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

The majority of women experience a variety of symptoms at the time of the menopause, but these are frequently regarded as being unworthy of management by their doctors. Recent reports of a possible association between exogenous oestrogens and endometrial carcinoma have increased professional reluctance to prescribe oestrogens for menopausal symptoms. This report describes the initial 50 patients who have attended a special clinic established to manage symptomatic menopausal women; common complaints included hot flushes, lack of energy, altered temperament, dyspareunia and headache. Oestrogen therapy was effective in the alleviation of symptoms and the practical aspects of oestrogen use are discussed. It is recommended that with due recognition of its potential complications, oestrogen therapy should be made available to symptomatic menopausal women, and that it requires further study in regard to its place in the long-term prophylaxis of osteoporosis.
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PMID:Oestrogens and menopausal and postmenopausal women. 19 65

Detailed histological evaluation of 72 femoral heads in terms of bone density, cartilagenous integrity and number of stress fractures in 3 different clinical groups of patients suggest that femoral trabecular fatigue fractures are largely determined by the degree of osteoporosis in all clinical states. The state of the hyaline cartilage also contibutes to the development of these fractures but only when the cartilage is degenerated to a severe degree as seen in rheumatoid arthritis. Both bone density and cartilage viability may be determining factors in the pathogenesis of trabecular stress fractures in rheumatoid hips.
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PMID:Etiological factors in the pathogenesis of femoral trabecular fatigue fractures. 91 91

This investigation involved a study of fatigue fractures of the neck of the femur and of the pubic branches based on the one hand on 97 cases from the literature, which were diagnosed mainly on radio-clinical criteria, and on the other hand on 5 personal cases for which a quantitative histological analysis was undertaken by needle biopsy of the bone of the iliac wing. After describing these fatigue fractures in an unusual site, the authors undertake a critical study taking account of the histological information that was available. They show that only a histological study makes it possible to differentiate clearly fatigue fractures from insufficiency fractures, particularly when the later occur concurrently with a clinically and radiologically latent osteoporosis.
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PMID:[Fatigue fractures of the femoral neck and pubic rami. Analytical and critical study apropos of 97 case reports from the literature and 5 personal cases]. 100 21

Under observation were 66 (50.3%) of 130 patients with an ossific form of hyperparathyroidism. Fourty five patients showed the classical picture of Recklinghausen disease, and 21-only diffuse osteoporosis. The correct diagnosis would be established 4-5 years following the onset of the disease. During the period of most distinct manifestations pains in bones were noted in 93 per cent of cases. Two thirds of patients showed marked atonia and fatigue. Pathological fractures were multiple and were observed in 45 of 66 patients (totally 125 fractures). Great importance in establishing the diagnosis of the form of hyperparathroidism is attached to roentgenological investigation of all bones and biochemical assay of blood and urine.
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PMID:[Diagnosis of an osseous form of hyperparathyroidism]. 122 36

The introduction of multiphasic screening and the development of sensitive parathormone assays have changed the demography and clinical symptomatology of patients presenting with primary hyperparathyroidism. This retrospective review includes 158 patients operated on for primary hyperparathyroidism at the Medical College of Georgia from 1973-1987. Compared to the 46 patients managed prior to 1973, the frequency of subclinical hyperparathyroidism has increased from 46% to 64%. The median patient age has increased from 50 to 59 years. Recognition of primary hyperparathyroidism in a more geriatric population modifies indications for surgical intervention in subclinical disease. Osteoporosis, myalgias, fatigue, arthralgias, memory loss, or constipation occurred in 50% of patients. These complaints are frequent in normocalcemic elderly people. They represent disease, not normal aging. Their exacerbation by hypercalcemia should not go uncorrected if neck exploration can be tolerated by the patient.
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PMID:The changing face of primary hyperparathyroidism. 143 43

Five different pedicle screw systems: AO Fixator Interne, VSP Steffee plate, Luque ISF, modified Zielke, and Chiba-type plate screw system (experimental device), were evaluated for biomechanical strength. A fatigue test for the screw, compressive, and torsional tests for the pedicle screw systems and a pull-out test of the pedicle screw were done. Even the Schanz screw, which showed the highest endurance limit, may be broken under the continuous loading condition in the body. The AO Fixator Interne and Steffee plate system themselves are rigid and are indicated for injuries that need reduction. The Luque ISF, modified Zielke, and Chiba-type plate screw systems, however, are indicated for degenerative lumbar disease requiring in situ fusion. There was a linear positive correlation between the bone mineral density of the vertebral body and the pull-out strength of the pedicle screw (correlation coefficient, 0.68). The fixation strength of the pedicle screw to the bone decreased remarkably in osteoporosis.
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PMID:Mechanical stability of the pedicle screw fixation systems for the lumbar spine. 156 85

Osteoporotic bone fragility is due not only to decreased bone mass but to inadequate repair of fatigue damage and to trabecular disconnection. The precise roles and relative contributions of these three factors are not known for osteoporosis in general, and certainly not in any individual case. However, it is known that reduced physical activity causes bone loss. It is a virtual certainty, therefore, that, to the extent that the fracture produces disability, osteoporotics lose bone after they first experience a fracture, whatever its antecedent causes. In that sense, some of the bone loss we find in our patients is indeed an epiphenomenon. However, this is not to suggest that reduced bone mass is unimportant. Quite the contrary: prospective studies have clearly established that reduction in bone mass does increase risk of fracture, and hence, when it is consequent upon a fracture, it aggravates the patient's condition. In this way a vicious circle may develop: the pain and fear that follow fracture lead to decreased activity, which leads to bone loss, which can only increase the fragility, and hence predispose to further fracturing, even in cases in which the initial fragility may not have been due to low bone mass. But low bone mass, with its proper fragility, may not be inevitable. That is why pain control and a comprehensive programme of rehabilitation are critically important in the early management of patients with symptomatic vertebral fractures.
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PMID:The natural history of vertebral osteoporosis. Is low bone mass an epiphenomenon? 162 10

In a retrospective study of 632 patients with pituitary disease we diagnosed pituitary insufficiency without hypersecretion of any pituitary hormone in 122 patients. Patients were substituted with sex hormones (76%), hydrocortisone (74%) and/or L-thyroxine (77%). 76% had additional growth hormone deficiency, as shown by an increase of growth hormone of less than 5 ng/ml after i.v. administration of L-arginine. In 17% of all patients the diagnosis of osteoporosis was proven or suspected radiologically. 57% had low bone mass of lumbar spine (dualphotonabsorptiometry) and 73% had low bone mass of the proximal forearm (singlephotonabsorptiometry). BMD values of pituitary insufficient patients were in the same range as those of patients with established osteoporosis. More than half of all patients (53%) complained of tiredness, exhaustion and muscle weakness. 40% suffered from adipositas. 77% had hyperlipidemia (68% hypertriglyceridemia and 42% hypercholesterinemia), 18% had hypertension. 14% of the patients had arteriosclerotic events in their history (myocardial infarction or stroke). These figures are higher than incidences shown in the German PROCAM-study. These data show an increased prevalence of osteoporosis and vascular diseases. This is in contrast to the general opinion, that patients with pituitary insufficiency are adequately treated by substitution with adrenal, thyroid and sex hormones. Whether other factors such as the additional growth hormone deficiency are responsible for these diseases has to be examined in prospective studies.
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PMID:[Increased prevalence of osteoporosis and arteriosclerosis in conventionally substituted anterior pituitary insufficiency: need for additional growth hormone substitution?]. 176 81

The aging of the skeleton represents an important cause of both morbidity and mortality in the Western World. A great deal is known about the epidemiology, pathogenesis, and structural alterations which occur during the osteoporotic process to increase the risk of fracture with age. Whereas osteoporosis is associated with a decrease in bone mass, factors other than bone mass are clearly important. These include the turnover of bone and the destruction of trabecular elements, the repair of fatigue damage, as well as extraskeletal factors. An improved understanding of the aging of bones will form a basis for improved strategies for its prevention and treatment.
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PMID:Bone loss and age-related fractures. 222 63

We report on a 36-year-old female patient suffering from bilateral inguinal pain. The x-ray revealed significant osteoporosis of both proximal femurs with an impacted fatigue fracture of the right calcar and Looser zones at the left subtrochanteric femur. The intestinal biopsy proved coeliac disease, resulting in a secondary malabsorption. The authors conclude that osteomalacia in young patients could indicate coeliac-induced malabsorption.
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PMID:[Osteomalacia and fatigue fractures in celiac disease]. 234 37


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