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

To obtain information to guide future health care planning, data from government and other sources on the demographic and medical characteristics of menopausal Taiwanese women were reviewed. The average age at menopause, according to a 1995-96 study of 386 menopausal women in Taipei, is 49.5 +or- 2.3 years. In 1994, women aged 50 years and over comprised 18.3% of Taiwan's female population and 8.9% of the total population. 68% of menopausal women in the 1995-96 study reported lower back pain; other common symptoms included fatigue (59%), decreased memory (55%), vaginal dryness (50%), hot flashes (49%), insomnia (46%), loss of libido (46%), dry skin (41%), and depression (40%). After menopause, the prevalence of hypertension and coronary heart disease becomes higher among women than men. In addition, bone mineral density decreases markedly and 19.8% of women 65 years of age and over have experienced vertebral fractures. About 60% of malignant neoplasms diagnosed in 1992 involved women aged 50 years and older. By age 60 years, women's risk of cancer begins to increase substantially. An estimated 80% of Taiwanese women initiate hormone replacement therapy for relief of menopausal symptoms, prevention of cardiovascular disease, and prevention and treatment of osteoporosis. Since 30% of menopausal women in Taiwan are currently widowed or unmarried, there is a need to design programs that offer psychosocial support as well as comprehensive medical care.
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PMID:Demographic characteristics and medical aspects of menopausal women in Taiwan. 934 80

Vital exhaustion, defined as a combination of fatigue, lack of energy, feelings of hopelessness, loss of libido, and increased irritability, has been proposed as a risk indicator for the development of coronary heart disease (CHD). It is unclear if the association between vital exhaustion and CHD is independent of sleep behavior, depression, and physical activity. We ascertained sense of exhaustion among 5,053 male college alumni who were free of cardiovascular disease, cancer, and chronic obstructive pulmonary disease by asking, "How often do you experience sense of exhaustion (except after exercise)?" on a health survey in 1980. Eight hundred fifteen men died during 12 years of follow-up, 25% due to CHD. After adjustment for age, body mass index, smoking status, and history of physician-diagnosed diabetes and hypertension, frequent sense of exhaustion was associated with a twofold increase in CHD mortality (rate ratio 2.07; 95% confidence interval 1.08 to 3.96). After additional adjustment for insomnia, sleep duration, use of sleeping pills and tranquilizers, physical activity, history of physician-diagnosed depression, and alcohol intake, the rate ratio was not appreciably altered; however, the association now was of borderline significance (rate ratio 2.06; 95% confidence interval: 0.98 to 4.36) because there were only 10 deaths from CHD among men who were frequently exhausted. In a prospective observational study, frequent sense of exhaustion appeared to be independently associated with increased risk of CHD mortality in men.
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PMID:Sense of exhaustion and coronary heart disease among college alumni. 1060 12

The new "24-hour society" increases night work and the diversity of flexible work-hour patterns. At the same time, the number of older shift workers is growing in most developed countries due to the general aging of the working population. Together with new experimental and epidemiologic data on the alarming relationship of shift work to fatigue, performance, accidents, and chronic health effects like coronary heart disease, there is reason to believe that shift work may become a major occupational health and safety problem in the near future. The prevention of shiftwork-related health and safety problems will be a major challenge for the employer, employees, and occupational health professionals during the next few decades. The present paper shortly summarizes the current knowledge on the relationship between shift work, aging, and health and outlines practical countermeasures and research needs to improve the health and well-being of aging shift workers.
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PMID:Towards the 24-hour society--new approaches for aging shift workers? 1088 61

Negative emotions have been claimed to be a cause of coronary heart disease (CHD) as well as a consequence of cardiovascular disorders. Early case studies of cardiac disorders of soldiers in battle drew attention to the possibility that strong negative emotional states could cause CHD. Subsequent reports of reactions to natural disasters supported the notion that intense negative emotions could precipitate somatic disorders such as CHD. Since then, numerous studies have investigated relations between negative emotions and CHD. Over the years, retrospective studies have found, for example, that negative emotions are often present before the occurrence of CHD. Cross-sectional studies have indicated that symptoms of depression and anxiety are often present in CHD patients. Prospective studies have shown that the likelihood of CHD tends to be higher for people with negative emotions than for those without them. The main symptoms of negative emotional states that seem to be most closely associated with CHD are nervousness, getting easily upset, feeling fatigue, being indecisive, having sleep disturbances, being usually worried about something, and feeling that others would be better off if oneself were dead. Although the findings appear to support the notion of causal connections between negative emotions and CHD, they fail to provide conclusive proof of such relations. An alternative explanation that could also account for the findings is simply that negative emotions and CHD often coexist.
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PMID:Negative emotions and coronary heart disease: causally related or merely coexistent? A review. 1127 79

Systolic and pulse blood pressures are stronger predictors of stroke, coronary heart disease, myocardial infarction, heart failure, end-stage renal disease, and cardiovascular mortality than diastolic pressure. Furthermore, diastolic pressure is inversely related to coronary heart disease and cardiovascular mortality. Increased elastance (or stiffness, inverse of compliance) of the central elastic arteries is the primary cause of increased systolic and pulse pressure with advancing age and in patients with cardiovascular disease, including hypertension, and is due to degeneration and hyperplasia of the arterial wall; diastolic pressure decreases as arterial elastance increases. As elastance increases, transmission velocity of both forward and backward (or reflected) traveling waves increases, which causes the reflected wave to arrive earlier in the central aorta and augments pressure in late systole. These changes in arterial wall properties cause an increase in left ventricular afterload and myocardial oxygen consumption and a decrease in myocardial perfusion pressure, which may induce an imbalance in the supply-demand ratio, especially in hypertrophied hearts with coronary artery disease. Also, an increase in systolic pressure increases arterial wall circumferential stress, which promotes fatigue and development of atherosclerosis. Vasodilator drugs have little direct active effect on large elastic arteries but can markedly reduce wave reflection amplitude and augmentation index by decreasing elastance of the muscular arteries and reducing pulse wave velocity of the reflected wave from the periphery to the heart. This decrease in intensity (or amplitude) and increase in travel time (or delay) of the reflected wave causes a generalized decrease in systolic pressure and arterial wall stress and an increase in ascending aortic flow during the deceleration phase. The decrease in systolic pressure brought about by this mechanism is grossly underestimated when systolic pressure is measured in the brachial artery.
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PMID:Arterial elastance and wave reflection augmentation of systolic blood pressure: deleterious effects and implications for therapy. 1145 32

It is well known that cardiovascular morbidity and mortality are high in diabetic patients. Cardiac involvement is silent and early and these diabetic patients generally complain of chronic fatigue. This study was designed to evaluate the relation between glycemic control and exercise capacity in 330 diabetic patients who have no cardiac symptoms by sustaining dynamic exercise. After a cardiac examination, patients with coronary heart disease, ECG abnormalities, cardiac failure, valvular disease, cerebrovascular disease, peripheral artery disease, anaemia and peripheral neuropathy were excluded. Plasma HbA1c and lipid levels were obtained and a symptom limited exercise test based on "Bruce Protocol" was performed on all patients. Plasma HbA1c levels were significantly increased in smokers and in hypercholesterolemic patients (p<0.001, p=0.006). A moderate correlation between exercise capacity and HbA1c levels, and a weak correlation between duration of diabetes, age, sex, hypertension and plasma lipids were obtained. Multivariant regression analys is revealed that only HbA1c and hypercholesterolemia affected exercise capacity independently (r=-0.54 r=-0.30). In conclusion, poor glycemic control in diabetic patients causes earlier cellular involvement. Because of the high affinity of HbA1c to oxygen, the energy metabolism of the cell is affected, with a clinical correlation between chronic fatigue and worsening exercise capacity.
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PMID:Serum HbA1c levels and exercise capacity in diabetic patients. 1180 2

Eight patients with coronary heart disease were studied during two periods of exercise separated by 30 min of rest; workload was increased in a stepwise fashion every minute of exercise up to a level that produced limiting symptoms of angina, fatigue, or dyspnea. The magnitude of ST-segment depression and the central aortic pressure were measured during exercise and recovery periods, and myocardial oxygen requirements were estimated by the pressure-time index (systolic aortic pressure x heart rate x ejection time). Seven of the eight patients exhibited a close relationship (r ranged from 0.74 to 0.98) between magnitude of exercise ST-segment depression and indices expressing myocardial oxygen requirements; heart rate, blood pressure, and ejection time were also related to magnitude of exercise ST-segment depression. These relationships were reproducible during two consecutive exercises. Like onset of angina, magnitude of exercise ST-segment depression is usually related to hemodynamic factors influencing myocardial oxygen needs. Consequently, comparisons of exercise-induced ST depression before and after therapy (drugs, physical training, and surgery) are valid only if ECG findings are compared at the same level of myocardial oxygen requirements. In contrast, absence of such a relationship during recovery suggests an important difference in mechanisms of the post-exercise electrocardiogram.
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PMID:Hemodynamic determinants of exercise ST-segment depression in coronary patients. 1199 2

From the clinical standpoint a cardiomyopathy can be classified as primitive when other causes, i.e. ischemic, infiltrative, systemic diseases, can be ruled out. Initial symptoms usually include a progressive dyspnea and fatigue with tachycardia in a patient previously healthy. Congestive heart failure may be the initial manifestation. Angina is often present, not only because of coronary heart disease. Auscultatory findings usually include a gallop rhythm with a third heart sound, not rarely a four-sound gallop. Blood test to evaluate renal and liver function should be performed. The dosage of troponin I and/or troponin T, plasma renin activity, brain natriuretic peptide or endothelins has recently gained some reputation to indicate prognosis, but there is no reason to believe that these measures are superior to cardiopulmonary stress test.
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PMID:[Dilated cardiomyopathy: role of clinical and laboratory evaluation]. 1202 82

"Vital exhaustion," characterized by fatigue, irritability, and demoralization, precedes new and recurrent coronary events. Biological mechanisms explaining this association are not fully understood. The objective was to investigate the relationship between vital exhaustion, lifestyle, and lipid profile. Vital exhaustion, smoking, body mass index (BMI), alcohol consumption, exercise capacity, and serum lipids were determined in 300 healthy women, aged 56.4 +/- 7.1 years. No statistically significant associations were found between vital exhaustion and lifestyle variables. Divided into quartiles, vital exhaustion was inversely related to high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 in a linear fashion after adjustment for age, BMI, exercise capacity, and alcohol consumption. A multivariate-adjusted vital exhaustion-score in the top quartile, as compared to one in the lowest, was associated with 12% lower HDL-C and 8% lower apolipoprotein A1 (p < .05). In conclusion, alterations in lipid metabolism may be a possible mediating mechanism between vital exhaustion and coronary heart disease. The impact of lifestyle variables was weak.
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PMID:Vital exhaustion in relation to lifestyle and lipid profile in healthy women. 1258 47

The purpose of this descriptive study was to determine the perceptions of activity and vocational status in women with cardiac illness. A convenience sample of 20 women with the diagnosis of coronary heart disease or hypertrophic cardiomyopathy participated. Subjects underwent an audiotaped interview, using a semistructured interview guide, which was then transcribed into the Ethnograph software program (Qualis Research Associates, Salt Lake City, UT). Transcripts were analyzed for common themes via content analysis. There were four themes identified for activity: variable activity patterns, fatigue, guilt, and depression. There were four themes identified for vocational status: desire to work, social aspects of work, unpaid work, and struggle to maintain the status quo. In conclusion, the themes of fatigue, guilt over unmet activity expectations, and the common occurrence of unpaid work validated prior research findings. The themes of variable patterns of activity management, feelings of depression about lowered activity levels, the desire to return to a prior vocation, the importance of the social nature of work, and the struggle to balance both home and work roles were new findings.
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PMID:Perceptions of activity and vocational status in women with cardiac illness. 1289 74


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