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

We report a case of intestinal capillariasis in a 32-year-old Italian man. After he made a trip to Indonesia that lasted approximately one month, he developed heartburn, abdominal pain, irregular bowel movements, headache, fatigue, weight loss, low-grade fever, and severe itching. The diagnosis was provided by the recovery of Capillaria philippinensis eggs in the stool. Treatment with oral albendazole, 200 mg twice a day for 21 days, resulted in clinical and parasitologic cure. This is the first report of C. philippinensis infection acquired in Indonesia.
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PMID:Intestinal capillariasis (Capillaria philippinensis) acquired in Indonesia: a case report. 163 74

In June 1983, an outbreak of waterborne giardiasis occurred in a group of 93 university students and faculty participating in a geology field course in Colorado. All cases occurred in one subgroup of persons who were heavily exposed to untreated stream water on a field trip, and the risk of illness was strongly related to the amount of untreated stream water consumed. The median incubation period from a brief exposure to the first symptom was 7 days. The authors compared symptoms and stool sample results among 31 Giardia-positive persons in the exposed group and 36 Giardia-negative participants in an unexposed group to assess several case definitions for acute giardiasis. Diarrhea, abdominal cramps, flatulence, foul-smelling stools, nausea, excessive tiredness, bloating, anorexia, and chills were each significantly more common in the first group than in the second. A giardiasis case definition of 5 days or more of diarrhea--the definition used in many epidemiologic studies of giardiasis--had a specificity of 100 percent but a sensitivity of only 32.2 percent compared with a definition based on results of stool examinations. When a case was defined as an illness lasting 7 days or more, with a combination of two or more of six symptoms (diarrhea, flatulence, foul-smelling stools, nausea, abdominal cramps, and excessive tiredness), sensitivity rose to 73 percent, with a specificity of 88 percent. Such a case definition may be an improvement over that of 5 days of diarrhea, especially in outbreaks where there is good laboratory documentation that Giardia is the etiologic agent. The definition should be validated in other outbreaks and in situations where giardiasis must be distinguished from gastrointestinal disease caused by other agents.
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PMID:Acute giardiasis: an improved clinical case definition for epidemiologic studies. 199 3

Sleep and circadian rhythms of aircrew were studied during a 7-d polar schedule operated between London and Tokyo. Sleep, rectal temperature, and subjective alertness were recorded for 2 d before departure during the schedule, and for 10 d after the return. Changes in sleep during the early part of the trip were due to sleep loss on the outward journey, but later these changes were related to the displacement of the circadian rhythm. The acrophases of the circadian rhythms of temperature were delayed by the outward journey, and amplitudes were reduced throughout the trip. During the return, aircrew reported high levels of tiredness which persisted until the second recovery night. Though the amounts of sleep obtained during the schedule were satisfactory for the aircrew as a group, some crewmembers experienced difficulties. Realignment of circadian rhythms was attained by an advance of the circadian phase in eight aircrew and by a delay in three, and resynchronization was achieved in all cases within 6 d.
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PMID:Circadian rhythmicity and sleep of aircrew during polar schedules. 199 28

Travelers' diarrhea is only mild or moderate in the majority of cases. Consequently, severe fluid and electrolyte losses are encountered only rarely. Secretory, osmotic, and inflammatory processes in the intestine result in increased losses of fluid and electrolytes due to diarrhea. Disorders of intestinal motor activity, coupled with fluid secretion, may also have a role in causing an increase in the frequency of bowel movements. Several systemic symptoms, such as malaise, fatigue, anorexia, nausea, and fever, are commonly associated with diarrhea and contribute to significant morbidity, which is often sufficient to compromise effective participation in a vacation or business trip. Several putative mechanisms for the systemic symptoms associated with travelers' diarrhea are discussed in light of recent understanding of the enteric nervous system, intestinal neuropeptides and hormones, and other inflammatory mediators released from the bowel wall during enteric infections.
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PMID:Pathophysiology of diarrheal disorders. 240 54

Federal regulation allows truck drivers to use sleeper berths to accumulate eight hours of off-duty rest in two separate periods. Because sleep disruption may cause fatigue and deterioration of performance, a study was conducted to evaluate the association between sleeper-berth use in two periods and tractor-trailer driver fatality. Using Bureau of Motor Carrier Safety Reports, crashes that resulted in tractor-trailer driver fatality were compared with property damage crashes. After adjusting for confounding variables by logistic regression, tractor-trailer driver fatality was found to be significantly associated with sleeper-berth use in two shifts (odds ratio = 3.05). Statistically significant but weaker associations were found between driver fatality and rural district, night driving, gross vehicle weight of 72,000 pounds or more, single-vehicle collision, intercity trip, and employment on an occasional basis.
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PMID:Tractor-trailer driver fatality: the role of nonconsecutive rest in a sleeper berth. 322 67

Driver fatigue is well recognized as an important causational factor in accidents involving long-distance truck drivers. Drivers may drive while fatigued for a variety of reasons. Important among these is the assignment of difficult or unreasonable delivery schedules. Using self-reported data, the frequency of violation-inducing schedules is estimated during their ongoing movement for a sample of 498 long-distance drivers. Assuming average legal speed limits of 55 MPH, 26% of the drivers were found to have violation-inducing schedules. Solo drivers, drivers hauling refrigerated loads, regular route drivers, and those with longer current trip distances are the most likely to have such schedules. Also estimated were total weekly work hours. Assuming average attained travelling speeds of 50 MPH, the average driver drives 46 hours per week and works a total of 58 hours.
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PMID:Schedule-induced hours-of-service and speed limit violations among tractor-trailer drivers. 771 76

Age-related changes in trip-induced sleep loss, personality (n = 205), and the pre-duty temperature rhythm (n = 91) were analyzed in crews from various flight operations. Eveningness decreased with age (subjects aged 20-30 were more evening-type than subjects over 40). The minimum of the baseline temperature rhythm occurred earlier with age (earlier in subjects aged 30-50 than in subjects aged 20-30). The amplitude of the baseline temperature rhythm declined with age (greater in subjects aged 20-30 than in subjects over 40). Average daily percentage sleep loss during trips increased with age. Among crewmembers flying longhaul flight operations, subjects aged 50-60 averaged 3.5 times more sleep loss per day than subjects aged 20-30. These studies support previous findings that evening types and subjects with later peaking temperature rhythms adapt better to shift work and time zone changes. Age and circadian type may be important considerations for duty schedules and fatigue countermeasures.
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PMID:Age, circadian rhythms, and sleep loss in flight crews. 844 98

Twenty seven professional truck drivers completed a 12 hour, 900 km trip under each of three driving regimes-a relay (staged) trip, a working hours regulated one-way (single) trip, and a one-way (flexible) trip with no working hours constraints. The results indicated that none of the driving regimes prevented fatigue and that the pattern of fatigue experienced during the trips appeared to be related to pretrip fatigue levels.
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PMID:The impact of work practices on fatigue in long distance truck drivers. 900 39

Three Norwegian physicians crossed the inland glacier of Greenland on skis without any support. Body weight, fat and lean body mass was measured by dual X-ray absorptiometry scanning. Maximal oxygen uptake, lung capacity measurements, and various blood tests were recorded. Subjective health-related well-being and four transistory arousal states were also recorded (GHQ-30 and AD ACL, short form). One participant lost 1 kilo body weight, while the others gained 1 and 4 kilos, respectively, during the trip. Overall, lean body mass increased (1.2-4.0 kg), while body fat was reduced (0.4-2.7 kg). These changes reversed after four weeks. Bone mass, lung function and blood tests did not vary throughout the study period. The level of energy and calmness were high at baseline and even higher towards the end of the expedition, while the scores were low and stable for tiredness and tension. Subjective well-being increased for all participants towards the second half of the trip. We conclude that expeditions involving physical and mental strain can produce positive psychological changes. Catabolic conditions are avoidable. Changes in body mass composition revert quickly.
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PMID:[Skiing over Greenland--physical and psychological changes]. 941 73

This study is the fourth in a series examining driver fatigue in the Australian long distance road transport industry. Thirty-seven long haul truck drivers were measured on a routine 4500 km round trip. Two types of driving operations were compared, single driving, involving a solo driver, and two-up driving, where a pair of drivers operate a truck continuously and alternate between work and rest. Two-up drivers reported higher levels of fatigue than single drivers overall and tended to show poorer levels of performance. However, this result appeared to reflect differential fatigue at the start of the trip. Both two-up and single drivers showed marked increases in fatigue across the first half of the trip, followed by a substantial recovery of alertness and performance provided that drivers had stationary overnight rest at mid trip or had shorter trips. Fatigue continued to increase on the second half of the trip for drivers who did longer trips without the benefit of a substantial night rest or who did not have access to on-board rest, that is single drivers. The use of overnight rest, in combination with two-up driving, appeared to be the most successful strategy for managing fatigue across the trip.
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PMID:Balancing work and rest to combat driver fatigue: an investigation of two-up driving in Australia. 924 13


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