Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The classical symptoms of malabsorption syndrome are diarrhea, steatorrhea, weight loss, and fatigue. Tetany, ecchymosis, anorexia, bone pain, pallor, muscle wasting, hyperpigmentation, apathy, digital clubbing, abdominal distention which contrasts in view of the reduced common statement are other signs of malabsorption. Long before the onset of these symptoms there may be a disinterest in regular daily activities often associated with the passage of three soft stools per day and with the remarkable sign of difficulties in flushing bulky stools. Anamnesia, clinical examination in connection with common laboratory findings, small intestinal x-rays and endoscopic investigations associated with biopsies of the small (and large) bowel as well as estimation of stool fat excretion, xylose- and Schilling-test allow the diagnosis in most of the cases.
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PMID:[Clinical aspects and differential diagnosis of malabsorption]. 684 29

We performed a pilot study of 10 patients with the objective to determine the efficacy of interferon alpha-2a in the treatment of age-related macular degeneration with freshly diagnosed choroidal neovascular membrane. Interferon was given at a dose of 3 MIU/m2 three times a week for 8 weeks. Mean age of the patients was 74 years. In 3 patients we combined laser photocoagulation of extrafoveal part of the choroidal neovascular membrane to interferon therapy. The patients were followed up for 1 year after termination of interferon treatment. In 1 patient a visual improvement of two Snellen lines was noted, while in 7 patients visual acuity remained the same during the treatment (includes 3 patients treated with combined Krypton-laser photocoagulation). In 2 patients there was a decrease in acuity of one line. Six months later visual acuity had deteriorated in 7 patients and 1 year later all the patients had visual acuity < or = 20/200. We did not find any regression of choroidal neovascular membrane in fluorescein angiography in any of the patients during the treatment except the laser-treated area. At the 6-month follow-up there was still leakage or choroidal neovascular membrane growth in 6 patients. Combined interferon-laser therapy did not prove to be more effective in preventing the membrane growth. Side-effects included weakness, apathy, and fatigue in this elderly population. Our results indicate that treatment with 3 MIU/m2 interferon for 8 weeks is not an effective treatment for subfoveal choroidal neovascular membranes.
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PMID:Interferon alpha-2a in the treatment of exudative senile macular degeneration. 753 27

Quality of life assessments were performed in 24 haemodialysis patients (10 males, 14 females, age 45 +/- 15 years) undergoing rHuEpo treatment. The results in the rHuEpo-treated patients were compared with those in eight haemodialysis patients not on rHuEpo and with the results of a nationwide study of dialysis patients in Sweden (carried out before rHuEpo was registered). Survey questionnaires (112 items, divided into three dimensions, i.e. physical, social, and emotional wellbeing) were completed before treatment (Hb 73 +/- 1.1 g/l), when the target Hb value of 10 g/dl was reached (1-7 months) and in 14 patients 1 year after correction of the anaemia. Before treatment, the rHuEpo group had significantly more complaints about poor appetite, fatigue, and irritability than the controls. After the anaemia was corrected, the rHuEpo group had significantly improved physical and emotional wellbeing. The most significant changes occurred in satisfaction with health, physical activities of daily life, and fatigue. Alterations in emotional symptoms, such as depression and apathy, were less pronounced. Only minor changes were observed in their social wellbeing. One year after correction of the anaemia, the improvements in physical and emotional wellbeing were still present in the rHuEpo-treated patients. A positive effect was also noted on hospitalization rate. Scores for the subdimensions of satisfaction with health, sexual adjustment, physical symptoms, and emotional wellbeing improved in the rHuEpo-treated group and reached a level that was the same, or even higher, than the scores in the dialysis patients in the nationwide study. In conclusion, the quality of life improved during rHuEpo treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term effects on quality of life in haemodialysis patients of correction of anaemia with erythropoietin. 839 47

Intravenous infusion of physostigmine (a centrally active anticholinesterase agent) in normal subjects leads to a syndrome of psychomotor inhibition; this has been proposed as a model for selected symptoms of depression. In view of its similarity to the negative schizophrenic syndrome, we compared the 'physostigmine syndrome' to the negative symptom profile by evaluating the behavioral effects of intravenous physostigmine infusion in seven normal volunteers. Observer ratings and self description revealed significant withdrawal, apathy, alogia, lethargy, decreased energy, slowed thoughts, diminished affective responsivity, and reduced hedonic capacity. Subjects did not report sadness, ideas of hopelessness, worthlessness, or guilt. These findings support the implication of cholinergic hyperactivity as one mechanism in the pathophysiology of negative schizophrenic symptoms.
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PMID:Cholinergic hyperactivity and negative symptoms: behavioral effects of physostigmine in normal controls. 846 Dec 67

Organic solvent abuse in adolescents has become a serious social problem. One of the reasons for this is the relationship to juvenile delinquency, and another is that it leads to various clinical symptoms including disturbance of consciousness, hallucinations, fantasia and apathy. In this study, using a health questionnaire that is composed of 33 psychiatric and 29 physical items and the Rorschach Test, we investigated these symptoms and the psychodynamics of personality respectively. The principal component analysis obtained for the health questionnaire extracted four factors as follows: 1) feelings of general fatigue and somatic symptoms, 2) feelings of guilt and self blame, 3) low self esteem and withdrawal adaptation, and 4) unreasonable anxiety and sleeping disturbance. The results of Rorschach Test supported the loss of libido, disability of reality testing and ego vulnerability in organic solvent abusers. This research strongly suggests that apathetic or depressive mood in chronic organic solvent abusers relates with loss of drive.
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PMID:[Psychological problem due to long-term organic solvent abuse]. 853 23

The chronic fatigue syndrome (CFS) has been intensively studied over the last 40 years, but no conclusions have yet been agreed as to its cause. Most cases nowadays are sporadic. In the established chronic condition there are no consistently abnormal physical signs or abnormalities on laboratory investigation. Many physicians remain convinced that the symptoms are psychological rather than physical in origin. This view is reinforced by the emotional way in which many patients present themselves. The overlap of symptoms between CFS and depression remains a source of confusion and difficulty. But even if all CFS patients were rediagnosed as depressives, this would not negate the possibility of an underlying organic cause for the condition, in view of the growing evidence that depression itself has a physical cause and responds best to physical treatments. There is some evidence both for active viral infection and for an immunological disorder in the CFS. Many observations suggest that the syndrome could derive from residual damage to the reticular activating system (RAS) of the upper brain stem and/or to its cortical projections. Such damage could be produced by a previous viral infection, leaving functional defects unaccompanied by any gross histological changes. In animal experiments activation of the RAS can change sleep state and activate or stimulate cortical functions. RAS lesions can produce somnolence and apathy. Studies by modern imaging techniques have not been entirely consistent, but many magnetic resonance imaging (MRI) studies already suggest that small discrete patchy brain stem and subcortical lesions can often be seen in CFS. Regional blood flow studies by single photon-emission computerized tomography (SPECT) have been more consistent. They have revealed blood flow reductions in many regions, especially in the hind brain. Similar lesions have been reported after poliomyelitis and in multiple sclerosis--in both of which conditions chronic fatigue is characteristically present. In the well-known post-polio fatigue syndrome, lesions predominate in the RAS of the brain stem. If similar underlying lesions in the RAS can eventually be identified in CFS, the therapeutic target for CFS would be better defined than it is at present. A number of logical approaches to treatment can already be envisaged.
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PMID:Chronic fatigue syndrome--aetiological aspects. 946 37

The cardinal clinical manifestations of major depression with melancholic features include sustained anxiety and dread for the future as well as evidence of physiological hyperarousal (e.g., sustained hyperactivity of the two principal effectors of the stress response, the corticotropin-releasing-hormone, or CRH, system, and the locus ceruleus-norepinephrine, or LC-NE, system). Sustained stress system activation in melancholic depression is thought to confer both behavioral arousal as well as the hypercortisolism, sympathetic nervous system activation, and inhibition of programs for growth and reproduction that consistently occur in this disorder. Data also suggest that activation of the CRH and LC systems in melancholia are involved in the long-term medical consequences of depression such as premature coronary artery disease and osteoporosis, the two-three-fold preponderance of females in the incidence of major depression, and the mechanism of action of antidepressant drugs. In addition, recent data reveal important bidirectional interactions between stress-system hormonal factors in depression and neural substrates implicated in many discrete behavioral alterations in depression (e.g., the medial prefrontal cortex, important in shifting affect based on internal and external cues, the mesolimbic dopaminergic reward system, and the amygdala fear system). We have also advanced data indicating that the hypersomnia, hyperphagia, lethargy, fatigue, and relative apathy of the syndrome of atypical depression are associated with concomitant hypofunctioning of the CRH and LC-NE systems. These data indicate the need for an entirely different therapeutic strategy than that used in melancholia for the treatment of atypical depression, and they suggest that this subtype of major depression will be associated with its own unique repertoire of long-term medical consequences.
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PMID:The endocrinology of melancholic and atypical depression: relation to neurocircuitry and somatic consequences. 989 54

The purpose of this study was to explore and describe aspects which cause and promote burnout amongst psychiatric nurses. Participants were purposively selected and individual focus interviews were recorded on tape. Certain themes were identified during data analysis and based on that the following conclusion were reached: an external locus of control leads to feelings of "stuckness"; high personal standards lead to psychiatric nurses making themselves available in the work environment with subsequent negative effects on themselves; psychiatric nurses take too much responsibility and become indifferent or overly involved (co-dependent) due to vague boundaries leading to feelings of fatigue, apathy and loss of motivation; lack of support and a need of recognition in the work environment lead to emotional fatigue; a too heavy workload, staff shortage and an uncertainty regarding role description in the work environment leads to feelings of fatigue, negativity, "stuckness", anger and apathy.
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PMID:[Burnout among psychiatric nurses in a private, psychiatric hospital]. 1022 96

Despite numerous studies the relationship between depression and Alzheimer's disease has not yet been clarified. The high prevalence of depression in Alzheimer's disease has been confirmed but the data on its incidence vary. Generally, depressed mood is the most prevalent symptom in 0-86% of dementia syndrome, minor depression, dysthymia is considered to be present in 20-30% of patients and major depression is least frequent. It seems confirmed that depression may be considered to be a risk factor for dementia, but the coincidence of these two diseases remains still unknown. Since the symptoms of depression and dementia are very similar, the clinical picture brings other controversies. Loss of energy, speech paucity, poor attention and concentration, diminished interest and psychomotor slowness cannot differentiate dementia from depression, the disability level seems to be the only differentiating factor. Depression may be suspected in case of changes in functional level, complaints about pain and diurnal variation of symptoms. From the practical point of view the type of contact and the willingness of perform tests are among the crucial symptoms. Sometimes, it is difficult to separate apathy and pathological crying from depression. The pathomechanism of depression in dementia is not known. The role of serotoninergic and cholinergic transmission changes, alterations of glucocorticoid cascade and presence of apoE are considered but without evident results.
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PMID:[Depression and Alzheimer's disease]. 1040 20

Antiepileptic drugs (AEDs) have various mechanisms of actions and therefore have diverse anticonvulsant, psychiatric, and adverse effect profiles. Two global categories of AEDs are identified on the basis of their predominant psychotropic profiles. One group has "sedating" effects in association with fatigue, cognitive slowing, and weight gain, as well as possible anxiolytic and antimanic effects. These actions may be related to a predominance of potentiation of gamma-aminobutyric acid (GABA) inhibitory neurotransmission induced by drugs such as barbiturates, benzodiazepines, valproate, gabapentin, tiagabine, and vigabatrin. The other group is associated with predominant attenuation of glutamate excitatory neurotransmission and has "activating" effects, with activation, weight loss, and possibly anxiogenic and antidepressant effects. This group includes agents such as felbamate and lamotrigine. Agents such as topiramate, with both GABAergic and antiglutamatergic actions, may have "mixed" profiles. Mechanisms of actions, activity in animal models of anxiety and depression, and clinical psychotropic effects of AEDs in psychiatric and epilepsy patients are reviewed in relationship to this proposed categorization. These considerations suggest the testable hypothesis that better psychiatric outcomes in seizure disorder patients could be achieved by treating patients with baseline "activated" profiles (insomnia, agitation, anxiety, racing thoughts, weight loss) with "sedating" predominantly GABAergic drugs, and conversely those with baseline "sedated" or anergic profiles (hypersomnia, fatigue, apathy, depression, sluggish cognition, weight gain) with "activating" predominantly antiglutamatergic agents. Systematic clinical investigation of more precise relationships of discrete mechanisms of actions to psychotropic profiles of AEDs is needed to assess the utility of this general proposition and define exceptions to this broad principle.
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PMID:Positive and negative psychiatric effects of antiepileptic drugs in patients with seizure disorders. 1049 35


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