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

A total of 187 random cases of untreated idiopathic scoliosis, seen from a minimum of 15 to a maximum of 47 years after the end of growth, were reviewed. All curves increased after skeletal maturity (average progression: 0.4 degrees per year). Thoracic curves tend to progress more than lumbar, lumbar more than thoracolumbar, and thoracolumbar more than double major curves. Pain was present in 114 cases (61%) and appeared more frequently in women, after pregnancies, and with fatigue. Cardiopulmonary symptoms were present in 42 patients (22%), especially those with thoracic and thoracolumbar curves greater than 40 degrees. Psychologic disturbances were found in 35 cases (19%), mostly female patients with thoracic curves greater than 40 degrees. The cosmetic appearance of these patients at long-term follow-up was better compared with that at the end of growth, even though the curves progressed. Patients with decompensation of the trunk at the end of growth seemed to improve with time. In an unselected group of patients with severe curves a mortality rate of 17% was found, twice as much as in the Italian general population.
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PMID:Natural history of untreated idiopathic scoliosis after skeletal maturity. 381 Feb 93

Malignant histiocytosis (MH) is a disease which clinically and histologically resembles non-Hodgkin lymphoma. Tumoural cells appear to be derived from histiomonocytes. Clinical signs commonly include: high fever, sudden onset of extreme fatigue, diffuse painful polyadenopathies and infiltrated cutaneous nodules. This study involved the radiological findings of 23 pediatric cases of MH. Thoracic involvement is very frequent (69%) and most often involves mediastinal lymph nodes. Interstitial (34%) and pleural (38%) lesions are often associated. Nine of 21 (42%) lymphographies showed pathologic changes, the most frequent pattern in retroperitoneal nodes was multilacunar and nodes were moderately enlarged. Some isolated lymph nodes were normal. Bone lesions were rare and were either lytic or sclerotic.
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PMID:Radiological findings in 23 pediatric cases of malignant histiocytosis (MH). 684 Jan 8

We tested the hypothesis that electrical stimulation of respiratory muscles can be obtained from intramuscular electrodes. In acute anesthetized dogs, suture-type intramuscular electrodes were placed in each hemidiaphragm and needle electrodes were placed in various intercostal regions of the thorax. During a hyperventilation induced period of apnea a 2-second stimulation was applied to the diaphragm or to the thoracic electrodes, followed by a combined thoracic-diaphragm stimulation period. Thoracic expansion and tidal volumes were measured as indices of inspiratory effort. We found that diaphragm stimulation produced tidal volumes between 104% and 180% of spontaneous breathing. Electrodes in the upper thorax produced chest expansion and when combined with diaphragm stimulation increased tidal volumes (p < .05). We conclude that intramuscular electrodes represent a feasible method for long-term electrogenic ventilation. Also, thoracic support for diaphragm pacing in quadriplegics could produce a more effective long-term system that is less prone to fatigue and failure.
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PMID:Diaphragm and accessory respiratory muscle stimulation using intramuscular electrodes. 771 21

The American Thoracic Society (ATS) has formulated guidelines for spirometry. We hypothesized that individuals with SCI (SCI), as a result of weak respiratory muscles, would exhibit poor test acceptability and reproducibility. Seventy-eight SCI subjects (39 with complete SCI) answered a respiratory questionnaire and performed spirometry. Of those with complete SCI, the proportion of subjects which met ATS criteria decreased with higher levels of injury. Poor test performance was not associated with age, respiratory symptoms or muscle fatigue. The most common reason for failing to meet ATS criteria for acceptability was excessive back extrapolated volumes (EBEV). Individuals with efforts that were acceptable except for EBEV and/or for exhalation of less than six seconds had values for forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) that were reproducible. If ATS criteria for acceptable spirometry were used in studying subjects with SCI, individuals producing otherwise reproducible values for FVC and FEV1 would be excluded. We found reproducibility similar to what has been reported in other cohorts and conclude that longitudinal study of respiratory function in SCI is feasible.
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PMID:Spirometry--acceptability and reproducibility in spinal cord injured subjects. 827 Sep 15

So-called carcinosarcoma of the esophagus is rare malignant tumors composed of carcinoma and sarcomataous components. We described a case of so-called carcinosarcoma and reviewed some literature. A 67-year-old man visited our hospital because of difficulty in swallowing, general fatigue, and sore throat. Barium swallow esophagogram showed a large polypoid lesion in the middle, lower thoracic esophagus. Endoscopy also demonstrated a pedunculated polypoid tumor. Histological examination of the biopsy specimen revealed malignant findings. Thoracic esophagectomy with cervical, thoracic, abdominal dissection was performed. A polypoid tumor, 10.5 x 5.2 x 3.5 cm in size, was removed. In the polypoid lesion, spindle-shaped cells made interlacing bundles similar to sarcoma and surrounded nests of squamous cell carcinoma. Near the pedicle, squamous cell carcinoma invaded muscularis mocosae. And lymph node metastasis was detected. Epitherial membrane antigen (EMA) was detected in some parts of the polypoid lesion. So according to Guide Lines for Clinical and Pathological Studies on Carcinoma of the Esophagus, this case was diagnosed as so called carcinosarcoma.
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PMID:[A case of so-called carcinosarcoma of the esophagus]. 855 Oct 76

Respiratory therapy, consists in the administration of gases or drugs via airways; it includes: oxygen, humidity, aerosol therapy, IPPB, chest physiotherapy and mechanical ventilation. Asthmatic patients frequently require oxygen support which is delivered by low and high flow systems, for best results, gases must be humidified, either by bubble or wick humidifiers, heat increases usefulness. Spray is produced by nebulizers and metered dose inhalers, the last are cheaper but they need a certain grade of coordination. Powder inhalers are easier to use. IPPB is indicated in patients with severe fatigue, this method is used sporadically. Chest physiotherapy teaches utilization of relaxation and inferior thoracic respiration techniques. Thoracic percussion must be avoided in an asthmatic crisis. Mechanical ventilation is delivered through a large bore canule, its goal is to assure an adequate gas exchange and to avoid respiratory muscular fatigue.
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PMID:[Inhalation therapy in asthma]. 900 2

Chronic airflow limitation (CAL) is a major contributor to the burden of ill-health in Australia and, where hypoxia is present, can be treated with home oxygen therapy (HOT). At Flinders Medical Centre, a prospective longitudinal study was undertaken to examine the impact of HOT on the health-related quality of life (HRQoL) of subjects with CAL. All eligible adult patients, aged < 80 yrs, with a primary diagnosis of CAL who met the prescription guidelines of the Thoracic Society of Australia and New Zealand were offered HOT and invited to participate. After baseline assessment, subjects were followed-up 3, 6 and 12 months after commencement of HOT. Physiological assessment and three validated HRQoL measures were applied, the Nottingham Health Profile (NHP), the Chronic Respiratory Questionnaire (CRQ) and, for a subset of the patients, the Medical Outcomes Study short-form 36-item questionnaire (SF-36). This study reports the results from January 1, 1991 to July 31, 1997. One hundred and fourteen CAL patients were included in the study. Female subjects experienced significant improvements from baseline in the energy, emotional reactions, sleep and physical mobility areas of the NHP, in the fatigue, emotional function and mastery dimensions of the CRQ and in the role-physical, vitality, role-emotional, and mental health dimensions of the SF-36. Males experienced significant improvements in the emotional reactions, sleep and social isolation areas of the NHP, in the fatigue dimension of the CRQ and in the vitality dimension of the SF-36. Some of the improvements in the various domains persisted for > 6 months. Female patients prescribed home oxygen therapy appear to have a greater overall improvement in health-related quality of life and survival than males. Follow-up is continuing.
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PMID:Effects of long-term oxygen therapy on quality of life and survival in chronic airflow limitation. 1039 40

The incidence of Mycobacterium avium complex (MAC) pulmonary disease in HIV-negative patients was studied prospectively from January 1, 2000 to December 31, 2002 through 32 sentinel sites distributed all over France. Among the 275 patients who yielded MAC isolates from respiratory clinical specimens, 101 (36.7%) met the bacteriological, radiographical and clinical criteria established by the American Thoracic Society for nontuberculous mycobacterial respiratory disease. Of these 101 patients, 81 had underlying lung disease, mainly previous tuberculosis, bronchectasis or chronic obstructive pulmonary disease. Among the 20 patients with no underlying lung disease, 12 had a predisposing factor such as leukaemia or immunosuppressive treatment and eight had no predisposing factor. All patients with MAC respiratory disease had clinical symptoms, commonly cough and fatigue, and 52 (51.5%) were sputum smear positive for acid-fast bacillus. The ratio of patients with Mycobacterium avium complex pulmonary disease to patients with pulmonary tuberculosis in France was estimated to be 3% and the incidence of Mycobacterium avium complex pulmonary disease in France was 0.2 per 100,000 inhabitants.
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PMID:Sentinel-site surveillance of Mycobacterium avium complex pulmonary disease. 1631 41

In laparoscopic surgery, the way of thinking about operating room design is beginning to include ergonomic requirements. No study has yet been published about ergonomic concerns in Video-Assisted Thoracic Surgery (VATS). The aim of this paper is to describe ergonomic issues encountered in VATS and to propose recommendations for operating room design for thoracoscopic surgery. To obtain an inventory of the ergonomic problems fifteen thoracoscopic operations were attended at the Institut Mutualiste Montsouris (Paris, France). Ergonomics can be divided into three divisions: physical, perceptual and cognitive ergonomics. During the observations of thoracoscopic operations the physical problems were registered. The perceptual and cognitive problems were obtained from a literature study. In general two different positions of the surgeon can be distinguished, depending on the placement of the trocars and the endoscope. One position resembles the body position during laparoscopy, involving the same problems such as fatigue of the legs, a static body position, a large working area, extreme movements of the upper limbs and the wrist and stiffness of the neck. The other position is specific for VATS resulting in a rotated upper body while the surgeon has to lean over the patient to be able to handle the instruments. This awkward position causes even more serious problems. The study resulted in a list of ergonomic problems encountered during VATS. Reorganisation of the operating room set-up and monitor position, design of a dedicated operating table and specific instruments might help to overcome the current ergonomic problems.
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PMID:Ergonomic problems encountered during video-assisted thoracic surgery. 1675 3

Here we report a case of a primary idiopathic chylopericardium in a 13 years old child. Pericardial effusion was diagnosed because the child suffered chest pain and fatigue. Pericardial drainage was performed and 800mL of chylous fluid was evacuated. Extensive investigations were performed but no cause could be found. Thoracic CT scan, lymphoscintigraphy and MRI did not evidence any communication between the thoracic duct and pericardium. After 2 recurrences of pericardial effusion while the child was on a medium chain triglycerides regimen, it was decided to ligate the thoracic duct and to do a partial pericardectomy. The result was excellent with complete resolution of the pericardial effusion and no recurrence since 3 years.
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PMID:[Spontaneous idiopathic chylopericardium in childhood]. 1680 50


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