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

Prevalence rates of various side effects were studied comparatively among 3 oral contraceptive preparations containing 50 mcg of the estrogen component. Norinyl 1/50, Ovral, and Norlestrin 1 were each randomly assigned to groups of 160 healthy women who had consented to participate in the study designed to quantitate probabilities of experiencing specific side effects and of their continuing into the subsequent cycles. Acne, breast discomfort, nausea, abdominal bloating, headache, fatigue, depression, irritability, vaginal discharge, and breakthrough bleeding were the specific side effects studied; only breakthrough bleedings showed a statistical difference in prevalence. The rate of breakthrough bleeding associated with Ovral use in the 1st 3 cycles (16.6%) was significantly (P .05) lower than that associated with using either Norinyl or Norlestrin (46% and 51.7%, respectively). Norelestrin, aside from breakthrough bleeding, was reported as generally freer of side effects than the other 2 preparations. The probabilities of side effects being experienced in the 2nd or 3rd cycle after the effect(s) was experienced in the 1st cycle showed that overall, for all 3 combination pills, the probabilities significantly decreased from the 2nd to the 3rd cycle (P .05). Also examined was the probability that a side effect would occur in the 2nd or 3rd cycle if the user had not experienced such an effect in the 1st cycle. In each instance, the probabilities are significantly lower (P .05) than the corresponding probabilities where the symptom had been experienced in a previous cycle. These data support the contention that side effects experienced on inititation of oral contraceptives should not prohibit its continuation because the majority of symptoms will disappear as the patient becomes accustomed to the hormonal preparation.
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PMID:The probability of side effects with ovral, norinyl 1/50 and norlestrin. 16 Aug 60

In preparation for introducing the injectable contraceptive norethisterone enanthate (NET-EN) into the national family planning program, a field study was conducted in 6 family planning clinics in Bangladesh. 3 of the clinics were located in Dhaka, the capital city, 1 was located in a town approximately 15 kilometers from Dhaka, and the other 2 clinics were located several hundred kilometers from Dhaka. A total of 913 women were chosen to receive injections of NET-EN every 8 weeks for 6 months and every 12 weeks thereafter. The mean age of the subjects was 26.8 years, and the mean number of live births was 3.4. The overall cumulative discontinuation rates were 26.3/100 women at 6 months, 37.3/100 at 12 months, and 42.9/100 at 18 months. The most common reason for discontinuing was a disturbance in bleeding. Heavy and/or prolonged bleeding was the single most frequent reason (6.3/100 women at 12 months), but amenorrhea was not uncommon (5.1/100 women at 12 months), while irregular bleeding or spotting was given as a reason somewhat less frequently (3.9/100 women). 3 women became pregnant during the study, giving a cumulative pregnancy rate of 0.4/100 women at 18 months. A variety of complaints fell within the category of "other medical reasons," the most common being fatigue, headache, and dizziness. The overall discontinuation rates varied markedly by center, as did the reasons for discontinuation. The lowest discontinuation rate of 14.7/100 women at 12 months was seen in the Mohammedpur Fertility Services and Training Center. This rate was considerably lower than that in any other center. The highest discontinuation rate was found by the Bangladesh Association for Voluntary Sterilization -- 52.0/100 women at 12 months. The variation in rate of discontinuation because of bleeding disturbances was most dramatic, with relatively high rates at the Bangladesh Association for Voluntary Sterilization, markedly low rates in the Mohammedpur Fertility Services and Training Centre, and intermediate rates elsewhere. Neither the overall discontinuation rate, nor the individual reasons for discontinuation varied much by age group. The most notable finding regarding discontinuation of NET-EN was the marked difference between centers. This is particularly notable given the lack of any major differences with respect to age, parity, residence, and history of contraception of the subjects. These findings suggest that the specific approach used in each clinic had a considerable impact on continuation rates and acceptance of NET-EN.
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PMID:Introduction of the injectable contraceptive NET-EN into family planning clinics in Bangladesh. 387 43

618 women used Ortho-Novum 2mg (2 mg norethindrone and .1mg mestranol) for 5330 cycles of treatment. There were no pregnancies. 34.8% of the patients experienced some diminution of menstrual flow volume and 20.6% experienced bleeding episodes, most commonly during the first few cycles. There was no weight change in 20%, 46.5% noted a gain of 5 to 10 pounds, weight loss occurred in 24.4%. The most common side effects were nausea (2.9%), mastalgia (1.6%), nervousness (1.3%), fatigue (1.1%), and headaches (1.1%). 10.3% of the clinic patients and 14.7% of the private patients complained of side effects. The dropout rate was 5.5%.
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PMID:Long-term study of oral contraception with norethindrone 2 mg. and mestranol 0.1 mg. 590 Oct 12

Hyper- and hypothyroidism in the elderly do--as many other diseases--not present with the typical clinical picture known from textbook descriptions. Thus hyperthyroidism may be the cause of common complaints and symptoms such as weight loss, fatigue, lack of appetite and cardiac failure with tachycardiac arrhythmias. Due to completely unspecific symptoms and signs, the hypothyroid elderly patient will initially be presented to a psychiatrist, neurologist, dermatologist, gastroenterologist or ENT-specialist rather than to an endocrinologist or geriatrician. The serious consequences which may result from overlooking hyper- and hypothyroidism in the elderly can be prevented if the possibility of thyroid disease is more frequently taken into consideration, if the diagnosis is based on modern in-vitro measurements, and if hyper- and hypothyroidism are systematically looked for in groups at risk, i.e. in inhabitants of old people's, homes, nursing homes as well as in patients of psychiatric and geriatric hospitals.
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PMID:[Diagnostic and therapeutic problems of hyper- and hypothyroidism in the aged]. 644 66

2 strengths of a new low-dose, combined oral contraceptive were tested to determine their efficacy and any untoward side effects or complications. The new contraceptive agent formulation, Ovysmen, contains either .5 mg or 1 mg or norethisterone combined with .35 mg of ethinyl estradiol. A total of 36 nonselected patients, aged 16-35 years, were studied. 3 were parous, and the remainder were nonparous; few had histories of hormonal contraception. The patients were divided into 2 groups, and 1 was administered Ovysmen 1/35 and the other was given Ovysmen .5/35. The contraceptives were administered in a cyclic manner. Patients were tested for various clinical parameters at intervals of 3, 6, and 12 months from start of therapy; no irregularities were reported. There were no pregnancies in this study. In the Ovysmen .5/35 group, 7 of 18 patients continued through 12 months, without menstrual irregularities, 4 continued 6-9 months, and 7 discontinued use after only 3 months. Most early discontinuers were switched to the 1-mg preparation. In contrast, 16 or 18 subjects in the Ovysmen 1/35 group continued for 12 months without irregularities. On Ovysmen .5/35, 11 subjects experienced intermenstrual bleeding, 2 experienced amenorrhea, 1 reported fatigue, 1 reported diminished libido, and 7 complained of vaginal discharge; in the Ovysmen 1/35 group, 6 subjects experienced intermenstrual bleeding, 1 was hypermenorrheic, 3 reported diminished libido, and 6 complained of vaginal discharge. Both formulations were judged safe and effective.
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PMID:Experiences with the new oral contraceptive Ovysmen. 735 10

The obstructive sleep apnea syndrome is a highly prevalent and underdiagnosed disease. Repetitive arousals due to upper airway obstruction lead to hypersomnia. Due to the insidious onset, patients often underestimate the severity of their symptoms. Relatives can give helpful additional informations and should be involved in history taking and motivation for treatment. In general, GP's are confronted with the problem of fatigue and hypersomnia in the first line. They play the most important role in selecting patients for further investigations. The patient history helps to separate hypersomnia from fatigue. Hypersomnia indicates falling asleep at daytime in unappropriate situations, especially when the subject is passive. Often, a multidisciplinary approach including respiratory physicians, ENT specialists, orthopedic dentists and neurologists is warranted. Anatomic narrowing of the upper airway must be ruled out by clinical investigation. Overnight sleep studies detect apneas/hypopneas and repetitive arousals. Continuous positive airway pressure, applied by a nose mask and a flow generator remains the mainstay of therapy. Motivation, counseling and troubleshooting especially in the beginning of this therapy are of outmost importance. Ongoing research aims to improve comfort of nose masks and optimize function of flow generators.
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PMID:[Diagnosis of sleep apnea syndrome--role of family practitioner]. 1095 50

This study was designed to determine the quality of life of patients successfully treated for laryngeal cancer. A questionnaire was mailed to 233 patients. A total of 124 responses were suitable for analysis. The questionnaire consisted of three components: sociodemographic data, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ - C 30, version 2.0), and EORTC QLQ, Head and Neck Module (H & N 35). The assessment included five treatment groups: chordectomy, partial laryngectomy, irradiation as primary therapy, laryngectomy, laryngectomy and radiotherapy. The evaluation for the functional scales of the EORTC QLQ - C 30 resulted in a higher quality of life of patients with maintained larynx in comparison to laryngectomised patients. In the symptom scales, patients after laryngectomy and/or radiotherapy suffered more from fatigue, pains and appetite loss. Laryngectomees stated more financial difficulties. The evaluation of the ENT-specific EORTC module showed that patients after laryngectomy had more symptoms. Typical symptoms after radiotherapy were a dry mouth, sticky saliva and coughing. Noticeably, no differences existed among the several groups with regard to voice production. The EORTC QLQ- H & N 35 does not appear to be sensitive enough to assess this parameter.
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PMID:Quality of life of patients with laryngeal carcinoma: a post-treatment study. 1158 65

This study aimed to evaluate the mean shear bond strength of molar tubes with micro-etched bases bonded with either a compomer (Ultra Band-Lok), a resin-modified glass ionomer cement (3M Multi-Cure or Fuji Ortho LC), or a light-cured resin adhesive (Transbond). The amount of adhesive remaining on the tooth surface following tube removal was assessed also. Finally, survival time of molar tubes bonded with each bonding agent was assessed following simulated mechanical fatigue in a ball mill. A total of 120 extracted human third molars were collected and randomly divided into 4 test groups. Thirty teeth (20 to assess debonding force and 10 to assess survival time) were bonded with each adhesive according to the manufacturers' instructions. Debonding was carried out using a Nene M3000 testing machine with a crosshead speed of 0.5 mm/min. The mean shear bond strength of tubes bonded with Transbond was significantly less than that of those bonded with 3M Multi-Cure (P = .0036) or Fuji Ortho LC (P < .0001). Tubes bonded with Ultra Band-Lok also had significantly lower mean shear bond strength than those bonded with Fuji Ortho LC (P = .020). Distribution of adhesive remnant index scores only differed significantly between tubes bonded with 3M Multi-Cure or Transbond. Only I molar tube, bonded with Transbond, debonded in the ball mill at 5 hours, but at 50 hours there was no significant difference in the survival time of tubes bonded with any of the bonding agents. Compomer or resin-modified glass ionomer cements appear to be viable alternatives to light-cured resin adhesive for bonding molar tubes.
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PMID:Bonded molar tubes--an in vitro evaluation. 1160 72

Trismus is a firm closing of the jaw due to tonic spasm of the muscles of mastication from disease or the motor branch of the trigeminal nerve. Trismus may be produced by a variety of reasons such as dental abscess, trauma, following mandibular block with local anesthesia, as a result of radiation to the facial muscles, and patients after chemotherapy. A case of a referral of a six-year-old boy to a dentist from an ENT due to severe limitation in jaw opening is presented. Intraoral examination and panoramic radiograph demonstrated no signs of infection and/or other pathology. After a diagnosis of trismus was made, due to his icteric appearance, the general fatigue and loss of appetite in the last few days, palpated and sensitive lymph nodes in the submandibular and cervical regions, the child was referred for a complete blood count and sedimentation rate. The laboratory and clinical findings resulted in the diagnosis of acute lymphoblastic leukemia (ALL). Dental and oral manifestations of ALL are discussed, and the trismus may be explained by an intensive infiltration of leukemic cells into the deep portion of the contracting muscles of the face. This case emphasizes the importance of physical examination and independent judgement made by dentists, even when patients are referred to them by other members of the medical communities.
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PMID:Trismus in a 6 year old child: a manifestation of leukemia? 1217 25

The farnesyltransferase inhibitors (FTIs) have been shown in early clinical trials to elicit antitumor actions in a broad range of solid and hematologic malignancies. The mechanism of FTI action involves blockade of farnesyltransferase, an enzyme implicated in multiple cell-signaling pathways involved in proliferation, angiogenesis, or decreased apoptosis. Of the four main classes of FTIs, two orally bioavailable FTIs have advanced farthest in clinical development. ZARNESTRA (formerly R115777, Ortho Biotech Oncology, Raritan, NJ) and Sarasar (formerly SCH66336, Schering-Plough, Kenilworth, NJ) have demonstrated biologic and clinical activity in a range of solid tumors, and Zarnestra phase I trials have documented clinical responses in approximately 30% of patients with high-risk leukemias or myelodysplastic syndrome (MDS). The main across-class toxicities associated with the use of FTIs are myelosuppression and fatigue. Certain toxicities, such as the QTc abnormalities associated with L-778,123, do not appear to be class related. As results of phase II trials with FTIs in acute and chronic myeloid leukemias and in MDS become available, clinicians will learn more about the potential role of this class of targeted anticancer drugs-and possibly about the clinical distinctions among members of this class.
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PMID:Farnesyltransferase inhibitors: novel compounds in development for the treatment of myeloid malignancies. 1221 90


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