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

Muscle weakness and early fatigue are common symptoms of chronic organ diseases, like chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF) and chronic renal failure (CRF). It is becoming more and more clear that symptom intensities and exercise intolerance are related to muscle wasting and intrinsic alterations in peripheral skeletal muscle in these patient populations, while correlations with parameters of organ functioning are poor. Also, changes in muscle structure and function in COPD, CHF and CRF show much resemblance. Semi-starvation, reduced physical activity and ageing are external factors possibly confounding a direct relationship between the primary organ impairments and alterations in peripheral skeletal muscle and exercise capacity. Reducing the catabolic effects of the various contributing factors might improve muscle function and health status in chronic disease. In this review, we present a systematic overview of human studies on alterations in skeletal muscle function, morphology and energy metabolism in COPD, CHF, CRF and we compare the results with comparable studies in anorexia nervosa, disuse or inactivity and ageing. Unravelling the relative contributions of these external factors to the observed alterations in the various diseases may contribute to targeted intervention strategies to improve muscle function in selected groups of patients.
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PMID:The contribution of starvation, deconditioning and ageing to the observed alterations in peripheral skeletal muscle in chronic organ diseases. 1243 May 63

The SF-20 and the SF-36 are the most frequently used questionnaires for assessing the quality of life in SLE patients. The SF-36 is actually considered the most suitable for this disease, due to the inclusion of fatigue, a manifestation frequently observed in SLE patients. Using these instruments, it has been clearly demonstrated that patients with SLE have a worse quality of life than healthy people of the same age. Some aspects of daily life, like physical activity, job, social relationship and vitality, are particularly affected. In the majority of studies, an inverse relation between quality of life and disease activity has been observed. The influence the damage has on the quality of life is more complex, since a greater number of variables are involved. In fact, the amount of damage largely depends on the organ involved and on functional impairment resulting from it. To explain the variability in the quality of life among different patients, it is important to consider, besides the clinical complaints, the psycho-social dimension of each person. In fact, some SLE patients, unlike others, cope well with the disease. People behave differently when faced with critical situations, i.e. after being diagnosed with a chronic disease; their reaction depends on the degree of support they receive from family, friends and colleagues, and from the different strategies of coping, that they use.
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PMID:[Quality of life in systemic lupus erythematosus] 1216 84

A study by Dr. Nagiba Abdulghani, conducted for the University of London School of Hygiene and Tropical Medicine, reports that in almost 2/3 of the cases of maternal death during childbirth in North Yemen, the children died within 1 year of their mothers. The maternal mortality ratio in North Yemen is 753 per 100,000 live births. The study included 224 maternal deaths in 10 hospitals between May, 1987, and April, 1989. 9 out of 10 mothers who died were illiterate. Only 1/5 had received prenatal care. The inaccessibility of health services, the poor quality of care and facilities, and a lack of faith in a system that humiliates women were given as reasons for failure to seek medical care. Causes of death in order of frequency were hepatitis, hemorrhage, infection, and toxemia. 3/4 of the women died postpartum. 1/5 of the babies were stillbirths. 1/5 of the mothers had a history of maternal complications. 1/5 had chronic disease. 2/3 of the women had begun their pregnancies within 1 year of their last childbirth. 1/2 of the women had symptoms ranging from vomiting and fatigue to jaundice and vaginal bleeding. Recommendations of the study included: 1) programs to prevent and treat hepatitis and; 2) an information, education, and communication (IEC) community campaign on the signs of maternal complications. Personnel should also continue their training and research activities.
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PMID:Mother's death means baby is likely to die too. 1234 60

Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with chronic Lyme disease are generally consistent with the deficits that can be seen in processes with primarily frontal systems involvement. These observations are generally consistent with neuroradiologic findings. The clinical presentation in chronic Lyme disease and the nature of the neuropsychological deficits are discussed, as are several central issues in understanding neuropsychological functioning in chronic Lyme disease, such as the impact of chronic illness, response to treatment, and the relationship between neuropsychological performance and depression, fatigue, and neurological indicators of disease.
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PMID:Neuropsychological functioning in chronic Lyme disease. 1242 15

Ageing is associated with changes in body composition, including an increase and redistribution of adipose tissue and a decrease in muscle and bone mass, beginning as early as the fourth decade of life. These changes have significant implications for the health and functioning of the individual because of their associations with chronic disease expression and severity, as well as geriatric syndromes such as mobility impairment, falls, frailty and functional decline. Therefore, understanding the preventive and therapeutic options for optimizing body composition in old age is central to the care of patients in mid-life and beyond. Pharmacological interventions are currently available for maintaining or improving bone mass, and much current interest is focused on anabolic agents that will preserve or restore muscle mass, as well as those that can potentially limit adipose tissue deposition. However, in this brief review, non-pharmacological modulation of body composition through appropriate dietary intake and physical activity patterns, will be discussed. There is sufficient evidence currently to suggest that a substantial portion of what have been considered 'age-related' changes in muscle, fat and bone are in fact related either to excess energy consumption, decreased energy expenditure in physical activity, or both factors in combination. In addition, selective underconsumption of certain macro- or micronutrients contributes to losses of muscle and bone mass. Each of the three compartments will be considered in turn, with recommendations for optimizing the size of these body tissue stores in early adulthood, and minimizing undesirable changes typically seen in middle and old age.
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PMID:Benefits of exercise and dietary measures to optimize shifts in body composition with age. 1249 58

Progressive post-LASIK keratectasia (PPLK) is a progressive deformation of corneal anatomy that occurs rarely but may have severe consequences. Using the scientific literature and new hypotheses, we attempted to determine whether PPLK is a biomechanical result of laser in situ keratomileusis (LASIK), a chronic disease process affecting individuals predisposed to the condition, or a combination of processes. We look at whether the combination of fatigue, specifically a form of dynamic fatigue, and proteolysis provides an environment conducive to the occurrence and progression of PPLK. This review may raise more questions than it answers and in so doing may move us toward a better understanding of this occasionally serious consequence of LASIK.
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PMID:Progressive post-LASIK keratectasia: biomechanical instability or chronic disease process? 1249 19

A rise in the aging population has been predicted, and, as a result, it is expected that the incidence of age-related health conditions will also increase. Although common in the elderly, anemia is often mild and asymptomatic and rarely requires hospitalization. However, untreated anemia can be detrimental, because it is associated with increased mortality, poor health, fatigue, and functional dependence and can lead to cardiovascular and neurological complications. Several factors have been suggested to cause anemia in this population, for example, blood loss or chronic disease. In some cases, the cause is unknown. It has been suggested that this is a result of the presence of comorbid conditions that can mask the symptoms of anemia. Therefore, appropriate diagnosis and management strategies of anemia in the elderly need to be identified, particularly because anemia may indicate the presence of other serious diseases.
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PMID:Epidemiology of anemia in the elderly: information on diagnostic evaluation. 1258 65

Sexual dysfunction is a common finding in both men and women with chronic kidney failure. Common disturbances include erectile dysfunction in men, menstrual abnormalities in women, and decreased libido and fertility in both sexes. These abnormalities are primarily organic in nature and are related to uremia as well as the other comorbid conditions that frequently occur in the chronic kidney failure patient. Fatigue and psychosocial factors related to the presence of a chronic disease are also contributory factors. Disturbances in the hypothalamic-pituitary-gonadal axis can be detected before the need for dialysis but continue to worsen once dialytic therapy is initiated. Impaired gonadal function is prominent in uremic men, whereas the disturbances in the hypothalamic-pituitary axis are more subtle. By contrast, central disturbances are more prominent in uremic women. Therapy is initially directed toward optimizing the delivery of dialysis, correcting anemia with recombinant erythropoietin, and controlling the degree of secondary hyperparathyroidism with vitamin D. For many practicing nephrologists, sildenafil has become the first line therapy in the treatment of impotence. In the hypogonadal man whose only complaint is decreased libido, testosterone may be of benefit. Regular gynecologic follow-up is required in uremic women to guard against potential complications of unopposed estrogen effect. Uremic women should be advised against pregnancy while on dialysis. Successful transplantation is the most effective means of restoring normal sexual function in both men and women with chronic kidney failure.
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PMID:Sexual dysfunction in men and women with chronic kidney disease and end-stage kidney disease. 1261 63

Acromegaly is a chronic disorder invariably caused by a growth hormone (GH)-secreting pituitary tumour and is characterised by disabling symptoms (sweating, arthralgia, headache, paraesthesiae, fatigue), significant comorbidities (diabetes mellitus, hypertension, sleep apnoea), and premature mortality. Symptomatic control can be achieved by lowering insulin-like growth factor-I (IGF-I) concentrations to within the age-adjusted normal range, and survival can be improved to match that of the general population. However, even with optimal surgery and current medical therapies (dopamine agonists, somatostatin analogues), 30% to 50% of patients do not achieve target concentrations of IGF-I and GH. Pegvisomant is a new GH-receptor antagonist that blocks GH activity by inhibiting functional dimerisation of GH-receptors. Given as subcutaneous injections at dosages of 10 mg, 15 mg, or 20 mg/day for 3 Months, pegvisomant normalised serum IGF-I concentrations in, respectively, 54%, 81%, and 89% of acromegalic patients. Moreover, long-term pegvisomant therapy normalised IGF-I concentrations in 97% of patients treated for 12 Months or longer, with no evidence of tachyphylaxis. Pegvisomant is the most effective medical therapy, reported to date, in terms of normalisation of circulating IGF-I concentrations. In addition, pegvisomant appears to be safe and well tolerated. Although additional long-term studies are required to further assess safety, the introduction of this innovative treatment should allow for optimal disease control in patients with acromegaly.
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PMID:Pegvisomant: an advance in clinical efficacy in acromegaly. 1267 Feb 98

Fibromyalgia (FM) is a chronic disorder characterised by musculoskeletal pain, diffuse pain in "tender points", fatigue, sleep disturbances, and multiorgan functional disorders. The case is presented of a 16-year-old girl suffering from fibromyalgia. The clinical course, problems with diagnosis and treatment have been analysed.
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PMID:[Fibromyalgia syndrome: a case of a 16-year old girl: diagnosis, clinical and therapeutic problems]. 1293 24


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