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

Mental performance and adaptation to exercise and psychoemotional loads were studied in 119 patients with neurocirculatory asthenia (NCA), 245 patients with chronic focal infection (CFI) of the upper airways, and 247 NCA patients with CFI. Exercise tolerance was measured at spiroergometry, intellectual and psychoemotional adaptation were assessed by shifts in attention and fatigue while working with Schulte tables under conditions of time limits and the results criticism, vegetative reactivity was tested with insulin and epinephrine, variation pulsograms recorded vegetative provision of physical, intellectual and psychoemotional activity. Abnormalities in mental performance and the above adaptation related to clinical presentation of NCA and CFI as well as to vegetative regulation were registered in NCA+CFI patients. Mechanisms of the alterations observed and the role of CFI in their genesis are discussed.
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PMID:[Adaptation to physical and psychoemotional loads and mental work capacity in patients with neurocirculatory dystonia]. 801 21

A patient with insulin-dependent diabetes mellitus (type 1 diabetes) was admitted to hospital after complaining of general fatigue and weight loss. To control hyperglycaemia, the patient was given a conventional form of insulin subcutaneously twice daily. Although this conventional insulin replacement therapy effectively controlled the symptoms, it did not improve the metabolic state and eventually the patient was re-admitted due to a worsening of his condition. The patient was then given a new preparation of both short- and intermediate-acting forms of insulin, administered twice daily using a new, 'dial-a-dose' pen delivery system. Comparative studies of blood insulin dynamics revealed that this new method of delivery resulted in a circadian blood glucose pattern closely approximating normal levels, the complete elimination of subjective symptoms and the normalization of basal insulin secretory patterns. The clear superiority of the new delivery system and the combination insulins in relation to the quality of life of this patient is demonstrated.
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PMID:Treatment of type 1 diabetes using a pen-style delivery system and a preparation combining short- and intermediate-acting insulin. 811 79

Elevated circulating insulin levels have been reported in ischaemic heart disease, and may be of aetiological importance. Previous studies have not considered the potential influence of heart failure or of previous myocardial infarction, as opposed to stable angina. We therefore measured the insulin response to a 75 g oral glucose tolerance test in five groups with normal glucose tolerance, comparing normal male controls to men with chronic stable angina, men with recent myocardial infarction (two groups, 3 weeks and 3 months post infarction), and men with chronic severe heart failure. Only patients with chronic heart failure had fasting hyperinsulinaemia, probably reflecting associated neuroendocrine abnormalities. Stimulated hyperinsulinaemia was present in all patient groups, but was less pronounced and of shorter duration in patients with angina. At 120 min, only patients with heart failure or previous myocardial infarction were hyperinsulinaemic. The degree of stimulated hyperinsulinaemia was not influenced by the presence of heart failure or by the length of time from infarction. Hyperinsulinaemia is associated with impaired peripheral muscle glucose uptake and metabolism, and might contribute to muscular fatigue on exertion in patients with previous myocardial infarction or heart failure.
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PMID:Hyperinsulinaemia in ischaemic heart disease: the importance of myocardial infarction and left ventricular function. 769 98

The mechanical effects of ischemic contracture may be important in the development of irreversible cellular damage as it increases mechanical stress on sarcolemmal membranes and restricts endocardial perfusion. To assess the relative importance of these mechanical effects compared with decreased energy supply in the development of irreversible injury, the effects of inhibiting ischemic contracture with 2,3-butanedione monoxime (BDM), an agent that disrupts excitation-contraction coupling, were delineated in isovolumically contracting isolated rabbit hearts. Administration of 20 mmol/L BDM in 12 hearts subjected to 60 minutes of low-flow ischemia prevented ischemic contracture (left ventricular end-diastolic pressure [LVEDP], 12 +/- 3 compared with 48 +/- 14 mm Hg in 20 control hearts; P < .001), reduced membrane damage (creatine kinase [CK] release, -54% compared with control hearts; P < .05), and enhanced functional recovery during reperfusion (left ventricular developed pressure [LVDP], 86 +/- 10% of baseline compared with 56 +/- 23% in control hearts; P < .01). These observations were not related to increased intracavitary pressure and its effects on flow distribution, since venting the left ventricle in additional hearts did not result in improved function during reperfusion. Although it would be tempting to conclude that BDM protected ischemic myocardium by preventing ischemic contracture, administration of BDM was also associated with reduced depletion of ATP during ischemia, perhaps related to diminished energy demand. To distinguish between the relative importance of inhibiting contracture from provision of adequate energy, the period of ischemia was extended to 120 minutes. BDM still prevented ischemic contracture (LVEDP, 10 +/- 6 mm Hg) and preserved ATP stores, but it did not prevent membrane damage (CK release, 483 +/- 254 U/g dry weight) or contractile failure during reperfusion (LVDP, 68 +/- 7% of baseline). In contrast, increasing the rate of anaerobic glycolysis during ischemia by doubling glucose and insulin in the presence of BDM markedly decreased membrane damage (CK release, 114 +/- 72 U/g dry weight; P < .05) and contractile failure during reperfusion (LVDP, 88 +/- 7% recovery of baseline; P < .01). These results suggest that insufficient energy production is primarily responsible for myocardial ischemic damage, whereas mechanical effects of ischemic contracture appear to play only a minor role.
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PMID:The relative importance of myocardial energy metabolism compared with ischemic contracture in the determination of ischemic injury in isolated perfused rabbit hearts. 815 29

Several studies of the relationship of food intake to physical exercise strongly suggest that the two are closely linked. Serotonin transmission seems to be particularly important in the regulation of both appetite and central fatigue. Thus, the ingestion of branched-chain amino acids has been reported to decrease serotonin production and to improve physical performance. In the present study, the effects of three treatments (water, glucose, and branched-chain amino acids) were compared in 34 male Wistar rats. Maximal exercise duration, blood insulin, and glucose levels were measured. Results showed that following the ingestion of branched-chain amino acids, physical performance is lower and blood insulin level is higher than after glucose administration.
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PMID:Effects of administration of branched-chain amino acids vs. glucose during acute exercise in the rat. 819 Jul 72

Since alpha-interferon has been introduced an efficient therapy of chronic active hepatitis has become available for the first time. Among some of the treated patients, however, alpha-interferon therapy causes typical side effects. Fever, chills, loss of weight, fatigue as well as arthralgia, myalgia, loss of concentration and hematologic side effects have to be mentioned in particular. We report the occurrence of a diabetes mellitus under alpha-interferon therapy. The metabolic disorder gradually normalized after 3 weeks of antidiabetic treatment, although the interferon medication had been continued. We consider this disorder to be an effect caused by the alpha-interferon. The underlying mechanism might be an insulin resistance or an autoimmunologic defect. For that reason, when administering alpha-interferon, we recommend regular analyses of the blood sugar level during the regular patient monitoring.
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PMID:[Transient insulin-dependent diabetes mellitus with alpha-interferon therapy in chronic active hepatitis]. 825 76

Effects of carbohydrate (CHO) supplementation on muscle glycogen utilization and endurance were evaluated in seven well-trained male cyclists during continuous cycling exercise that varied between low [45% maximal O2 uptake (VO2 max)] and moderate intensity (75% VO2 max). During each exercise bout the subjects received either artificially flavored placebo (P), 10% liquid CHO supplement (L; 3 x 18 g CHO/h), or solid CHO supplement (S; 2 x 25 g CHO/h). Muscle biopsies were taken from vastus lateralis during P and L trials immediately before exercise and after first (124 min) and second set (190 min) of intervals. Subjects then rode to fatigue at 80% VO2 max. Plasma glucose and insulin responses during L treatment reached levels of 6.7 +/- 0.7 mM and 70.6 +/- 17.2 microU/ml, respectively, and were significantly greater than those of P treatment (4.4 +/- 0.1 mM and 17.7 +/- 1.6 microU/ml) throughout the exercise bout. Plasma glucose and insulin responses of S treatment were intermediate to those of L and P treatments. Times to fatigue for S (223.9 +/- 3.5 min) and L (233.4 +/- 7.5 min) treatments did not differ but were significantly greater than that of P treatment (202.4 +/- 9.8 min). After the first 190 min of exercise, muscle glycogen was significantly greater during L (79 +/- 3.5 mumol/g wet wt) than during P treatment (58.5 +/- 7.2 mumol/g wet wt). Furthermore, differences in muscle glycogen concentrations between L and P treatments after 190 min of exercise and in time to fatigue for these treatments were positively related (r = 0.76, P < 0.05). These results suggest that CHO supplementation can enhance prolonged continuous variable-intensity exercise by reducing dependency on muscle glycogen as a fuel source.
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PMID:Carbohydrate supplementation spares muscle glycogen during variable-intensity exercise. 828 93

To determine if exercise intolerance and fatigue in chronic heart failure could be exacerbated by an abnormal metabolic response to exercise, we studied 12 patients with stable chronic heart failure and 12 normal volunteers during symptom-limited maximal treadmill exercise. Peak VO2 was 17.2 (15.1-19.2) ml.kg-1 x min-1 in patients and 29.9 (26.3-33.5) in controls (mean and 95% confidence intervals; P < 0.0001, t-test). Overall, levels in peripheral venous blood of glucose, glycerol and free fatty acids were greater in patients, although the differences became less marked with increasing exercise intensity. Noradrenaline was elevated in patients at rest, but the peak exercise response was similar to controls. Responses of adrenaline, insulin and glucagon were similar in both groups. We conclude that depletion of the levels of circulating substrates is not contributory to exercise intolerance and fatigue in chronic heart failure. Greater levels of glycerol and free fatty acids may be mediated by excess sympathetic nervous system activity, reflected in elevated noradrenaline levels.
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PMID:Metabolic responses to graded exercise in chronic heart failure. 829 29

Data from studies in diabetic rodents and evidence from clinical situations of severe resistance to insulin suggest that insulin-like growth factor I (IGF-I) is able to at least partly overcome insulin resistance. To assess the efficacy of recombinant human IGF-I in subjects with the most common form of insulin resistance, e.g., obese, type II diabetic patients, we administered recombinant human IGF-I (rhIGF) in doses of 120 and 160 micrograms/kg twice daily for 4-52 days to seven such individuals who had been treated previously with high doses of insulin (> 0.7 U.kg-1 x day-1). Four patients exhibited comparable or enhanced, whereas three had diminished, blood glucose control on rhIGF-I relative to that while on twice daily NPH insulin during the six-week control period. The occurrence of adverse effects in all patients compelled us to discontinue rhIGF-I administration before completing the 8-week treatment period. These adverse effects included edema primarily on the face and hands, mild weight gain, occasional dyspnea, bilateral jaw tenderness, arthralgias and myalgias, fatigue, tachycardia, flushing, orthostatic hypotension, and local burning at the injection site. We conclude that the frequency and severity of side effects associated with administering high-dose subcutaneous rhIGF-I to obese insulin-resistant diabetic patients make it an unacceptable therapeutic agent for these patients despite its ability to produce reasonable blood glucose control in approximately 50% of them.
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PMID:Adverse effects of recombinant human insulin-like growth factor I in obese insulin-resistant type II diabetic patients. 831 9

Blood glutathione status and activities of antioxidant enzymes have been investigated during prolonged exercise with or without carbohydrate (CHO) supplementation. Eight subjects cycled at approximately 70% of maximal oxygen uptake to fatigue [134 +/- 19 (SE) min] on the first occasion (control, CON) and at the same work load and duration on the second occasion but with CHO ingestion during exercise. Blood reduced glutathione (GSH) concentration increased from 0.55 +/- 0.05 mM at rest to 0.77 +/- 0.09 mM after 120 min of exercise during CON (P < 0.01) but remained constant during CHO exercise. Blood glutathione disulfide (GSSG) levels were unchanged during CON and CHO exercise. Blood GSH + GSSG content and GSH/GSSG ratio were also significantly (P < 0.05) elevated during CON but not during CHO exercise. The increases in GSH and GSH + GSSG in CON were associated with decreases in plasma glucose and insulin levels. Activities of blood GSH peroxidase, GSSG reductase, and glucose-6-phosphate dehydrogenase were significantly increased during the CHO exercise, whereas only GSSG reductase activity was elevated during the CON ride. It is concluded that blood GSH increases during prolonged exercise and that CHO supplementation may prevent blood GSH increase possibly because of its inhibitory effects on hepatic hormonal releases, which stimulate GSH output.
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PMID:Blood glutathione status during exercise: effect of carbohydrate supplementation. 838 16


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