Gulf War Illness-relatred Medical Research & Publications
Defining Illnesses
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The
Iowa Persian Gulf Study Group. Self-reported Illness and Health Status
Among Gulf War Veterans. A Population-Based Study. JAMA 1997; 277: 238-245.
In this study of Iowans from the National Guard, Reserve, or active component
who were on active duty during the Gulf War, a stratified random sample
selected 4,886 subjects of whom 3,695 (76%) completed a structured telephone
interview. Personnel deployed to the Gulf reported significantly higher
prevalence rates of symptoms of depression, PTSD, chronic fatigue, cognitive
dysfunction, bronchitis, asthma, fibromyalgia, alcohol abuse, anxiety,
and sexual discomfort. Most of the self-reported GW exposures were significantly
related to many of the medical and psychiatric conditions.
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Haley,
R.W. et al. Evaluation of Neurologic Function in Gulf War Veterans. JAMA
1997; 277:223-230. Building upon the above study, the authors
compared 23 GW veterans with the most severe symptoms of Syndromes 1, 2,
and 3 (cases) with two groups of veterans with no serious health problems.
The 23 cases had more evidence of brain dysfunction by several neuropsychological
tests. Neurophysiological and audiovestibular tests among cases generally
did not exceed normal limits for the testing laboratory, but the results
were significantly more in the abnormal direction in the cases than in
the controls. The authors conclude that the cases' scores "more in the
abnormal direction on objective tests of neurologic function" support their
hypothesis that "a subset of veterans with Gulf War-related illnesses appears
to have a subtle neurologic injury or illness contracted in the war."
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Haley,
R.W. and Kurt, T.L. Self-reported Exposure to Neurotoxic Chemical Combinations
in the Gulf War. JAMA 1997; 277: 231-237. The authors administered
surveys to the 249 participants in the study above. The authors conclude
that they have demonstrated associations between specific risk factors
(especially cholinesterase-inhibiting compounds) and systematically defined
syndromes in GW veterans. They liken the syndromes to variants of organophosphate-induced
delayed polyneuropathy (OPIDP). The article's discussion elaborates on
the mechanism of OPIDP and the related scientific evidence which is compatible
with their hypothesis. They discuss at length the controversy about whether
or not chemical agents which do not cause acute symptoms can cause delayed
neurological effects.
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Unwin,
C. et al. Health of UK Servicemen Who Served in Persian Gulf War. Lancet
(1999) 353: 169-178. British servicemen who served in the
Gulf War (GWV) were compared to those who did not deploy to the Gulf and
to others who deployed to the Bosnia conflict. GWV reported all symptoms
and conditions more frequently than the comparison groups. Among servicemen
in all three groups, perceptions of poorer health were associated with
virtually all potential risk factors or exposures, regardless of deployment
status. Patterns of symptoms were the same in all three groups, suggesting
that there is no specific "Gulf War Syndrome." The authors plan further
studies which will include detailed examinations of symptomatic veterans
and controls.
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Ismail,
K. et al. Is There a Gulf War Syndrome ? Lancet (1999) 353: 179-182.The
authors used factor analysis to analyze the symptoms reported by British
Gulf War veterans and other veterans. Three factors (or groups of symptoms)
were identified and labeled mood-cognition, respiratory system, and peripheral
nervous system. Although Gulf War veterans reported a higher frequency
of symptoms than veterans who did not deploy to the Gulf and veterans of
the Bosnia deployment, the similarity in the patterns of symptoms among
all three study groups did not support the existence of a syndrome unique
to Gulf War veterans. The discussion compares this study with the two previously
published studies of Gulf War veterans which used factor analysis (Haley,
R. et al. and Fukuda, K. et al.) .
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