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)

To reduce the presence of U.S. military personnel in Cambodia, the Air Force, in September, 1974, completed negotiations with a civilian contractor to continue the emergency airlift of supplies and ammunition to that country. As the Khmer Rouge threat increased on the Cambodian capital, Phnom Penh, the airlift was expanded and the supply sorties increased. Because fatigue was a potential medical problem for the crews--they were required to fly excessive hours with little time off between 13 Jan. and 13 March, 1975--a flight surgeon was assigned to the company. The flight surgeon monitored the men by subjective evaluation, several physiological and hematological measurements, and anonymous questionnaires. Although none of the factors correlated with subjective fatigue or performance decrement, recommendations for aircrewmen flying emergency airlift operations in the future were made based upon this unique experience.
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PMID:Cambodian airlift. 88 Jan 85

In order to assess the suffering of patients who died at home and with whom family doctors participated in euthanasia or assisted suicide, an exploratory, descriptive, retrospective study was carried out regarding primarily the period 1986-1989. Data were collected via anonymous written inquiry among an at random sample of family doctors in North Holland (n = 521), and family doctors in the rest of the Netherlands (n = 521). With reference to the last case of euthanasia or assisted suicide they had encountered questions were included about physical and emotional suffering, signs and symptoms and life expectation. Correlations and differences were analysed by means of the chi2-test. The response to the inquiry was 67% (non-responders did not otherwise differ from responders): 228 (North Holland), 160 (rest of the Netherlands) cases could be analysed. Most patients suffered physically as well as emotionally. The most frequently mentioned aspect was 'general weakness or tiredness'. Also 'dependence or being in need of help', loss of dignity, humiliation' and 'pain' were often present to a (very) large extent. At the time the procedure was carried out the life expectation in almost two-thirds of the cases was less than 2 weeks; in 10% of the cases it was more than 3 months. For several reasons, this investigation reduces the possibilities of extrapolation. Further investigation is necessary to determine whether this picture of suffering is specific of this category of patients.
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PMID:[Euthanasia and assisted suicide by physicians in the home situation. 2. Suffering of the patients]. 192 91

A total of 1,671 schoolchildren aged 11, 13 and 15 years answered an anonymous questionnaire in 1988 on their social backgrounds, social networks, health, life satisfaction and health behaviour. The proportions who had tried to smoke were 24%, 51%, and 66% in the three age groups; the proportions of smokers were 3%, 8%, and 29%, and the proportions of daily smokers were 0%, 2% and 6%. More girls than boys were smokers but there was almost no difference if place of residence, social class, or family type were considered. Almost the entire variation could be explained by best friends' smoking habits and by the number of smokers at home. Smoking was associated with poor health, fatigue, school tiredness, school performance below the average, frequent contacts with friends outside school and at night, difficulties in discussion with parents, ease in discussions with friends, and with having close friends. The proportion of smokers, among children has been steadily declining since the first Danish nationwide survey was carried out in 1959.
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PMID:[Smoking habits among children aged 11-15 years in 1988. A study of smoking habits and their connection with social background factors, health, satisfaction and social networks]. 221 91

A questionnaire inquiring about existing and desirable work and rest patterns appeared in a newsletter mailed to about 22,000 anesthesiologists and anesthesiology residents and 24,000 nurse anesthetists (CRNA). Almost 3,000 anonymous replies were received and analyzed. Respondents reported mean work weeks of 47.5 h (CRNA) to 69.8 h (residents), longest continuous period of administering anesthesia without a break of 6.6 h (CRNA) to 7.7 h (residents), and longest period of administering anesthesia with or without breaks of 14.1 h (CRNA) to 20 h (resident). However, the respondents considered it safe to administer anesthesia without a break for 4.2 (CRNA) to 5.2 h (anesthesiologists) and with break for 12.8 h (CRNA) to 15 h (residents). A substantial number of respondents believed that they work at least occasionally beyond their perceived self-limitations. The majority of respondents recalled having made errors in the administration of anesthesia that they attributed to fatigue. These results may not be representative of work patterns or attitudes among American anesthesia providers because of the small sample size and the resultant potential for bias. Yet, the subject deserves attention and further study because fatigue can affect professional performance, ability to learn, and family life.
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PMID:Work and rest cycles in anesthesia practice. 232 88

Observations of 12 patients with AIDS at this institution from March 1981 to April 1984 are reported. Ten patients were homosexuals and two were bisexual. The majority had travelled abroad (USA, Haiti) and reported multiple anonymous sexual contracts. Eleven patients reported symptoms and signs, of 2-12 months' duration, frequently seen in pre-AIDS: fatigue (10), weight loss (10), diarrhea (7), night sweats (5), fever (4), and generalized lymphadenopathy (1). Laboratory studies showed anemia (10), lymphopenia (9), leukopenia (7), decreased T-helper/T-suppressor ratio (10) and cutaneous anergy to multiple skin-test antigens (9). P. carinii pneumonia was diagnosed in three patients, P. carinii pneumonia and Kaposi's sarcoma in one patient and Kaposi's sarcoma in six patients. Another patient had a chronic mucocutaneous infection with herpes simplex and another an intestinal cryptosporidiosis and Kaposi's sarcoma. Alpha-A-interferon was used to treat patients with Kaposi's sarcoma and three patients with limited disease showed a favorable response. Six patients with advanced disease died.
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PMID:[Acquired immune deficiency syndrome in the region of Zurich. Report on 12 cases]. 649 67

The author describes the evolution of the psychotherapy of an 11 year old child: starting with an anonymous depression related to diffuse somatic complaints, it evolved into a playful assertion of a self which seems to depart from the family destiny. The author describes his counter-transferential feelings of tiredness and boredom which were compensated by a constant complicity with his young client. The author suggests that it is this very act of supporting the assertion and formulation of the subject, and disregarding unconditionally the boredom of what is said, which has brought about such a striking and sudden change.
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PMID:[The stomach speaks: chronicle of a deadly boredom]. 830 71

We know from numerous industrial studies that stress, particularly in the form of tiredness and sleep deprivation, has a detrimental effect upon work performance, though this is not so clear-cut in studies of doctors, despite their stress levels being particularly high. This study explores the doctors' views on this using anonymous questionnaires from a population of 225 hospital doctors and general practitioners, 82 of whom reported recent incidents where they considered that symptoms of stress had negatively affected their patient care. The qualitative accounts they gave were coded for the attribution (type of stress symptom) made, and the effect it had. Half of these effects concerned lowered standards of care; 40% were the expression of irritability or anger; 7% were serious mistakes which still avoided directly leading to death; and two resulted in patient death. The attributions given for these were largely to do with tiredness (57%) and the pressure of overwork (28%), followed by depression or anxiety (8%), and the effects of alcohol (5%). The data are discussed in terms of the links made by the doctors between their fatigue or work pressure and the way they care for patients. It presumes that these incidents had been previously unreported and talks about the effects this secrecy has on the emotional state of the doctors concerned. It offers ways forward for tackling the problem, of interest to the profession, managers and commissioners.
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PMID:Doctors' perceptions of the links between stress and lowered clinical care. 908 22

We studied 13 patients with lipoamide dehydrogenase (LAD) deficiency, originating from seven Ashkenazi Jewish families. Their disease was characterized by recurrent attacks of vomiting, abdominal pain, and encephalopathy accompanied by elevated liver transaminases, prolonged prothrombin time, and occasionally associated with lactic and ketoacidemia or with myoglobinuria. Two patients who presented neonatally suffered from residual neurological damage with attention deficit hyperactive disorder, mild ataxia, motor incoordination, muscle hypotonia, and weakness. Nine patients who presented in early childhood or later suffered from exertional fatigue between decompensation episodes but were otherwise asymptomatic. Two patients died because of intractable metabolic acidosis and multi-organ failure. In all patients LAD activity was reduced to 8 to 21% of the control in muscle or lymphocytes. In four patients LAD protein in muscle was reduced to 20 to 60% of the control. Direct sequencing of the cDNA of the LAD gene showed that 12 of the 14 mutated alleles carried the G229C mutation and two carried an insertion mutation 105insA (Y35X). The patients who presented neonatally and had more severe sequelae were compound heterozygotes for the two mutations; patients who presented in early childhood or later were homozygous for the G229C mutation. Using an allele-specific oligonucleotide hybridization technique, nine heterozygotes for the G229C mutation were identified among 845 anonymous individuals of Ashkenazi Jewish origin disclosing a carrier rate of 1:94. Because of the significant morbidity associated with the disease, screening for the G229C mutation among Ashkenazi Jewish couples should be considered.
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PMID:Molecular basis of lipoamide dehydrogenase deficiency in Ashkenazi Jews. 993 85

Behaviour in the 2-h period before sleep onset was evaluated in 90 subjects with normal sleep/wake habits using an anonymous self-report questionnaire. This determined the timing of events from the initial preparation for sleep. The nature of the pre-sleep environment, the level of physical activity, and patterns of feeding behaviour were recorded together with self-ratings of tiredness, mood and security. Estimated sleep duration and sleep quality were determined. Ninety of 120 subjects responded. Sleep 'preparatory latency', from the time of initial sleep preparation to sleep onset, was 77 +/- 48 min; bed time to sleep onset time (sleep latency) was 41 +/- 42 min; lights out to sleep onset latency was 26 +/- 45 min. The estimated total sleep time was 7 +/- 1 h. In the pre-sleep period, mean noise and illumination levels were low and environmental temperature rating was at the median point on a very cold-very hot scale (mean scale scores: 23, 28 and 50, respectively). All subjects went to the bathroom before going to bed. Twenty-five percent of normal subjects had a snack or meal in the 2-h period before sleep onset. Sixty percentage recorded setting an alarm, 27% had a bath or shower, 23% checked door locks or windows and 49% read in bed. Nine percent of subjects slept with a cat on the bed. Humans, like other animal species, show a complex behavioural sequence in the 2-h period before falling asleep. A constant environment with limited metabolic activity may predispose to thermoregulatory changes prior to sleep onset.
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PMID:Pre-sleep behaviour in normal subjects. 1060 59

Medical students, who deal routinely with difficult studies and with patients, are not always prepared for this challenge. This may produce a specific and important source of stress. As a consequence, medical students may sometimes develop maladaptive responses, such as substance abuse. This study aimed to evaluate performance-enhancing drug use among medical students at the University Hospital of Nancy, France. A self-administered anonymous questionnaire was given to all 104 eighth-year residents. The 93 responding students (37 female and 56 male), were aged 28.0 +/- 2.2 years (mean +/- SD); 53 per cent of the subjects reported enhancing-substance use in their first year of medical studies (72 per cent during preparation for their difficult examinations and 28 per cent throughout the year). The main substances were vitamins, anti-fatigue capsules, betablockers, marijuana (illicit drug) and benzodiazepines; 46 per cent of them were still using these drugs during the second to sixth years of their medical course. The main sources of drugs were retail pharmacists, with or without medical prescriptions. Could this use persist and lead to doctors with substance problems?
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PMID:[Consumption of performance-enhancing drugs by medical students in Nancy]. 1096 17


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