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

Healthy sleeping habits is a complex balance between behaviour, environment and circadian rhythm. The quality of sleep can be improved by behaviour, e.g. eating tryptophan and carbohydrate rich foods, physical exercise in the afternoon or a cold shower just before going to bed. Total sleep time is maximal in thermoneutrality and decreases above and below the thermoneutrality zone. Thermoneutrality is reached for an environmental temperature of 30-32 degrees C without night clothing or of 16-19 degrees with a pyjama and at least one sheet. Noise also modifies sleep structure and above 50dB shortens total sleeping time. Although subjects do become subjectively accustomed to noise, vegetative cardiovascular reactivity to environmental noise remains unchanged. The spontaneous circadian awake/sleep cycle is 25 hours, slightly longer than the body temperature cycle, but when subjects are exposed to environmental synchronization, the two cycles coincide. In individuals undergoing temporal isolation, the two rhythms become independent often leading to subjective discomfort and fatigue. Certain factors including age can favour internal desynchronization. Other factors may include social contact, stress due to mental work load, and constant lighting which could lengthen the awake/sleep cycle. Caffeine blocks the receptors of adenosine, and thus its effects of inhibiting neurotransmission. Intake 30 to 60 minutes before sleeping shortens total sleep time and increases the duration of stage 2 and shortens stage 3 and 4. Alcohol may act as a relaxing, sedative agent when consumed just before sleeping but can also lead to night-time awakening due to sympathetic activation which does not return to baseline levels until the blood alcohol levels have returned to 0. Nicotine has a biphasic effect on sleep: at low concentrations, it leads to relaxation and sedation and at high concentrations inhibits sleep. A careful study of sleeping habits is the first step in evaluating complains of insomnia or hypersomnia. Before relying on drugs, treatment should start with attention to the sleep environment and personal habits.
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PMID:[Prevention and treatment of sleep disorders through regulation] of sleeping habits]. 802 26

1. Cumulative trauma disorder can be reduced by applying four ergonomic approaches: applying anthropometric data, reducing the number of repetitions, reducing the force required, and eliminating awkward postures as much as possible. 2. Selecting the proper work surface height will help reduce fatigue, pain, and discomfort and will allow the employee to be at the right height in relation to the task. Ideally, an adjustable height work surface should be provided that will accommodate all potential users. 3. Prolonged standing and sitting are physically stressful to the body. However, by providing a well designed work area with the appropriate accessories, such as antifatigue mats, ergonomic chairs, and footrests, fatigue and discomfort can be minimized. 4. In addition to providing a properly designed work area, a successful ergonomics program should include training, administrative actions, and exercise programs.
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PMID:Reducing cumulative trauma disorders: use of proper workplace design. 803 29

The purpose of this study is to clarify stressors resulting from continuous ambulatory peritoneal dialysis (CAPD) in CAPD patients and to discuss adaptation to daily life. With reference to the dialysis stressor scale used by Baldree and Masaki et al., a scale for CAPD stressors, consisting of 42 items, was devised, and the stressors were investigated in 56 patients, with the following results: 1) The items rated as high CAPD stressors included the frequency of bag exchange, itch, fatigue, anxiety about the future, and restricted physical activities. Restriction of meal and fluid intake, which are highly-rated stressors in patients on hemodialysis (HD) were not highly-rated stressors in these 56 CAPD patients. Thus, there was a difference between HD and CAPD. 2) The degree of cognition of CAPD stressors increased according to an individual's situation. (1) The presence or absence of an occupation had the greatest effect on the cognition of CAPD stressors. (2) The degrees of cognition of anxiety about the future and work-related difficulties as stressors were high in patients under 60 years of age. (3) The degree of cognition of items related to work as stressors was high in male patients while that of items related to body image as stressors was high in female patients. (4) There was a qualitative difference in stressor congnition between patients with a history of CAPD of shorter than 3 months and those whose history was 3 months or longer. (5) The degree of congnition of infection was also low in patients who suffered from peritonitis. (6) The degree of congnition of symptoms causing physical discomfort was high in patients with diabetic nephropathy. (7) There were significant differences in several variables, in terms of the degree of congnition, among patients with regard to work difficulties and the absence of familial cooperation. On the basis of these results, guidance for patients and their families is necessary.
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PMID:[Analysis of continuous ambulatory peritoneal dialysis (CAPD) stressors in CAPD patients]. 818 6

A 46-year-old woman with acute promyelocytic leukemia (APL) was treated with all-trans retinoic acid (ATRA) and chemotherapy according to the AML-92, M3 regimen of the Japan Adult Leukemia Study Group (JALSG). Between days 7 and 18 of therapy, she suffered chest discomfort, fever, cough, dyspnea and general fatigue. A chest roentogenogram showed bilateral interstitial infiltrates. Her leukocyte count began to increase rapidly to 6,400/microliters on day 14. Marked hypoxia (PO2 35.9 mmHg) suggested occurrence of retinoic acid (RA) syndrome. She underwent endotracheal intubation and mechanical ventilation with administration of methyl-prednisolone (m-PSL) pulse therapy. Her symptoms promptly abated. Therapy with ATRA was continued and her leukocyte count reached 44,800/microliters on day 19 of therapy. She achieved complete remission on day 48.
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PMID:[Effective methyl prednisolone pulse therapy for a patient with retinoic acid syndrome in acute promyelocytic leukemia]. 823 Jul 47

Eleven patients with mild or moderate myasthenia gravis (MG) were subjected to a strength training program of 27 to 30 sessions during ten weeks. Voluntary maximal muscle force and the degree of fatigue during repetitive maximal isometric muscle contractions were measured in three muscle groups. The subjects did not experience any subjective discomfort or any adverse effect on their MG due to the training. A 23% increase of the maximal voluntary muscle force in knee extension in the trained side was found, compared to 4% in the untrained side (p < 0.05). Only small changes were noted regarding maximal muscle force in elbow flexion and extension or in any of the muscle groups in the fatigue test. Physical training can be carried out safely in mild MG and provides some improvement of muscle force.
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PMID:Physical training effects in myasthenia gravis. 823 58

In spite of differences in embryologic origin, central nervous organization, and muscle fiber distribution, the physiology and action of mandibular elevator muscles are comparable to those of skeletal muscles of the limbs, back, and shoulder. They also share the same age-, sex-, and activity-related variations of muscular strength. With respect to pathogenesis, the type of muscular performance associated with the development of fatigue, discomfort, and pain in mandibular elevators seems to be influenced by the dental occlusion. Clinical research comparing the extent of occlusal contact in patients and controls as well as epidemiologic studies have shown reduced occlusal support to be a risk factor in the development of craniomandibular disorders. In healthy subjects with full natural dentition, occlusal support in the intercuspal position generally amounts to 12-14 pairs of contacting teeth, with predominance of contact on first and second molars. The extent of occlusal contact clearly affects electric muscle activity, bite force, jaw movements, and masticatory efficiency. Neurophysiologic evidence of receptor activity and reflex interaction with the basic motor programs of craniomandibular muscles tends to indicate that the peripheral occlusal control of the elevator muscles is provided by feedback from periodontal pressoreceptors. With stable intercuspal support, especially from posterior teeth, elevator muscles are activated strongly during biting and chewing with a high degree of force and masticatory efficiency, and with relatively short contractions, allowing for pauses. These variables of muscle contraction seem, in general, to strengthen the muscles and prevent discomfort. Therefore, occlusal stability keeps the muscles fit, and enables the masticatory system to meet its functional demands.
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PMID:Mandibular elevator muscles: physiology, action, and effect of dental occlusion. 824 35

A 85-year-old woman consulted our hospital with general fatigue, palpitation and chest discomfort changing with different postures. Her electrocardiogram showed sinus tachycardia, atrial premature beats and left atrial overload. 53% cardiothoracic ratio, slightly protruding third arch of the cardiac silhouette and dilated pulmonary artery were seen on the chest X-ray. Two dimensional echocardiography revealed a mass in the left atrium although the quality of echocardiography was suboptimal due to her thoracic deformity. There was no uptake of T1-201 or Ga-67 by the mass. The four-chamber view of Tc-99m ECG-gated SPECT radionuclide angiocardiography showed a filling defect in the left atrium. The T1 weighted magnetic resonance imaging revealed a left atrial mass with relatively low signal intensity. After intravenous injection of Gadolinium-DTPA the signal intensity of the mass increased significantly and the contrast of the mass was improved. The size of the mass was 4 x 4 x 3 cm with a stalk connecting to the interatrial septum. These findings were compatible with left atrial myxoma. Gadolinium-DTPA magnetic resonance imaging is useful in diagnosing left atrial myxoma because it provides information on the size, anatomical location, relationship with other cardiovascular structures and even the characteristics of the mass.
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PMID:[Gadolinium-DTPA magnetic resonance imaging in the diagnosis of left atrial myxoma in the elderly]. 829 60

Recent studies of obstructive sleep apnea and its comorbidity with other systemic diseases have stimulated interest in the relationship of apnea to renal disease and hypertension. Polysomnographic sleep studies in patients on dialysis who complain of day-time fatigue or sleepiness reveal significant apnea in up to 73% of those studied. Abnormalities in respiratory controller mechanisms from chronic hypocarbia, metabolic acidosis, and uremic toxins have been blamed for the occurrence of apnea in this setting. Proteinuria and sometimes nephrotic syndrome have been recognized in morbidly obese patients with sleep apnea syndrome. Renal biopsies of such patients have shown glomerulomegaly and focal segmental sclerosis. It is postulated that these lesions may result from increased glomerular filtration and blood flow. Elevated urine output, sodium and chloride excretion, and atrial natriuretic peptide have been well demonstrated in obstructive apnea patients and correct to control levels with treatment of the apnea. Both acute (with each apnea) and chronic daytime blood pressure elevation are frequently observed in sleep apnea patients, and occult sleep apnea is postulated as one possible cause of "primary" hypertension in middle-aged men. In younger patients, such hypertension seems to be more reversible with the elimination of apnea. In older patients, however, the cure of systemic hypertension cannot be guaranteed with the elimination of the apnea, and asymptomatic apnea patients tend not to tolerate the bother and discomfort of apnea treatment with nasal continuous positive airway pressure. Therefore, aside from a careful history regarding sleep symptomatology, polysomnographic studies of clinic populations with primary hypertension to search for apnea as a cause cannot be recommended.
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PMID:Obstructive sleep apnea and the kidney. 830 38

Our randomised study in parallel groups, double-blind double placebo, has compared the efficacy, onset of action and safety of terfenadine and cetirizine in chronic idiopathic urticaria. Over a fourteen day period, patients of the first group received a tablet containing 120 mg of terfenadine, those of the second group a tablet containing 10 mg of cetirizine. Symptoms were assessed every two hour period for the ten first hours on the first day (D1), and before and at the end of the study by the investigators. 193 patients were included by 48 dermatologists between May 1989 and July 1990. Both groups were well matched for all general characteristics and baseline symptoms scores. The onset and the intensity of regression of symptoms (pruritus, erythema and discomfort during sleeping time) were similar in both treatment groups public physicians: improvement of pruritus in over 90% of the patients. Meanwhile the tolerability was good or excellent for dermatologists and allergologists for 92% of the patients under terfenadine against 81% of the patients under cetirizine (p < 0.05). Adverse events (fatigue and drowsiness) were significantly reported less frequently (p < 0.05) in patients on terfenadine (19%) than on cetirizine (33%). This study confirms the efficacy of terfenadine compared with cetirizine in the treatment of chronic idiopathic urticaria. Adverse events were less significant for terfenadine (n = 18) than for cetirizine (n = 29) (p < 0.05).
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PMID:[Double-blind comparative study of terfenadine and cetirizine in chronic idiopathic urticaria]. 835 72

A 85-year-old female was admitted with general fatigue and chest discomfort in July 1991. Her chest X-ray film showed several pulmonary nodules in the bilateral lung fields without hilar lymphadenopathy. Metastatic lung cancer was suspected, but primary cancer was not detected in spite of cancer screening. Hemoglobin was 8.7 g/dl. The patient also had various immunological abnormalities including increased serum cold agglutinin titer, decreased serum complement, positive anti-nuclear antigen and IgM-kappa monoclonal gammopathy detected by immunoelectrophoresis. She was diagnosed as having autoimmune hemolytic anemia with cold agglutinin disease and M-protein. With the administration of corticosteroids, hemolytic anemia improved temporarily, but the patient died of hemorrhagic gastritis. At autopsy, a lung tumor was detected in the left upper lobe, mainly without hilar lymphadenopathy. The autopsy specimens showed Non-Hodgkin's lymphoma (diffuse medium-sized cell type), differentiated from macroglobulinemia by immunohistochemical studies. In elderly patients, with various immunological abnormalities, B-cell lymphoproliferative disorders such as malignant lymphoma should be suspected.
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PMID:[Non-Hodgkin's lymphoma with pulmonary involvement and various immunological abnormalities in an elderly patient]. 836 Oct 68


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