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

Two train conductors had chest tightness, painful breathing, muscle cramps, and nausea after fighting a fire in a battery box under a passenger coach. Shortly thereafter, they became anosmic and had excessive fatigue, persistent headaches, sleep disturbances, irritability, unstable moods, and hypertension. Urinary cadmium and nickel levels were elevated. Neurobehavioral testing showed, in comparison to referents, prolonged reaction times, abnormal balance, prolonged blink reflex latency, severely constricted visual fields, and decreased vibration sense. Test scores showed that immediate verbal and visual recall were normal but delayed recall was reduced. Scores on overlearned information were normal. Tests measuring dexterity, coordination, decision making, and peripheral sensation and discrimination revealed abnormalities. Repeat testing 6 and 12 months after exposure showed persistent abnormalities. Cadmium and vinyl chloride are the most plausible causes of the neurotoxicity, but fumes from the fire may have contained other neurotoxic chemicals.
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PMID:Persistent neurotoxicity from a battery fire: is cadmium the culprit? 868 56

Chronobiology is the science concerned with investigations of time-dependent changes in physiological variables. Circadian rhythms refer to variations that recur every 24 hours. Many physiological circadian rhythms at rest are endogenously controlled, and persist when an individual is isolated from environmental fluctuations. Unlike physiological variables, human performance cannot be monitored continuously in order to describe circadian rhythmicity. Experimental studies of the effect of circadian rhythms on performance need to be carefully designed in order to control for serial fatigue effects and to minimise disturbances in sleep. The detection of rhythmicity in performance variables is also highly influenced by the degree of test-retest repeatability of the measuring equipment. The majority of components of sports performance, e.g. flexibility, muscle strength, short term high power output, vary with time of day in a sinusoidal manner and peak in the early evening close to the daily maximum in body temperature. Psychological tests of short term memory, heart rate-based tests of physical fitness, and prolonged submaximal exercise performance carried out in hot conditions show peak times in the morning. Heart rate-based tests of work capacity appear to peak in the morning because the heart rate responses to exercise are minimal at this time of day. Post-lunch declines are evident with performance variables such as muscle strength, especially if measured frequently enough and sequentially within a 24-hour period to cause fatigue in individuals. More research work is needed to ascertain whether performance in tasks demanding fine motor control varies with time of day. Metabolic and respiratory rhythms are flattened when exercise becomes strenuous whilst the body temperature rhythm persists during maximal exercise. Higher work-rates are selected spontaneously in the early evening. At present, it is not known whether time of day influences the responses of a set training regimen (one in which the training stimulus does not vary with time of day) for endurance, strength, or the learning of motor skills. The normal circadian rhythms can be desynchronised following a flight across several time zones or a transfer to nocturnal work shifts. Although athletes show all the symptoms of 'jet lag' (increased fatigue, disturbed sleep and circadian rhythms), more research work is needed to identify the effects of transmeridian travel on the actual performances of elite sports competitors. Such investigations would need to be chronobiological, i.e. monitor performance at several times on several post-flight days, and take into account direction of travel, time of day of competition and the various performance components involved in a particular sport. Shiftwork interferes with participation in competitive sport, although there may be greater opportunities for shiftworkers to train in the hours of daylight for individual sports such as cycling and swimming. Studies should be conducted to ascertain whether shiftwork-mediated rhythm disturbances affect sports performance. Individual differences in performance rhythms are small but significant. Circadian rhythms are larger in amplitude in physically fit individuals than sedentary individuals. Athletes over 50 years of age tend to be higher in 'morningness', habitually scheduling relatively more training in the morning and selecting relatively higher work-rates during exercise compared with young athletes. These differences should be recognised by practitioners concerned with organising the habitual regimens of athletes.
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PMID:Circadian variation in sports performance. 872 47

Complaints of chronic fatigue as well as sleep disturbances are prevalent in Lyme disease. We compared polysomnographic measures of sleep in patients with documented Lyme disease with those of a group of age-matched normal control subjects. Eleven patients meeting Centers for Disease Control criteria for late Lyme disease with serologic confirmation by enzyme-linked immunosorbent assay and Western blot without a history of other medical or psychiatric illness and 10 age-matched control subjects were studied. Lyme disease patients and controls underwent 2 nights of polysomnography. Multiple sleep latency testing (MSLT) was performed in the patients. Sleep was staged by standard criteria, and continuity of sleep was assessed for each stage of frequency analysis of consecutive epochs. All patients studied reported sleep-related complaints, including difficulty initiating sleep (27%), frequent nocturnal awakenings (27%), excessive daytime somnolence (73%) and restless legs/nocturnal leg jerking (9%). Greater sleep latency, decreased sleep efficiency and a greater arousal index were noted in Lyme patients. The median length of uninterrupted occurrences of stage 2 and stage 4 non-rapid eye movement (NREM) sleep was less in Lyme patients (6.3 +/- 3.0 epochs in patients vs. 11.4 +/- 4.4 epochs in controls for stage 2, p < 0.01, and 4.3 +/- 4.4 epochs in patients vs. 11.2 +/- 6.3 epochs in controls for stage 4, p < 0.01), indicating greater sleep fragmentation. Mean sleep onset latency during the MSLT was normal (12.7 +/- 5.6 minutes). Three patients demonstrated alpha-wave intrusion into NREM sleep. These sleep abnormalities may contribute to the fatigue and sleep complaints common in this disease.
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PMID:Sleep quality in Lyme disease. 874 1

A computerised self-assessment instrument was used to capture data on the distress caused by symptoms in 110 patients treated with radical radiotherapy. Patients selected symptoms from a list of 34 problems and then quantified the distress associated with each problem using a linear Analogue self assessment (LASA)-type scale. The test instrument was feasible: 90% of assessments were completed in under 14 min. There was a significant increase in tiredness and significant decrease in anxiety and worries about the family, during treatment. Menopausal symptoms and post-surgical problems were important causes of distress in the patients with breast cancer. When the area under the curve method was used to quantify distress in the patients with breast cancer, difficulty concentrating, pain and sleep disturbances emerged as significantly troublesome problems. Computerised self-assessment may have a useful role in quantifying the distress caused by treatment with radiotherapy.
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PMID:A quantitative approach to the distress caused by symptoms in patients treated with radical radiotherapy. 876 83

A random door knock survey was conducted in five metropolitan postcode areas with a high proportion of low-income households to establish: 1. the health problems experienced by women, 2. the problems with which women would have liked more help, and 3. women's perceptions of how their health care experiences might have been improved. In all, 214 women were interviewed. Across all age groups the most common problems were tiredness, premenstrual syndrome, stress, being overweight and disturbed sleep. Premenstrual syndrome, tiredness and arthritis were the most commonly experienced problems among younger, middle-aged and older women respectively. In general, women were satisfied with the help available to them for their health problems, but one in five would have liked more help to cope with stress, and one in six said they would like help to address the issue of quality of medical care. In relation to health care services, suggestions for improvement included the provision of better health information from doctors and other health care professionals, and more opportunities for counselling and self-help. The project findings will be used to influence the development of local policies and services, and will form the focus for local women's health promotion programs.
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PMID:Women's health: consumer views for planning local health promotion and health care priorities. 879 89

The Quality of Well-Being Scale (QWB) quantifies health-related quality of life with a single number that represents community-based preferences for combinations of symptom/problem complexes, mobility, physical activity, and social activity. The aim of this study was to compare preferences of a long-term care population with those of the general population, determine whether preferences vary by the age of the hypothetical (target) person depicted in the health-state case description, and derive weights for new symptom/problem complexes of particular relevance to frail, older individuals. A sample of 38 female and 12 male long-term care residents with an average age of 86 years was asked to rate health-state scenarios that combined the four health domains of the QWB. This sample rates quality of life 0.10 units lower on average (on a 0-1 scale) than did the general population sample from which the QWB preferences were originally developed. Ratings of the same health state for younger versus older target persons did not differ significantly (all p values > 0.05 for t statistics). Weights derived for 11 new symptom/problem complexes were: disturbed sleep (-0.252), sit-to-stand requires maximal effort (-0.259), lonely (-0.265), walking a short distance causes extreme fatigue (-0.273), agitated (-0.284), hallucinating (-0.355), incontinent (0-359), unable to control one's behavior (-0.36), urinary catheter (-0.374), restrained in bed or chair (-0.374), and feeding tube through the nose or stomach (-0.402). These new weights increase the relevance of the QWB for cost-utility evaluations of health interventions for long-term care residents.
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PMID:Long-term care residents' preferences for health states on the quality of well-being scale. 881 24

Our purpose in conducting this descriptive study was to assess the health-related concerns and experiences of a sample of employed perimenopausal women in Alexandria, Egypt. In addition, we explored their help-seeking behavior and their perception of symptoms. We interviewed two hundred working women ages 40-60 years, 42% of whom were nurses, using a semistructured interview form as well as Koos's list of symptoms. The commonly mentioned concerns, in order of frequency, were chronic headaches, chronic fatigue, transportation and phone communication problems, financial problems, job dissatisfaction, backaches, hypertension, kidney disease and gall bladder disease, gastritis/indigestion, menstrual disturbances, arthritis, AIDS, and hepatitis B. With respect to the problems experienced by the women in the past 6 months, there was a high self-reported prevalence of headaches, fatigue, transportation and communication problems, backaches, job dissatisfaction, dissatisfaction with health insurance, financial problems, menstrual disturbances, gastritis/indigestion, gall bladder disease, anxiety, disturbed sleep, and hypertension. Women attempted to manage their problems mainly by taking over-the-counter drugs and self-prescribing (75.5%), doing nothing or using traditional remedies (56.5%), and going to a doctor or health insurance office (40%). Symptoms perceived by the majority of the women as not needing medical attention included loss of appetite, persistent backache, bleeding gums, chronic fatigue, persistent headaches, and loss of weight. The influence of education and occupation on women's perceptions and practices is discussed.
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PMID:Health-related concerns and experiences of employed perimenopausal women in Alexandria, Egypt. 885 19

Population-based data suggesting that contemporary society does not value sleep are difficult to obtain. In this report, historical change in item endorsements relevant for disturbed sleep and daytime fatigue from the Minnesota Multiphasic Personality Inventory (MMPI) generated from normative, upper Midwestern adult populations was analyzed. Response rates from the 1930s and 1980 were compared. The data indicated that, relative to individuals in the post-Great Depression/pre-World War II era, contemporary men were more likely to report fatigue and tiredness, although they were no more likely to report disturbed nocturnal sleep. The results are compatible with the voluntary curtailment of sleep typical in modern society described in the report of the National Commission on Sleep Disorders Research.
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PMID:Historical change in the report of daytime fatigue. 886 2

Chronic fatigue syndrome (CFS) is an illness characterized by disabling fatigue associated with complaints of fevers, sore throat, myalgia, lymphadenopathy, sleep disturbances, neurocognitive difficulties, and depression. A striking feature of CFS is its sudden onset following an acute, presumably viral, illness and the subsequent recurrent "flu-like" symptoms. It has been speculated that both CFS and debilitating chronic fatigue (CF) that does not meet strict criteria for CFS may be the direct or indirect result of viral infections. We therefore tested 548 chronically fatigued patients who underwent a comprehensive medical and psychiatric evaluation for antibodies to 13 viruses. Our objectives were to compare the seroprevalence and/or geometric mean titer (GMT) of antibodies to herpes simplex virus 1 and 2, rubella, adenovirus, human herpesvirus 6, Epstein-Barr virus, cytomegalovirus, and Cox-sackie B virus, types 1-6 in patients with CF to healthy control subjects. Other goals were to determine if greater rates of seropositivity or higher GMTs occurred among subsets of patients with CFS, fibromyalgia, psychiatric disorders, a self-reported illness onset with a viral syndrome, and a documented temperature > 37 degrees C on physical examination. Differences in the seroprevalence or GMTs of antibodies to 13 viruses were not consistently found in those with CF compared with control subjects, or in any subsets of patients including those with CFS, an acute onset of illness, or a documented fever. These particular viral serologies were not useful in evaluating patients presenting with CF.
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PMID:Viral serologies in patients with chronic fatigue and chronic fatigue syndrome. 889 37

Forty-four fibromyalgia patients were followed through 4.5 years to assess the extent to which symptom duration, physical activity level, disability pensions, and the occurrence of critical life events would predict long-term outcome. Outcome measures included pressure tenderness (dolorimeter score), work capacity (ergometer cycle test), global subjective improvement (verbal rating scale), and visual analogue scale ratings of pain, disturbed sleep, lack of energy, and depression. Significant outcome predictors were identified by means of separate multiple regression analyses on each outcome measure at follow-up, using symptom duration, physical activity level, disability pension status, and occurrence of critical life events as independent variables, together with baseline symptom intensity and age, which were adjusted for. An adequate physical activity level and increasing age predicted a positive outcome, while receiving a permanent disability pension or having experienced an excess of major negative life events predicted a negative outcome. Symptom duration did not affect outcome.
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PMID:Fibromyalgia outcome: the predictive values of symptom duration, physical activity, disability pension, and critical life events--a 4.5 year prospective study. 891 Feb 46


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