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

Ondansetron was compared with metoclopramide for antiemetic efficacy in a randomised double-blind trial in 122 patients with advanced breast cancer. All patients were treated with epirubicin (greater than 50 mg/m2) and cyclophosphamide (greater than 500 mg/m2). 50 patients receiving ondansetron and 60 with metoclopramide were considered evaluable. Ondansetron was at least as effective as metoclopramide in the control of vomiting and nausea. The percentage of patients with complete plus major control was 72% (59-85%) vs. 61% (48-74%) on day 1 (P = 0.230) and 79% (67-91%) vs. 66% (53-78%) on days 2-3 after chemotherapy (P = 0.122). Over the 3-day study period, nausea was absent or mild in 60% of the patients treated with ondansetron, compared to 45% given metoclopramide (P = 0.064). No major drug-related side-effects were reported. 1 patient receiving ondansetron experienced gastrointestinal disturbance and headache. Episodes of diarrhoea, fever, hyperkinetic syndrome, fatigue, restlessness and migraine with vomiting were reported by 5 patients treated with metoclopramide. None of the changes in the biochemical or haematological parameters was attributed to the antiemetic treatments.
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PMID:Double-blind randomised trial of the antiemetic efficacy and safety of ondansetron and metoclopramide in advanced breast cancer patients treated with epirubicin and cyclophosphamide. 183 24

This report describes the relationship between sleep and cognitive function in children. As reviewed, the empiric data to directly address the effects of sleep loss or disruption on children's cognitive function are quite sparse. However, a wide range of clinical and observational data support a general picture that inadequate sleep results in tiredness, difficulties with focussed attention, low threshold to express negative affect (irritability and easy frustration), and difficulty modulating impulses and emotions. In some cases these symptoms may resemble attention deficit hyperactivity disorder. These findings are discussed in relation to a model of sleep loss influencing prefrontal cortex including executive functions involved in the control of attention and emotions.
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PMID:The impact of inadequate sleep on children's daytime cognitive function. 879 41

The need for empirical, objective, clear, and practical outcome measures for therapy has long been recognized by clinicians and researchers. Pragmatic tools for objective determination of the efficacy of therapy have been scarce in clinical practice settings. Heart rate variability (HRV) is increasing in popularity for use in clinical settings as a measure of treatment success. Since HRV is stable and placebo-free, it has the potential to meet this need. Thirty-nine cases are presented from the clinical practices of the authors and three other clinicians where HRV was used as an outcome measure for Thought Field Therapy (TFT). The cases included TFT treatments which addressed a wide variety of problems including phobias, anxiety, trauma, depression, fatigue, attention deficit hyperactivity disorder, learning difficulties, compulsions, obsessions, eating disorders, anger, and physical pain. A lowering of subjective units of distress was in most cases related to an improvement in HRV.
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PMID:Heart rate variability as an outcome measure for Thought Field Therapy in clinical practice. 1152 7

Attention Deficit Hyperactivity Disorder (ADHD) is a relatively frequent affection that can generate severe problems (school, social, professional) if no take in charge is done. Treatment of ADHD is generally multifactorial; it can associate medical treatment, comportemental and analytical psychotherapies, reeducation of associated disorders (orthophony, psychomotor reeducation) and educative approach. Methylphenidate, considered as therapeutic reference, is a central nervous system stimulant. It produces a stimulation of vigilance and superior mental activities, a diminution of fatigue sensation and sleep need, an anorexigen power and sympathomimetic effect. Its mechanism of action is abundantly studied and is not completely known. Principal hypothesis are: increase of chemical mediators biodisponsibility and change in cerebral blood flow delivery. In France, it is agreed since 1995 for treatment of ADHD in over 6 years-old child. Ritaline 10 mg is registered on the narcotic list and an initial hospital prescription is needed, reserved to specialists and/or to neurologic, psychiatric and pediatric services. Mid-1995, 2.8% (namely 1.5 millions) of 5 to 18 years-old american children have taken this drug. Methylphenidate is effective on each three principal symptoms of ADHD: it decreases the level of activity, it improves apprentice capacity, just as school performances and it eases social interactions. The therapeutic schedule at short and middle term is reassuring, with substantial profits on school, familiar and social plans, but unknowns subsist and opinions diverge about long term efficacity. Methylphenidate is not the only one used in ADHD treatment. Other products, like dextroamphetamine and pemoline have been used in the USA and are for those who can't tolerate methylphenidate or badly respond to it. Those other drugs are not commercialized in France. The limits of stimulating drugs (fear to favour toxicomania, undesirable effects that need to stop treatment or non-responsive hyperactive children), just as positives experiences with antidepressants (especially on enuresis) led to use tricyclic antidepressants as second-line agents in ADHD treatment. Their efficiency is less and their well known side-effects are sometimes constraining. Antidepressants that inhibit serotonin recapture, MAOI and bupropion, central antihypertensive, such as clonidine and guanfacine have been tried in ADHD treatment as third-line agents. They should be useful on non-responsive or patients who can't tolerate stimulants or tricyclic antidepressants. Analytical and comportemental psychotherapies are used in addition to medicamental treatment. Reeducation of troubles such as dyslexia, language delay, corporal scheme troubles or fine coordination trouble is obtained by orthophony and psychomotricity. It's very important to instaurate an educative strategy in order to contend inattention and hyperactivity. Regular conservations with parents and child are necessary. The whole american literature shows better efficiency of multimodal treatment of ADHD in child, as opposed to single stimulant treatment.
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PMID:[Prescribing ritalin in combined modality management of hyperactivity with attention deficit]. 1176 Jun 93

This study used a double-dissociation design to evaluate whether children with ADHD demonstrated specific deficits relative to children with Reading Disorders. Recent theory suggests that ADHD children have deficits in time perception and working memory, whereas RD children have deficits in phonological decoding. The performance of 113 clinic-referred children aged 6-11 was examined using measures of working memory, phonological processing, and time perception. Respondents completed two time production tasks in which they were to judge when 30-s had elapsed, and another in which they were asked to estimate the duration of the Conners' CPT (CCPT). Time Perception and phonological processing variables were submitted to a 2 x 2 ANCOVA (ADHD vs. RD), covarying for age, SES, IQ, and working memory. Children with ADHD were more likely to overestimate the time taken for the CCPT than children without ADHD, but no group differences were found on the 30-s estimation tasks. Children with RD did not display deficits in time estimation, but showed deficits in auditory phonological processing. The lack of interaction effects supported an "etiological subtype" over the "phenocopy" model of ADHD and RD. No group differences were detected using the CCPT. Although our previous studies did not find an order effect for the Conners' CPT in a 1-hr battery, a fatigue effect was evident with a 1.5-hr battery. The implications for Barkley's behavioral inhibition theories (R. Barkley, 1997) are discussed.
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PMID:Time perception: does it distinguish ADHD and RD children in a clinical sample? 1550 28

A failure to adapt to novel or changing environmental demands is a core feature of a wide variety of neuropsychiatric disorders as well as the normal states of stress and fatigue. We review the neurochemistry of cognitive control, which has been associated primarily with the prefrontal cortex. Many drugs affect the functioning of the prefrontal cortex, but the direction and extent of drug effects vary across individuals and tasks. Apparently paradoxical effects are often observed, where the same medication causes both cognitive enhancement as well as cognitive side effects. We review neurobiological research that is beginning to elucidate the nature of these contrasting effects and the factors underlying the large variability across individuals and behaviours. The work has considerable implications for the understanding of and treatment development for abnormalities such as Parkinson's disease, attention deficit hyperactivity disorder and drug addiction.
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PMID:Chemistry of the adaptive mind. 1553 74

Attention deficit hyperactivity disorder affects 3-5% of children in the USA, and is commonly accompanied by disrupted sleep in the form of insomnia, restless sleep or excessive daytime tiredness. In addition, daytime inattention and hyperactivity which mimicks attention deficit hyperactivity disorder can result from intrinsic sleep disorders such as obstructive sleep apnea or periodic limb movement disorder. In most cases, the correct clinical evaluation permits appropriate diagnosis and management. Current research investigating the relationship between attention deficit hyperactivity disorder and sleep, as well as general precepts of clinical assessment and treatment are reviewed.
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PMID:Assessment and treatment of disturbed sleep in attention deficit hyperactivity disorder. 1585 72

Poor outcomes in ADHD may be related to problematic social functioning and consequences of social rejection. This study examines how ADHD symptom expression affects mood and social rejection. Working from findings in depression that describe maintenance through negative interpersonal interactions, the authors seek to examine this theory's applicability to poor outcomes in ADHD. In a completely randomized design, 130 participants are exposed to one of several videotape segments that include displays of ADHD, depression, and social anxiety. A normal control is also used. All abnormal videotapes are met with greater rejection than the control. Displays of ADHD elicit similar levels of rejection to those elicited by displays of depression. Additionally, ADHD elicits greater levels of hostile mood, whereas depression elicits high levels of depression and fatigue. Implications for an interpersonal theory of vulnerability in ADHD are discussed along with implications for future research, prevention, and intervention.
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PMID:Social rejection and ADHD in young adults: an analogue experiment. 1600 61

This paper gives an overview of the pharmacology, efficacy, duration, tolerance, and side effects of atomoxetine for children, adolescents, and adults. A systematic analysis of the published clinical studies and poster abstracts was conducted. Atomoxetine is the first selective inhibitor of the noradrenaline transporter that was approved by the FDA in the US as a nonstimulant for the treatment of ADHD in children, adolescents, and adults. In clinical studies, its efficacy was studied in 4,000 patients. Compared with placebo, atomoxetine proved to be superior with respect to reducing impulsiveness, hyperactivity, and inattention. There are indications that its efficacy is comparable to that of methylphenidate. In general, atomoxetine was well tolerated. The most frequently reported adverse events were decrease of appetite, abdominal problems, tiredness, and vertigo. These were classified as mild and found mostly at the beginning of treatment. The existing results indicate that atomoxetine is promising for the treatment of ADHD in children, adolescents, and adults.
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PMID:[The effectiveness of atomoxetine in children, adolescents, and adults with ADHD. A systematic overview]. 1613 34

Smoking is highly prevalent among patients with Attention Deficit Hyperactivity Disorder (ADHD). Previous studies using the reversed continuous performance task (R-CPT) have suggested that nicotine reduces inattention. Since especially adults with ADHD have been claimed to suffer from a core deficit in inhibitory control, this study aimed at determining whether nicotine improves response inhibition in addition to attention. Sixteen healthy regular smokers participated in a pre/post treatment design in which transdermal patches containing 7 and 21 mg nicotine per day were administered in a counterbalanced, double-blind manner. In a second study, patches containing 0 mg (placebo) and 21 mg per day were administered to a different group of regular smokers. For replication purposes, the R-CPT and the profile of mood states (POMS) were administered. Furthermore, a different version of the continuous performance task (CPT-AX) and the stop-signal task, traditionally used to measure response inhibition, were presented. The high dose of nicotine was found to relieve self-reported Depression in Study 1 and Fatigue in Study 2. Performance data indicated acute effects of nicotine on attention-related, but not on inhibition-related measures. Especially the comparison with placebo revealed decreases in reaction time and variability of responding. The results imply that patients with ADHD smoke to reduce inattention.
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PMID:Acute effects of nicotine on attention and response inhibition. 1636 Aug 13


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