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

We used the combined subtemporal presigmoid and suboccipital retrosigmoid multidirectional approach with the aid of a rotatable head frame (periauricular three-quarter twist-rotation approach) in 20 cases of petroclival meningiomas. Patients were placed in the lateral decubitus (park-bench) position. The head is twisted, rotated, and positioned 30 degrees face down in the Sugita rotatable head frame. By rotating this head frame, a 30- to 60-degree face-down position can be obtained when the suboccipital retrosigmoid route is used. Alternatively, the straight lateral or slightly brow-up position is obtained when the subtemporal presigmoid route is used. This twist-rotation approach provides multiple trajectories through the petroclival region with minimal drilling of the petrous bone, fatigue of the surgeon, and retraction of the brain.
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PMID:Combined pre- and retrosigmoid approach for petroclival meningiomas with the aid of a rotatable head frame: peri-auricular three-quarter twist-rotation approach: technical note. 1614 7

Venous thromboembolism (VTE), which is manifested as deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a significant cause of death, disability, and discomfort. They are frequent complications of various surgical procedures. The aging population and the survival of more severely injured patients may suggest an increasing risk of thromboembolism in the trauma patients. Expanded understanding of the population at risk challenges physicians to carefully examine risk factors for VTE to identify high-risk patients who can benefit from prophylaxis. An accurate knowledge of evidence-based risk factors is important in predicting and preventing postoperative DVT, and can be incorporated into a decision support system for appropriate thromboprophylaxis use. Standard use of DVT prophylaxis in a high-risk trauma population leads to a low incidence of DVT. The incidence of VTE is common in Asia. The evaluation includes laboratory tests, Doppler test and phlebography. Screening Doppler sonography should be performed for surveillance on all critically injured patients to identify DVT. D-Dimer is a useful marker to monitor prophylaxis in trauma surgery patients. The optimal time to start prophylaxis is between 2 hours before and 10 hours after surgery, but the risk of PE continues for several weeks. Thromboprophylaxis includes graduated compression stockings and anticoagulants for prophylaxis. Anticoagulants include Warfarin, which belongs to Vitamin K antagonists, unfractionated heparin, low molecular weight heparins, factor Xa indirect inhibitor Fondaparinux, and the oral IIa inhibitor Melagatran and ximelagatran. Recombinant human soluble thrombomodulin is a new and highly effective antithrombotic agent. Prophylactic placement of vena caval filters in selected trauma patients may decrease the incidence of PE. The indications for prophylactic inferior vena cava filter insertion include prolonged immobilization with multiple injuries, closed head injury, pelvic fracture, spine fracture, multiple long bone fracture, and attending discretion. Multiple-trauma patients are at increased risk for DVT but are also at increased risk of bleeding, and the use of heparin may be contraindicated. Serial compression devices (SCDs) are an alternative for DVT prophylaxis. Compression devices provide adequate DVT prophylaxis with a low failure rate and no device-related complications. Immobilization is one of important reasons of VTE. The ambulant patient is far less likely to develop complications of inactivity, not only venous thrombosis, but also contractures, decubitus ulcers, or osteoporosis (with its associated fatigue fractures), as well as bowel or bladder complications.
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PMID:Prophylaxis against venous thromboembolism in orthopedic surgery. 1684

Foam mattress quality affects pressure ulcer risk but no reliable method to assess mattress fatigue and indentation is available. To ascertain Indentation Quality values of standard 14-cm (5-inch) foam mattresses after 15 years of use, a convenience sample of 50 visco-elastic foam mattresses from a total of 1,000 same-brand mattresses used in a Dutch University hospital was tested using a durometer. Indentation Quality values were obtained on the mattress cover at a relatively unloaded zone (corner), at the head and heel zones, the knee and shoulder areas, and in the middle (buttocks area). Indentation Quality values ranged from a mean of -11.91 mm (+/-2.58) in the unloaded zone to a mean of -26.96 mm (+/-4.31) in the middle zone (buttocks area, P <0.001 compared to all other mattress areas). The value at the relatively unloaded zone was significantly and positively related to the values at the head and the heel zones (r = .70, P <.01) and the knee and the shoulder zones (r = .33, P <.05). The value at the buttocks zone was positively related to the value at the knee and the shoulder zones (r = .35, P <.05). The study showed that mattresses that appeared similar had a wide range of indentation values (indicating a need for individual assessments to monitor their quality) and that Indentation Quality values, determined using the durometer, facilitate objective and quantifiable mattress assessments. Consideration of the consequences of foam mattress life span on quality of care, hospital management practices, and cost analysis is justified.
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PMID:Using an indentation measurement device to assess foam mattress quality. 1805 47

Inactivity and muscular adaptations following spinal cord injury (SCI) result in secondary complications such as cardiovascular disease, obesity, and pressure sores. Functional electrically stimulated (FES) cycling can potentially reduce these complications, but previous studies have provided inconsistent results. We studied the effect of intensive long-term FES cycle training on muscle properties in 11 SCI subjects (mean +/- SEM: 41.8 +/- 2.3 years) who had trained for up to 1 hour/day, 5 days/week, for 1 year. Comparative measurements were made in 10 able-bodied (AB) subjects. Quadriceps maximal electrically stimulated torque increased fivefold (n = 5), but remained lower than in AB individuals. Relative force response at 1 HZ decreased, relaxation rate remained unchanged, and fatigue resistance improved significantly. Power output (PO) improved to a lesser extent than quadriceps torque and not to a greater extent than has been reported previously. We need to understand the factors that limit PO in order to maximize the benefits of FES cycling.
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PMID:Long-term intensive electrically stimulated cycling by spinal cord-injured people: effect on muscle properties and their relation to power output. 1881 13

Purpose. To highlight research priorities of people with spinal cord injury (SCI), outline the current state of rehabilitation research and suggest potentially fruitful avenues for future inquiry. Method. Commentary. Results. People with SCI identify pain, depression, fatigue, pressure sores, spasticity and the management of bladder and bowel as research priorities. Research reveals multiple interconnections between these secondary problems, all of which negatively impact quality of life (QOL). However, despite a substantial volume of existing research, significant gaps in knowledge remain, duplications of research effort are apparent and few interventions have an adequate evidence base. Issues concerning community participation - another research priority - have only recently attracted researchers' attention. Conclusions. This commentary contends that research should: focus on issues and outcomes of relevance and importance to people living with SCI; address the complexities of secondary conditions and their inter-relationships; appraise environmental barriers to participation in meaningful living; be designed to identify and inform effective and relevant interventions. Innovative approaches to research partnerships, mixed methods and exploring variables usually omitted from quantitative studies might enhance the likelihood that the complexity of issues facing people living with SCI will be identified and addressed. Moreover, a governing focus on achieving lives experienced as hopeful, purposeful, satisfying and meaningful could contribute to enhancing QOL outcomes following SCI.
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PMID:Spinal cord injury rehabilitation research: patient priorities, current deficiencies and potential directions. 2013 45

We report the initial and follow-up ultrasonography (US) findings in a pediatric case of wandering spleen with symptoms of acute abdomen, as a rare entity. A four-year-old boy was referred with complaints of blunt abdominal pain, vomiting and fatigue. US detected an oval- shaped, mildly enlarged spleen with inferomedial displacement. In right lateral decubitus, the spleen showed further medial displacement. Five months later, control US revealed further enlargement of the displaced spleen. Seven months later, due to acute torsion of the spleen, splenectomy was performed.
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PMID:Wandering spleen in a child with symptoms of acute abdomen: ultrasonographic diagnosis. Case report. 2239 42

The overview study deals with the secondary conditions in individuals with disability. In the framework of the overview study 24 researches (1984-2016) were analyzed. According to the researches, individuals with disabilities are exposed to several secondary conditions such as obesity, pressure sores, metabolic imbalance, pain, fatigue, depression and others. Secondary conditions have been observed mainly in individuals with physical disability. The most frequently used research approach was a quantitative research strategy based on the form of a questionnaire. The range of research sample differs among selected studies. Smallest research sample consisted of 71 respondents, the largest of 3076 respondents. Secondary symptoms of disability may be perceived as less serious problems, however their presence and cumulation can significantly decrease the quality of life of people with disabilities.
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PMID:[Secondary symptoms of disability in international studies]. 2936 26

In part I of this review, we introduced the duty cycle as a fundamental parameter in controlling the effect of electrical stimulation pulse trains on muscle structural and functional properties with special emphasis on fatigue. Following on from a survey of the literature, we discuss here the relative ability of intermittent and continuous stimulation to fatigue muscle. In addition, pertinent literature is explored on a more deeper level, highlighting contentions regarding the duty cycle across studies. In response to literature inconsistencies, we propose frameworks upon which the duty cycle parameter may be specified. We present the idea of domain reporting for the duty cycle, and illustrate with practical examples. In addition we dig further into the literature and present a set of notations that have been used by different researchers to report the duty cycle. We also propose the idea of the duty cycle multiple, which together with domain reporting, will help researchers understand more precisely duty cycles of electrical stimulation. As a case study, we also show how the duty cycle has been looked at by researchers in the context of pressure sore attenuation in patients. Together with part I, it is hoped that the frameworks suggested provide a complete picture of how duty cycle has been discussed across the literature, and gives researchers a more trans-theoretical basis upon which they may report the duty cycle in their studies. This may also lead to a more precise specification of electrical stimulation protocols used in patients.
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PMID:The duty cycle in Functional Electrical Stimulation research. Part II: Duty cycle multiplicity and domain reporting. 3066 96


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