Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A multicenter, double-blind, randomized, placebo-controlled study evaluated the efficacy and safety of gabapentin (Neurontin, GBP) as add-on therapy in 272 patients with refractory partial seizures who were receiving one to two standard antiepileptic drugs (AEDs). Efficacy assessments compared the frequency of partial seizures during the 12-week treatment phase (T) and the 12-week baseline period (B). The primary analysis compared data for patients receiving GBP 900 mg/day with placebo; the GBP 1,200-mg/day group provided dose-response data. Efficacy criteria were percentage of change in seizure frequency (PCH), responder rate (percentage of patients with > or = 50% reduction in seizure frequency), and response ratio, where RRatio = (T-B)/(T + B). Median PCH was -21.8% in the 900-mg/day group and -17.8% in the 1,200-mg/day group as compared with -0.3% in the placebo group. Responder rate was 22.9% in the 900-mg/day group and 10.1% in the placebo group (p = 0.020, Fisher's exact test). Adjusted mean RRatio was -0.136 in the 900-mg/day group and -0.025 in the placebo group (p = 0.0046, analysis of variance ANOVA). Results showed slightly greater improvement for the 1,200-mg/day than for the 900-mg/day group (RRatio = -0.157, responder rate 28.0%). Adverse events (AE) occurred in 69% of patients in the 900-mg/day group and in 64% in the 1,200-mg/day group as compared with 52% in patients receiving placebo as add-on therapy. The most frequent AE among patients treated with GBP were somnolence, dizziness, and fatigue. Clinical laboratory evaluations showed no clinically important trends and no evidence of hepatic or hematopoietic effects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Gabapentin (Neurontin) as add-on therapy in patients with partial seizures: a double-blind, placebo-controlled study. The International Gabapentin Study Group. 808 24

Biomechanical evaluation of twelve different spinal devices in vitro employing pedicle screws was performed using static (n = 5) and cyclical testing (n = 3) parameters. In general, the rank order of implant failures was similar between static and cyclical tests, performed at 600 N compressive load, 5 Hz, and 1 million cycles. The mean number of cycles to failure was higher for spinal instrumentation systems employing longitudinal rods than those using plates (ANOVA F = 16.94, P < .001). At 600 N, the compact Cotrel-Dubousset, TSRH, and ISOLA rod systems demonstrated mean cycles to failure ranging from 200,000 to 800,000 cycles. The remaining devices including Dyna-lok, Kirschner plate, and VSP devices had failures ranging from 50,000 to 210,000 cycles. Polyethylene cylinders representing vertebral bodies were used to eliminate the problems of biologic deterioration encountered with cadaveric spines (a full cyclical test to 1 million cycles required 56 hours), and thus to provide analysis of the weak portion of each spinal system. The failure of eleven of the twelve spinal systems occurred by fracture of a pedicle screw, most commonly at the junction of the upper screw thread and the collar (Kirschner, AO fixator, standard CD, ISOLA, and TSRH). However, in Dynalok and VSP systems, fracture of the threaded portion of the screw just posterior to the integral nuts was the most common screw fracture location. The compact CD system was the only spinal implant that consistently failed by fracture of the longitudinal spinal member (rod). The fatigue life of rod based systems was longer than plate based systems. These studies confirm the importance of anterior column load sharing (vertebral body, corpectomy bone graft) as the mean bending strength demonstrated by these implant systems was not inordinately high using this "worst case scenario" model.
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PMID:Static and cyclical biomechanical analysis of pedicle screw spinal constructs. 823 49

Developing interventions to maintain or restore attentional capacity during demanding phases of illness will help promote effective functioning in people with cancer. This study tested the effects of an experimental intervention aimed at maintaining or restoring attentional capacity in 32 women during the 3 months after surgery for localized (Stage I or II) breast cancer. The intervention was designed to minimize or prevent attentional fatigue through regular participation in activities that engage fascination and have other restorative properties. Attentional capacity was assessed using objective and subjective measures at four time points, approximately 3, 18, 60, and 90 days after breast cancer surgery. After the first observation, subjects were randomly assigned to receive the intervention (n = 16) or not to receive intervention (n = 16). Repeated measures ANOVA showed a significant interaction of experimental intervention and time on attentional capacity. Specifically, subjects in the intervention group showed significant improvement in attentional capacity over the four time points, while the nonintervention group showed a pattern of inconsistent performance over time. Findings suggest that nurses can intervene to maintain or restore attentional capacity in women after surgery for localized breast cancer. The theoretical basis for further development of attention-restoring interventions in patients with cancer is discussed.
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PMID:Development of an intervention to restore attention in cancer patients. 847 4

The purpose of this study was to evaluate the electromyographic (EMG) response of the erector spinae to whole body vibration in three different unsupported seated postures: neutral upright, forward lean, and posterior lean. Subjects were 11 healthy college-age men. EMG was collected using bipolar surface electrodes placed bilaterally over the erector spinae at the L4 level. A modified chair with attached accelerometer was affixed to an induction type vibrator. Subjects were vibrated vertically at 4.5 Hz and 6.21 m.s-2 RMS. Data were collected in each of the three postures for 30 s pre- and post-vibration and for 2 min during vibration. Mean EMG values were determined for each sampling period and compared using ANOVA. The mean value for anterior lean was significantly larger (p < 0.05) than that for posterior lean and neutral. EMG data analysed by triggered averaging showed a phase-dependent response to the vibratory cycle for the forward leaning and neutral upright postures. The results of this study indicate that the magnitude of the vibration synchronous response of the erector spinae musculature is dependent upon body posture. This response may be an important factor in the onset of muscular fatigue and the increased incidence of back disorders among individuals exposed to whole body vibration.
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PMID:Effects of seated posture on erector spinae EMG activity during whole body vibration. 851 74

Subjects were instructed to modify their N100-P200 component of VEP (in Cz recording) within selected time window. The aim was to increase the number of VEPs for which the amplitude of segment in question exceeded the definite threshold. The success in task performance suggests several modifications of the to-be-conditioned segment through different mechanisms. Of our 26 subjects, 14 were able to modify their VEPs according to the task demands. However, the latter subjects could be divided into 2 groups on the basis of the rate of increase in the number of correct responses under conditioning. Subjects which did not succeed in task performance could be also classed into 2 groups: one group with statistically negligible changes and the other decreasing the number of correct responses. ANOVA has shown significant distinctions in task performance for the groups with different levels of self-estimation of tiredness after experiment and different personal strategies. The success in task performance is likely to be dependent on the values of Eysenck questionnaire scales and topography of alpha activity.
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PMID:[The conditioning of the N100-P200 component of the human visual evoked potential by using biofeedback]. 854 Feb 51

A total of 43 patients with multiple sclerosis (MS) consecutively admitted to the Multiple Sclerosis Rehabilitation Hospital in Haslev completed a Danish version of the Laman & Lankhorst Questionnaire (LLQ) on quality of life (qol), and the Beck Depression Inventory (BDI). Twenty-one of the 43 pts completed the questionnaires at discharge as well. All patients received the standard multidisciplinary rehabilitative treatment. The purpose was to evaluate the LLQ as a measure of qol and as an outcome measure. The 43 MS-patients had low weighted qol scores on the following items: readily tired, fatigue, dependence on other people, worry about deterioration and walk. Correspondingly, the BDI showed high scores on fatigability, work difficulty and somatic preoccupation. The correlation between LLQ and BDI was statistically significant (0.54, p < 0002), but weak. ANOVA with repeated measures (LLQ and BDI at admission and discharge) was applied to evaluate rehabilitation outcome in 21 patients. LLQ: The patients experienced a significant reduction in disability on fatigue and mood; and in the importance of being able to climb stairs and to work. The weighted qol-scores increased significantly on physical endurance, work and mood. BDI scores showed a significant decrease on pessimism, irritability, loss of libido and total BDI-score. The changes measured by the LLQ were mainly on behavioral aspects. As the correlation coefficient was only 0.54, the LLQ and the BDI seem to address different aspects of quality of life.
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PMID:Quality of life as a measure of rehabilitation outcome in patients with multiple sclerosis. 873 30

The purposes of this study were to determine the effects of 4 wk of intensified training on resting plasma glutamine concentration, and to determine whether changes in plasma glutamine concentration relate to the appearance of upper respiratory tract infection (URTI) in swimmers during intensified training. Resting plasma glutamine concentration was measured by high performance liquid chromatography in 24 elite swimmers (8 male, 16 female, ages 15-26 yr) during 4 wk of intensified training (increased volume). Symptoms of overtraining syndrome (OT) were identified in eight swimmers (2 male, 6 female) based on decrements in swim performance and persistent high fatigue ratings; non-overtrained subjects were considered well-trained (WT). Ten of 24 swimmers (42%, 1 OT and 9 WT) exhibited URTI during the study. Plasma glutamine concentration increased significantly (P = 0.04, ANOVA) over the 4 wk, but the increase was significant only in WT swimmers (P < 0.05, post-hoc analysis). Compared with WT, plasma glutamine was significantly lower in OT at the mid-way timepoint only (P < 0.025, t-test with Bonferroni correction). There was no significant difference in glutamine levels between athletes who developed URTI and those who did not. These data suggest that plasma glutamine levels may not necessarily decrease during periods of intensified training, and that the appearance of URTI is not related to changes in plasma glutamine concentration in overtrained swimmers.
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PMID:Plasma glutamine and upper respiratory tract infection during intensified training in swimmers. 877 16

Isokinetic leg strength and fatigue were measured in 24 male U.S. Marine Corps volunteers in a simulated sleep loss and unusually heavy work scenario. Knee extension and flexion peak torque (PT) were measured at three isokinetic speeds (1.57, 2.62 and 3.66 rad.s-1) followed by 45 consecutive maximal reciprocal contractions at 3.14 rad.s-1 to measure fatigue index (FI). All subjects were retested 2 days later following 30-h sleep deprivation (SD). The exercise group (n = 12) spent 25 1-h sessions performing computer tasks, filling out questionnaires and walked 1.61 km with a 50% gross body mass pack load, during each of the 25 sessions. The control group (n = 12) did likewise but did not exercise. Repeated measures ANOVA indicated that flexion PT at 1.57 rad.s-1 decreases (P < 0.013) after SD. Exercise did not affect FI but did decrease PT. It was concluded that carrying a 50% load produces decrements in PT for both extension and flexion but more so for flexion. SD affected PT but had no effect on FI.
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PMID:The effect of sleep deprivation and exercise load on isokinetic leg strength and endurance. 878 57

Diaphragmatic fatigue can occur following high-intensity leg exercise to exhaustion. Exercise-induced diaphragmatic fatigue may be due to changes in the milieu to which the diaphragm is exposed (i.e., acidosis, etc.) and/or to increases in diaphragmatic activity during exercise. The purpose of this study was to determine whether changes in milieu are responsible for exercise-induced diaphragmatic fatigue. Fourteen subjects exercised at 70 to 75% of their maximal work capacity until volitional exhaustion. Transdiaphragmatic twitch pressure (Pdi) was measured during bilateral transcutaneous supramaximal phrenic nerve stimulation and adductor pollicis twitch force was measured during transcutaneous supramaximal ulnar nerve stimulation before and 10 to 15, 30, and 60 min after exercise. On a separate day, arterialized venous blood samples were obtained for lactate measurements at baseline and 5, 15, 30, and 60 min postexercise. Nine subjects demonstrated a > or = 10% decrease in twitch Pdi postexercise, which was considered indicative of diaphragmatic fatigue (fatigue group). In these subjects, twitch Pdi fell from 24.3 +/- 1.6 at baseline to 19.7 +/- 1.6 cm H2O at 10 min postexercise (p < 0.0001, ANOVA). Adductor pollicis twitch force was not significantly different from baseline at any time postexercise in either the fatiguers or nonfatiguers. In both groups, a significant lactic acidosis developed during exercise and the magnitude of this acidosis was similar for the two groups. The adductor pollicis muscle (a nonexercising muscle during cycle exercise) is exposed to the same milieu as the diaphragm. Because adductor pollicis twitch force was unchanged postexercise while twitch Pdi fell, changes in milieu cannot be solely responsible for exercise-induced diaphragmatic fatigue.
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PMID:Mechanisms for diaphragmatic fatigue following high-intensity leg exercise. 891 69

Upper respiratory illness (URI) may cause more frequent acute disability among athletes than all other diseases combined. The purposes of this study were to determine the impact of a rhinovirus-caused URI on resting pulmonary function submaximal exercise responses and on maximal exercise functional capacity. Twenty-four men and 21 women (18-29 yr) of varying fitness levels were assigned to the experimental group (URI), and 10 additional individuals served as a control group (CRL). An initial serological screening was performed on all URI group subjects to exclude those with the rhinovirus 16 (HRV16) antibody. All subjects completed both a baseline pulmonary function test and a graded exercise test to volitional fatigue. URI subjects were inoculated with HRV 16 on two consecutive days within 10 d of completing these tests. The day following the second inoculation (peak of illness), post-inoculation pulmonary function and graded exercise tests were performed. A noninfected control group completed these same pulmonary and exercise tests 1 wk apart. ANOVA identified no significant differences (P < 0.05) at minutes 2, 5, and 8 for the physiological responses measured between the pre- and post-exercise tests for both the URI and CRL, groups. Furthermore, there were no significant differences between maximal exercise performance between running trials for either group. There was also no significant interaction between treatment (pre/post URI) and group for any of the pulmonary function measures obtained. In conclusion, physiological responses to pulmonary function testing and submaximal and maximal exercise do not appear to be altered by an URI.
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PMID:Effect of a rhinovirus-caused upper respiratory illness on pulmonary function test and exercise responses. 914 Aug 95


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