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

As illustrated by the case study described in this paper, in-vivo fractures of distraction rods often occur by metallurgical fatigue at the junction between the smooth and ratcheted parts of the rod (i.e., at the first ratchet junction, FRJ). To clarify causative factors of fatigue at the FRJ, stresses are analyzed in a standard 11-in. rod using both experimental and theoretical methods. The analyses reveal how distraction force, eccentricity of loading, rod geometry and material determine the stresses at the FRJ. These stresses can exceed the fatigue endurance limit for certain clinically encountered conditions.
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PMID:Stresses in a Harrington distraction rod: their origin and relationship to fatigue fractures in vivo. 686 50

A 73-year-old woman with fatigue fracture of the right pubic rami following total hip arthroplasty had a long delay to union. Discrepancy in leg lengths due to nonunion of an intertrochanteric osteotomy of the contralateral hip may have contributed to the fatigue fracture of the pubic rami. The postarthroplasty fatigue fractures in patients reported in the literature were of the compression type and healed within a few weeks. In the patient reported here, the fracture was of the distraction type and was characterized by failure of callus formation with slow healing requiring two years to union.
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PMID:Fatigue fracture of the pubic ramus following total hip arthroplasty with unusual delayed healing. 708 66

Various studies (Tyson et.al.; Frantz; Aono et.al.) show that cycling of prolactin is critical to the establishment of successful lactation in the first 60 to 80 days postpartum, and that a 2-hour nursing interval is associated with a statistically significant earlier onset of milk production (Salarija et.al.). However, in the patient with a lactational insufficiency, efforts to increase the frequency of nursing more often than every 2 hours may be counterproductive, as experimental evidence shows that prolactin exerts a negative feedback upon itself, and the patient with a breastfeeding problems may experience increased episodes of anxiety and fatigue. The patient with breast milk insufficiency can be managed by ensuring that a sucking stimulus of 30 minutes (15 minutes bilaterally) be present and repeated every 2-3 hours to provide adequate stimulation for prolactin release. Maternal anxiety about milk supply can be relieved by using the Lact-Aid nursing supplementer, a device which provides an additional source of milk to the infant at the breast. Nursing should be carried out in a sheltered situation to provide an uninterrupted sucking stimulus devoid of distraction. The mother should be directed to focus on pleasant associations while nursing to keep her from worrying about whether she will have enough milk. Symptoms of lactational insufficiency can be corrected with proper hormonal regulation. Evaluation of a breastfeeding disorder depends upon a careful physical examination of the breast, preferably to be done prior to and during infant nursing. Observation of infant nursing has not been a standard part of physical examination, although it is critical to making a diagnosis of the problem. The principles of breastfeeding management are illustrated in 3 cases in this chapter. In cases where there is no response to treatment, additional evaluation of the patient's developmental (e.g., adolescent attitude towards the breast) attitude and sexual function history should be done.
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PMID:Prolactin cycling and the management of breast-feeding failure. 722 37

Carbon fiber reinforced polyetheretherketone (C/PEEK) composite materials are being investigated as an alternative to metal in the femoral component of a total hip arthroplasty. Wear is among the issues that must be addressed before introducing a new orthopaedic implant material. This study examines the generation of wear debris when zirconia femoral heads are mechanically attached to C/PEEK trunnions and loaded under simulated physiological conditions. Mechanical testing was performed on a trunnion/head assembly loaded from 445 to 4450N at an angle of 39 degrees to the long axis of the trunnion. The trunnions were tested at a frequency of 20 Hz for 10 million cycles. After completion of the fatigue test, solution from the test assembly was characterized by laser scattering and by SEM image analysis to determine the size, shape, total number, and identify of the particles. In addition, the peak load to pull the head from the trunnion was measured. The total number of particles generated during the test was in the range of 10(5) as indicated by both laser scattering and (SEM) image analysis. Both carbon fiber and PEEK particles were found in an average proportion of about 1:13, respectively. The carbon fiber particle size average was 153 microns and the PEEK particle size average was 2.2 microns. The zirconia heads remained well attached to the C/PEEK trunnions as indicated by a mean peak distraction force of 1942 +/- 116N.
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PMID:Characterization of wear in composite material orthopaedic implants. Part I: The composite trunnion/ceramic head interface. 795 Aug 68

Forty-nine skeletally mature patients who had either a non-union or a malunion of a fracture of the tibia or the femur had correction of the deformity and acute axial lengthening of the fractured bone. Distraction was provided by the short AO/ASIF fracture distractor applied directly to the site of the osteotomy or non-union. At an average of sixty-three months (range, twenty-six to 105 months), the average increase in the tibial and femoral length was 1.7 and 3.2 centimeters, respectively. There were no compartment syndromes or ischemia secondary to any of the procedures. One patient had a transient sensory-nerve loss. Fatigue fractures were seen in two tibial plates, two femoral plates, and one femoral intramedullary nail used for osteosynthesis. A non-union developed after four other femoral intramedullary nailing procedures. One infection developed after lengthening of a tibia. Restoration of normal length by acute lengthening and internal fixation was achieved in twenty-seven patients. One patient had overlengthening of one centimeter. Fifteen patients had residual shortening of approximately one centimeter, three had shortening of more than one to 2.5 centimeters, and three patients had more than 2.5 centimeters of shortening. The patients in this series had acute restoration of limb length after traumatic shortening with a low prevalence of complications of neurovascular compromise. Three of the thirty tibial lengthenings and seven of the nineteen femoral lengthenings had to be followed by at least one additional procedure to obtain union.
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PMID:Acute lengthening of shortened lower extremities after malunion or non-union of a fracture. 812 43

This study aimed to refine and extend the findings of an original study which focused on the description of fatigue associated with congestive heart failure. A descriptive approach based on Levine's Conservation Model provided both quantitative and qualitative data. Qualitative data addressed personal integrity and quantitative data measured energy conservation, structural and social integrity. Patients described fatigue as being tired and exhausted and containing both physical and emotional components. Fatigue occurred as a result of stress, physical activity and disease. Patient-identified interventions included rest, distraction, medicine, and physical and spiritual activities. Age, pH and oxygen saturation were significantly related to fatigue. The findings are examined using the concept of adaptation as defined by Levine. Implications for nursing are discussed within the framework of the Conservation Model with emphasis on a holistic approach to patient care.
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PMID:Fatigue associated with congestive heart failure: use of Levine's Conservation Model. 843 16

In a 10-week randomised cross-sectional study we used an 88-item questionnaire to assess the quality of life in 16 children (ages 8-17 years) with Crohn's disease and their families. The questionnaire covered six domains of health-related quality of life, including disease and its treatment, social, emotional, family, education, and future aspects. Crohn's disease affected education, with absenteeism in 12 and distraction during school work in six. Three children had had a home tutor, and five stated their need for one. Engaging in sports was a problem for eight children, mainly because of a lack of energy in five and the presence of a stoma in three children. Three children had missed every PE lesson in 1 year. Five children cited the social problem of being unable to stay over at friends' houses. Bullying concerned parents more than the children. Holiday difficulties included long distance traveling or lack of toilet facilities during school trips. Elemental diet was the preferred treatment, although the majority complained about the taste. Surgery was the most effective method of symptom control, though the resulting stoma was upsetting and restricted sports activities. Children on steroids had more depressive symptoms. Using the Rutter A Questionnaire, five children were designated "neurotic." Parents' views of the severity of symptoms significantly correlated with their children's views regarding rectal bleeding, poor growth, lack of energy, and poor appetite (p < 0.01). The main parental concerns were the side effects of medications and issues concerning their children's future, including schooling, job prospects, and marriage. The parents of 11 children cited problems with children's behaviour. The parents of seven cited disruption of work, and those of six named taking holidays. Crohn's disease in children, in addition to being a symptomatically disabling condition, has a great impact on the health-related quality of life of both sufferers and their parents. The questionnaire was a useful instrument, and with some adjustment it can be used again in large group studies.
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PMID:Quality of life in children with Crohn's disease. 898 40

This study investigated the impact of different types of music on tension, mood, and mental clarity. A total of 144 subjects completed a psychological profile before and after listening for 15 minutes to four types of music (grunge rock, classical, New Age, and designer). With grunge rock music, significant increases were found in hostility, sadness, tension, and fatigue, and significant reductions were observed in caring, relaxation, mental clarity, and vigor. In contrast, after listening to the designer music (music designed to have specific effects on the listener), significant increases in caring, relaxation, mental clarity, and vigor were measured; significant decreases were found in hostility, fatigue, sadness, and tension. The results for New Age and classical music were mixed. Feeling shifts among subjects were observed with all types of music. Designer music was most effective in increasing positive feelings and decreasing negative feelings. Results suggest that designer music may be useful in the treatment of tension, mental distraction, and negative moods.
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PMID:The effects of different types of music on mood, tension, and mental clarity. 943 23

Fatigue in children and adolescents with cancer is a disruptive symptom meriting clinical intervention by nurses, but has eluded definition, measurement, and intervention. Fatigue in these patients exists within a greater context of illness, treatment, and child and family development. Any effort to define, measure, and intervene with fatigue needs to take into consideration the major components of these children and adolescents' treatment context. The purpose of this descriptive study was to learn from three perspectives (patient, parent, and staff) how fatigue is identified and defined in 7- to 12-year-old children and in 13- to 18-year-old adolescents with cancer, and what factors contribute to or alleviate this fatigue. To elicit this information, separate focus groups were conducted with patients, parents, and staff at two pediatric oncology centers. Resulting interview data were analyzed using pragmatic and semantic content analysis techniques and the Wilson concept analysis process. Findings clearly indicated that children, adolescents, parents, and staff define patient fatigue differently. The conceptual definition from the child data emphasizes the physical sensation of the fatigue; alternating and at times merging physical and mental tiredness are emphasized in the adolescent's definition. Parents and staff view themselves as responsible for alleviating patient fatigue; patients viewed rest and distraction as their primary sources of improving fatigue. The conceptual definitions of fatigue as rendered by our three groups of participants can assist pediatric oncology patients, their parents, and staff in identifying fatigue. Factors identified by these participants as contributing or alleviating fatigue could be the basis for future interventions designed to reduce fatigue in pediatric oncology patients.
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PMID:Comparing patient, parent, and staff descriptions of fatigue in pediatric oncology patients. 1045 4

The Australian Incident Monitoring Study (AIMS) database of the Australian Patient Safety Foundation (APSF) was reviewed from its inception in April 1987 to October 1997. A total of 5600 AIMS reports were lodged in that period. Reports in which fatigue was listed as a Factor Contributing to Incident were examined. This occurred in 152 reports, or 2.7% of all reports. Confidence interval analysis suggested that fatigue was associated with various concurrently reported factors. These included pharmacological incidents (especially syringe swaps) and time of day. Other factors significantly associated with fatigue reports were haste, distraction, inattention and failure to check equipment. Relieving anaesthetists and healthy patients were reported more often as factors minimizing incidents. Anaesthetists reporting fatigue more often reported incidents during induction. These data suggest that fatigue alleviation strategies and equipment checking routines, improved workplace design (including drug ampoule and syringe labelling protocols) and regulation of working hours will facilitate minimization of fatigue-related incidents. Definitive prospective studies might be most usefully targeted at these and related interventions.
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PMID:Anaesthesia and fatigue: an analysis of the first 10 years of the Australian Incident Monitoring Study 1987-1997. 1085 13


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