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

Intermittent claudication may occur in well-conditioned athletes because of an unusual form of popliteal artery entrapment that results from overtraining. These patients complain of calf muscle cramping, rapid limb fatigue, and occasional paresthesias on the plantar surface of the foot when running on inclines or when repetitive jumping is performed. Results of plethysmographic screening tests for popliteal entrapment are positive in these patients. Magnetic resonance angiography and intravenous digital subtraction angiography studies, however, do not demonstrate findings typical of anatomic popliteal entrapment. No evidence exists of aberrant positioning of the popliteal artery in foot neutral positioning, but with forced plantar flexion, the neurovascular bundle is deviated and compressed laterally. Surgical exploration of the popliteal fossa demonstrates no obvious musculotendinous abnormality. Symptoms of claudication and arterial compression are relieved by surgical release of the soleus muscle from its tibial attachments, resection of its fascial band, and resection of the plantaris muscle.
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PMID:Popliteal entrapment as a result of neurovascular compression by the soleus and plantaris muscles. 173 89

Takayasu's arteritis is an inflammatory condition affecting the large arteries. While most reported cases are from Latin America and the Orient, the disease has a worldwide distribution. Patients frequently complain of claudication, arthralgias and fatigue, and physical examination is remarkable for vascular bruits and pulse deficits. The diagnosis is established by angiography and a typical clinical presentation. Prednisone is adequate treatment in the majority of patients. Cyclophosphamide and vascular bypass surgery are reserved for more severe cases. Two cases identified in western South Dakota are presented followed by a detailed literature review.
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PMID:Takayasu's arteritis in western South Dakota. 197 9

To determine whether foot transcutaneous oxygen tension (TcPO2) and ankle systolic blood pressure (SBP) measure similar aspects of peripheral vascular occlusive disease (PVOD), the authors examined their relationship at rest and following treadmill exercise. Thirty-seven PVOD patients (mean age 69.2 +/- 0.8 years) rested supine for twenty minutes, followed by a progressive treadmill walking test at a constant speed of 2 mph. The initial grade was 0%; this increased 2% every two minutes until maximal claudication pain (n = 19) or until the occurrence of such limiting symptoms as volitional fatigue (n = 6), ST segment depression (n = 4), dyspnea (n = 3), multiple premature ventricular contractions (n = 2), and angina (n = 2). Patients then rested supine for fifteen minutes. Foot TcPO2 was recorded before, during, and after exercise, whereas ankle SBP was measured before and after exercise. At rest, a curvilinear relationship was found between foot TcPO2 and ankle SBP (foot TcPO2 = 41.89 + 0.22(ankle SBP) + 0.0005 (ankle SBP2); SEE = 9.2, R = 0.64, R2 = 0.41, p less than 0.001). In contrast, the relationship was stronger and more linear during recovery, particularly at the sixth minute (foot TcPO2) = 8.33 + 0.35 (ankle SBP); SEE = 13.6, R = 0.86, R2 = 0.73, p less than 0.001). At rest, foot TcPO2 and ankle SBP characterized different aspects of PVOD because they shared only 41% common variance. During recovery, they provided similar information because up to 73% of the variance was shared. It is concluded that foot TcPO2 should also be used to assess PVOD patients because unique information is obtained at rest and values can be recorded during exercise.
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PMID:Relationship between foot transcutaneous oxygen tension and ankle systolic blood pressure at rest and following exercise. 204 97

Cardiovascular rehabilitation is defined as the process of development and maintenance of a desirable level of physical, social, and psychologic functioning after the onset of a cardiovascular illness. Patient education, counseling, nutritional guidance, and exercise training play prominent roles in the process of rehabilitation. Benefits from cardiac rehabilitation include improved exercise capacity and decreased symptoms of angina pectoris, dyspnea, claudication, and fatigue. Recent pooled data regarding exercise training after myocardial infarction demonstrated a 20 to 25% reduction in mortality and major cardiac events. Exercise training may result in an improvement in systemic oxygen transport, a reduction in the myocardial oxygen requirement for a given amount of external work, and a decrease in the extent of myocardial ischemia during physical activity. The efficacy of modification of risk factors in reducing the progression of coronary artery disease and future morbidity and mortality has been established. Herein we review the history, current practice and results, and future challenges of cardiovascular rehabilitation.
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PMID:Cardiovascular rehabilitation: status, 1990. 219 53

Various non-invasive methods exist for evaluating the cardiac status of patients presenting for peripheral vascular surgery. Methods involving exercise on a treadmill are frequently used, but adequate testing may be limited in amputees and patients with severe claudication or rest pain. An alternative means of exercise is the arm ergometer. A study of 130 patients subjected to arm ergometer exercise testing before peripheral vascular surgery was undertaken. A control group of 29 consecutive patients had coronary angiography. ECG exercise testing using the arm ergometer showed a sensitivity for detecting coronary artery disease of 46% and a specificity of 100%. In total, 42 tests were positive, 21 on patients with no symptoms of ischaemic heart disease and no resting ECG changes indicative of ischaemia, and 4 in patients with atypical angina. Muscle fatigue proved a problem, especially in women; while the accuracy of the test did not decline in patients over the age of 60 years when compared with those under this age.
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PMID:The arm ergometer exercise test for evaluating coronary artery status in patients presenting for peripheral vascular surgery. 228 76

A review of metabolic pathways is presented, which are involved in muscular energy production during hypoxia according to recent experimental findings. By means of own exercise examinations the course of reactions providing ATP anaerobically in the muscles of limbs with poor circulation is analysed. Therefore, the arteriovenous differences in the concentrations of lactate, pyruvate, ammonia, hypoxanthine and alanine in the femoral blood of patients with stage II AOD were determined. In addition, the intracellular phosphorus compounds ATP, PCr and Pi as well as the tissue pH were measured noninvasively in the calf muscles using 31P magnetic resonance spectroscopy. The results give evidence for marked activation of the creatine kinase reaction, of glycolysis, of the myokinase reaction and of the purine nucleotide cycle in the ischaemic musculature at loads of short duration, which are in total sufficient to maintain the concentration of ATP even during claudication pain. In spite of salvage pathways like alanine formation, the end products of these "emergency reactions", Pi, H+ and NH4+, accumulate and exert deleterious cytotoxic effects, which are thought to be responsible for rapid muscle fatigue and claudication pain in PAOD.
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PMID:[Regulation of ischemic muscle metabolism in peripheral arterial occlusive disease]. 267 1

Exercise testing is traditionally performed with leg exercise on either a treadmill or a bicycle ergometer. Many of these tests are terminated before dyspnoea occurs because of leg fatigue, arthritic pain, or claudication. A study was carried out to determine whether arm ergometry testing might serve as an alternative method to leg testing in eight patients with chronic obstructive lung disease. The patients had mild to moderate dyspnoea on exertion and required bronchodilator treatment. They had smoked an average of 62 pack years and had a mean FEV1 of 1.88 l. Arm and leg ergometry yielded similar levels of maximum ventilation (arm 47.2, leg 48.6 l/min), maximum heart rates (126 v 124 beats/min), maximum tidal volume (1.5 v 1.6 l), and respiratory rate (30 v 29 breaths/min); but maximum oxygen consumption (1120 v 966 ml/min), maximum power output (62 v 26 w), and oxygen pulse (9.1 v 7.8 ml/beat) were all higher with leg than with arm ergometry. In addition, ventilation and heart rate at a given level of oxygen consumption were higher for arm than for leg work during both submaximal and maximal exercise. It is concluded that arm ergometry offers an alternative testing method to leg testing in patients with moderate chronic obstructive lung disease.
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PMID:Comparison of arm and leg ergometry in patients with moderate chronic obstructive lung disease. 322 62

During 1984 and 1985, blood samples were obtained from 271 dogs that were suspected of having borreliosis. The dogs lived in areas known to be infested with ticks and had been examined because of limb/joint disorders or for unknown illnesses marked by fever, anorexia, or fatigue. Lameness had been the most frequently reported clinical manifestation. Analyses of serum specimens, by an indirect fluorescent antibody (IFA) method or by an ELISA, detected antibodies to Borrelia burgdorferi, the etiologic agent of borreliosis in dogs and of Lyme disease in human beings. Antibody to B burgdorferi was detected in 76.3% of 114 specimens from dogs living in the lower Hudson Valley region of New York State (predominantly Westchester County), in 66.5% of 155 specimens from dogs from southern Connecticut, and in single specimens from dogs from Rhode Island and California. Geometric mean antibody titers peaked during the winter. Results of IFA tests and ELISA were in agreement, but the latter method yielded less variable results, had greater sensitivity, and was more easily standardized. Five dogs from New York State and Connecticut seropositive to B burgdorferi had developed kidney disorders during or after episodes of intermittent lameness. Application of murine monoclonal antibody in an IFA procedure verified the presence of B burgdorferi in renal cortical tissues from one dog.
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PMID:Clinical and serologic studies of canine borreliosis. 331 89

Aerobic conditioning exercises have been shown to be beneficial for maintenance hemodialysis patients, but biochemical changes during exhaustive exercise in these functionally anephric patients have been less thoroughly studied. We evaluated serum biochemical changes in 7 patients during and after treadmill exercise to patient exhaustion. Duration of exercise was limited by lower leg fatigue without claudication. At exhaustion, only mild changes from baseline rest values were noted in arterial pH (7.39 +/- 0.03-7.33 +/- 0.04) and lactate (0.94 +/- 0.3-5.73 +/- 2.68 mmol/l) despite normal exercise-induced intracellular fluid shifts as evidenced by albumin concentration increases (44.9 +/- 2.8-49.3 +/- 3.1 g/l). Increases in serum K+ concentrations are also modest (change in K from baseline = 0.87 +/- 0.22 mmol/l). An explanation for these minimal biochemical alterations at exhaustion is unclear, but could relate to exercise being limited well below estimated maximum cardiac output and muscle O2 extraction levels by early, unexplained muscle fatigue. Fatigue in hemodialysis patients does not appear to be due to muscle hypoxia.
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PMID:Fatigue, acid-base and electrolyte changes with exhaustive treadmill exercise in hemodialysis patients. 360 Sep 12

Giant-cell or temporal arteritis is a generalized vasculitis that predominantly affects large- and medium-sized arteries in people over 50 years of age. The illness is commonly characterized by the initial symptoms of headache, temporal artery tenderness or pulselessness, musculoskeletal pain, fever, and fatigue. The most dreaded consequence of giant-cell arteritis is visual loss, which is usually irreversible on presentation. Giant-cell arteritis may present with unusual clinical manifestations such as lip, scalp, and tongue necrosis, carpal tunnel syndrome, claudication of the limbs, strokes, angina pectoris, myocardial infarction, hematuria, cough, or other CNS symptoms. The etiology of the disease is unknown. Emergency physicians are usually familiar with the more common clinical symptoms but one must consider the unusual manifestations of the disease, because early recognition and initiation of therapy (steroids) decrease morbidity and can prevent blindness.
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PMID:Giant-cell arteritis. 379 80


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