Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of androgen treatment in women remains controversial. The proposed "Female Androgen Insufficiency Syndrome" (Fertility and Sterility, April 2002) describes a number of non-specific symptoms including unexplained fatigue, decreased well being/dysphoric mood and/or blunted motivation and diminished sexual function. An estimated 40% of women experience sexual dysfunction, highlighting the need for ongoing research into this field in order to fully define the possible contribution of androgen insufficiency. The increasing availability of products, such as dehydroepiandrosterone (DHEA) supplements also points to the need for controlled studies to assess the safety of these and other preparations. Measurement of androgens in women requires sensitive assays with the ability to detect low levels and a narrow range with precision. Normal ranges of androgens for women of reproductive and post-reproductive age remain poorly defined. Debate exists as per importance of measurement of free versus total testosterone, with the "free androgen index" offering an alternative method of assessment of testosterone availability. Testosterone treatment is being developed for women in the form of transdermal patches, gels or cream, with percutaneous implants in common usage in some countries. Recent research has highlighted alternative means of administration, such as oral inhalation or buccal lozenge. DHEA is widely available in some countries. Research to date has demonstrated improvements in libido and sexual function, mood and well being. Evidence points to other potential benefits of androgen treatment, including preservation of bone mass, a possible protective role in breast cancer and beneficial effects on cognition. Adverse effects of androgen treatment in women are dose-dependent and include virilisation, mood disturbance and acne. These are uncommon if appropriate doses are administered and highlight the need for treatment to be closely monitored clinically and biochemically. Beneficial effects of testosterone treatment in post-menopausal women with lowered androgen levels have been well documented, and preliminary evidence suggests a role for treatment in pre-menopausal women with symptoms and lowered testosterone levels.
 ...
PMID:Androgens in women. 1294 23

Allogeneic transplantation of hematopoietic stem cells has potential for cure high risk malignant hematopoietic disorders. Advances in patients' supportive care and in graft versus host disease (GVHD) prevention have improved patient outcome. Although late relapses can occur, they are rare beyond 2 years after transplantation. However a prolonged follow-up is essential because of the risk of long-term complications. Some of them are life threatening (infections, secondary malignancy, chronic GVHD), others affect patient quality of life (chronic GVHD, cataract, osteonecrosis, sterility.). Fatigue, sleep disturbances and sexual dysfunction are the most common transplant related side effects and can also significantly impair patient quality of life. Despite these complications, most patients describe their quality of life as good, and consider that the benefit of the transplantation outweight its late effects.
 ...
PMID:[Bone marrow transplantation for leukemia: long term outcome]. 1295 1

In contrast to women, men do not experience a sudden cessation of gonadal function comparable to menopause. However, there is a progressive reduction in hypothalamic-pituitary-gonadal (HPG) axis activity in aging men: testosterone levels decline and there is a loss of the circadian rhythm of testosterone secretion. Such progressive HPG-axis hypofunctioning is thought to be responsible for some signs and symptoms that are common in elderly men such as fatigue, reduced muscle and bone mass, sexual dysfunction, and depression. Yet, such presumed hypogonadal sequelae have not been correlated with testosterone levels. Unlike the profound effects of replacement therapy in young men with frank hypogonadism, testosterone replacement in men with age-related mild hypogonadism is not apparently effective in reversing these symptoms. This article reviews the relationship between androgens, sexual function, and depression in aging men.
 ...
PMID:The aging male: androgens, erectile dysfunction, and depression. 1297 14

Premenstrual dysphoric disorder (PMDD) is considered a severe form of premenstrual syndrome. Symptoms of PMDD occur during the last week of the luteal phase of the menstrual cycle and usually abate at the onset of menses. About 3-8% of all menstruating women experience PMDD, which can lead to significant functional impairment. Several randomized, controlled trials have assessed the efficacy of selective serotonin reuptake inhibitors (SSRIs) in the treatment of PMDD. The SSRIs were found to significantly improve symptoms, particularly psychological or behavioral symptoms, during the luteal phase in women with PMDD. Also, SSRIs were found to improve the quality of life in women with PMDD. Headache, fatigue, insomnia, and anxiety were often reported as adverse effects. A decrease in libido or sexual dysfunction also was reported. In recent studies, intermittent SSRI therapy was found to be effective treatment for PMDD and allows a woman to take the drug for only 14 days each month. Intermittent SSRI therapy should be recommended before continuous daily dosing of SSRIs in the treatment of PMDD.
 ...
PMID:Treatment of premenstrual dysphoric disorder with selective serotonin reuptake inhibitors. 1452 45

Three wharf workers were acutely exposed to toluene diisocyanate (TDI) during an accidental chemical spill. Toluene is neurotoxic as a solvent, while cyanates can cause nervous tissue injury or death by hypoxia. Chronic symptoms which occurred following the incident included headache, fatigue, concentration problems, irritability, depression, sleep disturbance, memory and sexual dysfunction. Compared with two months post-exposure, at 16 months post-exposure Full Scale IQ dropped an average of 23 points. Results from additional neuropsychological testing at 16 months post-exposure indicated severe deficits in all three subjects in memory, manual dexterity, visuomotor tracking, mental flexibility, ability to detect figure-ground relationships, and word fluency. Nerve conduction velocity testing indicated abnormal peripheral nervous system function in two of the three workers; however, its etiology is not certain. These results may be relevant to the neurotoxicity of methyl isocyanate exposure, such as occurred in Bhopal, India, where an increasing magnitude of depression, anxiety, fatigue, restlessness, and headaches 18 months post-exposure have been reported. In general, continuing decrement in mental function without concomitant environmental exposure should be considered in neuropsychological assessment of chemical toxicity.
 ...
PMID:Progression of neuropsychological deficits following toluene diisocyanate exposure. 1459 Nov 41

Effects of double-blind treatment of chronic posttraumatic stress disorder (PTSD) with 2 SSRIs and placebo on emotional symptoms and autonomic reactivity were assessed prospectively. PTSD subjects received citalopram (n=25), sertraline (n=23), or placebo (n=10) for 10 weeks, with psychophysiologic assessments performed before and after treatment. Intent-to-treat analysis showed that all treatment groups improved significantly in total symptoms of PTSD (as measured by the Clinician Administered PTSD Scale), all 3 PTSD symptom clusters, and sleep time. However, subtle differences in improvements in PTSD symptom clusters, physiologic reactivity, and reported adverse events were identified. Citalopram treated subjects significantly lowered systolic and diastolic blood pressures, while sertraline and placebo treated patients significantly lowered only systolic blood pressure reactivity to individualized trauma scripts. The sertraline group showed significantly more improvement in avoidance/numbing symptoms than both other groups. Considering side effects, subjects on sertraline reported more gastrointestinal problems, with early terminators having more insomnia. Early terminators on citalopram reported more fatigue and appetite changes than other treatment groups, with completers reporting more sexual dysfunction. Results support a class effect of SSRIs in treating PTSD symptoms, but suggest a possible differential effect of drugs on symptom clusters, physiologic parameters, and side effects that may have clinical relevance. Implications of symptom reduction noted in the smaller placebo group are discussed relative to recent concerns about increasing placebo response in clinical trials.
 ...
PMID:Can physiologic assessment and side effects tease out differences in PTSD trials? A double-blind comparison of citalopram, sertraline, and placebo. 1460 46

Advances in the treatment of gynecologic cancer have extended the duration of survival of many patients. However, these patients frequently experience a variety of treatment- and disease-related side effects that diminish their quality of life (QOL) during and after treatment; among these are pain, nausea and vomiting, anemia, fatigue, peripheral neuropathy, emotional distress, and sexual dysfunction. Given the gains in survival time, patient care is being expanded to include enhancement or preservation of QOL in addition to early diagnosis and disease treatment, thus treating the whole person. In parallel with this evolution in cancer care, supportive measures are being increasingly recognized as crucial to effective patient management. This paper reviews some of the potential causes of diminished QOL in gynecologic cancer patients and basic treatment strategies for their control, with a focus on short-term QOL issues. It is important that clinicians monitor QOL during the course of the disease and its treatment, utilize procedures and therapeutic agents that take patient preferences and QOL into account, and proactively prevent and treat relevant symptoms.
 ...
PMID:Quality of life in patients receiving treatment for gynecologic malignancies: special considerations for patient care. 1476 77

Routine clinical assessment of health-related quality of life in persons with HIV infection has the potential to improve care by assessing and monitoring treatment effects, enhancing communication between patient and provider, and tracking changes in functional status over time. Currently available research-based assessment tools may be inadequate for routine clinical use because of the lack of inclusion of HIV-relevant aspects of quality of life and the impracticality of the use of such tools in the clinical setting. There may be a need for a new, clinically relevant, HIV-specific assessment tool that would be easy to incorporate into clinical practice to briefly, yet comprehensively, assess characteristics frequently found in HIV-infected persons, such as fatigue, pain, nausea and vomiting, sleep disturbances, sexual dysfunction, and body image issues. Until such a tool is developed, the Linear Analogue Self-Assessment questionnaire and the Medical Outcomes Study Short Form-12 (MOS SF-12) are short enough for routine use in a clinical setting. Slightly longer measures, such as the MOS-HIV Health Survey (MOS-HIV), can provide information in a greater number of domains.
 ...
PMID:Quality of life and HIV: current assessment tools and future directions for clinical practice. 1495 93

The diagnosis of chronic pelvic pain syndrome takes into account the fact that no clear etiology has been identified underlying chronic prostatitis and its associations with multiple somatic and psychological complaints. Based on a representative survey, this study enquires into the prevalence of pelvic pain in the community, its association with sexual dysfunction, somatic complaints and aging. Of the 770 men surveyed, 60 (7.8%) fulfilled the criteria for pelvic pain syndrome. This was assessed by a validated Giessen Prostatitis Symptom Score. Sexual dysfunction (particularly erectile dysfunction and loss of libido) were more frequently reported by men with pelvic pain than by men without a pain syndrome. The great majority of men afflicted by pelvic pain complained of additional pain symptoms (particularly back and joint pain) and fatigue. While sexual and somatic complaints were age-associated in the asymptomatic men, this was not the case for the symptomatic men. Our findings stress the fact that chronic pelvic pain syndrome is a major health problem in middle and late adulthood in men. Differentiated knowledge about comorbidity is a prerequisite for developing new interdisciplinary approaches to the diagnosis and therapy of this to date unsatisfactorily treated syndrome.
 ...
PMID:[Chronic pelvic pain and its comorbidity]. 1504 83

There are many treatment options for female sexual dysfunction (FSD), with the optimal therapy depending on the etiology of the problem. The cause of sexual dysfunction is multifactorial and may include psychological problems such as depression or anxiety disorders, conflict within the relationship, partner performance and technique, issues relating to prior abuse, medical illness, medications, fatigue, stress, or gynecological problems that make sexual activity uncomfortable. The role of low androgen concentrations in FSD is gaining increasing attention. Available therapeutic options include adjusting medications, counseling, treating depression or anxiety, reducing stress and fatigue, sex therapy, devices, estrogen therapy for genitourinary atrophy, and possibly vasoactive substances. Although no androgen therapies are currently approved by the Food and Drug Administration for FSD, they are being used in clinical practice, and early clinical trial results suggest that they may be both effective and safe in the treatment of FSD, specifically low libido. Androgen therapy should be considered primarily in women who have a physiological reason for reduced androgen concentrations, including aging, hypopituitarism, oophorectomy, or adrenal insufficiency. Products in use include oral methyltestosterone and dehydroepiandrosterone, topical testosterone ointment, and testosterone implants and injections. Products available for men, including skin patches and gels, are currently being studied at doses appropriate for women. Possible risks include hirsutism, acne, liver dysfunction, lowering of the voice, adverse lipid changes, virilization of a female fetus, and, as androgens are aromatized to estrogens, potentially the risks of estrogen therapy.
 ...
PMID:The role of androgens in female sexual dysfunction. 1506 34


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>