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

The major aim of the present study was to determine whether women exposed to a hysterectomy procedure showed any greater evidence of postsurgery mood disorder than a cholecystectomy control group. In addition, the investigation also considered whether sterilization by hysterectomy resulted in more frequent mood disturbance than in tubal ligation where the uterus remains undisturbed. Fifty-five hysterectomy patients were compared with 38 cholecystectomy and 60 tubal ligation patients by means of the Profile of Mood States. Presurgery, 6-weeks postsurgery, and 3-months postsurgery measures were obtained. No evidence was found to support the view that the special psychological significance of the uterus results in greater postsurgery mood disturbance than occurs with a control procedure such a cholecystectomy. Neither did the results suggest that sterilization involving organ removal was psychologically more traumatic than where the sterilization procedure left the uterus undisturbed. The two significant group X occasion interactions implied that the groups differed in their pattern of responding to surgery with respect to the Tension-Anxiety and the Fatigue-Inertia variables.
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PMID:An investigation into the psychological effects of hysterectomy. 83 Aug

The effects of dexmedetomidine, an alpha 2-adrenoceptor agonist, on vigilance, thiopental anesthetic requirements, and the hemodynamic, catecholamine, and hormonal responses to surgery were investigated in healthy (ASA physical status 1) women scheduled for dilatation and curettage (D & C) of the uterus. Fifteen minutes before induction they received single iv doses of either dexmedetomidine (0.5 micrograms/kg; n = 19) or saline (n = 20) in a double-blind fashion. Anesthesia was induced with thiopental and maintained with N2O/O2 (70/30%) and thiopental. Dexmedetomidine was well tolerated and no serious drug-related subjective side-effects or adverse events were observed. The most prominent subjective effects were fatigue and decreased salivation. The total amount of thiopental needed to perform D & C of the uterus was reduced approximately 30% (from 456 +/- 141 mg [mean +/- SD] after saline to 316 +/- 79 mg after dexmedetomidine). This was mostly due to a smaller induction dose in the group receiving dexmedetomidine. Dexmedetomidine appeared to improve the recovery from anesthesia as measured by visual analogue scales (VAS) on fatigue and nausea. The plasma concentration of norepinephrine was decreased by 56% after dexmedetomidine implying decreased sympathetic nervous activity. Systolic and diastolic blood pressure were moderately reduced after dexmedetomidine administration. The authors conclude that dexmedetomidine preanesthetic medication decreases thiopental anesthetic requirements and improves the recuperation from anesthesia with no serious hemodynamic or other adverse effects. Further studies in patients undergoing more stressful surgery are indicated.
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PMID:Dexmedetomidine, an alpha 2-adrenoceptor agonist, reduces anesthetic requirements for patients undergoing minor gynecologic surgery. 197 94

Three cases of giant cell arteritis involving the female genital tract of postmenopausal women are reported. The patients were 80, 64, and 57 years of age and presented with fatigue and anemia, fatigue and an abdominal mass, and fever and weight loss, respectively. Two of the patients had palpable pelvic masses; one had an ovarian mass visible on ultrasound examination. All three patients were anemic, and the erythrocyte sedimentation rate was elevated in the two women in whom it was tested. Exploratory laparotomy revealed ovarian tumors in two patients; one had a mucinous cystadenoma, and one had bilateral ovarian fibromas. The third patient had a cyst of the rete ovarii. Extensive giant cell arteritis of the small to medium-sized arteries was found unexpectedly in the ovaries and fallopian tubes of two patients who had prior hysterectomies and in the ovaries, fallopian tubes, and uterus of one patient. One patient was treated postoperatively with prednisone with improvement of symptoms and a decrease in the erythrocyte sedimentation rate. Of the two patients who received no therapy, one was found to have a thoracic aortic aneurysm 5 years postoperatively, and the other was alive without symptoms 17 years after the operation. Giant cell arteritis of the female genital tract is a rare finding in elderly women and may occur as an isolated finding or as part of generalized giant cell arteritis.
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PMID:Giant cell arteritis of the female genital tract. A report of three cases. 376 47

Literature on the etiology, diagnosis, and treatment of missed abortion is reviewed. Missed abortion during the 1st 28 weeks of gestation is defined as retention in the uterus of an abortus. The incidence of missed abortion among spontaneous miscarriages is 2.6-9.4%. Etiology of missed abortion is associated with intrauterine infections, severe abnormalities, inhibition of uterine contraction, or impairment of the hormonal balance. Prolonged retention of an abortus can result in fetal maceration or mummification. Clinical manifestations of missed abortion include absence of fetal heart tone, discharge from the breasts and diminution of their size, general fatigue, fever, and sometimes skin itch. Diagnosis of missed abortion is based upon the results of general and gynecologic examinations. Missed abortion is characterized by cessation of growth of the uterus, decrease in cyanosis of the cervix uteri, decrease in urinary excretion of estriol (up to 0-5 mg/day), drastic decrease in excretion of chorionic gonadotropin, decrease in blood level of placental lactogen, and decrease in pregnadiol excretion. Echographic signs of missed abortion during the 1st trimester include absence of heart activity, absence of fetal movements, and changes in the size of the uterus, amniotic cavity, and embryo. The most frequent complications of missed abortion are uterine hemorrhage, infection, and malignant transformation. Treatment of women with missed abortion consists of administration of abortifacient agents and curettage. The most frequently used abortifacient agents are oxytocin in large dosages, intravenous infusions of prostaglandin e2 (PGE2) or single intraamniotic injection of 15-methyl-PGF2alpha. The women with threatening uterine hemmorrage can be subjected to hysterectomy.
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PMID:[Diagnosis and treatment of missed abortion]. 661 58

A case of primary ovarian pregnancy involving a Copper 7 (Cu 7) IUD is described, and the pertinent literature is reviewed. A 29-year old white woman, gravida 2, para 2, presented with nausea and fatigue of 1 months' duration and severe bilateral upper abdominal pain with radiation to both shoulders of 1 day's duration. Her menstrual cycles for the previous 4 months had been irregular and her last menstrual period started 35 days prior to admission. She was known to have had a Cu 7 IUD in situ for 26 months. On admission, the patient was in moderate abdominal distress. Direct and rebound tenderness with some voluntary guarding was found in the upper abdomen, with minimal lower abdominal tenderness. Pelvic examination was normal, except for slight tenderness. Pelvic examination was normal, except for slight tenderness in the right adnexal area. No vaginal bleeding was observed. Serum pregnancy test (RIA) was positive. Sonogram of the abdomen showed the IUD in situ, free fluid in the peritoneal cavity, and a mass in the right adnexal area containing fetal parts and a fetal heartbeat. Dilation and curettage after removal of the IUD obtained a minimal amount of tissue. Laparotomy revealed 500-600 ml of blood. The uterus, both fallopian tubes, and the left ovary were normal. A hemorrhagic cystic area at the distal pole of the right ovary was actively bleeding. Wedge resection of the right ovary was performed. The patient recovered well and was discharged from the hospital 4 days after the operation. The hemorrhagic ovarian mass measured 6.0x4.5x3.0 cm. Section demonstrated at 3.0 cm cavity filled with clear fluid. The cavity was lined with a smooth membrane and contained a 1.6 cm embryo. A corpus luteum, 1.5 cm in greatest dimension, was adjacent to the cavity. Microscopic sections showed an edematous stroma and an area of implantation with vascularized chorionic villi adjacent to a corpus luteum. Hemorrhage extended from the area of implantation to the ovarian surface. Sections of the fetus were histologically normal. The diagnosis was ovarian pregnancy. Available data allow an approximation of the proportion of woman years of IUD use that involve the Cu 7 IUD in the US since 1966, which is calculated to be 28%. This calculation agrees with the observed 27% of the cases of ovarian pregnancy with an IUD in situ that involved the Cu 7 IUD reported in the US literature. This comparison suggests that the Cu 7 does not increase or decrease the risk of ovarian pregnancy relative to inert plastic IUDs. Clinicians should be aware of the possibility of ovarian pregnancy in patients who use the IUD.
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PMID:Ovarian pregnancy with a Copper-7 intrauterine device in situ. 682 9

A review is given of the findings obtained in 334 women in whom an IUD had been inserted at least 2 years previously. Regular follow-up examinations were subsequently undertaken. The most frequent indications were an expressed preference for an IUD on the part of the patient (38.3%), poor tolerance of the pill (24.8%), and pill fatigue (11.1%). Varicose veins led to IUD preference in 8.1% and thromboembolic disease in 6.0%. The failure rate, 12 pregnancies, was 3.6%, all within 6 months of device insertion. 1/2 of the pregnancies went to term and resulted in the birth of mature, healthy babies. The most frequent complications were menstrual disturbances (20.1%), pain (19.5%), cervicitis (18.3%), and adnexitis (13.8%), necessitating removal of the device in 5.7%, 4.2%, 5.1%, and 0.6% of all cases respectively. These rates are relatively high. The expulsion rate of 2.7% was relatively low. Further analysis of the complications led to the observation that menorrhagia was relatively common in nulliparae in women with a retroversion of the uterus, whereas the preinsertion finding of a pressure-sensitive uterus with a normal ESR, led in a significantly higher percentage of cases, to pain and adnexitis. The diagnosis by vaginal probe of a reduced uterine length led to faulty positioning and an increased tendency to pain in a significantly higher number of cases. The fact that only 56.6% of all women tolerated IUDs well and remained totally symptom-free, supports the view held by us that even today the pill remains the contraceptive of choice and should be recommended as such. (author's)
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PMID:[Intrauterine contraception with copper-T 200 device- a retrospective analysis of 334 cases (author's transl)]. 726 15

One case of giant-cell arteritis involving the female genital tract of a post-menopausal woman is reported. The patient was a 75 year-old female, who presented anemia, fatigue, weight loss and a palpable abdominal mass. A hysterectomy and bilateral salpingo-oophorectomy proved multiple uterine leiomyomas. The uterus, ovaries and tubes unexpectedly revealed extensive giant-cell arteritis of small and medium sized vessels. Giant-cell arteritis of the female genital tract is a rare finding that may occur as an isolated form or as part of generalized giant cell arteritis.
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PMID:[Giant-cell arteritis of the female genital tract]. 825 3

Pregnancy is accompanied by physiological hyperventilation that may be perceived as shortness of breath; causes are a reduced residual capacity and a reduced expiratory reserve volume due to the swelling uterus, and a larger tidal volume due to increase of the progesterone concentration and of the chemosensitivity to CO2 and O2. Fatigue, lowered exercise tolerance and orthopnoea also may occur, as do basal crepitations at auscultation. In pregnant asthma patients the symptoms may either improve greatly or become aggravated. During an asthma attack the foetus is exposed to hypoxaemia, which may be worsened by a decreased uteroplacental blood circulation in case of maternal alkalosis. Poorly controlled asthma has a stronger adverse effect on the unborn child than the judicious use of anti-asthma drugs. Safe drugs against asthma during pregnancy, around parturition and during breast feeding, are cromoglycic acid and ipratropium; relatively safe drugs are short-acting beta-sympathicomimetics, inhalation corticosteroids and systemic corticosteroids, as well as theophylline from the second trimester; use of long-acting beta-sympathicomimetics is advised against.
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PMID:[Asthma and pregnancy]. 962 12

Menorrhagia--menstrual periods lasting longer than 7 days and totaling blood losses greater than 80mL--affects 9%-14% of otherwise healthy women, and it can signal cancer, an endocrinologic disorder, or gynecologic disease. Blood loss can be high enough to result in anemia, fatigue, and syncope. Most often, abnormal uterine bleeding such as menorrhagia involves a disruption in the hypothalamic-pituitary axis, the ovary, and/or the uterus. Other identified causes include medications (especially psychotropics) that cross the blood-brain barrier; chronic diseases such as cancer, diabetes, and liver and kidney dysfunction; endocrine disorders, perimenopausal anovulation, polycystic ovary disease, pituitary tumors, and abnormal estrogen cycling caused by morbid obesity; and anatomic abnormalities of the uterus. Routine tests include hematocrit or hemoglobin to detect and evaluate anemia, thyroid stimulating hormone (TSH) level to evaluate thyroid function as a possible cause, and a pregnancy test to rule out an incomplete, spontaneous abortion as a cause. A Pap test is recommended to screen for dysplasia that can suggest a gynecologic cancer cause. Additional screening for endocrine disorders that may be causing menorrhagia include tests of thyroid, liver, and kidney function, and tests of follicle stimulating hormone (FSH), prolactin, and cortisol levels. Treatment can be medical or surgical. Medical treatment includes prostaglandin inhibitors, specifically nonsteroidal antiinflammatory drugs (NSAIDs), and hormonal therapy with estrogen, progesterone, gonadotropin-releasing hormone agonists, or oral contraceptives such as medroxyprogesterone (Depo-Provera). Surgical treatment includes hysteroscopic endometrial ablation by physical agents, laser electrodiathermy, and "roller ball," or surgical, resection. Hysterectomy is the treatment of last resort.
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PMID:Treatment Decisions in the Management of Menorrhagia. 974 72

Various separate studies indicate maternal morbidity is more common than had been believed. A Safe Motherhood Survey was conducted in 1993 in the Philippines among 9000 women, as part of efforts to study women's language and perceptions about pregnancy and symptoms of morbidity. In El Salvador, interviews were conducted among 2000 women on morbidity issues. Preliminary results from a Family Health International (FHI) five-country survey of 16,000 women revealed that 7 out of every 10 women reported a health problem related to maternity or chronic conditions stemming from pregnancy or childbirth. Conditions ranged from obstructed labor, complications from unsafe abortions, and bacterial infections, to anemia, hemorrhage, and eclampsia. The quality of care determines whether the health problems are life threatening. Less serious morbidity cases involve fatigue or back pain, which is exacerbated by poor nutrition and hard physical labor. Other reproductive morbidities are sexually transmitted diseases, side effects from contraceptives, and general gynecological problems. The FHI results from Ghana, Indonesia, and Egypt showed 240-300 morbidities for every maternal death; maternal mortality worldwide is estimated at 500,000 annually. A study of fistula (an injury during labor to the vagina and bladder that results in urinary or fecal incontinence) found that Nigerian community norms and limited access to emergency health care were factors. The women reported costs, poor roads, and transportation problems. A study in Ethiopia found that, in an Addis Ababa hospital between 1983-88, 600 fistulas were repaired every year, of which almost 66% occurred at first delivery. A study in Cairo in 1988 found that nearly 6 out of every 10 women reported a prolapsed uterus. Women in the studies were able to talk openly and willingly about their problems, when concepts and language were appropriate and interviewers were trained. A small study in India confirmed the correlation between reported symptoms and clinical conditions. Philippine pretests found that women's memories of morbidity were accurate for up to 4 years.
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PMID:Maternal morbidities affect tens of millions. 1228 12


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