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

Chronic fatigue syndrome (CFS) is easily differentiated from various neurological organic disorders by conventional clinical examinations. The most important disease for distinguishment from CFS is fibromyalgia syndrome, in which the prominent and cardinal feature is a deprivation of stage 4 slow wave sleep. Experimentally, the sleep disturbance in controls can induce general myalgia, muscle tender points, severe fatigue and stiffness on awakening. The EEG abnormality is slow alpha wave contaminants on slow wave background, which is identical to EEG of CFS. The results clearly imply that CFS is not a hysterical or psychogenic disease, and that fibromyalgia may be a central fundamental of CFS. Fibromyalgia, however, has distinct features such as no antecedent inflammatory process and no endemics. Therefore, the syndrome has features distinct from, in addition to common features to CFS. It is also very difficult to distinguish CFS from depression. The above-mentioned features can be observed in depression. Now, study of brain blood flow or metabolism by PET or SPECT can be a possible tool for establishment of the CFS identity.
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PMID:[Neuro-psychiatric aspects of chronic fatigue syndrome]. 128 39

The combination of widespread musculoskeletal pain, high tender point count, and nonrestorative sleep are sufficient criteria for the diagnosis of fibromyalgia. The condition is primary in the absence of underlying disease and is considered concomitant or secondary when closely associated with another organic disease. Despite more simplified diagnostic criteria, the work-up for fibromyalgia must always be directed toward excluding the underlying causes. In addition to general and rheumatic history and physical examination and selected laboratory studies, careful attention to defining any existing sleep and mood disturbances is important in designing a management program. Although 46 medical conditions have been associated with fibromyalgia, a practical differential diagnostic list included polymyalgia rheumatica, myofascial pain, connective tissue disease, endocrine myopathies, psychoneuroses, and other chronic fatigue syndromes.
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PMID:Evaluation and differential diagnosis of fibromyalgia. Approach to diagnosis and management. 264 76

Trauma to the head and neck can cause minor head injury with a brief alteration in consciousness. Generally, neurologic examination yields normal findings. In some patients, however, postconcussion syndrome marked by headache, dizziness, and neuropsychological deficits (eg, fatigue, cognitive impairment, emotional symptoms) results. This acceleration-deceleration injury with cerebral axonal dysfunction is an organic disease having objective abnormalities that necessitate early neurologic testing and treatment to prevent serious complications.
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PMID:Minor head injury may not be 'minor'. 265 25

Seventy patients presenting to the gastroenterologist with upper abdominal pain were examined by a psychiatrist to establish the presence of psychiatric disorder, illness behaviour and to record in detail their symptom pattern. The 37 patients who had no organic cause for their abdominal complaints were subdivided into those with and without psychiatric disorder. The former (21 patients) demonstrated more illness behaviour, they complained of more abdominal symptoms and their pain was both more severe and more persistent than in the patients with organic disease and those with non-organic illness who did not have psychiatric disorder. The latter group reported no symptoms of 'psychoneurosis' and should probably be regarded as a separate group if the aetiology of functional abdominal pain is to be clarified. Those with non-organic abdominal complaints who had psychiatric illness could be distinguished by the presence of three symptoms, namely depression, anxiety and fatigue. Detection and treatment of their psychiatric disorder might lead to a decrease in their symptomatic complaints and illness behaviour.
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PMID:Symptom complaints, psychiatric disorder and abnormal illness behaviour in patients with upper abdominal pain. 327 Aug 33

The clinical features of 150 consecutive patients with irritable bowel syndrome are reported. All patients were referred to a private practice. There was a marked female preponderance and a wide range of ages. Diarrhoea was predominant in 61,3%. The common symptoms were altered bowel habit, abdominal pain, emotional disturbance, flatulence and distension. Fatigue, weight loss, upper gastrointestinal symptoms, backache and urinary symptoms were frequent. The rectum showed nonspecific loss of vascular pattern, oedema and congestion in 11,4% of patients, but this was readily distinguished from inflammatory bowel disease on histological examination. The incidence of non-smokers in the group was 78,1%. The overall appendicectomy rate was 34%, and 65% of the 92 women had had gynaecological operations. A positive diagnosis was made on a typical history and simple basic investigations. More extensive investigations were required for those patients with markers of organic disease, but these yielded few associated lesions.
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PMID:The irritable bowel syndrome--a study from private practice. 403 10

When eight malnourished females without organic disease, were subjected to a controlled treadmill exercise test, they expended less total energy than females of normal body weight. The malnourished subjects consumed less oxygen than the control subjects, but oxygen consumption increased with increasing work load. The resting energy expenditure of the malnourished subjects was less than predicted values, but body composition as determined by muscle mass, total body water and thyroxine levels were within normal limits. Although decreased energy expenditure associated with malnutrition, has been attributed to decreased oxygen transport and altered hemoglobin, the malnourished subjects in this study did not have reduced hemoglobin levels. Metabolic adaptation may have occurred in order to improve the efficiency of aerobic metabolism. In order to confirm this theory, energy expenditure should be assessed under conditions of maximal oxygen intake.
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PMID:Energy expenditure in primary malnutrition during standardized exercise. 646 1

After organic disease had been excluded as far as possible by clinical examination, including laboratory tests, analysis of faeces, and X-ray examination or endoscopy of the upper and lower gastrointestinal tract, 61 patients were given either 50 mg trimipramine at bedtime or identically looking coded placebo in a prospective study for 4 weeks. The complaints were graded on an analogue scale by both the patients and the physicians. The results showed that the complaint scores were significantly reduced to about half in the placebo group. In the group treated with trimipramine a significantly greater reduction was found for the scores of vomiting, sleeplessness, depression, and for the mucus content of stools. The scores for tiredness during treatment had decreased less in the group receiving trimipramine than in the one receiving placebo. These improvements occurred already during the first week of treatment. No adverse side effect was recorded.
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PMID:The effect of trimipramine in patients with the irritable bowel syndrome. A double-blind study. 676 Mar 79

The frequency of functional complaints was examined in a group of 780 health men, employees of an industrial firm, who had no evidence of organic disease, were not under medical treatment and thought of themselves as healthy. As part of a standardised examination, questions were asked about 11 possible functional complaints, in addition to ten characteristics of their work. The presence of at least one functional symptom was affirmed by 48.3%, with a mean of two symptoms per person. Headaches and sweating were most frequent. In addition to an autonomic fatigue syndrome, a headache syndrome was the most characteristic. Some functional complaints were related to work stress, with factorial analysis distinguishing between time-limited overwork and emotional strain. These findings and corresponding one in the literature suggest that functional complaints frequently occur also in healthy persons.
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PMID:[Functional complaints--healthy or ill? A study of 780 working men]. 711 68

A gradual loss of anterior pituitary hormones is suspected in patients treated with irradiation due to brain tumors. Development of growth hormone deficiency (GHD) with age has been documented in patients with idiopathic GHD. A gradual loss of adrenocorticotropic hormone (ACTH) secretion has been also shown in a patient with severe GHD and an invisible pituitary stalk on magnetic resonance imaging (MRI). The purpose of this longitudinal and cross-sectional study was to evaluate the gradual loss of growth hormone (GH) and ACTH in a homogeneous group of patients with hypopituitarism. Twenty-eight patients (23 males, 5 females) from four hospitals were diagnosed as having prenatal or perinatal-onset hypothalamic hypopituitarism. They had an abnormal pituitary stalk on MRI (invisible in 18 patients, thin in 10 patients) without any other organic disease of the brain. Each patient had GHD upon initial evaluation. Height (n=20) was analyzed as standard deviation score (SDS). Longitudinal (n=8) and cross-sectional (n=28) GH secretion capacity was evaluated by GH peaks, in response to insulin tolerance test (ITT) and growth hormone releasing factor test (GRF test). Longitudinal (n=10) and cross-sectional (n=28) ACTH secretion capacity was evaluated by cortisol peaks in response to ITT. Height SDS decreased each year in all the untreated patients after birth. GH peaks decreased gradually with age. Longitudinal data showed decreased GH peaks with age in seven out of eight patients using ITT and in all four patients using GRF tests. Cortisol peaks also decreased gradually together with signs and symptoms for adrenal deficiency such as general fatigue. Cortisol peaks of less than 414 nmol/L (15 microg/dl) in response to ITT were seen in 24% of the tests before age 10 and 56% before age 25. In conclusion, GHD and ACTH deficiency developed gradually in patients with prenatal or perinatal-onset hypothalamic hypopituitarism who had invisible or thin pituitary stalks examined by MRI.
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PMID:Development of growth hormone and adrenocorticotropic hormone deficiencies in patients with prenatal or perinatal-onset hypothalamic hypopituitarism having invisible or thin pituitary stalk on magnetic resonance imaging. 1152 7

Functional dysepsia (FD) is defined as persistent or recurrent pain or discomfort centered in the upper abdomen without evidence of organic disease likely to explain the symptoms. Visceral hypersensitivity, motor dysfunction, and impaired gastric accommodation are found in some patients with FD, and psychological factors like chronic stress, attention and perception bias are also likely to play a part in the symptom formation. There is considerable overlap of non-specific symptoms like fatigue, headache, abdominal discomfort, muscle pain, and sleep disturbance in patients with different functional disorders, in this article exemplified by FD, fibromyalgia, and chronic fatigue syndrome. This overlap of symptoms indicates a common underlying sensitization process, leading to somatization.
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PMID:Somatization, sensitization, and functional dyspepsia. 1200 56


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