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

Osteoporosis is defined as "...a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture." Compared to normal bone, osteoporotic bone shows a reduction in the number of trabeculae, thinning of the trabeculae, and loss of connectivity of the trabeculae. The overall result is deterioration of bone strength and an increase in the susceptibility to fracture. Osteoporosis is essentially a "silent" disease until a fracture occurs. When multiple fractures occur, they can cause significant deformity of the spine, leading to kyphosis, loss of vertebral height, and subsequent loss of overall height. The patient with osteoporosis experiences chronic pain and back fatigue. In addition, gastrointestinal and respiratory symptoms may occur as a consequence of the changes in the skeletal shape.
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PMID:The epidemiology of osteoporosis. 885 43

Depressed patients often present to their family physicians with physical complaints that mimic other medical diseases rather than the classic symptoms of sadness, hopelessness, or loss of pleasure in usual activities. These somatic presentations of depression can include gastrointestinal disturbances, complaints of chronic pain, fatigue, and/or an extensive history of unexplained medical illness. Depression and other psychiatric disorders occurring in the somatic patient can often be identified through the use of a routine and noninvasive questionnaire administered at the initial physician encounter. Regardless of its presentation, however, major depression should be treated vigorously, with full therapeutic doses of antidepressants administered for at least 6 weeks to determine response, and followed by at least 6 months to ensure full remission utilizing antidepressants whose side-effect profile may help ameliorate the patient's somatic complaints while avoiding those that might exacerbate them. Effectively diagnosing and treating the somatic patient's depression will improve his or her quality of life and may reduce their current excessive use of healthcare resources.
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PMID:Recognizing and treating the patient with somatic manifestations of depression. 896 8

Practitioners today are confronted with an avalanche of difficult to treat patients with chronic pain for 2 reasons: (1) The culture increasingly encourages patients to conceive vague and nonspecific symptoms as evidence of real disease and to seek specialist help for them; and (2) the rising ascendancy of the media and the breakdown of the family encourage patients to acquire the fixed belief that they have a given illness, often a trendy nondisease such as repetition strain injury or chronic fatigue syndrome. In historic terms, many of these complaints, especially sensory ones featuring chronic pain and chronic fatigue, are relatively new. Patients tend to adopt them on the basis of what the culture considers to be legitimate illness, whereby different patterns exist for men and women.
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PMID:Somatization and chronic pain in historic perspective. 906 Apr 86

Fifty-three UK and 59 USA people with multiple sclerosis (MS) answered anonymously the first questionnaire on cannabis use and MS. From 97 to 30% of the subjects reported cannabis improved (in descending rank order): spasticity, chronic pain of extremities, acute paroxysmal phenomenon, tremor, emotional dysfunction, anorexia/weight loss, fatigue states, double vision, sexual dysfunction, bowel and bladder dysfunctions, vision dimness, dysfunctions of walking and balance, and memory loss. The MS subjects surveyed have specific therapeutic reasons for smoking cannabis. The survey findings will aid in the design of a clinical trial of cannabis or cannabinoid administration to MS patients or to other patients with similar signs or symptoms.
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PMID:The perceived effects of smoked cannabis on patients with multiple sclerosis. 925 98

The purpose of this study was to examine the base rate of cognitive and neurobehavioural complaints in patients with chronic pain (N = 170) who had not sustained a head injury. The patients completed a packet of questionnaires that contained numerous questions regarding physical, cognitive, and psychological symptoms. The 'postconcussive-like' symptoms were selected and analysed. Specific symptom endorsement rates ranged from 5% to 76.5%. Disturbed sleep, fatigue, and irritability were reported by the majority of chronic pain patients. Cognitive complaints relating to forgetfulness (29%), difficulty maintaining attention (18%), and difficulty with concentration or thinking (16.5%) were endorsed by a significant minority of patients. Most patients (80.6%) endorsed three or more symptoms from Category C of the DSM-IV Postconcussional Disorder research criteria. This study further illustrates that postconcussive-like symptoms are not unique sequelae of mild head injury, and the presence of chronic pain should be considered when interpreting patients' physical, cognitive, and psychological complaints following closed head injury.
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PMID:'Postconcussive' symptoms in persons with chronic pain. 935 55

Patients with unexplained chronic pain and/or fatigue have been described for centuries in the medical literature, although the terms used to describe these symptom complexes have changed frequently. The currently preferred terms for these syndromes are fibromyalgia and chronic fatigue syndrome, names which describe the prominent clinical features of the illness without any attempt to identify the cause. This review delineates the definitions of these syndromes, and the overlapping clinical features. A hypothesis is presented to demonstrate how genetic and environmental factors may interact to cause the development of these syndromes, which we postulate are caused by central nervous system dysfunction. Various components of the central nervous system appear to be involved, including the hypothalamic pituitary axes, pain-processing pathways, and autonomic nervous system. These central nervous system changes lead to corresponding changes in immune function, which we postulate are epiphenomena rather than the cause of the illnesses.
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PMID:Chronic pain and fatigue syndromes: overlapping clinical and neuroendocrine features and potential pathogenic mechanisms. 950 Jan 48

Fibromyalgia is present in 2% of the general population and leads to impairment by chronic pain and fatigue. It does not improve without therapy directed at the symptoms of fibromyalgia. We describe our interdisciplinary group treatment for patients with fibromyalgia. They received a physical examination, ergometry and psychometric tests both at admission and before discharge, and they were questioned to the degree and localization of their pain, to fatigue, sleeping disorders and functional symptoms. Therapy included information about fibromyalgia, learning of coping strategies, relaxation and endurance training. Our results show that our interdisciplinary group treatment is effective for fibromyalgia and improves anxiety, depression and well being after a period of 5 weeks of in-patient rehabilitation.
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PMID:[Interdisciplinary group therapy for fibromyalgia]. 962 47

The most menacing complication of herpes zoster in immunocompetent elderly people is chronic pain or postherpetic neuralgia (PHN). The cardinal epidemiological feature of PHN is its striking relationship to aging. Among zoster patients over 60 years old, estimates of the occurrence of PHN, defined as pain 1 month after rash onset, vary from 27 to 68%. The pathogenesis of PHN is incompletely understood but seems to involve varicella-zoster virus (VZV)-induced damage of peripheral afferent neurons and resultant changes in central afferent neurons and efferent pain-modulating neurons. PHN improves over time in many elderly patients, but an unfortunate subset experience of debilitating pain lasts for years. They experience constant and/or intermittent spontaneous pain and stimulus-evoked pain such as allodynia or hyperpathia. The outcomes of this pain include fatigue, sleep disturbance, anorexia, depression, social withdrawal, impaired activities of daily living and profound lowering of quality of life. The management of PHN is hampered by two problems: (1) a uniformly effective treatment for PHN is not available (although tricyclic antidepressants, local or regional anaesthetics, capsaicin, opiates, anticonvulsants and physical therapies are sometimes useful); and (2) early antiviral therapy of zoster may be ineffective in preventing PHN, partly related to the fact that days of VZV replication and neuronal destruction have occurred by the time the patient reaches the doctor. A potential solution to the problem of PHN is the vaccination of elderly persons with the varicella vaccine to prevent or attenuate zoster or PHN.
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PMID:Postherpetic neuralgia in immunocompetent elderly people. 977 54

The psychological well being of the patient and the patient's entire family is critically important to successful rehabilitation of individuals with multiple sclerosis (MS). This article deals with the psychotherapeutic management and problems faced by the person with MS, including fatigue, chronic pain, stressful life events, and cognitive defects.
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PMID:Neuropsychologic aspects of multiple sclerosis. 989 15

Fibromyalgia is a chronic pain syndrome, more common in women. Its prevalence is estimated around 2% in the general population, and up to 20% among rheumatology outpatients. Besides musculoskeletal pain, symptoms as fatigue and sleep disturbance are considered characteristic. Research criteria have been set up, but their seemingly preciseness is unable to distinguish clearly between fibromyalgia and other functional somatic syndromes (chronic fatigue syndrome, irritable bowel syndrome) and psychiatric disorders (depression, anxiety), with which a striking comorbidity is documented. The diagnosis of fibromyalgia does not theoretically require the exclusion of muscle, joint, or metabolic diseases, but in clinical practice this problem proves to be of crucial importance. There are numbers of pathophysiological hypothesis for fibromyalgia, but none of them is fully satisfying: muscle is probably innocent; sleep disturbance, although sometimes considered a landmark of the syndrome, is unspecific; stress response studies show subtle anomaly; psychiatric disorders may represent factors of vulnerability and perpetuation rather than causes. We propose to include some of these etiological contributors in vicious circles leading to a "final common pathway" characterized by generalized hyperalgesia. Treatments of fibromyalgia, whether pharmacological (antidepressants) or psychological (cognitive-behavioral therapies) are of little efficacy, and the global prognosis of fibromyalgia is poor. However, the outcome might prove better outside the specialized clinics in which studies of chronic sufferers with severe abnormal illness behaviors are done. The social consequences of the popularization of the diagnosis of fibromyalgia should not be neglected.
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PMID:[Fibromyalgia. A critical review]. 992 93


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