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Robert W Haley - One of the best experts on this subject based on the ideXlab platform.
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electrophysiological correlates of semantic memory retrieval in Gulf War Syndrome 2 patients
Journal of the Neurological Sciences, 2017Co-Authors: Gail D Tillman, Robert W Haley, Clifford S Calley, Virginia I Buhl, Hsueh Sheng Chiang, John Hart, Michael A KrautAbstract:Abstract Gulf War veterans meeting criteria for Haley Syndrome 2 of Gulf War illness endorse a particular constellation of symptoms that include difficulty with processing information, word-finding, and confusion. To explore the neural basis of their word-finding difficulty, we assessed event-related potentials (ERPs) associated with semantic memory retrieval in 22 veterans classified as Syndrome 2 and 28 veterans who served as controls. We recorded EEGs while subjects judged whether pairs of words that represented object features combined to elicit a retrieval of an object memory or no retrieval. Syndrome 2 subjects' responses were significantly slower, and those participants were less accurate than controls on the retrieval trials, but they performed similarly on the nonretrieval trials. Analysis of the ERPs revealed a difference between retrievals and nonretrievals that has previously been detected around 750 ms at the left temporal region was present in both the Syndrome 2 patients and controls. However, the Syndrome 2 patients also showed an ERP difference between retrievals and nonretrievals at the midline parietal region that had a scalp voltage polarity opposite from that recorded at the left temporal area. We hypothesize that the similarities between task performance and ERP patterns in Syndrome 2 veterans and in patients with amnestic mild cognitive impairment reflect disordered thalamic cholinergic neural activity, possibly in the dorsomedial nucleus.
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absolute quantification of human brain metabolites in Gulf War Syndrome using proton mr spectroscopy at 3t
2010Co-Authors: S Cheshkov, Richard W Briggs, A Chang, S Ganji, E Babcock, Robert W HaleyAbstract:Results Spectra with a large water line width (> 0.14 ppm or 18 Hz), low water suppression (< 99%), or obvious artifacts were discarded. On the basis of the criteria, 8 (15%) of 55 spectra in left BG and 2 (4%) of 53 spectra in right BG had unacceptable spectral quality. Short-TE MR spectra acquired on localized volume of interest in MRI normal-appearing basal ganglia of Gulf War veterans are shown in Figure 1. After the T1 and T2 corrections were made, the NAA concentration was significantly lower in basal ganglia in veterans with Syndrome 1 (left, P = 0.028; right, P = 0.008), Syndrome 2 (left, P = 0.002; right, P = 0.028), and Syndrome 3 (left, P = 0.313; right, P = 0.027) than in the control subjects, which is consistent with the findings of the previous study [1], which reported only ratios. In addition, the mean NAA concentration was significantly higher in the left basal ganglia than in the right basal ganglia in all GW Syndrome groups, with an overall hemispheric effect significance of P < 0.0001 (Figure 2). Discussion This study represents, to our knowledge, the first in vivo measurements of absolute metabolite concentrations from the basal ganglia in veterans with Gulf War Syndrome using 1 H MRS. The main observation in this work was the reduction of NAA concentration (-6% for Syndrome 1, -8% for Syndrome 2, and -3% for Syndrome 3) in left BG and in right BG (-6% for Syndrome 1, -6% for Syndrome 2, and -4% for Syndrome 3) of GWS subjects compared to healthy control subjects, significant for Syndromes 1 and 2 in left BG and Syndromes 1, 2, and 3 in right BG. Hence, the present study demonstrated that quantitative in vivo 1 H MRS can be used to detect the biochemical abnormalities in brain of GW illness veterans, which may have relevance for the mechanisms of Gulf War Syndrome. Our finding supports that the various neurological symptoms reported by Gulf War veterans could be linked to brain injury incurred during the Gulf War. References
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functional connectivity differences to ventral putamen of Gulf War Syndrome ii and control subjects
2009Co-Authors: L Jiang, Robert W Haley, P Gandhi, Aman Goyal, L Ouyang, Kaundinya Gopinath, Richard W BriggsAbstract:Introduction: The basal ganglia (e.g., caudate, putamen, globus pallidus) are classically regarded as motor structures, but serve a wide range of functions including motor, motivational, cognitive and emotional processes. Dysfunction of basal ganglia has been implicated in numerous neurological and psychiatric disorders, including Parkinson’s disease [1] and Gulf War Syndrome [2]. Functional connectivity magnetic resonance imaging (fcMRI) has been used to investigate brain networks by analysis of temporal and spatial correlations in spontaneous resting state BOLD signal oscillations [3, 4]. The purpose of this study was to compare the connectivity of ventral putamen to other brain regions between two groups of Gulf War veterans (one with Haley Syndrome II and the other normal controls) with resting state fcMRI. Data Acquisition: Twelve right-handed male Gulf War veterans (in two group exclusively consisting of either Gulf War Syndrome II patients or healthy deployed veterans: 5 members of Group A, mean age: 63.8±7.5 years; 7 members of Group B, mean age: 58.8±6.3 years) were studied. Signed informed consents were obtained prior to participation according to an IRB-approved protocol. A Siemens Trio TIM 3T MR scanner and a 12-channel array receive-only head coil were used for data acquisition. High-resolution T1-weighted anatomical images were acquired using a MPRAGE sequence (TR/TE = 2250/3.02 ms, FA = 9 , 160 slices, 240 mm FOV). Resting-state functional images were acquired with 40 sagittal slices, TR/TE = 2000/24 ms, FA = 80, in-plane resolution = 3 mm x 3 mm, FOV = 220 mm. Processing and Analysis: Data processing was carried out using both FSL (www.fmrib.ox.ac.uk/fsl) and AFNI (http://afni.nimh.nih.gov/afni). Grey matter, white matter, CSF, and subcortical regions were segmented from T1-weighted anatomical images using FSL’s FAST (cortical) and FIRST (subcortical) programs. For seed region selection and group analysis, data were spatially transformed to Talairach space using AFNI’s linear transformation based on manually defined landmarks. The preprocessing of EPI images using AFNI included slice-timing shifting, head motion correction, and spatial normalization to standard space. Data were then temporally band-pass filtered (0.01 2.3, p < 0.05.
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blunted circadian variation in autonomic regulation of sinus node function in veterans with Gulf War Syndrome
The American Journal of Medicine, 2004Co-Authors: Robert W Haley, Frederick Petty, Wanpen Vongpatanasin, Gil I Wolfe, Wilson W Bryan, Roseanne Armitage, Robert Hoffmann, Timothy S Callahan, Elizabeth Charuvastra, William E ShellAbstract:Purpose To test the hypothesis that subtle abnormalities of the autonomic nervous system underlie the chronic symptoms reported by many Gulf War veterans, such as chronic diarrhea, dizziness, fatigue, and sexual dysfunction. Methods Twenty-two ill Gulf War veterans and 19 age-, sex-, and education-matched control veterans underwent measurement of circadian rhythm of heart rate variability by 24-hour electrocardiography, ambulatory blood pressure recording, Valsalva ratio testing, sympathetic skin response evaluation, sweat imprint testing, and polysomnography. Investigators were blinded to case- or control-group status. Results High-frequency spectral power of heart rate variability increased normally 2.2-fold during sleep in controls but only 1.2-fold in ill veterans (P Conclusion Some symptoms of Gulf War Syndrome may be due to subtle autonomic nervous system dysfunction.
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severely reduced functional status in veterans fitting a case definition of Gulf War Syndrome
American Journal of Public Health, 2002Co-Authors: Robert W Haley, Ann Matt Maddrey, Howard K GershenfeldAbstract:More than 110 000 (16%) of the 696 000 US military personnel who served in the 1991 Persian Gulf War have been granted service-connected disability compensation.1 This is 2 to 3 times the rate that followed World War II (8.6%), the Korean Conflict (5%), or the Vietnam War (9.6%).1 Although many veterans report serious impairments in daily functioning, no research, to our knowledge, has assessed the health impact of Gulf War Syndrome as measured by a systematic case definition. In 1997, Haley et al. described a case definition of Gulf War Syndrome composed of 3 primary symptom complexes (Syndromes) beginning during or shortly after the War.2–4 This case definition, identified by a factor analysis of symptoms in 249 members of a battalion that served in the War, was found to be strongly associated (relative risks of 4 to 8) with self-reported Wartime exposures to low-level chemical nerve agents and other cholinesterase-inhibiting chemicals,4 genetic susceptibility to chemical nerve agents and other organophosphates,5,6 abnormal audiovestibular tests indicating brainstem dysfunction,3,7 evidence of basal ganglia and brain stem neuronal loss as measured by magnetic resonance spectroscopy,8,9 and abnormal brain dopamine production.10 Results were recently replicated in an independent sample of Gulf War veterans.11 In 1998, we conducted a nested case–control study at the University of Texas Southwestern Medical Center involving individuals from a naval reserve battalion; 22 subjects with the highest scores on one of the 3 Haley Syndrome factor scales were selected as case patients.2,3 This criterion allowed selection of subjects with symptoms most typical of the case definition irrespective of symptom severity (not measured) and total number of symptoms, and thus there was no bias for or against severity of illness. Sixteen healthy veterans matched with case patients in regard to age, sex, and education level were selected from the same battalion to serve as controls.3 We administered the Medical Outcomes Study 36-Item Short Form (MOS SF-36) self-report questionnaire, a validated, widely accepted measure of general health, functional status, and well-being, to assess the functional status and well-being of the case patients and controls.12 Because of the existence of population-based, noninstitutionalized norms, this questionnaire serves as the “gold standard” for comparisons among illnesses. Hundreds of published studies have applied the instrument in such comparisons.12 We found that the level of impairment of ill Gulf War veterans meeting the Haley case definition was generally far worse than that of patients with common illnesses known to have a substantial negative impact, including congestive heart failure, type 2 diabetes, recent acute myocardial infarction, chronic obstructive pulmonary disease, and clinical depression (Figure 1 ▶).12 Moreover, a repeated measures analysis of variance (F1,20 = 18, P < .001) showed that the impact of Haley's “confusion–ataxia” Syndrome was substantially worse than that of his “impaired cognition” and “central pain” Syndromes, confirming earlier published observations.2–5,7,8,10 In other settings, low MOS SF-36 scores such as those revealed in this study have been shown to be highly predictive of inability to work at a paying job.12 FIGURE 1 —Medical Outcomes Study 36-Item Short Form (MOS SF-36) scores among Gulf War veteran case patients and controls (top) and MOS SF-36 scores for 6 reference medical conditions (bottom). A previous survey suggested that MOS SF-36 scores were only slightly lower in samples of Gulf War veterans than in nondeployed military personnel residing in Iowa, giving rise to the view that Gulf War–related illness has a small impact on functional status and well-being.13 However, the Iowa study reported the scores of ill Gulf War veterans combined with those of the far larger veteran population, thus obscuring the true disability level of the former group. By separating ill Gulf War veterans by means of a case definition, our study demonstrated severely diminished functional status and quality of life among those affected, commensurate with our clinical observations. This finding, coupled with previous research,1–10 suggests that many veterans are seriously impaired by brain illnesses or injuries sustained in the Gulf War.
Olga Veralastra - One of the best experts on this subject based on the ideXlab platform.
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autoimmune inflammatory Syndrome induced by mineral oil a health problem
Clinical Rheumatology, 2018Co-Authors: Olga Veralastra, Gabriela Medina, Maria Del Pilar Cruzdominguez, Gabriel Medrano Ramirez, Raymundo Priego Blancas, Ana Lilia Peralta Amaro, Anabel Villanueva Martinez, Jesus Sepulveda Delgado, Luis J. JaraAbstract:Autoimmune/inflammatory Syndrome induced by adjuvant (ASIA) includes the following conditions: siliconosis, Gulf War Syndrome, macrophagic myofasciitis Syndrome, and post-vaccination phenomena. AfterWard, other Syndromes have been recognized, such as in ASIA by mineral oil (ASIA-MO). These conditions are triggered by adjuvants and they are the result of the interplay of genetic and environmental factors. ASIA-MO is defined as the infiltration of oily type modeling substances for cosmetic purposes. It has been reported in many countries and used surreptitiously. Pathogenesis of ASIA-MO is not clear, but is characterized by chronic granulomatous inflammation, like the pristane model in mice, with increase of proinflammatory cytokines: type I interferons (IFNα and IFNs), systemic lupus erythematosus (SLE), and erosive arthritis. In humans, an increase of interleukin 1 (IL-1) has been found. Clinical spectrum of ASIA-MO is heterogeneous, varying from mild to severe and being local and systemic. The systemic manifestations can be non-specific and specific, meeting criteria for any autoimmune disease (AID), i.e., SLE, rheumatoid arthritis, and systemic sclerosis, among others. The areas of the body where the mineral oil is mostly applied include the following: buttocks (38–72%), breasts (12–16%), lower extremities (18–22%), and face (6–10%). The penis augmentation is also common. Treatment is focused on local and systemic manifestations and requires medical and surgical management representing a challenge for the physician.
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still s disease lupus like Syndrome and silicone breast implants a case of asia shoenfeld s Syndrome
Lupus, 2012Co-Authors: G. Medina, Eduardo Gomezbanuelos, Olga Veralastra, Miguel Angel Saavedra, Luis J. JaraAbstract:In recent years, four conditions, siliconosis, Gulf War Syndrome (GWS), macrophagic myofasciitis Syndrome (MMF) and post-vaccination phenomena, were linked to a previous exposure to an adjuvant, suggesting a common denominator, and it has been proposed to incorporate comparable conditions under a common Syndrome entitled Autoimmune/inflammatory Syndrome Induced by Adjuvants (ASIA). We report a case of a female who at the age of 11 years was diagnosed with Still’s disease. At the age of 22 she underwent silicone breast implants and presented with a transient lupus-like Syndrome. Then, at 25 years old she had a severe activation of Still’s disease in association with rupture of silicone breast implants. When the prostheses were removed, the clinical picture improved. This case fulfills the criteria for ASIA and complements seven previous reports of Still’s disease in association with silicone breast implants. Lupus (2012) 21, 140–145.
Luis J. Jara - One of the best experts on this subject based on the ideXlab platform.
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autoimmune inflammatory Syndrome induced by mineral oil a health problem
Clinical Rheumatology, 2018Co-Authors: Olga Veralastra, Gabriela Medina, Maria Del Pilar Cruzdominguez, Gabriel Medrano Ramirez, Raymundo Priego Blancas, Ana Lilia Peralta Amaro, Anabel Villanueva Martinez, Jesus Sepulveda Delgado, Luis J. JaraAbstract:Autoimmune/inflammatory Syndrome induced by adjuvant (ASIA) includes the following conditions: siliconosis, Gulf War Syndrome, macrophagic myofasciitis Syndrome, and post-vaccination phenomena. AfterWard, other Syndromes have been recognized, such as in ASIA by mineral oil (ASIA-MO). These conditions are triggered by adjuvants and they are the result of the interplay of genetic and environmental factors. ASIA-MO is defined as the infiltration of oily type modeling substances for cosmetic purposes. It has been reported in many countries and used surreptitiously. Pathogenesis of ASIA-MO is not clear, but is characterized by chronic granulomatous inflammation, like the pristane model in mice, with increase of proinflammatory cytokines: type I interferons (IFNα and IFNs), systemic lupus erythematosus (SLE), and erosive arthritis. In humans, an increase of interleukin 1 (IL-1) has been found. Clinical spectrum of ASIA-MO is heterogeneous, varying from mild to severe and being local and systemic. The systemic manifestations can be non-specific and specific, meeting criteria for any autoimmune disease (AID), i.e., SLE, rheumatoid arthritis, and systemic sclerosis, among others. The areas of the body where the mineral oil is mostly applied include the following: buttocks (38–72%), breasts (12–16%), lower extremities (18–22%), and face (6–10%). The penis augmentation is also common. Treatment is focused on local and systemic manifestations and requires medical and surgical management representing a challenge for the physician.
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still s disease lupus like Syndrome and silicone breast implants a case of asia shoenfeld s Syndrome
Lupus, 2012Co-Authors: G. Medina, Eduardo Gomezbanuelos, Olga Veralastra, Miguel Angel Saavedra, Luis J. JaraAbstract:In recent years, four conditions, siliconosis, Gulf War Syndrome (GWS), macrophagic myofasciitis Syndrome (MMF) and post-vaccination phenomena, were linked to a previous exposure to an adjuvant, suggesting a common denominator, and it has been proposed to incorporate comparable conditions under a common Syndrome entitled Autoimmune/inflammatory Syndrome Induced by Adjuvants (ASIA). We report a case of a female who at the age of 11 years was diagnosed with Still’s disease. At the age of 22 she underwent silicone breast implants and presented with a transient lupus-like Syndrome. Then, at 25 years old she had a severe activation of Still’s disease in association with rupture of silicone breast implants. When the prostheses were removed, the clinical picture improved. This case fulfills the criteria for ASIA and complements seven previous reports of Still’s disease in association with silicone breast implants. Lupus (2012) 21, 140–145.
Simon Wessely - One of the best experts on this subject based on the ideXlab platform.
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early accounts of Gulf War illness and the construction of narratives in uk service personnel
Social Science & Medicine, 2008Co-Authors: Simon Cohn, Clare Dyson, Simon WesselyAbstract:"Gulf War Syndrome" has become firmly established in public and political discourse, and considerable numbers of veterans of the 1991 Gulf War now see it as part of their identity. In this paper we draw on open-ended questionnaire data drawn from a large, random sample of UK Gulf veterans, collected in 1996 and 1997. Whilst there is already some literature focussing on coherent personal narratives of some veterans and campaigners, we suggest that they are preceded by much more fragmentary, shared accounts. We take the idea of rumour as a way of encapsulating how these partial ideas swiftly gained value by reflecting and reproducing social ties. Accounts describing fears about this mystery condition simultaneously made reference to concerns about their role as a soldier, about the purpose of the conflict, and rising mistrust of their commanders. As doubt over soldiers' function increased, informal social networks became increasingly significant, perhaps also linked to an erosion of respect for formal military hierarchy. At the same time, rumours of "Gulf War Syndrome" began to circulate, reinforcing the idea that the cause was elusive, and invisible, whilst undermining both the unity of the military force and the individual soldier's body. We suggest that the nature of Gulf War Syndrome as a topic of contestation in the years after the conflict was keenly shaped by these early rumours, which entangled specific ideas of the illness with feelings of betrayal, distrust and ambiguity. Informed by the general literature on illness narratives, we explore how the transmission of ideas and causal theories were themselves instrumental in the emergence of the condition as it was experienced.
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Gulf War Syndrome an emerging threat or a piece of history
Emerging Health Threats Journal, 2008Co-Authors: Neil Greenberg, Simon WesselyAbstract:‘Gulf War Syndrome’ is a phrase coined after the 1991 Gulf War to group together disparate, unexplained health symptoms in Gulf veterans. This paper examines the many hypotheses that have been put forWard about the origins of the concept and gives an overview of the studies that have attempted to explain the lasting health effects associated with Gulf service. Our review finds that although in the UK there has not yet been evidence of a new Gulf War Syndrome as a result of the current conflicts in Iraq and Afghanistan, there is a rise in post-conflict psychiatric disorders now being reported in the USA. We postulate that after conflicts military personnel will always face some form of post-conflict Syndrome and the nature of the threats experienced is likely to dictate the form the Syndrome might take. We also postulate that media reporting is likely to have influenced and to continue unhelpfully to influence the health of service personnel. (Published: 27 November 2008) Citation: Emerging Health Threats Journal 2008, 1 :e10. doi: 10.3134/ehtj.08.010
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Gulf War Syndrome has it gone away
Advances in Psychiatric Treatment, 2008Co-Authors: Mark Tarn, Neil Greenberg, Simon WesselyAbstract:‘Gulf War Syndrome’ was a phrase coined after the 1991 Gulf War. This article looks at the variety of hypotheses that have been put forWard about the origins of the concept and the studies attempting to characterise the health manifestations of Gulf service and the lasting effects on veterans. It also serves to bring readers up to date with research on the present deployment in Iraq. Finally, consideration is given to how Gulf War Syndrome compares with the rich historical literature of post-conflict medical Syndromes and how sociological factors may interact with symptom attribution in veterans.
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searching for a Gulf War Syndrome using cluster analysis
Psychological Medicine, 2002Co-Authors: Brian Everitt, Anthony S David, Khalida Ismail, Simon WesselyAbstract:Background. Gulf veterans report medically unexplained symptoms more frequently than non-Gulf veterans did. We examined whether Gulf and non-Gulf veterans could be distinguished by their patterns of symptom reporting. Method. A k-means cluster analysis was applied to 500 randomly sampled veterans from each of three United Kingdom military cohorts of veterans; those deployed to the Gulf conflict between 1990 and 1991; to the Bosnia peacekeeping mission between 1992 and 1997; and military personnel who were in active service but not deployed to the Gulf (Era). Sociodemographic, health variables and scores for ten symptom groups were calculated. Results. The gap statistic indicated the five-group solution as one that provided a particularly informative description of the structure in the data. Cluster 1 consisted of low scores for all symptom groups. Cluster 2 had veterans with highest symptom scores for musculoskeletal symptoms and high scores for psychiatric symptoms. Cluster 3 had high scores for psychiatric symptoms and marginally elevated scores for the remaining nine groups symptom groups. Cluster 4 had elevated scores for musculoskeletal symptoms only and cluster 5 was distinguishable from the other clusters in having high scores in all symptom groups, especially psychiatric and musculoskeletal. Conclusion. The findings do not support the existence of a unique Syndrome aecting a subgroup of Gulf veterans but emphasize the excess of non-specific self-reported ill health in this group.
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prevalence of Gulf War veterans who believe they have Gulf War Syndrome questionnaire study
BMJ, 2001Co-Authors: Trudie Chalder, Matthew Hotopf, Catherine Unwin, Lisa Hull, Khalida Ismail, Anthony S David, Simon WesselyAbstract:Abstract Objectives: To determine how many veterans in a random sample of British veterans who served in the Gulf War believe they have “Gulf War Syndrome,” to examine factors associated with the presence of this belief, and to compare the health status of those who believe they have Gulf War Syndrome with those who do not. Design: Questionnaire study asking British Gulf War veterans whether they believe they have Gulf War Syndrome and about symptoms, fatigue, psychological distress, post-traumatic stress, physical functioning, and their perception of health. Participants: 2961 respondents to questionnaires sent out to a random sample of 4250 Gulf War veterans (69.7%). Main outcome measure: The proportion of veterans who believe they have Gulf War Syndrome. Results: Overall, 17.3% (95% confidence interval 15.9 to 18.7) of the respondents believed they had Gulf War Syndrome. The belief was associated with the veteran having poor health, not serving in the army when responding to the questionnaire, and having received a high number of vaccinations before deployment to the Gulf. The strongest association was knowing another person who also thought they had Gulf War Syndrome. Conclusions: Substantial numbers of British Gulf War veterans believe they have Gulf War Syndrome, which is associated with psychological distress, a high number of symptoms, and some reduction in activity levels. A combination of biological, psychological, and sociological factors are associated with the belief, and these factors should be addressed in clinical practice. What is already known on this topic The term Gulf War Syndrome has been used to describe illnesses and symptoms experienced by veterans of the 1991 Gulf War Concerns exist over the validity of Gulf War Syndrome as a unique entity What this study adds 17% of Gulf War veterans believe they have Gulf War Syndrome Holding the belief is associated with worse health outcomes Knowing someone else who believes they have Gulf War Syndrome and receiving more vaccinations were associated with holding the belief
David A Schwartz - One of the best experts on this subject based on the ideXlab platform.
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is there a persian Gulf War Syndrome evidence from a large population based survey of veterans and nondeployed controls
The American Journal of Medicine, 2000Co-Authors: Bradley N Doebbeling, William R Clarke, David Watson, James C Torner, Robert F Woolson, Margaret D Voelker, Drue H Barrett, David A SchwartzAbstract:Abstract PURPOSE: Concerns have been raised about whether veterans of the Gulf War have a medical illness of uncertain etiology. We surveyed veterans to look for evidence of an illness that was unique to those deployed to the Persian Gulf and was not seen in comparable military controls. SUBJECTS AND METHODS: A population-based sample of veterans (n = 1,896 from 889 units) deployed to the Persian Gulf and other Gulf War–era controls (n = 1799 from 893 units) who did not serve in the Gulf were surveyed in 1995–1996. Seventy-six percent of eligible subjects, including 91% of located subjects, answered questions about commonly reported and potentially important symptoms. We used factor analysis, a statistical technique that can identify patterns of related responses, on a random subset of the deployed veterans to identify latent patterns of symptoms. The results from this derivation sample were compared with those obtained from a separate validation sample of deployed veterans, as well as the nondeployed controls, to determine whether the results were replicable and unique. RESULTS: One half (50%) of the deployed veterans and 14% of the nondeployed controls reported health problems that they attributed to military service during 1990–1991. Compared with the nondeployed controls, the deployed veterans had significantly greater prevalences of 123 of 137 (90%) symptoms; none was significantly lower. Factor analysis identified three replicable symptom factors (or patterns) in the deployed veterans (convergent correlations ≥0.85). However, these patterns were also highly replicable in the nondeployed controls (convergent correlations of 0.95 to 0.98). The three factors also accounted for similar proportions of the common variance among the deployed veterans (35%) and nondeployed controls (30%). CONCLUSIONS: The increased prevalence of nearly every symptom assessed from all bodily organ systems among the Gulf War veterans is difficult to explain pathophysiologically as a single condition. Identification of the same patterns of symptoms among the deployed veterans and nondeployed controls suggests that the health complaints of Gulf War veterans are similar to those of the general military population and are not consistent with the existence of a unique Gulf War Syndrome.