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

Medical issues in sport diving include illnesses that are caused by diving, and medical disorders that compromise safety. Cerebral air embolism and decompression sickness of the brain and spinal cord can result from diving. Sport divers may manifest a spectrum of symptoms from air embolism, which can range from unconsciousness to minimal symptoms, which include fatigue, personality change, poor concentration, irritability, and changes in vision. The physician must search for these minor symptoms in divers who are suspected of pulmonary barotrauma. Medical disorders of concern in diving include diseases of the lungs, the heart, the brain, and the endocrine system, particularly diabetes. Other factors involved in diving safety are exercise capacity and training. Clinical practice standards usually prohibit diving by individuals who have a seizure disorder that requires continuous medication. In the United States, we will not approve diving for individuals who have insulin-dependent diabetes or severe asthma. Some divers can return to diving after myocardial infarction or bypass surgery if they demonstrate good exercise tolerance and no ischemia on a graded exercise test, which simulates the physical activity needed for safe diving.
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PMID:Medical aspects of sport diving. 914 89

Exercise echocardiography using treadmill exercise and immediate post-exercise imaging is an accurate means for detecting and stratifying coronary artery disease. It is applicable to patients with chest pain syndromes in whom the initial diagnosis is being contemplated and also in follow-up of patients after myocardial infarction or interventional procedures. Numerous studies have demonstrated that its accuracy is equivalent to that of competing radionuclide imaging techniques and that it has particular relevance in patients with non-diagnostic electrocardiograms. In addition to evaluating patients for the presence of coronary artery disease, because of the highly versatile nature of the imaging modality utilized (two-dimensional echocardiography), stress echocardiography is an excellent tool for evaluating atypical symptoms such as dyspnoea and fatigue.
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PMID:Treadmill exercise echocardiography: methodology and clinical role. 918 4

Do belching, chills, fatigue, and pressure just above the ribs sound like the symptoms of a heart attack? To most patients, they probably don't. However, research is indicating that a victim's actual symptoms often do not match his or her expectations of what a heart attack should feel like. As a result, many sufferers do not seek medical attention, or they delay it, which can result in permanent damage to the heart muscle or even death. A recent research study indicated that most patients with recent heart attack (74%) interviewed had symptoms different from what they expected. As a result, medical treatment was significantly delayed.
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PMID:Heart attack: what you don't know can hurt! 921 64

A placebo-controlled crossover design, with each treatment period lasting 6 weeks, was used to investigate effects of dronabinol in 15 patients with a diagnosis of probable Alzhemer's disease who were refusing food. Eleven patients completed both study periods; one patient who died of a heart attack 2 weeks before the end of the study was also included in the analysis. The study was terminated in 3 patients: one developed a grand mal seizure and 2 developed serious intercurrent infections. Body weight of study subjects increased more during the dronabinol treatment than during the placebo periods. Dronabinol treatment decreased severity of disturbed behavior and this effect persisted during the placebo period in patients who received dronabinol first. Adverse reactions observed more commonly during the dronabinol treatment than during placebo periods included euphoria, somnolence and tiredness, but did not require discontinuation of therapy. These results indicate that dronabinol is a promising novel therapeutic agent which may be useful not only for treatment of anorexia but also to improve disturbed behavior in patients with Alzheimer's disease.
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PMID:Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer's disease. 930 69

A state of 'vital exhaustion', characterized by unusual tiredness, increased irritability and feelings of demoralization has been found to preceed the onset of myocardial infarction and to increase the risk of a new coronary event after angioplasty. Probably this state reflects a decreased activity of the hypothalamic-pituitary-adrenal axis as part of an homeostatic reaction to prolonged stress and inflammation.
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PMID:Exhausted subjects, exhausted systems. 940 30

A state of vital exhaustion, characterised by unusual tiredness and lack of energy, increased irritability and feelings of demoralisation, has been found to be one of the precursors of myocardial infarction and other cardiac events. These feelings probably reflect decreased activity of the hypothalamic-pituitary-adrenal axis. Treatment of the conditions leading to this state of vital exhaustion might decrease the risk of a cardiac event.
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PMID:Why do imminent victims of a cardiac event feel so tired? 953 84

The goals of stable angina pectoris treatment are: (i) symptom relief and increase in angina-free walking time; and (ii) reduction of mortality and adverse outcome. Strategies used for plaque stabilisation resulting in a reduction in cardiovascular mortality and morbidity are: smoking cessation; aspirin (acetylsalicylic acid); blood pressure control; lipid lowering agents when low density lipoprotein cholesterol is elevated despite dietary therapy; coronary bypass surgery in patients with left main stem disease or triple vessel coronary disease and diminished left ventricular function; and use of estrogen in postmenopausal women. For symptom relief and to increase angina-free walking time, long acting nitrates, beta-blockers, calcium antagonists and potassium channel openers can be used. Drugs from these 3 classes are all effective when used optimally and choice of initial therapy should consider the presence of concomitant disease and underlying left ventricular function. However, none of the long acting nitrates provide continuous prophylaxis because nitrate tolerance develops during long term therapy. In patients with uncomplicated stable angina, nitrates, beta-blockers and calcium antagonists are all effective. Intermittent nitrate therapy is not associated with tolerance, but headache is a common adverse effect and the patient is unprotected at night and in the early hours of the morning. Concomitant treatment with a beta-blocker may be beneficial if the patient experiences withdrawal or early morning angina. For patients with stable angina and hypertension, therapy with a beta-blocker or a calcium antagonist rather than nitrate is indicated. beta-Blockers are preferred in patients who have had a myocardial infarction, or in those with a history of supraventricular tachyarrhythmias. beta-Blockers may produce excessive slowing of the heart rate, fatigue and bronchospasm in susceptible patients. Calcium antagonists are indicated as initial therapy when beta-blockers are either not tolerated or contraindicated. beta-Blockers and nondihydropyridine calcium antagonists should not be used in patients with sinus bradycardia and those with greater than first degree atrioventricular (AV) block because of the possibility of further slowing of heart rate and/or the development of high grade AV block. When monotherapy with one class is ineffective or associated with adverse effects, the patient should be switched to another class rather than given an additional drug. Optimal monotherapy is often as effective as combination therapy. If maximum monotherapy is only partially effective, a combination therapy which is not additive in terms of adverse effects should be chosen. Triple therapy may be deleterious and no more effective than dual therapy.
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PMID:Choosing the most appropriate treatment for stable angina. Safety considerations. 967 56

We tested the hypothesis that alterations in arterioles in locomotor skeletal muscles in rats with myocardial infarction (MI), but before development of congestive heart failure (CHF), precede structural and functional changes commonly observed in limb muscle in association with CHF. Resting diameters of third- (A3) and fourth-order arterioles (A4) in extensor digitorum longus (EDL) muscle were significantly smaller in rats with nonfailing small and medium-sized MI compared with control animals. Dilation of A4 in response to 10(-4) M adenosine was significantly attenuated in both groups (P < 0.05), whereas dilation of A3 was unaltered. Microvessels from both groups of infarcted rats constricted to all doses of acetylcholine (10(-9), 10(-8), and 10(-7) M) and showed a significantly exaggerated vasoconstrictor response to norepinephrine (10(-9), 10(-8), and 10(-7) M) compared with microvessels in control rats (P < 0.05). Peak isometric tension of combined tibialis anterior and EDL muscles and muscle fatigue (final/peak tension x 100), measured during 5-min isometric supramaximal twitch contractions at 4 Hz, were similar in control and MI rats (218 +/- 7 vs. 213 +/- 15 g/g muscle and 52 +/- 1 vs. 51 +/- 9%, respectively; n = 5 for both). There was also no difference with respect to the proportion of oxidative fibers or capillary-to-fiber ratios. Our results indicate that, in rats with left ventricular dysfunction but without failure, decreased diameter and perturbations in reactivity of small arterioles precede alterations in skeletal muscle performance often seen at a later date in association with CHF. These findings are consistent with the notion of aberrant endothelial and smooth muscle function and may contribute to the maintenance of blood pressure after MI but before CHF.
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PMID:Alterations in small arterioles precede changes in limb skeletal muscle after myocardial infarction. 972 10

Between April 1993 and June 1994, 29 patients (pts) with unresectable, locally advanced, or metastatic non-small cell lung cancer were treated with a combination of p.o. trans-retinoic acid (TRA), 150 mg/m2/day, in three divided doses and s.c. IFN-alpha, 3 x 10(6) units/day. The age range was 41-80 years (median, 63 years). The Eastern Cooperative Oncology Group performance status was 0-1 (24 pts) and 2 (5 pts). Pts had advanced disease, refractory to conventional therapy (5 stage IIIB and 24 stage IV). Twenty-one pts had adenocarcinoma, six had squamous cell carcinoma, and two had large cell carcinoma. Only 3 pts completed 8 weeks of treatment, requiring neither interruption nor dose modification. Fatigue occurred in 88% of pts. A syndrome complex consisting of dry oral and nasal mucosa, recurrent sinus infections, and epistaxis occurred in 64% of pts. Grade II/III dermatitis was seen in 52%. Severe scrotal dermatitis was seen in 7 pts (47% of 15 males). Hypertriglyceridemia was moderate/severe in 11 pts, and 3 pts required gemfibrozil for levels up to 1660 mg/dl. Hematological toxicity was not encountered, and none of the pts had leukocytosis. One pt died with complications of myocardial infarction while on TRA/IFN-alpha. Twenty-five pts had more than 2 weeks of treatment and are evaluable for response; two pts died early with complications of cancer, and two pts declined to continue after only 3 and 5 days of treatment. Final assessment of response was by accepted clinical and radiological criteria at 8 weeks. There have been four objective responses: complete response, 2 (18+ and 17 months) and partial response, 2 (7 and 14 months). Responses were observed in all histologies. Combined differentiation treatment with TRA/IFN-alpha has modest but objective activity in non-small cell lung cancer. Toxicity is considerable. Additional studies to elucidate the biological basis of TRA/IFN-alpha and to define prognostic parameters predicting response are needed.
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PMID:Phase II study of all-trans-retinoic acid and alpha-interferon in patients with advanced non-small cell lung cancer. 981 69

Many snorers complain of tiredness during the day, but little is known about the impact of snoring on daily life in other respects. The objective of this study was to assess the quality of life of middle-aged men who were heavy snorers. We used the Nottingham Health Profile (NHP), which has been utilized during the last two decades as an instrument for evaluating the influence different medical conditions have on quality of life. Forty-two men (median 45 years, mean BMI 26 kg/m2 and mean Respiratory Disturbance Index 8.6) completed quality of life questionnaires. The answers were compared with those of a population sample of 786 men from the region with the same mean age. There were significant differences between the snorers and the population sample in the total score for quality of life (p=0.001) and the sections about energy (p < 0.001) and emotional reactions (p=0.02). There were highly significant differences in the frequency of health-related problems among the snoring men compared with the population sample in the ability to perform tasks around the home (p < 0.001). social life (p=0.003), family relationship (p < 0.001 ) and sexual life (p=0.001). When the snorers were compared with results reported from patients suffering from other medical conditions (hypertensives, growth hormone deficiency, myocardial infarction, chronic obstructive pulmonary disease), we found an equal level of total mean score and negative influence on their quality of life. The study illustrates that snoring men have a poor quality of life, comparable to that of patients with chronic diseases.
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PMID:Evaluation of the quality of life of male snorers using the Nottingham Health Profile. 984 May 12


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