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

Excess fatigue is the most prevalent precursor of sudden cardiac death. This state may reflect prolonged tension or heart disease. In order to test the first explanation a prospective study was done among 3365 males, aged 45-59 years. This cohort was followed during an average period of 9.5 years. Exhaustion was assessed by the statement: 'At the end of the day I am completely exhausted mentally and physically'. Among those free of coronary heart disease at the beginning, 69 subjects died because of myocardial infarction. Data were analysed using Cox's regression analysis. The results showed a highly significant interaction between duration of follow-up and exhaustion upon the risk of cardiac death. The hazard ratios for exhaustion were 8.96, 6.33, 4.47 and 3.16 for the first 10, 20, 30 and 40 months of follow-up respectively. Thereafter the association between exhaustion and cardiac death is no more significant. It is argued that exhaustion before cardiac death does not reflect manifest heart disease but that an interaction between prolonged tension and subclinical levels of ischaemia may increase the risk of cardiac death.
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PMID:Exhaustion as precursor of cardiac death. 139 66

A 74-year-old housewife was admitted to the hospital with complaints of high fever and general fatigue. The physical examinations on admission showed no particular findings except for mild hepatomegaly, but laboratory findings showed severe liver dysfunction, active inflammation and negative tuberculine test. On the 4th day, she suddenly complained of severe respiratory distress. A chest X-ray film demonstrated surprising changes in comparison with that taken on admission. On suspicion of adult respiratory distress syndrome (ARDS) associated with military tuberculosis (Miliary TB), administration of Methylpredonisolone (1000 mg a day for 3 days) in addition to antituberculous drugs was immediately started. With this therapy she was recovered from such ill condition, but the general exhaustion and slight fever continued. We suspected that her condition might be due to adrenocortical involvement of Miliary TB and hormonal examinations were performed. Unexpectedly, Cushing's syndrome was suspected on the basis of the following; high level of plasma cortisol without normal daily variation, normal ACTH level, an absent response to the Dexamethasone suppression test. Computed tomography revealed left side adrenal mass. During these examinations, renal dysfunction probably due to Miliary TB grew gradually worse and she died of renal failure on the 56th day. Necropsy revealed disseminated tuberculosis involving the lungs and the liver, but the adrenal glands were not examined.
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PMID:[A case of miliary tuberculosis (miliary TB) accompanied with adult respiratory distress syndrome (ARDS) in a patient with Cushing's syndrome]. 140 68

We investigated whether fatigue of the expiratory muscle may account for a change in the respiratory effort sensation in normal subjects. We also examined the effects of inspiratory muscle training (IMT) and a beta 2-agonist, fenoterol, on respiratory effort sensation during loaded breathing. Experiment 1: Expiratory threshold loading was performed until exhaustion or 30 min, to induce expiratory muscle fatigue. The respiratory effort sensation was scored using a modified Borg scale. The maximum static expiratory pressure during loading (PEmaxload) decreased with time, and the Borg score rose with time. The relationship between the sensory score and PEmaxload was virtually linear. Experiment 2: Twice daily, IMT was performed using a pressure threshold device for 15 min in each session. The inspiratory threshold was set to 30% of each subject's maximum inspiratory pressure (Plmax) and IMT was continued for 4 weeks. Respiratory sensation (Borg score) was evaluated during a progressive exercise test. IMT increased inspiratory muscle pressure by 30%. However, there was no change in Borg score during the exercise test. Experiment 3: Fenoterol (5 mg) was given 2 hours before the inspiratory threshold loading, and then threshold loaded breathing was continued until exhaustion or 60 min. Endurance time increased by 50% in fenoterol group compared to placebo group. The increase in Borg score with time was less in fenoterol group than in placebo group. The decrease in respiratory muscle strength after loading was comparable in both groups. We conclude that the increased respiratory effort sensation during expiratory threshold loading is closely related to expiratory muscle fatigue as indicated by the decrease in expiratory muscle force.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Relationship of respiratory muscle fatigue and respiratory effort sensation: mechanisms and treatment]. 140 66

A group of 24 Dutch World War II Resistance veterans with a documented traumatic war history and a (partially) positive diagnosis of current posttraumatic stress disorder (PTSD) was studied. This special group of war victims is characterised by chronicity, suffering from intractable posttraumatic complaints for decades. They were treated with fluvoxamine (Fevarin), a selective serotonin reuptake inhibitor with antidepressive and anxiolytic properties. The study was designed as an open-ended, outpatient pilot study, with a treatment period of 12 weeks. Results of clinical examination, and questionnaires investigating PTSD, depression, sleeping problems, anxiety, and vital exhaustion indicate that a significant number of the subjects improved with respect to their PTSD symptomatology, and their symptoms of anxiety and vital exhaustion. However, at the end of the study, quantitative improvement was modest. The results indicate that treatment with fluvoxamine may offer alleviation of chronic PTSD symptoms, in particular insomnia, nightmares, anxiety, intrusive recollections, guilt feelings and tiredness.
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PMID:Fluvoxamine treatment for chronic PTSD: a pilot study. 141 Jan 91

This study examined the effect of previous intense exercise on energy production during exhaustive exercise. Subjects (n = 6) performed dynamic knee extensor exercise to exhaustion twice (Ex1 and Ex2) separated by 16 min of recovery consisting of 10 min of rest, 3.5 min of very high-intensity intermittent exercise, and a further 2.5 min of rest. This resulted in an elevated muscle lactate concentration of 13.1 mmol/kg wet wt before Ex2. Muscle lactate concentration was the same at end of Ex1 and Ex2, but the accumulation of lactate and net lactate release during Ex2 was reduced (P < 0.05) by 67 and 38%, respectively. The time to exhaustion was 3.73 and 2.98 min, respectively, and the mean rate of net lactate production for Ex2 was lower (P < 0.05) than for Ex1 (4.6 +/- 1.2 and 9.6 +/- 1.7 mmol.min-1.kg wet wt-1, respectively). Leg O2 uptake was the same for Ex1 and Ex2. Muscle pH (6.85) was lowered (P < 0.05) before Ex2, but at the end of Ex2 (6.77) it tended (P < 0.1) to be higher compared with that at the end of Ex1 (6.73). In summary, the net lactate production rate is reduced but the aerobic energy production is not significantly altered when intense exercise is repeated. Fatigue and the lowered glycolysis do not appear to be caused by the elevated acidity per se before exercise.
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PMID:Elevated muscle acidity and energy production during exhaustive exercise in humans. 141 3

Symptoms of depression in the majority of patients immediately following acute myocardial infarctions (AMI) resolve rapidly; they are an adjustment reaction. However, in a group of 552 male patients there were 80 (14.5%) patients with persistent major depressive symptoms during a finite period after AMI. Infarction size was assessed by maximum creatine kinase levels, the QRS-complex and the occurrence of late potentials. These measures did not correlate with the degree of depressed moods in these groups. An arrhythmic event in the early hospitalization phase, a recurrent infarction, dyspnoea, and persistent angina pectoris before the AMI were significantly related to more profound degrees of depression. Patients who reported serious life-events in the last 2 yr before AMI, or who suffered from exhaustion and fatigue in the prehospital phase were subject to significantly higher levels of depression. A prodromal phase prior to hospitalization free of bodily symptoms and the use of denial were related to low levels of depression. The logistic regression model incorporating all univariate significant variables revealed that symptoms of exhaustion and fatigue prior to AMI had the strongest independent correlation with post AMI depression.
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PMID:Factors which provoke post-infarction depression: results from the post-infarction late potential study (PILP). 143 62

Many studies have documented differing changes in forced vital capacity (FVC) following various intensities and durations of exercise. This investigation used three different intensities and durations of treadmill running, with subjects who were active runners, with the intent of finding an intensity or duration that might elicit changes in FVC and if these changes are related to respiratory muscle fatigue. Intensities and durations included a graded maximal test to exhaustion (7-14 min); a 7-min test at 90% of maximal VO2, and a 30-min test at 60% of maximal VO2 (intensity). Maximal inspiratory pressures (MIP), maximal expiratory pressures (MEP), forced expiratory volume in 1 s (FEV1.0) and FVC were measured pretest, and 5, 10, and 30 min post-test (time). MIP was not different across time or intensities. The decrease in MEP approached significance at 10-min post-exercise compared to pretest values (P = 0.0569), with no differences found between intensities. FVC was different between times (P = 0.0117) but not between intensities. FVC was decreased at 5 and 10 min post-test compared with pre and 30 min. FEV1.0 was significantly reduced at 5 and 10 min post-test compared with pretest. These data suggest that a combination of duration and intensity may be necessary to elicit pulmonary function changes after exercise and that expiratory muscle fatigue may be a factor that results in a reduced FVC.
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PMID:Pulmonary function changes following exercise. 147 19

The purpose of this study was to compare the intramuscular and the intravascular events in relation to energy metabolism during progressive arm exercise. Twelve healthy untrained Japanese males participated in this study as subjects. They performed wrist flexion in a ramp incremental load of 0.14 W/min until exhaustion. 31P-MR spectra were obtained from wrist flexor muscle before and throughout the exercise. Venous blood was also sampled from antecubital vein with one minute interval during the exercise, and a change in plasma lactate concentration (La) was observed. Intracellular pH (pH) was calculated from a chemical shift between phosphocreatine (PCr) and inorganic phosphate (Pi) of the 31P-MR spectra. Change in pH showed a threshold behavior during exercise. Threshold points at decline in pH (pHT), increase in Pi/PCr (PT), and increase in La (LT) were determined by piecewise linear regression analysis of minutes-by-minutes data. Mean values of pHT, PT and LT were 43.0, 42.5, and 24.8% of maximal work rate, respectively. LT was significantly smaller than pHT and PT. This result suggests that lactic acidosis has already existed when pH is kept at resting level, and pHT reflects the capacity of remaining intracellular biochemical homeostasis, which might be one of the physiological indices of muscle fatigue.
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PMID:Thresholds for decrease in intracellular pH and increase in blood lactate during progressive exercise: 31P-MRS study. 147 66

One of the most important nutritional goals amongst athletes is to maintain adequate energy and fluid balance, since these are subject to relatively rapid changes and are directly related to performance and health. This may especially be the case when exercise intensity is high. Furthermore, when due to exercise and environmental stress food and fluid intake become depressed. In such conditions there may be a dramatic increase in the utilization of carbohydrate (CHO), fluid, and in some instances protein. These increased requirements may then not be covered. Insufficient replacement of CHO may lead to hypoglycemia, altered protein metabolism, central fatigue and exhaustion. Large sweat losses may pose a risk to health by inducing severe dehydration, impaired blood circulation and heat transfer, leading to heat exhaustion and collapse. Inadequate CHO and protein intake leads to a negative nitrogen balance, which over the long term will lead to a loss of muscle mass. In the scope of this presentation we will refer to the most important nutritional factors which are known to affect performance over a short term, at sea level and altitude.
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PMID:Nutritional aspects of health and performance at lowland and altitude. 148 43

Seven healthy subjects exercised to exhaustion on a bicycle ergometer at a power output corresponding to 70% of maximum oxygen uptake after administration of either a placebo or 20 mg of paroxetine, a serotonin re-uptake inhibitor. Exercise time after paroxetine (median 94 min; range 84-127 min) was less (P < 0.05) than after placebo (median 116 min; range 86-133 min). The metabolic and cardiorespiratory responses to exercise were the same in both trials. This result supports the suggestion that there is a central component to fatigue which is mediated by the activity of serotoninergic neurones.
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PMID:Evidence for a possible role of 5-hydroxytryptamine in the genesis of fatigue in man: administration of paroxetine, a 5-HT re-uptake inhibitor, reduces the capacity to perform prolonged exercise. 148 48


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