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)

This case was a 51-year-old woman, who had been diagnosed as having rheumatoid arthritis at some clinic and had been treated with both non-steroidal anti-inflammatory drugs and steroid 3 years before visiting our clinic. When she noticed a decrease in visual acuity and general fatigue in June 1985, she was referred to an ophthalmologist of our hospital, and found to have blood pressure of 240/150 mmHg and KW grade IV retinal findings. She was admitted in our department to examine and treat malignant hypertension. On admission, remarkable hypergammaglobulinemia (29.3%), arthralgia, arthral deformity and pericardial effusion were present thus, she was suspected to be suffering from malignant rheumatoid arthritis. Anti-nuclear antibody (64X), anti-nuclear ribonucleoprotein antibody (64X) and anti-RNase sensitive antibody of anti-extractable nuclear antigens (ENA) antibody (81920X) were positive, while anti-RNase resistant antibody of anti-ENA antibody was negative. Immunologically, her condition was consistent with mixed connective tissue disease (MCTD). Since urinary protein was positive and creatinine clearance was 46.0 ml/min, renal function was thought to be diminished. Her chest roentgenogram revealed cardiomegaly (CTR 67.5%) and an increase in pulmonary vascular shadow. An echocardiogram demonstrated the presence of pericardial effusion. Plasma renin activity was 3.3 ng/ml/h and it was suspected that an intrarenal ischemic change resulted in increased renin release from the juxta-glomerular apparatus, leading to the marked hypertension. Treatment was started with prednisolone 60 mg/day during 4 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of mixed connective tissue disease complicated with malignant hypertension]. 219 30

We reported a case of 64 year-old female patient of pulmonary tuberculosis associated with ARDS during corticosteroid treatment of Rheumatoid Arthritis. On admission her chief complaints were fever, fatigue and dyspnea. A chest roentgenogram showed diffuse alveolar infiltration consistent with pulmonary edema. Arterial blood gas studies showed severe hypoxemia. We clinically diagnosed so-called ARDS. Smears of sputum for acid fast bacilli were negative, but transbronchial lung brushing by bronchofiberscope revealed many acid fast bacilli. Intensive therapy with anti-tuberculosis drugs (INH, RFP, SM), high dose corticosteroid (methylprednisolone) therapy and mechanical ventilation was started. During the following 2 weeks, the PaO2 rose gradually and the alveolar infiltration on the chest roentgenogram disappeared. The experience of this case to emphasized the importance of suspecting this condition because pulmonary tuberculosis is a potentially curable cause of ARDS and it should also be emphasized that the good treatment effect could be expected with combined use of high dose corticosteroid and mechanical ventilation.
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PMID:[A case of pulmonary tuberculosis associated with adult respiratory distress syndrome during corticosteroid treatment of rheumatoid arthritis]. 221 15

Reported here are the results of the first effort to examine the effects of a dance-based aerobic exercise program for people with rheumatoid arthritis (RA). Forty-three subjects with RA completed a 16-week program that met twice weekly for 2 hours. One hour was devoted to exercise consisting of 15 to 20 minutes of warm-ups, 20 to 30 minutes of dance-based aerobic exercise, and 15 to 20 minutes of mat work for muscle strengthening and flexibility. The second hour was devoted to discussion that emphasized participant problem solving. The combined exercise/problem-solving discussion program was called EDUCIZE. Analyses of pretest to posttest changes indicated no deleterious effects on disease activity. In fact, physician-assessed articular pain and swelling decreased significantly, as did 50-foot walk time, pain, and depression. Participants reported significant improvement in lower extremity function. Changes in vigor and fatigue approached significance. Perceptions of general health as well as four of five quality of life indices improved significantly. This study adds to the as yet limited literature that indicates that weight-bearing vigorous exercise is beneficial for people with arthritis. Controlled studies to validate the findings of this study appear warranted. Also important for future research is investigation of the influence of the problem-solving discussion component on program effects.
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PMID:Dance-based aerobic exercise for rheumatoid arthritis. 228 36

Fatigue is a frequent and debilitating problem for people with rheumatoid arthritis (RA). In this descriptive study a Fatigue Interview Schedule was administered to 20 patients with RA to elicit symptom-specific information. Qualitative analyses resulted in the identification of descriptors of fatigue, conditions under which fatigue occurs, an intricate repertoire of strategies used to prevent and manage fatigue, and the consequences of chronic fatigue.
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PMID:Fatigue in rheumatoid arthritis. Conditions, strategies, and consequences. 228 44

The purpose of this pilot study was to examine the symptom of fatigue in rheumatoid arthritis. The instruments used included the Profile of Mood States, fatigue and pain visual analog scales, and an interviewer's assessment of respondent fatigue. The results indicated that fatigue was a significant problem in this sample; fatigue was positively associated with depression, pain, and poorer overall mood state; and the three measures of fatigue produced congruent reports of fatigue.
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PMID:Self-reported fatigue in rheumatoid arthritis. A pilot study. 228 54

We describe the clinical characteristics and actuarial survival of a consecutive cohort of 41 patients with rheumatoid arthritis and clinical pericarditis who were seen at the Mayo Clinic between 1970 and 1987 and followed up until death or through 1987. The survivors were followed up for a median of 5.1 years. Approximately three-fourths of our patients had acute pericarditis, the remainder having recurrent acute pericarditis, chronic pericarditis with effusion, or chronic constrictive pericarditis. Most patients had symmetrical joint swelling, morning stiffness, subcutaneous nodules, rheumatoid factor, and classic radiographic changes of rheumatoid arthritis. Common extra-articular features included fatigue, loss of weight, and fever. Dyspnea or orthopnea, typical pericardial pain, peripheral edema, tachycardia, tachypnea, a diminished mean blood pressure, a pericardial friction rub, jugular venous distension, rales, radiographic evidence of cardiomegaly and pleural effusions, and abnormal echocardiograms were the most common cardiac manifestations. An elevated erythrocyte sedimentation rate and anemia were other common laboratory findings. Our cohort demonstrated decreased survival in comparison with an age- and sex-matched North Central white population (from the upper midwestern United States), especially during the first year after diagnosis. Increasing age, the presence of other heart disease, an increasing total number of other extra-articular manifestations of rheumatoid arthritis, jugular venous distention, and a lower mean blood pressure were associated with decreased survival.
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PMID:Rheumatoid pericarditis: clinical features and survival. 231 40

A 72-year-old woman of definite type of malignant rheumatoid arthritis (MRA) with severe peripheral neuropathy. She has often noted pain of both shoulders or knee joints since some years ago. At the age of 71, she noticed numbness of the feet with pain and swelling of knee joints. She was diagnosed as definite type of rheumatoid arthritis by one podiatrist. Although she took some medications, she subsequently developed general fatigue, appetite loss, exacerbation of arthritis, drop feet and hands with prominent coldness. She was admitted to our hospital on March 22, 1985. On examination, she revealed purpura, decubitis, heart murmur, arthritis of knee joints, and fingers necrosis with skin ulcer. She had severe muscle weakness, and wasting of four limbs. Moderate impairment of all-modality sensations were noted in all extremities. Distal involvement was greater than proximal. Laboratory data during administration of prednisolone (60 mg/day) were as follows: glucose in urine, 2+; occult blood in urine, 1+; white blood cells count, 18600 with 92% polymorphonuclear leukocytes; erythrocyte sedimentation rate, 60 mm in an hour; CRP, 14.62 mg/dl (normal 0.5 greater than); RA test, 2+; RAHA, 10240; CH50, 10 U/ml (normal 32-42); C3, 37 mg/dl (normal 55-75); C4, 9 mg/dl (normal 15-28); immune complex, 4.4 micrograms/ml (normal 3.0): Chest X-ray film showed cardiomegaly (CTR, 57%). ECG disclosed atrial premature contraction, and echo cardiography suggested epicarditis with aortic valve insufficiency. 99mTc RI angiogram revealed impairment of peripheral circulation. SCV on sural nerve was not elicited. Sural nerve biopsy showed obliterans type of endoarteritis and axonal degeneration with loss of myelinated fiber.
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PMID:[A case of malignant rheumatoid arthritis with severe peripheral neuropathy]. 258 90

Fatigue, a complex symptom, significantly affects the quality of life in many patients with systemic lupus erythematosus (SLE). To understand this phenomenon, 23 patients with SLE and fatigue were studied. Standardized tests of depression (NIMH), fatigue, exercise tolerance (ETT) on a bicycle ergometer, and SLE activity were obtained. At baseline, SLE patients had significantly lower maximum oxygen consumption (VO2 max) than normals (p less than 0.005). Adjusted for age and sex, SLE patients perform at 54% of their expected maximum VO2, which is similar to published data from patients with rheumatoid arthritis. Depression by NIMH was not correlated with VO2 max or length of time on ETT. Fatigue measured by Profile of Mood States (POMS) was correlated with ETT time (r = 0.476, p less than 0.025) and with VO2 max (r = -0.402, p less than 0.07). After an 8-week aerobic conditioning programme the experimental group increased their aerobic capacity by 19% in contrast to 8% in controls. This change correlated with decreased fatigue as measured by visual analogue scales. Exercise did not exacerbate disease, and only two of 16 experimental subjects experienced transient joint symptoms during exercise.
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PMID:Effects of aerobic conditioning in lupus fatigue: a pilot study. 259 Aug 2

Fatigue is commonly reported by patients with rheumatoid arthritis (RA), and it is frequently used to evaluate disease activity and response to therapy. We theorized that the feeling of fatigue in patients with RA may be a manifestation of disturbance of sleep. Sixteen patients with chronic, active RA, who were selected for early onset of fatigue (less than 6 hours after morning awakening), were extensively evaluated by formal all-night polysomnographic recording and multiple sleep latency testing (MSLT). Although no sleep deprivation was found, all patients had some type of marked disturbances of sleep, including unanticipated sleep apnea (2 patients), frequent movement of extremities (all 16 patients), and frequent arousal (all 16 patients). The alpha-delta sleep pattern was present in 13 patients, and 7 were found by MSLT to be hypersomnolent. None of the patients accurately recognized the degree of their sleep disruption. Our findings from the MSLT indicate that fatigue in patients with RA may be a manifestation of sleep fragmentation, rather than a nonspecific constitutional symptom.
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PMID:Sleep fragmentation in rheumatoid arthritis. 276 10

The hip with rheumatoid arthritis (RA) is characterized by reduced bone resistance. Protrusion, fatigue fractures and femoral head collapse are the typical consequences. The survival rate of total hip prostheses in hips with RA seems to be higher than for hips with osteoarthritis (OA), possibly due to lower demands. When isolated loosening of the acetabular and femoral component are compared, there is a definite shift towards acetabular loosening in RA compared to OA. This is definitely due to the reduction in the mentioned bone resistance at the acetabular level. In primary joint replacement, well-cemented femoral components provide more reliable clinical results. They will remain the gold standard for long-term performance as well. On the other hand, it is very likely that non-cemented acetabular components, fixed by means of screws in the direction of the resulting force or based on a compression principle, may prove at least as effective as well-cemented acetabuli. For revision of the loose acetabular component, the use of special metal rings fixed with screws and bridging severe bony defects with a bone graft and frequently also bone cement, have proved to be of value. For loose femoral components with a thin and brittle cortical wall, special non-cemented prostheses combined with a bone graft seem to promise a more reliable long-term solution than cemented versions. The follow-up of our revision cases confirms the value of the described methods - at least at the short and medium-term follow-up. More definite conclusions can only be arrived at after long-term follow-ups which have been carried out with different systems and where the results are compared using the same documentation procedure.
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PMID:[Loosening of hip prostheses in chronic rheumatoid polyarthritis]. 281 74


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