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

Symptoms associated with upper extremity cumulative trauma disorders (UECTDs) recently have been reported in professional sign language interpreters. The present investigation is a case control study of potential biomechanical factors that may exacerbate or maintain UECTD-related symptoms in this occupational group. Based on the results of a medical screening, interpreters were classified into two groups: working with pain (n = 16) and working without pain (n = 13). There were no significant differences between the groups on age, gender, years signing, years interpreting, and wrist and forearm endurance and flexibility as measured during an isokinetic strength test of the upper extremities. Subjects were exposed to a standard interpreting task. Groups were compared on measures of repetitiveness of hand/wrist motion, work/rest cycle, postural stress, and smoothness of movement. Heart rate, pain, fatigue, and perceived reduction in extremity flexibility also were measured. The group working with pain demonstrated a distinct pattern of potential biomechanical risk factors previously associated with UECTDs in other occupations. By comparison with the control group, those working with pain exhibited fewer rest breaks, more frequent hand/wrist deviations from neutral, more frequent lateral excursions from an optimal work envelope, and more rapid finger/hand movements while interpreting. Significant group differences on self-report measures of pain, fatigue, and perceived limitation in range of motion also were observed. An analysis of heart-rate response to the interpreting task revealed that both groups demonstrated a modest increase in heart rate to the interpreting task, although interpreters working with pain displayed lower heart rates across all phases of the experimental task.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Biomechanical factors affecting upper extremity cumulative trauma disorders in sign language interpreters. 154 77

Autopsy or surgical specimens from six patients with primary cardiac angiosarcoma seen at the Mayo Clinic (all in men) between 1939 and 1988 were studied (patients' ages, 31 to 80 years; mean 50 years). The symptoms were nonspecific and included dyspnea and thoracoabdominal pain in six; anorexia in five; fatigue, hemoptysis, or orthopnea in four; nausea and vomiting, fever, or weight loss in three; and night sweats in two. Cardiomegaly was present in five, and a pericardial effusion or density, a mass adjacent to the heart, or nonspecific ST-T wave changes were present in three. All six neoplasms arose from the right atrium and exhibited epicardial or endocardial extension; three produced obstructive intracavitary right atrial masses. Pulmonary metastatic lesions were noted in five patients. The cardiac neoplasm was diagnosed by computed tomography or magnetic resonance imaging in the three most recent patients, and surgical resection was performed in two of them. Mean survival was 6 months after presentation. Causes of death were pulmonary hemorrhage in three, thoracic metastasis in two, and hemopericardium in one. The diagnosis of primary cardiac angiosarcoma was established at operation in two patients and at autopsy in four. Despite diagnosis by noninvasive imaging procedures and aggressive early surgical intervention, survival was less than 6 months. Thus optimal therapy is unclear.
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PMID:Primary cardiac angiosarcoma: a clinicopathologic study of six cases. 154 8

Twenty patients undergoing colonic resection were randomized to either conventional postoperative pain treatment with morphine chloride and acetaminophen (group 1, n = 9) or methylprednisolone sodium succinate 90 minutes before surgery plus intraoperative neural blockade, with a postoperative analgesic regimen with combined bupivacaine hydrochloride-morphine and indomethacin sodium for systemic effect (group 2, n = 11). Assessments of pain, pulmonary function, convalescence, and various injury factors were done several times until 8 days after surgery. Postoperative pain and hyperthermic response were eliminated in group 2. Conventional reduction in pulmonary function measures was improved in group 2, and fatigue and mobility were less pronounced. Prostaglandin E2, interleukin 6, and C-reactive protein levels increased in both groups, but significantly less in group 2. These results suggest that a combined neural and humoral blockade may more effectively inhibit the global stress response to elective surgery than previously observed with neural blockade with or without indomethacin.
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PMID:Effect of combined prednisolone, epidural analgesia, and indomethacin on the systemic response after colonic surgery. 843 Nov 27

Fifty-one patients suffering from soft tissue injury of the cervical spine underwent clinical and psychometric examination. Clinical interview evaluated subjective complaints and formal testing of self-estimated cognitive impairment, divided attention, and speed of information processing. Results indicated at least two different syndromes: 1) the "cervicoencephalic syndrome," characterized by headache, fatigue, dizziness, poor concentration, disturbed accommodation, and impaired adaptation to light intensity; and 2) the "lower cervical spine syndrome," which is accompanied by cervical and cervicobrachial pain. When comparing patients with either of these two syndromes, those suffering from cervicoencephalic syndrome had significantly poorer results when tested for divided attention. Speed of information processing was reduced to a comparable extent in both syndromes. These findings were not related to the length of the post-traumatic interval. Reduced processing of working memory is assumed, which may account for more global cognitive problems as well as secondary neurotic reaction.
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PMID:Cognitive deficits in patients after soft tissue injury of the cervical spine. 155 81

Fifty Japanese patients were diagnosed as having fibromyalgia. This group was compared with 50 Japanese control patients and 293 North American patients with fibromyalgia. In comparison of pain complaints and symptoms for fibromyalgia in Japanese and North Americans, ["pain all over" (98%), fatigue (98%), anxiety (66%), irritable bowel syndrome (50%) and sicca symptoms (71%)] were more frequently found in the Japanese patients. However, the major components of fibromyalgia were not wholly different in Japanese individuals compared with North Americans.
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PMID:Fibromyalgia in Japanese. 155 71

The goals of surgery in treating intractable epilepsy are to eliminate seizures and improve quality of life. This report describes the development of the Epilepsy Surgery Inventory (ESI)-55, a 55-item measure of health-related quality of life for epilepsy patients. The ESI-55 includes the following scales (number of items in parentheses): health perceptions (9), energy/fatigue (4), overall quality of life (2), social function (2), emotional well-being (5), cognitive function (5), physical function (10), pain (2), and three separate scales of role limitations due to emotional, physical, or memory problems (5 items each). Also included is one change in health item. The ESI-55 was completed by 89% of 224 adults who had undergone a protocol evaluation for epilepsy surgery since 1974. Alpha internal consistency reliability coefficients ranged from 0.76 to 0.88 except for social function (alpha = 0.68). Multitrait scaling analyses supported item discrimination across scales. Factor analysis confirmed previously identified mental and physical health factors, and yielded a third factor defined by cognitive function and role limitations scales. Construct validity was supported by correlations of the ESI-55 with a mood profile instrument. Analysis of ESI-55 scale scores by seizure classification showed that the 44 patients who were seizure-free following surgery scored higher than did 55 patients who continued to have seizures (P less than 0.05 for all comparisons); 43 patients having seizures without loss of consciousness scored in between. Results of this study indicate that the ESI-55 is reliable, valid, and sensitive to differences in seizure status.
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PMID:A health-related quality of life instrument for patients evaluated for epilepsy surgery. 155 79

The heading craniomandibular disorders covers a wide range of abnormal and pathologic conditions accompanied by orofacial pain and impaired mandibular function, the masticatory muscles and the temporomandibular joints being the structures most frequently involved. Prevalences of severe craniomandibular disorders accompanied by headache and facial pain urgently in need of treatment are 1-2% in children, about 5% in adolescents, and 5-15% in adults, with higher values in women than in men. With respect to physiology and ergonomics, masticatory muscles are comparable to other human skeletal muscles, e.g. of shoulder, neck and lower back. Therefore these muscles share pathogenesis, symptoms and signs of muscular disorders caused by prolonged, low-level static contractions or intermittent isometric contractions at higher levels. Since the same elements of performance in the masticatory muscles are influenced by occlusal factors, they link the development of muscular fatigue, discomfort and pain to the dental occlusion. Furthermore, changes of the occlusal surfaces, e.g. due to dental treatment, may influence the performance of the masticatory muscles, and consequently interfere with local muscular function.
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PMID:Craniomandibular disorders and masticatory muscle function. 155 1

Twenty consecutive patients with recurrent Tolosa-Hunt syndrome were studied. One had a parent who suffered from recurrent Tolosa-Hunt syndrome. Thirty-three percent of the patients had also recurrent periods of weeks to months of unilateral periorbital pain without ophthalmoplegia. One patient had cluster headache before the Tolosa-Hunt syndrome started. Some patients had involvement of cranial nerves outside the cavernous sinus region during Tolosa-Hunt syndrome and also between episodes. The same systemic symptoms, i.e. back pain, cold feet, arthralgia, gut problems, varices, vertigo, chronic fatigue, thrombophlebitis, memory deficiency and signs of inflammation in serum, occurred in Tolosa-Hunt syndrome as earlier found in patients with orbital venous vasculitis. Seventy-three percent of the patients had pathologic orbital phlebograms. All patients treated with steroids reacted promptly; four who developed chronic pain syndromes were treated satisfactorily with azathioprine.
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PMID:Recurrent Tolosa-Hunt syndrome. 155 57

The quality of survival of 48 patients treated surgically for head and neck cancer was assessed using a problem-orientated self-administered questionnaire. The questionnaire was based on the European Organization for Research into the Treatment of Cancer (EORTC) core questionnaire to which a specific head and neck module was added. The following domains were studied: pain, fatigue, physical symptoms (gastrointestinal and 'other'), functional activity, psychological symptoms, overall physical condition and overall quality of life. For the analysis, five groups of patients were considered: laryngectomy (n = 15), pharyngolaryngoesophagectomy (n = 5), craniofacial procedure (n = 11), 'other operations' (n = 9) and patients with disease recurrence (n = 8). Each group identified different problem areas. Laryngectomees and 'other operation' patients reported relatively few problems, whereas patients with disease recurrence described difficulties in all of the domains examined. Symptoms of fatigue were common. Information collected in this way may facilitate improved rehabilitation and thus better quality of survival.
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PMID:Quality of life of patients treated surgically for head and neck cancer. 156 81

Sustained contractions were compared between with (AW) and without (NAW) spontaneous alternations of working arm to investigate the fatigue level at which the contraction is felt to be stopped. Subjects maintained an upper limb in the horizontally flexed position at 5%, 10%, 15% and 20% of maximum voluntary contraction strength (MVC). Contractions were continued until they felt exhausted or 45min. had passed. Fatigue level was evaluated with 4 levels of fatigue sensations and surface electromyogram (EMG) of the deltoid. Mean amplitude (AEMG) and relative power in 8-40Hz (RPLF) of EMG were calculated. The following results were obtained. Fatigue level was lower in AW than in NAW for the same amount of work done by one arm. As AEMG often decreased with time, fatigue was estimated by relating AEMG to RPLF. At 20% MVC in AW the alternation interval decreased and the muscle fatigued with repeated contractions though the fatigue level was not severe. Contraction was felt to be stopped when the first fatigue sensation occurred. But it was not necessary to stop the contraction until considerable tiredness or apparent pain occurred.
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PMID:Fatigue sensation and surface electromyogram during sustained shoulder flexion with spontaneous alternations of working arm. 156 14


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