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

Obstructive sleep apnea is a significant medical problem affecting up to 4 percent of middle-aged adults. The most common complaints are loud snoring, disrupted sleep and excessive daytime sleepiness. Patients with apnea suffer from fragmented sleep and may develop cardiovascular abnormalities because of the repetitive cycles of snoring, airway collapse and arousal. Although most patients are overweight and have a short, thick neck, some are of normal weight but have a small, receding jaw. Because many patients are not aware of their heavy snoring and nocturnal arousals, obstructive sleep apnea may remain undiagnosed; therefore, it is helpful to question the bedroom partner of a patient with chronic sleepiness and fatigue. Polysomnography in a sleep laboratory is the gold standard for confirming the diagnosis of obstructive sleep apnea; however, the test is expensive and not widely available. Home sleep studies are less costly but not as diagnostically accurate. Treatments include weight loss, nasal continuous positive airway pressure and dental devices that modify the position of the tongue or jaw. Upper airway and jaw surgical procedures may also be appropriate in selected patients, but invasiveness and expense restrict their use.
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PMID:Obstructive sleep apnea. 1059 19

Changes in mood, performance, cortisol, and physiological variables with a month-long energy restricting diet (3.347 MJ/day) were studied in nine overweight (mean mass 71.2 +/- 8 kg; body mass index 26.1 +/- 2.8 kg/m(2)), healthy premenopausal (age 20-36 years) women. Measurements were taken in the 2 weeks before the diet (baseline) and again in the final 2 weeks of the diet to attenuate menstrual cycle differences. A reduction in energy intake and concomitant weight loss (5.80 +/- 1.65 kg) were accompanied by a significant decline in systolic blood pressure (5.4%), heart rate (7.6%), and cortisol concentration (13.6%). Fatigue and vigour on the Profile of Mood States (POMS) questionnaire were adversely affected; however, subjective assessments of mood, concentration, temperature sensitivity, appetite, and sleep quality using visual analogue scales, were not significantly altered during the month-long period of energy restriction. Motor performance, as assessed by hand-eye coordination, improved with both a reduction in mean reaction time and improved accuracy in response to visual stimuli. The very low-energy diet appeared to be neither physiologically nor psychologically stressful. Beneficial effects were evident with a reduction in BMI, reduced risk of cardiovascular stress, improved motor performance, and a decline in physiological stress with dieting success.
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PMID:Beneficial physiological and performance responses to a month of restricted energy intake in healthy overweight women. 1071 82

The rapidly rising prevalence of obesity, worldwide, has prompted re-evaluations of the definitions and diagnostic criteria, and of the extent of the burden it contributes to health care services. Although categorized arbitrarily for epidemiological purposes according to BMI > 25 kg/m2 ('overweight') and BMI > 30 kg/m2 ('obese'), the disease itself (ICD code E.66) is the process of excess fat accumulation. It leads to multiple organ-specific pathological consequences, particularly if there is a tendency to intra-abdominal fat accumulation. The simplest field method to identify obesity and risk of medical problems is the waist circumference, and this method has found a special role in health promotion. Risks begin with waist > 80 cm (women) or > 94 cm (men). As a broad generalization, obesity produces few symptoms below the age of 40 years, but then several symptoms often develop; tiredness, breathlessness, back pain, arthritis, sweatiness, poor sleeping, depression and menstrual disorders all being common. The symptoms are often attributed to diseases in other body systems. Metabolic diseases like diabetes, hyperlipidaemia and, hypertension develop later, but the mean BMI at diagnosis of diabetes is 28 kg/m2. Ultimately, obesity increases the likelihood of myocardial infarction, stroke and several major cancers, but its biggest impact on health, especially in the elderly, is probably the multiplicity of effects on other body systems. The greatest challenge for public health is to develop effective preventive measures, recognizing that BMI > 25 kg/m2 before the age of 20 years is a very strong predictor of obesity and ill health in adulthood.
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PMID:Pathophysiology of obesity. 1099 48

The present investigation tested a 12-wk. treatment protocol which employed low intensity cardiovascular and resistance exercise as well as cognitive-behavior modification on 13 obese, previously sedentary women. Separate analyses were conducted on program maintenance, emotional change, and physiological change. Although self motivation was lower in the treatment group than in the control group (n=35), measures of exercise maintenance were significantly higher. Analyses within the treatment group only indicated significant improvements in measures of State Anxiety, Depression, Anger, Fatigue, Tension, and Vigor, also Health Evaluation, Body Area Satisfaction, and heightened Overweight Preoccupation, over the 12 weeks. Their feelings after individual bouts of exercise indicated significantly increased Positive Engagement, Revitalization, and Tranquility, and reduced Physical Exhaustion. Maximum volume of oxygen uptake (VO2max) significantly increased (2nd to 10th percentile), but not resting heart rate. No significant correlation was found between cardiorespiratory change and change in scores on depression and anxiety. No significant association was found between physiological change and change in body image. Preliminary evaluation of the minimal exercise treatment was given. The need to replicate findings with larger and different samples was emphasized.
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PMID:Effects of minimal exercise and cognitive behavior modification on adherence, emotion change, self-image, and physical change in obese women. 1101 3

Topiramate is a newly developed anticonvulsant agent with possible mood-stabilizing properties. Little is known about the short- and long-term effects of topiramate monotherapy in bipolar disorder. We here present the case of a 60-year-old female bipolar patient who received topiramate alone as maintenance treatment after recovering from euphoric mania. During 7 months, she was free from new manic symptomatology and she was able to reduce her overweight by 16.5 kg. The patient who is known to have a strongly hyperthymic temperament described symptoms of fatigue and sedation and eventually discontinued topiramate monotherapy. When she presented again in our bipolar clinic, severe euphoric mania had developed. After hospitalization, she slowly responded to oral sodium valproate loading plus zotepine. Her weight increased again and so did her triglyceride serum levels. Topiramate treatment and discontinuation did not seem to affect cholesterol serum levels.
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PMID:Topiramate monotherapy in the maintenance treatment of bipolar I disorder: effects on mood, weight and serum lipids. 1109 73

Wasting is a severe, dangerous medical condition, and it can occur quickly, even in overweight patients. In wasting, the digestive process is disrupted, and patients lose their ability to absorb necessary nutrients from food. HIV interferes with metabolism, causing the body to burn muscle mass before it burns fat. Additionally, other physical problems can make eating difficult or painful, and the nausea associated with HIV therapies compounds the problem. Several nutritional supplements are recommended for people with weakness, fatigue, or poor appetite. Some are standard supplements intended to boost caloric intake easily, others are modified fat supplements or special formula supplements designed for special purposes.
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PMID:Managing weight loss with nutritional supplements. 1136 27

Childhood obesity may be seen as a marker for high-risk dietary and physical inactivity practices. Recent increases in the prevalence of overweight and obesity among American children are not limited to one age, gender, or ethnic group, which suggests that unique behaviors of the members of various racial or ethnic subgroups of the population are unlikely to be the major contributing factors. Rather, it seems that environmental changes promoting increased energy intake and decreased energy output are occurring and have widespread impact on children from various backgrounds. Although no ethnic group is immune from the current shift in energy balance, differential rates of overweight seem to exist among ethnic groups. National probability samples of African-American, Hispanic, and white children in the United States provide clear evidence that white children are at lower risk for childhood overweight than are African-American or Hispanic children. Of concern is the lack of national data on the prevalence of overweight and obesity for Native-American and Asian-American groups. Also of concern is the aggregation of racial and ethnic subgroups, which may render prevalence rates meaningless. This possibility is clearly true with some surveys of weight status that combine diverse populations, such as Asians and Pacific Islanders, into one group. The high rates of obesity in African-American, Hispanic, and Native-American children are of concern. Although parental SES is associated inversely with childhood obesity among whites, higher SES does not seem to protect African-American and Hispanic children against obesity. In these groups, childhood obesity does not seem to be associated significantly with parental income and education. Health consequences of childhood obesity include a higher prevalence of type 2 diabetes and an increased risk for adverse levels of lipids, lipoproteins, and blood pressure. The effects of recently reported unprecedented levels of childhood overweight on subsequent risk for obesity in middle age are not known until future longitudinal data can be collected. It seems likely, however, that future health consequences of current early and severe childhood obesity will be staggering. Funding for adult follow-up of longitudinal studies of high-risk African American, Hispanic, and Native-American children is needed urgently to provide information on the long-term effects of childhood obesity. Halting the obesity epidemic is a formidable task, but the success in recent decades of drastically reducing childhood undernutrition offers hope and should spur similar action and leadership efforts. Promotion of efforts to reduce excess caloric intake with efforts to increase energy expenditure should receive paramount attention in the design of health programs. Given the relatively few published obesity-prevention and treatment studies that are designed to address specific cultural issues, it is important to promote the development of culturally appropriate intervention strategies that are shown to be effective among youth of diverse backgrounds. Although the dietary and activity goals will be similar, parental, family, and community messages and techniques grounded in cultural traditions and norms will be different for each ethnic group. This approach is crucial in the United States, a country with an increasingly diverse population.
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PMID:Ethnic issues in the epidemiology of childhood obesity. 1149 40

It's well known that physical growth and intellectual activity is influenced by nutritional status. With the purpose of evaluate the fasting effects on the cognitive functions, anthropometric state and cognitive functions (logic and school work performance), under fasting and post-breakfast condition were assessed in a group of 68 school children age 9 and 10 years, who studied in a private school (1998-1999). Logic reasoning was measured with Raven test and attention, precision, velocity and fatigue with the Lepez test. The main of the children (80%) were well-nourished and 20% had showed overweight. At breakfast condition all subjects were over 50 percentil for Raven test. Consumption of breakfast influence on logic reasoning (p < 0.001) and school work performance (p < 0.01). It is concluded that in these well nourished children, breakfast consumption improved cognitive performance.
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PMID:[Influence of breakfast on cognitive functions of children from an urban area in Valencia, Venezuela]. 1151 33

We examined potentially modifiable lifestyle factors as possible risk factors for the onset of fatigue and psychological distress after 1-year follow-up among 8833 employees who participated in the prospective Maastricht Cohort Study of "Fatigue at Work." Results showed, even after adjustment for demographics, presence of disease, other lifestyle factors, psychosocial work characteristics, and psychological distress, that overweight (body mass index, 25 to 29.9) and being physically inactive during leisure time were strongly related to onset of fatigue in men, whereas underweight (body mass index, < 18.5) in women increased the risk for future fatigue. In addition, the study suggests some differential effects of lifestyle factors in the onset of psychological distress. Certainly, these modifiable factors can be targeted in interventions, either on an individual or group level, to prevent or at least reduce the risk of developing fatigue and psychological distress in the working population.
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PMID:Lifestyle factors as risk factors for fatigue and psychological distress in the working population: prospective results from the Maastricht Cohort Study. 1185 91

This exploratory study attempted to estimate the severity of health complaints and disabilities in patients supplied with foot orthoses for degenerative foot disorders in the Netherlands. Information on the severity and the distribution of the complaints in these patients is important to acquire insight in the problems which these patients experience, and moreover is essential for further research, especially for evaluating effects of patients undergoing foot orthosis treatment. Patients with degenerative foot disorders aged 18 years and over were recruited from nine orthopaedic workshops over a period of three months in 2000. One hundred and twenty-two (122) patients were included in the study. Two approaches were used to obtain data. Firstly, shoe technicians and orthotists inspected patients' feet and legs and interviewed them at their initial visit. Data on gender, age, height, weight, existing and prescribed orthotic devices were recorded on a report form. Secondly, patients were asked to fill in a questionnaire assessing type, location, frequency, intensity and duration of health complaints, and disability. Data indicate that females with degenerative foot disorders and foot orthoses are twice as common as men. Patients supplied with foot orthoses are twice as often overweight compared to subjects in the general population. Besides frequent and protracted pain there are also fatigue complaints, particularly in the feet and lower leg. Duration and frequency of the complaints suggest that these patients suffer from a chronic pain syndrome. In addition, the results indicate that the functional level of these patients is below that of the general population, in particular regarding physical activities.
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PMID:Health complaints and disabilities in patients supplied with foot orthoses for degenerative foot disorders. 1256 71


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