Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Stem cell transplantation has assumed a prominent place in the treatment of multiple myeloma, but relative to patients with other malignancies there is surprisingly little information about the adjustment difficulties and quality-of-life changes that these patients experience. This study examined psychosocial and functional deficits among myeloma patients assessed at a uniform period during their initial diagnostic evaluation, prior to beginning protocols at a transplant center. Validated self-report measures and clinician rating scales were used to assess 213 patients. Outcomes evaluated included emotional distress (Hospital Anxiety and Depression Scale, Brief Symptom Inventory), depression (Hamilton Depression Rating Scale), physical functioning, pain, and energy (SF-12). A significant proportion of patients experienced compromised psychosocial and physical functioning. Roughly one-third reported clinically elevated levels of distress, anxiety, and depression. In all, 59% scored below age-adjusted norms for daily physical functioning, 58% reported at least moderate levels of pain, and over 80% noted at least moderate fatigue. Clinical and demographic correlates of these outcomes were examined. These findings are among the first to characterize quality-of-life outcomes among myeloma patients in the transplant setting, and indicate that many patients experience considerable supportive care needs even prior to beginning aggressive regimens. Results highlight the importance of early screening.
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PMID:Psychosocial adjustment and quality of life among multiple myeloma patients undergoing evaluation for autologous stem cell transplantation. 1503 42

The main aim of this study was to investigate the patients' self-reported symptom occurrence, symptom intensity (SI), and symptom distress (SD) from admission for stem-cell transplantation (SCT) until discharge from the ward. Forty-three patients participated and data were collected at 7 different time-points by using the self-administered Symptom Frequency, Intensity, and Distress questionnaire for SCT (SFID-SCT). The results showed that symptom occurrence followed a curve on which the highest frequencies of symptoms were reported from the day of the SCT (T2) until the end of the protective care period (T5). The mean SI and SD scores became higher when the number of reported symptoms increased. Between T2 and T5, 33% to 54% of the patients reported >10 simultaneous symptoms. Symptoms reported by more than 50% of the patients during T2-T5 were tiredness, loss of appetite, mouth dryness, nausea, sleeping disturbances, diarrhea, and changes of taste. Loss of appetite, tiredness, and mouth dryness were, in descending order, the 3 symptoms reported as most intense and distressing. A statistically significantly higher SD-score was found for the patients undergoing allogeneic SCT on the day before start of the conditioning regimen, as compared to the patients undergoing autologous SCT. Patients reporting no anxiety on admission were found to have higher, mean SD-scores at the end of the hospital stay than anxious patients. The SFID-SCT questionnaire was found to give useful information not only about symptom occurrence but also about SI and SD. To use an instrument that distinguishes between these aspects of the symptom experience may help health care professionals to support the patients through the SCT-process.
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PMID:Symptom occurrence, symptom intensity, and symptom distress in patients undergoing high-dose chemotherapy with stem-cell transplantation. 1510 52

A strong association between fatigue and depression in cancer patients has been reported repeatedly in clinical studies. The distinction remains difficult, mainly because of the similar phenomenology of fatigue and depression. It is the aim of this paper to work out similarities and differences in the conception of fatigue and depressive disorders. For that, a differentiation between depression as emotional distress and depression as clinical syndrome, according to the current classification systems, has to be made. Therefore, the classification of depressive disorders and their criteria is presented in the second section of this paper, especially in view of the diagnosis of depressive disorders in cancer patients. The comparison of the multidimensional fatigue construct and depression shows a strong overlap of symptoms. None of the fatigue symptoms are specific for fatigue, all being elements of depressive syndromes. It is in particular the psychological symptoms of depressive disorders that differentiate between the two concepts. To that end, the question is discussed whether fatigue in its current conceptualization can be defined as a diagnostic entity independent of depressive disorders. Additionally, research approaches are presented from the area of the chronic fatigue syndrome and neurasthenia, which could be adapted to cancer-related fatigue and help to clarify the clinical differences between fatigue and depression. In order to ensure better differential diagnostics in the future, criteria-orientated research in particular is needed.
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PMID:The concepts of fatigue and depression in cancer. 1511 68

While symptom distress can alter the cancer experience, it is difficult to define and measure. This study's aims were (1) to determine whether the McCorkle Symptom Distress Scale (SDS) or the Rhodes Adapted Symptom Distress Scale (ASDS) was the more accurate measure of symptom distress in women with breast cancer; (2) correlate both scales with a visual analogue scale (VAS) measuring anxiety, a symptom frequently reported clinically; (3) determine tool preference; and (4) establish when during the first cycle of chemotherapy the highest levels of symptom distress were experienced. One hundred twenty women were recruited and measurement of symptom distress (SDS and ASDS) and anxiety (VAS) taken at the start of chemotherapy (Time 1), at the nadir (Time 2), and at the end of the cycle (Time 3). Both instruments were highly correlated and detected change over time; none was correlated with the VAS anxiety scale. Symptom distress scores were generally low, with fatigue, appearance, insomnia, and concentration causing the greatest distress. Other factors like functioning, body image, and menopausal symptoms cited as contributors to symptom distress levels were not measured and could account for low scores and perhaps suggest that symptom distress may not be accurately measured in today's women with early-stage breast cancer.
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PMID:Measurement of symptom distress in women with early-stage breast cancer. 1525 72

The control, and ideally prevention, of symptoms such as pain, depression, and fatigue is dependent on a comprehensive clinical assessment. Furthermore, to advance the science of this field, symptom research requires the use of multidimensional instruments with proven validity and reliability in a cancer population across the lifespan. Studies demonstrate a significant correlation among pain, depression, fatigue, and other symptoms commonly seen throughout the course of cancer. Therefore, multidimensional scales incorporating the most common symptoms would ensure systematic assessment. Optimally, valid and reliable tools that measure symptom clusters would be feasible for use in both clinical and research settings. Currently available instruments that measure symptom clusters include the Edmonton Symptom Assessment Scale, the M.D. Anderson Symptom Inventory, the Memorial Symptom Assessment Scale, the Rotterdam Symptom Checklist, the Symptom Distress Scale, and others. Special populations include cancer patients with advanced disease, where symptom prevalence is expected to increase. Newer tools that attempt to address these populations are the Brief Hospice Inventory and the Hospice Quality of Life Index, appropriate for cancer patients with more advanced disease. Each of these tools has demonstrated utility in measuring symptom severity and quality of life. Few scales have been validated in the measurement of symptom clusters in children, in cognitively impaired adults, or in non-English speaking patients from various cultural backgrounds. The strengths and limitations presented in the clinical and research uses of each these instruments will be presented, as will be areas for future investigation.
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PMID:Assessment of symptom clusters in people with cancer. 1526 48

There is not yet sufficient evidence-based experience for the coordinated treatment of three symptoms that cluster in cancer: pain, depression, and fatigue. Each symptom taken individually has accepted treatment modalities. With some overlap between these symptoms, established treatments for one symptom may "cross-over" and reduce the burden of one, or both of the others. To optimize patient care in advance of the evidence basis, attention to these symptoms is value-added for patients and their families. Standardized screening using the Distress Thermometer for physical, practical, emotional, or spiritual symptoms helps effectively identify patients whose symptoms warrant attention. Cancer Supportive Services, an innovative program at the Continuum Cancer Centers of New York at Beth Israel and St. Luke's-Roosevelt, provides comprehensive intervention throughout the trajectory of care for pain, depression, and fatigue. These services are provided in tandem with efforts to cure or contain the cancer. Cancer Supportive Services sets up a natural entry point to survivors' follow-up or end-of-life care. Such an effort reinforces a basic principle that active symptom management is integral to each patient encounter in the cancer treatment setting.
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PMID:Treatment of symptom clusters: pain, depression, and fatigue. 1526 52

We evaluated stress during "restraint with gnawing (R+G+)" and "restraint without gnawing (R+G-)" in a mouse system. R+G- induced a higher serum glucocorticoid level than R+G+. Zena F-III (a nutritive-tonic drink prescribed as "Kampo", a traditional Japanese medicine with its origin in Chinese medicine) reduced the glucocorticoid elevation in R+G+, but not in R+G-. These results support the hypotheses that (i) activity, such as gnawing, which potentially leading to escape from distress, reduces the severity of emotional distress and (ii) Zena F-III reduces the severity of mental or emotional fatigue, or increases motivation, in a stressful situation that the animal can manage itself.
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PMID:Effect of a nutritive-tonic drink on stress-induced serum glucocorticoid in the mouse. 1567 91

In a majority of clinical trials in upper respiratory tract infections (URTIs), it is now standard to include a measure of health-related quality of life (HRQOL) as a key outcome, and numerous clinicians are now adding QOL to routine clinical assessments. Because of this, the design of a disease-specific instrument for URTIs that has strong measurement properties and is more sensitive to minute changes is of great value in having an appropriate perception of what value patients put on their QOL and how changes in these values correlate with positive or negative progress in health. This is an attempt to show the significance and effects of URTIs on the affected patient and the potential genesis in the construction of a HRQOL evaluative tool named QOLAURTI, which, if eventually tested for interpretability with positive results, will measure fluctuations in a patient's QOL score that will correlate with minute but significant, moderate, or huge improvement or decline in a patient's QOL and also help in treating illness of URTI origin by classifying severity of illness. Relevant articles retrieved through PubMed and MEDLINE were cited to describe the impact of URTIs. Current published and available references outlining ways to construct an effective evaluative instrument that is based on the specific disease state and its impact on affected patients are employed to help construct a QOL questionnaire that could be effective in measuring the QOL of an affected patient. The construction of a potentially effective evaluative tool was achieved and is included here. However, since this tool was not tested due to inadequate numbers of test subjects and facilities required, its reliability, validity, and interpretability cannot be determined as of yet. Patients with URTIs are usually troubled by nasal symptoms and other symptoms including fatigue and headache. It can be inferred that suffering from these symptoms concomitantly can cause quite severe impairments of normal daily human protocol including physical, occupational, and social functioning and can also cause emotional distress. Because of the importance of the potential impact of these symptoms on affected individuals, a closer look into how these symptoms affect the HRQOL of an individual is important. The main goal in treating patients with URTIs is to make sure that all individual patient problems are recognized so that they can be treated properly. To achieve this, it is important to measure QOL. Research has shown that generic health-status questionnaires are able to compare burden of illness across different medical conditions but that they are not usually responsive enough to small but clinically essential changes in patients' QOL. Because of this, it is important to have a disease-specific instrument for URTIs that can measure the QOL of the affected individual. The main importance in measuring the QOL of the affected individual would be in assessing the potential effectiveness of drug therapies and treatment protocols used in treating URTIs.
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PMID:The evaluation of upper respiratory tract infection symptoms to show the significance of developing a quality-of-life evaluation instrument for upper respiratory tract infections to assess respiratory disorder-related disability. 1576 32

This review discusses the clenching-grinding spectrum from the neuropsychiatric/neuroevolutionary perspective. In neuropsychiatry, signs of jaw clenching may be a useful objective marker for detecting or substantiating a self-report of current subjective emotional distress. Similarly, accelerated tooth wear may be an objective clinical sign for detecting, or substantiating, long-lasting anxiety. Clenching-grinding behaviors affect at least 8 percent of the population. We argue that during the early paleolithic environment of evolutionary adaptedness, jaw clenching was an adaptive trait because it rapidly strengthened the masseter and temporalis muscles, enabling a stronger, deeper and therefore more lethal bite in expectation of conflict (warfare) with conspecifics. Similarly, sharper incisors produced by teeth grinding may have served as weaponry during early human combat. We posit that alleles predisposing to fear-induced clenching-grinding were evolutionarily conserved in the human clade (lineage) since they remained adaptive for anatomically and mitochondrially modern humans (Homo sapiens) well into the mid-paleolithic. Clenching-grinding, sleep bruxism, myofacial pain, craniomaxillofacial musculoskeletal pain, temporomandibular disorders, oro-facial pain, and the fibromyalgia/chronic fatigue spectrum disorders are linked. A 2003 Cochrane meta-analysis concluded that dental procedures for the above spectrum disorders are not evidence based. There is a need for early detection of clenching-grinding in anxiety disorder clinics and for research into science-based interventions. Finally, research needs to examine the possible utility of incorporating physical signs into Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition posttraumatic stress disorder diagnostic criteria. One of the diagnostic criterion that may need to undergo a revision in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition is Criterion D (persistent fear-circuitry activation not present before the trauma). Grinding-induced incisor wear, and clenching-induced palpable masseter tenderness may be examples of such objective physical signs of persistent fear-circuitry activation (posttraumatic stress disorder Criterion D).
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PMID:The clenching-grinding spectrum and fear circuitry disorders: clinical insights from the neuroscience/paleoanthropology interface. 1578 58

The purpose of this study was to determine the effect of coronary artery bypass graft (CABG) surgery on the quality of life of women. Wilson and Cleary's conceptual model of health-related quality of life, which examines five major outcomes (biological variables, symptom status, functional status, general health perceptions, perceived quality of life), was used. Participants included 61 women who provided information by self-report questionnaires before and three months after surgery. The major findings of the study are that women had significantly improved quality of life (p = .004) due to increased satisfaction with health and functioning (p < .001) at three months following CABG surgery. They experienced less angina (p < .001) and shortness of breath (p = .014), although fatigue was unrelieved for the majority of women. Psychological well being improved after surgery for most women (p < .001), with lower anxiety levels (p < .001), greater levels of well being (p = .021), feelings of health (p < .001) and vitality (p = .023). Women reported less use of emotive coping (p = .043), indicating less emotional distress. Nevertheless, 25% of the sample continued to experience severe psychological distress three months after surgery, indicating the need for continued follow-up.
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PMID:Quality of life in women following coronary artery bypass graft surgery. 1917 51


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