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1.
Appl Ergon ; 98: 103577, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34488189

RESUMO

Bus controllers are an essential part of the London bus network. Although the bus driver is the individual directly in control of the vehicle, inputs from both the controller and driver influence operations. Currently, little research has focused on the dynamic between these parties, and how it works in the day-to-day operation of a bus. In the current study, data was collected across focus groups with controllers to understand the controller-driver relationship from the controller perspective. The objectives of the research were to: investigate interactions and working relationships between bus controllers and drivers in London and to explore the effect of controller/driver relationships on workload, stress and fatigue. It is clear that the working relationship between controllers and drivers is a challenging one, with both parties often misunderstanding the role of the other. This is made worse by the nature of communication via radio including poor quality audio leading to difficult interactions. All of the participating controllers expressed being overloaded with work, leading to feelings of stress and fatigue, with shift work and irregular hours being discussed as a cause of controller fatigue. Any steps taken to improve the difficult working relationship between drivers and controllers can be seen as beneficial because they could improve efficiency, worker wellbeing, and possibly safety.


Assuntos
Condução de Veículo , Corrida , Fadiga , Humanos , Londres , Carga de Trabalho
2.
Appl Ergon ; 98: 103596, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34628043

RESUMO

A 'compressed' shift schedule (substitution of a rest day by a shift, shortening the duration of work breaks) was introduced for a better fit with aircraft traffic load. Thereafter, the company asked for a survey assessing the effects of the compressed shift system. Air traffic controllers (ATCOs) completed retrospectively a specific questionnaire assessing the effects of shift schedule (modified vs. initial) and of traffic load on fatigue, alertness (on-shift, upon awakening, during daily non-work activities), and sleep (duration, satisfaction). Work organization had marginal and unexpected effects, which might indicate ATCOs' disapproval of the intervention. Traffic load affected sleep satisfaction and alertness during work and non-work activities. Specific effects of shift included reduced sleep time prior to morning shifts compared to night shifts, whereas alertness and fatigue were rated at comparable levels for both shifts. Results suggest that shiftwork features which favor sleep loss across a work cycle have deleterious consequences on alertness and increase the need for recovery, which are further enhanced by traffic load.


Assuntos
Jornada de Trabalho em Turnos , Atenção , Ritmo Circadiano , Fadiga , Humanos , Estudos Retrospectivos , Sono , Tolerância ao Trabalho Programado
3.
Holist Nurs Pract ; 36(1): 17-27, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34783697

RESUMO

Although hemodialysis treatment is one of the main treatment methods in chronic kidney failure, it also causes many health problems. A variety of complementary and integrative therapies are used to relieve or minimize hemodialysis symptoms. Fatigue (60%-97%) is also one of these problems. Therefore, we have conducted a systematic review to determine the effect of complementary and integrative therapies on fatigue in hemodialysis patients. Relevant studies published from 2005 to 2019, in PubMed, EBSCOhost, ScienceDirect, and Cochran Library databases have been reviewed. In the study, initially, 21 039 pieces of data were obtained, and then 14 randomized controlled studies meeting the inclusion criteria were reviewed. The methodological qualities of the articles included in the study were determined by using the quality evaluation checklist in Jadad randomized controlled studies. In the literature, acupressure, aromatherapy, reflexology, massage, and yoga practice were found to be applied to hemodialysis patients and be effective in reducing pain and anxiety as well as improving sleep quality. It is recommended that these methods be included in the routine clinical care of patients receiving hemodialysis.


Assuntos
Aromaterapia , Fadiga , Ansiedade , Fadiga/etiologia , Fadiga/terapia , Humanos , Massagem , Diálise Renal/efeitos adversos
4.
Crit Care Nurs Q ; 45(1): 35-41, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34818296

RESUMO

This article reports the findings of a study designed to investigate the effectiveness of the Roy Adaptation Model, as it relates to improvements in nursing care outcomes for patients undergoing coronary bypass graft surgery. Results revealed that the implementation of a training program based on this model enhanced staff education and led to decreases in the level of fatigue and improved the quality of life for this group of patients.


Assuntos
Cuidados de Enfermagem , Qualidade de Vida , Ponte de Artéria Coronária , Fadiga , Humanos
5.
Sci Rep ; 11(1): 21464, 2021 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-34728696

RESUMO

The Sputnik V is a COVID- 19 vaccine developed by the Gamalia institute of epidemiology and microbiology and released on August 11, 2020. We provided independent evidence on side effects and immunogenicity following the administration of the Sputnik V COVID-19 in Iran. In this observational study, the healthcare workers who were vaccinated with the Sputnik V COVID-19 vaccine within February and April 2021 were evaluated. Among a total of 13,435 vaccinated healthcare workers, we received 3236 self-declaration reports of Sputnik V associated adverse events with the mean age 39.32 ± 10.19 years old which 38.8% were men and 61.2% were women. Totally 68.8% of females versus 66.2% of males reported side effects after receiving the first dose and 31.2% of females versus 33.8% of males reported side effects after the second dose of vaccine. The most common side effect was a pain in the injection site (56.9%), fatigue (50.9%), body pain (43.9%), headache (35.7%), fever (32.9%), joint pain (30.3%), chilling (29.8%) and drowsiness (20.3%). Side effects of the vaccine were significantly more frequent in females and younger individuals. Among a total of 238 participants, more than 90% after the first and second dose of vaccine had a detectable level of SARS-CoV-2 RBD antibody and SARS-CoV-2 neutralizing antibody. Although the overall rate of adverse effects was higher than the interim results from randomized controlled trials, our findings support the manufacturer's reports about the high humoral immunogenicity of vaccine against COVID-19.


Assuntos
Vacinas contra COVID-19/imunologia , COVID-19/prevenção & controle , Imunidade Humoral , Adulto , Fatores Etários , Idoso , Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , COVID-19/imunologia , COVID-19/virologia , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/efeitos adversos , Fadiga/etiologia , Feminino , Pessoal de Saúde , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Dor/etiologia , SARS-CoV-2/isolamento & purificação , Fatores Sexuais , Adulto Jovem
6.
Medicine (Baltimore) ; 100(41): e27504, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731132

RESUMO

BACKGROUND: Post-stroke fatigue seriously affects the quality of life for stroke patients. There is no effective treatment at present. transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation which may have therapeutic effect on post-stroke fatigue. This study will explore about this. METHOD: A total of 60 patients with post-stroke fatigue were randomly divided into the control group and the treatment group with 30 patients each by minimization randomization. Both groups received basic treatment and conventional rehabilitation. In the treatment group, patients were treated with active tDCS, while in the control group, sham tDCS. Both active and sham tDCS were administered 6 times a week for 4 weeks. Before and after the trial, the Fatigue Severity Scale (FSS), Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI) were evaluated and analyzed. And comparisons were made among groups. And there were an 8-week follow-up after the intervention. RESULT: Before the intervention, there were no significant differences in baseline data and assessment scores between the groups (P > 0.05). After 4 weeks of intervention, FSS scores in the treatment group were significantly lower than those in the control group (P = 0.012), and FMA and BMI scores were significantly higher than those in the control group (P < 0.05). There was no significant change in FSS scores after 8 months of follow-up (P > 0.05). DISCUSSION: TDCS is a safe treatment that can effectively reduce the degree of fatigue after stroke, improve the motor function and daily activity ability of patients after stroke, and the efficacy is better than only routine rehabilitation training. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry, ChiCTR2000031120. Registered on March 22, 2020.


Assuntos
Fadiga/etiologia , Fadiga/terapia , Acidente Vascular Cerebral/complicações , Estimulação Transcraniana por Corrente Contínua/efeitos adversos , Atividades Cotidianas , Idoso , Estudos de Casos e Controles , Método Duplo-Cego , Fadiga/psicologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Recuperação de Função Fisiológica , Segurança , Índice de Gravidade de Doença , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Estimulação Transcraniana por Corrente Contínua/métodos , Resultado do Tratamento
7.
Health Qual Life Outcomes ; 19(1): 251, 2021 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-34736479

RESUMO

BACKGROUND: Patients with hematological cancer who experience relapse or progressive disease often face yet another line of treatment and continued mortality risk that could increase their physical and emotional trauma and worsen their health-related quality of life. Healthcare professionals who use patient-reported outcomes to identify who will have specific sensitivities in particular health-related quality of life domains may be able to individualize and target treatment and supportive care, both features of precision medicine. Here, in a cohort of patients with relapsed or progressive hematological cancer, we sought to identify health-related quality of life domains in which they experienced deterioration after relapse treatment and to investigate health-related quality of life patterns. METHOD: Patients were recruited in connection with a precision medicine study at the Department of Hematology, Aalborg University Hospital. They completed the European Organization for Research and Treatment of Cancer questionnaire and the Hospital Anxiety and Depression Scale at baseline and at 3, 6, 9, and 12 months after the relapse diagnosis or progressive cancer. Modes of completion were electronically or on paper. Clinically relevant changes from baseline to 12 months were interpreted according to Cocks' guidelines. We quantified the number of patients with moderate or severe symptoms and functional problems and the number who experienced improvements or deterioration from baseline to 12 months. RESULTS: A total of 104 patients were included, of whom 90 (87%) completed baseline questionnaires and 50 (56%) completed the 12-month assessments. The three symptoms that patients most often reported as deteriorating were fatigue (18%), insomnia (18%), and diarrhea (18%). The three functions that patients most often reported as deteriorating were role (16%) and emotional (16%) and cognitive (16%) functioning. CONCLUSION: In this study, patient-reported outcome data were useful for identifying negatively affected health-related quality of life domains in patients with relapsed or progressive hematological cancer. We identified patients experiencing deterioration in health-related quality of life during treatment and characterized a potential role for patient-reported outcomes in precision medicine to target treatment and supportive care in this patient group.


Assuntos
Recidiva Local de Neoplasia , Qualidade de Vida , Fadiga , Humanos , Medidas de Resultados Relatados pelo Paciente , Inquéritos e Questionários
8.
Arthritis Res Ther ; 23(1): 278, 2021 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-34736525

RESUMO

BACKGROUND: Clinical trials show intensive treatment to induce remission is effective in patients with highly active rheumatoid arthritis (RA). The TITRATE trial showed that the benefits of intensive treatment also extend to moderately active RA. However, many patients failed to achieve remission or show improvements in pain and fatigue. We investigated whether baseline predictors could identify treatment non-responders. METHODS: The impact of obesity, depression, anxiety and illness perception on RA outcomes, including disease activity, remission, pain and fatigue were determined using a pre-planned secondary analysis of the TITRATE trial data. RESULTS: Body mass index was associated with disease activity levels and remission: obese patients had a higher overall disease activity and fewer obese patients achieved remission. Intensive management was not associated with increased remission in these patients. Obesity was also associated with increased overall pain and fatigue. Anxiety, depression and health perceptions had no discernible impact on disease activity but were associated with high levels of pain and fatigue. There was a strong association between anxiety and high pain scores; and between depression and high fatigue scores; and health perception was strongly related to both. None of the predictors had an important impact on pain and fatigue reduction in cross-sectional analysis. CONCLUSIONS: Disease activity is higher in obese patients and they have fewer remissions over 12 months. Anxiety, depression and health perceptions were associated with higher pain and fatigue scores. Intensive management strategies need to account for these baseline features as they impact significantly on clinical and psychological outcomes. TRIAL REGISTRATION: ISRCTN 70160382 ; date registered 16 January 2014.


Assuntos
Antirreumáticos , Artrite Reumatoide , Antirreumáticos/uso terapêutico , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Estudos Transversais , Depressão , Fadiga/tratamento farmacológico , Fadiga/etiologia , Humanos , Dor/tratamento farmacológico , Índice de Gravidade de Doença
9.
Sensors (Basel) ; 21(21)2021 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-34770694

RESUMO

Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, the impact of MS, and QoL in PwMS. METHODS: A systematic review with meta-analysis was conducted through a bibliographic search on PubMed, Scopus, Web of Science, and PEDro up to April 2021. We included randomized controlled trials (RCTs) with PwMS that received VRBT in comparison to conventional therapy (CT) including physiotherapy, balance and strength exercises, and stretching or physical activity, among others; or in comparison to simple observation; in order to assess fatigue, MS-impact, and QoL. The effect size was calculated using Cohen's standardized mean difference with a 95% confidence interval (95% CI). RESULTS: Twelve RCTs that provided data from 606 PwMS (42.83 ± 6.86 years old and 70% women) were included. The methodological quality mean, according to the PEDro Scale, was 5.83 ± 0.83 points. Our global findings showed that VRBT is effective at reducing fatigue (SMD -0.33; 95% CI -0.61, -0.06), lowering the impact of MS (SMD -0.3; 95% CI -0.55, -0.04), and increasing overall QoL (0.5; 95% CI 0.23, 0.76). Subgroup analysis showed the following: (1) VRBT is better than CT at reducing fatigue (SMD -0.4; 95% CI -0.7, -0.11), as well as in improving the mental dimension of QoL (SMD 0.51; 95% CI 0.02, 1); (2) VRBT is better than simple observation at reducing the impact of MS (SMD -0.61; 95% CI -0.97, -0.23) and increasing overall QoL (SMD 0.79; 95% CI 0.3, 1.28); and (3) when combined with CT, VRBT is more effective than CT in improving the global (SMD 0.6, 95% CI 0.13, 1.07), physical (SMD 0.87; 95% CI 0.3, 1.43), and mental dimensions (SMD 0.6; 95% CI 0.08, 1.11) of QoL. CONCLUSION: VRBT is effective at reducing fatigue and MS impact and improving QoL in PwMS.


Assuntos
Esclerose Múltipla , Realidade Virtual , Adulto , Exercício Físico , Fadiga/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/terapia , Qualidade de Vida
11.
Artigo em Inglês | MEDLINE | ID: mdl-34769925

RESUMO

Various choline-based multi-ingredient supplementations (CMS) have been suggested in the current market, but the research is limited. The purpose of this study was to investigate the acute effect of a CMS on physical performance. Fourteen male college football players (20.4 ± 1.0 years) participated in a randomized double-blind crossover experiment separated by 7 days. Subjects were given a CMS or a placebo 60 min before physical performance testing measures, including maximum vertical jumps, maximum voluntary isometric contractions (MVIC), maximal voluntary concentric contractions (MVCC), and fatiguing contractions. Four MVICs and seven sets of two MVCCs at various loads (1 N·m to 60% MVIC torque) were performed with the knee extensor muscles while seated on a dynamometer before and after the fatiguing tasks. During the fatiguing tasks, 120 MVCCs (4 sets × 30 reps) were performed with a load equivalent to 20% MVIC. Twitch interpolation technique was used to assess muscle contractile properties and voluntary activation. No significant differences were seen at baseline between sessions for all testing measures including vertical jump height, strength, power, muscle contractile properties and voluntary activation. Rate of torque development and impulse was higher in supplemental session compared to control session throughout the fatiguing contractions (p = 0.018, p < 0.001, respectively). Acute CMS can improve explosive strength by delaying the onset of fatigue.


Assuntos
Substâncias Explosivas , Fadiga Muscular , Colina , Suplementos Nutricionais , Eletromiografia , Fadiga , Humanos , Masculino , Músculo Esquelético
12.
Intern Med ; 60(22): 3533-3542, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34776465

RESUMO

Objective In the present study, we prospectively examined the efficacy of levocarnitine in relieving symptoms of fatigue in patients with cirrhosis but without overt hepatic encephalopathy. Methods Twenty-one cirrhotic patients who were able to undergo fatigue symptom evaluations at our institution were enrolled. A total of 12 cirrhotic patients underwent levocarnitine treatment (1,200-1,800 mg/day), while 9 did not undergo levocarnitine treatment. As primary endpoints, we investigated whether or not levocarnitine treatment exerted any beneficial effects by assessing the symptoms of fatigue [8-item Short-Form Health Survey (SF-8) and Fisk Fatigue Severity Score (FFSS)] at baseline and three months after treatment. Furthermore, as exploratory secondary endpoints, we investigated whether or not levocarnitine treatment exerted ameliorative effects on oxidative stress by assessing the serum thioredoxin (TRX) and urinary 8-hydroxydeoxyguanosine (8-OHdG) levels. Results The median age of the patients was 73 years old. Three men and 18 women were categorized by their Child-Pugh class (A and B in 14 and 7 patients, respectively). There were no significant differences in the clinical laboratory values between the two groups. The FFSS and SF-8 scores were significantly improved in the patients with cirrhosis who underwent levocarnitine treatment (p<0.01) but not in those who did not undergo levocarnitine treatment. Furthermore, three months after levocarnitine treatment, the serum carnitine concentrations were significantly increased, and the serum thioredoxin levels were decreased in the patients with cirrhosis who underwent levocarnitine treatment (p<0.05). Conclusion These results suggest that levocarnitine treatment may relieve symptoms of fatigue in cirrhotic patients by reducing oxidative stress.


Assuntos
Encefalopatia Hepática , Idoso , Carnitina , Fadiga/tratamento farmacológico , Fadiga/etiologia , Feminino , Encefalopatia Hepática/tratamento farmacológico , Encefalopatia Hepática/etiologia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/tratamento farmacológico , Masculino
13.
Am J Nurs ; 121(12): 18-28, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34743129

RESUMO

ABSTRACT: For nurses, the challenges posed by demanding work environments and schedules often lead to fatigue, and this can be exacerbated during crises like the COVID-19 pandemic. In this article, the authors discuss causes and challenges of nurse fatigue and consider several evidence-based strategies and solutions for individual nurses and organizations. Barriers to implementation, including a negative workplace culture and inadequate staffing, are also described, and several resources are presented.


Assuntos
Fadiga/epidemiologia , Fadiga/prevenção & controle , Enfermeiras e Enfermeiros/psicologia , COVID-19/enfermagem , Humanos , Recursos Humanos/estatística & dados numéricos , Local de Trabalho/organização & administração , Local de Trabalho/psicologia
14.
Praxis (Bern 1994) ; 110(15): 887-891, 2021 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-34814726

RESUMO

Pain, Opioids and Their Crisis: Noisy and Silent Symptoms Abstract. Pain is a common reason for consultation in family practice and palliative care. The article addresses an update of the WHO guidelines and the benefits and disadvantages of opioids in palliative care. In addition to the "loud symptom" of pain, fatigue, depression and anxiety can be referred to as "silent symptoms" which are easily forgotten in the fast-paced daily practice. In the case of inadequate symptom control, co-care should be provided by specialized palliative care services in the outpatient or, if necessary, inpatient setting. In addition, psychosocial and, if desired, spiritual support should be offered with the involvement of relatives.


Assuntos
Analgésicos Opioides , Dor , Analgésicos Opioides/efeitos adversos , Fadiga , Humanos , Dor/tratamento farmacológico , Dor/etiologia , Cuidados Paliativos , Encaminhamento e Consulta
16.
Rev Assoc Med Bras (1992) ; 67(9): 1279-1285, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34816921

RESUMO

OBJECTIVE: Exercise is a nonpharmacological supportive therapy which has been specifically identified to reduce postoperative complications or adverse events of cancer or treatments. Although there are few studies combining resistance and aerobic exercise in cancer survivors, exercise programs are very rare in different places in the literature. This study aims to investigate the effects of mixed-type exercise in different venues on weight, body mass index, fatigue, and quality of life in cancer survivors. METHODS: This is a descriptive, intervention study. Participants were included in the study, and the exercise process was between January and November 2019. The exercise group consisted of 32 patients who had just completed their breast cancer treatment and did not have distant metastases, and they applied a mixed exercise program including resistance at home and aerobic exercise in the fitness center for 12 weeks. The patients with breast cancer in the control group (30 patients) did not receive any exercise program. RESULTS: Subjective feelings of fatigue and decrease in concentration, motivation, and physical activity significantly decreased after exercise (p<0.001, p<0.001, p=0.006, p=0.008, and p<0.001, respectively) in the study group. The results also showed that physical health, general health status, and emotional and social health status significantly increased with the exercise program (p<0.001, p<0.001, p=0.004, and p=0.003, respectively). CONCLUSION: Our results show that a mixed (fitness center and home) 12-week exercise program provides an improvement in general health and reduces the side effects of the treatments and fatigue in patients with breast cancer. For a good prognostic process after medical treatment, exercise can be recommended in every accessible area.


Assuntos
Neoplasias da Mama , Qualidade de Vida , Neoplasias da Mama/terapia , Exercício Físico , Terapia por Exercício , Fadiga/etiologia , Fadiga/prevenção & controle , Feminino , Humanos , Aptidão Física
17.
Drug Discov Ther ; 15(5): 254-260, 2021 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-34719599

RESUMO

Post COVID-19 sequelae are a constellation of symptoms often reported after recovering from COVID-19. There is a need to better understand the clinical spectrum and long-term course of this clinical entity. The aim of this study is to describe the clinical features and risk factors of post COVID-19 sequelae in the North Indian population. This prospective observational study was conducted at a tertiary healthcare centre in Northern India between October 2020 and February 2021. Patients aged >18 years with laboratory-confirmed COVID-19 were recruited after at least two weeks of diagnosis, and details were captured. A total of 1234 patients were recruited and followed up for a median duration of 91 days (IQR: 45-181 days). Among them, 495 (40.1%) had persistent symptoms post-discharge or recovery. In 223 (18.1%) patients, the symptoms resolved within four weeks; 150 (12.1%) patients had symptoms till 12 weeks, and 122 (9.9%) patients had symptoms beyond 12 weeks of diagnosis/symptom-onset of COVID-19. Most common symptoms included myalgia (10.9%), fatigue (5.5%), shortness of breath (6.1%), cough (2.1%), insomnia (1.4%), mood disturbances (0.48%) and anxiety (0.6%). Patients who were hospitalized were more likely to report fatigue as a feature of long COVID. Hypothyroidism (OR: 4.13, 95% CI: 2.2-7.6, p-value < 0.001) and hypoxia (SpO2 ≤ 93%) (OR: 1.7, 95% CI: 1.1-2.4, p-value 0.012) were identified as risk factors for long COVID sequelae. In conclusion, long COVID symptoms were common (22%), and 9.9% had the post COVID-19 syndrome. Myalgias, fatigue and dyspnoea were common symptoms. Patients with hypothyroidism and hypoxia during acute illness were at higher risk of long COVID.


Assuntos
COVID-19/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/etiologia , COVID-19/patologia , Tosse/epidemiologia , Tosse/etiologia , Dispneia/epidemiologia , Dispneia/etiologia , Fadiga/epidemiologia , Fadiga/etiologia , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Mialgia/epidemiologia , Mialgia/etiologia , Estudos Prospectivos , Fatores de Risco , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/etiologia , Adulto Jovem
18.
BMC Neurol ; 21(1): 458, 2021 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-34814882

RESUMO

BACKGROUND: Interleukin-6-receptor inhibitors like Tocilizumab and Satralizumab are showing promising results in the treatment of Neuromyelitis Optica spectrum disorder (NMOSD). We aimed to investigate the efficacy and safety of various Interleukin-6-receptor inhibitors in the management of NMO/NMOSD. METHODS: PubMed, Embase, and The Cochrane Library were systematically searched for suitable studies. Change in Annualized Relapse Ratio (ARR), Change in Extended Disability Status Scale (EDSS) s, the proportion of relapse-free patients and proportion of patients with adverse events, including serious adverse events and mortality were the parameters considered for the meta-analysis for Tocilizumab. Mean difference (MD) with 95% CI was used to quantify the change in ARR and change in EDSS before and after treatment. A forest plot was prepared to indicate the efficacy and adverse effects outcomes. The results were compared with those of Satralizumab included in two trials. RESULTS: A total of nine studies with 202 patients were included in our study. Tocilizumab found a good proportion (76.95% CI: 0.61-0.91; p < 0.001) of relapse free patients at follow up. It also significantly reduced mean ARR (mean difference: -2.6, 95% CI: - 2.71 to - 1.68; p < 0.001) and but did not show significant difference in change in EDSS score (mean difference = - 0.79, 95% CI: - 1.89 to - 0.31; p = 0.16). Also, the toxicity profile of Tocilizumab was acceptable considering the proportions of patients with adverse events 56% (95% C.I.;0.27-0.85, I2 = 88.95%, p < 0.001), proportions of patients with serious adverse events 11% (95% C.I.; 0.05 to 0.17, I2 = 0%, p < 0.001) and zero treatment related deaths. SAkura studies for Satralizumab showed similar relapse free patients (70% to 80%) and reduction of ARR and EDSS from baseline. Some studies of Tocilizumab have shown to reduce pain and fatigue while trials of Satralizumab had non-significant findings. CONCLUSION: Interleukin-6-receptor inhibitors therapy showed a promising result with good efficacy and acceptable adverse events profile for treatment of NMOSD.


Assuntos
Neuromielite Óptica , Anticorpos Monoclonais Humanizados , Fadiga , Humanos , Interleucina-6 , Neuromielite Óptica/tratamento farmacológico , Recidiva
19.
JAMA Netw Open ; 4(11): e2134803, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34783824

RESUMO

Importance: Infection with SARS-CoV-2 is associated with fatigue and sleep problems long after the acute phase of COVID-19. In addition, there are concerns of SARS-CoV-2 infection causing psychiatric illness; however, evidence of a direct effect is inconclusive. Objective: To assess risk of risk of incident or repeat psychiatric illness, fatigue, or sleep problems following SARS-CoV-2 infection and to analyze changes according to demographic subgroups. Design, Setting, and Participants: This cohort study assembled matched cohorts using the Clinical Practice Research Datalink Aurum, a UK primary care registry of 11 923 499 individuals aged 16 years or older. Patients were followed-up for up to 10 months, from February 1 to December 9, 2020. Individuals with less than 2 years of historical data or less than 1 week follow-up were excluded. Individuals with positive results on a SARS-CoV-2 test without prior mental illness or with anxiety or depression, psychosis, fatigue, or sleep problems were matched with up to 4 controls based on sex, general practice, and year of birth. Controls were individuals who had negative SARS-CoV-2 test results. Data were analyzed from January to July 2021. Exposure: SARS-CoV-2 infection, determined via polymerase chain reaction testing. Main Outcomes and Measures: Cox proportional hazard models estimated the association between a positive SARS-CoV-2 test result and subsequent psychiatric morbidity (depression, anxiety, psychosis, or self-harm), sleep problems, fatigue, or psychotropic prescribing. Models adjusted for comorbidities, ethnicity, smoking, and body mass index. Results: Of 11 923 105 eligible individuals (6 011 020 [50.4%] women and 5 912 085 [49.6%] men; median [IQR] age, 44 [30-61] years), 232 780 individuals (2.0%) had positive result on a SARS-CoV-2 test. After applying selection criteria, 86 922 individuals were in the matched cohort without prior mental illness, 19 020 individuals had prior anxiety or depression, 1036 individuals had psychosis, 4152 individuals had fatigue, and 4539 individuals had sleep problems. After adjusting for observed confounders, there was an association between positive SARS-CoV-2 test results and psychiatric morbidity (adjusted hazard ratio [aHR], 1.83; 95% CI, 1.66-2.02), fatigue (aHR, 5.98; 95% CI, 5.33-6.71), and sleep problems (aHR, 3.16; 95% CI, 2.64-3.78). However, there was a similar risk of incident psychiatric morbidity for those with a negative SARS-CoV-2 test results (aHR, 1.71; 95% CI, 1.65-1.77) and a larger increase associated with influenza (aHR, 2.98; 95% CI, 1.55-5.75). Conclusions and Relevance: In this cohort study of individuals registered at an English primary care practice during the pandemic, there was consistent evidence that SARS-CoV-2 infection was associated with increased risk of fatigue and sleep problems. However, the results from the negative control analysis suggest that unobserved confounding may be responsible for at least some of the positive association between COVID-19 and psychiatric morbidity.


Assuntos
COVID-19/complicações , Fadiga/etiologia , Pandemias , Angústia Psicológica , Psicotrópicos/uso terapêutico , Transtornos do Sono-Vigília/etiologia , Sono , Adulto , Ansiedade/tratamento farmacológico , Ansiedade/epidemiologia , Ansiedade/etiologia , COVID-19/psicologia , COVID-19/virologia , Estudos de Coortes , Depressão/tratamento farmacológico , Depressão/epidemiologia , Depressão/etiologia , Inglaterra/epidemiologia , Fadiga/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/etiologia , Fatores de Risco , SARS-CoV-2 , Transtornos do Sono-Vigília/epidemiologia , Estresse Psicológico/etiologia
20.
Hu Li Za Zhi ; 68(6): 43-52, 2021 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-34839490

RESUMO

BACKGROUND: Night-shift work affects the physical and mental health of employees. Early identification of relevant high-risk groups may be referenced in health promotion, job analysis, and job design. PURPOSE: To explore the differences in workplace fatigue, physiological index of metabolic syndrome, and risk of cardiovascular disease between long-term and non-long-term night-time working nursing staff. METHODS: The health examination data of 91 long-term and 119 non-long-term night-shift nurses were collected. A sub-data analysis approach was used and t-test, chi-square, Pearson`s correlation, and hierarchical multiple regression were used to conduct statistical analysis. RESULTS: A positive correlation between cardiovascular risk and workplace fatigue was found in the long-term night-shift working group. Moreover, a lower average duration of sleep was found in the non-long-term night-shift working group. Finally, the participants with workplace fatigue and metabolic syndrome were found to have higher levels of cardiovascular risk. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Nursing staff who work night shifts for long-term and non-long-term periods should all receive regular health check-ups and practice healthy eating, exercise, and sleep habits. Employers should provide regular health checkups to their nursing staff and implement measures to identify health hazards in accordance with laws on labor standards, occupational safety, and health and labor health protection regulations, and then adopt appropriate plans and necessary safety and health measures to achieve a mutually beneficial result for both employers and employees in the healthcare industry.


Assuntos
Doenças Cardiovasculares , Síndrome Metabólica , Enfermeiras e Enfermeiros , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Fadiga/epidemiologia , Fadiga/etiologia , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Tolerância ao Trabalho Programado , Local de Trabalho
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