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)

A retrospective study was performed to identify symptoms and clinical findings in postpolio patients seen in a postpolio clinic. Charts of 79 consecutive patients (28 men and 51 women) with histories and examinations compatible with the diagnosis of poliomyelitis were reviewed. The average current age of our patients was 47.3 +/- 10.4 years; the average age at onset of acute polio was 10.4 +/- 9.4 years; and the average number of years since function was first noticed to decline was 7.8 +/- 6.4 years. The most common symptoms acknowledged were progressive weakness (87%), muscle pain (86%), fatigue (86%), decreased activity level (78%), joint pain (77%), and back pain (70%). The clinical impression in most of these patients was arthritis/arthralgia (71% of the patients) or muscle overuse or myofascial pain (71%). Eleven (14%) had evidence of nerve compression, although 39% complained of sensory loss. Five patients had respiratory problems that required evaluation. Recommendations proved helpful for 78% of those seen at follow-up. These recommendations included pacing, energy conservation (planning, use of wheelchair or motorized scooter), gentle stretching or strengthening exercise, use of orthotic devices, weight loss or nutritional counseling, gentle aerobic exercise, use of a cane, and use of adaptive equipment.
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PMID:Symptoms and clinical impressions of patients seen in a postpolio clinic. 271 39

This study was undertaken in an attempt to determine the maximal oxygen uptake in a small muscle group by measuring directly the oxygen expenditure of the forearm. Five healthy medical students volunteered. The subjects' maximal forearm work capacity was determined on a spring-loaded hand ergometer. Exercise was continued until exhaustion by pain or fatigue. Two weeks later intra-arterial and intravenous catheters were placed in the dominant arm. Blood samples for measurement of oxygen concentration were collected via the catheters. Forearm blood flow was measured by means of the indicator dilution technique. Oxygen uptake was determined according to the Fick principle. The forearm oxygen uptake attained at maximal work loads was a mean of 201 (SD +/- 56) mumol.min-1.100 ml-1. It was impossible at maximal exercise to discern a plateau of the oxygen uptake curve in relation to work output. It is suggested that a plateau in the oxygen uptake curve is not a useful criterion for maximal oxygen uptake in a small muscle group. Skeletal muscle may have an unused capacity for oxygen consumption even at maximal exercise intensity where muscle work cannot be continued due to muscle pain and fatigue.
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PMID:Forearm oxygen uptake during maximal forearm dynamic exercise. 275 71

Recombinant interleukin-2 (rIL-2) (NSC# 600664; Hoffmann-La Roche, Inc., Nutley, NJ) was studied in a phase I clinical trial in 33 patients with advanced, measureable cancer of the colon or malignant melanoma, Eastern Cooperative Oncology Group (ECOG) performance status O-1, and no prior chemotherapy or radiotherapy. The goal of the study was to identify a dose and schedule of IL-2 to generate maximal immune modulation with tolerable toxicity. Such a regimen might allow the addition of other treatment modalities and/or prolonged treatment duration in later trials. Each patient received IL-2 as a continuous 24-hour infusion once weekly for 4 weeks and then twice weekly for 4 weeks. Five treatment groups received from 10(3) U/m2 to 3 x 10(7) U/m2 per 24-hour infusion. The maximal tolerated dose was 3 x 10(7) U/m2/d twice weekly. Patients treated twice weekly at 1 x 10(7) and 3 x 10(7) U/m2/d had immune modulation in terms of lymphocytosis, eosinophilia, increased natural killer (NK) activity, and elevated numbers of peripheral blood mononuclear cells expressing CD16, OKT10/Leu-17, and Leu-19 surface markers. Endogenous generation of peripheral blood lymphokine-activated killer (LAK) activity was demonstrated by lysis of NK-resistant Daudi targets, in patients treated at 3 x 10(7) U/m2/d. Biochemical and hematological abnormalities were moderate and reversible. Clinical toxicity included hypotension, myalgia, arthralgia, stomatitis, fever, fatigue, nausea, headache, chills, diarrhea, and oliguria at high doses. Cardiovascular toxicity was tolerable for most patients and reversed after IL-2 was stopped. Two of six melanoma patients at 3 x 10(7) U/m2/d achieved partial responses by the end of the eighth week. This IL-2 schedule appears to produce potentially clinically useful immune enhancement with tolerable toxicity.
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PMID:A phase I clinical trial of recombinant interleukin-2 by periodic 24-hour intravenous infusions. 278 32

The chronic Epstein-Barr virus syndrome is a poorly defined symptom complex characterized primarily by chronic or recurrent debilitating fatigue and various combinations of other symptoms, including sore throat, lymph node pain and tenderness, headache, myalgia, and arthralgias. Although the syndrome has received recent attention, and has been diagnosed in many patients, the chronic Epstein-Barr virus syndrome has not been defined consistently. Despite the name of the syndrome, both the diagnostic value of Epstein-Barr virus serologic tests and the proposed causal relationship between Epstein-Barr virus infection and patients who have been diagnosed with the chronic Epstein-Barr virus syndrome remain doubtful. We propose a new name for the chronic Epstein-Barr virus syndrome--the chronic fatigue syndrome--that more accurately describes this symptom complex as a syndrome of unknown cause characterized primarily by chronic fatigue. We also present a working definition for the chronic fatigue syndrome designed to improve the comparability and reproducibility of clinical research and epidemiologic studies, and to provide a rational basis for evaluating patients who have chronic fatigue of undetermined cause.
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PMID:Chronic fatigue syndrome: a working case definition. 282 79

Increased mobility of families and shorter hospital stays have added to the adjustment difficulties of new mothers, and lack of an adequate support system may cause the mother to end breast feeding. The purpose of this study was to identify the postpartum concerns of breast feeding mothers from time of discharge through the 1st postpartum month. The sample consisted of 32 women, aged 20-38, who had uncomplicated vaginal deliveries, were released from hospital by the 3rd day, and were breast feeding for the 1st time. They were telephoned daily during the 1st 2 weeks and twice a week for the 3rd and 4th week. 78% were primigravidas. 97% of the women reported a total of 210 concerns about the infant; 81% reported 237 concerns about themselves; and 19% reported 15 concerns about interactions with family or friends. Feeding-related concerns were most frequent in the 1st and 2nd weeks and included frequency of feeding (64%), formula and/or water supplementation, and duration of nursing time. Concerns about the infants' sleeping and crying behavior were also most frequent (76%) during the 1st 2 weeks. Sleeping concerns included the effects of long periods of wakefulness and sleeping during the day rather than at night. Crying or fussy behavior following feeding and during family dinner was reported by 53% of the mothers during the 1st week and 41% during the 2nd week. Concerns about the physical state of the infant included wellness and growth, temperature, cord care, bilirubin level, infection, and bowel movements. 81% of the mothers expressed concerns about themselves. Physical concerns included breast soreness, nipple pain and blisters, uterine bleeding and cramps, episiotomy pain, muscle pain, and hemorrhoids. 18 mothers reported emotional concerns, particularly fatigue. Only 6 mothers reported concern over interactions with family and friends, including lack of help from the father and pressure from visits by friends and relatives. The greatest number of concerns expressed in this study were related to the infant, whereas other studies have reported more maternal concerns. However, these women were all breast feeding, which may imply that they were more infant-oriented to begin with.
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PMID:Postpartum concerns of breastfeeding mothers. 283 23

Fifteen patients with metastatic malignant melanoma, including 10 who had not previously received systemic therapy, were treated with recombinant alpha2-interferon (IFN-alpha 2) in a dose of 20 million IU/m2 by 30-min i.v. infusion daily for 5 days each 14 days. Evaluable metastatic sites included lung, subcutaneous tissue, liver, nodes, adrenals, and bone. Subjective toxicity was generally mild to moderate, with fever (38.2-40.2 degrees C), occasional rigors, fatigue, myalgia, headache, and nausea. Objective toxicity included transient neutropenia and elevation of hepatic enzymes, particularly gamma-glutamyl transpeptidase. In 1 of the 10 patients receiving more than one cycle, IFN dosage was reduced because of toxicity, but later reescalated. All patients were evaluated for response. No overall partial or complete responses were observed, but two site responses (lung and subcutaneous tissue) were seen. Median survival from start of IFN treatment was 19 weeks. High doses of IFN were reasonably well tolerated in this study, but the results suggest little activity against malignant melanoma.
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PMID:Phase-II study of recombinant alpha 2-interferon in advanced malignant melanoma. 287 Nov 16

A case of polyarteritis nodosa (PAN) in a 54 year-old man is presented. The clinical picture showed a 6-month history of mixed sensorimotor distal symmetrical polyneuropathy in all limbs together with anorexia, weight loss, fatigue, arthralgia, myalgia, mild fever and hypertension. The laboratory studies showed leucocytosis, elevated ESR, positive HBsAg and presence of cryoglobulins. Selective renal, celiac and mesenteric angiography was performed by femoral approach and has showed innumerable aneurysms most of them in hepatic and renal circulation. After about two weeks death has occurred. A brief discussion is done on clinical aspects of PAN pointing out the importance of HBsAg determination on etiopathogenesis and angiographic study on diagnosis.
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PMID:[Polyarteritis nodosa: report of a case with angiographic study]. 287 24

Four weeks after the introduction of a therapeutic regimen with 80 mg 13-cis-retinoic acid/day, a 16-year-old male patient developed oozing hypergranulation with vulnerable masses within acne lesions. These local symptoms were accompanied by fever, fatigue, weight loss, polyarthralgia and myalgia, similar to acne fulminans. In spite of these unusual reactions treatment was continued. Local steroid ointments were additionally applied. Within a short period of time regression of granulations and normalization of the general health condition was observed. After 4 months, therapy was discontinued. The patient's acne had totally healed and did not relapse within an observation period of 2 years.
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PMID:[Acne conglobata: unusual course in 13-cis-retinoic acid therapy]. 293 99

In this review, the major types of immune mediated thyroiditis are described and the etiology explained in the light of current theories of autoimmunity. Hashimoto's thyroiditis is a common autoimmune disease. The onset is gradual with patients presenting with symptoms of hypothyroidism, nonspecific symptoms of the autoimmune process itself, or symptoms relating to a goitre. The disease is usually relentless and, except in young patients, permanent replacement with thyroxine is eventually required. Silent thyroiditis is another autoimmune disease of more acute onset. The initial, thyrotoxic, phase lasting several weeks is due to release of thyroid hormone from damaged follicles, and radionuclidic scans show absent uptake. There often follows a hypothyroid phase with final recovery in most patients. Post partum thyroiditis is due to silent thyroiditis, or, less commonly, Hashimoto's thyroiditis, occurring three to six months after delivery. Subacute thyroiditis often follows a viral infection and is not thought to be an autoimmune disease. It presents with severe thyroid pain and tenderness with marked non-specific symptoms such as myalgia and fatigue. The initial, thyrotoxic, phase is also due to release of thyroid hormone, and radionuclidic scans show absent uptake. A hypothyroid phase often follows and recovery is complete. Hashimoto's thyroiditis appears to be due to a congenitally present, antigen specific, T suppressor lymphocyte defect. It is proposed that in silent thyroiditis there is a less severe Ts defect and a correspondingly greater decompensating factor. In post partum thyroiditis, this factor appears to be a general decline in T suppressor lymphocyte function after delivery. Subacute thyroiditis is not an autoimmune disease. The thyroid appears to be an "innocent bystander" in an immune mediated antiviral attack.
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PMID:Thyroiditis. 293 21

Twenty previously treated patients with advanced bone sarcomas received thrice weekly im 50 X 10(6) IU/m2 doses of human alfa-interferon (interferon alfa-2a, recombinant; Roche). Seventeen patients had metastatic osteosarcomas and one each had fibrosarcoma, mesenchymal chondrosarcoma, and malignant fibrous histiocytoma. Two patients with osteosarcoma and the one with malignant fibrous histiocytoma experienced objective partial tumor regression for 1, 3, and 2 months, respectively. Fever, anorexia, myalgia, fatigue, lethargy, and moderate myelosuppression were observed commonly, and some patients developed mild nausea, vomiting, and diarrhea. No patient withdrew because of toxicity and no dose reductions were necessary except adjustments for changes in body surface area secondary to weight loss.
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PMID:Phase II study of recombinant alfa-2a interferon in patients with advanced bone sarcomas. 303 15


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