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

The soluble Ca2+-binding protein parvalbumin (PV) is expressed at high levels in fast-twitch muscles of mice. Deficiency of PV in knockout mice (PV -/-) slows down the speed of twitch relaxation, while maximum force generated during tetanic contraction is unaltered. We observed that PV-deficient fast-twitch muscles were significantly more resistant to fatigue than were the wild type. Thus components involved in Ca2+ homeostasis during the contraction-relaxation cycle were analyzed. No upregulation of another cytosolic Ca2+-binding protein was found. Mitochondria are thought to play a physiological role during muscle relaxation and were thus analyzed. The fractional volume of mitochondria in the fast-twitch muscle extensor digitorum longus (EDL) was almost doubled in PV -/- mice, and this was reflected in an increase of cytochrome c oxidase. A faster removal of intracellular Ca2+ concentration ([Ca2+]i) 200-700 ms after fast-twitch muscle stimulation observed in PV -/- muscles supports the role for mitochondria in late [Ca2+]i removal. The present results also show a significant increase of the density of capillaries in EDL muscles of PV -/- mice. Thus alterations in the dynamics of Ca2+ transients detected in fast-twitch muscles of PV -/- mice might be linked to the increase in mitochondria volume and capillary density, which contribute to the greater fatigue resistance of these muscles.
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PMID:Deficiency in parvalbumin increases fatigue resistance in fast-twitch muscle and upregulates mitochondria. 1140 33

Our hypothesis was that malnutrition sufficient to produce weight loss in weanling mice would decrease the ability of slow-twitch skeletal muscle to develop and maintain force. We isolated muscles from 3 groups (n = 5) of weanling C57BL/6J mice of both sexes (i) mice at 19 days of age serving as zero-time or baseline controls (CONT) (ii) mice fed for the next 14 days with a low-protein diet that produces features of incipient kwashiorkor (LPD) and (iii) mice fed for the next 14 days with a complete diet (NORM). Muscles were also obtained from 5 adult mice 7-9 months of age (MAT). We stimulated the soleus at 50 Hz for 500 ms at 0.6 tetanic contractions per min (tet x min(-1)), 6 tet x min(-1), and 30 tet x min(-1) in Krebs-Henseleit bicarbonate buffer at 27 degrees C gassed with 95% O2 and 5% CO2. The initial developed force (mN x mm(-2)) at 0.6 tet x min(-1) did not differ across groups (CONT 211.7 +/- 16.0, LPD 274.2 +/- 41.6, NORM 246.8 +/- 38.0, MAT 210.8 +/- 10.6). The fatigue rate (mN x mm(-2) x min(-1)) at 6 tet x min(-1) was significantly slower in muscles from CONT (0.6 +/- 0.3) and LPD (0.6 +/- 0.4) than in NORM (2.4 +/- 0.6) and MAT (2.3 +/- 0.2). At 30 tet x min(-1), the fatigue rate (mN x mm(-2) x min(-1)) did not differ across groups (CONT 2.4 +/- 0.5, LPD 2.7 +/- 0.5, NORM 2.5 +/- 0.4, MAT 2.0 +/- 0.2). After stimulation at 6 tet x min(-1) and 30 tet x min(-1), only muscles from CONT and LPD recovered to 100%. Because muscles from LPD mice developed equal force, fatigued less, and recovered from fatigue to a greater extent than muscles from NORM mice, we rejected the hypothesis. The function of the tissue remaining in the muscles from LPD mice approximated that of muscles from mice at 19 days of age rather than muscles from either mice of the same age fed a complete diet or adult mice.
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PMID:Contractile function in vitro of slow-twitch skeletal muscle from weanling mice subjected to wasting malnutrition. 1143 May 89

Acute and chronic radiotherapy-related fatigue occurs in up to 80% and 30%, respectively, of patients undergoing irradiation for cancer. Frequently, the symptom is not expected by the patients and is underestimated by medical and nursing staff. Fatigue can affect global quality of life more than pain, sexual dysfunction and other cancer- or treatment-related symptoms. Its etiology and correlates are not clear. Published reports are mainly descriptive, and in many of them numerous methodological biases are present. One of the limitations is lack of a standard method of assessment that could simplify the comparison between different series. In the last decade, modern instruments have been designed to measure fatigue. They include uni- and multidimensional tools. Use of these specific instruments is highly recommended for research on radiation-related fatigue. In daily practice when time is limited, simple assessment is necessary. For example, systemic use of plain and easily understandable questions about fatigue, its level and impact on daily life could be sufficient and reliable. Therapeutic strategies for radiotherapy-induced fatigue have not yet been clearly defined, but a few randomized studies have been recently published. Physical exercise, group psychotherapy and relaxation therapy have been demonstrated to be effective. Moreover, pharmacological treatment of concomitant disturbances (anemia, pain, insomnia, depression, dehydration, infection, malnutrition) and other radiotherapy side effects (diarrhea, hormonal insufficiency etc.) should be considered. Further methodologically correct studies are warranted to better define the causes, optimal prevention, assessment and management of this symptom.
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PMID:Radiotherapy-related fatigue: how to assess and how to treat the symptom. A commentary. 1150 69

Chronic heart failure is associated with a bad prognosis with considerably shortened survival and repeated hospitalisations. Patients suffering from heart failure also have symptoms that can affect their food intake, for example, tiredness when strained, breathing difficulties and gastrointestinal symptoms like nausea, loss of appetite and ascites. Pharmacological therapy can lead to a loss of appetite, which will make the intake of food inadequate to fill the required energy and nutritional needs. The nurse's interest in and knowledge of diet issues can improve these patients' nutritional status. The aim of this literature review was to describe the nurse's interventions regarding malnutrition in patients suffering from chronic heart failure. The literature search gave 13 articles, which were analysed, and sentences whose content was related to the aim were identified. Three areas of content appeared; drug treatment and consequences, gastrointestinal effects, and information and education. The results show that the nutritional status of these patients can be significantly improved by means of simple nursing interventions. Future research should focus on controlled experimental studies to evaluate differences in body weight, body mass index and quality of life between patients suffering from chronic heart failure, who are taking part in a fully enriched nutrition intervention, and patients suffering from chronic heart failure, who are eating their normal diet.
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PMID:Malnutrition in patients suffering from chronic heart failure; the nurse's care. 1151 31

In Germany every year about 100,000 people develop a malignant tumor of the gastrointestinal tract. Only few of them are included in a structured rehabilitation program after surgery. The aim of such a rehabilitation program is to minimize the sequels of gastrointestinal tumor disease and its treatment and influence on the daily life of patients. Malnutrition is a common symptom of tumor manifestation, especially in the gastrointestinal tract. It is important to establish the diagnosis of malnutrition and to treat such patients with nutritional support.Fatigue and impairment of physical performance are serious problems of cancer patients. Particularly in the recovery phase immediately after treatment, low physical performance imposes limitations on basic daily activities. An active aerobic training program can improve the physical performance and fitness in a short time. Deficits and symptoms depend on tumor stage and localisation. A specialised team is necessary to treat all the possible symptoms and complications after cancer surgery. Patients have to be informed precisely about structural and functional deficits due to tumor operation. Only the well informed patient will comply to the suggested treatment.
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PMID:[Rehabilitation after surgery for gastrointestinal malignant tumors]. 1193 Feb 98

The diet of many athletes is inadequate due to overly restrictive habits and an obsession with losing weight in order to maintain a particular level of body weight. Many female athletes, particularly those who participate in sports that emphasize leanness (gymnastics, distance running, diving, figure skating and classical ballet), have suboptimal energy and nutrient intakes and are at risk of compromised nutritional status, including fatigue, dehydration, nutrient inadequacies, delayed growth and an impaired immunocompetence. It is very well known that active women and girls who are driven to excel in sports may develop the so-called female athlete triad in which malnutrition, amenorrhoea and osteoporosis appear as typical signs of medical complications, frequently linked to serious psychological alterations. This outcome is mainly related to that found in eating disorders-syndromes in which athletes have been defined to be at increased risk. As a consequence of all these alterations, the immune system may be affected in athletes, and subsequently they might be more prone to infections. As there is a lack of knowledge about how the immune system may be affected in basal conditions of athletes, the study of immunocompetence as an index of the nutritional status is reviewed. In summary, it is necessary to encourage all professionals surrounding athletes to be aware of the importance of taking care of their nutritional status in order not only to avoid physical and psychological complications but also to improve performance and, thus, to achieve sporting goals.
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PMID:The implication of the binomial nutrition-immunity on sportswomen's health. 1214 60

Dietary deficiency in iron and to a lesser extent folic acid is the principle cause of anemia in the world. Reproductive aged women and growing children are the principle groups at risk of anemia. About half of nonpregnant reproductive aged women in tropical countries have hemoglobin levels lower than 12 g/100 ml, the level used by the World Health Organization to define anemia. Nutritional anemia is even more widespread among pregnant and lactating women because of the increased needs for iron during those periods. Pregnant women need almost 500 mg of iron for their increased red blood cell mass, 220 mg for routine iron loss through the urine, bile, sweat, and other routes; 290 mg for the fetus, and almost 25 mg for the placenta. In all, the pregnant women theoretically requires over 1000 mg of iron through diet or bodily reserves. Healthy, well-nourished women have total iron reserves of 2500 mg, but according to published data almost 2/3 of pregnant women even in favorable circumstances end their pregnancies with no remaining iron reserves. In tropical regions the lack of iron reserves is aggravated by parasites and infections, closely spaced pregnancies that do not allow restoration of reserves, and poor dietary availability of iron. Anemia during pregnancy is associated with elevated risks of maternal morbidity and mortality. Fatigue, dyspnea, palpitations and tachycardia, vertigo, loss of appetite and cravings for soil or other inappropriate substances are frequently observed in anemic women. The risks of prematurity and low weight are increased for infants of anemic women. Fetal malformation may be associated with folic acid deficiency. Nutrition education is needed for pregnant women. Local foods may be enriched with iron, and pregnant women may be given iron and vitamin B12 supplements directly. Iron supplements may rapidly increase iron reserves, but they are poorly tolerated by many women. The supplements should be avoided if possible early in the pregnancy because digestive intolerance is more likely in the 1st months of pregnancy. Parasitic and bacterial infections should be diagnosed and treated as a step in controlling anemia.
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PMID:[Impact of nutritional deficiencies on anemia in pregnant women]. 1228 20

Malnutrition is a common complication of chronic diseases in children and may lead to growth impairment (stunting). Malnutrition in cystic fibrosis (CF) results from increased energy expenditure, decreased energy intakes, malabsorption of ingested nutrients because of pancreatic insufficiency and chronic inflammation. Malnutrition and high levels of inflammatory cytokines affect IGF-1 production through interrelated mechanisms. Nutritional support was shown to improve both nutritional status and outcome in CF. However, some nutrients have a direct effect on the disease. n-3 fatty acids supplementation is able to correct lipid abnormalities resulting from a primary mechanism. Moreover, n-3 fatty acids have a direct effect on the inflammatory response, decreasing eicosanoid synthesis and modulating nuclear transcriptional factors nuclear factor kappaB and peroxisome proliferator-activated receptors gamma. Nutritional support may be considered part of the care of the CF patient together with antibiotics, pancreatic enzymes and physiotherapy, influencing significantly the evolution of the disease.
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PMID:Nutrition and growth in cystic fibrosis. 1237 8

Fatigue is the most frequent adverse event encountered in cancer patients and often underestimated by oncologists. This fatigue results in a deterioration of the quality of life physically, psychologically and socio-professionally. We have to distinguish various degrees of fatigue and identify "acute" fatigue from "chronic" fatigue. The acute fatigue appears normal after a physical or psychological effort and requires less than a week of rest to recover; the impact on quality of life is thus minimal. Chronic fatigue is more insidious; the causes are multiple. The patient feels that this fatigue is abnormal and disproportionate. It last several weeks and has a severe impact on the quality of life. Somatic mechanisms of fatigue related to the tumour and/or treatment are: vitaminic or proteic deficiencies due to malnutrition, accumulation of toxic metabolites, infections and septicemia, the abuse of sleeping tablets or antalgics, insomnias, immobilisation, organic insufficiencies or ionic disturbances. Anemia--observed in more than 50% of the cancerous patients--deserves a particular attention. The causes of this anemia are also multiple. It is obvious that anemia interferes with quality of life of the patient, decreases his physical performances and leads to a lack of motivation or energy. Patients with an hemoglobin level higher than 12 g/dl describe significantly less complaints and a higher physical and functional well being. To better assess the treatment of fatigue, it is important to first evaluate if the cause is organic, psychologic or mixed. Among the somatic causes, nutritious deficiencies, pain and anemia, ... all these complications can be treated with appropriate medications. This fatigue is often recognized by the patient as a progression of the tumour or as a treatment failure. Therefore, it is important to inform the patients of the possibility of that adverse event so that it does not generate additional stress and anxiety during the treatment.
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PMID:[Fatigue and quality of life in cancer patients]. 1242 50

The development of progressive malnutrition or cachexia is frequent in patients with gastrointestinal cancer - especially in patients with a carcinoma of the pancreas. The cachexia syndrome which is characterised by loss of body weight, negative nitrogen balance and fatigue significantly affects patients' quality of life, morbidity and survival. Because the currently established therapeutical strategies are often disappointing many physicians tended to develop a therapeutical nihilism. Cancer anorexia and cachexia are two distinct syndromes which may have synergistic effects in a patient. This review highlights the growing understanding of the multidimensional pathophysiological background. An algorithm of the current treatment strategies is given. In addition, we discuss new anabolic and anticatabolic agents (e.g. eicosapentanoic acid) and the results from first clinical trials.
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PMID:[Tumour anorexia--tumour cachexia in case of gastrointestinal tumours: standards and visions]. 1243 71


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