YP

@JackHadfield14 You worsened from immunoadsorption? What kind of was it exactly? Why do you think it worsened your condition? No positive effects at all, just worsening? Sorry to hear by the way.

After my worsening from immunoadsorption I tested positive for HHV6 reactivation. Highly suspect it drove the worsening.

@thealepalombo You mean Lecce province

This is Porto Cesareo, Salento, Puglia. One of the best beaches in Italy. That's why Puglia is so hot these days. Skip August, if you can visit in June or September. Have you been?

@ZdenekVrozina Anyway, it’s super interesting to find out what is going on immunewise…so if people could get tested to know what is going on with their individual immune systeme, that would be great. That’s why it really caught my attention.

Why don’t we usually call post HIV fatigue ME/CFS? Because HIV is a known, named, testable disease with its own pathway, biomarkers, treatment field, clinical category etc So when someone with HIV develops chronic fatigue, cognitive symptoms, autonomic problems, PEM, medicine tends to call it HIV-associated fatigue - not primary ME/CFS. That does not mean the phenotype cannot overlap. It means the label follows the known cause. This is important for Long Covid too - similar clinical phenotype can arise from different upstream biology. EBV, HIV, SARS, Q fever, Lyme all may produce chronic fatigue syndromes. But similar symptoms do not automatically mean identical disease. That is also why I wouldn’t throw this study in the trash. Medicine often names syndromes by the known trigger or context. HIV-associated fatigue, post-Q fever fatigue, LC, ME/CFS etc The phenotypes can overlap. But the upstream biology may still differ. This study is useful because it asks whether LC and ME/CFS look immunologically interchangeable. In this cohort, they did not.

Important new study. ME/CFS and Long COVID are not the same thing. Yes, they can look very similar from the outside - crushing fatigue, PEM, brain fog, dysautonomia. But when researchers looked deeper into the immune system, the biology looked different🧵

@ZdenekVrozina So I understood it like this - if there is “the“ kind of PEM (current up-to-date definition of experts), it is ME. So someone with LC without PEM doesn‘t have ME. Though they can suffer from a lot of fatigue. Someone with LC with PEM has ME, too (from Covid).

Yes, I do find it useful and interesting - see your last sentence. I‘m just confused as I thought the real-deal and very specific PEM is a hallmark symptome of ME/CFS specifically. Other kind of chronic fatigue syndromes do exist. Fatigue though is not cardinal symptome of ME. PEM is.

If you got further thoughts regarding that, I‘d appreciate further input. Maybe another post? Would be interesting to know if there are 2 different immune types of ME/CFS if you know what I mean. A specific one possibly after SARS-CoV2. And thank you for all your efforts! Much appreciated

@yvopitt The paper describes average immune patterns across cohorts, not a clinical test for individuals. For finer distinction in a specific patient, actual immunophenotyping would be needed.

@ZdenekVrozina Interesting subject. Especially as I understand it that way that sby with LC/PCC that has PEM does have ME/CFS. Guess I gotta take a closer look at the paper to see how/if they evaluated PEM or how/if they differenciated between people with LC/PCC WITH or WITHOUT PEM.

If one develops Long Covid/Post Covid Condition after infection and from it - as most severe part - ME/CFS (fulfilling all offical criteria, of course cardinal symptom PEM) plus classic comorbidities like MCAS, POTS/orthostatic intolerance, SFN, what can one make of it in the context of that study? Type 1 or 2 more likely?

And if the biology is different, we should not assume the same diagnostics or the same treatments will work for both. Long COVID should have been studied from the beginning as a potentially distinct post-infectious syndrome, rather than primarily through the lens of ME/CFS.

@thealepalombo Yes, I did. Was approx. 20 years ago.

@yvopitt Did you like it?

This is Naxos, Greece. Incredible beaches, prettier inland villages than many Cyclades islands, better food value. Have you been?

@Gilfrancoalejo @jota_snchez There is e.g. minimum hourly wage for each profession.

@jota_snchez ¿Cómo funciona los países que no tienen Salario Mínimo oficial? ¿Cada empleador paga lo que quiera?

Salario mínimos en Europa 2026 [Bruto Mensual] 🥉 Los más bajos 🇭🇺 Hungría — 838€ 🇷🇴 Rumanía — 795€ 🇱🇻 Letonia — 780€ 🇧🇬 Bulgaria — 620€ 🥈 Intermedio 🇪🇸 España — 1.381€ 🇸🇮 Eslovenia — 1.278€ 🇵🇱 Polonia — 1.139€ 🇵🇹 Portugal — 1.073€ 🇬🇷 Grecia — 1.027€ 🥇 Top ↓↓

@aledeniz For opera definitely. Vowels at the end of Italian words however can be a stylistic challenge for more modern music or particular genres.

The phonetic structure of Italian 🇮🇹 – particularly its small set of pure vowel sounds and the absence of the /h/ sound – gives Italian speakers a natural advantage when it comes to powerful, clear, and expressive singing. Italian is The language of singing.

@drgurner I share that belief.

@yvopitt No problem. I think that people should find professions and avenues that suit them, and that's where they thrive. We've not all the same, but if you have the ability to tailor what you do to how you function best - it's a real cheat code for insane progress.

The literal #1 most suicidal belief you can have is that you’re an introvert/socially anxious/don’t like people. I was this guy until around 22. Thought I was better than everyone else and actively chose not to be social. Life completely changed when I started interacting with random people and just trying to make them laugh. Opportunities opened up, made relationships with people I never thought possible. Everything was just less dull and boring. Every day was fun for no reason. You cannot be a lone wolf. It’s a mental illness. Life is meaningless without people.

@drgurner Thx for the insight.

@yvopitt I'm solidly an introvert and it suits me and what I do incredibly well. I love quiet spaces to think, reading research, 1:1 meetings, putting together frameworks and I would die a slow death at a noisy office or trying to do anything at a coffee shop. More power to those who can!

@drgurner Absolutely. May I ask what you consider yourself? Answer only if you feel like it.

@CardinalMason Being an introvert is different than thinking you are better than others. It's about what your nervous system finds energy from vs feeling drained by...it's not a judgment.

@MiezeMiezi Auch Ärztinnen sind oftmals so…leider…

Nein, Frauen erfahren keine minderwertige Behandlung durch (männliche) Ärzte. Ihnen wird stets geglaubt! 🫣

@neurostingl Danke

Müde wird man von den vielen schönen Worten ohne Handlungskonsequenz. Erschöpfend ist es, wenn sich Menschen mit ME/CFS ständig für ihre Erkrankung rechtfertigen müssen. Aber ME/CFS ist weder Müdigkeit noch Erschöpfung. Gerade am #MECFSAwarenessDay wichtig, daran zu erinnern.

@ErtlConstanze @eja_kapeller @c_haberhauer Bravo!! Gratulation und danke

Ich freu mich sehr über den Robert-Hochner-Preis 2026!! 🥰 Und hoffe, er bringt Rückenwind für Verbesserungen für alle, die an ME/CFS-erkrankt sind. Danke an meine Redaktion und an meine tollen Rechercheteam-Kolleg:innen @eja_kapeller und @c_haberhauer derstandard.at/story/30000003…

@thealepalombo Yes, it’s got character. Train very close to hotels and beach, that’s to be gotten used to. And very shallow water, it takes long till you can swim a bit. Otherwise, really beautiful and authentic atmosphere.

This is Fano, Marche. Very underrated. The combination old town + beach is unmatched and relatively rare. You can spend the morning at the beach, walking in the afternoon to the fully intact medieval and Renaissance centro storico. For ancient Rome fans like me, Fano was a major Roman colony, you still have the Arch of Augustus from 9 AD standing as the city's symbol, plus remnants of the Roman walls. Marche region is overall one of the most underrated. Have you been?

@thealepalombo Yes, however, I’m not so convinced about the water quality for swimming to be honest. Even if there are Blue Flag beaches. What’s your take?

Ravenna is massively underrated. Dense with history (once capital of the Western Roman empire), 20 minutes from the coast, with great beaches. Dante's tomb is here. Incredible food. The Italian adriatic coast is overall very underrated. Have you been?