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

Plasma exchange was performed in patients with recurrent colon cancer with evaluable liver metastasis or abdominal tumor with dissemination. This therapy was undertaken a total of 19 times in 11 cases. The cases were divided into effective and ineffective cases according in terms of the clinical effects, and changes in blood parameters and prognosis were examined in each case. Subjective symptoms, such as increase in appetite and disappearance of general fatigue or pain, were remarkably improved in 6 cases, and these patients were allowed to be discharged from the hospital. Marked regression of hepatomegalia was observed in 2 cases out of these 6 cases, but no remarkable effect was noted in patients with abdominal dissemination. In the effective cases the following parameters were significantly improved; beta- and gamma-globulin of serum protein fractions, IgG, IgA and IgM of immunoglobulin, alpha 2-macroglobulin, ceruloplasmin, and transferrin. However, since these effects are temporal and short-lived, one must consider applying plasma exchange therapy in conjunction with anticancer drugs, and the like. Plasma exchange seems applicable to cases of colon cancer with metastasis in the liver, because this therapy showed improvement in clinical symptoms, decreased hepatomegaly and prolonged survival.
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PMID:[Clinical trials of plasma exchange therapy in patients with recurrent colon cancer]. 643 4

Subjective feeling of fatigue was quantified before and 10, 20 and 30 days after elective uncomplicated abdominal surgery in 36 otherwise healthy patients, using a constructed fatigue scale model. One third of the patients had a remarkable increase in fatigue which continued throughout the first postoperative month. The fatigued patients showed a more pronounced postoperative loss in weight (P less than 0.001), triceps skinfold caliper (P less than 0.001) and arm muscle circumference (n.s.) and had lower levels in serum transferrin (P less than 0.02). No correlation was found between postoperative fatigue and postoperative changes in blood haemoglobin, lymphocyte count, plasma albumin, electrolytes and various minerals. Development of late postoperative fatigue was unpredictable from pre-operative nutritional status, serum transferrin, albumin, electrolytes, haemoglobin, lymphocyte count and various minerals, as well as from age, sex and duration of surgery. These results suggest future therapeutic measures against the postoperative fatigue syndrome.
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PMID:Postoperative fatigue and changes in nutritional status. 672 90

A 54 year-old previously healthy woman was admitted with staphylococcus aureus septicaemia. The patient had been treated with oral iron supplementation for two years due to fatigue. In the evaluation of postinfectious anaemia, serum transferrin saturation and serum ferritin were found persistently elevated with values of 74% and 950 micrograms/1, respectively. Hereditary haemochromatosis was suspected even though there was no history of liver disease or diabetes mellitus in the family. A bone marrow biopsy showed a normal content of haemosiderin iron. The liver biopsy revealed haemosiderosis, mainly located to the periportal hepatocytes, and fibrosis in the portal tracts. The HLA-type was A3, B7, B37. Over a period of ten months, a total of 3.9 g of iron was removed by venesection while S-ferritin declined to 31 micrograms/l. A sister to the proband had an identical HLA type, but normal iron status markers, either indicating heterozygosity or homozygosity with lack of penetrance. In preclinical hereditary haemochromatosis, early diagnosis and treatment is essential in order to prevent organ damage and to improve prognosis. Prophylactic screening is recommended. The identification of one homozygous subject in a Danish year-cohort of 60.000 persons costs approximately 40.000 Danish kroner (7.000 US+).
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PMID:[Preclinical hereditary hemochromatosis--is there an indication for preventive screening?]. 765 9

The goal of athletic training is to provide the body with a stimulus to adapt, increasing the capacity of the various systems to perform increased work loads. However, the magnitude of the stress must be large enough to induce the synthesis of new enzymes, tissues, and yet not so large that the biochemical and physiological processes of recovery are depressed. As each individual undergoes this process at a different rate, objective evaluation of the level of fatigue and adaptation is of enormous value in directing the training program of an athlete. The role of iron in the body is such that this element can be used as a marker of both adaptation to training and as an indicator of an acute inflammatory response to exercise. The various clinical measurements of iron in transport, storage, and in hematological parameters are discussed in this paper, relative to athletic populations. In addition expected changes in the level of the acute inflammatory protein, alpha 1-antitrypsin are also discussed relative to acute and chronic training protocols. Data is presented indicating that measurement of serum iron, transferrin, serum ferritin, and alpha 1-antitrypsin can be used to differentiate between an inflammatory response to tissue damage and infection. These parameters can also provide information as to the state of recovery, or lack thereof, experienced by an athlete to both acute and chronic training programs. The use of biochemical markers can help to avoid an overstress situation.
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PMID:Effects of high volume and/or intense exercise on selected blood chemistry parameters. 769 88

Convalescence after surgery is characterized by a period of fatigue (POF). If we assume that the POF syndrome has a multifactorial etiology, it is clear that the aim of therapeutic measures should be to reduce the response to surgical stress. The purpose of the present study was to determine if administering exogenous human growth hormone (hGH) can prevent the development or reduce the duration of the POF. We carried out a placebo-controlled randomized double-blind trial with 48 patients after elective cholecystectomy (placebo, or control group, n = 26; hGH-treated group, n = 22). Eligibility criteria were strict so as to introduce as few variables as possible. The results obtained in the study show that for moderate surgical injury (cholecystectomy in metabolically healthy subjects) the administering of low doses of hGH (8 IU/day) minimized the POF syndrome (Christensen score). Furthermore, a positive nitrogen balance was achieved in the hGH-treated group during the postoperative period from the first 24 hours onward. This finding correlates with the significant increase in serum levels of hGH (p < 0.05) and insulin-like growth factor 1 (IGF-1) (p < 0.001). On the other hand, anthropometric measurements in the hGH-treated group revealed a slight but continuous decrease in body weight and thickness of the triceps skinfold; however, arm muscle circumference did not significantly change during the postoperative period. These findings are related to the effects of the application of exogenous growth hormone, which preserves or increases lean body mass and reduces adipose tissue mass. The serum transferrin level proved to be a reliable biochemical indicator of POF.
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PMID:Can the use of growth hormone reduce the postoperative fatigue syndrome? 858 19

Hereditary hemochromatosis is an autosomal recessive disorder, the gene for which occurs in approximately 10% of Americans, most of whom are unaffected heterozygotes. Approximately 5/1000 white Americans are homozygous and at risk of developing severe and potentially lethal hemochromatosis. The disorder affects numerous organ systems, but the most common symptoms are fatigue, palpitations, joint pains, and impotence; the most common signs are those that relate to hypothalamic, cardiac, hepatic or pancreatic dysfunction, including poor cold tolerance, impotence in males, amenorrhea in females, cardiac arrhythmias, dyspnea, edema, hepatosplenomegaly, spider telangiectases, ascites, deformity, swelling or limitation of motion of joints, weight loss, hyperpigmentation. Characteristic abnormalities of laboratory tests include elevated serum iron concentration, high transferrin saturation, elevated serum ferritin concentration, elevated serum transaminases, hyperglycemia and low values for thyroid-stimulating hormone (TSH) and gonadotropins. Death may be the result of cardiac arrhythmia, congestive heart failure, liver failure or liver cancer. Since many of these complications cannot be reversed once they have developed, early diagnosis and treatment are essential. In view of the high prevalence in the American population (prevalence varies with ethnic background), the low cost of diagnosis and treatment, the efficacy of treatment if begun early, and, on the other hand, high costs and low success rate of late diagnosis and treatment, systematic screening for hemochromatosis is warranted for all persons over the age of 20 years. The initial screening should be by measurement of serum iron concentration and transferrin saturation. The practice guideline provides a diagnostic algorithm for cases in which the serum transferrin saturation is 60% or greater. It also provides guidelines for clinical management.
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PMID:Practice guideline development task force of the College of American Pathologists. Hereditary hemochromatosis. 886 84

Primary hemochromatosis is characterized by a specific pattern of clinical manifestations. It includes liver disease with hepatomegaly, glucose intolerance, e.g. diabetes, hyperpigmentation oft the skin, impotence/ amenorrhea, arthropathy, cardiomyopathy and fatigue. Laboratory investigation reveals significantly elevated serum ferritin and transferrin saturation with iron. The diagnosis is confirmed by liver biopsy and quantitative determination of elevated liver iron content. Wilson's disease represents a copper storage disease. Prominent clinical features are hepatomegaly and splenomegaly. Neurological alterations and detection of Kayser-Fleischer corneal rings are typical. In the acute initial phase the often young patients present with Coombs-negative hemolysis. Psychiatric alterations, cardiomyopathy, arthropathy, nephropathy, as well as thrombocytopenia and leucopenia are other clinical features. Laboratory parameters of Wilson's disease include low serum ceruloplasmin and serum copper. There is an elevated urinary copper excretion and elevated serum free copper concentration. The diagnosis is confirmed by liver biopsy with quantitative determination of an elevated liver copper content.
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PMID:[Current diagnosis: hereditary metabolic diseases of the liver (primary hemochromatosis, Wilson disease)]. 898 78

Previous studies have demonstrated that full recovery from weight loss may take months or years. The present investigation examined short-term recovery (5 wks "post") of physical performance (muscular strength, muscular power, vertical jump), body composition, metabolic hormones (testosterone, luteinizing hormone, sex hormone binding globulin, insulin-like growth factor-1, triiodothyronine, thyroxine, thyroid binding globulin, and thyroid-stimulating hormone) and metabolic markers (transferrin, ferritin, prealbumin, glycerol, nonesterified fatty acids, high-density lipoproteins, and lactate) in 10 healthy young men after an 8-week Army course with an energy deficit (1000 kcal/d) and loss of body mass (-12%). Subjects ate ad libitum after the course ended ("post"). Body composition was determined by dual-energy X-ray absorptiometry; strength from a simulated power clean, power from body mass and jump height, and metabolic hormones were measured in morning-fasted blood by radioimmunoassay. With the exception of transferrin and glycerol, all study parameters were significantly (p<.05) altered by the training course. At 5 weeks post fat-free mass along with all physical performance measures returned to initial levels; however, fat mass had significantly (p<.05) increased over initial levels. Also, with the exception of lactate, all measured hormones and markers were close to initial levels and within normal ranges. Reported complications during recovery included sleep irregularities, diarrhea, loss of motivation and feelings of fatigue. While the long range effect of this energy deprivation experience is uncertain, these data do suggest that severe weight loss does not result in lasting alterations of the contractile and metabolic properties of skeletal muscle in young, lean, healthy men.
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PMID:Physical performance and metabolic recovery among lean, healthy men following a prolonged energy deficit. 929 70

Chronic fatigue, arthralgia, infertility, impotence, cardiac disease, diabetes and abnormality of liver enzymes could point to the presence of haemochromatosis. A patient with one of these symptoms, a normal haemoglobin content, but an increased transferrin saturation and serum ferritin level most probably has a primary haemochromatosis. Most primary haemochromatoses have a genetic background. The diagnosis 'HFE-related haemochromatosis' is made when a homozygous Cys282Tyr mutation is found in the HFE-gene. However, in approximately 10% of the patients with the clinical features of primary haemochromatosis this mutation is absent. The treatment of primary haemochromatosis consists of regular phlebotomy. Liver biopsy is indicated if fibrosis, cirrhosis or another hepatic disease is suspected. Family screening of first-grade relatives is indicated for all patients with primary haemochromatosis.
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PMID:[Diagnosis and treatment of primary hemochromatosis]. 1042 53

Restless legs syndrome (RLS) occurs in some persons with iron deficiency, and some persons with RLS benefit from oral iron therapy. Approximately one in 200 persons of northern European ancestry have hemochromatosis attributable to inheritance of two common mutations of the hemochromatosis-associated HFE gene on chromosome 6. We evaluated and treated a 46-year-old man with RLS who was diagnosed as having hemochromatosis after he developed new symptoms associated with taking iron therapy for RLS. He had transferrin saturation 88%, serum ferritin 658 ng/ml, and C282Y homozygosity. Therapeutic phlebotomy of one unit of blood (450-500 ml) weekly (total 24 units) relieved his non-RLS symptoms, caused RLS symptoms to occur more frequently, and was associated with transient fatigue and mild dependent edema. His sister, who also has RLS, was subsequently diagnosed as having hemochromatosis. We conclude that serum transferrin saturation and ferritin levels should be measured before initiation of iron therapy of RLS. Patients with a history of iron deficiency or low serum iron parameters should undergo evaluation for iron deficiency; patients who have histories suggestive of hemochromatosis or iron overload or elevated pre-treatment transferrin saturation or serum ferritin levels should undergo evaluation to determine the cause of these abnormalities before they are treated with iron. In all persons with RLS treated with oral iron, serum iron parameters should be re-measured once or twice yearly during therapy.
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PMID:Hemochromatosis and iron therapy of Restless Legs Syndrome. 1131 89


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