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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Workups by physicians in response to five common complaints in a sample of 104 men and women--52 married couples--were evaluated by chart audit. For the total group of complaints, back pain, headache, dizziness, chest pain, and fatigue, the physicians' workups were significantly more extensive for men than they were for women. These data tend to support the argument that male physicians take medical illness more seriously in men than in women.
JAMA 1979 May 18
PMID:Response of physicians to medical complaints in men and women. 15 67

Eight patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) and average resting Pao2 of 66 mm Hg were studied clinically and physiologically at sea level and after ascent to 1,920 m. At sea level the patients were symptomatic but not disabled. After ascent the patients had only mild symptoms of fatigue and insomnia, and one had severe headache during exercise on the first day. Funduscopic changes were not observed, nor did cardiac or pulmonary findings change. Resting sea level Pao2 dropped to 51.5 mm Hg within three hours of ascent, and the Paco2 fell from 37.8 to 33.9 mm Hg. Over the next three days, the Pao2 increased to 54.5 mm Hg as hyperventilation continued. At exercise, sea level Pao2 dropped from a mean value of 63 to 46.8 mm Hg at altitude. Pulse rates at rest or exercise did not change. Normal values for 2,3-diphosphoglycerate (2,3-DPG) did not change after ascent at 16 and 42 hours. We believe aircraft flight or travel to moderate altitudes for this type of COPD patient is safe. Preexisting hypoxemia resulting from disease may facilitate the adaptation of patients to severe hypoxia and may prevent symptoms similar to acute mountain sickness.
JAMA 1978 Sep 29
PMID:Short-term adaptation to moderate altitude. Patients with chronic obstructive pulmonary disease. 68 52

Daily saunas taken by a young man were followed by fever, chills, malaise, dyspnea, cough, and myalgia from six to eight hours later. Symptoms, which were related to pouring water from a sauna bucket over the heating element, progressed to chronic dyspnea and fatigue. Serial serum samples showed precipitin reactions to bucket water and extracts of bucket mold. IgG antibody activity, demonstrated by radioimmunoassay, suggested that Pullularia was a major antigen.
JAMA 1976 Nov 08
PMID:Sauna-takers disease. Hypersensitivity pneumonitis due to contaminated water in a home sauna. 98 16

The cytotoxic food test was not found to be an accurate method for diagnosing atopic reactions to foods. Claims that the test correlated with other untoward reactions to foods (eg, headache, diarrhea, fatigue) could not be corroborated. The test itself is time-consuming, dependent on subjective interpretation, and inconsistent in results when repetitive runs are performed on the same patient.
JAMA 1975 Feb 17
PMID:Controlled study of the cytotoxic food test. 117 63

Fifteen Marine recruits with acute heat stroke were examined for (1) predisposing factors, (2) blood coagulation disturbances, (3) renal function abnormalities, and (4) blood composition alterations. Epidemiologic data identified the following risk factors; previous residence in a temperate climate, first phase of training, fatigue, and strenuous exercise in hot, humid conditions. Results of blood coagulation studies disclosed an increase in prothrombin and partial thromboplastin times, with a decrease in platelet count, probably indicating a transient, low-grade consumptive process. Blood urea nitrogen and creatinine levels and creatinine clearance were normal. Only mild elevations of SGOT, SGPT, and lactic dehydrogenase levels were noted, and in combination with clinical observations, they argued against significant muscle damage. No deaths or instances of renal failure occurred.
JAMA 1975 Nov 24
PMID:Acute heat stroke. Epidemiologic, biochemical, renal, and coagulation studies. 124 74

To evaluate the clinical and virologic course of patients with chronic fatigue who had elevated Epstein-Barr virus (EBV) titers, we prospectively followed up 26 patients with serial cultures for EBV in blood and saliva and serial EBV serologic and clinical and psychiatric evaluations, and we compared these results with those for healthy controls. The frequency of isolating EBV in blood or demonstrating EBV infection by in situ hybridization in blood lymphocytes or in saliva was similar in patients and controls. The prevalence and titers of antibody to human herpesvirus type 6 were also similar in the two populations. Patients with chronic fatigue did demonstrate higher in vitro natural killer activity and lower in vitro interleukin 2 production than controls, and patients had a high frequency of DSM-III depressive illness. Over 50% of patients with chronic fatigue improved over the course of follow-up. Improvement was not associated with any discernible change in titers of EBV proteins. No evidence of ongoing EBV infection with either transforming or nontransforming strains was demonstrated in this population of patients with chronic fatigue. Clinically, most patients gradually improve over time.
JAMA 1990 Jul 04
PMID:Chronic fatigue. A prospective clinical and virologic study. 184 16

The complex detection system leading to the discovery and treatment of precancerous lesions and early cancer of the uterine cervix is described in detail and discussed. By far the most difficult and underestimated component of this system is the screening and interpretation of cervical (Papanicolaou) smears. Cytologic case finding may fail because of inadequate samples, insufficient time devoted to screening, or human fatigue. Other weak points of the system, such as an inadequate clinical component, inadequate patient compliance, poor reproducibility of diagnoses, and ineffective aftercare, are also described. For example, obtaining a second smear to confirm or refute a diagnosis of cellular atypia is often a misleading practice. Although this cancer detection system has been shown to be effective in reducing the rate of morbidity and mortality from invasive cervical cancer in appropriately screened populations, there is no evidence that the Papanicolaou test has succeeded anywhere in complete eradication of this theoretically preventable disease. It is important to inform the public about the potential failures of the system and the reasons for them.
JAMA 1989 Feb 03
PMID:The Papanicolaou test for cervical cancer detection. A triumph and a tragedy. 273 21

Patients with acute or chronic respiratory failure exhibit severe pulmonary impairment as a baseline characteristic. Additional minor insults can precipitate cardiopulmonary failure that requires hospital admission and possibly mechanical ventilation. Our approach to these patients emphasizes evaluation of the imbalance between neuromuscular competence and mechanical load on the respiratory system. In this way, reversible factors can be identified and corrected before they progress to inspiratory muscle fatigue and respiratory failure. For cases in which deterioration is inexorable, guidelines for mechanical ventilation are given and approaches to eventual liberation from the ventilator are reviewed.
JAMA 1989 Jun 16
PMID:Acute or chronic respiratory failure. Assessment and management of patients with COPD in the emergency setting. 229 61

Antibody to Epstein-Barr virus (EBV) early antigen has been said to be the most specific indicator of symptomatic chronic EBV infection. We studied the clinical utility of this serologic test in the evaluation of patients with chronic fatigue. Thirty patients with chronic fatigue and highly elevated titers of antibody to early antigen (greater than or equal to 1:160) were compared with 30 age- and sex-matched controls with no antibody to early antigen. There were no significant differences noted between patients and controls at the initial evaluation (symptoms, physical examination, laboratory data). Follow-up information, available for 15 matched pairs, showed no differences in outcome between patients and controls. We conclude that the antibody to EBV early antigen is not helpful in the clinical evaluation of patients with chronic fatigue.
JAMA 1988 Aug 19
PMID:Chronic fatigue syndrome and the diagnostic utility of antibody to Epstein-Barr virus early antigen. 253 51

The incidence of acute mountain sickness was determined by questionnaire in 454 individuals who attended week-long continuing medical education programs at ski resorts in the Rocky Mountains with base elevations of about 2000 m. As a control group, 96 individuals who attended continuing medical education programs at sea level in San Francisco completed similar questionnaires. Study subjects were classified as having acute mountain sickness when they reported three or more of the five possible cardinal symptoms: headache, insomnia, dyspnea, anorexia, and fatigue. Only symptoms with an intensity of at least grade 2 (moderate) out of 5 were analyzed. Acute mountain sickness-like symptoms occurred in 25% of subjects at 2000 m compared with 5% of subjects at sea level. The incidence of acute mountain sickness at 2000 m was greatest among subjects who had come from lower altitudes. Half of the subjects with symptoms took medication. The duration of symptoms was short, with 90% of all symptoms that were reported occurring in the first 72 hours. Acute mountain sickness is common at intermediate altitudes, and it is frequently severe enough to prompt self-medication.
JAMA 1989 Feb 03
PMID:Incidence of acute mountain sickness at intermediate altitude. 291 Nov 69


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