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

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

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

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

Loss of weight, dehydration, pregnancy, fatigue, and otitis media are among the factors proposed as causes of a patulous eustachian tube, but true details remain obscure. We studied patients who developed a patulous eustachian tube following otitis media and discuss the relationship between these 2 conditions. Subjects were 12 patients diagnosed with otitis media at our department who later developed a patulous eustachian tube. The initial middle ear disease progressed from acute otitis media to otitis media with effusion in 2, acute otitis media in or acute mastoiditis in 1 each, and otitis media with effusion in the remaining 8 patients. Seven patients evidenced a low body mass index (BMI), weight loss, and underlying disease, but 5 with a patulous eustachian tube following otitis media did not. We retrospectively analyzed 119 patients diagnosed with a patulous eustachian tube in our department for whether they had been diagnosed by an ENT physician as having otitis media, i.e., acute otitis media or otitis media with effusion. Some 42 (35.3%) had a history of otitis media. At acute otitis media or otitis media with effusion, the tympanic cavity becomes inflamed, accompanied by inflammation of the eustachian tube mucosa and a stenotic tendency. Healing from otitis media is accompanied by decreased eustachian tube mucosa inflammation. We surmise that, depending on how inflammation disappears, fibrosis of the eustachian tube mucosa occurs, leading to a pathologically patulous eustachian tube. Many aspects of the causation of this condition remain unclear, but we surmised that in patients with earlier otitis media, a pathological patulous eustachian tube develops during resolution of inflammation. Our findings indicate the involvement of otitis media as a causative factors in a patulous eustacian tube.
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PMID:[Patulous eustachian tube following otitis media]. 1463 69

The main problem arising from tinnitus is the disturbance it causes in day-to-day life and disturbance in sleep leading to fatigue and general discomfort. We attempted to study the effect of melatonin in conjunction with Sulodexide as a treatment method for tinnitus and evaluate its effectiveness. We studied 102 patients suffering from tinnitus with a Prospective Randomised Controlled Study conducted in a tertiary care ENT department. After randomisation, 34 patients were treated with melatonin and Sulodexide, another 34 were treated with melatonin alone, and the remaining 34 (control group) were managed without therapy in order to evaluate spontaneous variations in quality of tinnitus. Patients were assessed prospectively with Tinnitus Handicap Inventory and Acufenometry both pre-treatment and post-treatment. Among the patients we studied, we found better results with both Tinnitus Handicap Inventory and Acufenometry in the group who received melatonin and Sulodexide as against melatonin alone. Any improvement was noted in the control group. In conclusion, our opinion is that melatonin in combination with Sulodexide is a viable treatment option for patients suffering from central or sensorineural tinnitus.
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PMID:Management of tinnitus: oral treatment with melatonin and sulodexide. 1958 91

Since very little is understood about the exact aetiology of tinnitus, this has made treatment of the condition difficult. Even though approximately 10-15% of the general population suffer from tinnitus, only 2% consider it serious enough to warrant any treatment. The main problem arising from tinnitus is the disturbance it causes not only in day to day life but also in sleep, leading to fatigue and general discomfort. The present study focused on the effect of Melatonin in conjunction with Sulodexide as a treatment method for tinnitus. Overall, 102 patients suffering from tinnitus were evaluated in a prospective randomised controlled study conducted in a tertiary care ENT department. After randomisation, 34 patients were treated with Melatonin and Sulodexide, another 34 were treated with Melatonin alone, while the remaining 34 (control group) were managed without treatment in order to evaluate spontaneous variations in the quality of tinnitus. Patients were assessed prospectively with the Tinnitus Handicap Inventory and Acufenometry, both pre- and post-treatment. Among the patients studied, better results with both Tinnitus Handicap Inventory and Acufenometry were found in the group who received Melatonin and Sulodexide compared to those receiving Melatonin alone. No improvement was observed in the control group. In conclusion, Melatonin in combination with Sulodexide is, in our opinion, a viable treatment option for patients suffering from central or sensorineural tinnitus.
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PMID:Treatment of central and sensorineural tinnitus with orally administered Melatonin and Sulodexide: personal experience from a randomized controlled study. 2011 18

A family of five and pet dog who rented a water-damaged home and developed multiple health problems. The home was analyzed for species of mold and bacteria. The diagnostics included MRI for chronic sinusitis with ENT and sinus surgery, and neurological testing for neurocognitive deficits. Bulk samples from the home, tissue from the sinuses, urine, nasal secretions, placenta, umbilical cord, and breast milk were tested for the presence of trichothecenes, aflatoxins, and Ochratoxin A. The family had the following diagnosed conditions: chronic sinusitis, neurological deficits, coughing with wheeze, nose bleeds, and fatigue among other symptoms. An infant was born with a total body flare, developed multiple Cafe-au-Lait pigmented skin spots and diagnoses with NF1 at age 2. The mycotoxins were detected in bulk samples, urine and nasal secretions, breast milk, placenta, and umbilical cord. Pseudomonas aueroginosa, Acinetobacter, Penicillium, and Aspergillus fumigatus were cultured from nasal secretions (father and daughter). RT-PCR revealed A. fumigatus DNA in sinus tissues of the daughter. The dog had 72 skin lesions (sebaceous glands and lipomas) from which trichothecenes and ochratoxin A. were detected. The health of the family is discussed in relation to the most recent published literature regarding microbial contamination and toxic by-products present in water-damaged buildings.
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PMID:A water-damaged home and health of occupants: a case study. 2222 Jan 87

Myasthenia gravis is an autoimmune disease, manifested by progressive muscular weakness and fatigue. There are frequent ocular and bulbar symptoms, among them, dysphonia. This article reports a case of dysphonia that contributed to the diagnosis of myasthenia gravis through a speech evaluation. The patient sought speech therapy with the ENT diagnosis of presbyphonia. The perceptual voice assessment and acoustic analysis pointed out respiration, glottal voice source and resonance affections. Considering that some of the data obtained from anamnesis and vocal assessments were not directly related to presbyphonia, the speech therapist discussed the case with the physician and they both concluded it was necessary to refer the patient to a neurological evaluation. The neurologist then raised the diagnostic hypotheses of myasthenia gravis and requested further examinations. The patient underwent speech therapy and drug treatment. A vocal reassessment, which occurred two months after the initial treatment, showed improvement in voice quality, with great impact on quality of life. This article shows the importance of detailed clinical speech evaluation and participation of a speech therapist in an interdisciplinary team.
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PMID:Dysphonia as the primary complaint in a case of myasthenia gravis: diagnosis and speech therapy. 2440 43

Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm that occurs extranodally and nodally. The following case report describes a 24-year-old male patient who suffered from FDCS of the tonsil. He presented at the ENT Department of the University Hospital Magdeburg with throat pain that had lasted for 3 months. There were neither B symptoms nor abnormal fatigue. An extended tonsillectomy was performed. The morphological and immunohistochemical findings confirmed the diagnosis of FDCS. FDCS should be considered as an important differential diagnosis in spindle cell tumors of the tonsil.
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PMID:Follicular dendritic cell sarcoma of the tonsil. 2551 60


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