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Spontaneous pupillary movements in darkness were recorded (1) in healthy subjects of different ages when they were rested or fatigued, (2) in chronically tired subjects without known neurological defects, and (3) in patients with various neurological lesions. In some of the experiments, local or systemic drugs were used. While the pupils are large and quiet in darkness when the subject is alert, they oscillate under the influence of tiredness. Waves of spontaneous pupillary contraction and dilation accompany periods of increasing sleepiness and spontaneous arousal until, at the moment immediately preceding sleep, the pupils become very small. The mechanism of these movements was analyzed and a simple test described which allows the objective determination of the degree of acute fatigue in a given subject at a given time. In the light of these results, the concepts of 'normal' and of 'pathologic' fatigue were discussed. (Author).
This monograph by Professor Alexandridis continues the proud tradition of German ophthalmology in its discussion of the pupil and its importance in the diagnosis of ocular, neurologic, and systemic diseases. The first encyclopedic work on the pupil was written by Wilbrand and Saenger at the end of the 19th century. This redoubtable pair of physicians collected, analyzed, and clas sified all the material available at that time, bringing order into the previous chaos. The second major work was the book by C. v. Behr shortly after World War 1. At that time, syphilis had been accurately diagnosed with the aid of serologic tests, and pharmacologic effects on the pupil had become well known. The third significant development was initiated before World War II by the neurologist Otto Lowenstein, whose work was later brilliantly continued by his pupil and niece Irene Lowenfeld. The introduction of their clinically useful pupillograph made quantitative analysis possible. There followed a number of important contributions to the knowledge of pupillary physiology and pathology, espe cially by Harms in Tiibingen and Thompson in Iowa City. But the next decisive contribution is this monograph by Alexandridis.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe chronic health condition that is often misunderstood or ignored by health establishments. The lack of definitive diagnostic markers to separate ME/CFS patients from the healthy population as well as from other chronic disorders is problematic for both health professionals and researchers. A consortium of Australian researchers gathered to systematically understand ME/CFS, ranging from a deep analysis of clinical and pathology data to metabolomic profiles and the investigation of mitochondrial function. From this broad collaboration, a number of compelling insights have arisen that may form the basis of specific serum, blood, and/or urinary biomarkers of ME/CFS. This Special Edition reports on a conference centred on these biomedical discoveries, with other contributions, with a translation focus for predictive markers for ME/CFS diagnosis. By supporting health professionals with developments in diagnostics for this condition, the patients and their families will hopefully benefit from an improved recognition of the biomedical underpinnings of the condition and will be better able to access the care that is urgently required. This Special Edition contains a mix of speaker submissions and other accepted manuscripts that contributed to our objective of advancing biomedical insights to enable the accurate diagnosis of ME/CFS.