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

The benefits of EPO treatment, including improved exercise tolerance, amelioration of lassitude and fatigue, improved cognitive function, and enhanced quality of life in general, can be extended to symptomatic anemic chronic renal failure patients before their need for dialysis treatment. The favorable pharmacokinetics and erythropoietic response with weekly subcutaneous dosing of EPO make this treatment suitable and convenient for patients and health care providers alike. EPO treatment can be provided without undue concern about accelerating the deterioration of renal function, but patients require frequent follow-up and close monitoring while treatment is initiated and adjusted over the first 3 to 6 months, in order to promptly detect and treat any adverse reaction or failure to respond.
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PMID:Clinical application of recombinant erythropoietin in predialysis renal failure. 785 15

A massive expansion of mountain tourism and the practice of sports at altitude (mountaineering, skiing, cycling, hang-gliding, parapente, etc) has been observed in the last decades. This emphasis on new forms of sports and recreation represented as a social phenomenon is accompanied by an increase in the mountain associated-disorders and related-accidents. These include headache, lassitude, pain, difficulty in breathing, rapid heartbeat, and in the worst of the cases loss of consciousness, always possible, manifest by poor judgement, fatigue, etc, and death. However, medical studies are rare, mainly because the molecular mechanisms of tissue damage induced by oxygen free radicals are still poorly understood. Therefore, the goals of the present report are: 1) to summarize the main adaptations of the body at high altitude, introducing the concepts of altitude sickness and oxygen free radicals and their relation; 2) to propose a mechanism of action of oxygen free radicals in the development of this pathology, with special attention in hypoxia and related mechanisms; 3) to suggest a role for antioxidants in the therapy of altitude-related disorders.
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PMID:Role of oxygen free radicals in altitude-related disorders. 802 27

Paired studies were conducted in 18 healthy volunteers (9 men, 9 women) to investigate whether differences in mood and daytime sleepiness induced by high-fat-low-carbohydrate (CHO) and low-fat-high-CHO morning meals were associated with specific hormonal responses. Plasma insulin concentrations were significantly higher after low-fat-high-CHO meals, and cholecystokinin (CCK) concentrations were significantly higher after high-fat-low-CHO meals. Subjects tended to feel more sleepy and less awake 2-3 h after the high-fat-low-CHO meal, and ratings of fatigue were significantly greater 3 h after the high-fat-low-CHO meal than after the low-fat-high-CHO meal. The results of the present study are consistent with the hypothesis that there is an association between the lassitude experienced after a meal and the release of CCK.
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PMID:Influences of fat and carbohydrate on postprandial sleepiness, mood, and hormones. 914 37

The HELLP syndrome is a serious complication of pregnancy, found most frequently in conjunction with severe preeclampsia. The incidence of this disease in preeclampsia is between 2 and 12%. The diagnosis is based on typical laboratory findings, i.e. haemolysis--H, elevated liver enzymes--EL and a low-platelet count--LP. Haemolysis is defined as microscopic finding of an abnormal peripheral blood smear, elevated total bilirubin above 1.2 mg/dl and elevated lactate dehydrogenase above 40 mukat/l. Transaminases (AST above 4.2 mukat/l) are also elevated. For HELLP a low platelet count is typical (number of thrombocytes less than 100,000 mm3). The symptoms include above all pain in the epigastrium, in the right subcostal area, nausea and vomiting. Non-specific symptoms resembling viroses are lassitude, general weakness, headache and fatigue. A correct differential diagnosis and early assessment of the diagnosis are decisive for starting treatment which can prevent the development of serious complications such as disseminated intravascular coagulopathies and hepatorenal failure. Treatment of the HELLP syndrome is symptomatic with the objective to stabilize the general condition of the mother, improved haemodynamic conditions and the impaired haemocoagulation. A very important therapeutic step is early termination of pregnancy which depends on ther mother's condition and the condition of the foetus with regard to gestational age.
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PMID:[The HELLP syndrome]. 992 33

Dysthymia, as defined in the American Psychiatric Association and International Classification of Mental Disorders, refers to a prevalent form of subthreshold depressive pathology with gloominess, anhedonia, low drive and energy, low self-esteem and pessimistic outlook. Although comorbidity with panic, social phobic, and alcohol use disorders has been described, the most significant association is with major depressive episodes. Family history is loaded with affective, including bipolar, disorders. The latter finding explains why dysthymia, especially when onset is in childhood, can lead to hypomanic switches, both spontaneously and upon pharmacologic challenge in as many as 30%. Indeed, antidepressants from different classes -tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), reversible inhibitors of monoamine oxidase A (RIMAs), selective serotonin-reuptake inhibitors (SSRIs) and, more recently, amisulpride, and spanning noradrenergic, serotonergic as well as dopaminergic mechanisms of action - have been shown to be effective against dysthymia in an average of 65% of cases. This is a promising development because social and characterologic disturbances so pervasive in dysthymia often, though not always, recede with continued pharmacotherapy beyond acute treatment. Despite symptomatic overlap of dysthymia with chronic fatigue syndrome - especially with respect to the cluster of symptoms consisting of low drive, lethargy, lassitude and poor concentration - neither the psychopathologic status, nor the pharmacologic response profile of the latter syndrome is presently understood. Chronic fatigue today is where dysthymia was two decades ago. We submit that the basic science - clinical paradigm that has proven so successful in dysthymia could, before too long, crack down the conundrum of chronic fatigue as well. At a more practical level, we raise the possibility that a subgroup within the chronic fatigue group represents a variant of dysthymia.
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PMID:Dysthymia: clinical picture, extent of overlap with chronic fatigue syndrome, neuropharmacological considerations, and new therapeutic vistas. 1035 46

Many persons associate fatigue and lassitude with iron deficiency and take extra iron "to be on the safe side". This is an unfortunate practice, as the early symptoms of iron deficiency anaemia and of hereditary iron overload (homozygous primary haemochromatosis) are similar. Primary haemochromatosis is considerably more prevalent than earlier believed. As many as 5 per 1,000 of the Norwegian population may have two mutated genes for haemochromatosis, while up to 15% may be carriers of a single mutated gene, and for these an extra intake of iron may be hazardous. The condition is highly underdiagnosed. In Norway at present, iron preparations of 60-100 mg are sold over the counter in pharmacies without prescription and often by self-service. However, no one should use iron tablets until iron deficiency and its cause has been ascertained. To avoid uncritical use of iron, iron preparations should be available only by doctor's prescription. Prolonged abuse of iron tablets may result in secondary haemochromatosis.
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PMID:[Should iron preparations be available only by prescription?]. 1125 63

Patients with chronic hepatitis C virus (HCV) infection frequently report fatigue, lassitude, depression, and a perceived inability to function effectively. Several studies have shown that patients exhibit low quality-of-life scores that are independent of disease severity. We therefore considered whether HCV infection has a direct effect on the central nervous system, resulting in cognitive and cerebral metabolite abnormalities. Twenty-seven viremic patients with biopsy-proven mild hepatitis due to HCV and 16 patients with cleared HCV were tested with a computer-based cognitive assessment battery and also completed depression, fatigue, and quality-of-life questionnaires. The HCV-infected patients were impaired on more cognitive tasks than the HCV-cleared group (mean [SD]: HCV-infected, 2.15 [1.56]; HCV-cleared, 1.06 [1.24]; P =.02). A factor analysis showed impairments in power of concentration and speed of working memory, independent of a history of intravenous drug usage (IVDU), depression, fatigue, or symptom severity. A subgroup of 17 HCV-infected patients also underwent cerebral proton magnetic resonance spectroscopy (1H MRS). The choline/creatine ratio was elevated in the basal ganglia and white matter in this group. Patients who were impaired on 2 or more tasks in the battery had a higher mean choline/creatine ratio compared with the unimpaired patients. In conclusion, these preliminary results demonstrate cognitive impairment that is unaccounted for by depression, fatigue, or a history of IVDU in patients with histologically mild HCV infection. The findings on MRS suggest that a biological cause underlies this abnormality.
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PMID:Hepatitis C and cognitive impairment in a cohort of patients with mild liver disease. 1182 20

Autologous hematopoietic stem cell transplantation (HSCT) is currently being evaluated as a therapy for patients with progressive multiple sclerosis (MS) at risk of debilitating neurological impairment. While preliminary results from a few studies have been reported, little is known about toxicities or outcome of HSCT for MS. We report a relatively frequent triad of non-infectious fever, rash and fatigue or lassitude that may also be associated with pruritus, pulmonary symptoms, and eosinophilia and frequently occurs around engraftment. This syndrome occurred in 26% of our series of patients (5/19) undergoing HSCT for multiple sclerosis. The engraftment syndrome is usually self-limited but may require intervention with systemic corticosteroids.
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PMID:Engraftment syndrome: a common cause for rash and fever following autologous hematopoietic stem cell transplantation for multiple sclerosis. 1184 Jan 50

A middle-aged woman presented with a history of constipation, easy fatigue, depressive mood, lassitude, polydipsia, and polyuria. The patient posed a challenging diagnostic dilemma due to the presence of persistent severe hypercalcemia and relative lack of clinically manifested symptoms. Clinical, biochemical, and genetic examinations confirmed the diagnosis of familial hypocalciuric hypercalcemia as a result of C562Y calcium-sensing receptor mutation, and a coexisting parathyroid adenoma. After adenectomy, the patient's clinical situation improved markedly, and a modest equilibrium hypercalcemia persisted. This case presents an unusual combination of two relatively common endocrine disorders.
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PMID:Parathyroid adenoma in a subject with familial hypocalciuric hypercalcemia: coincidence or causality? 1188 54

Fatigue is a very common symptom of multiple sclerosis (MS). Theoretically, fatigue may be related to neuromodulation by soluble products of the autoimmune process or by disruption of central nervous system pathways necessary for sustained activity, but little empirical evidence supports these possibilities. Amantadine, pemoline, and modafanil improved fatigue in placebo-controlled clinical trials, but these studies all had significant limitations. Difficulty measuring fatigue has impeded studies of its characteristics, mechanisms, and therapeutics. Most studies have relied on self-report questionnaires. These may be inappropriate, however, because they can be easily confounded by other symptoms of MS, they are entirely subjective, and they require patients to make difficult retrospective assessments. Studies of fatigue would be improved by including measures of more rigorously defined, quantifiable components of fatigue. For example, motor fatigue can be measured as the decline in strength during sustained muscle contractions. Cognitive fatigue can be measured as the analogous decline in cognitive performance during tasks requiring sustained attention. Lassitude is defined as a subjective sense of reduced energy, and it can be measured with the use of a visual analog diary. These measures provide reproducible results and demonstrate significant differences between MS patients and healthy controls. Dividing fatigue into these components can provide objective assessments that are less likely to be confounded by other symptoms of MS, such as weakness, spasticity, cognitive impairment, and depressed mood.
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PMID:Fatigue in multiple sclerosis: current understanding and future directions. 1205 65


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