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)

National, regional, state, and county rates of mortality and morbidity are frequently used as reference values in epidemiologic studies. However, baseline information on self-reported symptom rates is currently unavailable. This information is potentially very useful as outcome measures in environmental and occupational epidemiologic studies in which symptoms may be the most sensitive measure of effects of low-level chemical exposure. Comparison populations (n = 934 adults) from three community-based studies were used to determine 1-y symptom prevalence rates. Symptoms rates varied greatly between one study, in which a self-administered questionnaire was used, and the two studies for which data were collected via a similar questionnaire administered by trained interviewers. Four symptoms were selected for detailed analysis of covariates associated with symptom reporting: (1) skin irritation, (2) eye irritation, (3) sleep disturbance, and (4) fatigue. Logistic regression analysis of symptom reporting, by demographic data, and a risk perception variable suggested that the prevalence of symptoms varied with gender, race, and degree of respondent's environmental concern. The results from two of three surveys provide rates that might be used as reference rates in a community-based survey if resources are not available to permit the study of a comparison population. These rates may also provide a quick, initial impression prior to embarking on a full-scale epidemiologic study.
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PMID:Reported symptom prevalence rates from comparison populations in community-based environmental studies. 149 79

Sixteen of 22 elderly male patients (aged 60-74 years) who had previously taken only hydrochlorothiazide 50 mg completed a study evaluating the safety, efficacy, and tolerability of 12-20 weeks of transdermal clonidine (Catapres TTS) as monotherapy for mild hypertension. Thirteen of the sixteen patients (81%) responded to transdermal clonidine which was begun after 28 days of placebo. Five patients discontinued transdermal clonidine therapy because of intolerable skin irritation, and one because of daytime fatigue. Clonidine caused none of the metabolic effects we observed with hydrochlorothiazide: no change in serum potassium, uric acid, cholesterol, or triglyceride. Eleven of the 22 patients (50%) who began the study experienced a skin reaction under the transdermal clonidine patch. The incidence of dry mouth and fatigue in patients using transdermal clonidine was dose-related and similar to reports of dry mouth and fatigue in patients taking oral clonidine tablets. Rebound hypertension occurred in one patient upon withdrawal of transdermal clonidine. There was no effect of transdermal clonidine or hydrochlorothiazide on cognitive function or emotional state tested with three questionnaires. Overall, transdermal clonidine, in various doses, was as effective as hydrochlorothiazide in elderly male hypertensive patients. The effectiveness of both was inversely proportional to the level of untreated blood pressure. The high incidence of skin reactions limited prolonged use of transdermal clonidine in our patients.
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PMID:Transdermal clonidine compared with hydrochlorothiazide as monotherapy in elderly hypertensive males. 271 69

History of diagnosed illnesses, medical symptoms, and reproductive outcomes and their relation to combat intensity and herbicide exposure were studied, via a mailed questionnaire, among 6810 American Legionnaires who served during the Vietnam War (42% in Southeast Asia, 58% elsewhere). Heart disease, venereal disease, and benign fatty tumors were reported significantly more often by Vietnam veterans than by controls. Combat intensity was significantly dosage-related to history of high blood pressure, ulcers, arthritis and rheumatism, genito-urinary problems, nervous system disease, major injury, hepatitis, and benign fatty tumors. Agent Orange exposure was significantly dosage-related to history of benign fatty tumors, adult acne, skin rash with blisters, and increased sensitivity of eyes to light. Rates of the latter two conditions and of change in skin color were especially elevated in men whose military occupations involved direct handling of herbicides. Five "symptom complex" scales were constructed via factor analysis to measure degrees of feeling faint, fatigue or physical depression, body aches, colds, and skin irritation. Means of all five scales were significantly higher in Vietnam veterans compared to controls, and in herbicide handlers compared to nonhandlers. Both combat and Agent Orange exposure were significant, independent predictors of each of the five scales. Neither combat nor Agent Orange exposure was associated with difficulty in conception, time to conception of first child, or to birthweight or sex ratio of offspring, but maternal smoking was strongly related to reduced birthweight. The percentage of spouses' pregnancies which resulted in miscarriages was significantly higher for Vietnam veterans than controls (7.6% vs 5.5%, P less than 0.001). Logistic regression analysis showed that Agent Orange exposure and maternal smoking were both independently and significantly associated with miscarriage rates in a dose-related manner.
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PMID:Health and reproductive outcomes among American Legionnaires in relation to combat and herbicide exposure in Vietnam. 326 69

Forty-nine employees exposed to perchloroethylene (dry cleaning) and 41 employees exposed to styrene (fiber reinforced polyester) are compared to a control group of 68 persons. Symptoms such as dizziness, mouth dryness, fatigue, mucous membranes and skin irritation appear more frequently among the exposed groups, while liver and kidney functions remain unchanged. This study demonstrates that medical examination, industrial hygiene survey and biological monitoring can complement each other in the evaluation of work conditions.
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PMID:[Monitoring of persons exposed to perchloroethylene or styrene]. 376 81

The pulmonary function and symptoms of 125 workers exposed to carbon black in dry cell battery and tire manufacturing plants were investigated. There was no significant difference in the pulmonary function of the subjects in the two plants. There was good agreement in the symptoms reported in the two different factories: cough with phlegm production, tiredness, chest pain, catarrh, headache, and skin irritation. The symptoms also corroborate those reported in the few studies on the pulmonary effects of carbon black. The suspended particulate levels in the dry cell battery plant ranged from 25 to 34 mg/m3 and the subjects with the highest probable exposure level had the most impaired pulmonary function. The pulmonary function of the exposed subjects was significantly lower than that of a control, nonindustrially exposed population. The drop in the lung function from the expected value per year of age was relatively constant for all the study subgroups but the drop per year of duration of employment was more severe in the earlier years of employment. This study has underscored the need for occupational health regulations in the industries of developing countries.
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PMID:Pulmonary function and symptoms of Nigerian workers exposed to Carbon black in dry cell battery and tire factories. 683 5

This synthesis of the literature on the quality of life in relation to radiotherapy is based on 78 scientific articles, including 12 randomized studies, 25 prospective studies, and 20 retrospective studies. These studies involve 9884 patients. Radiotherapy is often organ-preserving, which inherently promotes a better quality of life. Many quality of life aspects related to radiotherapy have been studied, but seldom by prospective randomized studies that compare radiotherapy to other treatment (eg, surgery or chemotherapy). Radiotherapy involves numerous physical and psychological symptoms, mainly during the course of treatment. Examples include skin irritation and fatigue. Radiotherapy directed at the brain has delayed effects, in children treatment carries a substantial risk for lowering the IQ. The risk for encephalopathy in adults is probably underestimated. Patients with cancer in the head and neck may experience adverse side effects in the irradiated area long after the conclusion of radiotherapy. There are no confirmed differences in quality of life between breast cancer patients receiving adjuvant radiotherapy and those receiving chemotherapy. Impotency problems and urinary incontinence appear following radical surgery and radiotherapy for prostate cancer. The risk for delayed complications is low after radiotherapy for testicular cancer. Patients receiving radiotherapy for gynecologic cancers are often troubled by local side effects long after the conclusion of treatment.
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PMID:Radiotherapy for cancer. Quality of life. 915 7

Menopause and the accompanying reduction in estrogen production may cause a number of symptoms in women which include hot flushes, sweating, mood and sleep disturbances, fatigue and urogenital dysfunction. The effectiveness of estrogen-based hormone replacement therapy (HRT) in ameliorating these symptoms, and in preventing long term sequelae such as osteoporosis, is well established. Comparative trials indicate that oral conjugated estrogens 0.625mg, oral ethinyl estradiol 0.02mg and transdermal estradiol 0.05mg have equivalent efficacy in relief of mild to moderate menopausal symptoms and prevention of bone mineral loss. Concomitant progestogen therapy is usually prescribed for women with intact uteri to protect against endometrial hyperplasia and carcinoma. The addition of progestogen maintains and may even enhance the bone-conserving effects of estrogen, and continuous regimens appear to reduce the incidence of irregular menses. Adverse reactions are predominantly local skin irritation with transdermal preparations (14% of patients) and systemic effects common to most forms of HRT including breast tenderness, flushing, headache and irregular bleeding, occurring in less than or equal to 2% of patients. Data concerning the effect of HRT on quality of life are limited, but most analyses have assigned utility values of 0.99 for mild and 0.95 for severe menopausal symptoms. However, recent clinical data suggest that these utility values may underestimate the impact of menopausal symptoms on quality of life. The cost benefit and cost effectiveness of HRT in the treatment of menopausal symptoms have not been fully researched, although preliminary results suggest that conjugated estrogens and transdermal estradiol compare well with alternative therapies such as veralipride and Chinese medicines. A Swedish study using a prevalence-based approach estimated that estriol treatment in all women with urinary incontinence aged greater than or equal to 65 years resulted in monetary savings compared with treating 20% of women. Cost-utility data indicated that the change in quality-adjusted life years (QALYs) with HRT was always positive, but the degree of change was determined by the baseline assumptions. Estimated changes in QALYs with HRT ranged from 0.006 for 5 years of treatment with unopposed estrogen in women with intact uteri, to 0.5 for 10 years of the same treatment in women with severe menopausal symptoms following hysterectomy. Compliance with HRT is suboptimal as 5 to 50% of women withdraw from therapy, thereby increasing costs per year of life saved.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Hormone replacement therapy: I. A pharmacoeconomic appraisal of its therapeutic use in menopausal symptoms and urogenital estrogen deficiency. 1014 33

This study examines the relationships between satisfaction with information provided, understanding of consent procedures, and levels of anxiety/depression in a sample of patients undergoing radiotherapy for cancer. One hundred patients completed a 13-item self-report questionnaire and the Hospital Anxiety and Depression Scale (HADS). Twenty-two percent of patients could not recall signing a consent form and, for those who did recall, the level of understanding for what they had consented to was patchy. One fourth of patients could not recall being told of the side-effects from radiotherapy and were unable to list even common side-effects, such as tiredness, skin irritation, and sickness. No patient had been told about the low risk of second malignancy. Twenty-eight percent of patients were unhappy with the amount of information offered to them. Thirty percent of patients reached caseness for adjustment disorder +/- anxiety/depression. Thirteen percent of patients reached caseness for major depression. There was a significant correlation between patients who scored highly on the HADS and dissatisfaction with the information provided. Clinical implications and possible mechanisms of these findings are discussed.
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PMID:Psychological distress among cancer patients and informed consent. 1019 14

Formaldehyde (FA) is an occupational and general indoor hazard often affecting the respiratory airways. One of the main causes of multiple chemical sensitivity is gaseous FA, and it has become an important social problem in developed countries. FA concentrations in anatomy dissection classrooms are thought to be higher than under usual circumstances. The number of students developing physical symptoms during the anatomy dissection course in our university has been increasing over recent years. We planned to clarify the causes of such symptoms. Ninety-five medical students were interviewed using a questionnaire about allergic histories, physical symptoms developed during the anatomy dissection course, and symptoms related to chemical sensitivity up to three months after the course had finished. We measured total IgE, specific IgE to FA and specific IgE to house dust mites. Eighty-three percent of students had experienced symptoms, such as burning eyes, nasal discharge, sore throat, general fatigue or skin irritation during the course. Fifty percent of students had a past history of atopic disease. Fifty-eight percent of students tested positive to specific IgE to house dust mites; however, only one student, who did not complain of any symptoms during the course, tested positive to FA-IgE. Students with atopic factors (present histories of atopic diseases and higher total IgE) and/or chemical sensitivity demonstrated worse physical symptoms during the anatomy dissection course than students without such histories. In conclusion, it is suggested that gaseous FA exposure may exacerbate basic allergic symptoms, and moreover that people with chemical sensitivity demonstrated worse symptoms following gaseous FA exposure. Nevertheless, in our study we find no relationship between FA-IgE and the physical symptoms of gaseous FA exposure during or following an anatomy dissection course.
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PMID:[Relationship between atopic factors and physical symptoms induced by gaseous formaldehyde exposure during an anatomy dissection course]. 1124 81

Hypericum Perforatum Extract is an extract of the capsules, flowers, leaves, and stem heads of Hypericum perforatum, commonly called St. John's Wort. Hypericum Perforatum Oil is the fixed oil from H. perforatum. Techniques for preparing Hypericum Perforatum Extract include crushing in stabilized olive oil, gentle maceration over a period of weeks, followed by dehydration and filtration. Propylene Glycol and Butylene Glycol extractions were also reported. The following components have variously been reported to be found in H. perforatum: hypericin, naphtodianthrones, flavonoids, terpene and sesquiterpene oils, phenylpropanes, biflavones, tannins, xanthones, phloroglucinols, and essential oils. Hypericum Perforatum Extract is used in over 50 cosmetic formulations and Hypericum Perforatum Oil in just over 10, both across a wide range of product types. Acute toxicity studies using rats, guinea pigs, and mice indicate that the extract is relatively nontoxic. Animals fed H. perforatum flowers for 2 weeks showed significant signs of toxicity, including erythema, edema of the portion of the body exposed to light, alopecia, and changes in blood chemistry. In a chronic study, rats fed H. perforatum gained less weight than control animals. Mixtures containing the extract and the oil were not irritants or sensitizers in animals. Because of the presence of hypericin, H. perforatum is a primary photosensitizer. In clinical tests, a single oral administration of Hypericum extract resulted in hypericin appearing in the blood. With long-term dosing, a steady-state level in blood was reached after 14 days. The polyphenol fraction of H. perforatum had immunostimulating activity, whereas the lipophilic portion had immunosuppressing properties. Mixtures of the extract and the oil produced minimal or no ocular irritation in rabbit eyes. Mutagenic activity in an Ames test was attributed to flavonols in one study and to quercitin in another, but other genotoxicity assays were negative. No carcinogenicity or reproductive and developmental toxicity data were available. A mixture of the extract and the oil was not irritating in clinical studies. Adverse reactions to Hypericum extract in the clinical treatment of depression include skin reddening and itching, dizziness, constipation, fatigue, anxiety, and tiredness. Absent any basis for concluding that data on one member of a botanical ingredient group can be extrapolated to another in a group, or to the same ingredient extracted differently, these data were not considered sufficient to assess the safety of these ingredients. Additional data needs include current concentration of use data; function in cosmetics; photosensitization and phototoxicity data using visible light; gross pathology and histopathology in skin and other major organ systems associated with repeated dermal exposures; dermal reproductive/developmental toxicity data; human skin irritation and sensitization data using the oil; and ocular irritation data, if available. Until these data are available, it is concluded that the available data are insufficient to support the safety of these ingredients in cosmetic formulations.
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PMID:Final report on the safety assessment of Hypericum perforatum extract and Hypericum perforatum oil. 1155 39


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