Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.630
Filtrar
1.
Intern Med ; 58(21): 3179-3183, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31685787

RESUMO

Human brucellosis, one of the most common zoonoses worldwide, rarely occurs in Japan, and only a few chronic cases have been reported. We herein report the case of a 39-year-old Japanese woman with chronic human brucellosis, considered a Brucella canis infection, that persisted for 19 years. Her medical history and fever pattern suggested chronic brucellosis, and the diagnosis was made based on the results of a serum tube agglutination test (SAT). After undergoing combination therapy with streptomycin and doxycycline, she achieved symptomatic relief and showed negative SAT results. Even in non-endemic areas, chronic brucellosis is an important differential diagnosis in patients with long-term persistent fatigue or a fever.


Assuntos
Brucelose/diagnóstico , Zoonoses/diagnóstico , Administração Oral , Adulto , Animais , Antibacterianos/administração & dosagem , Brucella canis , Brucelose/tratamento farmacológico , Doença Crônica , Diagnóstico Diferencial , Doxiciclina/administração & dosagem , Quimioterapia Combinada , Fadiga/diagnóstico , Fadiga/microbiologia , Feminino , Febre/diagnóstico , Febre/microbiologia , Humanos , Injeções Intramusculares , Japão , Estreptomicina/administração & dosagem , Zoonoses/tratamento farmacológico
2.
Aten. prim. (Barc., Ed. impr.) ; 51(9): 579-585, nov. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185934

RESUMO

Presentamos la evolución de la terminología y los criterios diagnósticos para el síndrome de fatiga crónica/encefalomielitis miálgica. Este síndrome es una entidad compleja y controvertida, de etiología desconocida, que aparece en la literatura médica en 1988, si bien desde el siglo XIX se identificaron cuadros clínicos de fatiga crónica idiopática con diferentes nombres, desde neurastenia, neuromiastenia epidémica y encefalomielitis miálgica benigna hasta la actual propuesta de enfermedad de intolerancia al esfuerzo (postesfuerzo). Todos ellos aluden a un estado crónico de fatiga generalizada de naturaleza desconocida, con limitaciones al esfuerzo físico y mental, acompañado de un conjunto de síntomas que comprometen diversos sistemas orgánicos. La Clasificación Internacional de Enfermedades (CIE-10) encuadra este síndrome en el apartado de trastornos neurológicos (G93.3), aunque todavía no se hayan encontrado hallazgos anatomopatológicos que lo clarifiquen. Se han documentado múltiples alteraciones orgánicas, pero no se ha establecido una biología común que aclare los mecanismos que subyacen a esta dolencia. Se enuncia como una disfunción neuroinmunoendocrina, con un diagnóstico exclusivamente clínico y por exclusión. Diversos autores han propuesto incluir el síndrome de fatiga crónica/encefalomielitis miálgica dentro de los síndromes de sensibilidad central, aludiendo a la sensibilización central como el sustrato fisiopatológico común para este síndrome y otros. El papel del médico de familia es clave en la enfermedad, para la detección de aquellos pacientes que presenten una fatiga de naturaleza desconocida que se prolonga de forma continua o intermitente durante más de 6 meses, al objeto de realizar un diagnóstico temprano y establecer un plan de actuación frente a una enfermedad crónica con unos altos niveles de morbilidad en la esfera física y mental. Objetivo: Realizar una revisión bibliográfica de la terminología y criterios diagnósticos del síndrome de fatiga crónica/encefalomielitis miálgica, al objeto de aclarar conceptualmente la enfermedad, como utilidad en el diagnóstico a los médicos de Atención Primaria


Changes in the terminology and diagnostic criteria for chronic fatigue syndrome/myalgic encephalomyelitis are explained in this paper. This syndrome is a complex and controversial entity of unknown origins. It appears in the medical literature in 1988, although clinical pictures of chronic idiopathic fatigue have been identified since the nineteenth century with different names, from neurasthenia, epidemic neuromyasthenia, and benign myalgic encephalomyelitis up to the current proposal of disease of intolerance to effort (post-effort). All of them allude to a chronic state of generalised fatigue of unknown origin, with limitations to physical and mental effort, accompanied by a set of symptoms that compromise diverse organic systems. The International Classification of Diseases (ICD-10) places this syndrome in the section on neurological disorders (G93.3), although histopathological findings have not yet been found to clarify it. Multiple organic alterations have been documented, but a common biology that clarifies the mechanisms underlying this disease has not been established. It is defined as a neuro-immune-endocrine dysfunction, with an exclusively clinical diagnosis and by exclusion. Several authors have proposed to include CFS/ME within central sensitivity syndromes, alluding to central sensitisation as the common pathophysiological substrate for this, and other syndromes. The role of the family doctor is a key figure in the disease, from the detection of those patients who present a fatigue of unknown nature that is continuous or intermittent for more than 6 months, in order to make an early diagnosis and establish a plan of action against a chronic disease with high levels of morbidity in the physical and mental sphere. Objective: To carry out a bibliographic review of the terminology and diagnostic criteria of the chronic fatigue syndrome/myalgic encephalomyelitis, in order to clarify the pathology conceptually, as a usefulness in the diagnosis of Primary Care physicians


Assuntos
Humanos , História do Século XIX , Neurastenia/epidemiologia , Neurastenia/história , Fadiga/diagnóstico , Encefalomielite/diagnóstico , Terminologia como Assunto , Síndrome de Fadiga Crônica/epidemiologia , Medicina de Família e Comunidade , Síndrome de Fadiga Crônica/história , Classificação Internacional de Doenças/história , Diagnóstico Precoce
3.
BMC Infect Dis ; 19(1): 833, 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31590634

RESUMO

BACKGROUND: Persistent symptoms attributed to Lyme borreliosis often include self-reported cognitive impairment. However, it remains unclear whether these symptoms can be substantiated by objective cognitive testing. METHODS: For this observational study, cognitive performance was assessed in 280 adults with persistent symptoms attributed to Lyme borreliosis (as part of baseline data collected for the Dutch PLEASE study). Cognitive testing covered the five major domains: episodic memory, working memory / attention, verbal fluency, information-processing speed and executive function. Patients' profiles of test scores were compared to a large age-, education- and sex-adjusted normative sample using multivariate normative comparison. Performance validity was assessed to detect suboptimal effort, and questionnaires were administered to measure self-reported cognitive complaints, fatigue, anxiety, depressive symptoms and several other psychological factors. RESULTS: Of 280 patients, one was excluded as the test battery could not be completed. Of the remaining 279 patients, 239 (85.4%) displayed sufficient performance validity. Patients with insufficient performance validity felt significantly more helpless and physically fatigued, and less orientated. Furthermore, they had a lower education level and less often paid work. Of the total study cohort 5.7% (n = 16) performed in the impaired range. Among the 239 patients who displayed sufficient performance validity, 2.9% (n = 7) were classified as cognitively impaired. No association between subjective cognitive symptoms and objective impairment was found. CONCLUSIONS: Only a small percentage of patients with borreliosis-attributed persistent symptoms have objective cognitive impairment. Performance validity should be taken into account in neuropsychological examinations of these patients. Self-report questionnaires are insufficiently valid to diagnose cognitive impairment. TRIAL REGISTRATION: ClinicalTrials.gov NCT01207739 . Registered 23 September 2010.


Assuntos
Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Doença de Lyme/complicações , Doença de Lyme/psicologia , Adulto , Ansiedade/diagnóstico , Atenção , Estudos de Coortes , Depressão/diagnóstico , Função Executiva , Fadiga/diagnóstico , Feminino , Humanos , Masculino , Memória Episódica , Memória de Curto Prazo , Pessoa de Meia-Idade , Testes Neuropsicológicos , Autorrelato
4.
Praxis (Bern 1994) ; 108(12): 793-798, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31530127

RESUMO

Fatigue - a Common Symptom in General Practice Abstract. When patients suffering from fatigue consult a GP surgery, GPs should understand what patients mean by fatigue, how strongly they are affected in everyday life and how they themselves explain the symptom. In a next step, dangerous diseases such as depression, addiction or sleep apnea syndrome must be excluded. The main somatic and psychiatric causes of fatigue should be explored simultaneously with a more in-depth history. A simple physical exam and a few lab examinations are sufficient to capture the major disorders that present with the isolated symptom of fatigue. For further care, a primary biopsychosocial approach with a viable physician-patient relationship is crucial. Rough conclusions based on laboratory findings should be avoided; comorbidities must be considered.


Assuntos
Fadiga , Medicina Geral , Comorbidade , Depressão/complicações , Depressão/diagnóstico , Medicina de Família e Comunidade , Fadiga/diagnóstico , Fadiga/etiologia , Humanos , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
5.
Eur J Oncol Nurs ; 42: 103-109, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31479846

RESUMO

PURPOSE: This pilot study aimed to evaluate the effect of an 8-weeks-yoga intervention on quality of life and upper extremity edema volume in women with breast cancer related lymphedema. METHODS: This was a controlled trial with pre-post design. A total of 40 women with breast cancer related lymphedema were randomly assigned into an intervention or control groups. The intervention group participated in a yoga exercise class for 8 weeks, in a twice a week instructor-led practice and once a week home practice. Outcomes were EORTC QLQ_C30 to measure quality of life, and water displacement volume-meter to measure upper extremity edema volume. The outcomes were evaluated at baseline, 4th and 8th week. Data were analyzed using SPSS. RESULTS: Four weeks after the intervention, a significant difference was observed between the groups with respect to role functioning of quality of life (P = 0.03). Eight weeks after the intervention, a significant difference was observed between groups concerning physical and emotional functioning of quality of life (P < 0.05). The changing trend in physical, role, emotional, and cognitive functioning had increased, and in some scales such as fatigue, pain, insomnia, and financial difficulties the scores were reduced in the intervention group. Regarding edema volume, no significant difference was found between both groups on the 4th and 8th week after the intervention (P > 0.05). CONCLUSION: As yoga exercise might improve physical, role, and emotional functioning of quality of life as well as reduce fatigue, pain, and insomnia, using this intervention can be suggested amongst women with breast cancer related lymphedema.


Assuntos
Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , Linfedema/terapia , Qualidade de Vida , Extremidade Superior , Ioga , Adulto , Neoplasias da Mama/patologia , Fadiga/diagnóstico , Fadiga/etiologia , Fadiga/prevenção & controle , Feminino , Humanos , Linfedema/etiologia , Linfedema/patologia , Pessoa de Meia-Idade , Projetos Piloto , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/prevenção & controle
6.
Eur J Oncol Nurs ; 42: 97-102, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31479847

RESUMO

PURPOSE: (a) To identify subgroups with unique psychoneurological symptom-cluster experience (depression, cognitive impairment, fatigue, sleep disturbance, and pain) and (b) to examine whether the selected demographic, clinical, psychological, and biological factors determine a symptom-cluster experience in cancer patients. METHOD: The sample included 203 patients with diverse cancer types recruited from a Korean university hospital. Latent profile analyses were conducted to identify subgroups. Influencing factors of subgroup membership (demographic/clinical variables, hemoglobin level, social support, and psychological stress) were included as covariates in latent profile analysis and analyzed by multinomial logistic regression. RESULTS: Latent profile analyses classified patients into two subgroups with a unique symptom cluster experience: patients experiencing high intensity in all symptoms within the cluster (the all-high-symptom subgroup, 71%) and patients experiencing low intensity in all symptoms within the cluster (all-low-symptom subgroup, 29%). The validity of the two subgroups was confirmed by the group classification accuracy (97% of the all-low-symptom subgroup and 99% of the all-high-symptom subgroup) and by significant Wald's mean equality tests, showing each symptom (depression, cognitive impairment, fatigue, sleep disturbance, and pain) significantly differentiated the two subgroups (ps < .001). Psychological stress independently determined the subgroup membership. Patients with high levels of stress were more likely to be in the all-high-symptom group (OR = 4.69, p < .0001). Hemoglobin level, cancer diagnosis, social support, and previous chemotherapy experience did not influence group membership. CONCLUSIONS: A large number of patients experience five psychoneurological symptoms simultaneously due to psychological stress. Interventions targeted to stress would be beneficial for those patients.


Assuntos
Neoplasias/complicações , Neoplasias/psicologia , Estresse Psicológico/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor do Câncer/diagnóstico , Dor do Câncer/epidemiologia , Dor do Câncer/psicologia , Análise por Conglomerados , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Fadiga/diagnóstico , Fadiga/epidemiologia , Fadiga/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/epidemiologia , Estresse Psicológico/diagnóstico , Avaliação de Sintomas , Síndrome , Adulto Jovem
7.
Neurology ; 93(12): e1180-e1192, 2019 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-31409737

RESUMO

OBJECTIVE: To determine the frequency and relative importance of the most meaningful symptoms in facioscapulohumeral muscular dystrophy (FSHD) and to identify the demographic and clinical features that are associated with the greatest disease burden in this population. METHODS: We performed a cross-sectional study involving 328 participants with FSHD. Collectively, participants reported the prevalence and relative importance of 274 symptoms and 15 symptomatic themes. We assessed the association between symptomatic theme prevalence and participants' age, sex, disease duration, pain level, employment status, and education. RESULTS: Participants answered >48,000 questions regarding their disease burden. The symptomatic themes with the highest prevalence in our sample were problems with shoulders or arms (96.9%), limitations with activities (94.7%), core weakness (93.8%), fatigue (93.8%), limitations with mobility and walking (93.6%), changed body image due to the disease (91.6%), and pain (87.7%). Problems with shoulders and arms and limitations with mobility and walking had the greatest effect on participants' lives. Employment status and the report of pain had the most extensive association with the prevalence of symptoms, with employment being associated with 8 of 15 of the symptomatic themes and pain being associated with 7 of 15 of the symptomatic themes. Men and women with FSHD experienced a similar prevalence of all symptomatic themes. CONCLUSIONS: Adults with FSHD experience a variety of symptoms that play an important role in their disease burden. These symptoms have a variable prevalence and importance in the FSHD population and are associated with disease duration, employment status, and pain level.


Assuntos
Distrofia Muscular Facioescapuloumeral/diagnóstico , Distrofia Muscular Facioescapuloumeral/fisiopatologia , Medidas de Resultados Relatados pelo Paciente , Inquéritos e Questionários , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Fadiga/complicações , Fadiga/diagnóstico , Fadiga/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distrofia Muscular Facioescapuloumeral/complicações , Dor/complicações , Dor/diagnóstico , Dor/fisiopatologia , Adulto Jovem
8.
Res Nurs Health ; 42(5): 358-368, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31410868

RESUMO

Most nurses in Korea work rotating shifts, an important contributor to fatigue. The Occupational Fatigue Exhaustion Recovery (OFER) Scale assesses work-related fatigue among nurses. In this study, we aimed to translate and culturally adapt the Korean version of this scale (OFER-K) with nurses working rotating shifts in Korea. Instrument adaptation was performed using committee-based translation, cognitive interviewing, and expert panel interviewing. Criterion validity, convergent validity, construct validity, internal consistency, and test-retest reliability were examined as psychometric properties of the OFER-K. An online survey was completed by 331 nurses; 107 of these nurses completed a second survey after 1 month to assess test-retest reliability. The overall Cronbach's alpha was 0.88. The correlation between participants' initial and retest responses for the total scale was 0.64 (p < .001). The chronic fatigue subscale was stable over time, t(106) = -1.76, p = .08. Criterion and convergent validity were supported by correlations between the OFER-K scale and the Chalder Fatigue Questionnaire, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index. Confirmatory factor analysis showed a good fit using a three-factor model. The findings of this study showed that the OFER-K scale is a reliable and valid instrument for assessing chronic fatigue, acute fatigue, and inter-shift recovery in Korean nurses. Future research using this scale may lead to a better understanding of the antecedents and consequences of nurse fatigue and could provide important information to nurse researchers, administrators, and policymakers for developing interventions to reduce nurse fatigue.


Assuntos
Esgotamento Profissional/diagnóstico , Fadiga/diagnóstico , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Psicometria/métodos , Reprodutibilidade dos Testes , República da Coreia , Inquéritos e Questionários , Traduções
9.
Eur J Oncol Nurs ; 42: 14-20, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446259

RESUMO

PURPOSE: Symptoms experienced by breast cancer patients often cluster together in groups known as "symptom clusters". The aim was to determine the symptom clusters in women with non-metastatic breast cancer treated by radiation therapy (RT). METHODS: Edmonton Symptom Assessment Scale (ESAS) scores were taken from breast cancer patients receiving RT before, at completion of RT, and after RT. Exploratory factor analysis (EFA), principal component analysis (PCA), and hierarchical cluster analysis (HCA) were used to identify symptom clusters among the nine ESAS items at all three time points. RESULTS: This study included 1224 patients. The PCA and EFA identified the same two symptom clusters before the start of RT: 1) pain, tiredness, nausea, drowsiness, appetite, and dyspnea; 2) depression, anxiety, and wellbeing. The HCA further split the symptoms into three clusters. Wellbeing, depression, and anxiety consistently clustered together. Among the ESAS scores collected at the end of and after RT, each statistical method identified different symptom clusters. For the symptom clusters experienced at the end of RT, the following symptoms were always in the same cluster: wellbeing, depression, and anxiety; nausea and appetite; drowsiness and dyspnea. Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster. CONCLUSION: Among the symptom clusters derived before, at the end of RT, and after RT, the following symptoms consistently presented together: depression and anxiety, nausea and appetite, pain and tiredness, and drowsiness, dyspnea, and tiredness. Understanding symptom clusters in this population can improve management of symptoms.


Assuntos
Neoplasias da Mama/complicações , Neoplasias da Mama/radioterapia , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Neoplasias da Mama/psicologia , Dor do Câncer/diagnóstico , Dor do Câncer/epidemiologia , Análise por Conglomerados , Depressão/diagnóstico , Depressão/epidemiologia , Dispneia/diagnóstico , Dispneia/epidemiologia , Análise Fatorial , Fadiga/diagnóstico , Fadiga/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Náusea/diagnóstico , Náusea/epidemiologia , Análise de Componente Principal , Avaliação de Sintomas/métodos
11.
Medicina (Kaunas) ; 55(7)2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31315290

RESUMO

Background and objectives: Lymphoma patients experience a psychological and physiological decline that could be reversed by exercise. However, little is known about the effects of the exercise on psychological and physical fitness variables. Therefore, the purpose of this longitudinal study was to assess self-efficacy, fatigue and physical fitness before and after an eight-week exercise intervention. Materials and Methods: Thirty-six participants (54.4 ± 19.1 years) performed a supervised exercise program (~60 min, 2d·wk-1). Each session included a combined progressive training of cardiorespiratory, resistance, flexibility and postural education exercises. Self-efficacy and fatigue were measured with the Regulatory Emotional Self-Efficacy scale and 0-10 rating scale, respectively. Physical fitness was assessed with the body mass index, lower back flexibility, static balance, muscle strength and functional mobility. Results: Adherence to exercise was high (91.2% ± 4.8%) and no major health problems were noted in the patients over the intervention period. At baseline, significant differences were found between Hodgkin's lymphoma and non-Hodgkin's lymphoma patients by age and all dependent measures (p < 0.05). Fatigue significantly decreased and the perceived capability to regulate negative affect and to express positive emotions improved after exercise (p < 0.001). Significant improvements were found for body mass index, trunk lateral flexibility, monopodalic balance, isometric handgrip force and functional mobility (p < 0.001). Fatigue was significantly correlated with handgrip force (r = -0.56, p < 0.001) and functional mobility (r = -0.69, p < 0.001). Conclusions: The supervised exercise program improved psychological and physical fitness without causing adverse effects and health problems. Therefore, exercise to improve fitness levels and reduce perceived fatigue should be considered in the management of lymphoma patients.


Assuntos
Terapia por Exercício/normas , Linfoma/psicologia , Adulto , Idoso , Exercício/psicologia , Terapia por Exercício/métodos , Terapia por Exercício/psicologia , Fadiga/diagnóstico , Fadiga/etiologia , Feminino , Força da Mão/fisiologia , Humanos , Estudos Longitudinais , Linfoma/complicações , Linfoma/terapia , Masculino , Pessoa de Meia-Idade , Aptidão Física/psicologia , Psicometria/instrumentação , Psicometria/métodos , Autoeficácia
12.
Occup Ther Int ; 2019: 3027280, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31354395

RESUMO

Background: Fatigue is one of the most frequently reported symptoms by individuals with ankylosing spondylitis. However, it is often overlooked clinically and in research. Literature researching the impact of severe fatigue on occupational participation in ankylosing spondylitis is limited. Therefore, the aim of this research was to explore the impact of severe fatigue on occupational participation, disease activity, and quality of life in people with AS. Methods: A sequential exploratory mixed method study design was used in this study. Self-reported questionnaires gathered quantitative data which were analysed with descriptive and inferential statistics. Qualitative data were generated through semistructured interviews and analysed using a content analysis approach. Results: Fifty individuals with AS completed all study questionnaires. Participants had a mean age of 46.5 years; 72% were men with a mean disease duration of 14.5 years. High fatigue was reported by 38% of participants using the Multidimensional Assessment of Fatigue (MAF). Fatigue was significantly associated with lower occupational participation (p = 0.018), higher disease activity (p < 0.001), higher pain (p < 0.001), reduced physical capacity (p = 0.018), lower quality of life (p < 0.001), and lower global well-being (p < 0.001). There were significant differences between those with low and high fatigue levels for occupational participation (p = 0.007), disease activity (p < 0.001), physical capacity (p = 0.015), pain (p < 0.001), and quality of life (p < 0.001). Participants discussed the impact of fatigue on productivity and leisure. They also discussed a range of strategies for managing their fatigue but reported a lack of education from health professionals on managing this symptom. Conclusion: Severe fatigue is a prevalent symptom for individuals with ankylosing spondylitis and results in reduced occupational participation in productivity and leisure. Early fatigue management interventions may reduce the occupational participation impact of this symptom for individuals with ankylosing spondylitis.


Assuntos
Fadiga/diagnóstico , Qualidade de Vida/psicologia , Índice de Gravidade de Doença , Espondilite Anquilosante/fisiopatologia , Adulto , Avaliação da Deficiência , Fadiga/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Prevalência , Inquéritos e Questionários
13.
Int J Dermatol ; 58(8): 976-981, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31168791

RESUMO

BACKGROUND: Sleep problems are common in patients with dermatologic disorders. However, it is unknown whether inflammatory skin disorders are associated with more sleep problems than noninflammatory skin disorders. PURPOSE: To determine whether sleep problems occur more frequently in people with inflammatory skin disorders compared to noninflammatory skin disorders. STUDY DESIGN: Observational case-control study. METHODS: Patients with inflammatory skin disorders (psoriasis [n = 17] and chronic eczema [n = 30]) and noninflammatory skin disorders (nonmelanoma skin cancers [NMSC] [n = 31]) were enrolled. Data collection occurred during a single visit. Statistical analysis of questionnaire results between groups utilized inverse propensity score weighted (IPSW) ANOVA and logistic regression models. RESULTS: Groups differed in mean (SD) age (P < 0.001) and itch severity (P < 0.001). Based on IPSW ANOVA models, the inflammatory group had significantly higher fatigue scores (mean [95% CI]; 32.0 [28.4-35.5]) than the noninflammatory group (25.5 [21.6-29.3]; P = 0.017). The inflammatory group odds of insomnia were significantly greater based on two definitions of insomnia, ISI ≥ 15 and PSSQ-I, with odds ratios (95% CI) of 14.4 (2.16-525) and 4.82 (1.45-20.7), respectively. These results were consistent in comparisons between the three groups, with no difference between psoriasis and chronic eczema, but with chronic eczema, significantly more were affected than NMSC. CONCLUSIONS: Patients with inflammatory skin disorders report significantly more fatigue and have higher odds of insomnia compared to patients with noninflammatory skin cancers.


Assuntos
Eczema/complicações , Fadiga/epidemiologia , Psoríase/complicações , Neoplasias Cutâneas/complicações , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adulto , Estudos de Casos e Controles , Doença Crônica , Fadiga/diagnóstico , Fadiga/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de Doença , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/etiologia , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
14.
Ann Surg Oncol ; 26(9): 2711-2721, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31147993

RESUMO

BACKGROUND: Given a slow course of disease, end-of-life issues are understudied in neuroendocrine tumors (NETs). To date, there are no data regarding symptoms at the end of life. This study examined symptom trajectories and factors associated with high symptom burden in NETs at the end of life. METHODS: We conducted a retrospective cohort study of NET patients diagnosed from 2004 to 2015 and who died between 2007 and 2016, in Ontario, Canada. Prospectively collected patient-reported Edmonton Symptom Assessment System scores were linked to administrative healthcare datasets. Moderate-to-severe symptom scores (≥ 4 out of 10) in the 6 months before death were analyzed, with multivariable modified Poisson regression identifying factors associated with moderate-to-severe symptoms scores. RESULTS: Among 677 NET decedents, 2579 symptom assessments were recorded. Overall, moderate-to-severe scores were most common for tiredness (86%), wellbeing (81%), lack of appetite (75%), and drowsiness (68%), with these proportions increasing as death approached. For symptoms of lack of appetite, drowsiness, and shortness of breath, the increase was steepest in the 8 weeks before death. On multivariable analyses, the risk of moderate-to-severe symptoms was significantly higher in the last 2 months before death and for patients with shorter survival (< 6 months). Women had higher risks of anxiety, nausea, and pain. CONCLUSION: A high prevalence of moderate-to-severe symptoms was observed for NETs at the end of life, not previously described. The proportion of moderate-to-severe symptoms increases steeply as death nears, highlighting an opportunity for improved management. Combined with identified factors associated with moderate-to-severe symptoms, this information is important to improve patient-centred and personalized supportive care for NETs at the end of life.


Assuntos
Tumores Neuroendócrinos/complicações , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Índice de Gravidade de Doença , Avaliação de Sintomas/mortalidade , Assistência Terminal/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/diagnóstico , Ansiedade/etiologia , Fadiga/diagnóstico , Fadiga/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/diagnóstico , Náusea/etiologia , Tumores Neuroendócrinos/epidemiologia , Tumores Neuroendócrinos/terapia , Ontário/epidemiologia , Dor/diagnóstico , Dor/etiologia , Cuidados Paliativos , Prevalência , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Taxa de Sobrevida , Adulto Jovem
15.
PLoS One ; 14(5): e0213704, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150405

RESUMO

A biofeedback system may objectively identify fatigue and provide an individualized timing plan for micro-breaks. We developed and implemented a biofeedback system based on oculometrics using continuous recordings of eye movements and pupil dilations to moderate fatigue development in its early stages. Twenty healthy young participants (10 males and 10 females) performed a cyclic computer task for 31-35 min over two sessions: 1) self-triggered micro-breaks (manual sessions), and 2) biofeedback-triggered micro-breaks (automatic sessions). The sessions were held with one-week inter-session interval and in a counterbalanced order across participants. Each session involved 180 cycles of the computer task and after each 20 cycles (a segment), the task paused for 5-s to acquire perceived fatigue using Karolinska Sleepiness Scale (KSS). Following the pause, a 25-s micro-break involving seated exercises was carried out whether it was triggered by the biofeedback system following the detection of fatigue (KSS≥5) in the automatic sessions or by the participants in the manual sessions. National Aeronautics and Space Administration Task Load Index (NASA-TLX) was administered after sessions. The functioning core of the biofeedback system was based on a Decision Tree Ensemble model for fatigue classification, which was developed using an oculometrics dataset previously collected during the same computer task. The biofeedback system identified fatigue with a mean accuracy of approx. 70%. Perceived workload obtained from NASA-TLX was significantly lower in the automatic sessions compared with the manual sessions, p = 0.01 Cohen's dz = 0.89. The results give support to the effectiveness of integrating oculometrics-based biofeedback in timing plan of micro-breaks to impede fatigue development during computer work.


Assuntos
Biorretroalimentação Psicológica/métodos , Computadores , Fadiga/prevenção & controle , Movimentos Oculares , Fadiga/diagnóstico , Feminino , Humanos , Masculino , Modelos Estatísticos , Reflexo Pupilar
16.
Sensors (Basel) ; 19(12)2019 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-31212742

RESUMO

With the development of the Internet of Battlefield Things (IoBT), soldiers have become key nodes of information collection and resource control on the battlefield. It has become a trend to develop wearable devices with diverse functions for the military. However, although densely deployed wearable sensors provide a platform for comprehensively monitoring the status of soldiers, wearable technology based on multi-source fusion lacks a generalized research system to highlight the advantages of heterogeneous sensor networks and information fusion. Therefore, this paper proposes a multi-level fusion framework (MLFF) based on Body Sensor Networks (BSNs) of soldiers, and describes a model of the deployment of heterogeneous sensor networks. The proposed framework covers multiple types of information at a single node, including behaviors, physiology, emotions, fatigue, environments, and locations, so as to enable Soldier-BSNs to obtain sufficient evidence, decision-making ability, and information resilience under resource constraints. In addition, we systematically discuss the problems and solutions of each unit according to the frame structure to identify research directions for the development of wearable devices for the military.


Assuntos
Técnicas Biossensoriais , Monitorização Fisiológica/métodos , Dispositivos Eletrônicos Vestíveis , Tecnologia sem Fio , Fadiga/diagnóstico , Fadiga/fisiopatologia , Humanos , Militares , Análise de Sistemas
17.
Acta Oncol ; 58(9): 1286-1297, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31204538

RESUMO

Background: Fatigue is a common and distressing cancer symptom that negatively affects the quality of life. Many scales have been developed to assess cancer-related fatigue. The properties of the scales vary in terms of dimensionality, reliability, validity, length and method of administration. Insufficient of psychometric properties may affect the accuracy of scales findings, that may lead result obtained questionable. The main objective of this review was to conduct a quality assessment of the psychometric properties of cancer-related fatigue scales to identify appropriate scales that could be used in research and clinical practice. Method: A systematic search was carried out to identify validated scales that measure cancer-related fatigue. Five databases were searched: CINAHL, MEDLINE, EMBASE, PsycINFO, Cochrane Library. This review was conducted following the PRISMA and Terwee et al.'s quality assessment guidelines to evaluate the psychometric properties of the studies. Result: Seventy-one different studies published between 1970 and 2018 met the inclusion criteria. Twenty-five scales were identified. Of these, eighteen were multidimensional and seven were uni-dimensional, containing between 4 and 72 items. Reliability and/or validity information was missing for many scales. Four scales met the quality assessment criteria and were reported as the most appropriate for measuring fatigue in cancer patients. Conclusion: Further psychometric testing is required for other scales. Developing a universally-defined tool kit for the assessment of cancer-related fatigue may help clarify the concept of fatigue and promote a systematic approach to fatigue measurement.


Assuntos
Fadiga/diagnóstico , Neoplasias/complicações , Índice de Gravidade de Doença , Fadiga/etiologia , Feminino , Guias como Assunto/normas , Humanos , Masculino , Psicometria , Garantia da Qualidade dos Cuidados de Saúde , Qualidade de Vida , Reprodutibilidade dos Testes
18.
Sultan Qaboos Univ Med J ; 19(1): e44-e50, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31198595

RESUMO

Objectives: Fatigue is a common discomfort experienced during pregnancy and may contribute to severe labour pain and postpartum depression. This study aimed to translate the Multidimensional Assessment of Fatigue (MAF) scale into Farsi and validate it in a sample of pregnant Irani women. Methods: This cross-sectional questionnaire study was conducted between January and June 2016 at eight healthcare centres in Sabzevar, Iran. The English version of the MAF scale was translated into Farsi and assessed for content validity. Participants completed the Farsi MAF scale and the Farsi World Health Organization-5 Well-being index (WHO-5). Construct validity was assessed through exploratory factor analysis (EFA). Cronbach's alpha coefficient and the intraclass correlation coefficient (ICC) were used to determine the internal consistency and stability of the Farsi MAF scale. Results: A total of 582 women met the inclusion criteria, of which 541 completed the MAF scale (response rate: 93%). The EFA of the 15 items confirmed the previously proposed one-factor structure with a Cronbach's alpha coefficient of 0.957 for the Farsi MAF scale. Stability was confirmed by the ICC value (0.702) for the Global Fatigue Index (GFI) and the mean GFI was 20.33 ± 12.71. Concurrent validity was confirmed by a moderate negative correlation (r = -0.35; P <0.001) between the scores of the Farsi MAF scale and the Farsi WHO-5. Women who received a high level of support from their husbands, who were satisfied with the quality of their marital relationship and with a well-being score of >50 reported a lower level of fatigue than the other groups (P ≤0.012). Conclusion: The Farsi MAF scale is a reliable and valid questionnaire to investigate fatigue in pregnant Irani women. Interventions to promote marital satisfaction and women's well-being are recommended.


Assuntos
Fadiga/classificação , Psicometria/normas , Adulto , Estudos Transversais , Fadiga/diagnóstico , Fadiga/psicologia , Feminino , Humanos , Irã (Geográfico) , Dor do Parto/etiologia , Dor do Parto/psicologia , Gravidez , Psicometria/instrumentação , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Tradução
19.
Biosens Bioelectron ; 136: 106-111, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31048212

RESUMO

Numerous studies reported that psychological fatigue is one of the main reasons leading fatal road crashes. In order to quantify fatigue level of each subject, we measured a concentration of salivary cortisol from 4 subjects (20-40 years of age) using the Smart Fatigue Phone, which consists of a lateral flow immunosensor and a smartphone-linked fluorescence signal reader, during 50-min driving session. Since the salivary cortisol needs to be measured below 1 ng/mL to distinguish the subjects from awaken-drivers, we have employed the fluorescence detection module (Limit of detection: 0.1 ng/mL). To validate correlation between fatigue status and salivary cortisol concentration measured by the Smart Fatigue Phone, the electroencephalogram (EEG) signal was simultaneously obtained from the participants. As a result, alpha wave and concentration of cortisol over time was highly correlated, reflecting that quantification of salivary cortisol can be used for real-time monitoring of driver fatigue (p < 0.05). The Smart Fatigue Phone is expected to be a useful tool for drivers to recognize their fatigue status and subsequently to make a decision for driving a car. Thus, we assume that this fatigue detection system will consequently minimize road crashes by quantifying salivary cortisol in real time in the near future.


Assuntos
Condução de Veículo , Fadiga/diagnóstico , Hidrocortisona/análise , Saliva/química , Smartphone , Adulto , Técnicas Biossensoriais , Eletroencefalografia , Ensaio de Imunoadsorção Enzimática , Feminino , Fluorescência , Humanos , Masculino
20.
Arch Endocrinol Metab ; 63(3): 235-240, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31038594

RESUMO

OBJECTIVE: To evaluate whether hormonal profile, arterial function, and physical capacity are predictors of fatigue in patients with acromegaly. Subjects and methods: This is a cross-sectional study including 23 patients. The subjects underwent a Modified Fatigue Impact Scale (MFIS) assessment; serum growth hormones (GH) and IGF-1 measurements; pulse wave analysis comprising pulse wave velocity (PWV), arterial compliance (AC), and the reflection index (IR1,2); dominant upper limb dynamometry (DYN); and the six-minute walking distance test (6MWT). Multiple linear regression models were used to identify predictors for MFIS. The coefficient of determination R2 was used to assess the quality of the models' fit. The best model was further analyzed using a calibration plot and a limits of agreement (LOA) plot. RESULTS: The mean ± SD values for the participants' age, MFIS, PWV, AC, IR1,2, DYN, and the distance in the 6MWT were 49.4 ± 11.2 years, 31.2 ± 18.9 score, 10.19 ± 2.34 m/s, 1.08 ± 0.46 x106 cm5/din, 85.3 ± 29.7%, 33.9 ± 9.3 kgf, and 603.0 ± 106.1 m, respectively. The best predictive model (R2 = 0.378, R2 adjusted = 0.280, standard error = 16.1, and P = 0.026) comprised the following regression equation: MFIS = 48.85 - (7.913 × IGF-I) + (1.483 × AC) - (23.281 × DYN). CONCLUSION: Hormonal, vascular, and functional variables can predict general fatigue in patients with acromegaly.


Assuntos
Acromegalia/complicações , Fadiga/diagnóstico , Fadiga/etiologia , Adulto , Brasil , Estudos Transversais , Tolerância ao Exercício , Feminino , Humanos , Fator de Crescimento Insulin-Like I/análise , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Valor Preditivo dos Testes , Análise de Onda de Pulso , Teste de Caminhada
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA