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

Controversial views on the postviral fatigue syndrome ("myalgic encephalomyelitis") were critically appraised in their historical context and recent advances in research (virology, immunology, neurophysiology, histopathology, and epidemiology) reviewed. Flaws detected in certain aspects of recent research included in particular failure to define fatigue, inadequate assessment of psychological features, and absent or inappropriate control groups. The findings suggest that the fruitless dichotomy of "organic versus functional" should be replaced by a multifactorial approach. Most important, epidemiological studies with explicit operational case definition are essential before progress can be made in the management of this distressing disorder.
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PMID:Postviral fatigue syndrome: time for a new approach. 312 74

This article illustrates that the diagnostic evaluation as well as the management of the patient presenting with chronic fatigue can be done in an orderly manner. If a medical illness is the cause of the patient's fatigue, this is usually evident on initial presentation. A thorough history and complete physical examination, in conjunction with some screening laboratory tests, can rule out most medical causes of fatigue, and any remaining cases declare themselves over the next several visits. If a medical cause is not evident, a further "fishing expedition" is fruitless. Psychiatric illness, such as depression or generalized anxiety disorder, accounts for another significant proportion of cases of chronic fatigue. As with medical illness, psychiatric illness should be suspected based on history and is not a diagnosis of exclusion. Some patients presenting with chronic fatigue have a history and symptom pattern consistent with the diagnosis of CFS. The cause of this syndrome is controversial and is still unknown. The clinician, however, can offer the patient care in an environment that is respectful of their physical and psychological discomfort and can provide significant symptomatic improvement to the patient. Lastly, some patients with fatigue do not fit any diagnostic category, including CFS. As with many other common complaints, such as headaches or abdominal pain, although a diagnosis may not be given to the patient, the clinician can do a lot to reassure the patient and assist the patient in living with his or her symptoms. As Solberg eloquently wrote: "[E]valuation of the fatigued patient requires all of a physician's best attributes--a broad view of disease, psychosocial sensitivity, and a good ongoing relationship with the patient."
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PMID:The chronically fatigued patient. 787 93

Over the last 20 years, academic, industry and community stakeholders have been meeting at a biennial scientific conference to discuss fatigue-related research and policy in the transportation, resources and health sectors. During this period, the research conducted around the world has progressed substantially: we now better understand the basic processes of sleep and circadian physiology that underpin performance; we better understand that fatigue risk management in the absence of any discussion about sleep is fruitless at worst and inadequate at best; and we are improving the capacity of models and other technologies to assist us to predict, monitor, identify, minimise and mitigate fatigue-related risk. At the same time however, the relationship between performance on simple cognitive tasks in laboratory settings and performance on complex tasks required to operate efficiently and safely in the workplace, remains a stumbling block. This special issue brings together fifteen papers that cover the range of areas in the field of fatigue research and challenges us as researchers, regulators, industry representatives and community members to continue the work of managing the risk of fatigue.
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PMID:Fatigue research in 2011: from the bench to practice. 2223 22

Scurvy in modern times may not be as rare as previously thought. The link between adequate intake of vitamin C and scurvy has been known since ancient times and is recorded in Ebers Papyrus. Recent reports indicate that, with restricted diets, vitamin C deficiency is being seen in infants exclusively fed plant-based formula and children with oral aversion, autism, restricted diets, and cerebral palsy. Additional at-risk groups include the older adults and patients having alcoholism. Often costly, emergency department visits and elaborate diagnostic studies lead to fruitless results when a simple diet history is often overlooked. Here, we report a case of pediatric scurvy in an 11-year-old autistic child with a restricted diet who presented with refusal to walk, fatigue, a purpuric rash, and gingival bleeding. The diagnosis was made based on diet history, physical examination findings, and symptom resolution with vitamin C supplementation. Our case report reaffirms that vitamin C deficiency still occurs and should be considered in children with restrictive diets. Early recognition of this disease by physicians provides early diagnosis, avoids costly diagnostic workup and hospitalization, and expedites effective treatment.
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PMID:Do You C What I C: Emergency Department Evaluation and Diagnosis of Pediatric Scurvy in an Autistic Child With a Restricted Diet. 2936 63