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

Patients present themselves with neurotologic symptoms which may be early and subtle indicators of active vestibular pathology. The frequently slighted complaints of light-headedness, imbalance and a floating sensation are as important as "true rotatory vertigo." Ear fullness, the most underinvestigated of neurotologic complaints may be a cardinal symptom. Occipital headaches are a frequent complaint of the dizzy patient. Blurred vision, and, in some severe peripheral disorders, diplopia are symptoms referrable to oculovestibular interaction. Visual stimulation intensifies vestibular symptoms. Stress may precipitate or increase dizziness in patients who have partially compensated for a vestibular deficit. Anxiety, fatigue and systemic illness are exemplary. Patient histories are presented to emphasize clinical relevance and therapeutic modalities.
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PMID:Underrated neurotologic symptoms. 67 46

Eight patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) and average resting Pao2 of 66 mm Hg were studied clinically and physiologically at sea level and after ascent to 1,920 m. At sea level the patients were symptomatic but not disabled. After ascent the patients had only mild symptoms of fatigue and insomnia, and one had severe headache during exercise on the first day. Funduscopic changes were not observed, nor did cardiac or pulmonary findings change. Resting sea level Pao2 dropped to 51.5 mm Hg within three hours of ascent, and the Paco2 fell from 37.8 to 33.9 mm Hg. Over the next three days, the Pao2 increased to 54.5 mm Hg as hyperventilation continued. At exercise, sea level Pao2 dropped from a mean value of 63 to 46.8 mm Hg at altitude. Pulse rates at rest or exercise did not change. Normal values for 2,3-diphosphoglycerate (2,3-DPG) did not change after ascent at 16 and 42 hours. We believe aircraft flight or travel to moderate altitudes for this type of COPD patient is safe. Preexisting hypoxemia resulting from disease may facilitate the adaptation of patients to severe hypoxia and may prevent symptoms similar to acute mountain sickness.
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PMID:Short-term adaptation to moderate altitude. Patients with chronic obstructive pulmonary disease. 68 52

Sixty-eight patients with giant cell arteritis (GCA) are described. In 42, histological evidence of arteritis was recorded at biopsy of a temporal artery. Twenty-six patients were included according to clinical criteria. In 20 patients the onset of illness was associated with an infection. The first symptom was: in 30 patients, muscle pains; in 14, fever; in 11, headache with temporal localization, and in 13 patients, tiredness and anorexia. In all, 50 patients had muscular symptoms and 30 had symptoms of localized temporal arteritis. In 5 patients neither muscular symptoms nor localized arteritis were found. A high erythrocyte sedimentation rate was seen in all cases and elevated platelet count was found in 24 patients. Abnormal liver function was a common finding, whereas impaired renal function was not observed. In 8 cases reversible eye symptoms were noted and reduced hearing capacity was demonstrated in 5 patients.
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PMID:Giant cell arteritis. Clinical features and involvement of different organs. 72 50

During the course of an obscure illness in a teenage girl it was eventually realized that the diagnosis was 'epidemic neuromyasthenia'. The illness which occurred between February and September 1976 was characterized by fatigue, pallor, headache, nuchal pain, alterations in mentation, dizziness, nausea and vomiting, paraesthesiae, weakness and heaviness of limbs, and a prolonged relapsing course. Investigation brought to light fourteen patients with similar symptoms--twelve female and two male. In view of the shortcomings of retrospective enquiries, especially those involving the assessment of notes made by other people, and the problem of trying to define a nonfatal illness with protean symptoms, many of a nonspecific nature, with few physical findings and negative laboratory studies, caution is necessary. Under these circumstances it is claimed on clinical epidemiological evidence that a diagnosis of 'epidemic neuromyasthenia' could be sustained confidently in three patients and probably in a fourth. Six patients were considered possible cases and four were rejected.
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PMID:'Epidemic neuromyasthenia' in Southwest Ireland. 74 20

Twenty-one patients with brucellosis wereinvestigated. Four patients with the classical manifestations of acute brucellosis presented no problems in diagnosis. The other 17 patients suffered from chronic disease and had no history of any acute episode of brucellosis. The most common symptoms in this group were tiredness, fatigue, depression, arthralgia and muscular pains. Abdominal pain and pain in the temperomandibular joints were marked in some patients. Most of these patients had been receiving psychiatric treatment. Clinical examination was largely negative, but lymphadenopathy was found in 9 cases. Brucella meningo-encephalitis was diagnosed in 7 patients who complained of severe headache. Problems in the diagnosis of chronic brucellosis with an insidious onset are discussed.
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PMID:Clinical aspects of chronic brucellosis. 81 22

Tick-borne encephalitis is transmitted by the tick ixodes ricinus. After the second world war an increase in the number of cases of encephalitis was observed and the neurotropic virus was isolated for the first time in 1948. Reservoir animals are mouse-like wild animals and also agricultural domestic animals. The infection is transmitted to humans through tick bites. It becomes apparent subjectively in headaches, vomiting, tiredness, giddiness and insomnia, and objectively in meningeal symptoms, extrapyramidal tremor, cerebellar ataxia, vestibular nystagmus and paresis. The treatment consists of strict rest in bed for 10 days at least and symptomatic support of the general health. Good results are obtained with antiedematous therapy with hydrocortisone or pyritinol.
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PMID:[Clinical picture of Central European tick-borne encephalitis (author's transl)]. 82 10

In 1148 cases the serum digoxin concentration (SDC) was correlated with the extracardiac signs of digitalis intoxication. There is a considerably overlap of SDC levels of patients with and without extracardiac signs of toxicity even though the mean SDC's of these two groups differ significantly. An increasing percentage of clinical intoxicated patients with increasing SDC levels was found at digoxin concentrations of 2.0 ng/ml and higher. At lower SDC levels patients with and without extracardiac signs of digitalis intoxication did not differ significantly in their mean SDC but in mean age and in mean creatinine concentration indicating that at least part of the symptoms in these patients might be due to a more severe illness. We could show that many of the extracardiac signs of digitalis intoxication are also seen in patients with impaired kidney function at low SDC levels and may lead to a wrong diagnosis. The most common complaint in patients with SDC's of 2.0 ng/ml and more is nausea (39.4%), followed by tiredness (30.4%), dizzyness (23.7%), vomiting (23.1%), headache (16.0%), visual disturbances (13,5%), colour (yellow) seeing (6;7%), diarrhea (4.2%) and severe neuro-psychiatric disturbances (3.8%). In patients with digitalis-induced arrhythmias the sequence of symptoms is the same only with a somewhat higher percentage rate. Only about one half of the patients with digitalis-induced arrhythmias and SDC values up to 2.5 ng/ml showed also extracardiac signs of intoxication. Therefore these signs are not to be taken as early symptoms of digitalis intoxication. Divided into subgroups (patients with/without digitalis-induced arrhythmias, patients with SDC values of more/less than 2.0 ng/ml) the patients with and without extracardiac signs of digitalis toxicity are compared with each other in regard to: mean body height and weight, concentration of digoxin, potassium and creatinine, digoxin dosage and mean age. The greatest differences were found between patients with combined cardiac and extracardiac signs of intoxication and patients with neither cardiac nor extracardiac signs of intoxication: These intoxicated patients are of significantly higher mean age and lower body weight, their mean concentration of digoxin and creatinine and the digoxin dosage administered are significantly greater, but there is no significant difference in potassium concentration. An important group of patients, namely the elderly with impaired kidney function, are especially prone to develop digitalis intoxication. In this group, however, the extracardial symptoms are of little benefit in the diagnosis of digitalis intoxication. In these patients rhythm disturbances and intoxication-like symptoms are frequently caused by other reasons. In most cases the SDC value can clarify the diagnosis without withdrawal of the drug.
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PMID:[Digitalis intoxication: specifity and significance of cardiac and extracardiac symptoms. part II. Patients with extracardiac symptoms of digitalis intoxications (author's transl)]. 85 53

Thirty-two patients with the onset of erythema chronicum migrans, Lyme arthritis, or both in mid-1976 were studied prospectively. The skin lesion (24 patients) typically lasted about 3 weeks, beginning as a red macule or papule that expanded to form a large ring with central clearing. Associated symptoms ranged from none to malaise, fatigue, chills and fever, headache, stiff neck, backache, myalgias, nausea, vomiting, and sore throat. Three patients had been bitten by ticks at the site of the initial lesion 4 to 20 days before its onset. Nineteen patients suddenly developed a monoarticular or oligoarticular arthritis 4 days to 22 weeks (median, 4 weeks) after onset of the skin lesion; eight developed arthritis without a preceding skin lesion. Seven of these 27 experienced migratory joint pains. Arthritis attacks, most commonly in the knee, were typically short (median, 8 days) but sometimes persisted for months. Other manifestations included neurologic abnormalties, myocardial conduction abnormalities, serum cryoprecipitates, elevated serum IgM levels, and elevated erythrocyte sedimentation rates. The diagnostic marker is the skin lesion; without it, geographic clustering is the most important clue.
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PMID:Erythema chronicum migrans and Lyme arthritis. The enlarging clinical spectrum. 86 48

This letter is in reply to a previous article of April 30 asking if oral contraceptives cause disease of the uterine arteries. The writer has found that changes in the small vessels of the endometrium are an early effect of taking oral contraceptives. Proliferation of endometrial arterioles has been related to headache and migraine incidence. Distended sinusoids have accompanied tiredness and dilated leg veins. Stromal condensation around sinusoids has been found with leg cramps. These changes have preceded thrombosis. It is thought that oral contraceptives cause generalized vascular overactivity. Symptoms are usually rapidly reversible on discontinuing the therapy. At an acute migraine clinic, oral contraceptives and smoking have been important contributing factors in patients requiring emergency treatment. Oral contraceptives are thought to be a more potent cause of bascular disease than smoking.
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PMID:Oral contraceptives and the uterine vessels. 87 84

The syndrome of inappropriate secretion of antidiuretic hormone is characterized by production of less than maximally dilute urine in the presence of hypotonic plasma. It may be secondary to malignant disease, central nervous system disorders, or pulmonary disease, among other conditions, or it may be idiopathic. Manifestations are those of water intoxication, eg, confusion, fatigue, nausea, headache, and neurologic signs. The pathogenesis is not completely understood. Restriction of fluid intake to obtain a negative water balance is effective treatment.
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PMID:Inappropriate secretion of antidiuretic hormone. An overview of the syndrome. 90 56


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