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

The effects of 12 weeks of low-impact aerobic exercise on fatigue, aerobic fitness, and disease activity were examined in a quasi-experimental time series study of 25 adults with rheumatoid arthritis (RA). Measures were obtained preintervention, midtreatment (after 6 weeks of exercise), end of treatment (after 12 weeks of exercise), and at a 15-week follow-up. ANOVAS for repeated measures showed that those subjects who participated more frequently reported decreased fatigue, while those who participated less frequently reported an increase in fatigue. All subjects, on average, showed increased aerobic fitness and increased right and left hand grip strength, decreased pain, and decreased walk time. There were no significant increases in joint count or sedimentation rate. Significant improvements in measures at the 15-week follow-up also were found. Findings indicate that persons with RA who participate in appropriate exercises may lessen fatigue levels and experience other positive effects without worsening their arthritis.
 ...
PMID:Effects of exercise on fatigue, aerobic fitness, and disease activity measures in persons with rheumatoid arthritis. 917 74

Although the Restless-Legs-Syndrome (RLS) is harmless, it can be considerably bothersome on occasions. It seems to affect 1-5% of the population. The minimal criteria for diagnosis are: Symmetric or asymmetric dysesthesias of the lower, sometimes also of the upper extremities, present at rest, especially at night. This induces a need to move. Moving gives always relief, but only for a few seconds. Occasionally, dysesthesia can be painful. Additional features are: Involuntary, rhythmic retraction movements occurring especially at night, during sleep stages I und II. Sleep is disrupted and superficial, followed by daytime fatigue. Aetiologically, it is a mostly primary or hereditary disease, but may go along with uremia, diabetes and rheumatoid arthritis. Pathophysiologically there seems to be a malfunction of dopamine and opiate receptors in the central nervous system. Recently, morphological modifications have been found in peripheral nerves. Coffeine has been claimed as causative factor, but its role remains questionable. Therapy shows a high success rate. Some patients may complain about some remaining symptoms even with high doses of medication. Although carbamazepine, clonazepam and clonidine showed satisfactory results in controlled studies, dopaminergic agents and opiates have many advantages. In contrast to the former compounds, the latter are also effective against periodic movements in sleep. Side effects will be discussed according to the literature. In the second part of this paper, practical aspects concerning the care of RLS patients are considered.
 ...
PMID:[Restless legs syndrome--current aspects]. 924 61

Arthritis is one of the most common chronic illnesses managed in primary care. Osteoarthritis and rheumatoid arthritis are two common types the provider must distinguish between in terms of diagnosis and treatment. Osteoarthritis, the most common form, typically occurs in people more than 60 years of age and involves cartilage destruction. Signs and symptoms are local and include cool, bony joints and arthralgia that worsens with weight bearing. Treatment includes acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), exercise, and joint arthroplasty in severe cases. Rheumatoid arthritis is a systemic disease that results in symmetrical joint inflammation along with constitutional symptoms such as fatigue and depression. Current treatment recommendations include early use of disease modifying anti-rheumatic drugs along with NSAIDs. The key to arthritis management is early diagnosis and treatment to prevent further joint destruction and maximize functional ability.
 ...
PMID:A comparison of osteoarthritis and rheumatoid arthritis: diagnosis and treatment. 931 63

Methotrexate's mechanism of action affects both the inflammatory and immunosuppressive aspects of response. Its kinetics are defined and include variable absorption, intracellular metabolism, and both renal and biliary excretion. Methotrexate is clearly effective in the treatment of rheumatoid arthritis and may be able to decrease the rate of formation of new bony erosions. It is also effective in psoriatic arthritis and is being used in a multiplicity of other rheumatic diseases. The most common toxicities ascribed to methotrexate are gastrointestinal (e.g. stomatitis) and central nervous system (e.g. headache, fatigue, malaise). Methotrexate-induced hepatic cirrhosis is less common in rheumatoid arthritis than previously thought, although its occurrence in psoriasis is probably higher than in rheumatoid arthritis. Haematological, renal and pulmonary toxicity occur, but are rare, while teratogenicity is well documented. A new and disturbing adverse event, pseudolymphomas are being reported at present.
 ...
PMID:The rational use of methotrexate in rheumatoid arthritis and other rheumatic diseases. 971 72

Interleukin-6, an inflammatory cytokine, is characterized by pleiotropy and redundancy of action. Apart from its hematologic, immune, and hepatic effects, it has many endocrine and metabolic actions. Specifically, it is a potent stimulator of the hypothalamic-pituitary-adrenal axis and is under the tonic negative control of glucocorticoids. It acutely stimulates the secretion of growth hormone, inhibits thyroid-stimulating hormone secretion, and decreases serum lipid concentrations. Furthermore, it is secreted during stress and is positively controlled by catecholamines. Administration of interleukin-6 results in fever, anorexia, and fatigue. Elevated levels of circulating interleukin-6 have been seen in the steroid withdrawal syndrome and in the severe inflammatory, infectious, and traumatic states potentially associated with the inappropriate secretion of vasopressin. Levels of circulating interleukin-6 are also elevated in several inflammatory diseases, such as rheumatoid arthritis. Interleukin-6 is negatively controlled by estrogens and androgens, and it plays a central role in the pathogenesis of the osteoporosis seen in conditions characterized by increased bone resorption, such as sex-steroid deficiency and hyperparathyroidism. Overproduction of interleukin-6 may contribute to illness during aging and chronic stress. Finally, administration of recombinant human interleukin-6 may serve as a stimulation test for the integrity of the hypothalamic-pituitary-adrenal axis.
 ...
PMID:The pathophysiologic roles of interleukin-6 in human disease. 944 73

The silicone breast implant controversy rages on. Recent work has demonstrated that normal or baseline breast tissue silicon levels in women who had had no prior exposure to any type of breast implant may be as high as 446 microg/gm of tissue. These data ranged from 4 to 446 microg/gm of tissue, with a median of 27.0 microg/gm of tissue. In addition, numerous other epidemiologic and rheumatologic studies have demonstrated no association between silicone breast implants and any connective-tissue diseases. Despite these reports, the use of silicone implants remains restricted. The present study measured breast and capsular tissue silicon levels from 23 breasts in 14 patients with saline implants, and from 42 breasts in 29 patients with silicone implants. No patient in the saline implant group presented with signs or symptoms of connective-tissue disease. Patients with silicone implants, however, were divided into three groups based on the presence or absence of signs or symptoms of connective-tissue disease: group I, no symptoms or signs; group II, + symptoms, no signs; and group III, + symptoms, + signs. Six patients in group III were diagnosed with a specific connective-tissue disease, including systemic lupus erythematosus, rheumatoid arthritis, or scleroderma. The most common indications for implant removal or exchange were capsular contracture and implant rupture, although 41 percent of patients with silicone implants expressed media-related concern over the implant issue. The most common symptoms described by patients in groups II and III were joint pain and stiffness, arm pain and numbness, and fatigue. In all groups, capsular tissue silicon levels were significantly greater than breast tissue levels. This finding may indicate that the capsule serves as a barrier to the distribution of silicone from the implant into adjacent breast tissue. Although breast tissue silicon levels in patients with silicone implants were not significantly greater than those in patients with saline implants (p = 0.48), capsular tissue levels in patients with silicone implants were, indeed, significantly greater than those in patients with saline implants (p < 0.001). However, no statistically significant differences in tissue silicon levels were observed with relation to the presence or absence of connective-tissue disease signs or symptoms in patients with silicone implants (groups I to III). Therefore, these data strengthen the conclusion that there is no association between tissue silicon levels and connective-tissue disease.
 ...
PMID:Silicon analysis of breast and capsular tissue from patients with saline or silicone gel breast implants: II. Correlation with connective-tissue disease. 962 24

Sleep disturbances and related daytime complaints are frequent in rheumatoid arthritis (RA). The aim of the current study was therefore to evaluate the effect of a newer hypnotic on sleep structure and clinical parameters in RA. Forty outpatients were randomized to a two week treatment regimen with either 7.5 mg zopiclone or placebo at bedtime. Clinical examinations were performed before and after treatment and the degree of pain, fatigue, sleepiness, morning stiffness, and activities of daily living were assessed. Two sleep questionnaires were also completed weekly. Polysomnography was performed before the study and after 14 days of treatment. Recordings were evaluated using conventional sleep scoring as well as frequency analysis of the electroencephalography (EEG). Patients in the zopiclone group had subjective improvement of sleep, but otherwise no differences in pain score or the other clinical parameters were found. Conventional sleep assessments showed only minor changes during treatment, but frequency analysis demonstrated a shift from the lower towards the higher EEG frequencies in the active treatment group. Although the modulation of the EEG can represent a non-specific pharmacologic epiphenomenon, it might also reflect a disturbance of sleep microstructure. In conclusion, treatment with zopiclone may be of value for subjective sleep complaints in selected patients with RA, but it is doubtful whether hypnotics improve daytime symptoms in this patient group.
 ...
PMID:Zopiclone as night medication in rheumatoid arthritis. 964 12

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by progressive damage of synovial-lined joints and variable extra-articular manifestations. Tendon and bursal involvement are frequent and often clinically dominant in early disease. RA can affect any joint, but it is usually found in metacarpophalangeal, proximal interphalangeal and metatarsophalangeal joints, as well as in the wrists and knee. Articular and periarticular manifestations include joint swelling and tenderness to palpation, with morning stiffness and severe motion impairment in the involved joints. The clinical presentation of RA varies, but an insidious onset of pain with symmetric swelling of small joints is the most frequent finding. RA onset is acute or subacute in about 25% of patients, but its patterns of presentation also include palindromic onset, monoarticular presentation (both slow and acute forms), extra-articular synovitis (tenosynovitis, bursitis), polymyalgic-like onset, and general symptoms (malaise, fatigue, weight loss, fever). The palindromic onset is characterized by recurrent episodes of oligoarthritis with no residual radiologic damage, while the polymyalgic-like onset may be clinically indistinguishable from polymyalgia rheumatica in elderly subjects. RA is characteristically a symmetric erosive disease. Although any joint, including the cricoarytenoid joint, can be affected, the distal interphalangeal, the sacroiliac, and the lumbar spine joints are rarely involved. The clinical features of synovitis are particularly apparent in the morning. Morning stiffness in and around the joints, lasting at least 1 h before maximal improvement is a typical sign of RA. It is a subjective sign and the patient needs to be carefully informed as to the difference between pain and stiffness. Morning stiffness duration is related to disease activity. Hand involvement is the typical early manifestation of rheumatoid arthritis. Synovitis involving the metacarpophalangeal, proximal interphalangeal and wrist joints causes a characteristic tender swelling on palpation with early severe motion impairment and no radiologic evidence of bone damage. Fatigue, feveret, weight loss, and malaise are frequent clinical signs which can be associated with variable manifestations of extra-articular involvement such as rheumatoid nodules, vasculitis, hematologic abnormalities, Felty's syndrome, and visceral involvement. Although there is no laboratory test to exclude or prove the diagnosis of rheumatoid arthritis, several laboratory abnormalities can be detected. Abnormal values of the tests for evaluation of systemic inflammation are the most typical humoral features of RA. These include: erythrocyte sedimentation rate, acute phase proteins and plasma viscosity. Erythrocyte sedimentation rate and C-reactive protein provide the best information about the acute phase response. The C-reactive protein is strictly correlated with clinical assessment and radiographic changes. Plain film radiography is the standard investigation to assess the extent of anatomic changes in rheumatoid arthritis patients. The radiographic features of the hand joints in early disease are characterized by soft tissue swelling and mild juxtaarticular osteoporosis. In the the past 10 years, ultrasonography has gained acceptance for studying joint, tendon and bursal involvement in RA. It may improve the early clinical assessment and the follow-up of these patients, showing such details as synovial thickening even within finger joints. Other imaging techniques, such as magnetic resonance, computed tomography and scintigraphy may provide useful information about both the features and the extent for anatomic damage in selected rheumatoid arthritis patients. The natural history of the disease is poorly defined; its clinical course is fluctuating and the prognosis unpredictable. RA is an epidemiologically relevant cause of disability. An adequate early treatment of RA may alter the diseas
 ...
PMID:The clinical features of rheumatoid arthritis. 965 97

The purpose of this quasi-experimental study was to evaluate the effectiveness of a cognitive-behavioral nursing intervention for women with rheumatoid arthritis (RA). Ninety adult women with RA participated in 1 of 14 nurse-led groups over an 18-month period. Personal coping resources, pain-coping behaviors, psychological well-being, and disease symptomatology were measured at four time periods. There were significant changes on all of the measures of personal coping resources (p < .001) and psychological well-being (p < .05), half of the pain-coping behaviors (p < .05), and one indicator of disease symptomatology (fatigue, p < .05) from pre- to postintervention. Furthermore, the positive changes brought about by the program were maintained over the 3-month follow-up period. The intervention may be adapted to benefit individuals with a variety of stressful medical conditions.
 ...
PMID:Effects of a cognitive-behavioral intervention for women with rheumatoid arthritis. 967 8

Rheumatoid arthritis (RA) is a chronic, systemic, progressively deteriorating, connective tissue disease characterized by inflammation of the synovial membrane of the joints, pain, immobility, and fatigue. Exacerbations of RA are frequently associated with periods of physical and/or emotional stress. It is estimated that 1 in every 100 persons throughout the world suffers from RA. In the United States, women have 2 to 3 times the incidence rate of men, with no significant radical differences noted between Caucasians and African-Americans. In this article a case study format is used to provide information pertaining to the diagnosis and treatment of the adult RA patient.
 ...
PMID:Rheumatoid arthritis: a case study. 976 52


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>