathies, chronic cerebrospinal venous insufficiency Autoreactive T and B cells, ANA, ACA, DS-DNA, Rituxan, Methotrexate, Alemtuzumab, hyperactive B cells. cytokine profiles ATGAM, Enbrel, Humira, Kineret, IVIG (inflammatory, anti- (gamma globulin) inflammatory), antibodies to retroviral Env & Gag proteins, B cell cytokine (IL7), CD20, flow cytometric immune profiles Date: April 21, 2013 Working Summary BIOLOGICAL
EXAMPLES2
CLINICAL/LAB TESTS3
DRUGS WITH POTENTIAL FOR
Immune dysfunction Leukocyte deficiencies (NK cells, MMP-9, C3a, C4a, TGFβ1, Immune modulators including: GcMAF5, B cells, T cells, monocyte TNFα, IgA, IgG and IgM Enbrel, IVIG (gamma globulin), Alpha-1 compartments), immunoglobulin levels, IgA and IgG, CD56, antiprotinease, low dose naltrexone, subclass deficiencies, innate and CD57, ImmuKnow®, Nexavir, Hepapressin5 Isoprinosine, adaptive immune disorders, monocyte elastase, RNAseL, Equlibrant5, IVIG PKR, IFNα, Ig subclasses, immunodeficiency NK cell function/lymphocyte enumeration, pre and post vaccination titers Chronic infections Viral - EBV, CMV, HHV6A, IgG, IgM, viral titres and Acyclovir, Valgancyclovir, Amantadine, shingles, enteroviruses, antibodies, cytokine profiles, Valacyclovir, Famvir, Cidofovir, Viread, coxsackie B, parvovirus B19 enterovirus panels Nexavir, Foscarnet, artemisinin, Interferon beta, Ampligen6, RAP-101 (formerly Peptide T)6 Microbial and parasitic - Borrelia Microbial testing, cytokine Various antibiotics, antimycotics, Bicillin, (Lyme), Bartonella, Babesia, profiles (e.g. IL8, Ceftriaxone IV, Rifampin mycoplasma pneumonia, chlamydia pneumonia, GIardia Fungal - Candida, mold TGFβ1, MSH, MMP-9, C3a, Diflucan, Nystatin, VIP, Cholestyramine, C4a, vasoactive intestinal peptide (VIP), Leptin, VEGF Postural orthostatic tachycardia MSRI, echocardiogram, Florinef, Atenolol, Viagra, midodrine, (POTS), neurally mediated cerebral blood flow, heart hypotension (NMH), orthostatic rate, BP, tilt table intolerance (OI), loss of muscle tone Sleep abnormalities Primary and secondary Xyrem, Suramin, Suvorexant6, Ambien, insomnia, non-restorative sleep Oxytocin, Klonopin, Doxepin, with alpha wave intrusion, lack Remerone, Trazadone Energy production Mitochondrial abnormalities, Muscle biopsy, mitochondrial Dichloroacetate (DCA) 6 impairment, oxidative stress, exercise function profile, Post-exertional intolerance, abnormal anaerobic cardiopulmonary exercise threshold, VO2max worse day 2 test with blood gases, Fitbit Chronic venous insufficiency, hypercoagulation Date: April 21, 2013 Working Summary BIOLOGICAL
EXAMPLES2
CLINICAL/LAB TESTS3
DRUGS WITH POTENTIAL FOR
Pain, peripheral Joint and muscle pain, Lyrica, Clonidine, Depakote, Aricept, migraines, headaches behind prilocaine, lidocaine eyes, numb hands/feet channelopathies GI abnormalities and Chronic diarrhea, constipation, LPS in blood, microbiome Xifaxan, Flagyl, SIBO (small intestinal bacterial analysis/CDSA, secretory pre/probiotic treatment5, fecal overgrowth), leaky gut syndrome IgA, Lactulose Breath Test microbiome transplant (FMT) 5 Cortisol, progesterone, estrogen, Standard hormonal testing, Cortisol, progesterone, estrogen, testosterone, vitamin D, urinalysis, fluid deprivation testosterone, DHEA, pregnenolone, adrenalin, vasopressin, polyuria test, urine osmolality, serum human growth hormone, Metformin, anti diuretic hormone (ADH) Methylation cycle defects Deplin, Decitabine, hydroxocobalamin, Examples of Comorbidities, related tests and related treatments
Fibromyalgia, chronic sinusitis, chronic allergies, interstitial Inflammatory cytokines (e.g.
Synthroid, Cytomel, Low dose naltrexone, cystitis, multiple chemical sensitivities, hypothyroidism IL1β, IL6, IL8), Isoprinosine, Anatabloc, Lenalidomide, Hashimoto's thyroiditis, carpal tunnel, Raynaud's, IBS, Ketotifen, Amantadine, antifungals, diabetes insipidus MMP-9, C3a, C4a, TGFβ1, Nexavir, Hydroxyzine, antihistamines, CD47, cystoscopy DRAFT DOCUMENT -- This table is a patient-driven effort to show what tests and drugs they have been prescribed. It is a work-in-progress and should be viewed as a preliminary draft that wil continue to be refined with additional input. It will be aligned with the clinical guidelines published by experts in the field (below). We are eager for feedback, suggestions and corrections from researchers, clinicians and patients. Please email [email protected] using a subject line of "Biological abnormalities". GUIDELINES -- For a drug to be included on this table, it must meet the fol owing criteria: 1. Drugs: ME/CFS patients must have used the drugs listed to treat their ME/CFS. The drug was either prescribed off-label by their doctor or taken in the context of a ME/CFS drug trial. The drug is classified in RXlist.com as a drug. Currently the table uses a mix of brand names and generic names. 2. Non-drug treatments: This list includes a few selected supplements, non-drug treatments or CAM (Complimentary and Alternative Medicine) that are widely used by this patient population. It is not intended to be an exhaustive list. 3. Comorbidities: The most common comorbidities experienced by ME/CFS patients are listed at the end of the table. Date: April 21, 2013 Working Summary
For Additional Information
Additional information on ME/CFS, its biological abnormalities, along with the tests and drugs used to diagnose and treat the
disease, can be found in the fol owing sources:
ME/CFS Case Definitions:
Canadian Consensus Criteria: http://www.cfids-cab.org/MESA/ccpccd.pdf ME International Consensus Criteria: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2011.02428.x/full Primers for Medical Practitioners:
IACFS/ME Primer for clinical practitioners: http://guideline.gov/content.aspx?id=38316 ME-ICC Primer for Medical Practitioners: http://www.hetalternatief.org/ICC primer 2012.pdf The most current version of this table can be found at: http://bit.ly/15op5sE
Footnotes:
1 Biological Abnormalities: Biological and clinical abnormalities associated with ME/CFS. 2 Examples: Examples of the clinical abnormalities (symptoms and abnormal test results) an ME/CFS patient might experience. 3 Clinical/Lab Tests: Used by some clinicians to assist diagnosis, and also to recommend and monitor treatments. Potential diagnostic 4 Drugs with Potential for Repurposing: These are prescription drugs that have been prescribed off-label by doctors to treat ME/CFS patients and are potential candidates for repurposing. These are examples only and not an exhaustive list. 5 Complementary or alternative medicine, supplements or non-drug therapies. Only a few are listed. See the Primers listed above for more information. 6 In development, studies in clinicaltrial.gov 7 PEM is also called Post-exertional neuroimmune exhaustion (PENE)
Source: http://pandoraorg.net/uploads/Abnormalities__Tests__Potential_Drugs_ME-CFS_-_April_21_2013_10_pm.pdf
anale.agro-craiova.ro
Analele Universitatii din Craiova, Seria Agricultura – Montanologie – Cadastru (Annals of the University of Craiova – Agriculture, Montanology, Cadastre Series) Vol. XLIV 2014 INFLUENCE OF STAGE AND NUMBER OF LACTATION ON SUCCESS OF THE ARTIFICIAL INSEMINATION IN DAIRY COWS Constantin Găvan1, Vergil Motorga2 1. Faculty of Agriculture and Horticulture Craiova, street Libertății no.19, Craiova, Dolj, Romania 2. Agricultural Research and Development Station Șimnic, Street Balcești, no. 45, Craiova, Romania Keywords: artificial insemination, calving interval, days open, estrous detection.
Microsoft word - 11-023r.doc
Journal of Civil Engineering (IEB), 40 (1) (2012) 11-22 Micro-pollutant risks associated with using Mohammad Zaved Kaiser Khan School of Natural & Built Environment, University of South Australia, Mawson Lakes Boulevard, Mawson Lakes, SA 5095, Australia Received 18 January 2011 Abstract Overwhelming demand of water with the modernization of globe consequences paucity as the total amount of fresh water remains fixed. In this vision, reclaimed water from wastewater instead of disposing it to the environment has become one of the viable options in the integrated water resources management over the few decades. The most common sources of recycled water are treated sewage effluent, stormwater runoff, domestic greywater and industrial wastewater. This water can be used for both agricultural and landscape irrigation, industrial reuse, environmental and recreational uses, groundwater recharge, non-potable purposes such as toilet flushing, indirect or direct potable reuse. Instead a long history of water reuse in different parts of the world, the question of safety and issue of health risks are being hotly debated. The most common human microbial pathogens found in reused water are enteric pathogens such as viruses, bacteria, protozoa and Helminths. Moreover, long term health risks may be associated with chemical contaminants such as pharmaceutically active compounds (PhAC), pesticides, personal care products (PCPs), endocrine disrupting compounds (EDC) and disinfection by-product (DBPs) in reclaimed water. However, this paper discusses about the micro-pollutant risks associated with reclaimed water particularly on agriculture, indirect potable reuse and toilet flushing. © 2012 Institution of Engineers, Bangladesh. All rights reserved.