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)

Patients with stable heart failure show decreased exercise tolerance and consequently quality of life. The reduced physical capacity in these patients is a result of decreased strength of skeletal muscles and even their atrophy. The physical activity is limited by metabolic disorders and histological changes in myocytes. Dysfunction of respiratory muscles plays a role in the development of exertional dyspnea. Patients with stable heart failure are recommended to perform low or moderate physical training, which improves exercise tolerance. Intensive physical training in patients with reduced left ventricular ejection fraction improves maximal oxygen consumption through increased left ventricular stroke and increased arteriovenous difference. Recent studies indicate that regular physical training has a positive physiological effect on exercise tolerance, and decreases dyspnea and fatigue, in many patients with heart failure.
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PMID:[Role of physical training in cardiac rehabilitation in patients with congestive heart failure]. 1523 Jan 52

A 72-year-old woman with primary biliary cirrhosis (PBC) and antineutrophil cytoplasmic autoantibody (ANCA)-associated rapidly progressive glomerulonephritis is described. She had a 6-year history of PBC diagnosed histologically, with a positive test finding for antimitochondrial antibodies and elevated biliary enzyme activity. The myeloperoxidase-ANCA test result was negative. The patient was treated with ursodeoxycholic acid (600 mg/day) and had been stable for 6 years. She was admitted to our hospital because of general fatigue, exertional dyspnea, and peripheral edema. Her serum level of creatinine was increased (4.4 mg/dL), and her hemoglobin concentration was reduced (8.0 g/dL). The patient was diagnosed as having rapidly progressive glomerulonephritis. Test results for serum antinuclear antibody and myeloperoxidase-ANCA were positive. The diagnosis by renal biopsy was necrotizing crescentic glomerulonephritis. Prednisolone followed by methylprednisolone pulse therapy and cyclophosphamide were administered. The patient underwent plasma exchange twice weekly for 4 weeks. After 4 weeks, her serum creatinine level fell to 1.8 mg/dL, and she recovered renal function without hemodialysis. After 24 weeks, her renal function (serum creatinine level, 1.6 mg/dL) was stable.
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PMID:Antineutrophil cytoplasmic autoantibody-associated rapidly progressive glomerulonephritis in a patient with primary biliary cirrhosis. 1536 78

Certain acute anterior poliomyelitis survivors express complaints of abnormal fatigue, weakness and muscular atrophy many years after acute onset. These are basic clinical symptoms of so-called post-polio syndrome (PPS). PPS is characterized by a relatively slow, but progressive pathological muscular process, in some cases leading to functional impairment of daily living and professional activity. Breathing, speaking and swallowing impairment are common but not severe medical problems of post-polio patients. Diagnosis is usually based on a typical medical history, electromyographic investigation and exclusion of other diseases presenting similar features. We report a case of PPS in a 49-year-old woman diagnosed in the Neurological Department in Zabrze. Thirty six years after acute anterior poliomyelitis with partial recovery, new symptoms of fatigue, muscular atrophy, exertional dyspnea, walking impairment and joint pain developed. Electromyography revealed features of coexisting spinal denervation and reinnervation in tested muscles. The differential diagnosis excluded other neuromuscular diseases. The patient fulfilled clinical and electromyographic criteria of PPS.
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PMID:[Post-polio syndrome. A case report]. 1538 63

A 43-year-old man who had a Carbomedics prosthetic aortic valve replacement in 1997 was admitted to our hospital with complaints of shortness of breath and dyspnea on exertion in 2000. The patient was hospitalized due to atrioventricular (AV) complete block and a permanent pacemaker was implanted. At that time echocardiography indicated an aneurysm at the left sinus of Valsalva. In 2003, the patient was re-admitted to our clinic with complaints of shortness of breath and fatigue. Echocardiography showed a sinus of Valsalva aneurysm dissecting into interventricular septum. Operation confirmed dissection of the interventricular septum and communication between this cavity and the aneurysm of the left sinus of Valsalva. The postoperative course was uneventful and the patient was discharged in a satisfactory condition. This is the first reported case of aneurysm of the sinus of Valsalva dissecting into interventricular septum late and complicating aortic valve replacement.
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PMID:Aneurysm of sinus of Valsalva dissecting into interventricular septum: a late complication of aortic valve replacement. 1548 95

A 52 year-old woman noticed general fatigue, polyarthralgia, and muscle weakness of lower extremities in October 2001. In December, she felt difficulty in walking due to muscle weakness. In January 2002, she admitted another hospital because of dyspnea on exertion and edema of lower extremities. Laboratory test revealed leukocytopenia, the elevation of creatine kinase and positive anti-U1-RNP antibodies. Her chest computed tomography (CT) showed severe interstitial pneumonia. Cardiac echogram revealed that she had pericardial effusion and pulmonary hypertension. Then she was transferred to Keio University Hospital and she was diagnosed as having mixed connective tissue disease (MCTD) manifestating myositis, interstitial pneumonia, pulmonary hypertension and pericarditis. Prednisolone (PSL) 60mg daily following to methylprednisolone (mPSL) pulse therapy was begun and her symptoms were gradually improved. In middle of February, she complained of high fever over 39.0 degrees C. Bacterial culture tests were negative and laboratory data indicated pancytopenia and a high level of serum ferritin. Bone marrow aspiration revealed hemophagocytosis in bone marrow specimens and she was diagnosed as having hemophagocytic syndrome associated with MCTD. mPSL pulse therapy was not effective and intermittent cyclophosphamide pulse therapy (IV-CY) was performed resulting in improvement of the symptoms. This case suggested the effectiveness of IV-CY therapy in patients with corticosteroid-resistant HPS associated with connective tissue diseases.
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PMID:[A case of mixed connective tissue disease successfully treated for hemophagocytic syndrome with intermittent intravenous injection of cyclophosphamide]. 1555 24

Preservation and restoration of the aortic valve and root, as well as relief of the stenosis, is of paramount importance during surgical treatment of supravalvular aortic stenosis. A 23-year-old woman with a history of medically treated endocarditis presented with progressive fatigue and dyspnea on exertion. A diagnostic work-up revealed multiple stenoses and a small saccular aneurysm involving the diffusely hypoplastic ascending aorta, in addition to severe mitral regurgitation. The aortic root and ascending aorta were replaced using the Yacoub remodeling technique. Hemiarch replacement was performed under hypothermic circulatory arrest, and the mitral valve replaced. By using a remodeling technique, it was possible to augment the left sinus of Valsalva, to obtain the largest diameter at the sinotubular junction, and to adjust the spatial relationship of commissures that renders good leaflet coaptation. Although extended aortoplasty has been used widely for supravalvular aortic stenosis, the Yacoub procedure is a good option in diffuse type hypoplasia with multiple stenosis of the ascending aorta.
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PMID:Supravalvular aortic stenosis: repair with the Yacoub procedure. 1559 82

We report the case of a 61-year-old female, who presented with a history of chronic fatigue, dyspnea on exertion, a widened mediastinum with tracheal deviation on chest X-ray, and a neck mass. After a diagnostic workup, the patient was found to have a paratracheal mass extending into the chest in addition to a 6.5 cm ascending aortic aneurysm with aortic insufficiency, and a 70% stenosis of the right coronary artery. She underwent successful resection of a substernal goiter via a neck incision facilitated by a previously performed sternotomy for a concomitant ascending aortic root replacement and a bypass utilizing the RIMA to the distal RCA.
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PMID:Management of an ascending aortic aneurysm with coronary artery disease and tracheal compression from a substernal goiter. 1572 45

Acute myocarditis may result in severe hemodynamic compromise with fatal outcome. Furthermore, recent studies suggest myocarditis as a major cause of sudden unexpected death. A variety of cardiotropic viral, rickettsial, and bacterial infectious agents have been identified to date. Parvovirus B19 (PVB19) is usually benign in childhood, but it may also cause death due to myocarditis. We present here the case of an adult female who presented with fatigue, dyspnea on exertion, and orthostatic dizziness 8 months after successful liver transplantation. Cardiologic work-up, including left ventricular endomyocardial biopsy, revealed acute myocarditis secondary to PVB19. Since no specific therapy for this virus is available, the patient was treated symptomatically with an angiotensin-converting enzyme inhibitor plus beta-blocker and diuretics. After a period of stabilization, new-onset rapid atrial fibrillation caused acute low-output syndrome within 14 days after hospital admission. The patient eventually died because of refractory cardiogenic shock. In conclusion, to our knowledge this is the first report of PVB19-induced myocarditis confirmed by detection of viral genome in myocardium in a liver transplant recipient.
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PMID:Fatal course of parvovirus B19-associated myocarditis in a female liver transplant recipient. 1577 13

A 79-year-old woman was admitted for exertional dyspnea in September 2001. She had begun to experience unusual fatigue from the age of 40 years. Cardiac examination revealed a single S2, Levine grade II/VI presystolic murmur in the 5th left sternal border, and a right parasternal impulse. Echocardiography showed dilated right chambers and absence of pulmonary valve leaflets. Doppler echocardiography at the pulmonary annulus revealed a 'to and fro' pattern. Cardiac catheterization indicated the same diastolic pressures in the pulmonary artery and right ventricle. The diagnosis was absent pulmonary valve syndrome. Administration of a diuretic agent resulted in almost immediate improvement of symptoms. Absent pulmonary valve syndrome, generally associated with tetralogy of Fallot, often causes severe respiratory failure or right heart failure during infancy. A case of such long survival without associated cardiac anomalies is very rare.
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PMID:[Long-surviving patient with isolated absent pulmonary valve syndrome: a case report]. 1587 39

Impaired diastolic function is related to subjective symptoms, reduced exercise capacity, and poor prognosis in patients with congestive heart failure, and an angiotensin II type-I receptor blocker might have a beneficial effect on diastolic function in such patients with heart failure. A 53-year-old woman underwent valvuloplasty of the mitral valve and later presented with heart failure symptoms, including exertional dyspnea and easy fatigue. Although no pathological changes could be identified by radiography of the chest, electrocardiography, or routine echocardiography, the assessment of diastolic function with Doppler echocardiography revealed left ventricular diastolic dysfunction. Her neurohumoral parameters and left ventricular diastolic dysfunction improved after 1 month of treatment with Valsartan, an angiotensin II type-I receptor blocker, accompanied by improvement of her subjective symptoms. This case implies that angiotensin II type-I receptor blocker could improve left ventricular diastolic dysfunction and that Doppler echocardiography might be useful for detecting diastolic dysfunction in high-risk patients undergoing cardiac surgery.
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PMID:Valsartan, an angiotensin II type-I receptor blocker, and left ventricular diastolic function--a case report. 1607 31


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