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

Ultrafiltration, diffusion, osmotic shifts, blood-membrane interactions, and psychological factors have all been implicated in the pathogenesis of postdialysis fatigue (PDF). To identify responsible factors, we performed a prospective, randomized, crossover analysis of fatigue scores (scale, 0 to 4) in 12 maintenance hemodialysis subjects with PDF. Fatigue scores were evaluated on nondialysis days (baseline) and after the following procedures on midweek treatment days: standard dialysis using either a 135- to 140-mEq/L sodium bath (routine hemodialysis) or a 150- to 155-mEq/L sodium bath (hypernatric hemodialysis); isolated ultrafiltration; isolated diffusion; and sham procedures with (isolated membrane) or without (recirculation) exposure to a dialysis membrane. Maximal fatigue scores are expressed as mean and 95% confidence intervals (CIs). The highest scores were recorded by patients who had just undergone routine hemodialysis (mean score, 2. 6; 95% CI, 1.7 to 3.4), isolated ultrafiltration (mean score, 2.1; 95% CI, 1.3 to 2.9), and isolated diffusion (mean score, 2.4; 95% CI, 1.5 to 3.2). There were no significant differences in fatigue scores between baseline periods and isolated membrane and recirculation procedures (mean score, 1.3; 95% CI, 0.4 to 2.2). Fatigue scores after hypernatric hemodialysis occupied an intermediate position (mean score, 1.7; 95% CI, 0.8 to 2.6). These results suggest that rapid hydraulic and molecular flux have a greater role in the pathogenesis of PDF than psychological stress and blood-membrane interactions. Use of a high-sodium bath may ameliorate PDF. We conclude that appropriate adjustments in both ultrafiltration and sodium profiling remain the most important means for controlling PDF in patients on short-duration hemodialysis.
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PMID:Identification of factors responsible for postdialysis fatigue. 1046 56

Twenty years ago, I became an "unstable patient", starting with a short episode of precordial discomfort and tiredness, ischemic ECG without enzymes, hypokinetic apex and no other signs. Following a week in bed and a lot of sleep, I went back to my usual lifestyle, refusing to undergo cineangiography or any hydraulic intervention. For ten years, the periodic controls showed no changes and I continued my intense activity under adequate therapy until another more severe episode occurred. Again, during a stressful and psychologically negative period, I experienced more severe precordial discomfort that was accentuated after minor psychological tension, whereas long and intense physical exercise was instead asymptomatic. The hypokinetic area was more extensive--no enzymes again--with a more severe ischemic ECG. My inability to face my psychological stress suggested surgical bypass, given the fact that since the Fifties, any type of intervention--even if nothing is vascularized--would nevertheless block pain and allow me to return to a normal lifestyle (denervation). At that time, cineangiography showed the occlusion of all three main coronary arteries. These occlusions had been there for years without an infarct and were obviously already compensated by adequate collateral circulation, as demonstrated by the normal lifestyle I had led with intense and long-lasting physical exercise. I returned to my regular activity, again mainly under anti-adrenergic stress therapy, and now, another ten years after surgery, I am still waiting for a third episode or something else. What have I learned from studying myself? I've learned that every ischemic patient has his own history and must learn how to face his own risks, the different patterns of so-called ischemic heart disease can not be theorized in a unique etiopathogenesis, the adrenergic system plays a major role in this disease, the "plumbing" vision is supported by reasons which have little to do with the knowledge--as yet incomplete--of the natural history of this disease, and the data obtained in years of research have been confirmed.
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PMID:[What I have learned by monitoring my own ischemia]. 1054 37

The pathogenesis of chronic fatigue syndrome (CFS) is unknown but one of the most characteristic features of the illness is fluctuation in symptoms which can be induced by physical and/or mental stress. Other conditions in which fluctuating fatigue occurs are caused by abnormal ion channels in the cell membrane. These include genetically determined channelopathies, e.g. hypokalemic periodic paralysis, episodic ataxia type 2 and acquired conditions such as neuromyotonia, myasthenic syndromes, multiple sclerosis and inflammatory demyelinating polyneuropathies. Our hypothesis is that abnormal ion channel function underlies the symptoms of CFS and this is supported also by the finding of abnormal cardiac-thallium201 SPECT scans in CFS, similar to that found in syndrome X, another disorder of ion channels. CFS and syndrome X can have identical clinical symptoms. CFS may begin after exposure to specific toxins which are known to produce abnormal sodium ion channels. Finally, in CFS, increased resting energy expenditure (REE) occurs, a state influenced by transmembrane ion transport. The hypothesis that ion channels are abnormal in CFS may help to explain the fluctuating fatigue and other symptoms.
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PMID:The symptoms of chronic fatigue syndrome are related to abnormal ion channel function. 1109 Mar 4

Fatigue--which is a complex, multicausal, and multidimensional subjective experience--is today the most frequently reported symptom from patients with cancer. The aim of this study was to explore the experience of fatigue in cancer patients and to describe the categories and dimensions of the symptoms. A qualitative method--grounded theory--was used. Unstructured, tape-recorded interviews with 15 cancer patients were used for data collection. The categories found in this study illustrate fatigue as a process. Three major categories were found: (1) experiences (of loss, need, malaise, psychological stress, emotional affection, abnormal weakness, difficulties in taking the initiative); (2) consequences (social limitation, affected self-esteem, affected quality of life); and (3) actions (coping). The categories were constructed on the basis of dimensions with subordinated qualities. Knowledge concerning the different expressions of fatigue is important in caring for patients with cancer. The results from this study may contribute to a better understanding of how a cancer patient can experience and express fatigue and how the symptoms may affect the patient.
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PMID:A qualitative study to explore the experience of fatigue in cancer patients. 1088 20

The relationship between psychological state and skin lesions of atopic dermatitis were investigated with a 31-year-old male patient. He had severe atopic dermatitis which became worse with psychological stress. A psychological test, profile of mood states (POMS), was performed on him every 2 weeks. Peripheral lymphocytes and natural killer (NK) cell activity were investigated at some points. When the psychological state showed more depressive, anxiety, anger, fatigue and confusion, the skin lesions became worse and recovered after the psychological states turned well. Correlation was shown between itch and stress or fatigue by a visual analogue scale (VAS) (p < 0.001). NK cell activity decreased during the worse psychological state and recovered during the near normal psychological state, although, the lymphocyte count and CD4/8 ratio in peripheral blood did not change during the study. These results suggest that some patients with atopic dermatitis should be treated psychologically in addition to standard dermatological treatment.
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PMID:[A case of atopic dermatitis which showed correlation of psychological state and lesions--changes of value of psychological test, skin lesion and NK cell activity]. 1091 87

The chronic fatigue syndrome is characterised by a fatigue that is disproportionate to the intensity of effort that is undertaken, has persisted for 6 months or longer, and has no obvious cause. Unless there has been a long period of patient- or physician-imposed inactivity, objective data may show little reduction in muscle strength or peak aerobic power, but the affected individual avoids heavy activity. The study of aetiology and treatment has been hampered by the low disease prevalence (probably <0.1% of the general population), and (until recently) by a lack of clear and standardised diagnostic criteria. It is unclear how far the aetiology is similar for athletes and nonathletes. It appears that in top competitors, overtraining and/or a negative energy balance can be precipitating factors. A wide variety of other possible causes and/or precipitating factors have been cited in the general population, including psychological stress, disorders of personality and affect, dysfunction of the hypothalamic-pituitary-adrenal axis, hormonal imbalance, nutritional deficits, immune suppression or activation and chronic infection. However, none of these factors have been observed consistently. The prognosis is poor; often disability and impairment of athletic performance are prolonged. Prevention of overtraining by careful monitoring seems the most effective approach in athletes. In those where the condition is established, treatment should aim at breaking the vicious cycle of effort avoidance, deterioration in physical condition and an increase in fatigue through a combination of encouragement and a progressive exercise programme.
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PMID:Chronic fatigue syndrome: an update. 1128 55

Road traffic crashes (RTCs) are responsible for a substantial fraction of morbidity and mortality and are responsible for more years of life lost than most of human diseases. In this review, we have tried to delineate behavioral factors that collectively represent the principal cause of three out of five RTCs and contribute to the causation of most of the remaining. Although sharp distinctions are not always possible, a classification of behavioral factors is both necessary and feasible. Thus, behavioral factors can be distinguished as (i) those that reduce capability on a long-term basis (inexperience, aging, disease and disability, alcoholism, drug abuse), (ii) those that reduce capability on a short-term basis (drowsiness, fatigue, acute alcohol intoxication, short term drug effects, binge eating, acute psychological stress, temporary distraction), (iii) those that promote risk taking behavior with long-term impact (overestimation of capabilities, macho attitude, habitual speeding, habitual disregard of traffic regulations, indecent driving behavior, non-use of seat belt or helmet, inappropriate sitting while driving, accident proneness) and (iv) those that promote risk taking behavior with short-term impact (moderate ethanol intake, psychotropic drugs, motor vehicle crime, suicidal behavior, compulsive acts). The classification aims to assist in the conceptualization of the problem that may also contribute to behavior modification-based efforts.
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PMID:Human factors in the causation of road traffic crashes. 1129 24

Fatigue, a common presenting complaint in primary care, is described as a lack of energy, sleepiness, tiredness, exhaustion, an inability to get enough rest, or weakness. Thus, fatigue affects quality of life. The prevalence rate of fatigue among patients with HIV infection is estimated to be 20% to 60%, and as the disease worsens, fatigue may become even more prevalent. The causes of HIV-related fatigue may be multifactorial and may include lack of rest or exercise, or improper or inadequate diet; psychological stress including depression and anxiety; the use of recreational substances; anemia; abnormalities of the thyroid gland and hypogonadism; infections; side effects of medications; sleep disturbances; and fever. This article reviews the common causes of HIV-related fatigue and briefly discusses options for reducing fatigue.
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PMID:Assessment and treatment of HIV-related fatigue. 1156 35

The present study examines the prevalence of chronic fatigue (CF) among bank workers in Brazil and possible associations with gender and working conditions. The study sample included all 735 workers from the department of data processing of a state bank. CF was assessed using the Chalder Fatigue Scale. Working conditions and socio-demographic, socio-economic and psychosocial factors at work were analysed. Psychiatric symptoms were measured with the SRQ-20. The overall estimate of the prevalence of CF was 8.7% [95% confidence intervals (95% CI) = 6.4-10.9%]: 7.8% (95% CI = 5.5-10.7%) among men and 11.0% (95% CI = 6.7-16.9%) among women. The male-female difference was not statistically significant, even after adjusting for minor psychiatric disorders. The overall prevalence of CF without minor psychiatric disorders was 4.5% (95% CI = 2.7-6.3%): 3.9% (95% CI = 1.9-5.9%) among men and 6.4% (95% CI = 2.0-10.1%) among women. In the final model, risk factors for CF were fast work speed [odds ratio (OR) = 3.5], dissatisfaction at work (OR = 3.1), minor psychiatric disorders (OR = 6.8), and medium (OR = 1.8) and heavy domestic workload (OR = 12.0). CF is common among these bank workers and is associated with psychosocial factors at work. Particularly among women, domestic workload, marital status and the presence of young children were associated with CF in the stratified analysis. Domestic workload may add physical and mental stress, putting employees at risk for CF from overload, or CF may cause workers to perceive domestic work as heavy.
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PMID:Chronic fatigue among bank workers in Brazil. 1209 84

Fatigue is a common complaint of patients seen in primary care. Factors that contribute to fatigue in a patient population include poor health status, psychological stress, poor nutrition, and pregnancy. Less well understood are factors that contribute to fatigue among healthy, nonpregnant individuals. Within the framework of the theory of unpleasant symptoms, 40 healthy young smoking and nonsmoking adults between the ages of 18 and 35 were evaluated to determine self-report level of fatigue and contributing physiological, psychological, and situational factors. Results indicate that while self-report of fatigue did not vary in this population based on gender, subjects who were moderate to heavy cigarette smokers were significantly more fatigued than were nonsmokers (F = 10.24, df = 1, 38, P < 0.01), with the effect being specific to male smokers. Self-report of fatigue did not correlate with body mass index, baseline inflammatory or immune status, or blood pressure. Positive psychological and situational predictors of fatigue included depression (r = 0.556, P < 0.001), state anxiety (r = 0.569, P < 0.001), sleep quality (r = -0.399, P < 0.05), and sleep quantity (r = -0.411, P < 0.05). These results suggest that psychological and situational factors are key contributors to fatigue in young adults and that smoking is a risk factor for fatigue in men.
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PMID:Predictors of fatigue in healthy young adults: moderating effects of cigarette smoking and gender. 1218 65


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