Acute effects of thirty minutes of light-intensity, intermittent exercise on patients with chronic fatigue syndrome.

BACKGROUND AND PURPOSE: Currently, there is no consensus on exercise prescription for patients with chronic fatigue syndrome (CFS). This investigation examined whether light-intensity, intermittent physical activity exacerbated symptoms in patients with CFS immediately following exercise to 7 days following exercise. Subjects. Subjects were 9 women (mean age=44.2 years, SD=8.4, range=29-56; mean weight=74.2 kg, SD=18.8, range=56.36-110.91; and mean height=1.63 m, SD=0.8, range=1.55-1.78) and 1 man (age=48 years, weight=97.1 kg, and height= 1.98 m) who met the Centels for Disease Control and Prevention's criteria fi)r (FS. METHODS: Subjects performed 10 discontinuous 3-minute exercise bouts (separated by 3 minutes of recovery) at a self-selected, comfortable walking pace on a treadmill. Oxygen consumption, minute ventilation, respiratory exchange ratio, and heart rate were measured every minute during the exercise session. To assess degree of disability, general health status, activity level, symptoms, and mood, subjects completed various questionnaires before and after exercise. RESULTS: Results indicated that degree of disability, general health status, symptoms, and mood did not change immediately and up to 7 days following exercise. CONCLUSION AND DISCUSSION: Thirty minutes of intermittent walking did not exacerbate symptoms in subjects with CFS. The physiological data did not show any abnormal response to exercise. Although this study did not determine whether 30 minutes of continuous versus intermittent exercise would exacerbate symptoms, all 10 subjects felt that they could not exercise continuously for 30 minutes without experiencing symptom exacerbation. Despite this limitation, the results indicate that some individuals with CFS may be able to use low-level, intermittent exercise without exacerbating their symptoms.

Normal versus pathological aging: knowledge of family practice residents.

Family physicians may lack discriminatory ability to differentiate normal aging from disease states. To assess such ability, 53 aging-related indicators or symptoms were presented to 65 physicians in three family practice residency programs. Respondents classified each symptom as normal aging or disease. On average, residents classified 73.4% of symptoms correctly. They were more likely to classify disease states correctly (80.0%) than to classify signs of normal aging correctly (66.8%). Misattribution of normal aging signs as disease may prompt physicians to overmedicate and overtreat patients, resulting in adverse clinical outcomes.

Preventing falls in hospitals. The roles of patient age and diagnostic status in predicting falls.

Patient falls are some of the most frequent accidents in hospitals, and they can lead to significant personal and financial costs for both patients and facilities. This study examines the relationship between two patients characteristics and patient falls at a large general hospital and a small psychiatric facility in Tennessee; its findings should be useful for hospital risk management.

Limitations to heavy work at 21 degrees C of personnel wearing the U.S. military chemical defense ensemble.

The purpose of this study was to determine the limitations to work of personnel performing heavy work at 21 degrees C (70 degrees F) while wearing the chemical defense ensemble (CDE) worn by all branches of the U.S. military. Male volunteers (N = 17) wearing the CDE performed an arm and leg work task yielding a time-weighted energy consumption rate of 450 W, under environmental conditions of 21 degrees C and 65-70% relative humidity. Each work bout was continued until one of the following limits occurred: volitional fatigue, rectal temperature (Tre) of 39 degrees C, or calculated heat storage (S) of 140 Wh. Subjects then rested until heat stored due to this work was lost, then repeated the work-rest cycles until refusal, or inability to restart work after a rest cycle. Over a total of 36 work cycles, subjects terminated work cycles for S on only two occasions, with the remainder almost equally divided between cumulative fatigue and high Tre. Intersubject variability was high for work and rest times, S, heat loss, and sweat production. U.S. Air Force Regulation (AFR) 355-8, which provides guidance for heat stress in the form of work/rest cycles, underestimated work tolerance under these study conditions.

Severe hypoglycemia associated with trimethoprim-sulfamethoxazole therapy.

Hypoglycemia associated with sulfamethoxazole therapy in patients with chronic renal insufficiency has previously been documented. We report the case of an elderly patient with relatively normal renal function who developed severe hypoglycemia associated with trimethoprim-sulfamethoxazole therapy.

Rubeola.

Although immunization practices have dramatically reduced the incidence of measles, several populations remain at risk of the disease. Modified measles may occur in those who received immune globulin in childhood. Atypical measles, often confused with Rocky Mountain spotted fever, may develop in those who received inactivated measles virus vaccine and were subsequently exposed to the natural disease. The diagnosis of measles requires a high index of suspicion and a careful immunization history.

Fatal digoxin-quinidine interaction in an elderly woman.

The medical records of an elderly woman revealed strong evidence of a lethal digoxin-quinidine interaction. This case and several problems contributing to digitalis toxicity are presented. Physicians should be more aware of the potential toxicities involved in cardioactive drug therapy in the elderly. Current concepts of the quinidine-digoxin interaction are discussed.

Tetanus and diphtheria immune status of patients in a family practice.

Sera obtained randomly from 37 patients seen at a family practice center were evaluated for protective antibodies against tetanus and diphtheria using in vivo toxin neutralization methods. The patients' ages ranged from 1 to 99 years. Seventy-four percent and 83 percent of patients were found to have protective antitoxin titers against tetanus and diphtheria, respectively. No significant differences in immune status were detected among different sexes or races. Whereas the mean age of subjects susceptible to tetanus was significantly greater than for those with protective antibody levels, this was not the case with diphtheria. It is postulated that natural diphtheria infection may be responsible for the high degree of protection noted among older subjects surveyed. Practical as well as educational benefits that may be obtained from a study of this nature are discussed.