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

Symptoms of Parkinsonism, most likely induced by an oral contraceptive, were greatly reduced by combined therapy of nicergoline and bromocriptine. A 38-year-old housewife had taken an oral contraceptive, which contained .05 mg of ethinyl estradiol and .5mg of norgestrel per tablet, for 7 years, when she presented took the following symptoms: she stumbled easily, took short, quick dancing/skating steps without arm movement, and found it increasingly difficult to keep slippers on while walking. In the afternoons she experienced extreme fatigue and rigidity in her lower limbs. After a while, languor spread to other parts of her body as well, and she was examined on April 5, 1991. The patient's face was mask-like, and her body was bent forward with her forearms flexed. She showed frozen gait and lowered initiation in her movement. Muscle rigidity was found in both upper and lower extremities, and especially on the right side. A brain MRI showed lacunar infraction with small patches of high signal intensities in the white matter of the bilateral frontal lobes and high signal intensities in the left periventricular white matter. Urine was normal; blood cholesterol and iron were slightly raised. Hormonal examinations showed lowered LH, FSH, progesterone and 24-hr 17-KGS. CT was normal. She was ordered to stop taking pills and to take nicergoline and bromocriptine, which greatly reduced these symptoms except during the first menstruation following the treatment. When mask-like facial expressions, demarche a petit pas, and languor in her lower extremities did not recur during the next menstruation, bromocriptine treatment was discontinued. Four months later nicergoline therapy was also discontinued.
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PMID:[A case of parkinsonism induced by an oral contraceptive]. 156 36

A double blind, crossover study was used to test the effect of transdermal oestrogen therapy (Estraderm) in 22 women with climacteric complaints. The number and intensity of hot flushes were both reduced by approximately 80% (p less than 0.0025). Some improvement was also seen as regards general wellbeing, disturbed sleep and tiredness. We noted a significant increase in serum oestradiol to premenopausal follicular phase levels, and a decrease in FSH values. Systolic blood pressure was lowered during active treatment (p less than 0.025), a smaller reduction of diastolic pressure was not significant. Body weight remained unchanged. Some patients reported tender breasts, and some reported slight irritation of the skin. Neither condition necessitated withdrawal of treatment. It is concluded that Estraderm is effective and suitable for treatment of climacteric complaints.
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PMID:[Transdermal estrogen treatment. A placebo controlled study]. 194 34

The study of skeletal muscle disorders is providing potentially important insights into regulatory mechanisms in human exercise and fatigue and information useful for diagnostic and treatment purposes. This review primarily concerned the general metabolic and physiological factors which set upper limits to performance of various types of exercise in patients with a variety of muscle disorders. From the standpoint of exercise performance, skeletal muscle diseases can be classified into three major groups. One group consists of primary disorders of muscle energy metabolism, including defects in muscle carbohydrate and lipid metabolism, disorders of mitochondrial electron transport, and abnormalities of purine nucleotide metabolism. Exercise performance largely reflects the capacity for ATP resynthesis. Oxidative phosphorylation is the dominant quantitative source of energy for ATP resynthesis under most exercise conditions. Consequently, patients with disordered oxidative metabolism (i.e., patients with defects in the availability or utilization of oxidizable substrate, such as those with phosphorylase or PFK deficiency or those with defects in mitochondrial electron transport) typically demonstrate severely impaired exercise performance. Intolerance to sustained exercise and premature fatigability are salient features of muscle oxidative disorders. Maximal oxygen uptake and maximal a-v O2 difference are markedly subnormal related to an attenuated muscle oxygen extraction. Muscle weakness and atrophy are less common. Anaerobic muscle performance is dramatically limited in patients with virtually complete defects of glycogenolysis/glycolysis but appears relatively normal in those with electron transport defects. A second major group of disorders includes patients with decreased muscle mass due to muscle necrosis, atrophy, and replacement of muscle by fat and connective tissue. These disorders are exemplified by the various muscular dystrophies (Duchenne's dystrophy, Becker's dystrophy, LG dystrophy, FSH dystrophy, and myotonic dystrophy) in which exercise performance is severely impaired due to muscle wasting and weakness in spite of largely normal pathways for muscle ATP resynthesis. In muscular dystrophy patients, the degree to which maximal oxygen uptake and anaerobic muscle performance are impaired appears to be a function of the severity of muscle weakness and atrophy. A third group of disorders includes patients with impaired activation of muscle contraction or relaxation. These disorders may be considered in two subcategories. In the first, impaired activation or relaxation of contractile activity is due to intrinsic muscle dysfunction (e.g., diseases associated with myotonia or periodic paralysis). In the second subcategory, there is impaired muscle activation due to a primary abnormality in the central nervous system, motor nerves, or neuromuscular junction.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Skeletal muscle disorders and associated factors that limit exercise performance. 267 57

This research asked whether androgen substitution therapy is as efficacious in hypogonadotropic hypogonadal men as in hypergonadotropic hypogonadal men. Erotosexual functions of two groups of six men of each diagnostic category were compared after 5-6 years of continuous androgen treatment. Treatment regimen was the same in both groups: Parenteral testosterone esters 250 mg/2 weeks. No difference was found in erectile and ejaculatory potency, but the number of sexual acts and scores of subjective quality of sexual acts, sexual excitement, and frequency of sexual thoughts and of nonsexual parameters as vigor, fatigue, anxiety were more negative in the hypogonadotropic men. The most obvious difference between the two groups is the value of LH/FSH and presumably of LHRH. Hypogonadotropic hypogonadal men may be better treated with gonadotropins (or with pulsatile LHRH, when the hypophysis is intact) than with androgens.
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PMID:Hypogonadotropic hypogonadal men respond less well to androgen substitution treatment than hypergonadotropic hypogonadal men. 304 97

An unusual case of isolated ACTH deficiency with coexisting chronic thyroiditis in a 53-year-old man is reported. The patient was admitted with a 2-year history of generalized fatigue, a 13-kg weight loss, muscular weakness, and frequent hypotensive and hypoglycemic attacks. On admission serum thyroxine and triiodothyronine were significantly elevated. Basal TSH concentration was not detected and TSH showed no response to TRH, but one month after replacement therapy with hydrocortisone it was shown that serum T3, T4 and TSH response were all within normal limits. Thyroid antibodies were positive and biopsy of the thyroid gland showed chronic thyroiditis. Arginine and 1-Dopa provoked a subnormal rise in GH with a maximum of 5.6 ng/ml and 5.0, respectively. One month after treatment with hydrocortisone, GH response to 1-Dopa and arginine increased to the normal range. Prolactin response to TRH was normal and FSH response to LHRH was also normal. LH showed an exaggerated response to LHRH, although a normal response was revealed after treatment with hydrocortisone. We also presented a summary of 44 Japanese cases, 23 males (mean age; 46 yrs old) and 21 females (mean age; 48 yrs old), with isolated ACTH deficiency.
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PMID:A case with isolated ACTH deficiency accompanying chronic thyroiditis. 629 Feb

Twelve healthy males were exposed to 48 hr of sleep deprivation under conditions of strictly controlled activity and of food and drink intake. During the experiment the subjects were isolated from external time cures, i.e. no daylight, clocks, etc. Plasma samples were obtained before and at the end of the vigil, as well as after 5 days of recovery. Samples were analyzed for adrenal and gonadal steroid hormones and for follicle-stimulating (FSH) and luteinizing hormones (LH). The levels of all unconjugated steroids studied (cortisol, 17-hydroxypregnenolone, 17-hydroxyprogesterone, androstenedione, dihydrotestosterone) were significantly lower at the end of the sleep deprivation period. Self-ratings of fatigue were significantly higher at the end of the deprivation period. After recovery, all values returned to base line. No changes were observed in the levels of FSH, LH, or most conjugated steroids. It was concluded that the results were not consistent with the view that sleep deprivation induces an emergency reaction with increased activation, but rather that it results in lower levels of both psychological and physiological activation.
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PMID:Adrenocortical and gonadal steroids during sleep deprivation. 678 Oct 27

Seventeen females with a history of hot flushes, perspiration, and amenorrhea of at least 6 months' duration, and a serum FSH level exceeding 40 IU/l entered a cyclic treatment with 17 beta-estradiol and estriol combined with norethsterone (Trisekvens, Novo). Each patient took part in three experimental sessions, six weeks apart, in which stress was induced by mental performance tests. To permit separation of treatment and habituation effects the patients were randomly assigned to one of two groups, Group 1 starting therapy after the first, Group 2 after the second session. Treatment eliminated hot flushes and perspiration and reduced serum FSH levels without causing changes in blood pressure or heart rate. There was no correlation between hormonal treatment and excretion of catecholamines during stress. Testosterone and androstenedione serum levels remained unchanged during therapy. Self-reports showed that tiredness, headache, tension and anxiety were significantly reduced following treatment.
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PMID:Psychophysiological stress responses in postmenopausal women before and after hormonal replacement therapy. 718 90

The authors examined clinically 1710 women. Among them 199 women with symptoms of menopause were selected and divided into two groups: group I (control) included 80 women without contact with carbon disulphide and group II (examined) included 119 women chronically exposed to carbon disulphide at a concentration of 9.36-23.4 mg/m3. Menopause was present in 16.59% of women chronically exposed to CS2 as compared with 8.05% of the normal population. The mean age at menopause was 48.1 years in group I and 43.9 in group II. Significantly more frequent headaches, weight gain and loss of libido (p < 0.01) were observed in women chronically exposed to CS2. While in the control group fatigue, palpitations and hot flushes were more often (p < 0.001). The concentrations of estrone (p < 0.01), estradiol, progesterone, 17-hydroxy-progesterone, testosterone and dehydroepiandrosterone sulphate (DHAS) were significantly decreased in women chronically exposed to CS2 (p < 0.001). No difference in the level of dehydroepiandrosterone was found. The daily excretion of adrenaline and noradrenaline in urine and concentrations of dopamine in plasma of women chronically exposed to CS2 were lower (p < 0.001), while the concentrations of serotonin and prolactin in plasma were higher (p < 0.001). No differences in the level of FSH or LH were noted between the two groups. Significant negative linear correlations between serotonin and FSH (r = -0.45; p < 0.01) serotonin and daily excretion of adrenalin (r = -0.43; p < 0.01) or noradrenalin (r = -0.58; p < 0.001) were found in the exposed group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effect of carbon disulfide on menopause in women]. 799 46

A case of systemic lupus erythematosus (SLE) complicated with hypopituitarism after steroid pulse therapy is reported. A 46-years-old-female with a history of SLE starting in 1975 was admitted to our hospital in February 1991 for lupus nephritis. Steroid pulse therapy, 1000 mg methyl-prednisolone for 3 successive days as one therapy unit, was administered. Proteinuria improved remarkably, however, general fatigue and headache appeared 2 weeks after initiation of therapy. Endocrinological examination revealed hypopituitarism including the levels of TSH, FSH, GH and ACTH. The secretion of FSH and LH gradually improved after replacement therapy of dried thyroid. MRI examination of the brain revealed an empty sella. It is known that pituitary tumor, cerebrovascular accident and autoimmune lymphocytic hypophysitis cause hypopituitarism. In this case, it is unlikely that the pulse therapy may be responsible for the infarction of the anterior pituitary artery furthermore, there has been no articles describing such incidence after steroid pulse therapy. This case may be indicative of a very rare case in which the empty sella might have been exacerbated by the pulse therapy in the causation of hypopituitarism.
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PMID:[Hypopituitarism associated with empty sella after steroid pulse therapy in a patient with SLE]. 814 29

Schmidt syndrome consists of adrenal insufficiency and Hashimoto's thyroiditis, which are probably caused by an autoimmune process. We encountered a patient who manifested severe generalized fatigue due to Schmidt syndrome recurrently. The endocrinological examination tests on the patient showed that the increase in thyroid stimulating hormone (TSH) and ACTH concentrations were not remarkable, despite hypo-function of the peripheral glands. Subsequent cranial magnetic resonance imaging (MRI) exhibited the existence of a pituitary tumor. The pathological findings on the resected tumor and endocrinological stimulation tests proved that the tumor was a FSH-producing adenoma. Although involvement of the pituitary region in Schmidt syndrome on rare occasions presents as hypophysitis, no pituitary adenoma has previously been reported in association with this syndrome. We present a patient with Schmidt syndrome and an accompanying FSH-producing pituitary adenoma. The coexistence of these disorders suggests that the functioning pituitary tumor might be considered as a pituitary lesion in Schmidt syndrome.
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PMID:A case of Schmidt syndrome accompanied by a pituitary adenoma. 898 Aug 88


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