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1.
Clin Transl Sci ; 17(6): e13826, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38894576

RESUMO

Following SARS-CoV-2 infection, some patients develop lingering neurologic symptoms of post-acute sequelae of COVID-19 (PASC) that commonly include fatigue and "brain fog." PASC symptoms are also linked with reduced growth hormone (GH) secretion, but GH treatment has not been tested to relieve symptoms. We enrolled 13 adults with neurologic PASC symptoms and peak stimulated GH secretion less than 10 ng/mL (glucagon stimulation) in a pilot study to receive 9 months of daily GH injections and an additional 3 months of off-treatment assessment. We compared peak stimulated GH secretion at baseline and 12 months and assessed measures of cognition, metabolism, body composition, and physical performance over the first 6 months of treatment. Patient-reported outcomes of fatigue, quality of life, sleep, and mood were recorded at baseline and compared with timepoints at 6, 9, and 12 months. GH treatment was associated with significantly improved scores for Brief Fatigue Inventory, Multidimensional Fatigue Symptom Inventory, Quality of Life Assessment of Growth Hormone Deficiency in Adults, Profile of Mood States, and Beck Depression Inventory-II, with no significant change in Pittsburgh Sleep Quality Index. Six months of adjunct GH treatment was not associated with significant changes in cognition, body composition, resting energy expenditure, or physical performance. Peak stimulated GH secretion was not altered at 12 months following 9 months of GH treatment. GH treatment significantly improved neurologic symptoms in PASC patients but cognition, sleep, and physical performance were not significantly altered.


Assuntos
COVID-19 , Fadiga , Hormônio do Crescimento Humano , Síndrome de COVID-19 Pós-Aguda , Qualidade de Vida , SARS-CoV-2 , Humanos , Masculino , Feminino , COVID-19/complicações , Pessoa de Meia-Idade , Hormônio do Crescimento Humano/uso terapêutico , Projetos Piloto , Fadiga/tratamento farmacológico , Fadiga/etiologia , Adulto , Idoso , Resultado do Tratamento , Composição Corporal/efeitos dos fármacos
2.
Brain Behav ; 14(6): e3575, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38867451

RESUMO

BACKGROUND: Acupuncture as a traditional Chinese medicine therapy relies on unique theories to alleviate fatigue. The aim of this study is to evaluate the effect of acupuncture on exercise-induced fatigue utilizing transcranial magnetic stimulation (TMS). METHODS: A total of 20 participants with regular exercise habits were recruited for this study. All participants were randomly assigned to receive either acupuncture or sham acupuncture intervention for exercise-induced fatigue. TMS and a heart rate monitor were used to measure the amplitude and latency of motor evoked potential (MEP) as well as heart rate every 5 min over a 30-min period. The blood lactic acid (BLA) levels were measured using Lactate Scout+ at baseline, 0 min, and 30 min after fatigue. Two-way repeated measures analysis of variance was utilized to compare the differences between the effects of acupuncture method and time. Bonferroni post hoc tests were conducted to compare specific differences. Statistical significance was set at p < .05. RESULTS: Interaction effect was observed between acupuncture method and time effect in terms of amplitude (F(1, 38) = 5.40, p < .001, η2 = 0.12) and latency (F(1, 38) = 3.78, p = .008, η2 = .09) of MEP. The application of acupuncture can promote the recovery of heart rate especially at 30 min (p < .05), but which seem insufficient to generate significant difference in BLA (F(1, 38) = 0.067, p = .797, η2 = 0.002). CONCLUSIONS: Acupuncture can promote the increase of MEP amplitude, shorten MEP latency, and restore heart rate. Preliminary findings provide novel insights for individuals with exercise habits to alleviate fatigue and enhance sports performance.


Assuntos
Terapia por Acupuntura , Potencial Evocado Motor , Exercício Físico , Fadiga , Frequência Cardíaca , Estimulação Magnética Transcraniana , Humanos , Estimulação Magnética Transcraniana/métodos , Masculino , Terapia por Acupuntura/métodos , Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Feminino , Adulto Jovem , Adulto , Potencial Evocado Motor/fisiologia , Fadiga/terapia , Fadiga/fisiopatologia , Fadiga/etiologia , Ácido Láctico/sangue
4.
Sci Rep ; 14(1): 13387, 2024 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862585

RESUMO

Post-COVID-19 condition (PCC) is defined as the persistence of symptoms, like fatigue and dyspnea, at least 3 months post-COVID infection. As dyspnea is a common symptom, we attempted to further clinically phenotype those with PCC-associated dyspnea. 1642 adults (average age of 49.6y with 63% female-predominance and BMI of 31.2 kg/m2) with physician confirmed diagnosis of PCC from June 2020-April 2023 in Alberta, Canada were included. Those with dyspnea were more likely to be female (56.5%, p = 0.005) and have higher BMI (31.3 kg/m2 vs. 29.5 kg/m2; p = 0.0008), history of asthma (21.1% vs. 12.3%; p < 0.001), more persistent PCC symptoms (p = 0.0001), more functional limitations, as well as lower quality of life (p < 0.0001). Multivariable-adjusted logistic regression analysis demonstrated dyspnea was independently associated with fatigue (OR = 4.20; CI = 2.71,6.59) and inversely associated with hospitalization for COVID-19 (OR = 0.53; CI = 0.32,0.91), age (OR = 0.98 per one year of age; CI = 0.96,0.99) and 6-min-walk-distance per 10 m difference (OR = 0.98, CI = 0.96,1.0). Fatigue was a predictor of dyspnea, and was associated with milder infection, higher BMI, and reduced 6-min-walk-distance despite normal pulmonary function. Reduced TLC or DLCO was associated with more severe infection and reduced 6-min-walk-distance. Thus, we speculate there are at least two dyspnea-associated phenotypes: phenotype with pronounced fatigue (normal PFT) and phenotype with pronounced pulmonary abnormalities (abnormal PFT). Improved understanding of the dyspnea-associated phenotypes may allow for better targeted rehabilitation.


Assuntos
COVID-19 , Dispneia , Fadiga , Fenótipo , Humanos , Dispneia/etiologia , Dispneia/fisiopatologia , Feminino , COVID-19/complicações , COVID-19/virologia , Masculino , Pessoa de Meia-Idade , Estudos Transversais , Adulto , Fadiga/etiologia , SARS-CoV-2/isolamento & purificação , Síndrome de COVID-19 Pós-Aguda , Qualidade de Vida , Idoso , Índice de Massa Corporal , Alberta/epidemiologia , Hospitalização
5.
BMC Cancer ; 24(1): 722, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862904

RESUMO

BACKGROUND: Childhood, adolescent, and young adult (CAYA) cancer survivors, at risk for late effects, including cancer-related fatigue, cardiovascular issues, and psychosocial challenges, may benefit from interventions stimulating behaviour adjustments. Three nurse-led eHealth interventions (REVIVER) delivered via video calls and elaborating on person-centred care, cognitive behaviour therapy and/or motivational interviewing were developed. These interventions target: 1) fatigue management, 2) healthier lifestyle behaviours, and 3) self-efficacy and self-management. This study aimed to assess the feasibility and potential effectiveness of the REVIVER interventions for CAYA cancer survivors and healthcare professionals. METHODS: In a single-group mixed methods design, CAYA cancer survivors aged 16-54, more than five years post-treatment, were enrolled. Feasibility, assessed via Bowen's outcomes for feasibility studies, included acceptability, practicality, integration and implementation, demand and adherence. Qualitative data from semi-structured interviews and a focus group interview with survivors and healthcare professionals supplemented the evaluation. Paired sample t-tests assessed changes in self-reported quality of life, fatigue, lifestyle, self-management, and self-efficacy at baseline (T0), post-intervention (T1), and 6-month follow-up (T2). RESULTS: The interventions and video consults were generally acceptable, practical, and successfully integrated and implemented. Success factors included the nurse consultant (i.e., communication, approach, and attitude) and the personalised approach. Barriers included sustainability concerns, technical issues, and short intervention duration. Regarding demand, 71.4%, 65.4%, and 100% of eligible CAYA cancer survivors engaged in the fatigue (N = 15), lifestyle (N = 17) and empowerment (N = 3) intervention, respectively, with 5, 5 and 2 participants interviewed, correspondingly. Low interest (demand) in the empowerment intervention (N = 3) and dropout rates of one-third for both fatigue and empowerment interventions were noted (adherence). Improvements in quality of life, fatigue (fatigue intervention), lifestyle (lifestyle intervention), self-efficacy, and self-management were evident among survivors who completed the fatigue and lifestyle interventions, with medium and large effect sizes observed immediately after the intervention and six months post-intervention. CONCLUSIONS: Our study demonstrates the feasibility of nurse-led video coaching (REVIVER interventions) despite lower demand for the empowerment intervention and lower adherence to the fatigue and empowerment interventions. The medium and high effect sizes found for those who completed the interventions hold potential clinical significance for future studies investigating the effectiveness of the REVIVER interventions.


Assuntos
Sobreviventes de Câncer , Estudos de Viabilidade , Qualidade de Vida , Humanos , Sobreviventes de Câncer/psicologia , Adolescente , Feminino , Masculino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Telemedicina , Tutoria/métodos , Autoeficácia , Fadiga/etiologia , Neoplasias/enfermagem , Neoplasias/psicologia , Terapia Cognitivo-Comportamental/métodos , Autogestão/métodos , Criança , Entrevista Motivacional/métodos
6.
Cancer Med ; 13(11): e7313, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38845458

RESUMO

OBJECTIVE: Cancer-related fatigue (CRF) and fear of cancer recurrence (FCR) are two common concerns experienced by cancer survivors. However, the relationship between these two concerns is poorly understood, and whether CRF and FCR influence each other over time is unclear. METHODS: Data were from a national, prospective, longitudinal study, the American Cancer Society's Study of Cancer Survivors-I (SCS-I). Surveys were completed by 1395 survivors of 10 different cancer types at three time-points, including assessment 1.3 years (T1), 2.2 years (T2) and 8.8 years (T3) following their cancer diagnosis. CRF was assessed using the fatigue-inertia subscale of the Profile of Mood States, and FCR by the FCR subscale of the Cancer Problems in Living Scale. Multiple group random intercepts cross-lagged panel models investigated prospective associations between CRF and FCR. RESULTS: For younger participants (at or below median age of 55 years, n = 697), CRF at T1 and T2 marginally and significantly predicted FCR at T2 and T3, respectively, but no lagged effects of FCR on subsequent CRF were observed. Cross-lagged effects were not observed for survivors over 55 years of age. CONCLUSION: Both CRF and FCR are debilitating side effects of cancer and its treatments. Given that CRF may be predictive of FCR, it possible that early detection and intervention for CRF could contribute to lowering FCR severity.


Assuntos
Sobreviventes de Câncer , Fadiga , Medo , Recidiva Local de Neoplasia , Neoplasias , Humanos , Sobreviventes de Câncer/psicologia , Medo/psicologia , Feminino , Pessoa de Meia-Idade , Fadiga/etiologia , Fadiga/psicologia , Estudos Longitudinais , Masculino , Neoplasias/complicações , Neoplasias/psicologia , Recidiva Local de Neoplasia/psicologia , Estudos Prospectivos , Idoso , Adulto , Inquéritos e Questionários
7.
Medicine (Baltimore) ; 103(23): e38460, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38847730

RESUMO

RATIONALE: Mindfulness-Based Cancer Recovery (MBCR) program is a group course training for cancer patients that combines cancer knowledge and psychological knowledge, emphasizing focusing on the psychosomatic symptoms of cancer patients. Currently, the application value of Mindfulness-Based Cancer Recovery in improving psychosomatic health of cancer patients has been confirmed, however, its intervention effect on breast neoplasm patients has not yet been widely studied in China. PATIENT CONCERNS AND DIAGNOSES: This study introduced the Mindfulness-Based Cancer Recovery protocol into the rehabilitation process of breast cancer patients, aiming to elucidate the effects of Mindfulness-Based Cancer Recovery on anxiety, depression, post-traumatic stress disorder, and cancer-related fatigue in breast neoplasm patients, to provide a practical basis for improving the physical and mental health of breast cancer patients. INTERVENTION: In this study, 80 patients with chemotherapy-stage breast neoplasm attending the oncology department of a tertiary-level hospital from January 2022 to December 2022 were selected, 40 patients attending from January 2022 to June 2022 were included in the study group, and 40 patients attending from July 2022 to December 2022 were included in the control group. The control group was administered conventional care, and the study group was administered Mindfulness-Based Cancer Recovery based on conventional care in the control group for 8 weeks. After the intervention, hospital anxiety and depression scale, impact of event scale-revised, and cancer fatigue scale were used for evaluation. OUTCOMES: After the intervention, hospital anxiety and depression scale scores decreased in both groups compared with pre-intervention, with the study group scoring lower than the control group (P < .05). After the intervention, the impact of event scale-revised scores of the 2 groups decreased from the preintervention period, with the study group scoring lower than the control group (P < .05). After the intervention, cancer fatigue scale scores decreased in the 2 groups compared with the preintervention period, with the study group scoring lower than the control group (P < .05). LESSONS: Mindfulness-Based Cancer Recovery can effectively reduce the levels of anxiety, depression and post-traumatic stress disorder in breast neoplasm patients undergoing chemotherapy, reduce the levels of cancer-related fatigue, and promote the physical and mental health of patients.


Assuntos
Ansiedade , Neoplasias da Mama , Depressão , Fadiga , Atenção Plena , Transtornos de Estresse Pós-Traumáticos , Humanos , Atenção Plena/métodos , Feminino , Neoplasias da Mama/complicações , Neoplasias da Mama/psicologia , Neoplasias da Mama/tratamento farmacológico , Pessoa de Meia-Idade , Fadiga/etiologia , Fadiga/terapia , Fadiga/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Ansiedade/etiologia , Ansiedade/terapia , Depressão/etiologia , Depressão/terapia , Depressão/psicologia , Adulto , China , Antineoplásicos/uso terapêutico , Antineoplásicos/efeitos adversos
8.
Reprod Biol Endocrinol ; 22(1): 66, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38849828

RESUMO

Fatigue, an increasingly acknowledged symptom in various chronic diseases, has garnered heightened attention, during the medical era of bio-psycho-social model. Its persistence not only significantly compromises an individual's quality of life but also correlates with chronic organ damage. Surprisingly, the intricate relationship between fatigue and female reproductive health, specifically infertility, remains largely unexplored. Our exploration into the existing body of evidence establishes a compelling link between fatigue with uterine and ovarian diseases, as well as conditions associated with infertility, such as rheumatism. This observation suggests a potentially pivotal role of fatigue in influencing overall female fertility. Furthermore, we propose a hypothetical mechanism elucidating the impact of fatigue on infertility from multiple perspectives, postulating that neuroendocrine, neurotransmitter, inflammatory immune, and mitochondrial dysfunction resulting from fatigue and its co-factors may further contribute to endocrine disorders, menstrual irregularities, and sexual dysfunction, ultimately leading to infertility. In addition to providing this comprehensive theoretical framework, we summarize anti-fatigue strategies and accentuate current knowledge gaps. By doing so, our aim is to offer novel insights, stimulate further research, and advance our understanding of the crucial interplay between fatigue and female reproductive health.


Assuntos
Fadiga , Infertilidade Feminina , Humanos , Feminino , Infertilidade Feminina/etiologia , Fadiga/etiologia , Fadiga/fisiopatologia , Qualidade de Vida
9.
Brain Behav ; 14(6): e3553, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38873875

RESUMO

BACKGROUND: Fatigue has been observed after the outbreaks of several infectious diseases around the world. To explore the fatigue level among physicians working in COVID-19-designated hospitals in Bangladesh, a matched case‒control study was conducted on post-SARS-CoV-2 fatigue. METHOD: In this study, 105 physicians diagnosed with COVID-19 who were declared cured at least 6 weeks before the interview date were recruited as cases, and the same number of age- and designation-matched healthy physicians were recruited as controls from the same hospital at a 1:1 ratio. Diagnosis of COVID-19 infection was confirmed by detection of SARS CoV-2 antigen by RT‒PCR from reference laboratories in Bangladesh or by HRCT chest. RESULT: Approximately two-thirds of the physicians were male (67.6% vs. 32.4%). More than 80% of them were younger than 40 years. The cases had a significantly greater number of comorbid conditions. The fatigue severity scale (FSS) score (mean) was much higher for cases (36.7 ± 5.3 vs. 19.3 ± 3.8) than for the control group, with a statistically significant difference. Similarly, approximately 67.7% of the previously COVID-19-positive physicians were in the highest FSS score tertile compared to the respondents in the control group, who had a mean score of <3. CONCLUSION: Physicians who had a previous history of COVID-19 infection had significantly higher total and mean FSS scores, signifying a more severe level of fatigue than physicians who had never been COVID-19 positive while working in the same hospital irrespective of their age and sex.


Assuntos
COVID-19 , Fadiga , Médicos , Humanos , COVID-19/epidemiologia , COVID-19/diagnóstico , Masculino , Bangladesh/epidemiologia , Fadiga/epidemiologia , Fadiga/etiologia , Fadiga/diagnóstico , Feminino , Adulto , Médicos/estatística & dados numéricos , Estudos de Casos e Controles , Pessoa de Meia-Idade , SARS-CoV-2 , Hospitais/estatística & dados numéricos
10.
Trials ; 25(1): 361, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840199

RESUMO

BACKGROUND: Although hematopoietic stem cell transplantation provides the chances of survival for aplastic anemia patients, it is also related to many treatment-related physical and psychological side effects that severely influence the quality of life. Exercise interventions have shown positive results in mixed hematology populations. The study aims to determine the effectiveness of exercise rehabilitation in improving the quality of life, fatigue, and physical function in these patients. METHODS: The study will enroll a total of 82 aplastic anemia patients receiving hematopoietic stem cell transplantation. They will be randomly divided into two groups in a 1:1 ratio. The intervention group will participate in structured exercise rehabilitation (plus usual care), while control group participants will receive usual care. The exercise rehabilitation program will be performed from neutrophil and platelet engraftment until 100 days after transplantation. All outcomes will be measured at the following time points: the neutrophil and platelet engraftment (± 1day, T0), discharge from the transplantation module (± 1 day, T1), hospital discharge (± 1 day, T2), and 100 days post-transplantation (± 5 days, T3). DISCUSSION: This study aims to assess the effectiveness of exercise rehabilitation for aplastic anemia patients receiving hematopoietic stem cell transplantation in a Chinese single center. It is particularly vital to conduct the studies in this population. Moreover, the evidence obtained from the study will provide evidence for future research and clinical practice to exercise in aplastic anemia patients. TRIAL REGISTRATION: ChiCTR2200060762. Registered on May 2022, www.trialregister.nl/trial/7702.


Assuntos
Anemia Aplástica , Terapia por Exercício , Transplante de Células-Tronco Hematopoéticas , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Anemia Aplástica/reabilitação , Anemia Aplástica/terapia , Terapia por Exercício/métodos , Resultado do Tratamento , Adulto , Masculino , Adolescente , Feminino , Adulto Jovem , Fadiga/etiologia , Pessoa de Meia-Idade , Fatores de Tempo , China , Recuperação de Função Fisiológica
11.
Immun Inflamm Dis ; 12(6): e1313, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38874275

RESUMO

INTRODUCTION: Fatigue is a common symptom that negatively affects the outcomes and functions of rheumatoid arthritis (RA) patients. This study aimed to assess the fatigue by two scales and validate their consistency, also to comprehensively evaluate fatigue-related risk factors in RA patients. METHODS: In this case-control study, the fatigue of 160 RA patients and 60 healthy controls was evaluated by the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire (BRAF-MDQ) and the Chinese version of the Brief Fatigue Inventory (BFI-C). The 28-joint disease activity score using erythrocyte sedimentation rate of RA patients was assessed. RESULTS: The BRAF-MDQ and BFI-C scores were elevated in RA patients versus healthy controls (all p < .001). Interestingly, BRAF-MDQ global fatigue score positively correlated with BFI-C global fatigue score in both RA patients (r = .669, p < .001) and healthy controls (r = .527, p < .001); meanwhile, Kendall's tau-b test showed a high consistency between BRAF-MDQ and BFI-C global fatigue scores in RA patients (W = 0.759, p < .001) and healthy controls (W = 0.933, p < .001). Notably, higher education level (В = -4.547; 95% confidence interval: -7.065, -2.029; p < .001) and swollen joint count (В = 1.965; 95% confidence interval: 1.375, 2.554; p < .001) independently related to BRAF-MDQ global fatigue score; higher education level (В = -0.613; 95% confidence interval: -0.956, -0.269; p = .001) and clinical disease activity index (В = 0.053; 95% confidence interval: 0.005, 0.102; p = .032) independently linked with BFI-C global fatigue score. CONCLUSION: Fatigue commonly occurs in RA patients, which independently relates to education level and disease activity. Furthermore, BRAF-MDQ and BFI-C scales exhibit a high consistency in assessing fatigue.


Assuntos
Artrite Reumatoide , Fadiga , Humanos , Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico , Fadiga/diagnóstico , Fadiga/etiologia , Feminino , Masculino , Pessoa de Meia-Idade , Estudos de Casos e Controles , Fatores de Risco , Inquéritos e Questionários , Adulto , Índice de Gravidade de Doença , Idoso
12.
BMC Womens Health ; 24(1): 344, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38877474

RESUMO

BACKGROUND: Breast cancer patients undergoing chemotherapy via peripherally inserted central catheter often experience serious behavioral and psychological challenges, with uncertainty and cancer-related fatigue being prevalent issues that profoundly impact prognosis. Therefore, this study aimed to investigate the relationship between uncertainty and cancer-related fatigue by employing a chain mediation model to examine the potential mediating roles of psychological resilience and self-care. METHODS: A cross-sectional study was conducted with 223 breast cancer patients receiving peripherally inserted central catheter chemotherapy at two tertiary affiliated hospitals of China Medical University in Liaoning, China, from February 2021 to December 2022. Participants completed self-reported questionnaires to assess uncertainty, psychological resilience, self-care, and cancer-related fatigue. The collected data were subsequently analyzed using Pearson's correlation analysis, hierarchical regression analysis, and mediation analysis. RESULTS: Uncertainty exhibited a significant positive correlation with cancer-related fatigue (p < 0.01) and a negative correlation with psychological resilience (p < 0.01) and self-care (p < 0.01). Uncertainty was found to impact cancer-related fatigue through three pathways: psychological resilience mediated the relationship between uncertainty and cancer-related fatigue (mediating effect = 0.240, 95% confidence interval: 0.188 to 0.298, effect ratio = 53.22%); self-care also mediated this relationship (mediating effect = 0.080, 95% confidence interval: 0.044 to 0.121, effect ratio = 17.74%); furthermore, there was a significant joint mediating effect of psychological resilience and self-care on the association between uncertainty and cancer-related fatigue (mediating effect = 0.042, 95% confidence interval: 0.021 to 0.068, effect ratio o = 9.31%). CONCLUSION: The findings of this study revealed that uncertainty not only directly influenced cancer-related fatigue, but also operated through the mediating effect of psychological resilience, self-care, and sequential mediation of psychological resilience and self-care. Interventions tailored for breast cancer patients receiving peripherally inserted central catheter chemotherapy should target these factors to help alleviate uncertainty, enhance psychological resilience, and improve self-care practices, thereby ameliorating cancer-related fatigue.


Assuntos
Neoplasias da Mama , Fadiga , Resiliência Psicológica , Autocuidado , Humanos , Feminino , Neoplasias da Mama/psicologia , Neoplasias da Mama/complicações , Neoplasias da Mama/tratamento farmacológico , Fadiga/psicologia , Fadiga/etiologia , Incerteza , Pessoa de Meia-Idade , Autocuidado/psicologia , Autocuidado/métodos , Estudos Transversais , Adulto , China/epidemiologia , Inquéritos e Questionários , Cateterismo Periférico/psicologia , Cateterismo Periférico/efeitos adversos , Idoso , Antineoplásicos/uso terapêutico , Antineoplásicos/efeitos adversos , Antineoplásicos/administração & dosagem
13.
Acta Oncol ; 63: 426-432, 2024 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-38881340

RESUMO

PURPOSE: The Region of Southern Denmark has recently established four late effects clinics to help cancer survivors suffering from complex and severe late effects. This study aimed to capture and analyze the full range of physical, mental, and psychosocial issues using patient-reported outcomes. Moreover, we aimed to describe demographic data and the type and severity of the late effects. METHODS: A prospective cohort study was conducted among cancer survivors referred to a late effects clinic. Before their first appointment, patients completed the European Organization for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire (EORTC QLQ-SURV100). We compared mean scores of the EORTC QLQ-SURV100 scales that were comparable to the scales/items from the EORTC QLQ-C30 questionnaire with norm data for the Danish population and EORTC reference values. RESULTS: All patients referred to the clinic within its first 2 years were included (n = 247). The mean age was 57 [23-85] years and 74% were females. The most common cancer diagnoses was breast cancer (39%). The five most commonly reported late effects were fatigue (66%), pain (51%), cognitive impairment (53%), sleep problems (42%), and neuropathy (40%). A total of 236 of the patients entering the clinic completed QLQ-SURV100. They reported significantly worse mean scores on all scales compared to the Danish norm population and EORTC reference values for pretreatment cancer patients, p < 0.001. Effect sizes were moderate or large for all scales. INTERPRETATION: In this study, we collected demographic data and described the late effects presented by the patents referred to the clinic. Moreover, we captured and analyzed the full range of physical, mental, and psychosocial issues using QLQ-SURV100. Patients referred to the Late Effects Clinic (LEC) had a number of late effects and reported a significantly lower health-related quality of life compared to the general Danish population and patients who have just been diagnosed with cancer, suggesting the aim of helping patients suffering from late effects gain a better quality of life is in dire need.


Assuntos
Sobreviventes de Câncer , Neoplasias , Qualidade de Vida , Humanos , Feminino , Masculino , Estudos Prospectivos , Dinamarca/epidemiologia , Pessoa de Meia-Idade , Idoso , Adulto , Sobreviventes de Câncer/psicologia , Sobreviventes de Câncer/estatística & dados numéricos , Idoso de 80 Anos ou mais , Neoplasias/psicologia , Adulto Jovem , Inquéritos e Questionários , Medidas de Resultados Relatados pelo Paciente , Fadiga/epidemiologia , Fadiga/etiologia , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/epidemiologia
14.
Harefuah ; 163(6): 376-381, 2024 Jun.
Artigo em Hebraico | MEDLINE | ID: mdl-38884292

RESUMO

INTRODUCTION: Fibromyalgia syndrome (FMS) is a chronic pain syndrome, prevalent in women more than men. The main symptoms are widespread musculoskeletal pain, fatigue, and weakness. To date, the pathophysiological mechanisms are unclear, and there are several pathogenic theories elucidating this condition. In this review, we summarized articles published in the past few years, regarding the effect of musculoskeletal dysfunction on FMS. We focused on the musculoskeletal system and central nervous system (CNS) disarrays.


Assuntos
Fibromialgia , Fibromialgia/fisiopatologia , Humanos , Feminino , Masculino , Fadiga/fisiopatologia , Fadiga/etiologia , Dor Crônica/fisiopatologia , Dor Crônica/etiologia , Sistema Nervoso Central/fisiopatologia , Dor Musculoesquelética/fisiopatologia , Dor Musculoesquelética/etiologia , Debilidade Muscular/fisiopatologia , Debilidade Muscular/etiologia
15.
Mult Scler Relat Disord ; 87: 105697, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38833975

RESUMO

BACKGROUND: Patients diagnosed with multiple sclerosis (MS) commonly encounter heightened postural instability and challenges in aligning their eyes, head, and bodily motions while engaging in specific tasks. This study aims to compare the effects of Cawthorne-Cooksey and mechanical hippotherapy exercises on fatigue, balance, gait, dizziness, and life quality in patients with MS. METHODS: The MS patients were randomly divided into Cawthorne-Cooksey (n:25) and mechanical hippotherapy exercise (n:25) groups. In addition to the traditional physical therapy program, Cawthorne-Cooksey and hippotherapy exercises were applied to the groups 3 days a week, for 8 weeks. The trial's clinical number is NCT06005909. The Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS), Dizziness Handicap Inventory, Tinetti Balance and Gait Assessment Scale, and Ferrans&Powers Quality-of-Life Index were used for pre-and post-treatment assessment. RESULTS: Both groups exhibited a significant decrease in FSS, FIS, and Dizziness Handicap Inventory scores, as well as an increase in Tinetti Balance and Gait Assessment Scale and Ferrans&Powers Quality-of-Life Index scores following treatment. In the inter-group comparison, the Tinetti balance and gait assessment and the Ferrans&Powers quality of life index scores were higher in the hippotherapy group compared to the Cooksey group. CONCLUSIONS: Although both forms of physical activity have demonstrated effectiveness in reducing fatigue among individuals with MS, hippotherapy shows superior efficacy in enhancing balance, gait, and overall quality of life.


Assuntos
Terapia Assistida por Cavalos , Terapia por Exercício , Esclerose Múltipla , Equilíbrio Postural , Qualidade de Vida , Humanos , Feminino , Masculino , Adulto , Equilíbrio Postural/fisiologia , Esclerose Múltipla/terapia , Esclerose Múltipla/complicações , Esclerose Múltipla/reabilitação , Terapia por Exercício/métodos , Pessoa de Meia-Idade , Fadiga/terapia , Fadiga/etiologia , Tontura/terapia , Tontura/etiologia , Tontura/reabilitação , Avaliação de Resultados em Cuidados de Saúde , Resultado do Tratamento
16.
J Sports Sci Med ; 23(2): 366-395, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38841642

RESUMO

Breast cancer survivors with obesity are at a high risk of cancer recurrence, comorbidity, and mortality. This review aims to systematically evaluate the effects of combined aerobic and resistance training (CART) on body composition, lipid homeostasis, inflammation, adipokines, cancer-related fatigue, sleep, and quality of life in breast cancer patients and survivors with overweight/obesity. An electronic search was conducted in PubMed, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases from inception up to January 8, 2024. Randomized controlled trials (RCTs) meeting the inclusion criteria were selected for the analysis. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the quality of evidence. A random-effects model was used, and data were analyzed using mean (MD) and standardized mean differences (SMD) for continuous variables with 95% confidence intervals (CI). We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. A total of 17 randomized controlled trials were included in the systematic review involving 1,148 female patients and survivors (mean age: 54.0 ± 3.4 years). The primary outcomes showed significant improvements in body mass index (SMD -0.57 kg/m2, p = 0.04), body fat (SMD -0.50%, p = 0.02), fat mass (SMD -0.63 kg, p = 0.04), hip circumference (MD -3.14 cm, p = 0.02), and fat-free mass (SMD 1.03 kg, p < 0.001). The secondary outcomes indicated significant increases in high-density lipoprotein cholesterol (MD -0.05 mmol/L, p = 0.008), natural killer cells (SMD 0.42%, p = 0.04), reductions in triglycerides (MD -81.90 mg/dL, p < 0.01), total cholesterol (SMD -0.95 mmol/L, p < 0.01), tumor necrosis factor α (SMD -0.89 pg/mL, p = 0.03), and leptin (SMD -0.63 ng/mL, p = 0.03). Also, beneficial alterations were found in cancer-related fatigue (SMD -0.98, p = 0.03), sleep (SMD -1.17, p < 0.001), and quality of life (SMD 2.94, p = 0.02) scores. There was very low to low confidence in the estimated effect of most of the outcomes. The present findings reveal that CART could be considered an adjunct therapy in supporting the conventional clinical approach observed following exercise. However, further high-quality research is needed to evaluate whether CART would be a valuable intervention to lower aggressive pharmacologic use in breast cancer patients with overweight/obesity.


Assuntos
Composição Corporal , Neoplasias da Mama , Sobreviventes de Câncer , Obesidade , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Treinamento Resistido , Humanos , Feminino , Treinamento Resistido/métodos , Obesidade/terapia , Fatores de Risco Cardiometabólico , Adipocinas/sangue , Exercício Físico , Fadiga/etiologia , Sono/fisiologia , Sobrepeso/terapia
17.
Niger J Clin Pract ; 27(5): 635-642, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38842713

RESUMO

BACKGROUND: Fatigue is a common problem in patients with multiple sclerosis (MS) and is one of the most serious symptoms of the disease. Although many factors play a role in the etiology of fatigue in patients with MS, it has been reported that fatigue is caused by irregular or disrupted sleep patterns. AIM: The purpose of the study was to examine the effects of lavender oil aromatherapy on the sleep and fatigue of MS patients. METHODS: The study was designed as a randomized controlled trial and was conducted in Turkey. The data of the study were collected using the Patient Description Form, Fatigue Severity Scale, and Pittsburgh Sleep Quality Index. RESULTS: The mean FSS score in the experimental group was 6.86 ± 0.94 before the procedure and 3.42 ± 0.85 after the procedure, the mean PSQI score was 9.45 ± 1.23 before the procedure and 6.68 ± 2.87 after the procedure, and the difference in the mean scores between the two groups was found to be statistically significant (P < 0.001). CONCLUSION: The results showed that aromatherapy with lavender essential oil has significant impacts on fatigue and sleep in MS patients. Lavender essential oil aromatherapy can be used by nurses as an independent nursing practice. It is an inexpensive, noninvasive, and reliable technique to manage fatigue in individuals with MS.


Assuntos
Aromaterapia , Fadiga , Lavandula , Esclerose Múltipla , Óleos Voláteis , Óleos de Plantas , Humanos , Óleos Voláteis/uso terapêutico , Aromaterapia/métodos , Turquia , Feminino , Óleos de Plantas/uso terapêutico , Adulto , Esclerose Múltipla/complicações , Masculino , Fadiga/tratamento farmacológico , Fadiga/etiologia , Fadiga/terapia , Pessoa de Meia-Idade , Sono/efeitos dos fármacos , Transtornos do Sono-Vigília/terapia , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/tratamento farmacológico , Resultado do Tratamento
18.
J Neuroeng Rehabil ; 21(1): 94, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840208

RESUMO

BACKGROUND: Many individuals with neurodegenerative (NDD) and immune-mediated inflammatory disorders (IMID) experience debilitating fatigue. Currently, assessments of fatigue rely on patient reported outcomes (PROs), which are subjective and prone to recall biases. Wearable devices, however, provide objective and reliable estimates of gait, an essential component of health, and may present objective evidence of fatigue. This study explored the relationships between gait characteristics derived from an inertial measurement unit (IMU) and patient-reported fatigue in the IDEA-FAST feasibility study. METHODS: Participants with IMIDs and NDDs (Parkinson's disease (PD), Huntington's disease (HD), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), primary Sjogren's syndrome (PSS), and inflammatory bowel disease (IBD)) wore a lower-back IMU continuously for up to 10 days at home. Concurrently, participants completed PROs (physical fatigue (PF) and mental fatigue (MF)) up to four times a day. Macro (volume, variability, pattern, and acceleration vector magnitude) and micro (pace, rhythm, variability, asymmetry, and postural control) gait characteristics were extracted from the accelerometer data. The associations of these measures with the PROs were evaluated using a generalised linear mixed-effects model (GLMM) and binary classification with machine learning. RESULTS: Data were recorded from 72 participants: PD = 13, HD = 9, RA = 12, SLE = 9, PSS = 14, IBD = 15. For the GLMM, the variability of the non-walking bouts length (in seconds) with PF returned the highest conditional R2, 0.165, and with MF the highest marginal R2, 0.0018. For the machine learning classifiers, the highest accuracy of the current analysis was returned by the micro gait characteristics with an intrasubject cross validation method and MF as 56.90% (precision = 43.9%, recall = 51.4%). Overall, the acceleration vector magnitude, bout length variation, postural control, and gait rhythm were the most interesting characteristics for future analysis. CONCLUSIONS: Counterintuitively, the outcomes indicate that there is a weak relationship between typical gait measures and abnormal fatigue. However, factors such as the COVID-19 pandemic may have impacted gait behaviours. Therefore, further investigations with a larger cohort are required to fully understand the relationship between gait and abnormal fatigue.


Assuntos
Fadiga , Estudos de Viabilidade , Marcha , Fadiga Mental , Doenças Neurodegenerativas , Caminhada , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Fadiga/diagnóstico , Fadiga/fisiopatologia , Fadiga/etiologia , Caminhada/fisiologia , Idoso , Fadiga Mental/fisiopatologia , Fadiga Mental/diagnóstico , Doenças Neurodegenerativas/complicações , Doenças Neurodegenerativas/fisiopatologia , Doenças Neurodegenerativas/diagnóstico , Marcha/fisiologia , Dispositivos Eletrônicos Vestíveis , Doenças do Sistema Imunitário/complicações , Doenças do Sistema Imunitário/diagnóstico , Adulto , Acelerometria/instrumentação , Acelerometria/métodos
19.
Tidsskr Nor Laegeforen ; 144(7)2024 Jun 04.
Artigo em Norueguês | MEDLINE | ID: mdl-38832606
20.
J Nurs Res ; 32(3): e334, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38814999

RESUMO

BACKGROUND: Fatigue, a major health concern among patients receiving hemodialysis, is associated with poor quality of life, negative emotions, and cognitive dysfunction. Acupressure is a low-cost and noninvasive traditional Chinese therapy that has been widely used in community and clinic settings. However, the beneficial effects of acupressure on various aspects of fatigue among these patients have not been systematically investigated. PURPOSE: This study was designed to determine the effects of acupressure on fatigue in patients receiving hemodialysis. The moderating influences of bio-sociodemographic characteristics and methodology on the association between acupressure and posthemodialysis fatigue were also examined. METHODS: Four electronic databases were searched for qualified articles published between database inception and November 2, 2022. Only randomized controlled trials designed to investigate the effects of acupressure on fatigue in patients receiving hemodialysis were qualified for consideration. A random-effects model was used for data analysis. RESULTS: Eight randomized controlled trials with 11 effect sizes and 725 participants were included in this study. In these studies, acupressure was found to have a significantly higher alleviation effect on general fatigue (g = -0.78; 95% confidence interval [-1.09, -0.48]) and the behavioral, emotional, sensory, and cognitive domains of fatigue (g = -0.51, -0.51, -0.72, and -0.41, respectively) among patients receiving hemodialysis than those in the control groups. Furthermore, the stimulation of the Shenmen acupoint was found to increase the effects (p < .01) of acupressure on fatigue reduction significantly. Notably, the use of special equipment to perform the acupressure was not found to significantly improve outcomes (p = .99). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Acupressure is effective in alleviating fatigue in patients receiving hemodialysis, particularly when the Shenmen acupoint is used together with other acupoints, and is effective without the application of special equipment. Acupressure may be adopted as a complementary therapy for fatigue alleviation in patients receiving hemodialysis. Based on the findings, healthcare providers should coach patients receiving hemodialysis with fatigue on how to use acupressure therapy appropriately to alleviate this health concern.


Assuntos
Acupressão , Fadiga , Ensaios Clínicos Controlados Aleatórios como Assunto , Diálise Renal , Humanos , Acupressão/métodos , Acupressão/normas , Diálise Renal/métodos , Diálise Renal/efeitos adversos , Fadiga/terapia , Fadiga/etiologia , Qualidade de Vida/psicologia
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