Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To simulate conditions aboard a disabled submarine, 7 submariners were confined for 5 d to a normobaric environment of 16.75% O2, 2.5% CO2, 4 degrees C, and 85% relative humidity (RH). After 2 control days and 1 d of hypoxia, the remaining environmental conditions were imposed for the next 5 d, followed by 1 additional day of just hypoxia. Daily morning symptoms were assessed using the Environmental Symptoms Questionnaire (ESQ). Postural stability was determined on 4 occasions using a computerized balance system: control period, after 2.7 and 4.7 d of steady-state test conditions, and after 5.7 d (with return to normal ambient temp, RH, and CO2). Three balance tests were performed: eyes open, eyes closed, and a dynamic test. Postural stability deteriorated after 2.7 d (87% eyes open, P < 0.001 and 26% eyes closed, P = 0.01). ESQ symptom subsets for acute mountain sickness, exertion, fatigue, alertness, and ear/nose/throat were not significantly different. Cold symptom subsets were increased after 3-7 d (P < 0.001); distress and muscle discomfort subsets after 7 d (P = 0.02). Continued exposure to the combination of cold and hypoxia elicited subjective symptom changes and disturbances in postural stability that are statistically significant. These observations may be of practical importance when tasks aboard a disabled submarine involve balance and mobility.
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PMID:Subjective symptoms and postural control during a disabled submarine simulation. 1267 Jan 22

Headache is the cardinal symptom of acute mountain sickness (AMS). The headache normally worsens, with increased cerebral affection and the development of high-altitude cerebral edema (HACE). A Norwegian expedition aimed to climb Baruntse (7129 m) in Nepal in 2003. At 5400 m a 35-year-old man felt exhausted. The next day he aborted his attempt at further climbing as a result of extreme fatigue. Over the next 24 hours he developed cough, dyspnea, and severe hypoxia before progressing to ataxia and blurred vision. At no point did he experience headache or nausea. The patient was evacuated by helicopter. He improved immediately after descent and recovered completely within a week. The speed of progression from AMS to HACE varies. Abrupt onset of HACE is occasionally reported. High-altitude pulmonary edema (HAPE) may induce severe hypoxia that can lead to rapid development of HACE. High-altitude cerebral edema in the setting of HAPE was the most likely diagnosis despite the unusual lack of headache. Rapid onset of HAPE with subsequent severe desaturation should raise awareness of the development of HACE, even in the absence of headache.
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PMID:High-altitude cerebral edema with absence of headache. 1744 14

The Lake Louise Scoring System (LLSS) was designed to evaluate adults for symptoms of acute mountain sickness (AMS). The language used in the LLSS may be too complex for young children to comprehend. This study evaluates if age-appropriate language alters the results of AMS diagnostic scores in 4- to 11-yr-old children. With parental help, subjects completed the LLSS and an equivalent Lake Louise Age-Adjusted Symptom Score (LLAASS) daily for 3 days. Measurements were made at 1605 m, in the subjects' homes, without any altitude change. Equivalent questions between the two surveys were assessed for agreement on the day when the most symptoms were recorded for each question. Thirty-seven children (19 girls), ages 4 to 11 yr (mean age 7.4 +/- 2.3 yr) completed the study. Kappa values: headache (kappa = 0.22), gastrointestinal (kappa = 0.34), fatigue (kappa = 0.88), dizziness (kappa = 0.65), and sleep (kappa = 0.88) ranged from fair to very good. The LLAASS resulted in higher mean symptom scores (1.14 +/- 0.98) compared to LLSS questions (0.61 +/- 0.82) (p < 0.01). The AMS diagnostic threshold was reached in 9% (95% CI, 4-16) of measurements using the LLAASS and 4.5% (95% CI, 1.5-10) with the LLSS. The LLSS results in reporting of fewer AMS symptoms in this population when compared with a diagnostic tool using age-appropriate language and/or visual representations. Age-appropriate communication must be used to assess AMS, particularly for headache (the key symptom of AMS) and gastrointestinal symptoms. Young children report symptoms of AMS at baseline without altitude gain; therefore, the AMS diagnostic threshold in this population may require modification.
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PMID:Language used in Lake Louise Scoring System underestimates symptoms of acute mountain sickness in 4- to 11-year-old children. 1758 6

Exposure to high altitude in nonacclimatized subjects may lead to acute mountain sickness (AMS). AMS is a syndrome characterized by headache accompanied by one or more other symptoms, such as light-headedness, dizziness, loss of appetite, nausea, vomiting, fatigue, lassitude, and trouble sleeping. Assessing the presence and degree of AMS can be done using self-administered questionnaires like the Lake Louise Questionnaire (LLQ) and the Environmental Symptoms Questionnaire-III (ESQ-III). We compared LLQ and ESQ-III in 266 trekkers of different nationalities trekking over a 5400-m-high pass to assess if the two questionnaires identify the same population as suffering from AMS and to see whether using English questionnaires poses problems for nonnative English-speaking persons. The use of English questionnaires by nonnative English speakers influenced the outcome for some nationalities. For criterion scores yielding similar prevalence of AMS, ESQ-III labeled 20% of cases differently (AMS or no AMS) when compared to LLQ. Correlations between similar individual questions of ESQ-III and LLQ were variable, and there was considerable scatter between ESQ-III and LLQ scores. In conclusion, English questionnaires may pose problems in some international settings, and ESQ-III and LLQ may identify different populations as suffering from AMS.
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PMID:Comparing questionnaires for the assessment of acute mountain sickness. 1782 18

Although thousands of people ascend 4205 m to visit the summit of Mauna Kea each year, there has been no information on the rate of altitude illness triggered by such visits. Two surveys were used: one for tourists driving up to the summit and the other for summit astronomy workers staying at lodging facilities at intermediate altitude. The surveys included the standardized Lake Louise Self-report Acute Mountain Sickness (AMS) Questionnaire that, when scored, gave the Lake Louise Symptoms Score (LLSS). Thirty percent of surveyed day visitors and 69% of surveyed professional astronomy staff had AMS, defined as a LLSS score of 3 or greater, with headache. Nine participants reported "disorientation/confusion" or greater consciousness changes. A majority of astronomy professionals reported fatigue, disturbed sleep, reduced activity, and mental status changes. Few took any AMS medications. The incidence of AMS in visitors to Mauna Kea's summit warrants increased education and increased availability of supplemental oxygen at the summit. The absence of reported serious altitude illness in the community is probably due to the rapid descent available on Mauna Kea, with prompt reversibility of adverse effects.
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PMID:Survey of acute mountain sickness on Mauna Kea. 1782 20

The aim of this study was to evaluate the prevalence of acute mountain sickness (AMS) among trekkers on Mount Kilimanjaro during the winter season of 2006-2007. A A total of 130 Finnish trekkers at Marungu route were asked to complete daily a Lake Louise self-report and clinical assessment score questionnaire with the help of a trainee Finnish guide during their trek to Kilimanjaro. A Lake Louise questionnaire score>or=3 indicated AMS. Altogether 112 mountaineers or travelers [54 men, 58 women, mean age 51+/-10 (SD) years] were studied. Fifty-nine travelers (53%) reached Gillman's Point or Uhuru Peak. The incidence of AMS among Finnish Kilimanjaro trekkers was 75%. The most common high altitude symptoms were headache, followed by sleeping problems and fatigue or weakness. The incidence of AMS is high among trekkers climbing Mount Kilimanjaro.The main reason for this seems to be rapid ascent. Kilimanjaro treks normally have a fixed timetable, and for commercial reasons there is little opportunity to spend extra days for acclimatization in the camps. Some contributing factors are preventable, so we recommend an educational program for all the trekking agencies that guide on this peak and, in particular, the Tanzania-based guiding agencies, which, typically, are driving these very fast ascent rates.
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PMID:Prevalence of acute mountain sickness among Finnish trekkers on Mount Kilimanjaro, Tanzania: an observational study. 1977 22

High altitude sickness is a common name for illnesses that can occur at high altitude, usually above 3000 meters from sea level. The cause is hypoxia but the pathophysiology of the diseases is a complex mixture of multiple factors, involving the human response to hypoxia. The most common symptom is headache, but loss of appetite, nausea and sleep disturbances are also common complaints. With rapid or high ascent there is increased risk of acute mountain sickness, with severe headache that responds poorly to pain medications, nausea, vomiting and extreme fatigue as the most common symptoms. The most severe forms of high-altitude sickness are high altitude cerebral edema and high altitude pulmonary edema. High altitude sickness can be prevented by slow ascent and avoiding overexertion. Medications can also be used to reduce symptoms. In this overview high altitude physiology and acclimatisation are reviewed. The main types of high altitude sickness are described with special emphasis on symptoms and diagnosis, but treatment and prevention are also reviewed.
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PMID:[High altitude sickness - review]. 1949 9

Assessment of the presence and severity of acute mountain sickness (AMS) is based on subjective reporting of the sensation of symptoms. The Lake Louise symptom scoring system (LLS) uses categorical variables to rate the intensity of AMS-related symptoms (headache, gastrointestinal distress, dizziness, fatigue, sleep quality) on 4-point ordinal scales; the sum of the answers is the LLS self-score (range 0-15). Recent publications indicate a potential for a visual analogue scale (VAS) to quantify AMS. We tested the hypothesis that overall and single-item VAS and LLS scores scale linearly. We asked 14 unacclimatized male subjects [age 41 (14), mean (SD) yr; height 176 (3) cm; weight 75 (9) kg] who spent 2 days at 3647 m and 4 days at 4560 m to fill out LLS questionnaires, with a VAS for each item (i) and a VAS for the overall (o) sensation of AMS, twice a day (n = 172). Even though correlated (r = 0.84), the relationship between LLS(o) and VAS(o) was distorted, showing a threshold effect for LLS(o) scores below 5, with most VAS(o) scores on one side of the identity line. Similar threshold effects were seen for the LLS(i) and VAS(i) scores. These findings indicate nonlinear scaling characteristics that render difficult a direct comparison of studies done with either VAS or LLS alone.
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PMID:Comparison of a visual analogue scale and Lake Louise symptom scores for acute mountain sickness. 2036 91

High altitude problems like hypoxia, acute mountain sickness, high altitude cerebral edema, pulmonary edema, insomnia, tiredness, lethargy, lack of appetite, body pain, dementia, and depression may occur when a person or a soldier residing in a lower altitude ascends to high-altitude areas. These problems arise due to low atmospheric pressure, severe cold, high intensity of solar radiation, high wind velocity, and very high fluctuation of day and night temperatures in these regions. These problems may escalate rapidly and may sometimes become life-threatening. Shilajit is a herbomineral drug which is pale-brown to blackish-brown, is composed of a gummy exudate that oozes from the rocks of the Himalayas in the summer months. It contains humus, organic plant materials, and fulvic acid as the main carrier molecules. It actively takes part in the transportation of nutrients into deep tissues and helps to overcome tiredness, lethargy, and chronic fatigue. Shilajit improves the ability to handle high altitudinal stresses and stimulates the immune system. Thus, Shilajit can be given as a supplement to people ascending to high-altitude areas so that it can act as a "health rejuvenator" and help to overcome high-altitude related problems.
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PMID:Shilajit: A panacea for high-altitude problems. 2053 96

Previous attempts to detect global cerebral hemodynamic differences between those who develop headache, nausea, and fatigue following rapid exposure to hypoxia [acute mountain sickness (AMS)] and those who remain healthy have been inconclusive. In this study, we investigated the effects of two drugs known to reduce symptoms of AMS to determine if a common cerebral hemodynamic mechanism could explain the prophylactic effect within individuals. With the use of randomized, placebo-controlled, double-blind, crossover design, 20 healthy volunteers were given oral acetazolamide (250 mg), dexamethasone (4 mg), or placebo every 8 h for 24 h prior to and during a 10-h exposure to a simulated altitude of 4,875 m in a hypobaric chamber, which included 2 h of exercise at 50% of altitude-specific VO(2max). Cerebral hemodynamic parameters derived from ultrasound assessments of dynamic cerebral autoregulation and vasomotor reactivity were recorded 15 h prior to and after 9 h of hypoxia. AMS symptoms were scored using the Lake Louise Questionnaire (LLQ). It was found that both drugs prevented AMS in those who became ill on placebo (~70% decrease in LLQ), yet a common cerebral hemodynamic mechanism was not identified. Compared with placebo, acetazolamide reduced middle cerebral artery blood flow velocity (11%) and improved dynamic cerebral autoregulation after 9 h of hypoxia, but these effects appeared independent of AMS. Dexamethasone had no measureable cerebral hemodynamic effects in hypoxia. In conclusion, global cerebral hemodynamic changes resulting from hypoxia may not explain the development of AMS.
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PMID:Effects of acetazolamide and dexamethasone on cerebral hemodynamics in hypoxia. 2139 64


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