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

PFS is a painful rheumatologic disorder that may be detected by the wary clinician attuned to the presence of seven or more tender points. This common disorder may be seen at any age, including childhood, and may be associated with secondary symptoms of depression and other affective disorders. It may also be associated with findings of disturbed sleep, hearing and vestibular abnormalities, and profound complaints of fatigue. The vagueness of this latter complaint means that PFS must be distinguished from the newly described CEBV syndrome. Although the etiology of PFS remains unknown, recent investigations suggest that these patients may suffer a disorder with a central nervous system component as well as a subtle peripheral tissue lesion. Newer PFS studies demonstrate tissue changes that may be consistent with altered microvascular permeability and blood flow, tissue hypoxia, and chronic muscle spasm. An immunologic abnormality, or even a previously undescribed connective tissue disease, may be important as a pathogenic factor in some PFS patients.
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PMID:New concepts in primary fibrositis syndrome. 265 50

The desynchronisation of an athlete's physiological and psychological cycles has adverse effects on his/her performance. The primary cause of dysrhythmia in an athlete is jet-lag, which is a rapid displacement across the earth's time zones and is often experienced while competing in international events and in continental leagues. General symptoms which arise from dysynchronization include malaise, appetite loss, tiredness during the day and disturbed sleep. The specific symptoms resulting from jet-lag are characterised as phase shifts in physiological and psychological cycles. These phase shifts occur in body temperature, ability to mobilise energy substrates, excretion of water and metabolites, arousal levels, sleep/wake cycles and reaction time. The severity of these adverse effects and therefore the time required for resynchronization depends on the ability to preset the bodily rhythms prior to flying, the number of time zones crossed, the direction of flight, the type of individual (introvert/extrovert), age, social interaction and activity, diet plan and prescribed use of chronobiotic drugs.
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PMID:Jet-lag and human performance. 269 17

The antihypertensive efficacy and tolerability of the 5HT2-receptor antagonist ketanserin was investigated in 188 patients aged 41 to 82 years with mild to moderate essential hypertension. Ketanserin was given as monotherapy (n = 107) as well as in combination with either the diuretic hydrochlorothiazide/amiloride (n = 42) or the betablocker atenolol (n = 39) for 12 weeks. Compared to placebo, ketanserin lowered systolic blood pressure by 11 +/- 16 (SD), 9 +/- 13 and 9 +/- 11 mm Hg (p less than 0.01 for all) and diastolic blood pressure by 9 +/- 10, 10 +/- 9 and 7 +/- 9 mm Hg (p less than 0.001 for all), in the three treatment groups; body weight, serum sodium, potassium, uric acid, cholesterol and triglycerides remained unchanged. The incidence of withdrawals due to unwanted effects was 4% on ketanserin monotherapy, and 12% and 10% on the diuretic/ketanserin and the betablocker/ketanserin combination respectively. Well-being during ketanserin therapy was improved in the older patients in particular; sleep disturbances, daytime fatigue and overall weakness decreased. Ketanserin was well tolerated in combination with the diuretic, whereas in combination with the betablocker the occurrence of dry mouth and stuffy nose was slightly higher. - Ketanserin proved to be an effective antihypertensive drug comparable to other blood pressure lowering agents. It can be combined advantageously with a potassium sparing diuretic or a betablocker. The greater efficacy and tolerability in patients greater than or equal to 60 years qualify ketanserin primarily as an antihypertensive agent for older patients.
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PMID:[Blood pressure lowering action and tolerance of ketanserin in mono- or combination therapy]. 271 Nov 55

Bright white light (500lx) for 4 h/day was applied to seven narcoleptic patients (age 47-65 years, mean 55 years). The effects of the light on the disturbed sleep-wake cycle in narcoleptics were investigated by the measurement of the following parameters: (1) excessive daytime sleepiness and sustained attention (multiple sleep latency test); (2) rest-activity cycles; (3) self-ratings (mood, anxiety, tiredness); (4) urinary cycles of 6-OH melatonin sulphate and cortisol; (5) sleep EEG. Treatment with bright light showed neither objective nor subjective changes in the clinical symptoms of narcolepsy. While similar "dosage" light applications can phase shift human circadian rhythms and improve depression and hypersomnia in winter depression, it is not an appropriate treatment for narcolepsy.
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PMID:Bright white light does not improve narcoleptic symptoms. 275 54

The effects of ketanserin on blood pressure and well-being were investigated in 188 patients, aged 41-82 years, with mild to moderate essential hypertension. At entry, 107 were untreated, 42 were taking the diuretic combination hydrochlorothiazide (50 mg/day) plus amiloride (5 mg/day) and another 39 were taking the beta-blocker atenolol (100 mg/day). A single-blind, 4-week placebo run-in period was followed by 12 weeks' oral ketanserin treatment at 20 or 40 mg twice a day. This regimen significantly reduced systolic and diastolic blood pressures in each group. Response rates were greater in patients aged over 60 years. Compared with placebo, sleep disturbances, daytime fatigue and overall weakness decreased during ketanserin treatment (P less than 0.05 for all), but the incidence of dry mouth and stuffy nose increased. In patients older than 60 years there was a greater reduction of complaints than in younger patients. Ketanserin proved effective and well tolerated, improving peripheral circulatory symptomatology, particularly in older patients and those with a good blood pressure response.
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PMID:Antihypertensive efficacy and well-being during monotherapy and combination therapy with ketanserin. 280 91

beta-Adrenoreceptor antagonists are liable to produce behavioural side-effects such as drowsiness, fatigue, lethargy, sleep disorders, nightmares, depressive moods, and hallucinations. These undesirable actions indicate that beta-blockers affect not only peripheral autonomic activity but also some central nervous mechanisms. In experimental animals beta-blockers have been found to reduce spontaneous motor activity, to counteract isolation-, lesion-, stimulation- and amphetamine-induced hyperactivity, and to produce slow-wave and paradoxical sleep disturbances. Furthermore, central effects such as tranquilizing influences are used for the treatment of conditions such as anxiety. Several different mechanisms of action could be responsible for these CNS effects: Centrally mediated specific actions on centrally located beta-adrenergic receptors, known to exist downstream from, and at the terminals of, 'vigilance-enhancing' central noradrenergic pathways. Centrally mediated specific actions on centrally located receptors of the non-adrenergic type; an affinity of some beta-blockers towards 5-HT-receptors is well documented. Centrally mediated non-specific actions on centrally located neurones, owing to the membrane-stabilizing effects of beta-blockers. Peripherally mediated actions whereby beta-blockers induce changes in the autonomic activity in the periphery, which are relayed to the CNS to induce changes in activity of a variety of central systems. It can be assumed that with any one of the beta-blockers all these mechanisms come into play, yet with varying degrees depending on characteristics of the drugs such as lipophilicity and hydrophilicity, the ratio of antagonist versus (partial) agonist properties, affinity to 'alien' receptor sites, strength of membrane-stabilizing activity, stereospecific affinity, and potency.
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PMID:CNS-related (side-)effects of beta-blockers with special reference to mechanisms of action. 286 51

The sedative or excitatory effects of drugs are difficult to evaluate in patients with depression, where sleep disturbances and tiredness in the daytime belong to the clinical manifestations of the psychiatric disorder. A refined method of vigilance measurement, based on the EEG spectra, together with proper statistical analysis of the data, is helpful for correct interpretation of the data. In two groups of patients with depression, the intensity of sleep disturbances was considered as a background variable in partial correlations, reflecting the relationships between vigilance and drug concentration in a more specific way. It was shown that the sedative effect of maprotiline interferes with the increased vigilance in the patients, with improved night sleep after treatment. As a result, the patients do not experience decreased vigilance although maprotiline has a sedative action. The results obtained in the patients treated with beta-blockers suggest that the drug itself has no sedative effect but the patients suffer from decreased vigilance in the daytime, caused by the sleep disturbances and depression.
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PMID:EEG assessment of the sedative and excitatory properties of CNS-active compounds in the patients with depression. 295 8

Sleep disturbances commonly occur in the premenstruum in both Premenstrual Syndrome (PMS) patients and in women from the general population. Reports on the Post-Sleep Inventory were obtained from a clinic sample of PMS patients and samples from the general population dichotomized into a non-clinic group with and without premenstrual disturbance on the basis of their scores on the Premenstrual Tension Syndrome Self Rating Scale. The patients reported degrees of disturbance that were consistently higher than either or both the other two groups. PMS patients reported unpleasant dreams, awakenings, failure to wake at the expected time and tiredness in the morning, and heightened mental activity during the night and upon awakening. The three groups could be reliably discriminated on this basis with an overall accuracy of 82%. Sleep disturbances form an important component of premenstrual disturbance and merit specific clinical intervention and more detailed investigation.
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PMID:Sleep in the premenstrual phase: a self-report study of PMS patients and normal controls. 317

Prior research has demonstrated that providing patients with descriptions of impending experiences in the form of concrete sensory information enhances recovery. Sensory information reflects the experience from the patient's point of view as it describes what the patient can expect. The purpose of this study was to describe recovery from coronary artery bypass surgery from the patients' perspective over a 2-month period after discharge from the hospital. Thirty-four subjects were interviewed via telephone six times over an 8-week period after discharge. Patients described general feelings of well-being, occurrences of symptoms (fatigue, sleep disturbances, changes in appetite, changes in bowel function, incisional and nonincisional discomforts), activity level, and changes in mood. Data can be used in postoperative teaching by giving patients a standard against which to compare their own experience. The ability to anticipate possible symptoms can be helpful to patients in making appropriate plans for activities during the recovery period.
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PMID:Patient perceptions of recovery from coronary artery bypass grafting after discharge from the hospital. 326 60

The literature on fibrositis (fibromyalgia), which originated in the early years of the last century in the UK and proliferated there in the first half of this century, has since diminished there in the last 30 years or so, but has increased in Canada and the US. Criteria suggested for diagnosis have created a syndrome with no diagnostic tests, serological or radiological signs, and no truly objective physical signs, but with predictable tender spots on pressure. The syndrome is largely, but not completely, confined to females, mostly of middle age; the symptoms include widespread aching of more than 3 months' duration, disturbed sleep, morning fatigue and stiffness, a failure to respond satisfactorily to any one form of therapy and a tendency to persist over long periods, but without permanent tissue changes. Features of psychological disturbance are present in many patients but not in all or even the majority. Definition of the condition as a disorder of pain modulation - a pain amplification syndrome - would seem to fit the facts best. Most would agree that an abnormal response to stress is an important factor in the appearance of the syndrome, as other stress related disorders, such as the irritable bowel syndrome and tension headaches, may coexist. Response to therapy, whether physical or pharmacological, is on the whole unsatisfactory. This type of patient has been well recognised in hospital clinic and general practice for many years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fibrositis (fibromyalgia). A common non-entity? 328 15


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