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

A review of some of the outbreaks of disease caused by echoviruses demonstrates their ability to cause significant morbidity and mortality world-wide. There are now 30 recognised echovirus serotypes; several of the original serotypes have been re-classified. More recently, echovirus 22 has been shown to have significant molecular differences from other types and unusual epidemiological features. Echovirus types 7, 11, 19 and 30 have been associated with significant outbreaks in neonatal units and echovirus types 9, 16 and 25 are more frequently associated with exanthem. Echovirus type 3, although relatively uncommon in the UK, was associated with large outbreaks in China. Since the decline in poliomyelitis, the increase in reports of non-polio enteroviruses has revealed a corresponding increase in associated cases of myalgic encephalomyelitis and post-viral fatigue syndrome.
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PMID:Are echoviruses still orphans? 891 50

The aim of the study was to seek knowledge of psychological and psychosocial aspects of coping with late effects of polio. Sixty-three polio survivors, 43 women and 20 men (mean age 55.3 years) 3-5 years ago former inpatients at the Post-Polio Program at Sunnaas Rehabilitation Hospital, participated in the study. In addition to a semi-structured interview-guide, the Hospital Anxiety and Depression scale (HAD), the Sickness Impact Profile (SIP), Cope-Scale, Brief Type-A Questionnaire (BTAQ) and the Fatigue Severity Scale (FSS) were used. As a measure of physical status, we used working capacity defined as peak O2 (oxygen) uptake. Levels of working capacity did not correlate significantly with any psychological variables, and the subjects reporting improved psychological health over the last 3-5 years did not have higher levels of working capacity or less physical decrement. A significant correlation was found between self-reported fatigue. psychological variables and social support. Compared to previous studies, low psychological distress, normal type-A scores, high adjustment and problem-focused coping characterized the respondents, pointing to the importance of timing in psychosocial research of post-polio.
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PMID:Psychological distress, social support and coping behaviour among polio survivors: a 5-year perspective on 63 polio patients. 913 54

The chronic fatigue syndrome (CFS) has been intensively studied over the last 40 years, but no conclusions have yet been agreed as to its cause. Most cases nowadays are sporadic. In the established chronic condition there are no consistently abnormal physical signs or abnormalities on laboratory investigation. Many physicians remain convinced that the symptoms are psychological rather than physical in origin. This view is reinforced by the emotional way in which many patients present themselves. The overlap of symptoms between CFS and depression remains a source of confusion and difficulty. But even if all CFS patients were rediagnosed as depressives, this would not negate the possibility of an underlying organic cause for the condition, in view of the growing evidence that depression itself has a physical cause and responds best to physical treatments. There is some evidence both for active viral infection and for an immunological disorder in the CFS. Many observations suggest that the syndrome could derive from residual damage to the reticular activating system (RAS) of the upper brain stem and/or to its cortical projections. Such damage could be produced by a previous viral infection, leaving functional defects unaccompanied by any gross histological changes. In animal experiments activation of the RAS can change sleep state and activate or stimulate cortical functions. RAS lesions can produce somnolence and apathy. Studies by modern imaging techniques have not been entirely consistent, but many magnetic resonance imaging (MRI) studies already suggest that small discrete patchy brain stem and subcortical lesions can often be seen in CFS. Regional blood flow studies by single photon-emission computerized tomography (SPECT) have been more consistent. They have revealed blood flow reductions in many regions, especially in the hind brain. Similar lesions have been reported after poliomyelitis and in multiple sclerosis--in both of which conditions chronic fatigue is characteristically present. In the well-known post-polio fatigue syndrome, lesions predominate in the RAS of the brain stem. If similar underlying lesions in the RAS can eventually be identified in CFS, the therapeutic target for CFS would be better defined than it is at present. A number of logical approaches to treatment can already be envisaged.
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PMID:Chronic fatigue syndrome--aetiological aspects. 946 37

"The Norwegian Polio Study 1994" was conducted in order to survey the medical and social situation and the needs of polio victims. A questionnaire consisting of 133 questions with subquestions was sent to a total of 2,392 polio victims in Norway. 1,449 persons responded, of whom 66% were between 45 and 64 years of age. When specifying new health problems, between 55% and 85% stated that they had experienced increasing weakness of the muscles affected by polio, weakness in previously non-affected muscles, fatigue, intolerance to cold and/or pain in muscles and joints. Only 17% were satisfied with the public health services for polio victims. On the other hand, 67% of those who had undergone a comprehensive evaluation and had been treated at a central hospital were satisfied. The study indicates an obvious need to build up expertise in multidisciplinary evaluation and treatment of post-polio victims.
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PMID:[Polio victims in Norway. Results of a national study 1994]. 914 46

A large number of patients previously affected by polio have symptoms, including increased weakness and fatigue, which are collectively known as a post-polio syndrome. Prospective measurements of strength and endurance using twitch interpolation in post-polio patients are lacking and hence the exact rate of decline in muscle function in these patients is not well defined. We therefore measured performance of the elbow flexor muscles twice, at a mean of 2.5 years apart in a group of selected post-polio subjects (Group A, n = 13) and matched control subjects (n = 11), and in a second group of unselected polio patients from a post-polio clinic (Group B, n = 40) at a mean of 1.7 years apart. All subjects performed 10 attempted maximal voluntary isometric contractions of the elbow flexor muscles, during which voluntary activation of the elbow flexor muscles was measured using a sensitive form of twitch interpolation. The first group of selected polio subjects (Group A) and matched control subjects also performed 45 min of submaximal exercise. During this time, at 5-min intervals, maximal voluntary force, voluntary activation and the amplitude of twitch responses to single and paired stimuli were measured in order to investigate central and peripheral components of muscle fatigue. There was no change in the polio patients' strength, voluntary activation or peripheral muscle endurance between testing sessions, despite an 80% probability of detecting a 2.5% change per year in these variables. The unselected group of patients from the post-polio clinic (Group B) showed no change in maximal voluntary strength or voluntary activation between the first and second test. There was an absence of decline in muscle performance in these polio patients over the test interval, despite a subjective deterioration in muscle function consistent with the 'post-polio syndrome'. This supports the view that symptoms of the post-polio syndrome are not due to a progressive neuronal dysfunction.
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PMID:Quantitative assessments of elbow flexor muscle performance using twitch interpolation in post-polio patients: no evidence for deterioration. 915 28

Post Polio Syndrome, or PPS, is defined as a clinical syndrome of new weakness, fatigue, and pain in people who have previously recovered from acute paralytic poliomyelitis. Other common symptoms include cold intolerance, dysphagia, dyspnea, and overuse syndromes. PPS afflicts an estimated 50% of polio survivors, a population estimated at 1.6 million people, and begins roughly 30 years after the acute disease. The main impact of PPS is on mobility related activities affecting one's daily routine. With an insidious onset, and several differential diagnoses for each symptom, PPS can be difficult to diagnose and to validate. However, once identified, there are treatment plans and many avenues of support for this disabling syndrome. The purpose of this article is to provide an overview of the pathophysiology of both acute paralytic poliomyelitis as well as PPS. This article also reviews the current literature concerning the etiology and pathophysiology of both poliomyelitis and PPS, symptom evaluation and differential diagnoses, and treatment recommendations. The psychosocial impact and care of the client are also identified, and several resources for support and education of both the client and provider are provided.
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PMID:Post polio syndrome: an update for the primary health care provider. 921 57

To examine the effect of Type A behavior, self-concept, and loneliness on completion of and compliance with a postpolio sequelae treatment program, all 204 individuals who had been evaluated by the Postpolio Service were mailed the Postpolio Fatigue Questionnaire, the revised UCLA Loneliness Scale, and the Tennessee Self-Concept Scale. Patients were also asked to rate the frequency of assistive device use, their engaging in self-care activities, and requesting physical assistance from others; they had previously been administered the brief Type A Scale. Of the 46 respondents, 63% had completed the Postpolio Sequelae treatment program (completers), and 37% had either been discharged for noncompliance or refused treatment (noncompleters). Wheelchair use was significantly positively correlated with age at the time of contracting polio, number of limbs affected by polio, the Loneliness score, and months since leaving the treatment program, but significantly negatively correlated with Social Self and Family Self scores on the Tennessee Self-Concept Scale. Family Self score was significantly negatively correlated with crutch use but significantly positively correlated with asking co-workers for assistance. The frequency of taking two 15-minute breaks each day was significantly negatively correlated with a Type A score. Noncompleters reported a 61% increase in muscle weakness compared with a 1% decrease for completers. These results indicate that Type A behavior must be decreased so polio survivors complete and comply with a postpolio sequelae treatment program, be able to make necessary lifestyle changes, and possibly feel less lonely. Friends and family members must help polio survivors to accept lifestyle changes and support new assistive device use if patients are to feel valuable within their families and society and treat their postpolio sequelae.
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PMID:Compliance with treatment for postpolio sequelae: effect of type A behavior, self-concept, and loneliness. 935 91

'The Norwegian Polio Study 1994' was performed to make a nation-wide survey of the medical and social situation, and of the needs of anterior poliomyelitis (polio). A questionnaire, consisting of 133 questions with sub-questions, was sent to a total of 2392 polio victims, most of them registered in 'The National Society of Polio Victims' in Norway. 1449 persons (61%) answered. Sixty-six per cent were between 45 and 64 years of age, 25% were above 64 years and 9% were under 45 years. When specifying new health problems, 85% stated that they had experienced increased weakness in muscles affected by polio, while 58% had experienced increased weakness in previous non-affected muscles. Other health problems related to polio were fatigue during exercise (80%), general fatigue (57%), joint pain (58%), muscular pain (58%) and cold intolerance (62%). The participants indicated an increasing need of aids, but 80% were still independent of help from others and 57% were still employed, fully or part time. Only 17% were satisfied with the public health services for polio survivors, while 67% of those who had undergone comprehensive examination at some central hospital were satisfied. This study indicates an obvious need of building up expertise in multidisciplinary evaluation and treatment of post polio problems in countries where acute polio has been eliminated.
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PMID:The Norwegian Polio Study 1994: a nation-wide survey of problems in long-standing poliomyelitis. 958 29

Poliomyelitis has almost been eradicated world-wide, but during the last decades polio survivors have noted new problems: late effects of polio and post-polio. In Denmark, 7-8000 polio survivors are disabled by poliomyelitis. Late effects of polio, defined as onset of new symptoms decades after the acute poliomyelitis, include fatigue and overuse muskuloskeletal problems. Post-polio is a sub-category of the late effects of polio and related to impaired neuro-muscular function with unexpected onset, which is not caused by the patient's age. Post-polio is a clinical diagnosis and cannot be verified by a definitive test. The dysfunction of the muscles is caused by loss of motor neurones and reduced neuromuscular reserve capacity, in combination with a disturbed balance between the ongoing reinnervation and denervation at the expense of the reinnervation. Many polio survivors suffering from late effects of polio have a need for multidisciplinary rehabilitation, physiotherapy, reconstruction of orthosis, social counselling, modifications to the home and individual aids.
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PMID:[Sequelae after polio--a review]. 965 30

Nearly two-thirds of polio survivors report abnormal movements in sleep, with 52% reporting that their sleep is disturbed by these movements. Sleep studies were performed in seven polio survivors to document objectively abnormal movements in sleep. Two patients demonstrated generalized random myoclonus, with brief contractions and even ballistic movements of the arms and legs, slow repeated grasping movements of the hands, slow flexion of the arms, and contraction of the shoulder and pectoral muscles. Two other patients demonstrated periodic movements in sleep with muscle contractions and ballistic movements of the legs, two had periodic movements in sleep plus restless legs syndrome, and one had sleep starts involving only contraction of the arm muscles. Abnormal movements in sleep occurred in Stage II sleep in all patients, in Stage I in some patients, and could significantly disturb sleep architecture even though patients were totally unaware of muscle contractions. Poliovirus-induced damage to the spinal cord and brain is presented as a possible cause of abnormal movements in sleep. The diagnosis of post-polio fatigue, evaluation of abnormal movements in sleep, and management of abnormal movements in sleep using benzodiazepines or dopamimetic agents are described.
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PMID:Abnormal movements in sleep as a post-polio sequelae. 971 25


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