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

From January 1982 through December 1988, 150 patients with 153 Winquist Class III and IV comminuted diaphyseal femur fractures due to high energy blunt trauma were treated with immediate plate fixation. A total of 260 major general surgical systems were injured in 150 patients. Forty-nine patients did not have adequate preoperative spine radiographs due to positioning or time factors. Nineteen patients had spine fractures; nine were diagnosed post-femoral fixation. The average injury severity score (ISS) was 22.7. Three patients died (2%). Our institution predicted mortality with this ISS for patients without pelvic or femur fractures at 15% (P = .0003). Six patients moved to other states and three were lost to follow up due to noncompliance. One of us reviewed 141 fractures in 138 patients at a minimum of 12 months follow up and completion of treatment. Forty-nine fractures were open; 8 grade I, 25 grade II, 10 grade IIIA, 4 IIIB, 2 IIIC. A total of 153 pelvic or ipsilateral major orthopedic injuries were present in 141 fractures. An additional 188 major associated orthopedic injuries were noted. The average time to union was 17.2 weeks. One plate was applied in 11 degrees of varus. Five plates failed from fatigue and five from repeat traumas. Seven plate failures were rodded and healed within 8 weeks. There was one persistent nonunion. One fracture, open IIIC, became infected after uniting. One patient has 110 degrees of knee motion and 140 fractures have greater than 130 degrees of knee motion. Plate fixation is a safe technique for immediate femoral stabilization in the face of high energy blunt trauma. Failures occur late and are easy to reconstruct. Intramedullary nails are the preferred method of reconstruction. Ultimate knee function is excellent. Infection rates (1/49) in open fractures are acceptably low.
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PMID:Immediate plate fixation of highly comminuted femoral diaphyseal fractures in blunt polytrauma patients. 150 66

Infections caused by Chlamydia pneumoniae were first described in 1985. The infection can cause common cold, sore throat, hoarseness, cough, headache, fatigue and sometimes influenza-like illness. Examination can indicate serous otitis media, sinusitis, laryngitis, bronchitis and pneumonia. The course can be long and relapsing. The recommended drugs for treatment are tetracycline or erythromycin for at least two weeks. Five verified cases are described in the article, four of them with symptoms from the upper respiratory tract only. It is concluded that Chlamydia pneumoniae is a not unusual cause of upper airway diseases. Up to now the diagnosis can best be verified by micro immunofluorescence. The authors call for a rapid and reliable test for use in physician's office. It is proposed that infections caused by Chlamydia pneumoniae be termed TWAR.
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PMID:[TWAR infection is a common diagnosis in outpatient clinics]. 157 35

Infection with Epstein-Barr virus has been reported to have numerous systemic and ocular manifestations. In this study, a 38-year-old man with acute infectious mononucleosis was examined for a painless left red eye of three days' duration. The patient had a two-week history of fatigue, low-grade fever, sore throat, and lymphadenopathy. Serologic evaluation was indicative of an acute primary infection with Epstein-Barr virus. A large, salmon-colored, supranasal bulbar conjunctival mass was observed in the left eye. No associated conjunctivitis was present. Biopsy of the conjunctival lesion disclosed a dense leukocytic infiltrate, which consisted primarily of mature lymphocytes and plasma cells. Immunocytochemical evaluation of the tissue with monoclonal antisera disclosed Epstein-Barr latent membrane protein and nuclear protein 2 in a small fraction of the cells constituting the infiltrate. The conjunctival infiltrate resolved completely within one month, paralleling the regression of the patient's lymphadenopathy.
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PMID:Conjunctival lymphocytic nodule associated with the Epstein-Barr virus. 165 1

Human herpesvirus-6 (HHV-6) was first isolated in 1986 from peripheral blood leukocytes of patients with lymphoproliferative disorders. Although HHV-6 is distinct from the other human herpes viruses, DNA studies have revealed some genomic similarities with cytomegalovirus. It has recently become evident that up to 95% of older children and adults are HHV-6 seropositive. Infection is believed to occur early in life, after maternal antibody has waned. Up to 92% of healthy adults shed HHV-6 in saliva, and evidence indicates that this secretion is important in spread of the virus. In situ hybridization and immunochemical studies suggest that the salivary glands themselves may be the site of replication and persistence of HHV-6. There is good evidence that HHV-6 is causally linked to exanthema subitum, a common febrile disease of infants. Associations of HHV-6 with postviral fatigue syndrome, lymphoproliferative disorders and progression of AIDS have all been examined, but the evidence in these cases remains conflicting.
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PMID:Human herpesvirus-6: the latest human herpes virus. 166 30

This is a report on an eight-year-old girl who presented with facial palsy, headache, fatigue, arthralgias and myalgias six weeks after two tick bites. Physical examination was unremarkable with the exception of a left-sided facial palsy. Laboratory investigation revealed normal complete blood count, ESR and CRP. The spinal tap showed a protein of 63 mg/dl, glucose 45 mg/dl and no cells. IFT titres to Borrelia burgdorferi in serum and CSF were significantly elevated. The diagnosis was supported by Western blot analysis. Treatment was started with ceftriaxone i.v. for a total of 14 days. Under this therapeutic regimen the patient improved substantially within five days. Investigation of CSF in patients with facial palsy may help to establish the diagnosis of Lyme disease by simultaneously measuring IFT to B. burgdorferi in serum and spinal fluid, even in cases where CSF shows little or no signs of inflammation.
Infection
PMID:Facial palsy with elevated protein in otherwise normal CSF in a child with Lyme disease. 191 37

Clinical features in 173 white expatriates returning to Britain with the sole diagnosis of schistosomiasis were compared with those in non-infected control subjects, matched for age and sex, returning from similar endemic areas. Infection was, with one exception, acquired in Africa. Schistosoma mansoni was found in 135 patients, S haematobium in 29, and mixed infection in 9. 79% of patients with S haematobium had symptoms, compared with 47% of patients with S mansoni. Tiredness, headache, and gastrointestinal disturbance were no more frequent in symptomatic patients than in control subjects. In over 50% of patients with schistosomiasis the diagnosis was established from snips of rectal mucosa, and this raises the question of how best to look for infection in those who have been exposed. Urine examination and schistosomal serology appear to be the best screening methods; patients with haematuria or seropositivity should be investigated further.
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PMID:Schistosomiasis in expatriates returning to Britain from the tropics: a controlled study. 286 26

An epidemic outbreak of non-A, non-B hepatitis occurred in 1977/78 involving 30 donors at a plasmapheresis center. Of 27 hospitalized patients with peak ALT values between 334 and 1736 (mean 831) IU/l, only 16 had subjective symptoms like fatigue and lack of appetite, 11 had nausea, 11 were jaundiced and one developed transient arthritis. Patients with jaundice became chronically ill significantly less frequently than those without jaundice. Nineteen of 26 patients followed up had elevated ALT values after 12 months (73%) and 11 after 46 months (42%). Needle liver biopsies performed in 18 of the 19 patients with elevated ALT after 12 months revealed chronic persistent hepatitis in 14 and chronic active hepatitis in three. Follow-up biopsies always showed improvement (nine patients) or complete recovery (eight patients).
Infection
PMID:Epidemic outbreak of non-A, non-B hepatitis in a plasmapheresis center. II: Clinical observations and a four-year follow-up of patients. 392 97

Within a three-year period 712 patients with Campylobacter jejuni infection were diagnosed at our laboratory in Helsinki and 524 (72%) were treated as outpatients. More than half (57%) of the patients became infected when abroad, chiefly during holiday trips in the Mediterranean and in East European countries. The risk of acquiring infection was about 250 times greater abroad than in Finland, and it differed considerably from country to country, being highest in Morocco and Tunisia. Among domestic cases the incidence of infection was significantly higher (p less than 0.001) during the summer and autumn months than during winter or spring. Animal contact prior to infection was reported in 59% of domestic and 31% of imported cases, and previous consumption of poultry in 28% and 42% of those from whom information was obtained. Besides diarrhoea (98%), the main symptoms included abdominal pain (87%), fatigue (81%), fever (78%), malaise (70%) and headache (51%). Arthralgia was observed in 19% and arthritis in 2% of patients. The mean duration of diarrhoea was 10.8 days, of fever 2.8 days.
Infection
PMID:Infection due to Campylobacter jejuni: a report of 524 outpatients. 646 63

The Mentor inflatable penile prosthesis is manufactured from Bioflex polyurethane, a material which is less elastic and more durable than silicone. Use of this new biocompatible polymer eliminates cylinder aneurysms and wear-induced cylinder leaks. The new prosthesis also incorporates a snap-on connector system designed to eliminate connector leaks and decrease operative time. The Mentor prosthesis has been implanted in 52 patients with organic impotence. The patients have been followed up for 2 to 16 months (average 8.3), the follow-up exceeding 1 year in 15 patients. A satisfactory cosmetic and functional result was achieved in 51 cases. Infection necessitated removal of the prosthesis in one patient. There were no pump, reservoir or tubing failures. After early connector failures there were no connector failures in the subsequent 48 patients. Additional complications included an incisional hernia and a cylinder failure which resulted from a manufacturing defect. There were no failures attributable to wear or material fatigue. The inherent reliability of this new prosthesis and the excellent functional and cosmetic results it produces justify its use in any patient who is a candidate for a penile prosthesis.
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PMID:Mentor inflatable penile prosthesis: clinical experience in 52 patients. 653 55

In a randomized multicenter therapeutic trial, 32 patients with erythema migrans received oral azithromycin 500 mg once daily and 33 patients received phenoxymethylpenicillin (penicillin V) 1 million U three times daily for 10 days. Follow-up was for a median of 17 (range 3-32) months. Four weeks after initiation of therapy, 20 (62%) patients given azithromycin and 17 (51%) patients given penicillin V were completely free of all signs and symptoms and did not develop new ones subsequently (no significant difference). Three months after initiation of therapy, the corresponding figures were 25 (78%) azithromycin and 28 (85%) penicillin V recipients (no significant difference). There were only minor sequelae such as arthralgia, headache, fatigue, stiff neck and dysesthesia. Azithromycin led to a significantly faster resolution of the erythema migrans than penicillin V (p < 0.001). Significantly more patients with more severe compared with mild initial disease had an elevated IgM antibody titer prior to therapy (p < 0.001). Usually mild to moderate side effects occurred in 12 patients given azithromycin and five patients given penicillin V (p < 0.05). Azithromycin appears to be as effective as penicillin V for the treatment of early Lyme borreliosis and it seems to clear the erythema migrans more promptly.
Infection
PMID:Azithromycin versus penicillin V for the treatment of early Lyme borreliosis. 813 65


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