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

During the past year many studies have been published on fibromyalgia and chronic fatigue syndromes. Randomized clinical trials using current operational diagnostic criteria were reported, but no single therapy has been highly effective in either condition. The working case definition of chronic fatigue syndrome has been criticized and suggestions for a new case definition have been made. Further understanding of the overlap of these three common disorders will also require that uniform diagnostic criteria be tested in chronic fatigue syndrome and myofascial pain syndrome.
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PMID:Fibromyalgia, chronic fatigue, and myofascial pain syndromes. 158 Nov 54

This paper describes the initial development of a patient-based outcomes assessment program in an outpatient dialysis unit. This project presented four logistical and practical issues that are discussed in this paper: patient acceptance of quarterly administrations of a generic health status survey (the SF-36); timing of administration during dialysis session; respondent burden; and staff burden. Also discussed are three issues related to the clinical use of these assessments: medical record status of SF-36 data; use in clinical decisionmaking; and clinicians' responses to aggregate data from patient-based health status assessments. The investigation reported presents strong evidence of patient acceptance of the SF-36. Data collection problems reflected the nature of a busy dialysis unit, and most have been corrected. Considering functional status, the role functioning of dialysis patients is most adversely affected; among well-being measures, patients are most compromised by pain and lack of energy. Clinicians' reviews of these results point to the need for normative data, information about severity of primary and comorbid diseases, and knowledge of relationships between SF-36 scores and physiologic parameters to make clinical use of generic health outcome assessments.
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PMID:Patient-based health status measures in outpatient dialysis. Early experiences in developing an outcomes assessment program. 158 28

A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.
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PMID:The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. 2722 30

Acute lymphatic filariasis developed in an American traveling recreationally to Asia. The illness was characterized by fatigue, eosinophilia, and lymphedema of the arm and chest wall, but no lymphangitis, lymphadenitis, or pain. Complete resolution occurred over 1-2 years. We discuss this syndrome and describe the use of new diagnostic tests in its diagnosis and management.
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PMID:Acute lymphatic filariasis in an American traveler. 161 49

Silent myocardial ischaemia is now well-recognised in patients with symptomatic coronary artery disease. Its pathogenesis remains speculative, though diminished sensitivity to pain is thought to be one of the mechanisms involved. Because cardiovascular autonomic dysfunction occurs frequently in diabetic patients, we postulate that it contributes towards painless myocardial ischaemia among them. Forty consecutive diabetic (type II) male patients and ten normal volunteers were studied. Using 5 previously-validated noninvasive tests for autonomic dysfunction, 14 of these diabetic men had definite autonomic neuropathy (at least 2 abnormal tests). All 50 subjects were then exercised on a motor-driven treadmill to either exhaustion or chest pains. Thirty-three diabetic subjects were tested positive, with significant (greater than 1 mm) ST segment depression over at least 2 contiguous leads. Of these, 18 were associated with typical angina but the other 15 stopped because of fatigue or exhaustion (ie painless). Thirteen subjects who had definite autonomic neuropathy (AN+) had positive exercise ECG tests-10 had painless ischaemia, and only 3 had angina. This contrasted with 15 patients who had painful ischaemia and 5 who had painless ischaemia among the group without (AN-)autonomic dysfunction (p = 0.0047, Fisher's exact test). There were no significant differences among the various groups for peak rate-pressure-product, all subjects attaining similar maximal oxygen consumption states during which ischaemic ST segment changes were noted (painful AN+: 21917 +/- 4753; painless AN+: 20117 +/- 6752; painful AN-: 16544 +/- 4063; painless AN-: 22220 +/- 4341, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Association of diabetic autonomic neuropathy with painless myocardial ischaemia induced by exercise. 162 Nov 24

Venous function was investigated in 29 women during late pregnancy before and after short term treatment with graduated compression hosiery. A significant improvement of venous emptying was found, combined with a subjective decrease of leg problems such as swelling, tiredness and pain.
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PMID:Venous function during late pregnancy, the effect of elastic compression hosiery. 162 43

A cancer-specific self-reporting quality of life questionnaire has been validated. The questionnaire is designed to assess physical functioning, role functioning, cognitive functioning, emotional functioning, social functioning, pain, fatigue, emesis and quality of life by means of multi-item scales, and other disease- and treatment-related symptoms by means of single items. The questionnaire was completed by 126 head and neck cancer patients with a mean age of 67 years. The internal consistency (scale reliability) was satisfactory for all scales but one. Correlations between scales and items assessing the same underlying dimension were also satisfactory. The questionnaire discriminates between patient subgroups and between acute, subacute and late toxicity. Patient compliance was high. The questionnaire provided valuable information, and most of the scales/items functioned well. A few problems were found, especially with the modified visual analogue scales, and minor modifications will be made.
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PMID:Psychometric validation of the EORTC Core Quality of Life Questionnaire, 30-item version and a diagnosis-specific module for head and neck cancer patients. 162 51

Osteoporotic bone fragility is due not only to decreased bone mass but to inadequate repair of fatigue damage and to trabecular disconnection. The precise roles and relative contributions of these three factors are not known for osteoporosis in general, and certainly not in any individual case. However, it is known that reduced physical activity causes bone loss. It is a virtual certainty, therefore, that, to the extent that the fracture produces disability, osteoporotics lose bone after they first experience a fracture, whatever its antecedent causes. In that sense, some of the bone loss we find in our patients is indeed an epiphenomenon. However, this is not to suggest that reduced bone mass is unimportant. Quite the contrary: prospective studies have clearly established that reduction in bone mass does increase risk of fracture, and hence, when it is consequent upon a fracture, it aggravates the patient's condition. In this way a vicious circle may develop: the pain and fear that follow fracture lead to decreased activity, which leads to bone loss, which can only increase the fragility, and hence predispose to further fracturing, even in cases in which the initial fragility may not have been due to low bone mass. But low bone mass, with its proper fragility, may not be inevitable. That is why pain control and a comprehensive programme of rehabilitation are critically important in the early management of patients with symptomatic vertebral fractures.
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PMID:The natural history of vertebral osteoporosis. Is low bone mass an epiphenomenon? 162 10

The influence of chronic pain on daily life was studied in 58 patients (55 women and three men) with fibromyalgia. The mean age was 45 +/- 11 (SD) years. A mail questionnaire including a 2-day diary was used for data collection. Information was gathered on social background, employment status, symptoms, physical training habits, patients' experience of general health, physical condition, and difficulties in performing motor tasks. The patient reported every half hour in the activity diary the degree of pain and fatigue, whether the activities were difficult to perform, and whether the patient considered them to be enjoyable, valuable, and meaningful. Fifty-five percent of the group had gainful employment. Most were working shorter hours and with changed work tasks. Motor tasks, such as carrying, holding, and running were more difficult to perform than before the onset of the symptoms, and half of the group reported most of their activities as strenuous to perform. Thirty-nine persons (67%) reported no, or very short, pain-free periods during the 2 days. In conclusion, symptoms influenced daily life considerably, and almost all patients reported changes in habits and routines as a consequence of fibromyalgia. An assessment of the patient's total life situation gives valuable information for understanding the patients' ability to handle everyday life.
Clin J Pain 1992 Jun
PMID:Living with fibromyalgia. Consequences for everyday life. 163 77

Recombinant Interleukin 4 was administered by subcutaneous injection at daily doses of 0.5, 1.0 or 5.0 micrograms kg-1 to nine patients as part of a Phase I Dose Toxicity Study. Dose limiting toxicity was reached at 5 micrograms kg-1 day-1. Symptoms of toxicity included fatigue, 'flu like symptoms and elevated liver enzymes. Modest but significant elevations of neutrophil and platelet counts occurred. No clear evidence of antitumour effects emerged although pain in metastatic lymph nodes and a small fall in myeloma paraprotein levels during dosing were observed. In vitro and murine in vivo studies indicate that patients with lymphoproliferative disease should be selected for Phase II trials.
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PMID:Recombinant human interleukin 4 (IL-4) given as daily subcutaneous injections--a phase I dose toxicity trial. 163 69


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