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1.
Rev Med Suisse ; 16(692): 901-903, 2020 May 06.
Artigo em Francês | MEDLINE | ID: mdl-32374533

RESUMO

Patients with acquired brain injury often suffer from pathological fatigue that differs from "normal" fatigue in that it appears more quickly and during non-demanding tasks, and recovery is not complete despite rest. It limits physical and cognitive activities, interferes with rehabilitation and return to work. The underlying mechanisms are poorly understood but appear to involve dysfunction of brain interactions. Current management combining physical reconditioning, cognitive compensatory strategies, and treatment of associated factors often leads to significant clinical improvement and promotes socio-professional reintegration. However, the effect remains insufficient in some patients, which underlines the importance of developing new therapeutic approaches based on a better understanding of the underlying neuronal deficits.


Assuntos
Lesões Encefálicas/fisiopatologia , Lesões Encefálicas/reabilitação , Encéfalo/fisiopatologia , Fadiga/complicações , Fadiga/fisiopatologia , Lesões Encefálicas/complicações , Lesões Encefálicas/psicologia , Cognição , Humanos , Descanso
2.
J Bone Joint Surg Am ; 102(10): 847-854, 2020 05 20.
Artigo em Inglês | MEDLINE | ID: covidwho-275825

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) broke out in Wuhan, the People's Republic of China, in December 2019 and now is a pandemic all around the world. Some orthopaedic surgeons in Wuhan were infected with COVID-19. METHODS: We conducted a survey to identify the orthopaedic surgeons who were infected with COVID-19 in Wuhan. A self-administered questionnaire was distributed to collect information such as social demographic variables, clinical manifestations, exposure history, awareness of the outbreak, infection control training provided by hospitals, and individual protection practices. To further explore the possible risk factors at the individual level, a 1:2 matched case-control study was conducted. RESULTS: A total of 26 orthopaedic surgeons from 8 hospitals in Wuhan were identified as having COVID-19. The incidence in each hospital varied from 1.5% to 20.7%. The onset of symptoms was from January 13 to February 5, 2020, and peaked on January 23, 8 days prior to the peak of the public epidemic. The suspected sites of exposure were general wards (79.2%), public places at the hospital (20.8%), operating rooms (12.5%), the intensive care unit (4.2%), and the outpatient clinic (4.2%). There was transmission from these doctors to others in 25% of cases, including to family members (20.8%), to colleagues (4.2%), to patients (4.2%), and to friends (4.2%). Participation in real-time training on prevention measures was found to have a protective effect against COVID-19 (odds ratio [OR], 0.12). Not wearing an N95 respirator was found to be a risk factor (OR, 5.20 [95% confidence interval (CI), 1.09 to 25.00]). Wearing respirators or masks all of the time was found to be protective (OR, 0.15). Severe fatigue was found to be a risk factor (OR, 4 [95% CI, 1 to 16]) for infection with COVID-19. CONCLUSIONS: Orthopaedic surgeons are at risk during the COVID-19 pandemic. Common places of work could be contaminated. Orthopaedic surgeons have to be more vigilant and take more precautions to avoid infection with COVID-19. LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Cirurgiões Ortopédicos/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Estudos de Casos e Controles , China/epidemiologia , Infecções por Coronavirus/prevenção & controle , Fadiga/complicações , Feminino , Hospitais/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Cirurgiões Ortopédicos/educação , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Prevenção Primária/educação , Roupa de Proteção/estatística & dados numéricos , Fatores de Risco
4.
J Bone Joint Surg Am ; 102(10): 847-854, 2020 05 20.
Artigo em Inglês | MEDLINE | ID: covidwho-47273

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) broke out in Wuhan, the People's Republic of China, in December 2019 and now is a pandemic all around the world. Some orthopaedic surgeons in Wuhan were infected with COVID-19. METHODS: We conducted a survey to identify the orthopaedic surgeons who were infected with COVID-19 in Wuhan. A self-administered questionnaire was distributed to collect information such as social demographic variables, clinical manifestations, exposure history, awareness of the outbreak, infection control training provided by hospitals, and individual protection practices. To further explore the possible risk factors at the individual level, a 1:2 matched case-control study was conducted. RESULTS: A total of 26 orthopaedic surgeons from 8 hospitals in Wuhan were identified as having COVID-19. The incidence in each hospital varied from 1.5% to 20.7%. The onset of symptoms was from January 13 to February 5, 2020, and peaked on January 23, 8 days prior to the peak of the public epidemic. The suspected sites of exposure were general wards (79.2%), public places at the hospital (20.8%), operating rooms (12.5%), the intensive care unit (4.2%), and the outpatient clinic (4.2%). There was transmission from these doctors to others in 25% of cases, including to family members (20.8%), to colleagues (4.2%), to patients (4.2%), and to friends (4.2%). Participation in real-time training on prevention measures was found to have a protective effect against COVID-19 (odds ratio [OR], 0.12). Not wearing an N95 respirator was found to be a risk factor (OR, 5.20 [95% confidence interval (CI), 1.09 to 25.00]). Wearing respirators or masks all of the time was found to be protective (OR, 0.15). Severe fatigue was found to be a risk factor (OR, 4 [95% CI, 1 to 16]) for infection with COVID-19. CONCLUSIONS: Orthopaedic surgeons are at risk during the COVID-19 pandemic. Common places of work could be contaminated. Orthopaedic surgeons have to be more vigilant and take more precautions to avoid infection with COVID-19. LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Cirurgiões Ortopédicos/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Estudos de Casos e Controles , China/epidemiologia , Infecções por Coronavirus/prevenção & controle , Fadiga/complicações , Feminino , Hospitais/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Cirurgiões Ortopédicos/educação , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Prevenção Primária/educação , Roupa de Proteção/estatística & dados numéricos , Fatores de Risco
5.
J Bone Joint Surg Am ; 102(10): 847-854, 2020 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-32271208

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) broke out in Wuhan, the People's Republic of China, in December 2019 and now is a pandemic all around the world. Some orthopaedic surgeons in Wuhan were infected with COVID-19. METHODS: We conducted a survey to identify the orthopaedic surgeons who were infected with COVID-19 in Wuhan. A self-administered questionnaire was distributed to collect information such as social demographic variables, clinical manifestations, exposure history, awareness of the outbreak, infection control training provided by hospitals, and individual protection practices. To further explore the possible risk factors at the individual level, a 1:2 matched case-control study was conducted. RESULTS: A total of 26 orthopaedic surgeons from 8 hospitals in Wuhan were identified as having COVID-19. The incidence in each hospital varied from 1.5% to 20.7%. The onset of symptoms was from January 13 to February 5, 2020, and peaked on January 23, 8 days prior to the peak of the public epidemic. The suspected sites of exposure were general wards (79.2%), public places at the hospital (20.8%), operating rooms (12.5%), the intensive care unit (4.2%), and the outpatient clinic (4.2%). There was transmission from these doctors to others in 25% of cases, including to family members (20.8%), to colleagues (4.2%), to patients (4.2%), and to friends (4.2%). Participation in real-time training on prevention measures was found to have a protective effect against COVID-19 (odds ratio [OR], 0.12). Not wearing an N95 respirator was found to be a risk factor (OR, 5.20 [95% confidence interval (CI), 1.09 to 25.00]). Wearing respirators or masks all of the time was found to be protective (OR, 0.15). Severe fatigue was found to be a risk factor (OR, 4 [95% CI, 1 to 16]) for infection with COVID-19. CONCLUSIONS: Orthopaedic surgeons are at risk during the COVID-19 pandemic. Common places of work could be contaminated. Orthopaedic surgeons have to be more vigilant and take more precautions to avoid infection with COVID-19. LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Cirurgiões Ortopédicos/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Estudos de Casos e Controles , China/epidemiologia , Infecções por Coronavirus/prevenção & controle , Fadiga/complicações , Feminino , Hospitais/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Cirurgiões Ortopédicos/educação , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Prevenção Primária/educação , Roupa de Proteção/estatística & dados numéricos , Fatores de Risco
7.
Adv Exp Med Biol ; 1228: 333-343, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32342468

RESUMO

Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system (CNS) with an estimated prevalence approaching 1 million adults in the United States. The disease pathogenesis and resulting damage express as dysfunction (e.g., walking and cognitive impairment) and symptoms (e.g., fatigue and depression) that compromise quality of life (QOL) and full participation. There has been a steadily increasing body of research on the outcomes of exercise among persons with MS, and this has accelerated sharply over the past decade. The current chapter provides a review of exercise and its outcomes, safety, and prescription in MS. This chapter initially reviews the evidence for benefits of exercise based principally on meta-analyses and literature reviews. The chapter then reviews evidence on the safety of exercise in MS and lastly provides guidelines for exercise prescription in MS. Collectively, this chapter serves as an overview and reference for researchers and clinicians interested in the benefits, safety, and prescription of exercise in MS.


Assuntos
Exercício Físico , Esclerose Múltipla , Terapia por Exercício , Fadiga/complicações , Fadiga/prevenção & controle , Humanos , Esclerose Múltipla/complicações , Esclerose Múltipla/terapia , Qualidade de Vida
8.
Postgrad Med ; 132(7): 575-580, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32314938

RESUMO

Health care has become increasingly fragmented, partly due to advancing medical technology. Patients are often managed by various specialty teams when presenting with symptoms that could be manifestations of different diseases. Approximately one third of them are referred to specialists, at over half for outpatient appointments. Fatigue, pain, depression, dry mouth, headaches, and arthralgia are common complaints and frequently require referral to specialist physicians. Differential diagnoses include fibromyalgia (FM), Sjogren's syndrome (SS), and depression. Evaluations involve various sub-specialist especially physicians like those practicing pain management, rheumatology, and psychiatry. Thresholds for referring vary. Patients sometime feel lost in a 'medical maze'. Disagreement is frequent between specialties regarding management. Each discipline has its own diagnostic and treatment protocols and there is little consensus about shared decision-making. Communication between doctors could improve continuity. There are many differences and similarities in the pathophysiology, symptomatology, diagnosis, and treatment of fibromyalgia, Sjogren's syndrome, and depression. Understanding the associations between fibromyalgia, Sjogren's syndrome and depression should improve clinical outcome via a common holistic approach.


Assuntos
Depressão/complicações , Fibromialgia/complicações , Síndrome de Sjogren/complicações , Depressão/diagnóstico , Diagnóstico Diferencial , Fadiga/complicações , Fibromialgia/classificação , Fibromialgia/diagnóstico , Humanos , Índice de Gravidade de Doença , Síndrome de Sjogren/classificação , Síndrome de Sjogren/diagnóstico
9.
Muscle Nerve ; 62(3): 309-320, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32212331

RESUMO

Myotonic dystrophies (DM), the most common muscular dystrophies, are known to have significant sleep disturbances. We analyzed the literature on sleep and excessive daytime sleepiness (EDS) in DM over the past 30 years. In this review we provide a brief overview of sleep, sleep disorders, and methods of assessment. We also analyze data regarding major sleep disorders in DM patients, including: sleep-disordered breathing (SDB), with both central and obstructive sleep apneas (CSA,OSA); EDS; sleep-related movement disorders; and poor sleep quality. We review the possible pathogenesis of these disorders and outline management strategies. We also consider possible future avenues for research. The findings highlight the complex set of sleep-related problems, including the primary abnormality of sleep control in myotonic dystrophies. In individual patients the roles of poor sleep hygiene, SDB, primary hypersomnia, and excess fatigue require careful assessment for appropriate management.


Assuntos
Fadiga/complicações , Distrofia Miotônica/complicações , Transtornos do Sono-Vigília/complicações , Fadiga/fisiopatologia , Humanos , Distrofia Miotônica/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia
10.
Workplace Health Saf ; 68(6): 272-278, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32089121

RESUMO

Background: Sleep disorders can result in sleepiness, fatigue, and apathy, and may contribute to serious occupational consequences such as errors at work. The aim of the study was to examine the level of insomnia, sleepiness, and fatigue in a sample of Polish nurses. Methods: The research was conducted among nurses employed in the Lublin region of Poland. A sample of nurses were invited to participate in a survey in which we measured insomnia, sleepiness, and fatigue using the Athens Insomnia Scale (AIS), the Epworth Sleepiness Scale (ESS), and the Fatigue Severity Scale (FSS). Findings: Among the 200 nurses that were surveyed, 141 (70.5%) responded. The findings indicated that a total of 47.8% of the surveyed nurses reported insomnia. Half (50.0%) exceeded the threshold for fatigue relative to the general population. Although no differences in fatigue and sleepiness were observed by level of insomnia between those who did and did not work night shift, we observed an overall correlation between insomnia (AIS) and sleepiness (ESS), as well as between insomnia (AIS) and fatigue (FSS). Conclusions/Application to practice: This sample of Polish nurses displayed problems with sleep quality. The consequences of insomnia and fatigue challenge occupational health workers to go beyond traditional care and standard diagnostic tests. Undertaking preventive measures aimed at reducing health hazards, and the risk of making a mistake at work due to increased sleepiness and fatigue, in nurses are warranted.


Assuntos
Fadiga/complicações , Enfermeiras e Enfermeiros/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Sonolência , Adulto , Fadiga/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Polônia , Distúrbios do Início e da Manutenção do Sono/etiologia , Inquéritos e Questionários , Tolerância ao Trabalho Programado/psicologia
11.
Med. clín (Ed. impr.) ; 154(3): 94-97, feb. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-189061

RESUMO

ANTECEDENTES Y OBJETIVO: En este trabajo se pretende describir el tipo de pie y las alteraciones podológicas más frecuentes, el nivel de dolor, la discapacidad, la fatiga y la alteración de la calidad de vida que presentan los pacientes con síndrome de Ehlers-Danlos (SED). MATERIALES Y MÉTODOS: Treinta y ocho individuos con SED tipo hipermóvil o clásico fueron reclutados. Se registró el porcentaje de dolor en el pie y las deformidades, y se les aplicaron distintos cuestionarios. El tipo de pie se clasificó según la huella y el Foot Posture Index. RESULTADOS: Se registra un alto grado de dolor, discapacidad, intensidad de la fatiga y bajo nivel de calidad de vida en estos pacientes. Según la huella el 20% presentó pies planos, el 47% pies normales y el 33% pies cavos. CONCLUSIONES: Los participantes en este estudio presentaron un alto porcentaje de problemas podológicos, altos niveles de dolor y limitación de la funcionalidad en los pies. La calidad de vida de estos pacientes aparece disminuida. Se han observado tipos de pies según la huella y de deformidades similares a la población general


BACKGROUND AND OBJECTIVE: This paper aims to describe the type of foot and most frequent podiatric alterations, as well as the level of pain, disability, fatigue and alteration of quality of life in patients with Ehlers-Danlos syndrome (EDS). MATERIALS AND METHODS: Thirty-eight individuals with hypermobile or classic EDS participated. The percentage of pain in the foot and deformities was recorded, and several questionnaires were administered. The type of foot was classified according to the footprint and the Foot Posture Index. RESULTS: There was a high degree of pain, disability, intensity of fatigue and low quality of life in these patients. According to the footprint, 20% presented flat feet, 47% normal feet and 33% cavus feet. CONCLUSIONS: The participants in this study had a high percentage of foot problems related to high levels of pain and limited functionality in the feet. The quality of life of these patients appeared diminished. Foot types were observed according to the footprint and deformities similar to those of the general population


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Síndrome de Ehlers-Danlos/fisiopatologia , Deformidades do Pé/fisiopatologia , Instabilidade Articular/fisiopatologia , Deformidades do Pé/complicações , Avaliação da Deficiência , Qualidade de Vida , Fadiga/complicações , Inquéritos e Questionários , Instabilidade Articular/complicações , Estudos Transversais , Medição da Dor , Hallux Valgus/diagnóstico , Fatores de Risco
12.
Neth J Med ; 78(1): 34-36, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32043476

RESUMO

Iron deficiency, without anaemia, is common in the general population and induces various symptoms. Its management consists of oral and intravenous supplementation for cases of inefficacy of or intolerance to oral iron. We assessed the efficacy of intravenous iron therapy in non-anaemic iron-deficient patients with fatigue. We prospectively evaluated the level of fatigue, using the Fatigue Severity Scale (FSS), in patients suffering from iron deficiency without anaemia, treated by intravenous iron at the moment of the perfusion (W0), after 4 weeks (W4), and 12 weeks (W12). Of 25 patients, at W0, the mean FFS was 49.3+/-13.7. There was a significant improvement in FSS at W4 (44+/-15; p = 0.01) and a sustained response at W12 with an FFS of 35.8+/-17.1 (p < 0,0001). There was no correlation between FSS and serum ferritin level at W12 (p=0.54) or between serum ferritin at W12 and difference between FSS at W0 and W12 (p=0.58). There were six mild adverse events (24%): asthenia (8%), nausea (8%), headache (4%), local pain (4%); and no serious adverse events. Our results suggest the rapid efficacy of intravenous iron in improving fatigue in iron deficiency without anaemia with a good profile of tolerance.


Assuntos
Fadiga/tratamento farmacológico , Ferro/deficiência , Ferro/farmacologia , Administração Intravenosa , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Fadiga/complicações , Feminino , Humanos , Ferro/administração & dosagem , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
13.
J Assoc Nurses AIDS Care ; 31(3): 325-336, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32084038

RESUMO

With adherence to combination antiretroviral therapy, HIV infection is now a chronic, but manageable, disease with associated symptoms and complications. However, there is limited evidence on how symptom burden affects perceived overall function among people living with HIV (PLWH). Furthermore, there is no consensus on the factors that affect symptom burden in PLWH. We examined relationships between factors that may influence symptom burden and perceived overall function, and the association between symptom burden and overall function in 179 adult PLWH. This study was a cross-sectional, secondary analysis using the Theory of Unpleasant Symptoms (Lenz, Pugh, Milligan, Gift, & Suppe, 1997). We found strong evidence that symptoms, especially pain, tiredness, and depression, are prevalent in PLWH, and that symptoms were predicted by perceived social support and the number of comorbidities. Increased symptom burden predicts reduced overall function. Interventions are needed to reduce symptoms and strengthen social support in PLWH. Initiating symptom assessment and management strategies early is paramount.


Assuntos
Doença Crônica/psicologia , Efeitos Psicossociais da Doença , Depressão/complicações , Fadiga/complicações , Infecções por HIV/complicações , Qualidade de Vida/psicologia , Adulto , Antirretrovirais/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Doença Crônica/terapia , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Perfil de Impacto da Doença , Apoio Social
14.
Leukemia ; 34(9): 2451-2459, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32086447

RESUMO

We aimed to compare fatigue of newly diagnosed patients with myelodysplastic syndromes (MDS) with that of the general population (GP). We also investigated the ability of the IPSS and IPSS-R to capture severity of patient-reported fatigue at diagnostic workup. A sample of 927 newly diagnosed patients with MDS was consecutively enrolled in a large international observational study and all patients completed the FACIT-Fatigue questionnaire at baseline. Fatigue was compared with that of the GP (N = 1075) and a 3-point difference in mean scores was considered as clinically meaningful. Fatigue of MDS patients was on average 4.6 points below the mean of the GP (95% CI, -5.9 to -3.2, p < 0.001), reflecting clinically meaningful worse fatigue. Unlike the IPSS, the IPSS-R identified clearly distinct subgroups with regard to burden of fatigue. Mean scores differences compared with GP ranged from nonclinically relevant for very low risk (Δ = -1.8, 95% CI, -4.0 to 0.5, p = 0.119) to large clinically meaningful differences for very high-risk IPSS-R patients (Δ = -8.2, 95% CI, -10.3 to -6.2, p < 0.001). At diagnostic workup, fatigue of MDS is clinically meaningful worse than that reported by the GP. Compared with the IPSS classification, the IPSS-R provides a better stratification of patients with regard to fatigue severity.


Assuntos
Fadiga/diagnóstico , Síndromes Mielodisplásicas/fisiopatologia , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Fadiga/complicações , Fadiga/fisiopatologia , Feminino , Humanos , Masculino , Prognóstico , Fatores de Risco
15.
Horm Behav ; 118: 104667, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31899259

RESUMO

Subjective, disabling fatigue is a common complaint and a key feature of numerous medical conditions, and is a transdiagnostic feature of psychiatric disorders. Despite physical and mental fatigue being associated with functional impairment and reduced quality of life, little is understood about its underlying mechanisms or modulating factors. Women commonly experience exacerbation of other (non-fatigue related) psychiatric symptoms during the luteal phase of the menstrual cycle, and report greater fatigue prevalence compared to men. It is therefore plausible that subjective fatigue may similarly fluctuate across the menstrual cycle. Here we compared physical and mental fatigue in the early-follicular (lower ovarian hormones) and mid-luteal (higher ovarian hormones) phases of a single menstrual cycle, while controlling for sleep disruption, in women with (n = 18) and without (non-anxious; n = 20) generalised anxiety disorder (GAD). As expected, women with GAD reported greater physical and mental fatigue than healthy women. Further, although there were no changes in physical fatigue from the early-follicular to mid-luteal phases in both groups, mental fatigue in non-anxious women increased to levels equivalent to those experienced by their GAD counterparts in the mid-luteal phase. Although salivary levels of estradiol and progesterone increased from the early-follicular to mid-luteal phase, hormones did not significantly predict fatigue in either phase. These findings are consistent with the exacerbations of state anxiety and mood disturbance recognised to occur in the luteal phase of the menstrual cycle. We speculate that increased mental fatigue in the luteal phase may represent a vulnerable period for the development and maintenance of psychiatric disorders, potentially via compromised emotional regulation.


Assuntos
Transtornos de Ansiedade/epidemiologia , Fadiga/epidemiologia , Ciclo Menstrual/psicologia , Fadiga Mental/epidemiologia , Adolescente , Adulto , Transtornos de Ansiedade/sangue , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/fisiopatologia , Estudos de Casos e Controles , Regulação Emocional/fisiologia , Estradiol/sangue , Fadiga/sangue , Fadiga/complicações , Feminino , Humanos , Ciclo Menstrual/sangue , Fadiga Mental/sangue , Fadiga Mental/complicações , Progesterona/sangue , Qualidade de Vida , Adulto Jovem
16.
J Psychosom Res ; 130: 109916, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31927347

RESUMO

OBJECTIVES: The purpose of this meta-analysis was to critically evaluate the effects of mindfulness-based stress reduction (MBSR) on cancer-related fatigue (CRF). METHODS: A systematic search of eight databases (Web of Science, Pubmed, Cochrane Library, Spring link, CNKI, Wanfang, VIP, CBM) was performed, to find randomized controlled trials (RCTs) from inception to January 2019. Using Cochrane Collaboration criteria, two reviewers critically and independently assessed the risk of bias and extracted correlated data using the designed form. All analyses were performed with Review Manager 5.3. RESULTS: In all, fifteen RCTs were included in the systematic review, fourteen of which, consisting of 3008 patients (MBSR, 1502; control, 1506), were included in the meta-analysis. MBSR had a significant effect on fatigue in cancer patients, particularly among lung cancer patients. The meta-analysis also indicated that MBSR could significantly mitigate CRF compared with usual care or no intervention. 8 weeks of MBSR, supervised by experts, had a large effect on CRF. CONCLUSIONS: MBSR is effective for CRF management and can be recommended as a beneficial complementary therapy for CRF patients.


Assuntos
Fadiga/complicações , Fadiga/psicologia , Atenção Plena , Neoplasias/complicações , Estresse Psicológico/complicações , Estresse Psicológico/terapia , Humanos
17.
J Stroke Cerebrovasc Dis ; 29(4): 104630, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31959502

RESUMO

BACKGROUND: Hypertension is a well-known risk factor for intracerebral hemorrhage (ICH). On many of the other potential risk factors, such as smoking, diabetes, and alcohol intake, results are conflicting. We assessed risk factors of ICH, taking also into account prior depression and fatigue. METHODS: This is a population-based case-control study of 250 primary ICH patients, conducted in Helsinki University Hospital, Finland. The controls (n = 750) were participants of the FINRISK study, a large Finnish population survey on risk factors of chronic noncommunicable diseases, matched with cases by sex and age. Ages were matched in 5-year age bands. However, as the oldest FINRISK participants were 74-year-olds, controls for the age group 75-84 were selected from the age group of 70-74 years. Patients aged greater than or equal to 85 years were excluded. Patients and controls were compared in univariate analyses. The age categories less than 70, and greater than or equal to 70 years were also analyzed separately. Binary logistic regression analysis was performed for variables with P less than .1 in univariate analysis. RESULTS: Analyzing all cases and controls, the cases had more hypertension, history of heart attack, lipid-lowering medication, and reported more frequently fatigue prior to ICH. In persons aged less than 70 years, hypertension and fatigue were more common among cases. In persons aged greater than or equal to 70 years, factors associated with risk of ICH were fatigue prior to ICH, use of lipid-lowering medication, and overweight. CONCLUSIONS: Hypertension was associated with risk of ICH among all patients and in the group of patients under 70 years. Fatigue prior to ICH was more common among all ICH cases.


Assuntos
Hemorragia Cerebral/etiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Estudos de Casos e Controles , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/fisiopatologia , Depressão/complicações , Dislipidemias/complicações , Dislipidemias/tratamento farmacológico , Fadiga/complicações , Feminino , Finlândia , Nível de Saúde , Humanos , Hipertensão/complicações , Hipertensão/fisiopatologia , Hipolipemiantes/uso terapêutico , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Medição de Risco , Fatores de Risco
18.
Dev Med Child Neurol ; 62(3): 372-378, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31777955

RESUMO

AIM: To describe health-related quality of life (HRQoL), pain, fatigue, and other health variables in young adults with cerebral palsy (CP), and to explore associations with the Gross Motor Function Classification System - Expanded and Revised (GMFCS-ER) and physical activity. METHOD: This was a cross-sectional study of 61 young adults at a mean age of 21 years 2 months (standard deviation 8mo, range 20-22y) with CP, from a geographically defined area. Data collection included: Short Form 36 version 2 for HRQoL, Brief Pain Inventory - Short Form, Fatigue Severity Scale, level of physical activity, medical history, and physical examination. RESULTS: Overall HRQoL equalled that of population norms; however self-reported physical health was lower in GMFCS-ER levels III to V compared to GMFCS-ER levels I to II. Self-reported mental health was, inversely, lower in GMFCS-ER levels I to II compared to GMFCS-ER levels III to V. Pain prevalence was 49%, and pain was present across all GMFCS-ER levels. Fatigue, as well as sleep problems, had 41% prevalence, with fatigue severity decreasing with increasing level of physical activity. INTERPRETATION: General HRQoL in young adults with CP was comparable to population norms. Pain and fatigue are important to address in high motor-functioning individuals also. Physical activity could be a possible protective factor against fatigue. WHAT THIS PAPER ADDS: Health-related quality of life in young adults with cerebral palsy (CP) was comparable to population norms. Pain, fatigue, and sleep problems occurred at all Gross Motor Function Classification System levels. There is a possible protective effect of physical activity on fatigue.


Assuntos
Paralisia Cerebral/complicações , Fadiga/complicações , Dor/complicações , Qualidade de Vida , Paralisia Cerebral/fisiopatologia , Estudos Transversais , Fadiga/diagnóstico , Fadiga/fisiopatologia , Feminino , Nível de Saúde , Humanos , Masculino , Dor/diagnóstico , Dor/fisiopatologia , Medição da Dor , Índice de Gravidade de Doença , Adulto Jovem
19.
Cancer ; 126(1): 174-180, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31553815

RESUMO

BACKGROUND: Fatigue is a common and disabling side effect of targeted therapies such as tyrosine kinase inhibitors (TKIs) used to treat chronic myeloid leukemia (CML). The goal of the current study was to conduct a pilot randomized trial of the first cognitive behavioral intervention developed for fatigue due to targeted therapy. METHODS: Patients with CML treated with a TKI who were reporting moderate to severe fatigue were recruited and randomized 2:1 to cognitive behavioral therapy for targeted therapy-related fatigue (CBT-TTF) delivered via FaceTime for the iPad or to a waitlist control (WLC) group. The outcomes were acceptability, feasibility, and preliminary efficacy for fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue; primary outcome) and quality of life (Functional Assessment of Cancer Therapy-General; secondary outcome). Participants were assessed before randomization and after treatment (ie, approximately 18 weeks later). RESULTS: A total of 44 patients (mean age, 55 years; 48% female) were assigned to CBT-TTF (n = 29) or WLC (n = 15). The study participation rate was 59%. Among the patients assigned to CBT-TTF, 79% completed the intervention. Intent-to-treat analyses indicated that patients assigned to CBT-TTF demonstrated greater improvements in fatigue (d = 1.06; P < .001) and overall quality of life (d = 1.15; P = .005) than those assigned to WLC. More patients randomized to CBT-TTF than WLC demonstrated clinically significant improvements in fatigue (85% vs 29%) and quality of life (88% vs 54%; P values ≤ .016). CONCLUSIONS: CBT-TTF displays preliminary efficacy in improving fatigue and quality of life among fatigued patients with CML treated with TKIs. The findings suggest that a larger randomized study is warranted.


Assuntos
Cognição , Terapia Cognitivo-Comportamental , Fadiga/terapia , Leucemia Mielogênica Crônica BCR-ABL Positiva/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Fadiga/complicações , Fadiga/fisiopatologia , Feminino , Humanos , Internet , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Leucemia Mielogênica Crônica BCR-ABL Positiva/fisiopatologia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida , Resultado do Tratamento
20.
Clin Child Psychol Psychiatry ; 25(1): 200-212, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30957529

RESUMO

BACKGROUND: Both fatigue and sleep difficulties are common symptoms of mental health presentations such as depression and anxiety. Despite this, little is known about how psychologists in Child and Adolescent Mental Health Services (CAMHS) assess and treat these common symptoms. METHOD: Qualitative interviews with nine psychologists working in CAMHS analysed using thematic analysis. RESULTS: Fatigue and sleep problems do not tend to be the focus of assessment because they are seen to be part of other presentations and not accorded priority. Psychologists struggled to differentiate fatigue from sleep problems, with greater clarity about sleep problems, which appear to be more routinely assessed. A number of barriers to addressing fatigue and sleep problems were identified, including lack of motivation from young people to make behavioural changes to address fatigue and/or sleep difficulties. Psychologists wished for more training, access to information for young people and families and more service integration with paediatric physical health settings. CONCLUSION: Sleep problems and fatigue may not be thoroughly assessed and addressed in CAMHS and are often conflated, with the focus on enquiring about sleep, not fatigue. Further research is required to elucidate whether the themes identified are more pervasive. Potential interventions include training and information provision.


Assuntos
Fadiga/terapia , Transtornos Mentais/complicações , Transtornos do Sono-Vigília/terapia , Adolescente , Serviços de Saúde do Adolescente , Criança , Serviços de Saúde da Criança , Fadiga/complicações , Humanos , Serviços de Saúde Mental , Pesquisa Qualitativa , Transtornos do Sono-Vigília/complicações , Resultado do Tratamento
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