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Sample records for fatigue immune dysfunction

  1. Retroviral sequences related to human T-lymphotropic virus type II in patients with chronic fatigue immune dysfunction syndrome

    International Nuclear Information System (INIS)

    DeFreitas, E.; Hilliard, B.; Cheney, P.R.; Bell, D.S.; Kiggundu, E.; Sankey, D.; Wroblewska, Z.; Palladino, M.; Woodward, J.P.; Koprowski, H.

    1991-01-01

    Chronic fatigue immune dysfunction syndrome (CFIDS) is a recently recognized illness characterized by debilitating fatigue as well as immunological and neurological abnormalities. Once thought to be caused by Epstein-Barr virus, it is now thought to have a different but unknown etiology. The authors evaluted 30 adult and pediatric CFIDS patients from six eastern states for the presence of human T-lymphotropic virus (HTLV) types I and II by Western immunoblotting, polymerase chain reaction, and in situ hybridization of blood samples. The majority of patients were positive for HTLV antibodies by Western blotting and for HTLV-II gag sequences by polymerase chain reaction and in situ hybridization. Twenty nonexposure healthy controls were negative in all assays. These data support an association between an HTLV-II-like virus and CFIDS

  2. Chronic fatigue and immune dysfunction syndrome associated with Staphylococcus spp. bacteraemia responsive to thiacetarsamide sodium in eight birds of prey.

    Science.gov (United States)

    Tarello, W

    2001-05-01

    Chronic fatigue and immune dysfunction syndrome (CFIDS) is a recognized human illness with zoonotic implications that is rarely described in animals. Eight birds of prey examined between 1992 and 1995 and sharing common symptoms (asthenia, inability to fly, poor appetite and emaciation) underwent laboratory tests revealing immunodeficiency, anaemia, high creatine kinase levels and low serum magnesium levels. Diagnosis of CFIDS was based upon these features. The effectiveness of an arsenic-based medication, thiacetarsamide sodium, administered intravenously for 2-3 days at low dosages (0.1 ml/kg/day) has been demonstrated by checks carried out 10, 20 and 30 days after therapy. The symptoms and the immune and haematological dysfunctions disappeared within 2-4 weeks of treatment. In all patients, micrococcus-like organisms found adhering to the outer surface of many red blood cells, had disappeared at post-treatment controls. Two of five blood cultures were positive for Staphylococcus spp. (S. intermedius and S. xilosus). Consideration is given to the pharmacological activity of an arsenic-based drug in animal illnesses resembling CFIDS.

  3. Understanding Muscle Dysfunction in Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Gina Rutherford

    2016-01-01

    Full Text Available Introduction. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME is a debilitating disorder of unknown aetiology, characterised by severe disabling fatigue in the absence of alternative diagnosis. Historically, there has been a tendency to draw psychological explanations for the origin of fatigue; however, this model is at odds with findings that fatigue and accompanying symptoms may be explained by central and peripheral pathophysiological mechanisms, including effects of the immune, oxidative, mitochondrial, and neuronal pathways. For example, patient descriptions of their fatigue regularly cite difficulty in maintaining muscle activity due to perceived lack of energy. This narrative review examined the literature for evidence of biochemical dysfunction in CFS/ME at the skeletal muscle level. Methods. Literature was examined following searches of PUB MED, MEDLINE, and Google Scholar, using key words such as CFS/ME, immune, autoimmune, mitochondria, muscle, and acidosis. Results. Studies show evidence for skeletal muscle biochemical abnormality in CFS/ME patients, particularly in relation to bioenergetic dysfunction. Discussion. Bioenergetic muscle dysfunction is evident in CFS/ME, with a tendency towards an overutilisation of the lactate dehydrogenase pathway following low-level exercise, in addition to slowed acid clearance after exercise. Potentially, these abnormalities may lead to the perception of severe fatigue in CFS/ME.

  4. Association of mitochondrial dysfunction and fatigue: A review of the literature

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    Kristin Filler

    2014-06-01

    Full Text Available Fatigue is often described by patients as a lack of energy, mental or physical tiredness, diminished endurance, and prolonged recovery after physical activity. Etiologic mechanisms underlying fatigue are not well understood; however, fatigue is a hallmark symptom of mitochondrial disease, making mitochondrial dysfunction a putative biological mechanism for fatigue. Therefore, this review examined studies that investigated the association of markers of mitochondrial dysfunction with fatigue and proposes possible research directions to enhance understanding of the role of mitochondrial dysfunction in fatigue. A thorough search using PubMed, Scopus, Web of Science, and Embase databases returned 1220 articles. After the application of inclusion and exclusion criteria, a total of 25 articles meeting eligibility criteria were selected for full review. Dysfunctions in the mitochondrial structure, mitochondrial function (mitochondrial enzymes and oxidative/nitrosative stress, mitochondrial energy metabolism (ATP production and fatty acid metabolism, immune response, and genetics were investigated as potential contributors to fatigue. Carnitine was the most investigated mitochondrial function marker. Dysfunctional levels were reported in all the studies investigating carnitine; however, the specific type of carnitine that was dysfunctional varied. Genetic profiles were the second most studied mitochondrial parameter. Six common pathways were proposed: metabolism, energy production, protein transport, mitochondrial morphology, central nervous system dysfunction and post-viral infection. Coenzyme Q10 was the most commonly investigated mitochondrial enzyme. Low levels of Coenzyme Q10 were consistently associated with fatigue. Potential targets for further investigation were identified as well as gaps in the current literature.

  5. Immune responsiveness in chronic fatigue syndrome.

    OpenAIRE

    Milton, J. D.; Clements, G. B.; Edwards, R. H.

    1991-01-01

    We have endeavoured to find immunological indications of chronic virus infection in patients with chronic fatigue syndrome (myalgic encephalomyelitis) and to investigate immune responsiveness to viruses in such patients in comparison with normal subjects and patients with muscular dystrophy. Levels of circulating IgM immune complexes were elevated (above the 95% normal control range) in 10 (17%) of 58 patients with chronic fatigue syndrome, which was not significantly different from the norma...

  6. The effect of fatigue and fibromyalgia on sexual dysfunction in women with chronic fatigue syndrome.

    Science.gov (United States)

    Blazquez, Alicia; Ruiz, Eva; Aliste, Luisa; García-Quintana, Ana; Alegre, José

    2015-01-01

    Sexual dysfunction in patients with chronic fatigue syndrome is attracting growing interest but, to date, few studies have analyzed it. For this reason, the authors evaluated sexual dysfunction in women with chronic fatigue syndrome (using the Golombok Rust Inventory of Sexual Satisfaction) and explore correlations with fatigue and other symptoms. Sexual dysfunction was greater in patients with chronic fatigue syndrome (n = 615) with a higher number of cognitive, neurological, and neurovegetative symptoms, concomitant fibromyalgia, Sjögren's syndrome, or myofascial pain syndrome, and more intense fatigue (p <.05).

  7. Fibromyalgia and fatigue: central processing, widespread dysfunction.

    Science.gov (United States)

    Finan, Patrick H; Zautra, Alex J

    2010-05-01

    Biological and psychological bases for the covariation of pain and fatigue in fibromyalgia (FM) are reviewed. FM is characterized as a disorder of central sensitization, with pain and fatigue as the most prominent symptoms. The roles of sleep disturbance and affective dysregulation as both precipitants and consequences of pain and fatigue in FM are discussed. It is argued that a positive affective disturbance may uniquely characterize pain and fatigue symptoms in FM. Finally, pharmacological and nonpharmacological treatments for FM are highlighted, with an emphasis on the efficacy of these treatments in alleviating pain and fatigue symptoms. Copyright (c) 2010 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  8. Skin Immunization Obviates Alcohol-Related Immune Dysfunction

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    Rhonda M. Brand

    2015-11-01

    Full Text Available Alcoholics suffer from immune dysfunction that can impede vaccine efficacy. If ethanol (EtOH-induced immune impairment is in part a result of direct exposure of immune cells to EtOH, then reduced levels of exposure could result in less immune dysfunction. As alcohol ingestion results in lower alcohol levels in skin than blood, we hypothesized that the skin immune network may be relatively preserved, enabling skin-targeted immunizations to obviate the immune inhibitory effects of alcohol consumption on conventional vaccines. We employed the two most common chronic EtOH mouse feeding models, the liver-damaging Lieber-DeCarli (LD and liver-sparing Meadows-Cook (MC diets, to examine the roles of EtOH and/or EtOH-induced liver dysfunction on alcohol related immunosuppression. Pair-fed mice were immunized against the model antigen ovalbumin (OVA by DNA immunization or against flu by administering the protein-based influenza vaccine either systemically (IV, IM, directly to liver (hydrodynamic, or cutaneously (biolistic, ID. We measured resulting tissue EtOH levels, liver stress, regulatory T cell (Treg, and myeloid-derived suppressor cell (MDSC populations. We compared immune responsiveness by measuring delayed-type hypersensitivity (DTH, antigen-specific cytotoxic T lymphocyte (CTL, and antibody induction as a function of delivery route and feeding model. We found that, as expected, and independent of the feeding model, EtOH ingestion inhibits DTH, CTL lysis, and antigen-specific total IgG induced by traditional systemic vaccines. On the other hand, skin-targeted vaccines were equally immunogenic in alcohol-exposed and non-exposed subjects, suggesting that cutaneous immunization may result in more efficacious vaccination in alcohol-ingesting subjects.

  9. Skin Immunization Obviates Alcohol-Related Immune Dysfunction.

    Science.gov (United States)

    Brand, Rhonda M; Stottlemyer, John Mark; Cline, Rachel A; Donahue, Cara; Behari, Jaideep; Falo, Louis D

    2015-11-06

    Alcoholics suffer from immune dysfunction that can impede vaccine efficacy. If ethanol (EtOH)-induced immune impairment is in part a result of direct exposure of immune cells to EtOH, then reduced levels of exposure could result in less immune dysfunction. As alcohol ingestion results in lower alcohol levels in skin than blood, we hypothesized that the skin immune network may be relatively preserved, enabling skin-targeted immunizations to obviate the immune inhibitory effects of alcohol consumption on conventional vaccines. We employed the two most common chronic EtOH mouse feeding models, the liver-damaging Lieber-DeCarli (LD) and liver-sparing Meadows-Cook (MC) diets, to examine the roles of EtOH and/or EtOH-induced liver dysfunction on alcohol related immunosuppression. Pair-fed mice were immunized against the model antigen ovalbumin (OVA) by DNA immunization or against flu by administering the protein-based influenza vaccine either systemically (IV, IM), directly to liver (hydrodynamic), or cutaneously (biolistic, ID). We measured resulting tissue EtOH levels, liver stress, regulatory T cell (Treg), and myeloid-derived suppressor cell (MDSC) populations. We compared immune responsiveness by measuring delayed-type hypersensitivity (DTH), antigen-specific cytotoxic T lymphocyte (CTL), and antibody induction as a function of delivery route and feeding model. We found that, as expected, and independent of the feeding model, EtOH ingestion inhibits DTH, CTL lysis, and antigen-specific total IgG induced by traditional systemic vaccines. On the other hand, skin-targeted vaccines were equally immunogenic in alcohol-exposed and non-exposed subjects, suggesting that cutaneous immunization may result in more efficacious vaccination in alcohol-ingesting subjects.

  10. Association between autonomic dysfunction and fatigue in Parkinson disease.

    Science.gov (United States)

    Chou, Kelvin L; Gilman, Sid; Bohnen, Nicolaas I

    2017-06-15

    Fatigue is a disabling non-motor symptom in Parkinson disease (PD). We investigated the relationship between autonomic dysfunction and fatigue in PD while accounting for possible confounding factors. 29 subjects with PD (8F/21M; mean age 61.6±5.9; mean disease duration 4.8±3.0years), underwent clinical assessment and completed several non-motor symptom questionnaires, including a modified version of the Mayo Clinic Composite Autonomic Symptom Score (COMPASS) scale and the Fatigue Severity Scale (FSS). The mean modified COMPASS was 21.6±14.2 (range 1.7-44.2) and the mean FSS score was 3.3±1.6 (range 1.0-6.7). There was a significant bivariate relationship between the modified COMPASS and FSS scores (R=0.69, P<0.0001). Stepwise regression analysis was used to assess the specificity of the association between the modified COMPASS and FSS scores while accounting for possible confounder effects from other variables that were significantly associated with autonomic dysfunction. Results showed that the modified COMPASS (R 2 =0.52, F=28.4, P<0.0001) was highly associated with fatigue, followed by ESS (R 2 =0.13, F=8.4, P=0.008) but no other co-variates. Post-hoc analysis exploring the association between the different modified COMPASS autonomic sub-domain scores and FSS scores found significant regressor effects for the orthostatic intolerance (R 2 =0.45, F=21.2, P<0.0001) and secretomotor sub-domains (R 2 =0.09, F=4.8, P=0.04) but not for other autonomic sub-domains. Autonomic dysfunction, in particular orthostatic intolerance, is highly associated with fatigue in PD. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Systemic immune dysfunction in pancreatic cancer patients.

    Science.gov (United States)

    Poch, Bertram; Lotspeich, Errki; Ramadani, Marco; Gansauge, Susanne; Beger, Hans G; Gansauge, Frank

    2007-05-01

    We investigated the immune status in 32 pancreatic cancer patients (PC) in comparison with healthy controls (HC). Using flow cytometry, peripheral blood lymphocytes (PBL) were characterized by the expression of surface markers for T helper cells (CD4), T suppressor cells (CD8), B cells (CD19) and NK cells (CD56). The blastogenic response of PBL was analyzed after stimulation with concavalin A (ConA), phytohemagglutinin (PHA), pokeweed mitogen (PWM) and anti-CD3 antibodies. The serum levels of TNF-alpha, IL-1beta, IL-2, IL-10, IL-12, IL-18, IL-1RA, sIL-2R and TGF-beta were determined by ELISA. No differences in the distribution of peripheral immunocytes in PC were found, whereas the blastogenic response of peripheral blood lymphocytes (PBL) after stimulation with PHA or anti-CD3 antibodies was significantly decreased in PC. In PC, we found reduced serum levels of IL-2 and significantly elevated levels of TNF-alpha, TGF-beta1, IL-10, IL-2R, IL-1beta and IL-1RA. These data provide evidence for a systemic immune dysfunction in pancreatic cancer patients characterized by a shift towards a T helper cell type 2 cytokine profile, a significant elevation of substances related to T cell suppression and a reduced blastogenic response to PHA and anti-CD3 antibodies of PBL.

  12. Immune System Dysfunction in the Elderly.

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    Fuentes, Eduardo; Fuentes, Manuel; Alarcón, Marcelo; Palomo, Iván

    2017-01-01

    Human aging is characterized by both physical and physiological frailty that profoundly affects the immune system. In this context aging is associated with declines in adaptive and innate immunity established as immunosenescence. Immunosenescence is a new concept that reflects the age-associated restructuring changes of innate and adaptive immune functions. Thus elderly individuals usually present chronic low-level inflammation, higher infection rates and chronic diseases. A study of alterations in the immune system during aging could provide a potentially useful biomarker for the evaluation of immune senescence treatment. The immune system is the result of the interplay between innate and adaptive immunity, yet the impact of aging on this function is unclear. In this article the function of the immune system during aging is explored.

  13. Problems with balance and binocular visual dysfunction are associated with post-stroke fatigue

    DEFF Research Database (Denmark)

    Schow, Trine; Teasdale, Thomas William; Jensen Quas, Kirsten

    2016-01-01

    Trine Schow, Thomas William Teasdale, Kirsten Jensen Quas& Morten Arendt Rasmussen (2016): Problems with balance and binocular visual dysfunction are associated with post-stroke fatigue, Topics in Stroke Rehabilitation, DOI: 10.1080/10749357.2016.1188475......Trine Schow, Thomas William Teasdale, Kirsten Jensen Quas& Morten Arendt Rasmussen (2016): Problems with balance and binocular visual dysfunction are associated with post-stroke fatigue, Topics in Stroke Rehabilitation, DOI: 10.1080/10749357.2016.1188475...

  14. Pathways and Genes Associated with Immune Dysfunction in Sheep Paratuberculosis

    Science.gov (United States)

    Gossner, Anton; Watkins, Craig; Chianini, Francesca; Hopkins, John

    2017-01-01

    Multibacillary and paucibacillary paratuberculosis are both caused by Mycobacterium avium subspecies paratuberculosis. Multibacillary lesions are composed largely of infected epithelioid macrophages and paucibacillary lesions contain T cells but few bacteria. Multibacillary disease is similar to human lepromatous leprosy, with variable/high levels of antibody and a dysfunctional immune response. Animals with paucibacillary disease have high cell-mediated immunity and variable levels of antibody. This study aims to characterize the immunological dysfunction using TruSeq analysis of the ileocaecal lymph node that drains disease lesions. Immune dysfunction is highlighted by repression of TCR/CD3 genes, T cell co-receptors/co-stimulators, T cell activation and signal-transduction genes. Inflammation was an acute phase response and chronic inflammation, with little evidence of acute inflammation. The high levels of immunoglobulin and plasma cell transcripts is consistent with the anti-MAP antibody responses in paratuberculosis sheep. Also notable was the overwhelming reduction in mast cell transcripts, potentially affecting DC activation of the immune response. This study also shows that there were no fundamental differences in the gene expression patterns in multibacillary and paucibacillary disease, no shift in T cell genes from Th1 to Th2 pattern but rather an incremental decline into immune dysfunction leading to multibacillary pathology. PMID:28436433

  15. Pathophysiology and Immune Dysfunction in Endometriosis

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    Soo Hyun Ahn

    2015-01-01

    Full Text Available Endometriosis is an estrogen-dependent, chronic, proinflammatory disease prevalent in 10% of women of reproductive age worldwide. Characterized by the growth of endometrium-like tissue in aberrant locations outside of the uterus, it is responsible for symptoms including chronic pelvic pain, dysmenorrhea, and subfertility that degrade quality of life of women significantly. In Canada, direct and indirect economic cost of endometriosis amounts to 1.8 billion dollars, and this is elevated to 20 billion dollars in the United States. Despite decades of research, the etiology and pathophysiology of endometriosis still remain to be elucidated. This review aims to bring together the current understanding regarding the pathogenesis of endometriosis with specific focus on mechanisms behind vascularization of the lesions and the contribution of immune factors in facilitating lesion establishment and development. The role of hormones, immune cells, and cytokine signaling is highlighted, in addition to discussing the current pharmaceutical options available for management of pain symptoms in women with endometriosis.

  16. Pathophysiology and Immune Dysfunction in Endometriosis

    Science.gov (United States)

    Ahn, Soo Hyun; Monsanto, Stephany P.; Miller, Caragh; Singh, Sukhbir S.; Thomas, Richard; Tayade, Chandrakant

    2015-01-01

    Endometriosis is an estrogen-dependent, chronic, proinflammatory disease prevalent in 10% of women of reproductive age worldwide. Characterized by the growth of endometrium-like tissue in aberrant locations outside of the uterus, it is responsible for symptoms including chronic pelvic pain, dysmenorrhea, and subfertility that degrade quality of life of women significantly. In Canada, direct and indirect economic cost of endometriosis amounts to 1.8 billion dollars, and this is elevated to 20 billion dollars in the United States. Despite decades of research, the etiology and pathophysiology of endometriosis still remain to be elucidated. This review aims to bring together the current understanding regarding the pathogenesis of endometriosis with specific focus on mechanisms behind vascularization of the lesions and the contribution of immune factors in facilitating lesion establishment and development. The role of hormones, immune cells, and cytokine signaling is highlighted, in addition to discussing the current pharmaceutical options available for management of pain symptoms in women with endometriosis. PMID:26247027

  17. A mechanism for trauma induced muscle wasting and immune dysfunction

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    Madihally, S.; Toner, M.; Yarmush, M.; Mitchell, R.

    A diverse physiological conditions lead to a hypercatabolic state marked by the loss of proteins, primarily derived from skeletal muscle. The sustained loss of proteins results in loss of muscle mass and strength, poor healing, and long-term hospitalization. These problems are further compounded by the deterioration of immunity to infection which is a leading cause of morbidity and mortality of traumatic patients. In an attempt to understand the signal propagation mechanism(s), we tested the role of Interferon-? (IFN-? ) in an animal burn injury model; IFN-? is best conceptualized as a macrophage activating protein and known to modulate a variety of intracellular processes potentially relevant to muscle wasting and immune dysfunction. Mice congenitally -deficient in IFN-? , and IFN-? -Receptor, and wild type (WT) animals treated with IFN-? neutralizing antibody received either a 20% total body surface area burn or a control sham treatment. At days 1, 2, and 7 following treatment, skeletal muscle, peripheral blood, and spleen were harvested from both groups. Overall body weight, protein turnovers, changes in the lymphocyte subpopulations and alterations in the major histocompatibility complex I expression (MHC I) and proliferation capacity of lymphocytes was measured using mixed lymphocyte reaction (MLR). These results indicate that we can prevent both muscle wasting and immune dysfunction. Based on these observations and our previous other animal model results (using insulin therapy), a novel mechanism of interactions leading to muscle wasting and immune dysfunction will be discussed. Further, implications of these findings on future research and clinical therapies will be discussed in detail.

  18. Neurodegenerative and Fatiguing Illnesses, Infections and Mitochondrial Dysfunction: Use of Natural Supplements to Improve Mitochondrial Function

    Directory of Open Access Journals (Sweden)

    Garth L. Nicolson

    2014-01-01

    Full Text Available Background: Many chronic diseases and illnesses are associated with one or more chronic infections, dysfunction of mitochondria and reduced production of ATP. This results in fatigue and other symptoms that occur in most if not all chronic conditions and diseases. Methods: This is a review of the published literature on chronic infections in neurodegenerative diseases and fatiguing illnesses that are also typified by mitochondrial dysfunction. This contribution also reviews the use of natural supplements to enhance mitochondrial function and reduce the effects of chronic infections to improve overall function in various chronic illnesses. Results: Mitochondrial function can be enhanced by the use of various natural supplements, notably Lipid Replacement Therapy (LRT using glyerolphospholipids and other mitochondrial supplements. In various chronic illnesses that are characterized by the presence of chronic infections, such as intracellular bacteria (Mycoplasma, Borrelia, Chlamydia and other infections and viruses, LRT has proven useful in multiple clinical trials. For example, in clinical studies on chronic fatigue syndrome, fibromyalgia syndrome and other chronic fatiguing illnesses where a large majority of patients have chronic infections, LRT significantly reduced fatigue by 35-43% in different clinical trials and increased mitochondrial function. In clinical trials on patients with multiple intracellular bacterial infections and intractable fatigue LRT plus other mitochondrial supplements significantly decreased fatigue and improved mood and cognition. Conclusions: LRT formulations designed to improve mitochondrial function appear to be useful as non-toxic dietary supplements for reducing fatigue and restoring mitochondrial and other cellular membrane functions in patients with chronic illnesses and multiple chronic infections.

  19. Fatigue in patients with inflammatory bowel disease is associated with distinct differences in immune parameters

    Directory of Open Access Journals (Sweden)

    Vogelaar L

    2017-05-01

    Full Text Available Lauran Vogelaar, 1,* Colin de Haar,2,* Bas RJ Aerts,1 Maikel P Peppelenbosch,1 Reinier Timman,3 Bettina E Hanssen,1 C Janneke van der Woude1 1Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, 2Applied Tumor Immunology, Laboratory of Translational Immunology, UMC Utrecht, Utrecht, 3Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, the Netherlands *These authors contributed equally to this work Background: Although it is well recognized that fatigue is an important problem in many of the quiescent inflammatory bowel disease (IBD patients, it is unknown whether the immune status is different in fatigued versus non-fatigued patients. In this study, we contrasted various characteristics of the immune system in fatigued against non-fatigued patients with IBD in clinical remission.Patients and methods: Patients with IBD in clinical remission were phenotyped according to the Montreal classification, and the checklist individual strength-fatigue (CIS-fatigue was used to assess fatigue (CIS-fatigue ≥ 35. Flow cytometry on peripheral blood samples was used to investigate differences in leukocyte subsets. The expression of various cytokines was determined in stimulated whole blood and serum samples using enzyme-linked immunosorbent assay. Differences between fatigued and non-fatigued patients with IBD were assessed.Results: In total, 55 patients were included in the fatigue group (FG and 29 patients in the non-fatigue group (NFG. No differences in demographic and clinical characteristics were observed between the groups. Flow cytometry data showed a significantly lower percentage of monocytes (p = 0.011 and a higher percentage of memory T-cells (p = 0.005 and neutrophils (p = 0.033 in the FG compared with the NFG. Whole blood stimulation showed increased TNF-α (p = 0.022 and IFN-γ (p = 0.047 in the FG. The median serum level was significantly higher for IL-12 (p < 0.001 and IL-10 (p

  20. Muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction.

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    Woźniak, Krzysztof; Lipski, Mariusz; Lichota, Damian; Szyszka-Sommerfeld, Liliana

    2015-01-01

    The aim of this study is to evaluate muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction (TMD). Two hundred volunteers aged 19.3 to 27.8 years (mean 21.50, SD 0.97) participated in this study. Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany). Muscle fatigue was evaluated on the basis of a maximum effort test. The test was performed during a 10-second maximum isometric contraction (MVC) of the jaws. An analysis of changes in the mean power frequency of the two pairs of temporal and masseter muscles (MPF%) revealed significant differences in the groups of patients with varying degrees of temporomandibular disorders according to Di (P muscle fatigue of the temporal and masseter muscles correlated with the intensity of temporomandibular dysfunction symptoms in patients. The use of surface electromyography in assessing muscle fatigue is an excellent diagnostic tool for identifying patients with temporomandibular dysfunction.

  1. Muscle Fatigue in the Temporal and Masseter Muscles in Patients with Temporomandibular Dysfunction

    Directory of Open Access Journals (Sweden)

    Krzysztof Woźniak

    2015-01-01

    Full Text Available The aim of this study is to evaluate muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction (TMD. Two hundred volunteers aged 19.3 to 27.8 years (mean 21.50, SD 0.97 participated in this study. Electromyographical (EMG recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany. Muscle fatigue was evaluated on the basis of a maximum effort test. The test was performed during a 10-second maximum isometric contraction (MVC of the jaws. An analysis of changes in the mean power frequency of the two pairs of temporal and masseter muscles (MPF% revealed significant differences in the groups of patients with varying degrees of temporomandibular disorders according to Di (P<0.0000. The study showed an increase in the muscle fatigue of the temporal and masseter muscles correlated with the intensity of temporomandibular dysfunction symptoms in patients. The use of surface electromyography in assessing muscle fatigue is an excellent diagnostic tool for identifying patients with temporomandibular dysfunction.

  2. The effects of low-intensity laser irradiation on the fatigue induced by dysfunction of mitochondria

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    Xu, Xiao-Yang; Liu, Timon C.; Duan, Rui; Liu, Xiao-Guang

    2003-12-01

    Exercise-induced fatigue has long been an important field in sports medicine. The electron leak of mitochondrial respiratory chain during the ATP synthesis integrated with proton leak and O-.2 can decrease the efficiency of ATP synthesis in mitochondria. And the exercise-induced fatigue occur followed by the decrease of performance. If the dysfunction of mitochondria can be avoided, the fatigue during the exercise may be delayed and the performance may be enhanced. Indeed there are some kind of materials can partially prevent the decrease of ATP synthesis efficiency in mitochondria. But the side effects and safety of these materials is still needed to be studied. Low intensity laser can improve the mitochondria function. It is reasonable to consider that low intensity laser therapy may become the new and more effective way to delay or elimination the fatigue induced by dysfunction of mitochondria. Because the effect of laser irradiation may not be controlled exactly when study in vivo, we use electrical stimulation of C2C12 muscle cells in culture to define the effect of low intensity laser on the dysfunction of mitochondria, and to define the optimal laser intensity to prevent the decrease of ATP synthesis efficiency. Our study use the C2C12 muscle cells in culture to define some of the mechanisms involved in the contractile-induced changes of mitochondrial function firstly in sports medicine and may suggest a useful study way to other researchers. We also give a new way to delay or eliminating the fatigue induced by dysfunction of mitochondria without side effect.

  3. Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction

    NARCIS (Netherlands)

    Howell, S. J.; Radford, J. A.; Smets, E. M.; Shalet, S. M.

    2000-01-01

    Fatigue, sexual dysfunction, anxiety and depression are all more common in patients who have previously been treated with cytotoxic chemotherapy and radiotherapy (XRT) for haematological malignancies. Following therapy, a significant proportion of men have biochemical evidence of Leydig cell

  4. Implications of immune dysfunction on endometriosis associated infertility.

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    Miller, Jessica E; Ahn, Soo Hyun; Monsanto, Stephany P; Khalaj, Kasra; Koti, Madhuri; Tayade, Chandrakant

    2017-01-24

    Endometriosis is a complex, inflammatory disease that affects 6-10% of reproductive-aged women. Almost half of the women with endometriosis experience infertility. Despite the excessive prevalence, the pathogenesis of endometriosis and its associated infertility is unknown and a cure is not available. While many theories have been suggested to link endometriosis and infertility, a consensus among investigators has not emerged. In this extensive review of the literature as well as research from our laboratory, we provide potential insights into the role of immune dysfunction in endometriosis associated infertility. We discuss the implication of the peritoneal inflammatory microenvironment on various factors that contribute to infertility such as hormonal imbalance, oxidative stress and how these could further lead to poor oocyte, sperm and embryo quality, impaired receptivity of the endometrium and implantation failure.

  5. Illness progression in chronic fatigue syndrome: a shifting immune baseline.

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    Russell, Lindsey; Broderick, Gordon; Taylor, Renee; Fernandes, Henrique; Harvey, Jeanna; Barnes, Zachary; Smylie, AnneLiese; Collado, Fanny; Balbin, Elizabeth G; Katz, Ben Z; Klimas, Nancy G; Fletcher, Mary Ann

    2016-03-10

    Validation of biomarkers for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) across data sets has proven disappointing. As immune signature may be affected by many factors, our objective was to explore the shift in discriminatory cytokines across ME/CFS subjects separated by duration of illness. Cytokine expression collected at rest across multiple studies for female ME/CFS subjects (i) 18 years or younger, ill for 2 years or less (n = 18), (ii) 18-50 years of age, ill for 7 years (n = 22), and (iii) age 50 years or older (n = 28), ill for 11 years on average. Control subjects were matched for age and body mass index (BMI). Data describing the levels of 16 cytokines using a chemiluminescent assay was used to support the identification of separate linear classification models for each subgroup. In order to isolate the effects of duration of illness alone, cytokines that changed significantly with age in the healthy control subjects were excluded a priori. Optimal selection of cytokines in each group resulted in subsets of IL-1α, 6, 8, 15 and TNFα. Common to any 2 of 3 groups were IL-1α, 6 and 8. Setting these 3 markers as a triple screen and adjusting their contribution according to illness duration sub-groups produced ME/CFS classification accuracies of 75-88 %. The contribution of IL-1α, higher in recently ill adolescent ME/CFS subjects was progressively less important with duration. While high levels of IL-8 screened positive for ME/CFS in the recently afflicted, the opposite was true for subjects ill for more than 2 years. Similarly, while low levels of IL-6 suggested early ME/CFS, the reverse was true in subjects over 18 years of age ill for more than 2 years. These preliminary results suggest that IL-1α, 6 and 8 adjusted for illness duration may serve as robust biomarkers, independent of age, in screening for ME/CFS.

  6. Loneliness predicts pain, depression, and fatigue: understanding the role of immune dysregulation.

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    Jaremka, Lisa M; Fagundes, Christopher P; Glaser, Ronald; Bennett, Jeanette M; Malarkey, William B; Kiecolt-Glaser, Janice K

    2013-08-01

    The pain, depression, and fatigue symptom cluster is an important health concern. Loneliness is a common risk factor for these symptoms. Little is known about the physiological mechanisms linking loneliness to the symptom cluster; immune dysregulation is a promising candidate. Latent herpesvirus reactivation, which is reflected by elevated herpesvirus antibody titers, provides a window into immune dysregulation. Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are two common herpesviruses. Participants were 200 breast cancer survivors who were 2 months to 3 years post-treatment at the time of the study. They completed questionnaires and provided a blood sample that was assayed for CMV and EBV antibody titers. Lonelier participants experienced more pain, depression, and fatigue than those who felt more socially connected. Lonelier participants also had higher CMV antibody titers which, in turn, were associated with higher levels of the pain, depression, and fatigue symptom cluster. Contrary to expectations, EBV antibody titers were not associated with either loneliness or the symptom cluster. The pain, depression, and fatigue symptom cluster is a notable clinical problem, especially among cancer survivors. Accordingly, understanding the risk factors for these symptoms is important. The current study suggests that loneliness enhances risk for immune dysregulation and the pain, depression, and fatigue symptom cluster. The present data also provide a glimpse into the pathways through which loneliness may impact health. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Combined dysfunctions of immune cells predict nosocomial infection in critically ill patients.

    Science.gov (United States)

    Conway Morris, A; Anderson, N; Brittan, M; Wilkinson, T S; McAuley, D F; Antonelli, J; McCulloch, C; Barr, L C; Dhaliwal, K; Jones, R O; Haslett, C; Hay, A W; Swann, D G; Laurenson, I F; Davidson, D J; Rossi, A G; Walsh, T S; Simpson, A J

    2013-11-01

    Nosocomial infection occurs commonly in intensive care units (ICUs). Although critical illness is associated with immune activation, the prevalence of nosocomial infections suggests concomitant immune suppression. This study examined the temporal occurrence of immune dysfunction across three immune cell types, and their relationship with the development of nosocomial infection. A prospective observational cohort study was undertaken in a teaching hospital general ICU. Critically ill patients were recruited and underwent serial examination of immune status, namely percentage regulatory T-cells (Tregs), monocyte deactivation (by expression) and neutrophil dysfunction (by CD88 expression). The occurrence of nosocomial infection was determined using pre-defined, objective criteria. Ninety-six patients were recruited, of whom 95 had data available for analysis. Relative to healthy controls, percentage Tregs were elevated 6-10 days after admission, while monocyte HLA-DR and neutrophil CD88 showed broader depression across time points measured. Thirty-three patients (35%) developed nosocomial infection, and patients developing nosocomial infection showed significantly greater immune dysfunction by the measures used. Tregs and neutrophil dysfunction remained significantly predictive of infection in a Cox hazards model correcting for time effects and clinical confounders {hazard ratio (HR) 2.4 [95% confidence interval (CI) 1.1-5.4] and 6.9 (95% CI 1.6-30), respectively, P=0.001}. Cumulative immune dysfunction resulted in a progressive risk of infection, rising from no cases in patients with no dysfunction to 75% of patients with dysfunction of all three cell types (P=0.0004). Dysfunctions of T-cells, monocytes, and neutrophils predict acquisition of nosocomial infection, and combine additively to stratify risk of nosocomial infection in the critically ill.

  8. Perinatal Stress, Fatigue, Depressive Symptoms, and Immune Modulation in Late Pregnancy and One Month Postpartum

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    C. Y. Cheng

    2014-01-01

    Full Text Available Stress and fatigue are common complaints of pregnant and postpartum women as is depression. These symptoms may be related to immunomodulation. However, few studies have examined these relationships. The aim of this study was to examine the relationships among stress, fatigue, depression, and cytokines as markers of immune modulation in prenatal and postpartum women. Women completed questionnaires and gave blood samples during late pregnancy and again at 4–6 weeks postpartum. Blood was analyzed for cytokines as measures of immune modulation. Stress, fatigue, and depression were experienced at moderately high levels, with higher levels of fatigue and depression in the postpartum but higher stress in the prenatal period. Levels of several cytokines were increased in the postpartum over the prenatal period. Stress and depression were related in the prenatal period and stress, depression, and fatigue were related in the postpartum. While various cytokines were related to each other in both periods, only stress was related to MIP-1β, a cytokine that may be important for childbirth processes. More studies, especially longitudinal and interventional studies, are needed to increase our knowledge about etiology, patterns, symptoms, factors, and management of maternal distress. The search for reliable biomarkers for at-risk mothers remains a priority.

  9. Immune dysfunction prior to Staphylococcus aureus bacteremia is a determinant of long-term mortality.

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    Jared A Greenberg

    Full Text Available The clinical implications for patients who survive serious infections are not well understood. It has been hypothesized that the excess mortality for survivors of sepsis observed in epidemiological studies is due to increased vulnerability to subsequent infections. We undertook this study to identify characteristics of patients who are at high risk for death after surviving a common type of blood-stream infection.At a single academic medical center, 237 patients with Staphylococcus aureus bacteremia admitted during a three-year period were retrospectively identified. The primary outcomes were 30-day and 31 to 90-day mortality after the first positive blood culture. The primary predictor variable of interest was clinical immune dysfunction prior to bacteremia.The 30-day mortality was not significantly different for patients with and without prior immune dysfunction. However, during days 31 to 90, 11 patients (20% with prior immune dysfunction compared to 10 patients (8.6% without prior immune dysfunction died (OR 2.59, 95% CI 1.03-6.53, p = 0.04. In a Cox-proportional hazard model controlling for age, there was a significant association between prior immune dysfunction and greater 31 to 90 day mortality (HR 2.44, 95% CI 1.01-5.90, p = 0.05 and a non-significant trend towards occurrence of subsequent infections and greater 31 to 90 day mortality (HR 2.12, 95% CI 0.89-5.07, p = 0.09.Patients with prior immune dysfunction are at high risk for death 31 to 90 days, but not <30 days, after S. aureus bacteremia. Further investigation is needed to determine if this finding is due to poor prognosis of chronic disease or increased vulnerability to subsequent infections.

  10. Bipolar Disorder and Immune Dysfunction: Epidemiological Findings, Proposed Pathophysiology and Clinical Implications

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    Rosenblat, Joshua D.; McIntyre, Roger S.

    2017-01-01

    Bipolar disorder (BD) is strongly associated with immune dysfunction. Replicated epidemiological studies have demonstrated that BD has high rates of inflammatory medical comorbidities, including autoimmune disorders, chronic infections, cardiovascular disease and metabolic disorders. Cytokine studies have demonstrated that BD is associated with chronic low-grade inflammation with further increases in pro-inflammatory cytokine levels during mood episodes. Several mechanisms have been identifie...

  11. Bipolar Disorder and Immune Dysfunction: Epidemiological Findings, Proposed Pathophysiology and Clinical Implications

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    Joshua D. Rosenblat

    2017-10-01

    Full Text Available Bipolar disorder (BD is strongly associated with immune dysfunction. Replicated epidemiological studies have demonstrated that BD has high rates of inflammatory medical comorbidities, including autoimmune disorders, chronic infections, cardiovascular disease and metabolic disorders. Cytokine studies have demonstrated that BD is associated with chronic low-grade inflammation with further increases in pro-inflammatory cytokine levels during mood episodes. Several mechanisms have been identified to explain the bidirectional relationship between BD and immune dysfunction. Key mechanisms include cytokine-induced monoamine changes, increased oxidative stress, pathological microglial over-activation, hypothalamic-pituitary-adrenal (HPA axis over-activation, alterations of the microbiome-gut-brain axis and sleep-related immune changes. The inflammatory-mood pathway presents several potential novel targets in the treatment of BD. Several proof-of-concept clinical trials have shown a positive effect of anti-inflammatory agents in the treatment of BD; however, further research is needed to determine the clinical utility of these treatments. Immune dysfunction is likely to only play a role in a subset of BD patients and as such, future clinical trials should also strive to identify which specific group(s of BD patients may benefit from anti-inflammatory treatments.

  12. Converging Pathways in Autism Spectrum Disorders: Interplay Between Synaptic Dysfunction and Immune Responses

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    Irina eVoineagu

    2013-11-01

    Full Text Available Autism spectrum disorders (ASD are highly heritable, yet genetically heterogeneous neurodevelopmental conditions. Recent genome-wide association and gene expression studies have provided evidence supporting the notion that the large number of genetic variants associated with ASD converge toward a core set of dysregulated biological processes. Here we review recent data demonstrating the involvement of synaptic dysfunction and abnormal immune responses in ASD, and discuss the functional interplay between the two phenomena.

  13. Targeting Multiple-Myeloma-Induced Immune Dysfunction to Improve Immunotherapy Outcomes

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    Sergio Rutella

    2012-01-01

    Full Text Available Multiple myeloma (MM is a plasma cell malignancy associated with high levels of monoclonal (M protein in the blood and/or serum. MM can occur de novo or evolve from benign monoclonal gammopathy of undetermined significance (MGUS. Current translational research into MM focuses on the development of combination therapies directed against molecularly defined targets and that are aimed at achieving durable clinical responses. MM cells have a unique ability to evade immunosurveillance through several mechanisms including, among others, expansion of regulatory T cells (Treg, reduced T-cell cytotoxic activity and responsiveness to IL-2, defects in B-cell immunity, and induction of dendritic cell (DC dysfunction. Immune defects could be a major cause of failure of the recent immunotherapy trials in MM. This article summarizes our current knowledge on the molecular determinants of immune evasion in patients with MM and highlights how these pathways can be targeted to improve patients’ clinical outcome.

  14. Effector, Memory, and Dysfunctional CD8+ T Cell Fates in the Antitumor Immune Response

    Science.gov (United States)

    2016-01-01

    The adaptive immune system plays a pivotal role in the host's ability to mount an effective, antigen-specific immune response against tumors. CD8+ tumor-infiltrating lymphocytes (TILs) mediate tumor rejection through recognition of tumor antigens and direct killing of transformed cells. In growing tumors, TILs are often functionally impaired as a result of interaction with, or signals from, transformed cells and the tumor microenvironment. These interactions and signals can lead to transcriptional, functional, and phenotypic changes in TILs that diminish the host's ability to eradicate the tumor. In addition to effector and memory CD8+ T cells, populations described as exhausted, anergic, senescent, and regulatory CD8+ T cells have been observed in clinical and basic studies of antitumor immune responses. In the context of antitumor immunity, these CD8+ T cell subsets remain poorly characterized in terms of fate-specific biomarkers and transcription factor profiles. Here we discuss the current characterization of CD8+ T cell fates in antitumor immune responses and discuss recent insights into how signals in the tumor microenvironment influence TIL transcriptional networks to promote CD8+ T cell dysfunction. PMID:27314056

  15. [Immune dysfunction and cognitive deficit in stress and physiological aging (Part I): Pathogenesis and risk factors].

    Science.gov (United States)

    Pukhal'skiĭ, A L; Shmarina, G V; Aleshkin, V A

    2014-01-01

    The concept of stressful cognitive dysfunction, which is under consideration in this review, allows picking out several therapeutic targets. The brain, immune and endocrine systems being the principal adaptive systems in the body permanently share information both in the form of neural impulses and soluble mediators. The CNS differs from other organs due to several peculiarities that affect local immune surveillance. The brain cells secluded from the blood flow by a specialized blood-brain-barrier (BBB) can endogenously express pro- and anti-inflammatory cytokines without the intervention of the immune system. In normal brain the cytokine signaling rather contributes to exclusive brain function (e.g. long-term potentiation, synaptic plasticity, adult neurogenesis) than serves as immune communicator. The stress of different origin increases the serum cytokine levels and disrupts BBB. As a result peripheral cytokines penetrate into the brain where they begin to perform new functions. Mass intrusion of biologically active peptides having a lot of specific targets alters the brain work that we can observe both in humans and in animal experiments. In addition owing to BBB disruption dendritic cells and T cells also penetrate into the brain where they take up a perivascular position. The changes observed in stressed subject may accumulate during repeated episodes of stress forming a picture typical of the aging brain. Moreover long-term stress as well as physiological aging result in hormonal and immunological disturbances including hypothalamic-pituitary-adrenal axis depletion, regulatory T-cell accumulation and dehydroepiandrosterone decrease.

  16. Efficacy of kinesiology tape versus postural correction exercises on neck disability and axioscapular muscles fatigue in mechanical neck dysfunction: A randomized blinded clinical trial.

    Science.gov (United States)

    El-Abd, Aliaa M; Ibrahim, Abeer R; El-Hafez, Haytham M

    2017-04-01

    Mechanical neck dysfunction (MND), with axioscapular muscles fatigue, is highly prevalent worldwide. While postural correction is commonly used for its treatment, efficacy of kinesiology tape (KT) has received considerable attention. To determine the effectiveness of KT versus correction exercises on neck disability, and axioscapular muscles fatigue in MND patients. 46 MND patients were randomly assigned into 1 of 2 groups receiving 4 weeks treatment of either KT or correction exercises. Neck disability and axioscapular muscles fatigue as median frequency of electromyography (EMG-MF) were measured pre and post treatment. Group-by-time interaction was not significant in the multivariable test. Post hoc tests revealed that KT produced more disability reduction than the postural exercises. However, there was no significant interaction for EMG-MF. KT has been found to be more effective than postural exercises to reduce neck disability. However, both modalities have similar effects to reduce axioscapular muscles fatigue. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Cytokine expression profiles of immune imbalance in post-mononucleosis chronic fatigue

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    Broderick Gordon

    2012-09-01

    Full Text Available Abstract Background As Chronic Fatigue Syndrome (CFS has been known to follow Epstein-Bar virus (EBV and other systemic infections; our objective was to describe differences in immune activation in post-infective CFS (PI-CFS patients and recovered controls. We studied 301 adolescents prospectively over 24 months following the diagnosis of monospot-positive infectious mononucleosis (IM. We found an incidence of CFS at 6, 12 and 24 months of 13%, 7% and 4% respectively. Methods Using chemiluminescent imaging we measured the concentrations of IL-1a, 1b, 2, 4, 5, 6, 8, 10, 12 (p70, 13, 15, 17 and 23, IFN-γ, TNF-α and TNF-β in duplicate plasma samples available in bio-bank from 9 PI-CFS subjects and 12 recovered controls at 24 months post-infection. Results Standard comparative analysis indicated significant differences in IL-8 and 23 across subject groups. In constructing a linear classification model IL-6, 8 and 23 were selected by two different statistical approaches as discriminating features, with IL-1a, IL-2 and IFN-γ also selected in one model or the other. This supported an assignment accuracy of better than 80% at a confidence level of 0.95 into PI-CFS versus recovered controls. Conclusion These results suggest that co-expression patterns in as few as 5 cytokines associated with Th17 function may hold promise as a tool for the diagnosis of post-infectious CFS.

  18. TRESK channel as a potential target to treat T-cell mediated immune dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Han, Jaehee [Medical Research Center for Neural Dysfunction, Department of Physiology, Institute of Health Sciences, Gyeongsang National University, School of Medicine, Jinju 660-751 (Korea, Republic of); Kang, Dawon, E-mail: dawon@gnu.ac.kr [Medical Research Center for Neural Dysfunction, Department of Physiology, Institute of Health Sciences, Gyeongsang National University, School of Medicine, Jinju 660-751 (Korea, Republic of)

    2009-12-25

    In this review, we propose that TRESK background K{sup +} channel could serve as a potential therapeutic target for T-cell mediated immune dysfunction. TRESK has many immune function-related properties. TRESK is abundantly expressed in the thymus, the spleen, and human leukemic T-lymphocytes. TRESK is highly activated by Ca{sup 2+}, calcineurin, acetylcholine, and histamine which induce hypertrophy, whereas TRESK is inhibited by immunosuppressants, such as cyclosporin A and FK506. Cyclosporine A and FK506 target the binding site of nuclear factor of activated T-cells (NFAT) to inhibit calcineurin. Interestingly, TRESK possesses an NFAT-like docking site that is present at its intracellular loop. Calcineurin has been found to interact with TRESK via specific NFAT-like docking site. When the T-cell is activated, calcineurin can bind to the NFAT-docking site of TRESK. The activation of both TRESK and NFAT via Ca{sup 2+}-calcineurin-NFAT/TRESK pathway could modulate the transcription of new genes in addition to regulating several aspects of T-cell function.

  19. Atopic dermatitis: immune deviation, barrier dysfunction, IgE autoreactivity and new therapies

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    Masutaka Furue

    2017-07-01

    Full Text Available Atopic dermatitis (AD is a chronic or chronically relapsing, eczematous, severely pruritic skin disorder mostly associated with IgE elevation and skin barrier dysfunction due to decreased filaggrin expression. The lesional skin of AD exhibits Th2- and Th22-deviated immune reactions that are progressive during disease chronicity. Th2 and Th22 cytokines further deteriorate the skin barrier by inhibiting filaggrin expression. Some IgEs are reactive to self-antigens. The IgE autoreactivity may precipitate the chronicity of AD. Upon activation of the ORAI1 calcium channel, atopic epidermis releases large amounts of thymic stromal lymphopoietin (TSLP, which initiates the Th2 and Th22 immune response. Th2-derived interleukin-31 and TSLP induce an itch sensation. Taken together, TSLP/Th2/Th22 pathway is a promising target for developing new therapeutics for AD. Enhancing filaggrin expression using ligands for the aryl hydrocarbon receptor may also be an adjunctive measure to restore the disrupted barrier function specifically for AD.

  20. Innate Immune Signalling Genetics of Pain, Cognitive Dysfunction and Sickness Symptoms in Cancer Pain Patients Treated with Transdermal Fentanyl.

    Directory of Open Access Journals (Sweden)

    Daniel T Barratt

    Full Text Available Common adverse symptoms of cancer and chemotherapy are a major health burden; chief among these is pain, with opioids including transdermal fentanyl the mainstay of treatment. Innate immune activation has been implicated generally in pain, opioid analgesia, cognitive dysfunction, and sickness type symptoms reported by cancer patients. We aimed to determine if genetic polymorphisms in neuroimmune activation pathways alter the serum fentanyl concentration-response relationships for pain control, cognitive dysfunction, and other adverse symptoms, in cancer pain patients. Cancer pain patients (468 receiving transdermal fentanyl were genotyped for 31 single nucleotide polymorphisms in 19 genes: CASP1, BDNF, CRP, LY96, IL6, IL1B, TGFB1, TNF, IL10, IL2, TLR2, TLR4, MYD88, IL6R, OPRM1, ARRB2, COMT, STAT6 and ABCB1. Lasso and backward stepwise generalised linear regression were used to identify non-genetic and genetic predictors, respectively, of pain control (average Brief Pain Inventory < 4, cognitive dysfunction (Mini-Mental State Examination ≤ 23, sickness response and opioid adverse event complaint. Serum fentanyl concentrations did not predict between-patient variability in these outcomes, nor did genetic factors predict pain control, sickness response or opioid adverse event complaint. Carriers of the MYD88 rs6853 variant were half as likely to have cognitive dysfunction (11/111 than wild-type patients (69/325, with a relative risk of 0.45 (95% CI: 0.27 to 0.76 when accounting for major non-genetic predictors (age, Karnofsky functional score. This supports the involvement of innate immune signalling in cognitive dysfunction, and identifies MyD88 signalling pathways as a potential focus for predicting and reducing the burden of cognitive dysfunction in cancer pain patients.

  1. Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: a review of case-control studies.

    Science.gov (United States)

    Martínez-Martínez, Laura-Aline; Mora, Tania; Vargas, Angélica; Fuentes-Iniestra, Mario; Martínez-Lavín, Manuel

    2014-04-01

    Fibromyalgia often coexists and overlaps with other syndromes such as chronic fatigue, irritable bowel syndrome, and interstitial cystitis. Chronic stress has been implicated in the pathogenesis of these illnesses. The sympathetic nervous system is a key element of the stress response system. Sympathetic dysfunction has been reported in these syndromes, raising the possibility that such dysautonomia could be their common clustering underlying pathogenesis. The objective of this study was to carry out a review of all published comparative case-control studies investigating sympathetic nervous system performance in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. Online databases PubMed and EMBASE were accessed using the following key words: autonomic (OR) sympathetic (AND) fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. All entries up to December 10th 2012 were reviewed by 2 independent investigators searching for case-control studies in humans. The Method for Evaluating Research and Guidelines Evidence adapted to the Scottish Intercollegiate Guidelines Network was used to rank the level of evidence contained in the selected articles. A total of 196 articles are included in this review. The most often used methods to assess sympathetic functionality were heart rate variability analysis, sympathetic skin response, tilt table testing, and genetic studies. The majority of studies (65%) described sympathetic nervous system predominance in these overlapping syndromes. In contrast, 7% of the studies found parasympathetic predominance. This review demonstrates that sympathetic nervous system predominance is common in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. This concordance raises the possibility that sympathetic dysfunction could be their common underlying pathogenesis that brings on overlapping clinical features. The recognition of

  2. Innate Immune Signalling Genetics of Pain, Cognitive Dysfunction and Sickness Symptoms in Cancer Pain Patients Treated with Transdermal Fentanyl

    Science.gov (United States)

    Barratt, Daniel T.; Klepstad, Pål; Dale, Ola; Kaasa, Stein; Somogyi, Andrew A.

    2015-01-01

    Common adverse symptoms of cancer and chemotherapy are a major health burden; chief among these is pain, with opioids including transdermal fentanyl the mainstay of treatment. Innate immune activation has been implicated generally in pain, opioid analgesia, cognitive dysfunction, and sickness type symptoms reported by cancer patients. We aimed to determine if genetic polymorphisms in neuroimmune activation pathways alter the serum fentanyl concentration-response relationships for pain control, cognitive dysfunction, and other adverse symptoms, in cancer pain patients. Cancer pain patients (468) receiving transdermal fentanyl were genotyped for 31 single nucleotide polymorphisms in 19 genes: CASP1, BDNF, CRP, LY96, IL6, IL1B, TGFB1, TNF, IL10, IL2, TLR2, TLR4, MYD88, IL6R, OPRM1, ARRB2, COMT, STAT6 and ABCB1. Lasso and backward stepwise generalised linear regression were used to identify non-genetic and genetic predictors, respectively, of pain control (average Brief Pain Inventory fentanyl concentrations did not predict between-patient variability in these outcomes, nor did genetic factors predict pain control, sickness response or opioid adverse event complaint. Carriers of the MYD88 rs6853 variant were half as likely to have cognitive dysfunction (11/111) than wild-type patients (69/325), with a relative risk of 0.45 (95% CI: 0.27 to 0.76) when accounting for major non-genetic predictors (age, Karnofsky functional score). This supports the involvement of innate immune signalling in cognitive dysfunction, and identifies MyD88 signalling pathways as a potential focus for predicting and reducing the burden of cognitive dysfunction in cancer pain patients. PMID:26332828

  3. Understanding the function and dysfunction of the immune system in lung cancer: the role of immune checkpoints

    International Nuclear Information System (INIS)

    Karachaliou, Niki; Cao, Maria Gonzalez; Teixidó, Cristina; Viteri, Santiago; Morales-Espinosa, Daniela; Santarpia, Mariacarmela; Rosell, Rafael

    2015-01-01

    Survival rates for metastatic lung cancer, including non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), are poor with 5-year survivals of less than 5%. The immune system has an intricate and complex relationship with tumorigenesis; a groundswell of research on the immune system is leading to greater understanding of how cancer progresses and presenting new ways to halt disease progress. Due to the extraordinary power of the immune system—with its capacity for memory, exquisite specificity and central and universal role in human biology—immunotherapy has the potential to achieve complete, long-lasting remissions and cures, with few side effects for any cancer patient, regardless of cancer type. As a result, a range of cancer therapies are under development that work by turning our own immune cells against tumors. However deeper understanding of the complexity of immunomodulation by tumors is key to the development of effective immunotherapies, especially in lung cancer

  4. Understanding the function and dysfunction of the immune system in lung cancer: the role of immune checkpoints.

    Science.gov (United States)

    Karachaliou, Niki; Cao, Maria Gonzalez; Teixidó, Cristina; Viteri, Santiago; Morales-Espinosa, Daniela; Santarpia, Mariacarmela; Rosell, Rafael

    2015-06-01

    Survival rates for metastatic lung cancer, including non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), are poor with 5-year survivals of less than 5%. The immune system has an intricate and complex relationship with tumorigenesis; a groundswell of research on the immune system is leading to greater understanding of how cancer progresses and presenting new ways to halt disease progress. Due to the extraordinary power of the immune system-with its capacity for memory, exquisite specificity and central and universal role in human biology-immunotherapy has the potential to achieve complete, long-lasting remissions and cures, with few side effects for any cancer patient, regardless of cancer type. As a result, a range of cancer therapies are under development that work by turning our own immune cells against tumors. However deeper understanding of the complexity of immunomodulation by tumors is key to the development of effective immunotherapies, especially in lung cancer.

  5. [Chronic fatigue syndrome: biochemical examination of blood].

    Science.gov (United States)

    Hakariya, Yukiko; Kuratsune, Hirohiko

    2007-06-01

    Though patients with chronic fatigue syndrome (CFS) have lots of complaints, abnormal findings cannot be detected by biochemical screening tests. However, some specialized blood tests have revealed neuroendocrine immune axis abnormalities, which is closely associated with each other. Recent studies indicate that CFS can be understood as a special condition based on abnormality of the psycho-neuro-endocrino-immunological system, with the distinguishing feature of CFS seeming to be the secondary brain dysfunction caused by several cytokines and/or autoantibodies. In this paper, we summarize these abnormalities found in CFS and show the neuro-molecular mechanism leading to chronic fatigue.

  6. Gut immune dysfunction through impaired innate pattern recognition receptor expression and gut microbiota dysbiosis in chronic SIV infection.

    Science.gov (United States)

    Glavan, T W; Gaulke, C A; Santos Rocha, C; Sankaran-Walters, S; Hirao, L A; Raffatellu, M; Jiang, G; Bäumler, A J; Goulart, L R; Dandekar, S

    2016-05-01

    HIV targets the gut mucosa early in infection, causing immune and epithelial barrier dysfunction and disease progression. However, gut mucosal sensing and innate immune signaling through mucosal pattern recognition receptors (PRRs) during HIV infection and disease progression are not well defined. Using the simian immunodeficiency virus (SIV)-infected rhesus macaque model of AIDS, we found a robust increase in PRRs and inflammatory cytokine gene expression during the acute SIV infection in both peripheral blood and gut mucosa, coinciding with viral replication. PRR expression remained elevated in peripheral blood following the transition to chronic SIV infection. In contrast, massive dampening of PRR expression was detected in the gut mucosa, despite the presence of detectable viral loads. Exceptionally, expression of Toll-like receptor 4 (TLR4) and TLR8 was downmodulated and diverged from expression patterns for most other TLRs in the gut. Decreased mucosal PRR expression was associated with increased abundance of several pathogenic bacterial taxa, including Pasteurellaceae members, Aggregatibacter and Actinobacillus, and Mycoplasmataceae family. Early antiretroviral therapy led to viral suppression but only partial maintenance of gut PRRs and cytokine gene expression. In summary, SIV infection dampens mucosal innate immunity through PRR dysregulation and may promote immune activation, gut microbiota changes, and ineffective viral clearance.

  7. Human Cytotoxic T Lymphocytes Form Dysfunctional Immune Synapses with B Cells Characterized by Non-Polarized Lytic Granule Release

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    Anna Kabanova

    2016-04-01

    Full Text Available Suppression of the cytotoxic T cell (CTL immune response has been proposed as one mechanism for immune evasion in cancer. In this study, we have explored the underlying basis for CTL suppression in the context of B cell malignancies. We document that human B cells have an intrinsic ability to resist killing by freshly isolated cytotoxic T cells (CTLs, but are susceptible to lysis by IL-2 activated CTL blasts and CTLs isolated from immunotherapy-treated patients with chronic lymphocytic leukemia (CLL. Impaired killing was associated with the formation of dysfunctional non-lytic immune synapses characterized by the presence of defective linker for activation of T cells (LAT signaling and non-polarized release of the lytic granules transported by ADP-ribosylation factor-like protein 8 (Arl8. We propose that non-lytic degranulation of CTLs are a key regulatory mechanism of evasion through which B cells may interfere with the formation of functional immune synapses by CTLs.

  8. Preliminary evidence of mitochondrial dysfunction associated with post-infective fatigue after acute infection with Epstein Barr Virus

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    Hickie Ian B

    2006-01-01

    Full Text Available Abstract Background Acute infectious diseases are typically accompanied by non-specific symptoms including fever, malaise, irritability and somnolence that usually resolve on recovery. However, in some individuals these symptoms persist in what is commonly termed post-infective fatigue. The objective of this pilot study was to determine the gene expression correlates of post-infective fatigue following acute Epstein Barr virus (EBV infection. Methods We followed 5 people with acute mononucleosis who developed post-infective fatigue of more than 6 months duration and 5 HLA-matched control subjects who recovered within 3 months. Subjects had peripheral blood mononuclear cell (PBMC samples collected at varying time points including at diagnosis, then every 2 weeks for 3 months, then every 3 months for a year. Total RNA was extracted from the PBMC samples and hybridized to microarrays spotted with 3,800 oligonucleotides. Results Those who developed post-infective fatigue had gene expression profiles indicative of an altered host response during acute mononucleosis compared to those who recovered uneventfully. Several genes including ISG20 (interferon stimulated gene, DNAJB2 (DnaJ [Hsp40] homolog and CD99, CDK8 (cyclin-dependent kinase 8, E2F2 (E2F transcription factor 2, CDK8 (cyclin-dependent kinase 8, and ACTN2 (actinin, alpha 2, known to be regulated during EBV infection, were differentially expressed in post-infective fatigue cases. Several of the differentially expressed genes affect mitochondrial functions including fatty acid metabolism and the cell cycle. Conclusion These preliminary data provide insights into alterations in gene transcripts associated with the varied clinical outcomes from acute infectious mononucleosis.

  9. Immunopathophysiology of inflammatory bowel disease: how genetics link barrier dysfunction and innate immunity to inflammation.

    Science.gov (United States)

    Mehta, Minesh; Ahmed, Shifat; Dryden, Gerald

    2017-08-01

    Inflammatory bowel diseases (IBD) comprise a distinct set of clinical symptoms resulting from chronic or relapsing immune activation and corresponding inflammation within the gastrointestinal (GI) tract. Diverse genetic mutations, encoding important aspects of innate immunity and mucosal homeostasis, combine with environmental triggers to create inappropriate, sustained inflammatory responses. Recently, significant advances have been made in understanding the interplay of the intestinal epithelium, mucosal immune system, and commensal bacteria as a foundation of the pathogenesis of inflammatory bowel disease. Complex interactions between specialized intestinal epithelial cells and mucosal immune cells determine different outcomes based on the environmental input: the development of tolerance in the presence of commensal bacterial or the promotion of inflammation upon recognition of pathogenic organisms. This article reviews key genetic abnormalities involved in inflammatory and homeostatic pathways that enhance susceptibility to immune dysregulation and combine with environmental triggers to trigger the development of chronic intestinal inflammation and IBD.

  10. Prehospital immune responses and development of multiple organ dysfunction syndrome following traumatic injury: A prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Jon Hazeldine

    2017-07-01

    Full Text Available Almost all studies that have investigated the immune response to trauma have analysed blood samples acquired post-hospital admission. Thus, we know little of the immune status of patients in the immediate postinjury phase and how this might influence patient outcomes. The objective of this study was therefore to comprehensively assess the ultra-early, within 1-hour, immune response to trauma and perform an exploratory analysis of its relationship with the development of multiple organ dysfunction syndrome (MODS.The immune and inflammatory response to trauma was analysed in 89 adult trauma patients (mean age 41 years, range 18-90 years, 75 males with a mean injury severity score (ISS of 24 (range 9-66, from whom blood samples were acquired within 1 hour of injury (mean time to sample 42 minutes, range 17-60 minutes. Within minutes of trauma, a comprehensive leukocytosis, elevated serum pro- and anti-inflammatory cytokines, and evidence of innate cell activation that included neutrophil extracellular trap generation and elevated surface expression of toll-like receptor 2 and CD11b on monocytes and neutrophils, respectively, were observed. Features consistent with immune compromise were also detected, notably elevated numbers of immune suppressive CD16BRIGHT CD62LDIM neutrophils (82.07 x 106/l ± 18.94 control versus 1,092 x 106/l ± 165 trauma, p < 0.0005 and CD14+HLA-DRlow/- monocytes (34.96 x 106/l ± 4.48 control versus 95.72 x 106/l ± 8.0 trauma, p < 0.05 and reduced leukocyte cytokine secretion in response to lipopolysaccharide stimulation. Exploratory analysis via binary logistic regression found a potential association between absolute natural killer T (NKT cell numbers and the subsequent development of MODS. Study limitations include the relatively small sample size and the absence of data relating to adaptive immune cell function.Our study highlighted the dynamic and complex nature of the immune response to trauma, with immune

  11. Cell-mediated immunity and postpartum thyroid dysfunction: a possibility for the prediction of disease?

    NARCIS (Netherlands)

    Kuijpens, J. L.; de Hann-Meulman, M.; Vader, H. L.; Pop, V. J.; Wiersinga, W. M.; Drexhage, H. A.

    1998-01-01

    Postpartum (pp) thyroid dysfunction (PPTD) is thought to be caused by an autoimmune (AI) destruction of thyroid follicles during the pp period. The chronic thyroid AI process [already present in pregnancy, as shown by the positivity for thyroid peroxidase antibodies (TPO-Ab)] becomes overt disease

  12. Serological profiling of the EBV immune response in Chronic Fatigue Syndrome using a peptide microarray.

    Directory of Open Access Journals (Sweden)

    Madlen Loebel

    Full Text Available Epstein-Barr-Virus (EBV plays an important role as trigger or cofactor for various autoimmune diseases. In a subset of patients with Chronic Fatigue Syndrome (CFS disease starts with infectious mononucleosis as late primary EBV-infection, whereby altered levels of EBV-specific antibodies can be observed in another subset of patients.We performed a comprehensive mapping of the IgG response against EBV comparing 50 healthy controls with 92 CFS patients using a microarray platform. Patients with multiple sclerosis (MS, systemic lupus erythematosus (SLE and cancer-related fatigue served as controls. 3054 overlapping peptides were synthesised as 15-mers from 14 different EBV proteins. Array data was validated by ELISA for selected peptides. Prevalence of EBV serotypes was determined by qPCR from throat washing samples.EBV type 1 infections were found in patients and controls. EBV seroarray profiles between healthy controls and CFS were less divergent than that observed for MS or SLE. We found significantly enhanced IgG responses to several EBNA-6 peptides containing a repeat sequence in CFS patients compared to controls. EBNA-6 peptide IgG responses correlated well with EBNA-6 protein responses. The EBNA-6 repeat region showed sequence homologies to various human proteins.Patients with CFS had a quite similar EBV IgG antibody response pattern as healthy controls. Enhanced IgG reactivity against an EBNA-6 repeat sequence and against EBNA-6 protein is found in CFS patients. Homologous sequences of various human proteins with this EBNA-6 repeat sequence might be potential targets for antigenic mimicry.

  13. Attenuation of phosphamidon-induced oxidative stress and immune dysfunction in rats treated with N-acetylcysteine

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    S.G. Suke

    2008-09-01

    Full Text Available The effect of N-acetylcysteine, a thiolic antioxidant, on attenuation of phosphamidon-induced oxidative stress and immune dysfunction was evaluated in adult male Wistar rats weighing 200-250 g. Rats were divided into four groups, 8 animals/group, and treated with phosphamidon, N-acetylcysteine or the combination of both for 28 days. Oral administration of phosphamidon (1.74 mg/kg, an organophosphate insecticide, increased serum malondialdehyde (3.83 ± 0.18 vs 2.91 ± 0.24 nmol/mL; P < 0.05 and decreased erythrocyte superoxide dismutase (567.8 ± 24.36 vs 749.16 ± 102.61 U/gHb; P < 0.05, catalase activity (1.86 ± 0.18 vs 2.43 ± 0.08 U/gHb; P < 0.05 and whole blood glutathione levels (1.25 ± 0.21 vs 2.28 ± 0.08 mg/gHb; P < 0.05 showing phosphamidon-induced oxidative stress. Phosphamidon exposure markedly suppressed humoral immune response as assessed by antibody titer to ovalbumin (4.71 ± 0.51 vs 8.00 ± 0.12 -log2; P < 0.05, and cell-mediated immune response as assessed by leukocyte migration inhibition (25.24 ± 1.04 vs 70.8 ± 1.09%; P < 0.05 and macrophage migration inhibition (20.38 ± 0.99 vs 67.16 ± 5.30%; P < 0.05 response. Phosphamidon exposure decreased IFN-у levels (40.7 ± 3.21 vs 55.84 ± 3.02 pg/mL; P < 0.05 suggesting a profound effect of phosphamidon on cell-mediated immune response. A phosphamidon-induced increase in TNF-α level (64.19 ± 6.0 vs 23.16 ± 4.0 pg/mL; P < 0.05 suggests a contributory role of immunocytes in oxidative stress. Co-administration of N-acetylcysteine (3.5 mmol/kg, orally with phosphamidon attenuated the adverse effects of phosphamidon. These findings suggest that oral N-acetylcysteine treatment exerts protective effect and attenuates free radical injury and immune dysfunction caused by subchronic phosphamidon exposure.

  14. Stress-Induced Endocrine and Immune Dysfunctions in Caregivers of People with Eating Disorders

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    Ángel Romero-Martínez

    2017-12-01

    Full Text Available Caregivers have to cope repeatedly with acute stressors in their daily lives, and this is associated with disturbances in the hypothalamic–pituitary–adrenal (HPA axis and the immune system. Such disturbances could contribute to the development of health problems in informal caregivers of people with chronic illnesses, such as eating disorders (EDs. The main objective of this study was to examine endocrine (salivary cortisol levels (Csal, immune (immunoglobulin-A (IgA, and psychological (anxiety, mood, and anger feelings responses to an acute psychological stressor in a sample of informal caregivers of individuals with EDs compared to a sample of non-caregivers. In addition, it also aimed to analyze the potential relationship of the aforementioned endocrine and immune response parameters with psychological variables in the caregivers. Caregivers had lower Csal and IgA levels at all assessment points except baseline. Moreover, they also exhibited lower Csal and IgA responses and greater worsening of mood in response to acute psychosocial stress than the non-caregivers, which suggests that caregivers had dampened endocrine and immune reactivity to acute stress. On the other hand, endocrine and immune parameters were unrelated to psychological variables. These findings advance our understanding of how a chronically stressed population reacts to acute stress, and should be considered for the development of effective interventions focused on stress management that could help caregivers to reduce their stress levels, which, in turn, would improve their health.

  15. HTT-lowering reverses Huntington's disease immune dysfunction caused by NFκB pathway dysregulation.

    Science.gov (United States)

    Träger, Ulrike; Andre, Ralph; Lahiri, Nayana; Magnusson-Lind, Anna; Weiss, Andreas; Grueninger, Stephan; McKinnon, Chris; Sirinathsinghji, Eva; Kahlon, Shira; Pfister, Edith L; Moser, Roger; Hummerich, Holger; Antoniou, Michael; Bates, Gillian P; Luthi-Carter, Ruth; Lowdell, Mark W; Björkqvist, Maria; Ostroff, Gary R; Aronin, Neil; Tabrizi, Sarah J

    2014-03-01

    Huntington's disease is an inherited neurodegenerative disorder caused by a CAG repeat expansion in the huntingtin gene. The peripheral innate immune system contributes to Huntington's disease pathogenesis and has been targeted successfully to modulate disease progression, but mechanistic understanding relating this to mutant huntingtin expression in immune cells has been lacking. Here we demonstrate that human Huntington's disease myeloid cells produce excessive inflammatory cytokines as a result of the cell-intrinsic effects of mutant huntingtin expression. A direct effect of mutant huntingtin on the NFκB pathway, whereby it interacts with IKKγ, leads to increased degradation of IκB and subsequent nuclear translocation of RelA. Transcriptional alterations in intracellular immune signalling pathways are also observed. Using a novel method of small interfering RNA delivery to lower huntingtin expression, we show reversal of disease-associated alterations in cellular function-the first time this has been demonstrated in primary human cells. Glucan-encapsulated small interfering RNA particles were used to lower huntingtin levels in human Huntington's disease monocytes/macrophages, resulting in a reversal of huntingtin-induced elevated cytokine production and transcriptional changes. These findings improve our understanding of the role of innate immunity in neurodegeneration, introduce glucan-encapsulated small interfering RNA particles as tool for studying cellular pathogenesis ex vivo in human cells and raise the prospect of immune cell-directed HTT-lowering as a therapeutic in Huntington's disease.

  16. Chronic fatigue syndrome and fibromyalgia following immunization with the hepatitis B vaccine: another angle of the 'autoimmune (auto-inflammatory) syndrome induced by adjuvants' (ASIA).

    Science.gov (United States)

    Agmon-Levin, Nancy; Zafrir, Yaron; Kivity, Shaye; Balofsky, Ari; Amital, Howard; Shoenfeld, Yehuda

    2014-12-01

    The objectives of this study were to gather information regarding demographic and clinical characteristics of patients diagnosed with either fibromyalgia (FM) or chronic fatigue (CFS) following hepatitis B vaccination (HBVv) and furthermore to apply the recently suggested criteria of autoimmune (auto-inflammatory) syndromes induced by adjuvants (ASIA), in the aim of identifying common characteristics that may suggest an association between fibromyalgia, chronic fatigue and HBV vaccination. Medical records of 19 patients with CFS and/or fibromyalgia following HBVv immunization were analyzed. All of which were immunized during 1990-2008 in different centers in the USA. All medical records were evaluated for demographics, medical history, the number of vaccine doses, as well as immediate and long term post-immunization adverse events and clinical manifestations. In addition, available blood tests, imaging results, treatments and outcomes were analyzed. ASIA criteria were applied to all patients. The mean age of patients was 28.6 ± 11 years, of which 68.4 % were females. 21.05 % had either personal or familial background of autoimmune disease. The mean latency period from the last dose of HBVv to onset of symptoms was 38.6 ± 79.4 days, ranging from days to a year. Eight (42.1 %) patients continued with the immunization program despite experiencing adverse events. Manifestations that were commonly reported included neurological manifestations (84.2 %), musculoskeletal (78.9 %), psychiatric (63.1 %), fatigue (63.1 %), gastrointestinal complains (58 %) and mucocutaneous manifestations (36.8 %). Autoantibodies were detected in 71 % of patients tested. All patients fulfilled the ASIA criteria. This study suggests that in some cases CFS and FM can be temporally related to immunization, as part of ASIA syndrome. The appearance of adverse event during immunization, the presence of autoimmune susceptibility and higher titers of autoantibodies all can be suggested as risk

  17. The concept of depression as a dysfunction of the immune system

    OpenAIRE

    Leonard, Brian E.

    2010-01-01

    Chronic stress, by initiating changes in the hypothalamic-pituitary-adrenal axis and the immune system, acts as a trigger for anxiety and depression. Both experimental and clinical evidence shows that a rise in the concentrations of proinflammatory cytokines and glucocorticoids, as occurs in chronically stressful situations and in depression, contribute to the behavioural changes associated with depression.

  18. Aflatoxin-Related Immune Dysfunction in Health and in Human Immunodeficiency Virus Disease

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    Yi Jiang

    2008-01-01

    Full Text Available Both aflatoxin and the human immunodeficiency virus (HIV cause immune suppression and millions of HIV-infected people in developing countries are chronically exposed to aflatoxin in their diets. We investigated the possible interaction of aflatoxin and HIV on immune suppression by comparing immune parameters in 116 HIV positive and 80 aged-matched HIV negative Ghanaians with high (≥0.91 pmol/mg albumin and low (<0.91 pmol/mg albumin aflatoxin B1 albumin adduct (AF-ALB levels. AF-ALB levels and HIV viral load were measured in plasma and the percentages of leukocyte immunophenotypes and cytokine expression were determined using flow cytometry. The cross-sectional comparisons found that (1 among both HIV positive and negative participants, high AF-ALB was associated with lower perforin expression on CD8+ T-cells (P=.012; (2 HIV positive participants with high AF-ALB had significantly lower percentages of CD4+ T regulatory cells (Tregs; P=.009 and naive CD4+ T cells (P=.029 compared to HIV positive participants with low AF-ALB; and (3 HIV positive participants with high AF-ALB had a significantly reduced percentage of B-cells (P=.03 compared to those with low AF-ALB. High AF-ALB appeared to accentuate some HIV associated changes in T-cell phenotypes and in B-cells in HIV positive participants.

  19. [Immune dysfunction and cognitive deficit in stress and physiological aging. Part II: New approaches to cognitive disorder prevention and treatment ].

    Science.gov (United States)

    Pukhal'skiĭ, A L; Shmarina, G V; Aleshkin, V A

    2014-01-01

    Long-term stress as well as physiological aging result in similar immunological and hormonal disturbances including hypothalamic-pituitary-adrenal) axis depletion, aberrant immune response (regulatory T-cells, Tregs, and T(h17)-lymphocyte accumulation) and decreased dehydroepian-drosterone synthesis both in the brain and in the adrenal glands. Since the main mechanisms of inflammation control, "prompt" (stress hormones) and "delayed" (Tregs), are broken, serum cytokine levels increase and become sufficient for blood-brain-barrier disruption. As a result peripheral cytokines penetrate into the brain where they begin to perform new functions. Structural and functional alterations of blood-brain-barrier as well as stress- (or age-) induced neuroinflammation promote influx of bone marrow derived dendritic cells and lymphocyte effectors into the brain parenchyma. Thereafter, mass intrusion ofpro-inflammatory mediators and immune cells having a lot of specific targets alters the brain work that we can observe both in humans and in animal experiments. The concept of stressful cognitive dysfunction, which is under consideration in this review, allows picking out several therapeutic targets: 1) reduction of excessive Treg accumulation; 2) supporting hypothalamic-pituitary-adrenal axis and inflammatory reaction attenuation; 3) recovery of dehydroepiandrosterone level; 4) improvement of blood-brain-barrier function.

  20. Gut inflammation in chronic fatigue syndrome

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    Kirchgessner Annette

    2010-10-01

    Full Text Available Abstract Chronic fatigue syndrome (CFS is a debilitating disease characterized by unexplained disabling fatigue and a combination of accompanying symptoms the pathology of which is incompletely understood. Many CFS patients complain of gut dysfunction. In fact, patients with CFS are more likely to report a previous diagnosis of irritable bowel syndrome (IBS, a common functional disorder of the gut, and experience IBS-related symptoms. Recently, evidence for interactions between the intestinal microbiota, mucosal barrier function, and the immune system have been shown to play a role in the disorder's pathogenesis. Studies examining the microecology of the gastrointestinal (GI tract have identified specific microorganisms whose presence appears related to disease; in CFS, a role for altered intestinal microbiota in the pathogenesis of the disease has recently been suggested. Mucosal barrier dysfunction promoting bacterial translocation has also been observed. Finally, an altered mucosal immune system has been associated with the disease. In this article, we discuss the interplay between these factors in CFS and how they could play a significant role in GI dysfunction by modulating the activity of the enteric nervous system, the intrinsic innervation of the gut. If an altered intestinal microbiota, mucosal barrier dysfunction, and aberrant intestinal immunity contribute to the pathogenesis of CFS, therapeutic efforts to modify gut microbiota could be a means to modulate the development and/or progression of this disorder. For example, the administration of probiotics could alter the gut microbiota, improve mucosal barrier function, decrease pro-inflammatory cytokines, and have the potential to positively influence mood in patients where both emotional symptoms and inflammatory immune signals are elevated. Probiotics also have the potential to improve gut motility, which is dysfunctional in many CFS patients.

  1. Neutralization Interfering Antibodies: A “Novel” Example of Humoral Immune Dysfunction Facilitating Viral Escape?

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    Roberto Burioni

    2012-09-01

    Full Text Available The immune response against some viral pathogens, in particular those causing chronic infections, is often ineffective notwithstanding a robust humoral neutralizing response. Several evasion mechanisms capable of subverting the activity of neutralizing antibodies (nAbs have been described. Among them, the elicitation of non-neutralizing and interfering Abs has been hypothesized. Recently, this evasion mechanism has acquired an increasing interest given its possible impact on novel nAb-based antiviral therapeutic and prophylactic approaches. In this review, we illustrate the mechanisms of Ab-mediated interference and the viral pathogens described in literature as able to adopt this “novel” evasion strategy.

  2. Neutralization Interfering Antibodies: A “Novel” Example of Humoral Immune Dysfunction Facilitating Viral Escape?

    Science.gov (United States)

    Nicasio, Mancini; Sautto, Giuseppe; Clementi, Nicola; Diotti, Roberta A.; Criscuolo, Elena; Castelli, Matteo; Solforosi, Laura; Clementi, Massimo; Burioni, Roberto

    2012-01-01

    The immune response against some viral pathogens, in particular those causing chronic infections, is often ineffective notwithstanding a robust humoral neutralizing response. Several evasion mechanisms capable of subverting the activity of neutralizing antibodies (nAbs) have been described. Among them, the elicitation of non-neutralizing and interfering Abs has been hypothesized. Recently, this evasion mechanism has acquired an increasing interest given its possible impact on novel nAb-based antiviral therapeutic and prophylactic approaches. In this review, we illustrate the mechanisms of Ab-mediated interference and the viral pathogens described in literature as able to adopt this “novel” evasion strategy. PMID:23170181

  3. Neutralization interfering antibodies: a "novel" example of humoral immune dysfunction facilitating viral escape?

    Science.gov (United States)

    Nicasio, Mancini; Sautto, Giuseppe; Clementi, Nicola; Diotti, Roberta A; Criscuolo, Elena; Castelli, Matteo; Solforosi, Laura; Clementi, Massimo; Burioni, Roberto

    2012-09-01

    The immune response against some viral pathogens, in particular those causing chronic infections, is often ineffective notwithstanding a robust humoral neutralizing response. Several evasion mechanisms capable of subverting the activity of neutralizing antibodies (nAbs) have been described. Among them, the elicitation of non-neutralizing and interfering Abs has been hypothesized. Recently, this evasion mechanism has acquired an increasing interest given its possible impact on novel nAb-based antiviral therapeutic and prophylactic approaches. In this review, we illustrate the mechanisms of Ab-mediated interference and the viral pathogens described in literature as able to adopt this "novel" evasion strategy.

  4. Possible Role of Humoral Immunity on Liver Dysfunction in Male Albino Rats

    International Nuclear Information System (INIS)

    Michael, M.I.

    2011-01-01

    Fifty male albino rats were used in this study to correlate liver function after curcumin or/and malathion intake with the levels of immunoglobulin G (IgG) and immunoglobulin M (IgM). The rats were divided into four groups, the first was the control group, the second was given malathion in drinking water (200 ppm), the third was administrated curcumin orally (70 mg/kg b.w.) 5 times /week while the fourth group received both malathion and curcumin with the same previous concentrations. Liver state was evaluated every 10 days by estimating prothrombine time (P.T.) and concentration (PC) and albumin level from blood taken from the retroorbital vein of 5 rats of the malathion group. After 40 days when there is prolongation of P.T. and hypoalbuminemia, ten rats from each group were decapitated. Liver enzymes, total protein, glucose, insulin, IgG and IgM were estimated. The data revealed that there is an increase of liver enzymes, glucose, insulin, and immunoglobulins (IgG) and (IgM) in malathion group and positive correlation between liver enzymes and immunoglobulins. These results denoted that the increase of immunoglobulins after malathion intake had no beneficial effects on the prognosis of liver condition, on the contrary, it may worsen liver state if there is some element of auto immunity, as well as the study proved that turmeric has the potential to improve the toxic effects of Malathion, whether on the functions of the liver or immune globulins.

  5. Cognitive dysfunction in Duchenne muscular dystrophy: a possible role for neuromodulatory immune molecules.

    Science.gov (United States)

    Rae, Mark G; O'Malley, Dervla

    2016-09-01

    Duchenne muscular dystrophy (DMD) is an X chromosome-linked disease characterized by progressive physical disability, immobility, and premature death in affected boys. Underlying the devastating symptoms of DMD is the loss of dystrophin, a structural protein that connects the extracellular matrix to the cell cytoskeleton and provides protection against contraction-induced damage in muscle cells, leading to chronic peripheral inflammation. However, dystrophin is also expressed in neurons within specific brain regions, including the hippocampus, a structure associated with learning and memory formation. Linked to this, a subset of boys with DMD exhibit nonprogressing cognitive dysfunction, with deficits in verbal, short-term, and working memory. Furthermore, in the genetically comparable dystrophin-deficient mdx mouse model of DMD, some, but not all, types of learning and memory are deficient, and specific deficits in synaptogenesis and channel clustering at synapses has been noted. Little consideration has been devoted to the cognitive deficits associated with DMD compared with the research conducted into the peripheral effects of dystrophin deficiency. Therefore, this review focuses on what is known about the role of full-length dystrophin (Dp427) in hippocampal neurons. The importance of dystrophin in learning and memory is assessed, and the potential importance that inflammatory mediators, which are chronically elevated in dystrophinopathies, may have on hippocampal function is also evaluated. Copyright © 2016 the American Physiological Society.

  6. Immune Activation, Immunosenescence, and Osteoprotegerin as Markers of Endothelial Dysfunction in Subclinical HIV-Associated Atherosclerosis

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    Alessandra D’Abramo

    2014-01-01

    Full Text Available HIV-infected patients have a significantly greater risk of cardiovascular disease. Several markers including osteoprotegerin have been shown to be involved in the development and progression of atherosclerosis. We investigated the relationship between T-cell phenotype, osteoprotegerin, and atherosclerosis evaluated by carotid intima-media thickness (c-IMT in 94 HIV+ patients on suppressive antiretroviral therapy with Framingham score <10%. As for the control group, 24 HIV-negative subjects were enrolled. c-IMT was assessed by ultrasound. CD4+/CD8+ T-cell activation (CD38+ HLADR+ and senescence (CD57+ CD28− were measured by flow cytometry. IL-6 and OPG levels were measured by ELISA kit. c-IMT was higher in HIV+ than in controls. Among HIV+ patients, 44.7% had pathological c-IMT (≥0.9 mm. CD8+ T-cell activation and senescence and OPG plasma levels were higher in HIV+ patients than in controls. Subjects with pathological c-IMT exhibited higher CD8+ immune activation and immunosenescence and OPG levels than subjects with normal c-IMT. Multivariate analysis showed that age, CD8+ CD38+ HLADR+, and CD8+ CD28− CD57+ were independently associated with pathological c-IMT. Several factors have been implicated in the pathogenesis of atherosclerosis in HIV patients. Immune activation and immunosenescence of CD8+ T cell together with OPG plasma levels might be associated with the development and progression of early atherosclerosis, even in the case of viral suppression.

  7. Clinical Application of Development of Nonantibiotic Macrolides That Correct Inflammation-Driven Immune Dysfunction in Inflammatory Skin Diseases

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    Carmen Rodriguez-Cerdeira

    2012-01-01

    Full Text Available Background. Inflammation-driven immune dysfunction supports the development of several chronic human disorders including skin diseases. Nonantibiotic macrolides have anti-inflammatory and/or immunomodulatory activity that suggests the exploitation of these in the treatment of skin diseases characterized by inflammatory disorders. Materials and Methods. We performed an extensive review of the nonantibiotic macrolide literature published between 2005 and 2012, including cross-references of any retrieved articles. We also included some data from our own experience. Results. Calcineurin antagonists such as tacrolimus and ascomycins (e.g., pimecrolimus act by inhibiting the activation of the nuclear factor for activated T cells (NFAT. There are new applications for these macrolides that have been available for several years and have been applied to skin and hair disorders such as atopic dermatitis, oral lichen planus, vitiligo, chronic autoimmune urticaria, rosacea, alopecia areata, pyoderma gangrenosum, Behcet’s disease, neutrophilic dermatosis, and lupus erythematosus. We also reviewed new macrolides, like rapamycin, everolimus, and temsirolimus. In addition to the literature review, we report a novel class of nonantibiotic 14-member macrocycle with anti-inflammatory and immunomodulatory effects. Conclusions. This paper summarizes the most important clinical studies and case reports dealing with the potential benefits of nonantibiotic macrolides which have opened new avenues in the development of anti-inflammatory strategies in the treatment of cutaneous disorders.

  8. CORRECTION OF HUMORAL IMMUNITY DYSFUNCTIONS IN PATIENTS WITH CHRONIC TONSILLITIS AND DIABETES MELLITUS

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    Vdovichenko N.I.

    2015-05-01

    Full Text Available In the therapy of various forms of chronic tonsillitis (CT were used as immunomodulatory agents Respibron and Licopid. Diabetes mellitus type 1 (also known as type 1 diabetes, or T1DM is one of the important factors that could significantly complicate the therapy of chronic tonsillitis. T1DM is a form of diabetes mellitus that results from the autoimmune destruction of the insulin-producing beta cells in the pancreas. The aim of our study was to explore the dynamics of immunologic indicators during the active disease and treatments in patients with various forms of chronic tonsillitis, including tonsillitis complicated with T1DM. Materials and methods. 64 patients with various forms of chronic tonsillitis in active period of disease observed during the study. Patients were divided into the following groups: 21persons with the compensate form of CT (CTC, 24 persons with the decompensate form of CT (CTD and 9 persons with the decompensate form of CT complicated with T1DM (CTD+ T1DM. The control group consisted of 15 apparently healthy persons. Concentrations of sIgA and IgA in the oropharyngeal secret were determined by the method of radial immune diffusion by Manchini. Lysozyme content was determined using the test system "Lysozyme" ("Reakompleks", Russia. Levels of lactoferrin and SLPI in the oropharyngeal secret of patients were evaluated using ELISA test systems of "BioChemMack", Russia. Patients of group CTC were divided into subgroups CTC1 and CTC2, depending on the applied treatment. Both subgroups treated with standard therapy for two weeks, on the fifteenth day of therapy patients of subgroup CTC2 received Respibron during 10 days by 1 tablet once a day and Licopid during 10 days by 1 mg once a day. Similarly patients of group CTD were divided into subgroups CTD1 and CTD2. Patients of subgroup CTD2 received therapy according to the scheme of CTC2. Patients of group CTD+ T1DM divided into subgroups CTD1+ T1DM and CTD2+ T1DM. Patients of

  9. Increased IgA responses to the LPS of commensal bacteria is associated with inflammation and activation of cell-mediated immunity in chronic fatigue syndrome.

    Science.gov (United States)

    Maes, Michael; Twisk, Frank N M; Kubera, Marta; Ringel, Karl; Leunis, Jean-Claude; Geffard, Michel

    2012-02-01

    Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is accompanied by a) systemic IgA/IgM responses against the lipopolysaccharides (LPS) of commensal bacteria; b) inflammation, e.g. increased plasma interleukin-(IL)1 and tumor necrosis factor (TNF)α; and c) activation of cell-mediated immunity (CMI), as demonstrated by increased neopterin. To study the relationships between the IgA/IgM responses to the LPS of microbiota, inflammation, CMI and the symptoms of ME/CFS we measured the IgA/IgM responses to the LPS of 6 different enterobacteria, serum IL-1, TNFα, neopterin, and elastase in 128 patients with ME/CFS and chronic fatigue (CF). Severity of symptoms was assessed by the Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale. Serum IL-1, TNFα, neopterin and elastase are significantly higher in patients with ME/CFS than in CF patients. There are significant and positive associations between the IgA responses to LPS and serum IL-1, TNFα, neopterin and elastase. Patients with an abnormally high IgA response show increased serum IL-1, TNFα and neopterin levels, and higher ratings on irritable bowel syndrome (IBS) than subjects with a normal IgA response. Serum IL-1, TNFα and neopterin are significantly related to fatigue, a flu-like malaise, autonomic symptoms, neurocognitive disorders, sadness and irritability. The findings show that increased IgA responses to commensal bacteria in ME/CFS are associated with inflammation and CMI activation, which are associated with symptom severity. It is concluded that increased translocation of commensal bacteria may be responsible for the disease activity in some ME/CFS patients. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Immunization

    Science.gov (United States)

    ... a lot worse. Some are even life-threatening. Immunization shots, or vaccinations, are essential. They protect against things like measles, ... B, polio, tetanus, diphtheria, and pertussis (whooping cough). Immunizations are important for adults as well as children. ...

  11. Changes of serum endocrine hormone levels in patients with cancerrelated fatigue and their correlation with anti-tumor immune response and tumor load

    Directory of Open Access Journals (Sweden)

    Lu Yang

    2017-08-01

    Full Text Available Objective: To study the changes of serum endocrine hormone levels in patients with cancerrelated fatigue (CRF and their correlation with anti-tumor immune response and tumor load. Methods: A total of 137 patients who were diagnosed with primary lung cancer in West China Hospital, Sichuan University between June 2014 and November 2016 were selected and then divided into CRF group and control group according to their self-reported symptoms, serum was collected to determine the levels of endocrine hormones and tumor markers, and peripheral blood was collected to detect the levels of immune cells. Results: Serum ACTH and TSH levels of CRF group were significantly higher than those of control group while Cor, FT3 and FT4 levels were significantly lower than those of control group; peripheral blood CD11b+ CD15 - CD33+ CD14+ M-MDSC, CD11b+ CD15-CD33+ CD14- G-MDSC, CD4+ CD25+ CD127lowTreg and CD19+ CD5+ CD1d+ Breg levels as well as serum CEA, Cyfra21-1, SCC-Ag, HE4, GDF- 15 and PCNA levels of CRF group were significantly higher than those of control group, positively correlated with serum ACTH and TSH levels, and negatively correlated with Cor, FT3 and FT4 levels. Conclusion: The changes of thyroid hormone and adrenal cortical hormone levels in patients with cancer-related fatigue are closely related to the inhibited antitumor immune response and increased tumor load.

  12. Immune modulation with a staphylococcal preparation in fibromyalgia/chronic fatigue syndrome: relation between antibody levels and clinical improvement.

    Science.gov (United States)

    Zachrisson, O; Colque-Navarro, P; Gottfries, C G; Regland, B; Möllby, R

    2004-02-01

    The aims of this study were to evaluate the serological response to treatment with staphylococcal vaccine in fibromyalgia/chronic fatigue syndrome patients and to explore the relationship between serological response and clinical effect. Twenty-eight patients, half of whom served as controls, were recruited from a 6-month randomised trial in which repeated administration of the staphylococcal toxoid vaccine Staphypan Berna (Berna Biotech, Switzerland) was tested against placebo. Antibody status against extracellular toxins/enzymes, cell-wall components, and enterotoxins was evaluated at baseline and at endpoint. The clinical response to treatment was recorded in rating scales. In the group receiving active treatment, significant serological changes were recorded, whereas no significant changes were found in controls. Treatment led to a significantly increased capacity of serum to neutralise alpha-toxin and a significant increase in serum IgG to alpha-toxin and lipase. Furthermore, the increase in these parameters combined paralleled the improvement in clinical outcome. Thus, the greater the serological response, the greater was the clinical effect. In conclusion, this explorative study has shown that repeated administration of the Staphypan Berna vaccine in patients with fibromyalgia/chronic fatigue syndrome causes a serological response to several staphylococcal antigens, particularly to certain extracellular toxins and enzymes. The results further show that this response is related to the clinical outcome of treatment.

  13. Activation of cell-mediated immunity in depression: association with inflammation, melancholia, clinical staging and the fatigue and somatic symptom cluster of depression.

    Science.gov (United States)

    Maes, Michael; Mihaylova, Ivana; Kubera, Marta; Ringel, Karl

    2012-01-10

    Depression is characterized by activation of cell-mediated immunity (CMI), including increased neopterin levels, and increased pro-inflammatory cytokines (PICs), such as interleukin-1 (IL-1) and tumor necrosis factor-α (TNFα). These PICs may induce depressive, melancholic and chronic fatigue (CF) symptoms. We examined serum neopterin and plasma PIC levels in depressive subgroups in relation to the depressive subtypes and the melancholic and CF symptoms of depression. Participants were 85 patients with depression and in 26 normal controls. Severity of depression was assessed with the Hamilton Depression Rating Scale (HDRS) and severity of CF with the Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale. Serum neopterin was significantly higher in depressed patients and in particular in those with melancholia. There were positive correlations between serum neopterin, the plasma PICs and the number of previous depressive episodes. Neopterin and TNFα were associated with melancholia, while both PICs were associated with CF. Melancholia-group membership was predicted by the HDRS and neopterin, and CF group membership by age, the FF score and serum TNFα. Depression and melancholia are accompanied by CMI activation, suggesting that neopterin plays a role in their pathophysiology, e.g. through activation of oxidative and nitrosative stress and apoptosis pathways. The intertwined CMI and inflammatory responses are potentially associated with the onset of depression and with the melancholic and CF symptoms of depression. Exposure to previous depressive episodes may magnify the size of CMI and PIC responses, possibly increasing the likelihood of new depressive episodes. CMI activation and inflammation may contribute to the staging or recurrence of depression. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Interactions between host metabolism, immune regulation, and the gut microbiota in diet-associated obesity and metabolic dysfunction

    DEFF Research Database (Denmark)

    Andersen, Daniel

    The increase in the prevalence of obesity and obesity-associated complications such as the metabolic syndrome is becoming a global challenge. Dietary habits and nutrient consumption modulates host homeostasis, which manifests in various diet-induced complications marked by changes in host...... metabolism and immune regulation, which are intricately linked. In addition, diet effectively shapes the gut microbiota composition and activity, which in turn interacts with the host to modulate host metabolism and immune regulation. In the three studies included in this PhD thesis, we have explored...... the impact of specific dietary components on host metabolic function, immune regulation and gut microbiota composition and activity. In the first study, we have characterized the effect of a combined high-fat and gliadin-rich diet, since dietary gliadin has been reported to be associated with intestinal...

  15. Radiotherapy-related fatigue.

    Science.gov (United States)

    Jereczek-Fossa, Barbara Alicja; Marsiglia, Hugo Raul; Orecchia, Roberto

    2002-03-01

    Radiotherapy-induced fatigue is a common early and chronic side-effect of irradiation, reported in up to 80 and 30% of patients during radiation therapy and at follow-up visits, respectively. It is frequently underestimated by medical and nursing staff, only about 50% of patients discuss it with a physician and in one fourth of cases any intervention is proposed to the patient. The patients rarely expect fatigue to be a side-effect of treatment. The etiology of this common symptom, its correlates and prevalence are poorly understood. In numerous studies the level and time course of fatigue was demonstrated to depend on the site of tumor and treatment modalities. For example, psychological mechanisms have been proposed to explain fatigue in women receiving irradiation for early breast cancer, whereas decline in neuromuscular efficiency rather than psychological reasons can lead to the fatigue observed in patients undergoing radiotherapy for prostate cancer. Fatigue can affect global quality of life more than pain, sexual dysfunction and other cancer- or treatment-related symptoms. Several interventions have been tested in the management of radiotherapy-related fatigue and some randomized studies have been recently published. Although an optimal method has not yet been established, some promising results have been reported with relaxation therapy, group psychotherapy, physical exercise and sleep. Further methodologically correct studies are warranted to define better the causes, optimal prevention and management of this symptom.

  16. Evidence for inflammation and activation of cell-mediated immunity in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): increased interleukin-1, tumor necrosis factor-α, PMN-elastase, lysozyme and neopterin.

    Science.gov (United States)

    Maes, Michael; Twisk, Frank N M; Kubera, Marta; Ringel, Karl

    2012-02-01

    There is evidence that inflammatory pathways and cell-mediated immunity (CMI) play an important role in the pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Activation of inflammatory and CMI pathways, including increased levels of cytokines, is known to induce fatigue and somatic symptoms. Given the broad spectrum inflammatory state in ME/CFS, the aim of this study was to examine whether inflammatory and CMI biomarkers are increased in individuals with ME/CFS. In this study we therefore measured plasma interleukin-(IL)1, tumor necrosis factor (TNF)α, and PMN-elastase, and serum neopterin and lysozyme in 107 patients with ME/CFS, 37 patients with chronic fatigue (CF), and 20 normal controls. The severity of ME/CFS was measured with the Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale. Serum IL-1, TNFα, neopterin and lysozyme are significantly higher in patients with ME/CFS than in controls and CF patients. Plasma PMN-elastase is significantly higher in patients with ME/CFS than in controls and CF patients and higher in the latter than in controls. Increased IL-1 and TNFα are significantly correlated with fatigue, sadness, autonomic symptoms, and a flu-like malaise; neopterin is correlated with fatigue, autonomic symptoms, and a flu-like malaise; and increased PMN-elastase is correlated with concentration difficulties, failing memory and a subjective experience of infection. The findings show that ME/CFS is characterized by low-grade inflammation and activation of CMI. The results suggest that characteristic symptoms of ME/CFS, such as fatigue, autonomic symptoms and a flu-like malaise, may be caused by inflammatory mediators, e.g. IL-1 and TNFα. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. Comparison of Watermelon and Carbohydrate Beverage on Exercise-Induced Alterations in Systemic Inflammation, Immune Dysfunction, and Plasma Antioxidant Capacity

    Directory of Open Access Journals (Sweden)

    R. Andrew Shanely

    2016-08-01

    Full Text Available Consuming carbohydrate- and antioxidant-rich fruits during exercise as a means of supporting and enhancing both performance and health is of interest to endurance athletes. Watermelon (WM contains carbohydrate, lycopene, l-citrulline, and l-arginine. WM may support exercise performance, augment antioxidant capacity, and act as a countermeasure to exercise-induced inflammation and innate immune changes. Trained cyclists (n = 20, 48 ± 2 years participated in a randomized, placebo controlled, crossover study. Subjects completed two 75 km cycling time trials after either 2 weeks ingestion of 980 mL/day WM puree or no treatment. Subjects drank either WM puree containing 0.2 gm/kg carbohydrate or a 6% carbohydrate beverage every 15 min during the time trials. Blood samples were taken pre-study and pre-, post-, 1 h post-exercise. WM ingestion versus no treatment for 2-weeks increased plasma l-citrulline and l-arginine concentrations (p < 0.0125. Exercise performance did not differ between WM puree or carbohydrate beverage trials (p > 0.05, however, the rating of perceived exertion was greater during the WM trial (p > 0.05. WM puree versus carbohydrate beverage resulted in a similar pattern of increase in blood glucose, and greater increases in post-exercise plasma antioxidant capacity, l-citrulline, l-arginine, and total nitrate (all p < 0.05, but without differences in systemic markers of inflammation or innate immune function. Daily WM puree consumption fully supported the energy demands of exercise, and increased post-exercise blood levels of WM nutritional components (l-citrulline and l-arginine, antioxidant capacity, and total nitrate, but without an influence on post-exercise inflammation and changes in innate immune function.

  18. Dysfunction of Arabidopsis MACPF domain protein activates programmed cell death via tryptophan metabolism in MAMP-triggered immunity.

    Science.gov (United States)

    Fukunaga, Satoshi; Sogame, Miho; Hata, Masaki; Singkaravanit-Ogawa, Suthitar; Piślewska-Bednarek, Mariola; Onozawa-Komori, Mariko; Nishiuchi, Takumi; Hiruma, Kei; Saitoh, Hiromasa; Terauchi, Ryohei; Kitakura, Saeko; Inoue, Yoshihiro; Bednarek, Paweł; Schulze-Lefert, Paul; Takano, Yoshitaka

    2017-01-01

    Plant immune responses triggered upon recognition of microbe-associated molecular patterns (MAMPs) typically restrict pathogen growth without a host cell death response. We isolated two Arabidopsis mutants, derived from accession Col-0, that activated cell death upon inoculation with nonadapted fungal pathogens. Notably, the mutants triggered cell death also when treated with bacterial MAMPs such as flg22. Positional cloning identified NSL1 (Necrotic Spotted Lesion 1) as a responsible gene for the phenotype of the two mutants, whereas nsl1 mutations of the accession No-0 resulted in necrotic lesion formation without pathogen inoculation. NSL1 encodes a protein of unknown function containing a putative membrane-attack complex/perforin (MACPF) domain. The application of flg22 increased salicylic acid (SA) accumulation in the nsl1 plants derived from Col-0, while depletion of isochorismate synthase 1 repressed flg22-inducible lesion formation, indicating that elevated SA is needed for the cell death response. nsl1 plants of Col-0 responded to flg22 treatment with an RBOHD-dependent oxidative burst, but this response was dispensable for the nsl1-dependent cell death. Surprisingly, loss-of-function mutations in PEN2, involved in the metabolism of tryptophan (Trp)-derived indole glucosinolates, suppressed the flg22-induced and nsl1-dependent cell death. Moreover, the increased accumulation of SA in the nsl1 plants was abrogated by blocking Trp-derived secondary metabolite biosynthesis, whereas the nsl1-dependent hyperaccumulation of PEN2-dependent compounds was unaffected when the SA biosynthesis pathway was blocked. Collectively, these findings suggest that MAMP-triggered immunity activates a genetically programmed cell death in the absence of the functional MACPF domain protein NSL1 via Trp-derived secondary metabolite-mediated activation of the SA pathway. © 2016 The Authors The Plant Journal © 2016 John Wiley & Sons Ltd.

  19. Immune response against the coiled coil domain of Sjögren's syndrome associated autoantigen Ro52 induces salivary gland dysfunction.

    Science.gov (United States)

    Sroka, Magdalena; Bagavant, Harini; Biswas, Indranil; Ballard, Abigail; Deshmukh, Umesh S

    2018-01-31

    The structural domains of Ro52, termed the RING, B-box, coiled coil (CC) and B30.2/SPRY are targets of anti-Ro52 in multiple autoimmune disorders. In Sjögren's syndrome patients, the presence of anti-Ro52 is associated with higher disease severity, and in mice, they induce salivary gland hypofunction. This study was undertaken to investigate whether immune responses against different domains of Ro52, influences salivary gland disease in mice. Female NZM2758 mice were immunised with Ro52 domains expressed as recombinant fusion proteins with maltose binding protein (MBP) [MBP-RING-B-box, MBP-CC, MBP-CC(ΔC19), MBP-B30.2/SPRY]. Sera from immunised mice were studied for IgG antibodies to Ro52 by immunoprecipitation, and to salivary gland cells by immunofluorescence. Pilocarpine-induced saliva production was measured to evaluate salivary gland function. Submandibular glands were investigated by histopathology for inflammation and by immune-histochemistry for IgG deposition. Mice immunised with different Ro52-domains had comparable reactivity to Ro52 and to salivary gland cells. However, only mice immunised with the CC domain and its C-terminal truncated version CC(ΔC19) showed a significant drop in saliva production. None of the mice developed severe salivary gland inflammation. The salivary gland hypofunction significantly correlated with increased intra-lobar IgG deposits in the submandibular salivary glands. Our data demonstrate that epitope specificity of anti-Ro52 antibodies plays a critical role in the induction of glandular dysfunction. Clearly, screening Sjögren's syndrome patients for relative levels of Ro52 domain specific antibodies will be more informative for associating anti-Ro52 with clinical measures of the disorder.

  20. Association of nutrition and immune-endocrine dysfunction with muscle mass and performance in cognitively impaired older adults.

    Science.gov (United States)

    Tay, L; Leung, B P; Wee, S; Tay, K S; Ali, N; Chan, M; Lim, W S

    With lean mass declining early in Alzheimer's disease, muscle quality beyond quantity is relevant to physical performance. We sought to identify potentially modifiable factors for the differential loss of muscle mass (pre-sarcopenia) and its performance (sarcopenia) in older adults with mild cognitive impairment (MCI) and mild-to-moderate Alzheimer's disease (AD). This is a cross-sectional study of 108 community-dwelling older adults with MCI and mild-to-moderate AD. Participants were categorized as: (i) No sarcopenia (normal muscle mass), (ii) Pre-sarcopenia (low muscle mass without weakness or slowness), (iii) Sarcopenia (low muscle mass AND weak grip strength and/or slow gait speed) using Asian cut-offs. Muscle quality was defined as the ratio of grip and knee extension strength to average arm and leg lean mass respectively. We measured cognitive, functional and physical (Short Physical Performance Battery, SPPB) performance; physical activity level; nutritional status; and blood biomarkers of inflammation and endocrine dysfunction. SPPB (p=0.033) and activity level (p=0.010) were highest in the pre-sarcopenic group. Pre-sarcopenic group had highest arm muscle quality [10.6 (7.7-12.2) vs 13.9 (12.6-15.7) vs 11.3 (9.7-12.8), p<0.001], despite significantly lower appendicular lean mass than non-sarcopenic group. In multi-nomial logistic regression reference to non-sarcopenic group, malnutrition independently increased risk for both pre-sarcopenia (Relative risk=7.53, 95% C.I 1.20-47.51, p=0.032) and sarcopenia (Relative risk=11.91, 95% C.I 2.85-49.77, p=0.001). A combined pro-inflammatory and endocrine deficient state significantly increased the risk of sarcopenia (Relative risk=5.17, 95% C.I 1.31-20.37, p=0.019). Malnutrition is a precursor for progressive loss of muscle mass, but a pro-inflammatory and endocrine deficient state may potentially aggravate decline in muscle quality to culminate in frank sarcopenia. Copyright © 2017 Elsevier B.V. All rights

  1. Effects of Chinese medicine shen-fu injection on the expression of inflammatory cytokines and complements during post-resuscitation immune dysfunction in a porcine model.

    Science.gov (United States)

    Zhang, Qian; Li, Chun-sheng; Wang, Shuo; Gu, Wei

    2016-02-01

    To investigate the action of Shen-Fu Injection (SFI) in regulating the expression of the serum complements and inflammatory cytokines synthesized and released in response to the stress of global ischemia accompanying cardiac arrest (CA) and resuscitation. Thirty pigs were randomly divided into the sham (n=6) and 3 returns of spontaneous circulation (ROSC) groups (n=24). After 8-min untreated ventricular fibrillation and 2-min basic life support, 24 pigs of the ROSC groups were randomized into three groups (n=8 per group), which received central venous injection of SFI (SFI group), epinephrine (EP group), or saline (SA group). Hemodynamic status and blood samples were obtained at 0, 0.5, 1, 2, 4, 6, 12, and 24 h after ROSC. Serum concentrations of specific activation markers of the complement system C3, C4 and C5b-9 were increased during cardiopulmonary resuscitation through 24 h after ROSC. There were intense changes of various pro-inflammatory cytokines and anti-inflammatory cytokines as early as 0.5 h after CA. Compared with the EP and SA groups, SFI treatment reduced the proinflammatory cytokines levels of interleukin (IL)-6, IL-8 and tumor necrosis factor α (TNF-α, Pcytokine levels of IL-4 and IL-10 (Pcytokines levels. The current study provided an experimental basis for the clinical application of a potential pharmacologic target for post resuscitation immune dysfunction.

  2. Fatigue in cholestatic liver disease—a perplexing symptom

    OpenAIRE

    Kumar, D; Tandon, R

    2002-01-01

    Fatigue is an important symptom and a quality of life determinant in patients with cholestatic liver disease. The pathogenesis of fatigue is obscure, although alterations in central neurotransmission and peripheral muscle dysfunction have been incriminated. No effective treatment is available at present. The available literature on fatigue in cholestatic liver disease is reviewed.

  3. Traditional Chinese Medicine for Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Rui Chen

    2010-01-01

    Full Text Available More and more patients have been diagnosed as having chronic fatigue syndrome (CFS in recent years. Western drug use for this syndrome is often associated with many side-effects and little clinical benefit. As an alternative medicine, traditional Chinese medicine (TCM has provided some evidences based upon ancient texts and recent studies, not only to offer clinical benefit but also offer insights into their mechanisms of action. It has perceived advantages such as being natural, effective and safe to ameliorate symptoms of CFS such as fatigue, disordered sleep, cognitive handicaps and other complex complaints, although there are some limitations regarding the diagnostic standards and methodology in related clinical or experimental studies. Modern mechanisms of TCM on CFS mainly focus on adjusting immune dysfunction, regulating abnormal activity in the hypothalamic-pituitary-adrenal (HPA axis and serving as an antioxidant. It is vitally important for the further development to establish standards for ‘zheng’ of CFS, i.e. the different types of CFS pathogenesis in TCM, to perform randomized and controlled trials of TCM on CFS and to make full use of the latest biological, biochemical, molecular and immunological approaches in the experimental design.

  4. Immunophenotyping in post-giardiasis functional gastrointestinal disease and chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Hanevik Kurt

    2012-10-01

    Full Text Available Abstract Background A Giardia outbreak was associated with development of post-infectious functional gastrointestinal disorders (PI-FGID and chronic fatigue syndrome (PI-CFS. Markers of immune dysfunction have given conflicting results in CFS and FGID patient populations. The aim of this study was to evaluate a wide selection of markers of immune dysfunction in these two co-occurring post-infectious syndromes. Methods 48 patients, reporting chronic fatigue in a questionnaire study, were clinically evaluated five years after the outbreak and grouped according to Fukuda criteria for CFS (n=19 and idiopathic chronic fatigue (n=5 and Rome II criteria for FGIDs (n=54. 22 Giardia exposed non-fatigued individuals and 10 healthy unexposed individuals were recruited as controls. Peripheral blood lymphocyte subsets were analyzed by flow cytometry. Results In peripheral blood we found significantly higher CD8 T-cell levels in PI-FGID, and significantly lower NK-cell levels in PI-CFS patients. Severity of abdominal and fatigue symptoms correlated negatively with NK-cell levels. A tendency towards lower T-cell CD26 expression in FGID was seen. Conclusion Patients with PI-CFS and/or PI-FGID 5 years after Giardia lamblia infection showed alterations in NK-cell and CD8-cell populations suggesting a possible immunological abnormality in these conditions. We found no significant changes in other markers examined in this well-defined group of PI-CFS and PI-FGID elicited by a gastrointestinal infection. Controlling for co-morbid conditions is important in evaluation of CFS-biomarkers.

  5. Seafarer fatigue

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis; Zhao, Zhiwei; van Leeuwen, Wessel M. A.

    2015-01-01

    Background: The consequences of fatigue for the health and safety of seafarers has caused concern in the industry and among academics, and indicates the importance of further research into risk factors and preventive interventions at sea. This review gives an overview of the key issues relating...... to seafarer fatigue. Materials and methods: A literature study was conducted aiming to collect publications that address risk factors for fatigue, short-term and long-term consequences for health and safety, and options for fatigue mitigation at sea. Due to the limited number of publications that deals...

  6. Clinical investigation of athletes with persistent fatigue and/or recurrent infections.

    Science.gov (United States)

    Reid, V L; Gleeson, M; Williams, N; Clancy, R L

    2004-02-01

    To investigate whether underlying medical conditions contribute to the fatigue and high incidence of infections that can occur during repeated intense training. Forty one competitive athletes (22 male, 19 female) with persistent fatigue and/or recurrent infections associated with performance decrements had a thorough medical examination and a series of clinical investigations to identify potential medical causes. Conditions with the potential to cause fatigue and/or recurrent infections were identified in 68% of the athletes. The most common were partial humoral immune deficiency (28%) and unresolved viral infections (27%). Non-fasting hypoglycaemia was common (28%). Other conditions included allergic disease (15%), new or poorly controlled asthma (13%), upper airway dysfunction (5%), sleep disorders (15%), iron depletion (3%), and one case of a thyroid disorder. A positive antinuclear antibody was detected in 21% of the athletes, without any clinical evidence of autoimmune disorders. Evidence of Epstein-Barr virus reactivation was detected in 22% of the athletes tested. Athletes with recurrent infections, fatigue, and associated poor performance may benefit from a thorough investigation of potentially reversible underlying medical conditions, especially when these conditions cause disruption to training and competition. Unresolved viral infections are not routinely assessed in elite athletes, but it may be worth considering in those experiencing fatigue and performing poorly.

  7. Physical exercise for functional capacity, blood immune function, fatigue, and quality of life in high-risk prostate cancer patients during radiotherapy: a prospective, randomized clinical study.

    Science.gov (United States)

    Hojan, Katarzyna; Kwiatkowska-Borowczyk, Eliza; Leporowska, Ewa; Górecki, Maciej; Ozga-Majchrzak, Owidia; Milecki, Tomasz; Milecki, Piotr

    2016-08-01

    During radiotherapy (RT), prostate cancer (PCa) patients may report cancer related fatigue (CRF), which impairs functional capacity, psychological status, and quality of life (QoL). RT can induce cytokine responses that could play a role in mediating radiation toxicity by increasing inflammation. While it is known that physical exercise plays an important anti-inflammatory role in healthy adults, its specific anti-inflammatory effects in PCa patients with CRF have not yet been determined. Previous studies have shown that physical exercise in cancer patients undergoing RT improves cardiac fitness, muscle strength, and QoL, however it is still unknown how physical exercise affects inflammation and its specific consequences in PCa patients. Therefore, the purpose of this trial was to examine the effect of supervised physical exercise on inflammatory blood markers, as well as the relationship of these parameters with functional capacity, fatigue, and QoL in high-risk PCa patients undergoing RT. This was a prospective, two-arm randomized controlled clinical trial. The study was performed in our outpatients center. Fifty-four high-risk PCa men were randomly allocated to two groups prior to undergoing RT. Twenty-seven patients performed supervised, moderate-intensity physical exercise (exercise group; EG) and the other 27 formed a control group that carried out normal daily physical activity (usual group; UG). The following parameters were assessed before and after RT: functional capacity, changes in blood count variables and production of pro-inflammatory cytokines (interleukin [IL]-1β, IL-6, tumor necrosis factor [TNF]-α), fatigue, and QoL (using FACT-F score and EORTC questionnaires). No significant differences existed between the study groups at baseline assessment. After RT, there was a significant improvement in functional capacity (P0.05) and fatigue (PFatigue level was significantly higher in the UG (F[2.126]; Pfatigue scores provided by study participants

  8. HIV and thyroid dysfunction.

    Science.gov (United States)

    Parsa, Alan A; Bhangoo, Amrit

    2013-06-01

    Human Immunodeficiency virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS) are associated with dysfunction of many endocrine organs and their axis. HIV infectivity leads to altered metabolism, poor oral intake and increased prevalence of weight loss and wasting which may have a role in thyroid dysfunction. Overt thyroid dysfunction occurs at similar rates as the general population while subclinical disease such as nonthyroidal illness (sick euthyroid syndrome), subclinical hypothyroidism and isolated low T4 levels are more frequent. Moreover, HAART therapy can complicate thyroid function further through drug interactions and the immune reconstitution inflammatory syndrome (IRIS). In this review we report the common thyroid dysfunctions associated with HIV before and after HAART therapy. We discuss presentation, diagnostic work up, treatment and follow up in each condition.

  9. Chronic fatigue in Ehlers-Danlos syndrome-Hypermobile type.

    Science.gov (United States)

    Hakim, Alan; De Wandele, Inge; O'Callaghan, Chris; Pocinki, Alan; Rowe, Peter

    2017-03-01

    Chronic fatigue is an important contributor to impaired health-related quality of life in Ehlers-Danlos syndrome. There is overlap in the symptoms and findings of EDS and chronic fatigue syndrome. A proportion of those with CFS likely have EDS that has not been identified. The evaluation of chronic fatigue in EDS needs to include a careful clinical examination and laboratory testing to exclude common causes of fatigue including anemia, hypothyroidisim, and chronic infection, as well as dysfunction of major physiological or organ systems. Other problems that commonly contribute to fatigue in EDS include sleep disorders, chronic pain, deconditioning, cardiovascular autonomic dysfunction, bowel and bladder dysfunction, psychological issues, and nutritional deficiencies. While there is no specific pharmacological treatment for fatigue, many medications are effective for specific symptoms (such as headache, menstrual dysfunction, or myalgia) and for co-morbid conditions that result in fatigue, including orthostatic intolerance and insomnia. Comprehensive treatment of fatigue needs to also evaluate for biomechanical problems that are common in EDS, and usually involves skilled physical therapy and attention to methods to prevent deconditioning. In addition to managing specific symptoms, treatment of fatigue in EDS also needs to focus on maintaining function and providing social, physical, and nutritional support, as well as providing on-going medical evaluation of new problems and review of new evidence about proposed treatments. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  10. [Auditory fatigue].

    Science.gov (United States)

    Sanjuán Juaristi, Julio; Sanjuán Martínez-Conde, Mar

    2015-01-01

    Given the relevance of possible hearing losses due to sound overloads and the short list of references of objective procedures for their study, we provide a technique that gives precise data about the audiometric profile and recruitment factor. Our objectives were to determine peripheral fatigue, through the cochlear microphonic response to sound pressure overload stimuli, as well as to measure recovery time, establishing parameters for differentiation with regard to current psychoacoustic and clinical studies. We used specific instruments for the study of cochlear microphonic response, plus a function generator that provided us with stimuli of different intensities and harmonic components. In Wistar rats, we first measured the normal microphonic response and then the effect of auditory fatigue on it. Using a 60dB pure tone acoustic stimulation, we obtained a microphonic response at 20dB. We then caused fatigue with 100dB of the same frequency, reaching a loss of approximately 11dB after 15minutes; after that, the deterioration slowed and did not exceed 15dB. By means of complex random tone maskers or white noise, no fatigue was caused to the sensory receptors, not even at levels of 100dB and over an hour of overstimulation. No fatigue was observed in terms of sensory receptors. Deterioration of peripheral perception through intense overstimulation may be due to biochemical changes of desensitisation due to exhaustion. Auditory fatigue in subjective clinical trials presumably affects supracochlear sections. The auditory fatigue tests found are not in line with those obtained subjectively in clinical and psychoacoustic trials. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  11. Gut inflammation in chronic fatigue syndrome

    OpenAIRE

    Lakhan, Shaheen E; Kirchgessner, Annette

    2010-01-01

    Abstract Chronic fatigue syndrome (CFS) is a debilitating disease characterized by unexplained disabling fatigue and a combination of accompanying symptoms the pathology of which is incompletely understood. Many CFS patients complain of gut dysfunction. In fact, patients with CFS are more likely to report a previous diagnosis of irritable bowel syndrome (IBS), a common functional disorder of the gut, and experience IBS-related symptoms. Recently, evidence for interactions between the intestin...

  12. Exercise, inflammation, and fatigue in cancer survivors

    OpenAIRE

    LaVoy, Emily C.P.; Fagundes, Christopher P.; Dantzer, Robert

    2016-01-01

    Cancer-related fatigue significantly disrupts normal functioning and quality of life for a substantial portion of cancer survivors, and may persist for years following cancer treatment. While the causes of persistent fatigue among cancer survivors are not yet fully understood, accumulating evidence suggests that several pathways, including chronic inflammation, autonomic imbalance, HPA-axis dysfunction, and/or mitochondrial damage, could contribute towards the disruption of normal neuronal fu...

  13. Managing fatigue in the syncope unit.

    Science.gov (United States)

    Newton, Julia L

    2012-12-01

    The symptom of fatigue is frequently described by patients attending the syncope unit with a wide range of conditions including vasovagal syncope and postural orthostatic tachycardia syndrome. It is possible that the presence of autonomic dysfunction provides the common pathogenetic mechanism linking neurally mediated hypotension and fatigue. Managing this debilitating symptom can often be challenging but, with a structured approach, immensely rewarding, and as a result improve how patients cope with their disease.

  14. A multi-ingredient containing carbohydrate, proteins L-glutamine and L-carnitine attenuates fatigue perception with no effect on performance, muscle damage or immunity in soccer players.

    Directory of Open Access Journals (Sweden)

    Fernando Naclerio

    Full Text Available We investigated the effects of ingesting a multi-ingredient (53 g carbohydrate, 14.5 g whey protein, 5 g glutamine, 1.5 g L-carnitine-L-tartrate supplement, carbohydrate only, or placebo on intermittent performance, perception of fatigue, immunity, and functional and metabolic markers of recovery. Sixteen amateur soccer players ingested their respective treatments before, during and after performing a 90-min intermittent repeated sprint test. Primary outcomes included time for a 90-min intermittent repeated sprint test (IRS followed by eleven 15 m sprints. Measurements included creatine kinase, myoglobin, interleukine-6, Neutrophil; Lymphocytes and Monocyte before (pre, immediately after (post, 1 h and 24 h after exercise testing period. Overall, time for the IRS and 15 m sprints was not different between treatments. However, the perception of fatigue was attenuated (P<0.001 for the multi-ingredient (15.9±1.4 vs. placebo (17.8±1.4 but not for the carbohydrate (17.0±1.9 condition. Several changes in immune/inflammatory indices were noted as creatine kinase peaked at 24 h while Interleukin-6 and myoglobin increased both immediately after and at 1 h compared with baseline (P<0.05 for all three conditions. However, Myoglobin (P<0.05 was lower 1 h post-exercise for the multi-ingredient (241.8±142.6 ng·ml(-1 and CHO (265.4±187.8 ng·ml(-1 vs. placebo (518.6±255.2 ng·ml(-1. Carbohydrate also elicited lower neutrophil concentrations vs. multi-ingredient (3.9±1.5 10(9/L vs. 4.9±1.8 10(9/L, P = 0.016 and a reduced (P<0.05 monocytes count (0.36±0.09 10(9/L compared to both multi-ingredient (0.42±0.09 10(9/L and placebo (0.42±0.12 10(9/L. In conclusion, multi-ingredient and carbohydrate supplements did not improve intermittent performance, inflammatory or immune function. However, both treatments did attenuate serum myoglobin, while only carbohydrate blunted post-exercise leukocytosis.

  15. Gender differences in chronic fatigue syndrome.

    Science.gov (United States)

    Faro, Mònica; Sàez-Francás, Naia; Castro-Marrero, Jesús; Aliste, Luisa; Fernández de Sevilla, Tomás; Alegre, José

    2016-01-01

    Chronic fatigue syndrome (CFS) is a chronic condition that predominantly affects women. To date, there are few epidemiologic studies on CFS in men. The objective of the study was to assess whether there are gender-related differences in CFS, and to define a clinical phenotype in men. A prospective, cross-sectional cohort study was conducted including CFS patients at the time of diagnosis. Sociodemographic data, clinical variables, comorbid phenomena, fatigue, pain, anxiety/depression, and health quality of life, were assessed in the CFS population. A comparative study was also conducted between genders. The study included 1309 CFS patients, of which 119 (9.1%) were men. The mean age and symptoms onset were lower in men than women. The subjects included 30% single men vs. 15% single women, and 32% of men had specialist work vs. 20% of women. The most common triggering factor was an infection. Widespread pain, muscle spasms, dizziness, sexual dysfunction, Raynaud's phenomenon, morning stiffness, migratory arthralgias, drug and metals allergy, and facial oedema were less frequent in men. Fibromyalgia was present in 29% of men vs. 58% in women. The scores on physical function, physical role, and overall physical health of the SF-36 were higher in men. The sensory and affective dimensions of pain were lower in men. The clinical phenotype of the men with CFS was young, single, skilled worker, and infection as the main triggering agent. Men had less pain and less muscle and immune symptoms, fewer comorbid phenomena, and a better quality of life. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  16. Immunization Safety Review: Multiple Immunizations and Immune Dysfunction

    National Research Council Canada - National Science Library

    Stratton, Kathleen; Wilson, Christopher B; McCormick, Marie C

    2002-01-01

    .... Specifically, the committee looked at evidence of potential biological mechanisms and at epidemiological evidence for or against causality related to risk for infections, the autoimmune disease type...

  17. Orgasmic dysfunction

    Science.gov (United States)

    ... occurs less often. This can create resentment and conflict in the relationship. Causes About 10% to 15% ... relationship Fatigue and stress or depression Lack of knowledge about sexual function Negative feelings about sex (often ...

  18. Fatigue (PDQ)

    Science.gov (United States)

    ... can lessen the patient's quality of life and self-esteem . Getting help with fatigue may prevent some of ... National Institutes of Health FOLLOW US Facebook Twitter Instagram YouTube Google+ LinkedIn GovDelivery RSS CONTACT INFORMATION Contact ...

  19. The uremic environment and muscle dysfunction in man and rat

    DEFF Research Database (Denmark)

    Harrison, Adrian Paul; Nielsen, Arne Høj; Eidemak, I.

    2006-01-01

    Background: Patients reaching end-stage renal disease experience debilitating fatigue, with progression of this disease, rendering patients dysfunctional in their everyday lives. Methods: In vivo measurements of muscle function, assessed using surface electromyography (EMG), were made on 25...

  20. Is chronic fatigue syndrome an autoimmune disorder of endogenous neuropeptides, exogenous infection and molecular mimicry?

    Science.gov (United States)

    Staines, Donald R

    2004-01-01

    documented symptoms of CFS are explained by vasoactive neuropeptide compromise, namely fatigue and nervous system dysfunction through impaired acetylcholine activity, myalgia through nitric oxide and endogenous opioid dysfunction, chemical sensitivity through peroxynitrite and adenosine dysfunction, and immunological disturbance through changes in immune modulation. Perverse immunological memory established against these substances or their receptors may be the reason for the protracted nature of this condition. The novel status of these substances together with their extremely small concentrations in blood and tissues means that clinical research into them is still in its infancy. A biologically plausible theory of CFS causation associated with vasoactive neuropeptide dysfunction would promote a coherent and systematic approach to research into this and other possibly associated disabling conditions.

  1. Bowel Dysfunction

    Science.gov (United States)

    ... to PCF? Featured Fundraise for PCF: Many vs Cancer Contact Us Bowel Dysfunction The broad term of bowel dysfunction includes ... immodium) can be used to help with loose bowel movements. Increasing fiber intake through whole grains, ... mission 82% Join the fight against prostate ...

  2. Research progress of exercise-induced fatigue

    Directory of Open Access Journals (Sweden)

    Peng-yi DAI

    2016-12-01

    Full Text Available Exercise-induced fatigue is a comprehensive response to a variety of physiological and biochemical changes in the body, and can affect people's quality of life to different extents. If no timely recovery after occurrence of fatigue, accumulated gradually, it can lead to "burnout", a "overtraining syndrome", "chronic fatigue syndrome", etc., which will cause endocrine disturbance, immune suppression, even physical illness. Exercise-induced fatigue becomes an important factor endangering human health. In recent years, many experts and scholars at home and abroad are committed to the research of exercise-induced fatigue, and have put forward a variety of hypothesis to explain the cause of exercise-induced fatigue. They expect to find out the methods for preventing and eliminating exercise-induced fatigue. This article discusses mainly the pathogenesis, model building, elimination/ relief, etc. of exercise-induced fatigue to point out the research achievements of exercise-induced fatigue and its existing problems. DOI: 10.11855/j.issn.0577-7402.2016.11.14

  3. An overview of fatigue

    International Nuclear Information System (INIS)

    Mc Evily, A.J.

    1987-01-01

    Four topics are briefly discussed in this paper: fatigue crack initiation and growth in a nickel-base superalloy single crystal, the environment effect on near-threshold fatigue crack growth behaviour, the role of crack closure in load-interaction effects in fatigue crack growth, and the nature of creep-fatigue interactions, if any, during fatigue crack growth. (Author)

  4. Protective effects of sea cucumber (Holothuria atra) extract on testicular dysfunction induced by immune suppressant drugs in Wistar rats.

    Science.gov (United States)

    Saad, D Y; Soliman, M M; Mohamed, A A; Youssef, G B

    2018-04-23

    The current study was aimed to evaluate the protective effect of Holothurian atra (HA) extract; naturally occurring marine resource, against methotrexate (MTX) induced testicular dysfunction. Mature rats received either MTX (20 mg/kg, intraperitoneally) or saline on the 7th day of experiment al design. Seven days prior and after MTX-injection, rats received HA at dose of 300 mg/kg intragastrically (HA + MTX group; HA group alone). Serum was extracted and testicular tissues were examined for the changes in serum biochemistry (liver & kidney biomarkers, testicular hormones and antioxidants), molecular and histopthological alterations using RT-PCR and immunohistochemistry. MTX-injected rats induced alteration in all testicular parameters. Prior administration of HA ameliorated the MTX-induced oxidative stress. HA administration normalised MTX-induced decrease in serum levels of interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-α), interferon-gamma (IFN-γ), reproductive hormones (FSH, LH and testosterone) and antioxidants GST, SOD and catalase. MTX-injected rats down-regulated mRNA expression of GST, SOD, steroidogenesis associated genes, IFN-γ, Bcl2 and NFKB. MTX up-regulated BAX expression and caspase 9 immunoreactivity that were ameliorated in HA + MTX group. Collectively, HA ameliorated and restored all altered genes. In conclusion, HA is a promising supplement that is helpful in protection against testicular cytotoxicity and dysfunction induced by methotrexate. © 2018 Blackwell Verlag GmbH.

  5. Side Effects: Fatigue

    Science.gov (United States)

    Fatigue is a common side effect of many cancer treatments such as chemotherapy, radiation therapy, immunotherapy, and surgery. Anemia and pain can also cause fatigue. Learn about symptoms and way to manage fatigue.

  6. Erectile Dysfunction

    Science.gov (United States)

    ... rigid. Medications The oral medications for erectile dysfunction, sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), relax the muscles ... to begin working; the erection helping effects of sildenafil and vardenafil last for about 8 hours and ...

  7. Longitudinal Intravital Imaging of the Retina Reveals Long-term Dynamics of Immune Infiltration and Its Effects on the Glial Network in Experimental Autoimmune Uveoretinitis, without Evident Signs of Neuronal Dysfunction in the Ganglion Cell Layer

    Science.gov (United States)

    Bremer, Daniel; Pache, Florence; Günther, Robert; Hornow, Jürgen; Andresen, Volker; Leben, Ruth; Mothes, Ronja; Zimmermann, Hanna; Brandt, Alexander U.; Paul, Friedemann; Hauser, Anja E.; Radbruch, Helena; Niesner, Raluca

    2016-01-01

    A hallmark of autoimmune retinal inflammation is the infiltration of the retina with cells of the innate and adaptive immune system, leading to detachment of the retinal layers and even to complete loss of the retinal photoreceptor layer. As the only optical system in the organism, the eye enables non-invasive longitudinal imaging studies of these local autoimmune processes and of their effects on the target tissue. Moreover, as a window to the central nervous system (CNS), the eye also reflects general neuroinflammatory processes taking place at various sites within the CNS. Histological studies in murine neuroinflammatory models, such as experimental autoimmune uveoretinitis (EAU) and experimental autoimmune encephalomyelitis, indicate that immune infiltration is initialized by effector CD4+ T cells, with the innate compartment (neutrophils, macrophages, and monocytes) contributing crucially to tissue degeneration that occurs at later phases of the disease. However, how the immune attack is orchestrated by various immune cell subsets in the retina and how the latter interact with the target tissue under in vivo conditions is still poorly understood. Our study addresses this gap with a novel approach for intravital two-photon microscopy, which enabled us to repeatedly track CD4+ T cells and LysM phagocytes during the entire course of EAU and to identify a specific radial infiltration pattern of these cells within the inflamed retina, starting from the optic nerve head. In contrast, highly motile CX3CR1+ cells display an opposite radial motility pattern, toward the optic nerve head. These inflammatory processes induce modifications of the microglial network toward an activated morphology, especially around the optic nerve head and main retinal blood vessels, but do not affect the neurons within the ganglion cell layer. Thanks to the new technology, non-invasive correlation of clinical scores of CNS-related pathologies with immune infiltrate behavior and subsequent

  8. Research advances in pathogenesis and management of fatigue in patients with primary biliary cirrhosis

    Directory of Open Access Journals (Sweden)

    ZHAO Jian

    2016-11-01

    Full Text Available Fatigue is one of the most common symptoms of primary biliary cirrhosis (PBC and greatly affects patients′ quality of life. The pathogenesis of fatigue in PBC remains unknown and there are no effective therapeutic methods. This article reviews the latest advances in the pathogenesis and treatment of fatigue in PBC. Studies have shown that the causes of fatigue in PBC include various central and peripheral factors, such as the changes in the brain, sleep disorders, depression, autonomic nervous dysfunction, and abnormal muscle metabolism. Modafinil does not have a definite therapeutic effect in fatigue in PBC. The causes and treatment of fatigue in PBC still need in-depth systematic studies.

  9. Immune dysfunction and increased oxidative stress state in diet-induced obese mice are reverted by nutritional supplementation with monounsaturated and n-3 polyunsaturated fatty acids.

    Science.gov (United States)

    Hunsche, Caroline; Hernandez, Oskarina; Gheorghe, Alina; Díaz, Ligia Esperanza; Marcos, Ascensión; De la Fuente, Mónica

    2018-04-01

    Obesity is associated with impaired immune defences and chronic low levels of inflammation and oxidation. In addition, this condition may lead to premature aging. The aim of the study was to evaluate the effects of a nutritional supplementation with monounsaturated and n-3 polyunsaturated fatty acids on several functions and oxidative stress parameters in peritoneal immune cells of obese mice, as well as on the life span of these animals. Obesity was induced in adult female ICR/CD1 by the administration of a high-fat diet (HFD) for 14 weeks. During the last 6 weeks of HFD feeding, one group of obese mice received the same HFD, supplemented with 1500 mg of 2-hydroxyoleic acid (2-OHOA) and another with 3000 mg of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Several functions and oxidative stress parameters of peritoneal leukocytes were evaluated. The groups of obese mice treated with 2-OHOA or with EPA and DHA showed a significant improvement in several functions such as chemotaxis, phagocytosis, digestion capacity, Natural killer activity and lymphoproliferation in response to mitogens. All of these functions, which were decreased in obese mice, increased reaching similar levels to those found in non-obese controls. Both treatments also improved oxidative stress parameters such as xanthine oxidase activity, which decreased, catalase activity and glutathione levels, which increased. These data suggest that dietary supplementation with monounsaturated and n-3 polyunsaturated fatty acids could be an effective nutritional intervention to restore the immune response and oxidative stress state, which are impaired in obese mice.

  10. Transcriptomics: A Step behind the Comprehension of the Polygenic Influence on Oxidative Stress, Immune Deregulation, and Mitochondrial Dysfunction in Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Simona Granata

    2016-01-01

    Full Text Available Chronic kidney disease (CKD is an increasing and global health problem with a great economic burden for healthcare system. Therefore to slow down the progression of this condition is a main objective in nephrology. It has been extensively reported that microinflammation, immune system deregulation, and oxidative stress contribute to CKD progression. Additionally, dialysis worsens this clinical condition because of the contact of blood with bioincompatible dialytic devices. Numerous studies have shown the close link between immune system impairment and CKD but most have been performed using classical biomolecular strategies. These methodologies are limited in their ability to discover new elements and enable measuring the simultaneous influence of multiple factors. The “omics” techniques could overcome these gaps. For example, transcriptomics has revealed that mitochondria and inflammasome have a role in pathogenesis of CKD and are pivotal elements in the cellular alterations leading to systemic complications. We believe that a larger employment of this technique, together with other “omics” methodologies, could help clinicians to obtain new pathogenetic insights, novel diagnostic biomarkers, and therapeutic targets. Finally, transcriptomics could allow clinicians to personalize therapeutic strategies according to individual genetic background (nutrigenomic and pharmacogenomic. In this review, we analyzed the available transcriptomic studies involving CKD patients.

  11. Fatigue in chronic inflammation - a link to pain pathways.

    Science.gov (United States)

    Louati, Karine; Berenbaum, Francis

    2015-10-05

    Fatigue is a frequent symptom in several inflammatory diseases, particularly in rheumatic diseases. Elements of disease activity and cognitive and behavior aspects have been reported as causes of fatigue in patients with rheumatoid arthritis. Fatigue could be associated with activity of inflammatory rheumatism. Indeed, biologic agents targeting inflammatory cytokines are effective in fatigue. Fatigue is also associated with pain and depressive symptoms. Different pathways could be involved in fatigue and interact: the immune system with increased levels of pro-inflammatory cytokines (interleukin-1 and -6 and tumor necrosis factor alpha), dysregulation of the hypothalamic-pituitary-adrenal axis and neurological phenomena involving the central and autonomic nervous systems. A pro-inflammatory process could be involved in pain and behavioral symptoms. Inflammation could be a common link between fatigue, pain, and depression.

  12. Association Between Sleep Problems and Perceived Cognitive Dysfunction Over 12 Months in Individuals with Multiple Sclerosis.

    Science.gov (United States)

    Hughes, Abbey J; Turner, Aaron P; Alschuler, Kevin N; Atkins, David C; Beier, Meghan; Amtmann, Dagmar; Ehde, Dawn M

    2018-01-01

    Sleep problems are highly prevalent among individuals with multiple sclerosis (MS); however, the relationship between sleep problems and cognitive dysfunction is poorly understood in this population. In the present study, 163 individuals with MS and depression, fatigue, or pain completed self-report measures of sleep, cognitive dysfunction, and relevant demographic and clinical characteristics (e.g., disability severity, depressive symptomatology, pain intensity, fatigue impact) at four time points over 12 months. Mixed-effects regression demonstrated that poorer sleep was independently associated with worse perceived cognitive dysfunction (β = -0.05, p = .001), beyond the influence of depressive symptomatology. Fatigue impact was found to partially mediate this relationship. Results suggest that for individuals with MS and depression, fatigue, or pain, self-reported sleep problems are related to perceived cognitive dysfunction, and that fatigue impact accounts for part of this relationship.

  13. Immune dysfunction in bipolar disorder and suicide risk: is there an association between peripheral corticotropin-releasing hormone and interleukin-1β?

    Science.gov (United States)

    Monfrim, Xênia; Gazal, Marta; De Leon, Pâmela B; Quevedo, Luciana; Souza, Luciano D; Jansen, Karen; Oses, Jean P; Pinheiro, Ricardo T; Silva, Ricardo A; Lara, Diogo R; Ghisleni, Gabriele; Spessato, Barbara; Kaster, Manuella P

    2014-11-01

    The aim of the present study was to investigate the relationship between peripheral levels of corticotropin-releasing hormone (CRH) and interleukin-1β (IL-1β) in individuals with bipolar disorder (BD) with and without suicide risk (SR), and controls. A total of 120 young adults (40 controls, 40 subjects with BD without SR, and 40 subjects with BD with SR) were enrolled from a population-based study carried out in the city of Pelotas, Brazil. BD and SR were assessed through the Mini International Neuropsychiatric Interview (MINI 5.0), and peripheral markers were evaluated by enzyme-linked immunosorbent assay (ELISA). Levels of CRH were significantly lower both in subjects with BD without SR (p = 0.04) and subjects with BD with SR (p = 0.02) when compared to controls. However, levels of IL-1β were increased in subjects with BD with SR (p = 0.05) when compared to controls. Sociodemographic and clinical variables, current mood episode, and use of psychiatric medications were not associated with changes in these markers. No correlation was found between peripheral levels of CRH and IL-1β (p = 0.60) in the population or in the BD with SR group (p = 0.88). These results suggest that peripheral mechanisms linking stress hormones and the immune system might be critical patterns involved in suicidal behavior associated with BD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Erectile Dysfunction

    Science.gov (United States)

    ... cut out alcohol. Excess alcohol can contribute to erectile dysfunction. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for men older than age 65, and up to two drinks ...

  15. Endothelial dysfunction

    OpenAIRE

    Yaylalı, Yalın Tolga; Küçükaslan, Mete

    2011-01-01

    Endothelium is a multi-functional cluster of cells within the vascular system consisting of a single layer ofsquamous epithelium. Physiologically, endothelium performs various arrangement and protection functions.However, when these functions are disturbed toward derangement, endothelium also mediates pathologicalfunctions with negative effects on the body. Endothelial dysfunction is mediated by several mediators (nitricoxide, endothelins, prostaglandins, angiotensin 2, etc). Endothelial dysf...

  16. Using endogenous saccades to characterize fatigue in multiple sclerosis.

    Science.gov (United States)

    Ferreira, Marisa; Pereira, Paulo A; Parreira, Marta; Sousa, Inês; Figueiredo, José; Cerqueira, João J; Macedo, Antonio F

    2017-05-01

    Multiple Sclerosis (MS) is likely to cause dysfunction of neural circuits between brain regions increasing brain working load or a subjective overestimation of such working load leading to fatigue symptoms. The aim of this study was to investigate if saccades can reveal the effect of fatigue in patients with MS. Patients diagnosed with MS (EDSSendogenous generated saccade paradigm (valid and invalid trials). The fatigue severity scale (FSS) was used to assess the severity of fatigue. FSS scores were used to define two subgroups, the MS fatigue group (score above normal range) and the MS non-fatigue. Differences between groups were tested using linear mixed models. Thirty-one MS patients and equal number of controls participated in this study. FSS scores were above the normal range in 11 patients. Differences in saccade latency were found according to group (p<0.001) and trial validity (p=0.023). Differences were 16.9ms, between MS fatigue and MS non-fatigue, 15.5ms between MS fatigue and control. The mean difference between valid and invalid trials was 7.5ms. Differences in saccade peak velocity were found according to group (p<0.001), the difference between MS fatigue and control was 22.3°/s and between MS fatigue and non-fatigue was 12.3°/s. Group was a statistically significant predictor for amplitude (p<0.001). FSS scores were correlated with peak velocity (p=0.028) and amplitude (p=0.019). Consistent with the initial hypothesis, our study revealed altered saccade latency, peak velocity and amplitude in patients with fatigue symptoms. Eye movement testing can complement the standard inventories when investigating fatigue because they do not share similar limitations. Our findings contribute to the understanding of functional changes induced by MS and might be useful for clinical trials and treatment decisions. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Exercise, inflammation, and fatigue in cancer survivors

    Science.gov (United States)

    LaVoy, Emily C.P.; Fagundes, Christopher P.; Dantzer, Robert

    2016-01-01

    Cancer-related fatigue significantly disrupts normal functioning and quality of life for a substantial portion of cancer survivors, and may persist for years following cancer treatment. While the causes of persistent fatigue among cancer survivors are not yet fully understood, accumulating evidence suggests that several pathways, including chronic inflammation, autonomic imbalance, HPA-axis dysfunction, and/or mitochondrial damage, could contribute towards the disruption of normal neuronal function and result in the symptom of cancer-related fatigue. Exercise training interventions have been shown to be some of the more successful treatment options to address cancer-related fatigue. In this review, we discuss the literature regarding the causes of persistent fatigue in cancer survivors and the mechanisms by which exercise may relieve this symptom. There is still much work to be done until the prescription of exercise becomes standard practice for cancer survivors. With improvements in the quality of studies, evidenced-based exercise interventions will allow exercise scientists and oncologists to work together to treat cancer-related fatigue. PMID:26853557

  18. Special feature for the Olympics: effects of exercise on the immune system: overtraining effects on immunity and performance in athletes.

    Science.gov (United States)

    MacKinnon, L T

    2000-10-01

    Overtraining is a process of excessive exercise training in high-performance athletes that may lead to overtraining syndrome. Overtraining syndrome is a neuroendocrine disorder characterized by poor performance in competition, inability to maintain training loads, persistent fatigue, reduced catecholamine excretion, frequent illness, disturbed sleep and alterations in mood state. Although high-performance athletes are generally not clinically immune deficient, there is evidence that several immune parameters are suppressed during prolonged periods of intense exercise training. These include decreases in neutrophil function, serum and salivary immunoglobulin concentrations and natural killer cell number and possibly cytotoxic activity in peripheral blood. Moreover, the incidence of symptoms of upper respiratory tract infection increases during periods of endurance training. However, all of these changes appear to result from prolonged periods of intense exercise training, rather than from the effects of overtraining syndrome itself. At present, there is no single objective marker to identify overtraining syndrome. It is best identified by a combination of markers, such as decreases in urinary norepinephrine output, maximal heart rate and blood lactate levels, impaired sport performance and work output at 110% of individual anaerobic threshold, and daily self-analysis by the athlete (e.g. high fatigue and stress ratings). The mechanisms underlying overtraining syndrome have not been clearly identified, but are likely to involve autonomic dysfunction and possibly increased cytokine production resulting from the physical stress of intense daily training with inadequate recovery.

  19. Decreased basal ganglia activation in subjects with chronic fatigue syndrome: association with symptoms of fatigue.

    Directory of Open Access Journals (Sweden)

    Andrew H Miller

    Full Text Available Reduced basal ganglia function has been associated with fatigue in neurologic disorders, as well as in patients exposed to chronic immune stimulation. Patients with chronic fatigue syndrome (CFS have been shown to exhibit symptoms suggestive of decreased basal ganglia function including psychomotor slowing, which in turn was correlated with fatigue. In addition, CFS patients have been found to exhibit increased markers of immune activation. In order to directly test the hypothesis of decreased basal ganglia function in CFS, we used functional magnetic resonance imaging to examine neural activation in the basal ganglia to a reward-processing (monetary gambling task in a community sample of 59 male and female subjects, including 18 patients diagnosed with CFS according to 1994 CDC criteria and 41 non-fatigued healthy controls. For each subject, the average effect of winning vs. losing during the gambling task in regions of interest (ROI corresponding to the caudate nucleus, putamen, and globus pallidus was extracted for group comparisons and correlational analyses. Compared to non-fatigued controls, patients with CFS exhibited significantly decreased activation in the right caudate (p = 0.01 and right globus pallidus (p = 0.02. Decreased activation in the right globus pallidus was significantly correlated with increased mental fatigue (r2 = 0.49, p = 0.001, general fatigue (r2 = 0.34, p = 0.01 and reduced activity (r2 = 0.29, p = 0.02 as measured by the Multidimensional Fatigue Inventory. No such relationships were found in control subjects. These data suggest that symptoms of fatigue in CFS subjects were associated with reduced responsivity of the basal ganglia, possibly involving the disruption of projections from the globus pallidus to thalamic and cortical networks.

  20. Thermal Acoustic Fatigue Apparatus

    Data.gov (United States)

    Federal Laboratory Consortium — The Thermal Acoustic Fatigue Apparatus (TAFA) is a progressive wave tube test facility that is used to test structures for dynamic response and sonic fatigue due to...

  1. Effect of aerobic interval training on serum IL-10, TNFα, and adipokines levels in women with multiple sclerosis: possible relations with fatigue and quality of life.

    Science.gov (United States)

    Mokhtarzade, Motahare; Ranjbar, Rouholah; Majdinasab, Nastaran; Patel, Darpan; Molanouri Shamsi, Mehdieh

    2017-08-01

    Multiple sclerosis is associated with immune system dysfunction and chronic inflammation; however, possible relations between immunologic and metabolic factors and some psychological indexes such as fatigue and quality of life, especially in relation to exercise training, have not yet been investigated. The present study was designed to investigate the effect of aerobic interval training on interleukin-10/tumor necrosis factor ratio and adipokine (leptin and adiponectin) concentrations in women with multiple sclerosis. Furthermore, the relationship between these factors with fatigue and quality of life were assessed. Forty women with multiple sclerosis (Expanded Disability Status Scale ≤3) were randomized into either a non-exercising control or training group. The training group performed 8-weeks of upper and lower limb aerobic interval training. Serum concentrations of tumor necrosis factorα, interleukin-10, leptin, and adiponectin were measured before and after the 8-week intervention. Moreover, antropometric measures and measures for fatigue and quality of life were determined at the onset of and after exercise training. The results revealed that leptin and tumor necrosis factorα levels significantly decreased subsequent to the aerobic interval training. Although blood adiponectin levels considerably increased in the training group, interleukin-10 and interleukin-10/tumor necrosis factorα ratio underwent no substantial change after the exercise training. In addition, the aerobic interval training was associated with improvement in fatigue, quality of life, and maximal oxygen consumption. Our findings suggested that aerobic interval training can be an effective strategy for managing the immune system at least by its significant impact on inflammatory cytokines and adipokines levels in women with multiple sclerosis. Additionally, this positive impact improved fatigue and adipose tissue indicators.

  2. Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease.

    Science.gov (United States)

    Underhill, R A

    2015-12-01

    The etiology of myalgic encephalomyelitis also known as chronic fatigue syndrome or ME/CFS has not been established. Controversies exist over whether it is an organic disease or a psychological disorder and even the existence of ME/CFS as a disease entity is sometimes denied. Suggested causal hypotheses have included psychosomatic disorders, infectious agents, immune dysfunctions, autoimmunity, metabolic disturbances, toxins and inherited genetic factors. Clinical, immunological and epidemiological evidence supports the hypothesis that: ME/CFS is an infectious disease; the causal pathogen persists in patients; the pathogen can be transmitted by casual contact; host factors determine susceptibility to the illness; and there is a population of healthy carriers, who may be able to shed the pathogen. ME/CFS is endemic globally as sporadic cases and occasional cluster outbreaks (epidemics). Cluster outbreaks imply an infectious agent. An abrupt flu-like onset resembling an infectious illness occurs in outbreak patients and many sporadic patients. Immune responses in sporadic patients resemble immune responses in other infectious diseases. Contagion is shown by finding secondary cases in outbreaks, and suggested by a higher prevalence of ME/CFS in sporadic patients' genetically unrelated close contacts (spouses/partners) than the community. Abortive cases, sub-clinical cases, and carrier state individuals were found in outbreaks. The chronic phase of ME/CFS does not appear to be particularly infective. Some healthy patient-contacts show immune responses similar to patients' immune responses, suggesting exposure to the same antigen (a pathogen). The chronicity of symptoms and of immune system changes and the occurrence of secondary cases suggest persistence of a causal pathogen. Risk factors which predispose to developing ME/CFS are: a close family member with ME/CFS; inherited genetic factors; female gender; age; rest/activity; previous exposure to stress or toxins

  3. Sexual dysfunctions in psoriatic patients

    Directory of Open Access Journals (Sweden)

    Maria Isabela Sarbu

    2015-04-01

    Full Text Available Psoriasis is a chronic, immune-mediated disorder with a worldwide occurrence characterized by well-defined infiltrated erythematous papules and plaques, covered by silvery white or yellowish scales. It is a physically, socially and emotionally invalidating disorder that affects 1-2% of the population. Sexual health is an important part of general health and sexual dysfunctions can negatively affect self-esteem, confidence, interpersonal relationships and the quality of life. Dermatology Life Quality Index (DLQI, Psoriasis Disability Index (PDI and the Impact of Psoriasis on Quality of Life (IPSO questionnaire are all questionnaires used to assess the quality of life of patients with psoriasis and each has one question regarding sexual dysfunction. Several scales were also designed to particularly assess sexual satisfaction in men and women. The aim of this paper is to perform an overview of the existing studies on sexual dysfunction in psoriatic patients.

  4. Executive Dysfunction

    Science.gov (United States)

    Rabinovici, Gil D.; Stephens, Melanie L.; Possin, Katherine L.

    2015-01-01

    Purpose of Review: Executive functions represent a constellation of cognitive abilities that drive goal-oriented behavior and are critical to the ability to adapt to an ever-changing world. This article provides a clinically oriented approach to classifying, localizing, diagnosing, and treating disorders of executive function, which are pervasive in clinical practice. Recent Findings: Executive functions can be split into four distinct components: working memory, inhibition, set shifting, and fluency. These components may be differentially affected in individual patients and act together to guide higher-order cognitive constructs such as planning and organization. Specific bedside and neuropsychological tests can be applied to evaluate components of executive function. While dysexecutive syndromes were first described in patients with frontal lesions, intact executive functioning relies on distributed neural networks that include not only the prefrontal cortex, but also the parietal cortex, basal ganglia, thalamus, and cerebellum. Executive dysfunction arises from injury to any of these regions, their white matter connections, or neurotransmitter systems. Dysexecutive symptoms therefore occur in most neurodegenerative diseases and in many other neurologic, psychiatric, and systemic illnesses. Management approaches are patient specific and should focus on treatment of the underlying cause in parallel with maximizing patient function and safety via occupational therapy and rehabilitation. Summary: Executive dysfunction is extremely common in patients with neurologic disorders. Diagnosis and treatment hinge on familiarity with the clinical components and neuroanatomic correlates of these complex, high-order cognitive processes. PMID:26039846

  5. Fatigue Damage in Wood

    DEFF Research Database (Denmark)

    Clorius, Christian Odin; Pedersen, Martin Bo Uhre; Hoffmeyer, Preben

    1996-01-01

    An investigation of fatigue failure in wood subjected to load cycles in compression parallel to grain is presented. Fatigue failure is found to depend both on the total time under load and on the number of cycles.Recent accelerated fatigue research on wood is reviewed, and a discrepancy between...... to 10 Hz are used. The number of cycles to failure is found to be a poor measure of the fatigue performance of wood. Creep, maximum strain, stiffness and work are monitored throughout the fatigue tests. Accumulated creep is suggested identified with damage and a correlation between stiffness reduction...

  6. Cognitive and Physical Fatigue Tasks Enhance Pain, Cognitive Fatigue and Physical Fatigue in People with Fibromyalgia

    Science.gov (United States)

    Dailey, Dana L; Keffala, Valerie J; Sluka, Kathleen A

    2014-01-01

    Objective Fibromyalgia is a condition characterized by chronic widespread muscle pain and fatigue. The primary objective of this study was to determine if pain, perceived cognitive fatigue, and perceived physical fatigue were enhanced in participants with fibromyalgia compared to healthy controls during a cognitive fatigue task, a physical fatigue task and a dual fatigue task. Methods Twenty four people with fibromyalgia and 33 healthy controls completed pain, fatigue and function measures. A cognitive fatigue task (Controlled Oral Word Association Test) and physical fatigue task (Valpar peg test) were done individually and combined for a dual fatigue task. Resting pain, perceived cognitive fatigue and perceived physical fatigue were assessed during each task using visual analogue scales. Function was assessed with shoulder range of motion and grip. Results People with fibromyalgia had significantly higher increases in pain, cognitive fatigue and physical fatigue when compared to healthy controls after completion of a cognitive fatigue task, a physical fatigue task, or a dual fatigue task (pfibromyalgia performed equivalently on measures of physical performance and cognitive performance on the physical and cognitive fatigue tasks, respectively. Conclusions These data show that people with fibromyalgia show larger increases in pain, perceived cognitive fatigue and perceived physical fatigue to both cognitive and physical fatigue tasks compared to healthy controls. The increases in pain and fatigue during cognitive and physical fatigue tasks could influence subject participation in daily activities and rehabilitation. PMID:25074583

  7. Role of Dendritic Cells in Immune Dysfunction

    Science.gov (United States)

    Savary, Cherylyn A.

    1997-01-01

    Specific aims include: (1) Application of the bioreactor to enhance cytokine-regulated proliferation and maturation of dendritic cells (DC); (2) Based on clues from spaceflight: compare the frequency and function of DC in normal donors and immunocompromised cancer patients; and (3) Initiate studies on the efficiency of cytokine therapy and DC-assisted immunotherapy (using bioreactor-expanded DC) in animal models of experimental fungal infections.

  8. Differential associations between white blood cell counts and fatigue in young and older adults

    DEFF Research Database (Denmark)

    Avlund, Kirsten; Hokland, Marianne; Mehlsen, Mimi Y

    2012-01-01

    The aims of this exploratory study were to study whether fatigue might be related to the cellular immune system by 1) analysing if the number of white blood cell subsets are related to fatigue and 2) if possible relationships vary in younger and older community-dwelling individuals.......The aims of this exploratory study were to study whether fatigue might be related to the cellular immune system by 1) analysing if the number of white blood cell subsets are related to fatigue and 2) if possible relationships vary in younger and older community-dwelling individuals....

  9. [School phobia and childhood chronic fatigue syndrome (CCFS)].

    Science.gov (United States)

    Tomoda, Akemi

    2007-06-01

    Chronic fatigue occurring in previously healthy children and adolescents is a vexing problem encountered by pediatric practitioners and the impact of fatigue in youngsters should not be underestimated. In its severe form, it is often associated with mood disorders. Findings in children and adolescent cases suggest that severe unexplained fatigue might precede the development of fatigue-related illness, such as childhood chronic fatigue syndrome (CCFS). This is a disabling condition characterized by severe disabling fatigue and a combination of symptoms, the prominent features being self-reported impairments in concentration and short-term memory, sleep disturbances and autonomic symptoms that cannot be explained by medical or psychiatric illness. We have encountered such patients with these complaints; their major symptoms include: general fatigue, fever, headache (not migraine), and memory disturbance. From our clinical experience, we have inferred that patients with CCFS might experience changes in brain function levels, which induce an autonomic imbalance and engender symptoms such as general fatigue, higher-order level cognitive dysfunction, and memory disturbance.

  10. Clinical neurophysiology of fatigue.

    Science.gov (United States)

    Zwarts, M J; Bleijenberg, G; van Engelen, B G M

    2008-01-01

    Fatigue is a multidimensional concept covering both physiological and psychological aspects. Chronic fatigue is a typical symptom of diseases such as cancer, multiple sclerosis (MS), Parkinson's disease (PD) and cerebrovascular disorders but is also presented by people in whom no defined somatic disease has been established. If certain criteria are met, chronic fatigue syndrome can be diagnosed. The 4-item Abbreviated Fatigue Questionnaire allows the extent of the experienced fatigue to be assessed with a high degree of reliability and validity. Physiological fatigue has been well defined and originates in both the peripheral and central nervous system. The condition can be assessed by combining force and surface-EMG measurements (including frequency analyses and muscle-fibre conduction estimations), twitch interpolation, magnetic stimulation of the motor cortex and analysis of changes in the readiness potential. Fatigue is a well-known phenomenon in both central and peripheral neurological disorders. Examples of the former conditions are multiple sclerosis, Parkinson's disease and stroke. Although it seems to be a universal symptom of many brain disorders, the unique characteristics of the concomitant fatigue also point to a specific relationship with several of these syndromes. As regards neuromuscular disorders, fatigue has been reported in patients with post-polio syndrome, myasthenia gravis, Guillain-Barré syndrome, facioscapulohumeral dystrophy, myotonic dystrophy and hereditary motor and sensory neuropathy type-I. More than 60% of all neuromuscular patients suffer from severe fatigue, a prevalence resembling that of patients with MS. Except for several rare myopathies with specific metabolic derangements leading to exercise-induced muscle fatigue, most studies have not identified a prominent peripheral cause for the fatigue in this population. In contrast, the central activation of the diseased neuromuscular system is generally found to be suboptimal. The

  11. Adolescent fatigue, POTS, and recovery: a guide for clinicians.

    Science.gov (United States)

    Kizilbash, Sarah J; Ahrens, Shelley P; Bruce, Barbara K; Chelimsky, Gisela; Driscoll, Sherilyn W; Harbeck-Weber, Cynthia; Lloyd, Robin M; Mack, Kenneth J; Nelson, Dawn E; Ninis, Nelly; Pianosi, Paolo T; Stewart, Julian M; Weiss, Karen E; Fischer, Philip R

    2014-01-01

    Many teenagers who struggle with chronic fatigue have symptoms suggestive of autonomic dysfunction that may include lightheadedness, headaches, palpitations, nausea, and abdominal pain. Inadequate sleep habits and psychological conditions can contribute to fatigue, as can concurrent medical conditions. One type of autonomic dysfunction, postural orthostatic tachycardia syndrome, is increasingly being identified in adolescents with its constellation of fatigue, orthostatic intolerance, and excessive postural tachycardia (more than 40 beats/min). A family-based approach to care with support from a multidisciplinary team can diagnose, treat, educate, and encourage patients. Full recovery is possible with multi-faceted treatment. The daily treatment plan should consist of increased fluid and salt intake, aerobic exercise, and regular sleep and meal schedules; some medications can be helpful. Psychological support is critical and often includes biobehavioral strategies and cognitive-behavioral therapy to help with symptom management. More intensive recovery plans can be implemented when necessary. Copyright © 2014 Mosby, Inc. All rights reserved.

  12. The Identification of Fatigue Resistant and Fatigue Susceptible Individuals

    National Research Council Canada - National Science Library

    Harrison, Richard; Chaiken, Scott; Harville, Donald; Fischer, Joseph; Fisher, Dion; Whitmore, Jeff

    2008-01-01

    The present study was designed to target two specific areas regarding fatigue. The primary purpose was to begin investigations into possible genetic markers linked to fatigue resistance and fatigue susceptibility...

  13. Compressive Fatigue in Wood

    DEFF Research Database (Denmark)

    Clorius, Christian Odin; Pedersen, Martin Bo Uhre; Hoffmeyer, Preben

    1999-01-01

    An investigation of fatigue failure in wood subjected to load cycles in compression parallel to grain is presented. Small clear specimens of spruce are taken to failure in square wave formed fatigue loading at a stress excitation level corresponding to 80% of the short term strength. Four...... frequencies ranging from 0.01 Hz to 10 Hz are used. The number of cycles to failure is found to be a poor measure of the fatigue performance of wood. Creep, maximum strain, stiffness and work are monitored throughout the fatigue tests. Accumulated creep is suggested identified with damage and a correlation...

  14. Optimal Fatigue Testing

    DEFF Research Database (Denmark)

    Faber, Michael Havbro; Sørensen, John Dalsgaard; Kroon, I. B.

    1993-01-01

    life experiments for the same purpose. The methodology is basedon modern probabilistic concepts amd classical decision theory. The special case where the fatigue life experiments are given in terms of SN curves is considered in Particular. The proposed techniques are illustrated by an example.......This paper considers the reassessment of the reliability of tubular joints subjected to fatigue load. The reassessment is considered in two parts namely the task of utilizing new experimental data on fatigue life to update the reliability of the tubular joint ant the task of planning new fatigue...

  15. (Thunb.), Makino on Physical Fatigue

    African Journals Online (AJOL)

    fatigue agent, but there is a need for further research on long-term use in order to show its positive effects on physical fatigue. Key words: polysaccharides from Gynostemma pentaphyllum (Thunb.) Makino; physical fatigue; forced swimming test; ...

  16. Thyroid Dysfunction from Antineoplastic Agents

    Science.gov (United States)

    Larsen, P. Reed; Marqusee, Ellen

    2011-01-01

    Unlike cytotoxic agents that indiscriminately affect rapidly dividing cells, newer antineoplastic agents such as targeted therapies and immunotherapies are associated with thyroid dysfunction. These include tyrosine kinase inhibitors, bexarotene, radioiodine-based cancer therapies, denileukin diftitox, alemtuzumab, interferon-α, interleukin-2, ipilimumab, tremelimumab, thalidomide, and lenalidomide. Primary hypothyroidism is the most common side effect, although thyrotoxicosis and effects on thyroid-stimulating hormone secretion and thyroid hormone metabolism have also been described. Most agents cause thyroid dysfunction in 20%–50% of patients, although some have even higher rates. Despite this, physicians may overlook drug-induced thyroid dysfunction because of the complexity of the clinical picture in the cancer patient. Symptoms of hypothyroidism, such as fatigue, weakness, depression, memory loss, cold intolerance, and cardiovascular effects, may be incorrectly attributed to the primary disease or to the antineoplastic agent. Underdiagnosis of thyroid dysfunction can have important consequences for cancer patient management. At a minimum, the symptoms will adversely affect the patient’s quality of life. Alternatively, such symptoms can lead to dose reductions of potentially life-saving therapies. Hypothyroidism can also alter the kinetics and clearance of medications, which may lead to undesirable side effects. Thyrotoxicosis can be mistaken for sepsis or a nonendocrinologic drug side effect. In some patients, thyroid disease may indicate a higher likelihood of tumor response to the agent. Both hypothyroidism and thyrotoxicosis are easily diagnosed with inexpensive and specific tests. In many patients, particularly those with hypothyroidism, the treatment is straightforward. We therefore recommend routine testing for thyroid abnormalities in patients receiving these antineoplastic agents. PMID:22010182

  17. Chronic fatigue syndrome

    African Journals Online (AJOL)

    Chronic fatigue syndrome. Committee for Science and Education, Medical. Association of South Africa. Objective. ... Synonyms. Major controversy surrounds the name of the syndrome. In medical circles the preferred term is chronic fatigue .... urine tests using dipsticks. The above investigations should only be pursued when.

  18. Chronic fatigue syndrome

    OpenAIRE

    Reid, Steven F; Chalder, Trudie; Cleare, Anthony; Hotopf, Matthew; Wessely, Simon

    2008-01-01

    Chronic fatigue syndrome (CFS) is characterised by severe, disabling fatigue, and other symptoms including musculoskeletal pain, sleep disturbance, impaired concentration, and headaches. CFS affects between 0.006% and 3% of the population depending on the criteria used, with women being at higher risk than men.

  19. Chronic fatigue syndrome

    OpenAIRE

    Reid, Steven; Chalder, Trudie; Cleare, Anthony; Hotopf, Matthew; Wessely, Simon

    2011-01-01

    Chronic fatigue syndrome is characterised by severe, disabling fatigue, and other symptoms including musculoskeletal pain, sleep disturbance, impaired concentration, and headaches. CFS affects between 0.006% and 3% of the population depending on the criteria used, with women being at higher risk than men.

  20. Chronic fatigue syndrome

    OpenAIRE

    Cleare, Anthony J.; Reid, Steven; Chalder, Trudie; Hotopf, Matthew; Wessely, Simon

    2015-01-01

    Chronic fatigue syndrome (CFS) is characterised by severe, disabling fatigue, and other symptoms, including musculoskeletal pain, sleep disturbance, impaired concentration, and headaches. CFS affects between 0.006% and 3% of the population depending on the criteria used, with women being at higher risk than men.

  1. Perineal neuromuscular fatigue.

    Science.gov (United States)

    Deffieux, X; Hubeaux, K; Damphousse, M; Raibaut, P; Sheikh Ismael, S; Thoumie, P; Amarenco, G; Lapeyre, E; Jousse, M

    2006-07-01

    The physiology of urinary continence during stress is complex and the role of passive and active mechanisms remains unclear. Coughing leads to a contraction of urethral rhabdomyosphincter and pelvic floor muscles leading to a positive urethro-vesical gradient and continence. Neuromuscular fatigue can involve all striated muscles, including rhabdomyosphincter, peri-urethral and pelvic floor muscles. This article reviews results of studies assessing perineal muscular fatigue in urinary incontinence. A systematic review of the literature (Medline, Pascal and Embase) with use of the MESH keywords fatigue, stress, urinary incontinence, pelvic floor, urethra, urethral pressure, and muscle. Animal models have shown that the pelvic muscles (iliococcygeus and pubococcygeous) exhibit more neuromuscular fatigue than classical skeletal striated muscles (i.e. soleus muscle). Although the human external urethral sphincter is considered to be a highly fatigue-resistant muscle with its high proportion of slow muscle fibers, repeated coughing seems to lead to decreased urethral pressure in numerous women affected with stress urinary incontinence. In this case, "urethral fatigue" might be a possibility. Although few studies have focused on perineal muscular fatigue, such increased fatigue in pelvic floor muscles may play a role in the pathophysiologic features of stress urinary incontinence in women.

  2. Clinical neurophysiology of fatigue.

    NARCIS (Netherlands)

    Zwarts, M.J.; Bleijenberg, G.; Engelen, B.G.M. van

    2008-01-01

    Fatigue is a multidimensional concept covering both physiological and psychological aspects. Chronic fatigue is a typical symptom of diseases such as cancer, multiple sclerosis (MS), Parkinson's disease (PD) and cerebrovascular disorders but is also presented by people in whom no defined somatic

  3. Examining fatigue in COPD

    DEFF Research Database (Denmark)

    Al-Shair, Khaled; Muellerova, Hana; Yorke, Janelle

    2012-01-01

    ABSTRACT: INTRODUCTION: Fatigue is a disruptive symptom that inhibits normal functional performance of COPD patients in daily activities. The availability of a short, simple, reliable and valid scale would improve assessment of the characteristics and influence of fatigue in COPD. METHODS......: At baseline, 2107 COPD patients from the ECLIPSE cohort completed the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scale. We used well-structured classic method, the principal components analysis (PCA) and Rasch analysis for structurally examining the 13-item FACIT-F. RESULTS: Four items...... were less able to capture fatigue characteristics in COPD and were deleted. PCA was applied to the remaining 9 items of the modified FACIT-F and resulted in three interpretable dimensions: i) general (5 items); ii) functional ability (2 items); and iii) psychosocial fatigue (2 items). The modified...

  4. Porcine placenta mitigates protein-energy malnutrition-induced fatigue.

    Science.gov (United States)

    Han, Na-Ra; Kim, Kyu-Yeop; Kim, Myong-Jo; Kim, Min-Ho; Kim, Hyung-Min; Jeong, Hyun-Ja

    2013-01-01

    Fatigue can be caused by a deficiency of nutrition or immune function. The goal of this study was to identify the effects of porcine placenta extract (PPE) and its constituents, amino acids (glutamic acid, glycine, arginine, and proline), on protein-energy malnutrition (PEM)-induced fatigue. Mice were administered a PEM diet and came to immunodeficient status. Simultaneously, the mice were administered PPE or amino acids and a forced swimming test (FST) was performed. We analyzed the levels of fatigue-related factors in serum, splenocytes, and muscles. In the FST, PPE or amino acids significantly decreased immobility times compared with the PEM diet. PPE or amino acids also significantly decreased the serum levels of fatigue-related factors after the FST. Additionally, PPE significantly decreased the levels of fatigue-related muscle parameters after the FST. In this in vitro study, PPE increased the mRNA and protein expression of Ki-67 and promoted the proliferation of splenocytes. PPE or amino acids significantly increased the levels of intracellular calcium and the translocation into the nucleus of nuclear factor of activated T-cells cytoplasmic in stimulated splenocytes. PPE or amino acids significantly decreased the production of fatigue-related inflammatory cytokines in the stimulated splenocytes. Additionally, the translocated levels of nuclear factor-κB in the nucleus and the degradation of the inhibitory protein, IκBα, in the cytosol were inhibited by PPE or amino acids. These results demonstrate that PPE and its constituents regulate PEM-induced fatigue through improving levels of immunity and decreasing fatigue-related factors. PPE may be a potential agent for a recovery from fatigue. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. The Role of Selenium in Human Immunity | Chisenga | Medical ...

    African Journals Online (AJOL)

    ... including selenium deficiency, so it has been postulated that selenium has a role in immune function. Immune dysfunction, susceptibility to viral infections and increased mortality are some of the outcomes associated with selenium deficiency. Key Words: Selenium; Human; Cell-mediated immunity; Innate immunity; HIV; ...

  6. Creep-fatigue damage assessment by subsequent fatigue straining

    International Nuclear Information System (INIS)

    Yaguchi, M.; Nakamura, T.; Ishikawa, A.; Asada, Y.

    1993-01-01

    A series of creep-fatigue tests has been conducted with Modified 9Cr-1Mo steel at 600 deg. C in a high vacuum environment of 0.1mPa to assess an accumulation of creep-fatigue damage. In these tests, each test specimen has been subjected to prior creep-fatigue loading followed by subsequent fatigue loading or prior fatigue loading followed by subsequent creep-fatigue loading. A linear summation of cumulative damage of fatigue and creep life fraction is smaller than unity for the former case, and larger than unity for the latter case. SEM observation was conducted and it was shown that in the case of prior creep-fatigue loading, crack mode transforms from transgranular to intergranular type with the increase of the number of cycles of prior creep-fatigue loading, while crack mode is generally intergranular in the case of prior fatigue loading. (author)

  7. Fatigue Management (La Gestion de la Fatigue)

    Science.gov (United States)

    1991-12-01

    Management Pre’face Etant donne la tenidance de plus en plus marque ~e vets le maintien en service des aironefs au-delak des dates lintites...transport aircraft designed prototype sade its first flight one year about 20 years ago; from the fatigue point later. The results of the flight testing

  8. Fatigue evaluation algorithms: Review

    Energy Technology Data Exchange (ETDEWEB)

    Passipoularidis, V.A.; Broendsted, P.

    2009-11-15

    A progressive damage fatigue simulator for variable amplitude loads named FADAS is discussed in this work. FADAS (Fatigue Damage Simulator) performs ply by ply stress analysis using classical lamination theory and implements adequate stiffness discount tactics based on the failure criterion of Puck, to model the degradation caused by failure events in ply level. Residual strength is incorporated as fatigue damage accumulation metric. Once the typical fatigue and static properties of the constitutive ply are determined,the performance of an arbitrary lay-up under uniaxial and/or multiaxial load time series can be simulated. The predictions are validated against fatigue life data both from repeated block tests at a single stress ratio as well as against spectral fatigue using the WISPER, WISPERX and NEW WISPER load sequences on a Glass/Epoxy multidirectional laminate typical of a wind turbine rotor blade construction. Two versions of the algorithm, the one using single-step and the other using incremental application of each load cycle (in case of ply failure) are implemented and compared. Simulation results confirm the ability of the algorithm to take into account load sequence effects. In general, FADAS performs well in predicting life under both spectral and block loading fatigue. (author)

  9. Inflammation, Immunity, and Hypertension.

    Science.gov (United States)

    Agita, Arisya; Alsagaff, M Thaha

    2017-04-01

    The immune system, inflammation and hypertension are related to each other. Innate and adaptive immunity system triggers an inflammatory process, in which blood pressure may increase, stimulating organ damage. Cells in innate immune system produce ROS, such as superoxide and hydrogen peroxide, which aimed at killing pathogens. Long-term inflammation process increases ROS production, causing oxidative stress which leads to endothelial dysfunction. Endothelial function is to regulate blood vessel tone and structure. When inflammation lasts, NO bioavailability decreases, disrupting its main function as vasodilator, so that blood vessels relaxation and vasodilatation are absent. Effector T cells and regulatory lymphocytes, part of the adaptive immune system, plays role in blood vessels constriction in hypertension. Signals from central nervous system and APC activates effector T lymphocyte differentiation and accelerate through Th-1 and Th-17 phenotypes. Th-1 and Th-17 effectors participate in inflammation which leads to increased blood pressure. One part of CD4+ is the regulatory T cells (Tregs) that suppress immune response activation as they produce immunosuppressive cytokines, such as TGF-β and IL-10. Adoptive transfer of Tregs cells can reduce oxidative stress in blood vessels, endothelial dysfunction, infiltration of aortic macrophages and T cells as well as proinflammatory cytokine levels in plasma circulation.

  10. Inflammation, Immunity, and Hypertension

    Directory of Open Access Journals (Sweden)

    Arisya Agita

    2017-04-01

    Full Text Available The immune system, inflammation and hypertension are related to each other. Innate and adaptive immunity system triggers an inflammatory process, in which blood pressure may increase, stimulating organ damage. Cells in innate immune system produce ROS, such as superoxide and hydrogen peroxide, which aimed at killing pathogens. Long-term inflammation process increases ROS production, causing oxidative stress which leads to endothelial dysfunction. Endothelial function is to regulate blood vessel tone and structure. When inflammation lasts, NO bioavailability decreases, disrupting its main function as vasodilator, so that blood vessels relaxation and vasodilatation are absent. Effector T cells and regulatory lymphocytes, part of the adaptive immune system, plays role in blood vessels constriction in hypertension. Signals from central nervous system and APC activates effector T lymphocyte differentiation and accelerate through Th-1 and Th-17 phenotypes. Th-1 and Th-17 effectors participate in inflammation which leads to increased blood pressure. One part of CD4+ is the regulatory T cells (Tregs that suppress immune response activation as they produce immunosuppressive cytokines, such as TGF-β and IL-10. Adoptive transfer of Tregs cells can reduce oxidative stress in blood vessels, endothelial dysfunction, infiltration of aortic macrophages and T cells as well as proinflammatory cytokine levels in plasma circulation.

  11. Prolonged unexplained fatigue in paediatrics

    NARCIS (Netherlands)

    Bakker, R.J.

    2010-01-01

    Prolonged Unexplained Fatigue in Paediatrics. Fatigue, as the result of mental or physical exertion, will disappear after rest, drinks and food. Fatigue as a symptom of illness will recover with the recovering of the illness. But when fatigue is ongoing for a long time, and not the result of

  12. Perceived fatigue following pediatric burns

    NARCIS (Netherlands)

    Akkerman, Moniek; Mouton, Leonora J.; Dijkstra, Froukje; Niemeijer, Anuschka S.; van Brussel, Marco; van der Woude, Lucas H. V.; Disseldorp, Laurien M.; Nieuwenhuis, Marianne K.

    2017-01-01

    Purpose: Fatigue is a common consequence of numerous pediatric health conditions. In adult burn survivors, fatigue was found to be a major problem. The current cross-sectional study is aimed at determining the levels of perceived fatigue in pediatric burn survivors. Methods: Perceived fatigue was

  13. Perceived fatigue following pediatric burns

    NARCIS (Netherlands)

    Akkerman, Moniek; Mouton, Leonora J.; Dijkstra, Froukje; Niemeijer, Anuschka S.; van Brussel, Marco|info:eu-repo/dai/nl/30481962X; Van der Woude, Lucas H. V.; Disseldorp, Laurien M.; Nieuwenhuis, Marianne K.

    2017-01-01

    Purpose Fatigue is a common consequence of numerous pediatric health conditions. In adult burn survivors, fatigue was found to be a major problem. The current cross-sectional study is aimed at determining the levels of perceived fatigue in pediatric burn survivors. Methods Perceived fatigue was

  14. Postinjury Inflammation and Organ Dysfunction.

    Science.gov (United States)

    Sauaia, Angela; Moore, Frederick A; Moore, Ernest E

    2017-01-01

    The development of organ dysfunction (OD) is related to the intensity and balance between trauma-induced simultaneous, opposite inflammatory responses. Early proinflammation via innate immune system activation may cause early OD, whereas antiinflammation, via inhibition of the adaptive immune system and apoptosis, may induce immunoparalysis, impaired healing, infections, and late OD. Patients discharged with low-level OD may develop the persistent inflammation-immunosuppression catabolism syndrome. Although the incidence of multiple organ failure has decreased over time, it remains morbid, lethal, and resource intensive. However, single OD, especially acute lung injury, remains frequent. Treatment is limited, and prevention remains the mainstay strategy. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Hyperthermia and fatigue

    DEFF Research Database (Denmark)

    Nybo, Lars

    2008-01-01

    of the cardiovascular function, which eventually reduces arterial oxygen delivery to the exercising muscles. Accordingly, aerobic energy turnover is impaired and anaerobic metabolism provokes peripheral fatigue. In contrast, metabolic disturbances of muscle homeostasis are less important during prolonged exercise...... of the dopaminergic system, but may primarily relate to inhibitory signals from the hypothalamus arising secondary to an increase in brain temperature. Fatigue is an integrated phenomenon, and psychological factors, including the anticipation of fatigue, should not be neglected and the interaction between central...... and peripheral physiological factors also needs to be considered....

  16. Psychological profiles in patients with Sjögren's syndrome related to fatigue: a cluster analysis.

    Science.gov (United States)

    van Leeuwen, Ninke; Bossema, Ercolie R; Knoop, Hans; Kruize, Aike A; Bootsma, Hendrika; Bijlsma, Johannes W J; Geenen, Rinie

    2015-05-01

    Fatigue is a highly prevalent and debilitating symptom in the autoimmune disease SS. Although the disease process plays a role in fatigue, psychological factors may influence fatigue and the ability to deal with its consequences. Profiles of co-occurring psychological factors may suggest potential targets for the treatment of fatigue. The aim of this study was to identify psychological profiles in patients with SS and the accompanying levels of fatigue. Three hundred patients with primary SS (mean age 57 years, 93% female) completed questionnaires on fatigue (multidimensional fatigue inventory), physical activity cognitions (TAMPA-SK), illness cognitions, cognitive regulation, emotion processing and regulation [Toronto Alexithymia Scale 20, Emotion Regulation Questionnaire (ERQ), Berkeley Expressivity Questionnaire], coping strategies (Brief COPE) and social support. Principal axis factor analysis (oblimin rotation) yielded six psychological factors: social support, negative thinking, positive thinking, emotional expressivity, avoidance and alexithymia (i.e. the inability to differentiate emotions). Using cluster analyses, these factors were grouped in four psychological profiles: functional (39%), alexithymic (27%), self-reliant (23%) and dysfunctional (11%). Irrespective of the psychological profile, the level of fatigue was substantially higher in patients than in the general population. Patients with a dysfunctional or an alexithymic profile reported more fatigue than those with a self-reliant profile. Our study in SS yielded four psychological profiles that were differentially associated with fatigue. These profiles can be used to examine determinants and prognosis of fatigue as well as the possibility of customizing cognitive behavioural interventions for chronic fatigue. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Experiences of Fatigue at Sea

    DEFF Research Database (Denmark)

    Zhao, Zhiwei; Jepsen, Jørgen Riis; Chen, Zhonglong

    2016-01-01

    Fatigue has negative impacts on the general working population as well as on seafarers. In order to study seafarers’ fatigue, a questionnaire-base survey was conducted to gain information about potential risk factors for fatigue and construct indexes indicating fatigue. The study applies T-test t......-test to compare strata of seafarers to analyse work and sleep patterns in global seafaring. Qualitative analysis are also employed to explore the impacts of fatigue on seafarer’s occupational health and safety....

  18. Insomnia and Fatigue

    Science.gov (United States)

    ... in turn leads to fatigue, may affect your self-esteem, mood, emotions, relationships and work. But you don’ ... 19004 Phone: (855) 807-6386 email Facebook Twitter Instagram YouTube Contact Us Privacy Policy Site Credits Terms ...

  19. Fatigue Evaluation Algorithms: Review

    DEFF Research Database (Denmark)

    Passipoularidis, Vaggelis; Brøndsted, Povl

    A progressive damage fatigue simulator for variable amplitude loads named FADAS is discussed in this work. FADAS (Fatigue Damage Simulator) performs ply by ply stress analysis using classical lamination theory and implements adequate stiffness discount tactics based on the failure criterion of Puck...... series can be simulated. The predictions are validated against fatigue life data both from repeated block tests at a single stress ratio as well as against spectral fatigue using the WISPER, WISPERX and NEW WISPER load sequences on a Glass/Epoxy multidirectional laminate typical of a wind turbine rotor...... blade construction. Two versions of the algorithm, the one using single-step and the other using incremental application of each load cycle (in case of ply failure) are implemented and compared. Simulation results confirm the ability of the algorithm to take into account load sequence effects...

  20. Female Sexual Dysfunction

    Science.gov (United States)

    ... medically as female sexual dysfunction. Many women experience problems with sexual function at some point. Female sexual dysfunction can occur at any stage of life. It can be lifelong or be acquired later in life. It can ...

  1. The Recognition Of Fatigue

    DEFF Research Database (Denmark)

    Elsass, Peter; Jensen, Bodil; Mørup, Rikke

    2007-01-01

    Elsass P., Jensen B., Morup R., Thogersen M.H. (2007). The Recognition Of Fatigue: A qualitative study of life-stories from rehabilitation clients. International Journal of Psychosocial Rehabilitation. 11 (2), 75-87......Elsass P., Jensen B., Morup R., Thogersen M.H. (2007). The Recognition Of Fatigue: A qualitative study of life-stories from rehabilitation clients. International Journal of Psychosocial Rehabilitation. 11 (2), 75-87...

  2. Postanesthetic temporomandibular joint dysfunction.

    OpenAIRE

    Knibbe, M. A.; Carter, J. B.; Frokjer, G. M.

    1989-01-01

    Internal derangements, myofascial pain dysfunction, and chronic dislocation of the temporomandibular joint (TMJ) are three common sequelae resulting from mandibular trauma. Etiologic factors include prolonged dental and otolaryngologic procedures, and intraoperative use of the laryngoscope and bronchoscope. Three cases are reported to document postanesthetic TMJ dysfunction arising from normal preoperative joints. Four types of TMJ dysfunction are discussed: anterior meniscus dislocation with...

  3. Lower limb vascular dysfunction in cyclists

    Directory of Open Access Journals (Sweden)

    Thiago Ayala Melo Di Alencar

    2013-06-01

    Full Text Available Sports-related vascular insufficiency affecting the lower limbs is uncommon, and early signs and symptoms can be confused with musculoskeletal injuries. This is also the case among professional cyclists, who are always at the threshold between endurance and excess training. The aim of this review was to analyze the occurrence of vascular disorders in the lower limbs of cyclists and to discuss possible etiologies. Eighty-five texts, including papers and books, published from 1950 to 2012, were used. According to the literature reviewed, some cyclists receive a late diagnosis of vascular dysfunction due to a lack of familiarity of the medical team with this type of dysfunction. Data revealed that a reduced blood flow in the external iliac artery, especially on the left, is much more common than in the femoral and popliteal arteries, and that vascular impairment is responsible for the occurrence of early fatigue and reduced performance in cycling.

  4. Creep-fatigue damage assessment by subsequent fatigue straining

    International Nuclear Information System (INIS)

    Yaguchi, Masatsugu; Nakamura, Toshiya; Ishikawa, Akiyoshi; Asada, Yasuhide

    1993-01-01

    A series of creep-fatigue tests has been conducted with Modified 9Cr-1Mo steel at 600 C in a high vacuum environment of 0.1 mPa to assess an accumulation of creep-fatigue damage. In these tests, each test specimen has been subjected to prior creep-fatigue loading followed by subsequent fatigue loading or prior fatigue loading followed by subsequent creep-fatigue loading. A linear summation of cumulative damage of fatigue and creep life fraction was smaller than unity for the former case, and larger than unity for the latter case. Scanning electron microscopic observation showed that in the case of prior creep-fatigue loading, a crack propagated from inclusions around which cavities were observed and its appearance transformed from transgranular to intergranular type with the increase of the number of cycles of prior creep-fatigue loading, while crack mode was predominantly intergranular in the case of prior fatigue loading. It was suggested that in the case of prior creep-fatigue loading, the fatigue life becomes shorter than that predicted by the linear rule due to early initiation of a crack caused from the cavity creation. In the case of prior fatigue loading, the crack propagates different courses in each loading to lead to the life fraction which is larger than unity

  5. Mental Fatigue Evaluation

    Directory of Open Access Journals (Sweden)

    Valery V. Rozhentsov

    2013-01-01

    Full Text Available The article offers the method for evaluation of mental fatigue, based on the method of paired light pulses. Ten pre-trained test men with normal vision, aged 18–20 participated in the experiment. Testees were showed subsequent paired light pulses at a 200 ms interval, divided by initial interpulse interval of 70 ms, recurring at the fixed time interval of 1 s. Testees determined the threshold interpulse interval, at which the two pulses in a pair merged into one, three times, using the method of successive approximation. Then testees solved algebraic equations with several unknowns for two hours. The threshold interpulse interval was determined three times every 20 minutes in the course of equations solving. The degree of mental fatigue DMF was calculated, using the formula: DMFi = (TPIi – TPI0 100% / TPIi; i = 1, 2, … , n, where DMFi is the degree of mental fatigue at the i-th measurement; TPIi is average arithmetic duration of threshold interpulse interval at the i-th measurement; TPI0 is average arithmetic duration of threshold interpulse interval before algebraic equations solving; n is the dimension of threshold interpulse interval measurement in the course of algebraic equations solving. After 20 minutes of work, the degree of mental fatigue of one of the testees was 9.5 %, rose to 21 % by the end of the first hour and exceeded 39 % by the end of the second hour. Similar dynamics of mental fatigue was observed in all testees, but its development and the degree of fatigue are individual. To prevent fatigue and ensure high level of efficiency one should set the individual schedule and rest pauses duration during mental activity.

  6. The contribution of disease severity, depression and negative affectivity to fatigue in multiple sclerosis: a comparison with ulcerative colitis.

    Science.gov (United States)

    Bol, Yvonne; Duits, Annelien A; Vertommen-Mertens, Christianne E R; Hupperts, Raymond M M; Romberg-Camps, Mariëlle J L; Verhey, Frans R J; Vlaeyen, Johan W S

    2010-07-01

    Fatigue is one of the most common and troubling symptoms of multiple sclerosis (MS) and more severe and disabling than fatigue in other somatic populations. Although fatigue seems MS specific, its pathogenesis is still poorly understood. To study the disease specificity of fatigue in MS by comparing its level, its physical and psychological correlates to those of patients with ulcerative colitis (UC), a peripheral chronic auto-immune disease. We focused on the relative contribution of disease severity, depression and negative affectivity to fatigue in both patient samples. A total of 88 MS and 76 UC patients were included in this cross-sectional study. Fatigue, depression and negative affectivity were assessed respectively with the physical and mental fatigue subscales of the Multidimensional Fatigue Inventory, the depression subscale of the Hospital Anxiety and Depression Scale, and the neuroticism subscale of the Dutch NEO Five-Factor Inventory. The Expanded Disability Status Scale and the Colitis Activity Index were used to measure disease severity in MS and UC patients respectively. While levels of both physical and mental fatigue were significantly higher in MS patients than in UC patients, there were no group differences in the contribution of disease severity, depression and negative affectivity to both physical and mental fatigue. Although levels of fatigue are higher for MS patients when compared with UC patients, the correlates of fatigue do not indicate MS specificity. As such our results support a transdiagnostic approach to fatigue in MS. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  7. Brain neurotransmitters in fatigue and overtraining.

    Science.gov (United States)

    Meeusen, Romain; Watson, Philip; Hasegawa, Hiroshi; Roelands, Bart; Piacentini, Maria F

    2007-10-01

    Since the publication of the serotonin hypothesis, numerous theories involving the accumulation or depletion of different substances in the brain have been proposed to explain central fatigue. Although the theoretical rationale for the "serotonin-fatigue hypothesis" is clear, several seemingly well-conducted studies have failed to support a significant role for 5-hydroxytryptamine in the development of fatigue. As brain function appears to be dependent upon the interaction of a number of systems, it is unlikely that a single neurotransmitter system is responsible for central fatigue. Several other mechanisms are involved, with evidence supporting a role for the brain catecholamines. Fatigue is therefore probably an integrated phenomenon, with complex interaction among central and peripheral factors. When prolonged and excessive training happens, concurrent with other stressors and insufficient recovery, performance decrements can result in chronic maladaptations that can lead to the overtraining syndrome (OTS). The mechanism of the OTS could be difficult to examine in detail, perhaps because the stress caused by excessive training load, in combination with other stressors, might trigger different "defence mechanisms" such as the immunological, neuroendocrine, and other physiological systems that all interact and probably therefore cannot be pinpointed as the "sole" cause of the OTS. It might be that, as in other syndromes, the psychoneuroimmunology (study of brain-behavior-immune interrelationships) might shed a light on the possible mechanisms of the OTS, but until there is a definite diagnostic tool, it is of utmost importance to standardize measures that are now thought to provide a good inventory of the training status of the athlete. It is very important to emphasize the need to distinguish the OTS from overreaching and other potential causes of temporary underperformance such as anemia, acute infection, muscle damage, and insufficient carbohydrate intake.

  8. Immune mediated liver failure.

    Science.gov (United States)

    Wang, Xiaojing; Ning, Qin

    2014-01-01

    Liver failure is a clinical syndrome of various etiologies, manifesting as jaundice, encephalopathy, coagulopathy and circulatory dysfunction, which result in subsequent multiorgan failure. Clinically, liver failure is classified into four categories: acute, subacute, acute-on-chronic and chronic liver failure. Massive hepatocyte death is considered to be the core event in the development of liver failure, which occurs when the extent of hepatocyte death is beyond the liver regenerative capacity. Direct damage and immune-mediated liver injury are two major factors involved in this process. Increasing evidence has suggested the essential role of immune-mediated liver injury in the pathogenesis of liver failure. Here, we review the evolved concepts concerning the mechanisms of immune-mediated liver injury in liver failure from human and animal studies. Both innate and adaptive immunity, especially the interaction of various immune cells and molecules as well as death receptor signaling system are discussed. In addition, we highlight the concept of "immune coagulation", which has been shown to be related to the disease progression and liver injury exacerbation in HBV related acute-on-chronic liver failure.

  9. Biologic fatigue in psoriasis.

    Science.gov (United States)

    Levin, Ethan C; Gupta, Rishu; Brown, Gabrielle; Malakouti, Mona; Koo, John

    2014-02-01

    Over the past 15 years, biologic medications have greatly advanced psoriasis therapy. However, these medications may lose their efficacy after long-term use, a concept known as biologic fatigue. We sought to review the available data on biologic fatigue in psoriasis and identify strategies to help clinicians optimally manage patients on biologic medications in order to minimize biologic fatigue. We reviewed phase III clinical trials for the biologic medications used to treat psoriasis and performed a PubMed search for the literature that assessed the loss of response to biologic therapy. In phase III clinical trials of biologic therapies for the treatment of psoriasis, 20-32% of patients lost their PASI-75 response during 0.8-3.9 years of follow-up. A study using infliximab reported the highest percentage of patients who lost their response (32%) over the shortest time-period (0.8 years). Although not consistently reported across all studies, the presence of antidrug antibodies was associated with the loss of response to treatment with infliximab and adalimumab. Biologic fatigue may be most frequent in those patients using infliximab. Further studies are needed to identify risk factors associated with biologic fatigue and to develop meaningful antidrug antibody assays.

  10. Fatigue During Head-And-Neck Radiotherapy: Prospective Study on 117 Consecutive Patients

    International Nuclear Information System (INIS)

    Jereczek-Fossa, Barbara Alicja; Santoro, Luigi; Alterio, Daniela; Franchi, Benedetta; Fiore, Maria Rosaria; Fossati, Piero; Kowalczyk, Anna; Canino, Paola; Ansarin, Mohssen; Orecchia, Roberto

    2007-01-01

    Purpose: Fatigue is an underevaluated cancer-related and treatment-related symptom. We analyzed fatigue in head and neck cancer patients undergoing radiotherapy (RT). Methods and Materials: A total of 117 patients were enrolled (mean age, 58 years). Radiation therapy (median dose, 66 Gy) was given with either exclusive or postoperative intent in 52 and 65 patients, respectively. Chemotherapy (CT) was added before and/or during RT in 61 patients. The patients completed a 20-item questionnaire (Multidimensional Fatigue Inventory [MFI-20]) before, during (weekly), and after RT. The impact of patient-, tumor-, and treatment-related factors on fatigue was evaluated with unifactorial and multifactorial tests. Results: Fatigue level increased during RT reaching a maximum at Week 6 and then slowly decreased. In multivariate stepwise regression analysis age (inversely related, p < 0.05), psychologic disorders (p < 0.005), and previous head-and-neck surgery (inversely related, p < 0.005) were correlated with higher pre-RT fatigue level. Pre-RT fatigue score (p < 0.0001), induction and/or concomitant CT (p = 0.035), need of cortisone during RT (p = 0.005), and thyroid disorders (p = 0.032) were correlated with higher during-RT fatigue level. Pre-RT fatigue score (p < 0.0001), induction and/or concomitant CT (p < 0.001), and need of cortisone during RT (p < 0.005) were correlated with higher post-RT fatigue level. No impact of gender, performance status, comorbidities other than psychologic and thyroid, tumor stage/site, RT intent, dose, volume, duration, or toxicity was observed. Conclusion: Fatigue affects all patients undergoing RT for head-and-neck cancer, reaches maximum score at the 6th week of RT, and slowly decreases thereafter. Age, thyroid dysfunction, psychologic disorders, pre-RT fatigue score, CT, and cortisone use are correlated with RT-related fatigue levels

  11. The Identification of Fatigue Resistant and Fatigue Susceptible Individuals

    Science.gov (United States)

    2008-05-01

    normalized and compared 38 to normalized SAFTE predictions. See text for details. Figure 3 Fatigue plots for fatigue susceptible vs. fatigue...has 5 seconds to press the button to get points for successful signal detections. Lower tones are given with greater frequency and responses to...address the first question, and we use predictions of the Sleep Activity Fatigue Task Effectiveness, or SAFTE model (Hursh, Redmond, Johnson, Thorne

  12. Fatigue design 1998

    Energy Technology Data Exchange (ETDEWEB)

    Marquis, G.; Solin, J. [eds.] [VTT Manufacturing Technology, Espoo (Finland)

    1998-12-31

    These preprints contain the presentations to be delivered at the Fatigue Design 1998 symposium held on May 26-29, 1998 in Espoo. Fatigue Design 1998 is the tenth in a series of VTT symposia addressing the challenge of fatigue of materials, components and structures. Previous international events were in 1992 and 1995. The key theme of the current meeting is `RELIABILITY`. The two volumes (VTT symposium 181-182) represent 56 contributions by authors representing 26 countries. Emphasis has been given to application oriented research topics that report new technologies, new uses of existing methods and case studies. The objective of the symposium is to bring together researchers and engineers to share experiences and new innovations in designing reliable components to resist alternating loads. (orig.)

  13. Determinants of seafarers’ fatigue

    DEFF Research Database (Denmark)

    Bøggild Dohrmann, Solveig; Leppin, Anja

    2017-01-01

    of the present article was therefore to systematically detect, analyze and assess the quality of this evidence. Methods: Systematic searches in ten databases were performed. Searches considered articles published in scholarly journals from 1980 to April 15, 2016. Nineteen out of 98 eligible studies were included......Purpose: Fatigue jeopardizes seafarer’s health and safety. Thus, knowledge on determinants of fatigue is of great importance to facilitate its prevention. However, a systematic analysis and quality assessment of all empirical evidence specifically for fatigue are still lacking. The aim......: Realistic countermeasures ought to be established, e.g., in terms of shared or split night shifts. As internal as well as external validity of many study findings was limited, the range of factors investigated was insufficient and few studies investigated more complex interactions between different factors...

  14. Fatigue in Cambodia veterans.

    Science.gov (United States)

    de Vries, M; Soetekouw, P M; Van Der Meer, J W; Bleijenberg, G

    2000-05-01

    In 1992 and 1993, Dutch military personnel were deployed in the peace operation UNTAC in Cambodia. Since returning, Cambodia veterans have reported health complaints which they perceive to be related to their service. Their symptoms strikingly resemble health problems reported by Gulf War veterans. Four years post-return, a cross-sectional survey on health symptoms in Cambodia veterans was initiated. Questionnaires were sent to all Cambodia veterans and four comparison groups. Forgetfulness, difficulty concentrating and fatigue were the symptoms most commonly endorsed. An operational case definition was constructed using a validated fatigue severity questionnaire. Cases were not uniquely found in Cambodia veterans (17%). In Rwanda and Bosnia veterans, respectively, 28% and 11% also met our case definition. Fatigue severity level was predicted by pre-mission, during-mission and post-mission variables, of which retrospective recollection of side-effects of vaccines and causal attributions also have been shown to be relevant in studies on Gulf-related illness.

  15. Modafinil May Alleviate Poststroke Fatigue

    DEFF Research Database (Denmark)

    Poulsen, Mai Bang; Damgaard, Bodil; Zerahn, Bo

    2015-01-01

    was randomized, double-blinded, and placebo-controlled. Patients were treated with 400-mg modafinil or placebo for 90 days. Assessments were done at inclusion, 30, 90, and 180 days. The primary end point was fatigue at 90 days measured by the Multidimensional Fatigue Inventory-20 general fatigue domain......BACKGROUND AND PURPOSE: Poststroke fatigue is common and reduces quality of life. Current evidence for intervention is limited, and this is the first placebo-controlled trial to investigate treatment of poststroke fatigue with the wakefulness promoting drug modafinil. METHODS: The trial....... Secondary end points included the Fatigue Severity Scale, the Montreal Cognitive Assessment, the modified Rankin Scale and the Stroke-specific quality of Life questionnaire. Adult patients with a recent stroke achieving a score of ≥12 on the Multidimensional Fatigue Inventory-20 general fatigue domain were...

  16. Do cognitive and physical fatigue tasks enhance pain, cognitive fatigue, and physical fatigue in people with fibromyalgia?

    Science.gov (United States)

    Dailey, Dana L; Keffala, Valerie J; Sluka, Kathleen A

    2015-02-01

    Fibromyalgia is a condition characterized by chronic widespread muscle pain and fatigue. The primary objective of this study was to determine if pain, perceived cognitive fatigue, and perceived physical fatigue were enhanced in participants with fibromyalgia compared to healthy controls during a cognitive fatigue task, a physical fatigue task, and a dual fatigue task. In total, 24 people with fibromyalgia and 33 healthy controls completed pain, fatigue, and function measures. A cognitive fatigue task (Controlled Oral Word Association Test) and physical fatigue task (Valpar peg test) were done individually and combined for a dual fatigue task. Resting pain, perceived cognitive fatigue, and perceived physical fatigue were assessed during each task using visual analog scales. Function was assessed with shoulder range of motion and grip. People with fibromyalgia had significantly higher increases in pain, cognitive fatigue, and physical fatigue when compared to healthy controls after completion of a cognitive fatigue task, a physical fatigue task, or a dual fatigue task (P fibromyalgia performed equivalently on measures of physical performance and cognitive performance on the physical and cognitive fatigue tasks, respectively. These data show that people with fibromyalgia show larger increases in pain, perceived cognitive fatigue, and perceived physical fatigue to both cognitive and physical fatigue tasks compared to healthy controls. The increases in pain and fatigue during cognitive and physical fatigue tasks could influence subject participation in daily activities and rehabilitation. Copyright © 2015 by the American College of Rheumatology.

  17. Fatigue 󈨛. Volume 1,

    Science.gov (United States)

    1987-06-01

    Growth of Small Fatigue 261 Cracks in Copper at Room and Cryogenic Temperatures - I.B. KWON , J. WEERTMAN AND M.E. FINE -ehaviour of Short Cracks in a...Cycli Strai Amplitudes. 0 4 . /2 < 0.3 [maximum stress < 60% oy ] Upon cycling, short cracks initiated in the soft (115 HV) precipitate-free...THE INITIATION AND GROWTH OF SMALL FATIGUE CRACKS IN COPPER AT ROOM AND CRYOGENIC TEMPERATURES I. B. Kwon , J. Weertman and M. E. Fine * The

  18. Postanesthetic temporomandibular joint dysfunction.

    Science.gov (United States)

    Knibbe, M. A.; Carter, J. B.; Frokjer, G. M.

    1989-01-01

    Internal derangements, myofascial pain dysfunction, and chronic dislocation of the temporomandibular joint (TMJ) are three common sequelae resulting from mandibular trauma. Etiologic factors include prolonged dental and otolaryngologic procedures, and intraoperative use of the laryngoscope and bronchoscope. Three cases are reported to document postanesthetic TMJ dysfunction arising from normal preoperative joints. Four types of TMJ dysfunction are discussed: anterior meniscus dislocation with reduction, anterior meniscus dislocation without reduction, dislocation/subluxation of the mandibular condyle, and myofascial pain dysfunction syndrome. Preoperative screening of mandibular function is recommended in identifying patients as either normal or having potential TMJ dysfunction. Failure to recognize postoperative TMJ dysfunction can lead to long-term symptoms that are difficult to alleviate. Litigation is a common sequel in these cases. Images Figure 3 PMID:2604053

  19. Fatigue Strength of Weathering Steel

    Czech Academy of Sciences Publication Activity Database

    Kunz, Ludvík; Lukáš, Petr; Klusák, Jan

    2012-01-01

    Roč. 18, č. 1 (2012), s. 18-22 ISSN 1392-1320 Grant - others:GA MPO(CZ) FT/TA5/076 Institutional support: RVO:68081723 Keywords : fatigue of weathering steel * corrosion pits * fatigue notch factor Subject RIV: JL - Materials Fatigue, Friction Mechanics Impact factor: 0.522, year: 2012

  20. Fatigue data compilation and evaluation of fatigue on design

    International Nuclear Information System (INIS)

    Nyilas, A.

    1985-05-01

    The aim of this report is a review of the available fatigue data of various materials necessary for the design of large superconducting magnets for fusion. One of the primary objectives of this work is to present a broad outline of the low temperature fatigue data of relevant materials within the scope of available data. Besides the classical fatigue data of materials the fatigue crack propagation measurements are outlined widely. The existing recommendations for the design of cryogenic structures are described. A brief introduction of fracture mechanics as well as a historical background of the development of our present day understanding of fatigue has been done. (orig.) [de

  1. Burden of Sexual Dysfunction.

    Science.gov (United States)

    Balon, Richard

    2017-01-02

    Similar to the burden of other diseases, the burden of sexual dysfunction has not been systematically studied. However, there is growing evidence of various burdens (e.g., economic, symptomatic, humanistic) among patients suffering from sexual dysfunctions. The burden of sexual dysfunction has been studied a bit more often in men, namely the burden of erectile dysfunction (ED), premature ejaculation (PE) and testosterone deficiency syndrome (TDS). Erectile dysfunction is frequently associated with chronic conditions such as cardiovascular disease, diabetes, and depression. These conditions could go undiagnosed, and ED could be a marker of those diseases. The only available report from the United Kingdom estimated the total economic burden of ED at £53 million annually in terms of direct costs and lost productivity. The burden of PE includes significant psychological distress: anxiety, depression, lack of sexual confidence, poor self-esteem, impaired quality of life, and interpersonal difficulties. Some suggest that increase in female sexual dysfunction is associated with partner's PE, in addition to significant interpersonal difficulties. The burden of TDS includes depression, sexual dysfunction, mild cognitive impairment, and osteoporosis. One UK estimate of the economic burden of female sexual dysfunctions demonstrated that the average cost per patient was higher than the per annum cost of ED. There are no data on burden of paraphilic disorders. The burden of sexual dysfunctions is underappreciated and not well studied, yet it is significant for both the patients and the society.

  2. Association of chronic fatigue syndrome with human leucocyte antigen class II alleles

    Science.gov (United States)

    Smith, J; Fritz, E L; Kerr, J R; Cleare, A J; Wessely, S; Mattey, D L

    2005-01-01

    Background: A genetic component to the development of chronic fatigue syndrome (CFS) has been proposed, and a possible association between human leucocyte antigen (HLA) class II antigens and chronic fatigue immune dysfunction has been shown in some, but not all, studies. Aims: To investigate the role of HLA class II antigens in CFS. Methods: Forty nine patients with CFS were genotyped for the HLA-DRB1, HLA-DQA1, and HLA-DQB1 alleles and the frequency of these alleles was compared with a control group comprising 102 normal individuals from the UK. All patients and controls were from the same region of England and, apart from two patients, were white. Results: Analysis by 2 × 2 contingency tables revealed an increased frequency of HLA-DQA1*01 alleles in patients with CFS (51.0% v 35%; odds ratio (OR), 1.93; p  =  0.008). HLA-DQB1*06 was also increased in the patients with CFS (30.2% v 20.0%; OR, 1.73, p  =  0.052). Only the association between HLA-DQA1*01 and CFS was significant in logistic regression models containing HLA-DQA1*01 and HLA-DRQB1*06, and this was independent of HLA-DRB1 alleles. There was a decreased expression of HLA-DRB1*11 in CFS, although this association disappeared after correction for multiple comparisons. Conclusions: CFS may be associated with HLA-DQA1*01, although a role for other genes in linkage disequilibrium cannot be ruled out. PMID:16049290

  3. Fatigue and thermal fatigue of Pb-Sn solder joints

    International Nuclear Information System (INIS)

    Frear, D.; Grivas, D.; McCormack, M.; Tribula, D.; Morris, J.W. Jr.

    1987-01-01

    This paper presents a fundamental investigation of the fatigue and thermal fatigue characteristics, with an emphasis on the microstructural development during fatigue, of Sn-Pb solder joints. Fatigue tests were performed in simple shear on both 60Sn-40Pb and 5Sn-95Pb solder joints. Isothermal fatigue tests show increasing fatigue life of 60Sn-40Pb solder joints with decreasing strain and temperature. In contrast, such behavior was not observed in the isothermal fatigue of 5Sn-95Pb solder joints. Thermal fatigue results on 60Sn-40Pb solder cycled between -55 0 C and 125 0 C show that a coarsened region develops in the center of the joint. Both Pb-rich and Sn-rich phases coarsen, and cracks form within these coarsened regions. The failure mode 60Sn-40Pb solder joints in thermal and isothermal fatigue is similar: cracks form intergranularly through the Sn-rich phase or along Sn/Pb interphase boundaries. Extensive cracking is found throughout the 5Sn-95Pb joint for both thermal and isothermal fatigue. In thermal fatigue the 5Sn-95Pb solder joints failed after fewer cycles than 60Sn-40Pb

  4. Fatigue approach for addressing environmental effects in fatigue usage calculation

    International Nuclear Information System (INIS)

    Wilhelm, Paul; Rudolph, Juergen; Steinmann, Paul

    2015-01-01

    Laboratory tests consider simple trapezoidal, triangle, and sinusoidal signals. However, actual plant components are characterized by complex loading patterns and periods of holds. Fatigue tests in water environment show, that the damage from a realistic strain variation or the presence of hold-times within cyclic loading results in an environmental reduction factor (Fen) only half that of a simple waveform. This study proposes a new fatigue approach for addressing environmental effects in fatigue usage calculation for class 1 boiler and pressure vessel reactor components. The currently accepted method of fatigue assessment has been used as a base model and all cycles, which have been comparable with realistic fatigue tests, have been excluded from the code-based fatigue calculation and evaluated directly with the test data. The results presented show that the engineering approach can successfully be integrated in the code-based fatigue assessment. The cumulative usage factor can be reduced considerably.

  5. 6. THE ROLE OF SELENIUM IN HUMAN IMMUNITY

    African Journals Online (AJOL)

    Esem

    that selenium has a role in immune function. Immune dysfunction, susceptibility to viral infections and increased mortality are some of the outcomes associated .... In another experimental system, Listeria monocytogenes was administered to mice orally to assess the effect of Se. 17 on innate immunity. Mice were infected ...

  6. Chronic fatigue syndrome

    African Journals Online (AJOL)

    Objective. To acknowledge the dinical syndrome chronic fatigue syndrome (CFS) and outline the diagnostic criteria and reasonable management. Outcomes. Attempt at containment of treatmentcost and improvement of the quality of care of patients with. CFS. Evidence. Delphi-type commentary from 20 expert clinicians and ...

  7. Caffeine, fatigue, and cognition

    NARCIS (Netherlands)

    Lorist, M.M.; Tops, M.

    2003-01-01

    Effects of caffeine and fatigue are discussed with special attention to adenosine-dopamine interactions. Effects of caffeine on human cognition are diverse. Behavioural measurements indicate a general improvement in the efficiency of information processing after caffeine, while the EEG data support

  8. Fatigue Countermeasures in Aviation

    Science.gov (United States)

    2009-01-01

    310. 26. Booth-Bourdeau J, Marcil 1, Laurence :M, McCulloch K, Dawson D. Development of fatigue risk management systenls for the Canadian aviation... Warren PSG, Watson B, Drud M. The sleep and performance of shift workers. Hum Factors 1982; 24:629-41. 206. Touitou Y, Bogdan A. Promoting adjustment

  9. FATIGUE OF DENTAL CERAMICS

    Science.gov (United States)

    Zhang, Yu; Sailer, Irena; Lawn, Brian R

    2013-01-01

    Objectives Clinical data on survival rates reveal that all-ceramic dental prostheses are susceptible to fracture from repetitive occlusal loading. The objective of this review is to examine the underlying mechanisms of fatigue in current and future dental ceramics. Data/sources The nature of various fatigue modes is elucidated using fracture test data on ceramic layer specimens from the dental and biomechanics literature. Conclusions Failure modes can change over a lifetime, depending on restoration geometry, loading conditions and material properties. Modes that operate in single-cycle loading may be dominated by alternative modes in multi-cycle loading. While post-mortem examination of failed prostheses can determine the sources of certain fractures, the evolution of these fractures en route to failure remains poorly understood. Whereas it is commonly held that loss of load-bearing capacity of dental ceramics in repetitive loading is attributable to chemically-assisted 'slow crack growth' in the presence of water, we demonstrate the existence of more deleterious fatigue mechanisms, mechanical rather than chemical in nature. Neglecting to account for mechanical fatigue can lead to gross overestimates in predicted survival rates. Clinical significance Strategies for prolonging the clinical lifetimes of ceramic restorations are proposed based on a crack-containment philosophy. PMID:24135295

  10. Fatigue modelling for gas nitriding

    Directory of Open Access Journals (Sweden)

    H. Weil

    2016-10-01

    Full Text Available The present study aims to develop an algorithm able to predict the fatigue lifetime of nitrided steels. Linear multi-axial fatigue criteria are used to take into account the gradients of mechanical properties provided by the nitriding process. Simulations on rotating bending fatigue specimens are made in order to test the nitrided surfaces. The fatigue model is applied to the cyclic loading of a gear from a simulation using the finite element software Ansys. Results show the positive contributions of nitriding on the fatigue strength

  11. Muscle Deoxygenation Causes Muscle Fatigue

    Science.gov (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D.

    1999-01-01

    Muscle fatigue is a common musculoskeletal disorder in the work place, and may be a harbinger for more disabling cumulative trauma disorders. Although the cause of fatigue is multifactorial, reduced blood flow and muscle oxygenation may be the primary factor in causing muscle fatigue during low intensity muscle exertion. Muscle fatigue is defined as a reduction in muscle force production, and also occurs among astronauts who are subjected to postural constraints while performing lengthy, repetitive tasks. The objectives of this research are to: 1) develop an objective tool to study the role of decreased muscle oxygenation on muscle force production, and 2) to evaluate muscle fatigue during prolonged glovebox work.

  12. Sleep Dysfunction and Gastrointestinal Diseases.

    Science.gov (United States)

    Khanijow, Vikesh; Prakash, Pia; Emsellem, Helene A; Borum, Marie L; Doman, David B

    2015-12-01

    Sleep deprivation and impaired sleep quality have been associated with poor health outcomes. Many patients experience sleep disturbances, which can increase the risk of medical conditions such as hypertension, obesity, stroke, and heart disease as well as increase overall mortality. Recent studies have suggested that there is a strong association between sleep disturbances and gastrointestinal diseases. Proinflammatory cytokines, such as tumor necrosis factor, interleukin-1, and interleukin-6, have been associated with sleep dysfunction. Alterations in these cytokines have been seen in certain gastrointestinal diseases, such as gastroesophageal reflux disease, inflammatory bowel disease, liver disorders, and colorectal cancer. It is important for gastroenterologists to be aware of the relationship between sleep disorders and gastrointestinal illnesses to ensure good care for patients. This article reviews the current research on the interplay between sleep disorders, immune function, and gastrointestinal diseases.

  13. Erectile Dysfunction (ED)

    Science.gov (United States)

    ... men older than 75 years of age. Is erectile dysfunction just a part of old age? ED doesn’t have to be a part of getting older. It’s true that as you get older, you may need more ... Symptoms of erectile dysfunction The primary symptom of ED is not ...

  14. Loneliness and Sexual Dysfunctions.

    Science.gov (United States)

    Mijuskovic, Ben

    1987-01-01

    Argues that sexual dysfunctions result from early childhood experiences which were originally nonsexual in nature. Contends that psychological difficulties centered around problems of loneliness tend to generate certain sexual dysfunctions. Extends and explores suggestion that genesis of sexual conflicts is in nonsexual infant separation anxiety…

  15. Immunization Coverage

    Science.gov (United States)

    ... sheets Fact files Questions & answers Features Multimedia Contacts Immunization coverage Fact sheet Reviewed January 2018 Key facts ... at least 90% coverage of DTP3 vaccine. Global immunization coverage 2016 A summary of global vaccination coverage ...

  16. Immunizations - diabetes

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000331.htm Immunizations - diabetes To use the sharing features on this page, please enable JavaScript. Immunizations (vaccines or vaccinations) help protect you from some ...

  17. Immune response

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000821.htm Immune response To use the sharing features on this page, please enable JavaScript. The immune response is how your body recognizes and defends itself ...

  18. Genetics Home Reference: surfactant dysfunction

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Surfactant dysfunction Surfactant dysfunction Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Surfactant dysfunction is a lung disorder that causes breathing ...

  19. Immunization Schedule

    Science.gov (United States)

    ... may be given as part of a combination vaccine so that a child gets fewer shots. Talk with your doctor about ... Kids Teens Frequently Asked Questions About Immunizations Your Child's Immunizations Is the Flu Vaccine a Good Idea for Your Family? Word! Immunizations ...

  20. Fatigue Experiences Among OCD Outpatients.

    Science.gov (United States)

    Pasquini, Massimo; Piacentino, Daria; Berardelli, Isabella; Roselli, Valentina; Maraone, Annalisa; Tarsitani, Lorenzo; Biondi, Massimo

    2015-12-01

    Patients with OCD are impaired in multiple domains of functioning and quality of life. While associated psychopathology complaints and neuropsychological deficits were reported, the subjective experience of general fatigue and mental fatigue was scarcely investigated. In this single-center case-control study we compared 50 non-depressed OCD outpatients consecutively recruited and 50 panic disorder (PD) outpatients, to determine whether they experienced fatigue differently. Assessment consisted of structured clinical interview for DSM-IV criteria by using the SCID-I and the SCID-II. Symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale, the Hamilton Anxiety Rating Scale, the Hamilton Depression Rating Scale, the Clinical Global Impressions Scale, severity and the Global Assessment of Functioning Scale. Fatigue was assessed by using the Multidimensional Fatigue Inventory (MFI). Regarding MFI physical fatigue, an OR of 0.196 (95 % CI 0.080-0.478) was found, suggesting that its presence is associated with lower odds of OCD compared to PD. The same can be said for MFI mental fatigue, as an OR of 0.138 (95 % CI 0.049-0.326) was found, suggesting that its presence is associated with lower odds of OCD. Notably, OCD patients with OCDP co-morbidity reported higher scores of mental fatigue. In this study fatigue, including mental fatigue, seems not to be a prominent experience among adult non-depressed OCD patients.

  1. Relation of quantitative visual and neurologic outcomes to fatigue in multiple sclerosis.

    Science.gov (United States)

    Chahin, Salim; Miller, Deborah; Sakai, Reiko E; Wilson, James A; Frohman, Teresa; Markowitz, Clyde; Jacobs, Dina; Green, Ari; Calabresi, Peter A; Frohman, Elliot M; Galetta, Steven L; Balcer, Laura J

    2015-07-01

    The relation of fatigue in multiple sclerosis (MS) to the visual system, an emerging structural and functional surrogate in MS, has not been well established. We examined how physical and cognitive fatigue could be associated with visual dysfunction and neurologic impairment. At a single time-point, we assessed 143 patients with: Low-contrast letter acuity (LCLA) and high-contrast visual acuity (VA) testing, the 25-Item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) and Neuro-Ophthalmic Supplement, the Modified Fatigue Impact Scale (MFIS), the MS Functional Composite (MSFC), and the Expanded Disability Status Scale (EDSS). Worse binocular LCLA scores were associated with increased levels of total and physical fatigue (p≤0.026). Greater levels of fatigue were also associated with reduced vision-specific QOL (pcognitive, fatigue had greater levels of impairment by the Timed 25-Foot Walk (T25W, r=0.39, pvision in MS is highly associated with physical fatigue and could be used to capture more global, difficult to describe, symptoms. The potential differences in physical vs. cognitive fatigue and their correlates may begin to provide insight into their underlying mechanisms. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Diastolic dysfunction characterizes cirrhotic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Piyush O. Somani

    2014-11-01

    Conclusions: Present study shows that although diastolic dysfunction is a frequent event in cirrhosis, it is usually of mild degree and does not correlate with severity of liver dysfunction. There are no significant differences in echocardiographic parameters between alcoholic and non-alcoholic cirrhosis. HRS is not correlated to diastolic dysfunction in cirrhotic patients. There is no difference in survival at one year between patients with or without diastolic dysfunction. Diastolic dysfunction in cirrhosis is unrelated to circulatory dysfunction, ascites and HRS.

  3. Caffeine, fatigue, and cognition.

    Science.gov (United States)

    Lorist, Monicque M; Tops, Mattie

    2003-10-01

    Effects of caffeine and fatigue are discussed with special attention to adenosine-dopamine interactions. Effects of caffeine on human cognition are diverse. Behavioural measurements indicate a general improvement in the efficiency of information processing after caffeine, while the EEG data support the general belief that caffeine acts as a stimulant. Studies using ERP measures indicate that caffeine has an effect on attention, which is independent of specific stimulus characteristics. Behavioural effects on response related processes turned out to be mainly related to more peripheral motor processes. Recent insights in adenosine and dopamine physiology and functionality and their relationships with fatigue point to a possible modulation by caffeine of mechanisms involved in the regulation of behavioural energy expenditure.

  4. Helicopter Fatigue Design Guide

    Science.gov (United States)

    1983-11-01

    Utility Tactical Troop Carrying Heavy Lift Air Force: Transport Search and Rescue The sheer scale of the costs of designing and developing a modern...torsion, the latter being related to piano wire and stainless steel 18.8. To my knowledge a 25 % improvement can be ob- tained by shot peening on actual...N testing is not in the test itself, but in the sheer number of tests to be conducted. A modern helicopter may have from 75 to 100 fatigue

  5. Vocal cord dysfunction.

    Science.gov (United States)

    Deckert, James; Deckert, Linda

    2010-01-15

    Vocal cord dysfunction involves inappropriate vocal cord motion that produces partial airway obstruction. Patients may present with respiratory distress that is often mistakenly diagnosed as asthma. Exercise, psychological conditions, airborne irritants, rhinosinusitis, gastroesophageal reflux disease, or use of certain medications may trigger vocal cord dysfunction. The differential diagnosis includes asthma, angioedema, vocal cord tumors, and vocal cord paralysis. Pulmonary function testing with a flow-volume loop and flexible laryngoscopy are valuable diagnostic tests for confirming vocal cord dysfunction. Treatment of acute episodes includes reassurance, breathing instruction, and use of a helium and oxygen mixture (heliox). Long-term management strategies include treatment for symptom triggers and speech therapy.

  6. An unbiased metagenomic search for infectious agents using monozygotic twins discordant for chronic fatigue

    Directory of Open Access Journals (Sweden)

    Jacks Andreas

    2011-01-01

    Full Text Available Abstract Background Chronic fatigue syndrome is an idiopathic syndrome widely suspected of having an infectious or immune etiology. We applied an unbiased metagenomic approach to try to identify known or novel infectious agents in the serum of 45 cases with chronic fatigue syndrome or idiopathic chronic fatigue. Controls were the unaffected monozygotic co-twins of cases, and serum samples were obtained at the same place and time. Results No novel DNA or RNA viral signatures were confidently identified. Four affected twins and no unaffected twins evidenced viremia with GB virus C (8.9% vs. 0%, p = 0.019, and one affected twin had previously undetected hepatitis C viremia. An excess of GB virus C viremia in cases with chronic fatigue requires confirmation. Conclusions Current, impairing chronic fatigue was not robustly associated with viremia detectable in serum.

  7. Echinoderm immunity.

    Science.gov (United States)

    Smith, L Courtney; Ghosh, Julie; Buckley, Katherine M; Clow, Lori A; Dheilly, Nolwenn M; Haug, Tor; Henson, John H; Li, Chun; Lun, Cheng Man; Majeske, Audrey J; Matranga, Valeria; Nair, Sham V; Rast, Jonathan P; Raftos, David A; Roth, Mattias; Sacchi, Sandro; Schrankel, Catherine S; Stensvåg, Klara

    2010-01-01

    A survey for immune genes in the genome for the purple sea urchin has shown that the immune system is complex and sophisticated. By inference, immune responses of all echinoderms maybe similar. The immune system is mediated by several types of coelomocytes that are also useful as sensors of environmental stresses. There are a number of large gene families in the purple sea urchin genome that function in immunity and of which at least one appears to employ novel approaches for sequence diversification. Echinoderms have a simpler complement system, a large set of lectin genes and a number of antimicrobial peptides. Profiling the immune genes expressed by coelomocytes and the proteins in the coelomic fluid provide detailed information about immune functions in the sea urchin. The importance of echinoderms in maintaining marine ecosystem stability and the disastrous effects of their removal due to disease will require future collaborations between ecologists and immunologists working towards understanding and preserving marine habitats.

  8. Immunizing Children

    Directory of Open Access Journals (Sweden)

    Geraldine Jody Macdonald

    2014-11-01

    Full Text Available This article addresses the complex contexts within which Canadian health professionals engage in immunizing children and focuses on the Canadian practice guidelines and current scientific evidence that direct Canadian health professional competencies. The article begins by presenting two current global vaccine initiatives and links these to immunization in Canada. A selected literature review identifies current best immunization practices. With the purpose of promoting quality improvement, three key Canadian immunization competencies for health professional are highlighted: communication with parents, including those who are experiencing vaccine hesitancy; administration of immunizing agents; and documentation of immunizations. Health professionals are encouraged to reflect on immunization competencies and ensure evidence-based practices underpin vaccine delivery in their primary care settings.

  9. Probabilistic Fatigue Damage Program (FATIG)

    Science.gov (United States)

    Michalopoulos, Constantine

    2012-01-01

    FATIG computes fatigue damage/fatigue life using the stress rms (root mean square) value, the total number of cycles, and S-N curve parameters. The damage is computed by the following methods: (a) traditional method using Miner s rule with stress cycles determined from a Rayleigh distribution up to 3*sigma; and (b) classical fatigue damage formula involving the Gamma function, which is derived from the integral version of Miner's rule. The integration is carried out over all stress amplitudes. This software solves the problem of probabilistic fatigue damage using the integral form of the Palmgren-Miner rule. The software computes fatigue life using an approach involving all stress amplitudes, up to N*sigma, as specified by the user. It can be used in the design of structural components subjected to random dynamic loading, or by any stress analyst with minimal training for fatigue life estimates of structural components.

  10. Metabolic gene expression changes in astrocytes in Multiple Sclerosis cerebral cortex are indicative of immune-mediated signaling

    KAUST Repository

    Zeis, T.

    2015-04-01

    Emerging as an important correlate of neurological dysfunction in Multiple Sclerosis (MS), extended focal and diffuse gray matter abnormalities have been found and linked to clinical manifestations such as seizures, fatigue and cognitive dysfunction. To investigate possible underlying mechanisms we analyzed the molecular alterations in histopathological normal appearing cortical gray matter (NAGM) in MS. By performing a differential gene expression analysis of NAGM of control and MS cases we identified reduced transcription of astrocyte specific genes involved in the astrocyte–neuron lactate shuttle (ANLS) and the glutamate–glutamine cycle (GGC). Additional quantitative immunohistochemical analysis demonstrating a CX43 loss in MS NAGM confirmed a crucial involvement of astrocytes and emphasizes their importance in MS pathogenesis. Concurrently, a Toll-like/IL-1β signaling expression signature was detected in MS NAGM, indicating that immune-related signaling might be responsible for the downregulation of ANLS and GGC gene expression in MS NAGM. Indeed, challenging astrocytes with immune stimuli such as IL-1β and LPS reduced their ANLS and GGC gene expression in vitro. The detected upregulation of IL1B in MS NAGM suggests inflammasome priming. For this reason, astrocyte cultures were treated with ATP and ATP/LPS as for inflammasome activation. This treatment led to a reduction of ANLS and GGC gene expression in a comparable manner. To investigate potential sources for ANLS and GGC downregulation in MS NAGM, we first performed an adjuvant-driven stimulation of the peripheral immune system in C57Bl/6 mice in vivo. This led to similar gene expression changes in spinal cord demonstrating that peripheral immune signals might be one source for astrocytic gene expression changes in the brain. IL1B upregulation in MS NAGM itself points to a possible endogenous signaling process leading to ANLS and GGC downregulation. This is supported by our findings that, among others

  11. Perceived fatigue following pediatric burns.

    Science.gov (United States)

    Akkerman, Moniek; Mouton, Leonora J; Dijkstra, Froukje; Niemeijer, Anuschka S; van Brussel, Marco; van der Woude, Lucas H V; Disseldorp, Laurien M; Nieuwenhuis, Marianne K

    2017-12-01

    Fatigue is a common consequence of numerous pediatric health conditions. In adult burn survivors, fatigue was found to be a major problem. The current cross-sectional study is aimed at determining the levels of perceived fatigue in pediatric burn survivors. Perceived fatigue was assessed in 23 children and adolescents (15 boys and 8 girls, aged 6-18 years, with burns covering 10-46% of the total body surface area, 1-5 years post burn) using both child self- and parent proxy reports of the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale. Outcomes were compared with reference values of non-burned peers. At group level, pediatric burn survivors did not report significantly more symptoms of fatigue than their non-burned peers. Individual assessments showed, however, that four children experienced substantial symptoms of fatigue according to the child self-reports, compared to ten children according to the parent proxy reports. Furthermore, parents reported significantly more symptoms of fatigue than the children themselves. Age, gender, extent of burn, length of hospital stay, and number of surgeries could not predict the level of perceived fatigue post-burn. Our results suggest that fatigue is prevalent in at least part of the pediatric burn population after 1-5 years. However, the fact that parents reported significantly more symptoms of fatigue then the children themselves, hampers evident conclusions. It is essential for clinicians and therapists to consider both perspectives when evaluating pediatric fatigue after burn and to determine who needs special attention, the pediatric burn patient or its parent. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  12. Spinal Cord Dysfunction (SCD)

    Data.gov (United States)

    Department of Veterans Affairs — The Spinal Cord Dysfunction (SCD) module supports the maintenance of local and national registries for the tracking of patients with spinal cord injury and disease...

  13. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Sexual Dysfunction in Urogynaecology

    NARCIS (Netherlands)

    A.M.E. Roos (Anne-Marie)

    2014-01-01

    markdownabstract__abstract__ This thesis is dedicated to enhance understanding of sexual dysfunction in the field of urogynaecology, focussing on the prevalence of sexual problems in urogynaecology clinics, the clinical attention of the urogynaecologist to female sexual dyfunction, the impact

  15. Quality and fatigue characteristics relation

    Directory of Open Access Journals (Sweden)

    Libor Trško

    2016-03-01

    Full Text Available This paper will explore the mutual correlation of fatigue characteristics ((Kath, σc, ac = f (Rm of five structural steels tested at highfrequency loading based on tests (f ≈ 20 kHz, T = 20 ± 10 °C, R = -1. Different fatigue resistance parameters have different meanings and misunderstanding can lead to significant quality problems in component operation. Consequently, it is necessary to completely understand the relations between the two most important fatigue characteristics which are fatigue limit σc and the threshold value of the stress intensity factor amplitudeKath and how they act with changing of steel ultimate tensile strength.

  16. Gene expression in response to exercise in patients with chronic fatigue syndrome: a pilot study.

    Directory of Open Access Journals (Sweden)

    Andrew Keech

    2016-09-01

    Full Text Available Chronic fatigue syndrome (CFS is a debilitating disorder of unknown pathogenesis, characterised by fatigue, which is exacerbated after minimal exercise. We examined the effect of a single bout of aerobic exercise on leucocyte mRNA expression of genes putatively linked to exaggerated afferent signalling as an under-pinning of the fatigue state. A carefully-characterised sample of patients with CFS (N = 10 and healthy matched control participants (N = 12 were included. Participant ratings of fatigue and other symptoms, as well as blood samples, were obtained at baseline, and five other time-points up to 72 hours after 25 minutes of moderate-intensity cycling exercise. Leucocyte mRNA of 19 metabolite-sensing, adrenergic, immune and neurotransmission genes was examined using quantitative polymerase chain reaction. Patients with CFS reported substantial fatigue, functional impairment and poor sleep at baseline (all p < 0.02, and exercise immediately induced worsened patients’ fatigue (effect size, ES = 1.17. There were no significant changes in gene expression after exercise and patients did not differ from control participants at any time point. Higher levels of expression of ficolin (FCN1 and a purinergic receptor (P2RX4 in patients with CFS were found when all time points were combined. Patients with CFS did not show significant exercise-induced changes in leucocyte mRNA of 19 metabolite-sensing, adrenergic, immune and neurotransmission genes despite a prominent exacerbation of fatigue.

  17. Effect of supplement with lactic-acid producing bacteria on fatigue and physical activity in patients with chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Evengård Birgitta

    2009-01-01

    Full Text Available Abstract Disturbances in intestinal microbial ecology and in the immune system of the host have been implicated as a part of the pathogenesis in chronic fatigue syndrome. Probiotic lactic acid producing bacteria have been shown to prevent and alleviate gastrointestinal disturbances and to normalize the cytokine profile which might be of an advantage for patients suffering from chronic fatigue syndrome. The aim of the study was to evaluate the effect of Lactobacillus paracasei ssp. paracasei F19, Lactobacillus acidophilus NCFB 1748 and Bifidobacterium lactis Bb12 on fatigue and physical activity in CFS patients. Fifteen patients fulfilling the criteria set by international researchers in the field at the US Centre for Disease Control and Prevention in 1994 for chronic fatigue syndrome, were included in the study. The patients had high fatigue severity scores and high disability scores. During the first two weeks baseline observations without treatment were assessed, succeeded by four weeks of intake of a probiotic product and a four-week follow-up period. The fatigue, health and physical activity was assessed by the use of the Visual Analogue Scales and the SF-12 Health Survey. Faecal samples were collected and the normal microflora was analysed. Neurocognitive functions improved during the study period while there were no significant changes in fatigue and physical activity scores. No major changes occurred in the gastrointestinal microflora. At the end of the study 6 of 15 patients reported that they had improved according to the assessment described. The findings in this study that improvement of health is possible to achieve should encourage further studies with interventions with probiotics in patients with CFS.

  18. [Chronic fatigue syndrome: A new disorder?

    Science.gov (United States)

    de Korwin, J-D; Chiche, L; Banovic, I; Ghali, A; Delliaux, S; Authier, F-J; Cozon, G; Hatron, P-Y; Fornasieri, I; Morinet, F

    2016-12-01

    More than 30 years after its individualization, chronic fatigue syndrome (CFS) remains a debilitating condition for the patient and a confusing one to the physicians, both because of diagnostic difficulties and poorly codified management. Despite the numerous work carried out, its pathophysiology remains unclear, but a multifactorial origin is suggested with triggering (infections) and maintenance (psychological) factors as well as the persistence of inflammatory (low grade inflammation, microglial activation…), immunologic (decrease of NK cells, abnormal cytokine production, reactivity to a variety of allergens, role of estrogens…) and muscular (mitochondrial dysfunction and failure of bioenergetic performance) abnormalities at the origin of multiple dysfunctions (endocrine, neuromuscular, cardiovascular, digestive…). The complexity of the problem and the sometimes contradictory results of available studies performed so far are at the origin of different pathophysiological and diagnostic concepts. Based on a rigorous analysis of scientific data, the new American concept of Systemic Disease Exertion Intolerance proposed in 2015 simplifies the diagnostic approach and breaks with the past and terminologies (CFS and myalgic encephalomyelitis). It is still too early to distinguish a new disease, but this initiative is a strong signal to intensify the recognition and management of patients with CFS and stimulate research. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  19. Cyclic plasticity and fatigue of metals

    International Nuclear Information System (INIS)

    Mughrabi, H.

    1993-01-01

    This report is a survey of the cyclic deformation and fatigue behaviour of selected engineering steels and alloys. Emphasis is placed on the important roles of the cyclic slip mode and the stability of the microstructure during cyclic stressing and on the conditions of fatigue testing with respect to the failure mechanisms and fatigue life. The examples presented include low-temperature fatigue, high-temperature fatigue in the presence of dynamic strain ageing and thermomechanical fatigue. (orig.)

  20. Hepatitis C Virus-Induced Mitochondrial Dysfunctions

    Directory of Open Access Journals (Sweden)

    Birke Bartosch

    2013-03-01

    Full Text Available Chronic hepatitis C is characterized by metabolic disorders and a microenvironment in the liver dominated by oxidative stress, inflammation and regeneration processes that lead in the long term to hepatocellular carcinoma. Many lines of evidence suggest that mitochondrial dysfunctions, including modification of metabolic fluxes, generation and elimination of oxidative stress, Ca2+ signaling and apoptosis, play a central role in these processes. However, how these dysfunctions are induced by the virus and whether they play a role in disease progression and neoplastic transformation remains to be determined. Most in vitro studies performed so far have shown that several of the hepatitis C virus (HCV proteins localize to mitochondria, but the consequences of these interactions on mitochondrial functions remain contradictory, probably due to the use of artificial expression and replication systems. In vivo studies are hampered by the fact that innate and adaptive immune responses will overlay mitochondrial dysfunctions induced directly in the hepatocyte by HCV. Thus, the molecular aspects underlying HCV-induced mitochondrial dysfunctions and their roles in viral replication and the associated pathology need yet to be confirmed in the context of productively replicating virus and physiologically relevant in vitro and in vivo model systems.

  1. Fatigue 󈨛. Volume 3,

    Science.gov (United States)

    1987-06-01

    the University of Virginia, Charlottesville, Virginia. 0 June 28 - July 3, 1987 J 0 EDITORIAL PANEL p...c.. d R.P. Gangloff, R.O. Ritchie, E.A. Starke...8217- rrocee, s hi, ir-.---’atc- % apour prE r ardL heance the rt-4d;ee Kix it tho crac&’ tip cat sos ’ her , qrowtb. rate. in ’ a e oxi-rt-,-tcd -is t t...precursor wire) was typically 0.064 cm. 1334 FATIGUE 87 Fabrication of the precursor wire into panels was done by DWA Composite Specialties, Inc., using the

  2. Fatigue in soccer

    DEFF Research Database (Denmark)

    Mohr, Magni; Krustrup, Peter; Bangsbo, Jens

    2005-01-01

    in the game: (1) after short-term intense periods in both halves; (2) in the initial phase of the second half; and (3) towards the end of the game. Temporary fatigue after periods of intense exercise in the game does not appear to be linked directly to muscle glycogen concentration, lactate accumulation......, acidity or the breakdown of creatine phosphate. Instead, it may be related to disturbances in muscle ion homeostasis and an impaired excitation of the sarcolemma. Soccer players' ability to perform maximally is inhibited in the initial phase of the second half, which may be due to lower muscle...

  3. Magnesium deficiency and endothelial dysfunction: is oxidative stress involved?

    NARCIS (Netherlands)

    Wolf, F.I.; Trapani, V.; Simonacci, M.; Ferre, S.; Maier, J.A.

    2008-01-01

    Low magnesium (Mg) has been associated with oxidative stress, an important player in aging, atherosclerosis and other vascular diseases. In vivo, low Mg and immune system activation seem to cooperate to promote endothelial dysfunction. We therefore evaluated whether exposure of human endothelial

  4. Contributions of pulmonary hypertension to HIV-related cardiac dysfunction

    Directory of Open Access Journals (Sweden)

    Godsent C. Isiguzo

    2013-09-01

    Conclusion: Immune-suppression affects the cardiac function adversely and coexisting pulmonary hypertension contributes to poor systolic and diastolic function in affected patients. The subtle nature of presentation of pulmonary hypertension and other cardiac dysfunctions in HIV/AIDS patients demand a high-index of suspicion and early intervention if detected, to ensure better care for these emerging threats to our patients.

  5. Complement activation, endothelial dysfunction, insulin resistance and chronic heart failure

    DEFF Research Database (Denmark)

    Bjerre, M.; Kistorp, C.; Hansen, T.K.

    2010-01-01

    Objectives. Patients with chronic heart failure (CHF) have an exaggerated immune response, endothelial damage/dysfunction, and increased risk of diabetes mellitus (DM). The inter-relationship(s) between indices of complement activation (soluble membrane attack complex, sMAC), inflammation (hs......, IR was an independent predictor of sMAC in the CHF group beta = 0.37 (p complement system and thus...

  6. Determinants of fatigue after first-ever ischemic stroke during acute phase.

    Directory of Open Access Journals (Sweden)

    Shan-Shan Wang

    Full Text Available Fatigue after stroke is common and has a negative impact on rehabilitation and survival. However, its pathogenesis and contributing factors remain unclear. The purpose of this study was to identify factors influencing the occurrence of fatigue after first-ever ischemic stroke in acute phase.We examined 265 consecutive patients with first-ever ischemic stroke during acute phase (within 2 weeks in two tertiary stroke care hospitals in Henan, China. We documented patients' demographic and clinical characteristics through face-to-face interviews using structured questionnaires and reviews of medical records. Post-stroke fatigue was defined as a score of ≥4 using the Fatigue Severity Scale. Multivariate logistic regression was used to examine post-stroke fatigue in relation to socio-demographic, lifestyle, clinical characteristics and family function.About 40% first-ever ischemic stroke patients experienced post-stroke fatigue in acute phase. Post-stroke fatigue was associated with lack of exercise before stroke (adjusted odds ratio 4.01, 95% CI 1.95-8.24, family dysfunction (2.63, 1.20-5.80, depression (2.39, 1.02-5.58, the presence of pre-stroke fatigue (4.89, 2.13-11.21, use of sedative medications (4.14, 1.58-10.88, coronary heart disease (3.38, 1.46-7.79 and more severe Modified Rankin Scale (2.55, 1.65-3.95.The causes of post-stroke fatigue are multifaceted. More physical exercise, improving family function, reducing depression and appropriate use of sedative medications may be helpful in preventing post-stroke fatigue.

  7. Fatigue effects on tracking performance

    NARCIS (Netherlands)

    Huysmans, M.A.; Hoozemans, M.; Beek, A.J. van der; Looze, M.P. de; Dieën, J.H. van

    2006-01-01

    The objective of the present study was to test the effect of fatigue on task performance in a tracking task performed with a computer mouse. Participants performed a two-minute tracking task twice before and once immediately after a fatiguing wrist extension protocol. Results indicate that the mean

  8. Fatigue tests on aluminium bridges

    NARCIS (Netherlands)

    Maljaars, J.; Soetens, F.; Straalen, IJ.J. van

    2004-01-01

    Traffic bridges are subjected to variable loads and should therefore be checked on fatigue. Especially low weight materials, like aluminium, are sensitive to fatigue, because the variable load is a substantial part of the total load. This paper shows the structural design of an aluminium bridge

  9. Fatigue of Concrete Armour Units

    DEFF Research Database (Denmark)

    Sørensen, N. B.; Burcharth, H. F.; Liu, Z.

    1995-01-01

    In the present article fatigue as a possible reason for failure of Dolosse armour units made of plain concrete is discussed.......In the present article fatigue as a possible reason for failure of Dolosse armour units made of plain concrete is discussed....

  10. Fatigue failure in polysilicon not due to simple stress corrosion cracking.

    Science.gov (United States)

    Kahn, H; Ballarini, R; Bellante, J J; Heuer, A H

    2002-11-08

    In the absence of a corrosive environment, brittle materials such as silicon should be immune to cyclic fatigue. However, fatigue effects are well known in micrometer-sized polycrystalline silicon (polysilicon) samples tested in air. To investigate the origins of this phenomenon in polysilicon, we developed a fixed-grip fracture mechanics microspecimen but could find no evidence of static stress corrosion cracking. The environmental sensitivity of the fatigue resistance was also investigated under cyclic loading. For low-cycle fatigue, the behavior is independent of the ambient conditions, whether air or vacuum, but is strongly influenced by the ratio of compressive to tensile stresses experienced during each cycle. The fatigue damage most likely originates from contact stresses at processing-related surface asperities; subcritical crack growth then ensues during further cyclic loading. The lower far-field stresses involved in high-cycle fatigue induce reduced levels of fatigue damage. Under these conditions, a corrosive ambient such as laboratory air exacerbates the fatigue process. Without cyclic loading, polysilicon does not undergo stress corrosion cracking.

  11. Voiding dysfunction - A review

    Directory of Open Access Journals (Sweden)

    Sripathi V

    2005-01-01

    Full Text Available In a child who is toilet trained the sudden onset of daytime wetting with frequency or urgency is alarming to the parents. Initially this subject was subdivided into a number of descriptive clinical conditions which led to a lot of confusion in recognition and management. Subsequently, the term elimination dysfunction was coined by Stephen Koff to emphasise the association between recurrent urinary infection, wetting, constipation and bladder overactivity. From a urodynamic point of view, in voiding dysfunction, there is either detrusor overactivity during bladder filling or dyssynergic action between the detrusor and the external sphincter during voiding. Identifying a given condition as a ′filling phase dysfunction′ or ′voiding phase dysfunction′ helps to provide appropriate therapy. Objective clinical criteria should be used to define voiding dysfunction. These include bladder wall thickening, large capacity bladder and infrequent voiding, bladder trabeculation and spinning top deformity of the urethra and a clinically demonstrated Vincent′s curtsy. The recognition and treatment of constipation is central to the adequate treatment of voiding dysfunction. Transcutaneous electric nerve stimuation for the treatment of detrusor overactivity, biofeedback with uroflow EMG to correct dyssynergic voiding, and behavioral therapy all serve to correct voiding dysfunction in its early stages. In established neurogenic bladder disease the use of Botulinum Toxin A injections into the detrusor or the external sphincter may help in restoring continence especially in those refractory to drug therapy. However in those children in whom the upper tracts are threatened, augmentation of the bladder may still be needed.

  12. Simplified elastoplastic fatigue analysis

    International Nuclear Information System (INIS)

    Autrusson, B.; Acker, D.; Hoffmann, A.

    1987-01-01

    Oligocyclic fatigue behaviour is a function of the local strain range. The design codes ASME section III, RCC-M, Code Case N47, RCC-MR, and the Guide issued by PNC propose simplified methods to evaluate the local strain range. After having briefly described these simplified methods, we tested them by comparing the results of experimental strains with those predicted by these rules. The experiments conducted for this study involved perforated plates under tensile stress, notched or reinforced beams under four-point bending stress, grooved specimens under tensile-compressive stress, and embedded grooved beams under bending stress. They display a relative conservatism depending on each case. The evaluation of the strains of rather inaccurate and sometimes lacks conservatism. So far, the proposal is to use the finite element codes with a simple model. The isotropic model with the cyclic consolidation curve offers a good representation of the real equivalent strain. There is obviously no question of representing the cycles and the entire loading history, but merely of calculating the maximum variation in elastoplastic equivalent deformations with a constant-rate loading. The results presented testify to the good prediction of the strains with this model. The maximum equivalent strain will be employed to evaluate fatigue damage

  13. Fatigue - an underestimated symptom in psoriatic arthritis.

    Science.gov (United States)

    Krajewska-Włodarczyk, Magdalena; Owczarczyk-Saczonek, Agnieszka; Placek, Waldemar

    2017-01-01

    The nature of fatigue is very complex and involves physiological, psychological and social phenomena at the same time, and the mechanisms leading to occurrence and severity of fatigue are still poorly understood. The condition of chronic inflammation associated with psoriatic arthritis can be regarded as a potential factor affecting development of fatigue. Only a few studies so far have focused on the occurrence of fatigue in psoriatic arthritis. The problem of chronic fatigue is underestimated in everyday clinical practice. Identification and analysis of subjective fatigue components in each patient can provide an objective basis for optimal fatigue treatment in daily practice. This review presents a definition of chronic fatigue and describes mechanisms that may be associated with development of fatigue, highlighting the role of chronic inflammation, selected fatigue measurement methods and relations of fatigue occurrence with clinical aspects of psoriatic arthritis.

  14. Immune System

    Science.gov (United States)

    A properly functioning immune system is essential to good health. It defends the body against infectious agents and in some cases tumor cells. Individuals with immune deficiencies resulting from genetic defects, diseases (e.g., AIDS, leukemia), or drug therapies are more suscepti...

  15. Innate immunity

    African Journals Online (AJOL)

    various types of pathogen recognition receptors on epithelial cells and resident cells of the innate immune system, especially macrophages, initiate a localised inflammatory response characterised by an early influx of blood neutrophils.1,2. A comparison of the major characteristics of innate and adaptive immune responses ...

  16. Sepsis and myocardial dysfunction

    Directory of Open Access Journals (Sweden)

    Rafaela Deczka Morsch

    2006-12-01

    Full Text Available Sepsis and septic shock are prevalent in the intensive care setting,accounting for more than 40% of mortality in this scenario. Theappropriate management and recognition of sepsis-inducedmyocardial dysfunction are paramount for its proper treatmentand probably impact mortality rates. The objective of this articleis to review its definition, pathophysiologic mechanisms, possibletreatments and current research on the subject according to acritical view.Cellular signaling involved in myocardial depression is not fullyunderstood. Disturbances in calcium homeostasis,cardiodepressant circulating factors, inflammatory mediators,nitric oxide and apoptosis act as synergistic pathways that leadto severely depressed cardiac function. The diagnosis ofmyocardial dysfunction during sepsis carries a worse prognosisand increased mortality.Myocardial dysfunction plays an important role in morbidity andmortality rate of critically ill patients. Current research in thisarea will continue to evolve; we will, therefore, soon have moreinsights into potential novel therapies that can change its mortalityrates.

  17. Neurogenic voiding dysfunction.

    Science.gov (United States)

    Georgopoulos, Petros; Apostolidis, Apostolos

    2017-05-01

    This review aims to analyze and discuss all recently published articles associated with neurogenic voiding discussion providing readers with the most updated knowledge and trigger for further research. They include the proposal of a novel classification system for the pathophysiology of neurogenic lower urinary tract dysfunction (NLUTD) which combines neurological defect in a distinct anatomic location, and data on bowel dysfunction, autonomic dysreflexia and urine biomarkers; review of patient-reported outcome measures in NLUTD; review of the criteria for the diagnosis of clinically significant urinary infections; novel research findings on the pathophysiology of NLUTD; and review of data on minimally and more invasive treatments. Despite the extended evidence base on NLUTD, there is a paucity of high-quality new research concerning voiding dysfunction as opposed to storage problems. The update aims to inform clinicians about new developments in clinical practice, as well as ignite discussion for further clinical and basic research in the aforementioned areas of NLUTD.

  18. Double-Blind, Randomized Study of the Effects of Influenza Vaccination on the Specific Antibody Response and Clinical Course of Patients with Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Kenna M Sleigh

    2000-01-01

    Full Text Available OBJECTIVE: To determine whether influenza immunization is associated with early side effects, a deleterious impact on the illness course and depressed antibody response in patients with chronic fatigue syndrome (CFS.

  19. Inflammation-induced lymphangiogenesis and lymphatic dysfunction

    Science.gov (United States)

    Liao, Shan; von der Weid, Pierre-Yves

    2014-01-01

    The lymphatic system is intimately linked to tissue fluid homeostasis and immune cell trafficking. These functions are paramount in the establishment and development of an inflammatory response. In the past decade, an increasing number of reports has revealed that marked changes, such as lymphangiogenesis and lymphatic contractile dysfunction occur in both vascular and nodal parts of the lymphatic system during inflammation, as well as other disease processes. This review provides a critical update on the role of the lymphatic system in disease process such as chronic inflammation and cancer and examines the changes in lymphatic functions the diseases cause and the influence these changes have on the progression of the diseases. PMID:24449090

  20. Physiological Aging: Links Among Adipose Tissue Dysfunction, Diabetes, and Frailty.

    Science.gov (United States)

    Stout, Michael B; Justice, Jamie N; Nicklas, Barbara J; Kirkland, James L

    2017-01-01

    Advancing age is associated with progressive declines in physiological function that lead to overt chronic disease, frailty, and eventual mortality. Importantly, age-related physiological changes occur in cellularity, insulin-responsiveness, secretory profiles, and inflammatory status of adipose tissue, leading to adipose tissue dysfunction. Although the mechanisms underlying adipose tissue dysfunction are multifactorial, the consequences result in secretion of proinflammatory cytokines and chemokines, immune cell infiltration, an accumulation of senescent cells, and an increase in senescence-associated secretory phenotype (SASP). These processes synergistically promote chronic sterile inflammation, insulin resistance, and lipid redistribution away from subcutaneous adipose tissue. Without intervention, these effects contribute to age-related systemic metabolic dysfunction, physical limitations, and frailty. Thus adipose tissue dysfunction may be a fundamental contributor to the elevated risk of chronic disease, disability, and adverse health outcomes with advancing age. ©2017 Int. Union Physiol. Sci./Am. Physiol. Soc.

  1. Fatigue management in the workplace.

    Science.gov (United States)

    Sadeghniiat-Haghighi, Khosro; Yazdi, Zohreh

    2015-01-01

    Workers' fatigue is a significant problem in modern industry, largely because of high demand jobs, long duty periods, disruption of circadian rhythms, and accumulative sleep debt that are common in many industries. Fatigue is the end result of integration of multiple factors such as time awake, time of day, and workload. Then, the full understanding of circadian biologic clock, dynamics of transient and cumulative sleep loss, and recovery is required for effective management of workplace fatigue. It can be more investigated in a new field of sleep medicine called occupational sleep medicine. Occupational sleep medicine is concerned with maintaining best productivity and safety in the industrial settings. The fatigue risk management system (FRMS) is a comprehensive approach that is based on applying scientific evidence of sleep knowledge to manage workers fatigue. It is developing rapidly in the highly safety demand jobs; especially truck drivers, pilots, and power plant workers. The objective of this review is to explain about fatigue in the workplace with emphasis on its association work performance and errors/accidents. Also, we discussed about different methods of fatigue measurement and management.

  2. Fatigue management in the workplace

    Directory of Open Access Journals (Sweden)

    Khosro Sadeghniiat-Haghighi

    2015-01-01

    Full Text Available Workers′ fatigue is a significant problem in modern industry, largely because of high demand jobs, long duty periods, disruption of circadian rhythms, and accumulative sleep debt that are common in many industries. Fatigue is the end result of integration of multiple factors such as time awake, time of day, and workload. Then, the full understanding of circadian biologic clock, dynamics of transient and cumulative sleep loss, and recovery is required for effective management of workplace fatigue. It can be more investigated in a new field of sleep medicine called occupational sleep medicine. Occupational sleep medicine is concerned with maintaining best productivity and safety in the industrial settings. The fatigue risk management system (FRMS is a comprehensive approach that is based on applying scientific evidence of sleep knowledge to manage workers fatigue. It is developing rapidly in the highly safety demand jobs; especially truck drivers, pilots, and power plant workers. The objective of this review is to explain about fatigue in the workplace with emphasis on its association work performance and errors/accidents. Also, we discussed about different methods of fatigue measurement and management.

  3. Immunity booster

    International Nuclear Information System (INIS)

    Stefanescu, Ioan; Titescu, Gheorghe; Tamaian, Radu; Haulica, Ion; Bild, Walther

    2002-01-01

    The immunity booster is, according to its patent description, microbiologically pure water with an D/(D+H) isotopic concentration of 100 ppm, with physical-chemical characteristics similar to those of distilled water. It is obtained by sterilization of a mixture of deuterium depleted water, with a 25 ppm isotopic concentration, with distilled water in a volume ratio of 4:6. Unlike natural immunity boosters (bacterial agents as Bacillus Chalmette-Guerin, Corynebacterium parvum; lipopolysaccharides; human immunoglobulin) or synthetical products (levamysol; isoprinosyne with immunostimulating action), which cause hypersensitivity and shocks, thrill, fever, sickness and the immunity complex disease, the water of 100 ppm D/(D + H) isotopic concentration is a toxicity free product. The testing for immune reaction of the immunity booster led to the following results: - an increase of cell action capacity in the first immunity shielding stage (macrophages), as evidenced by stimulation of a number of essential characterizing parameters, as well as of the phagocytosis capacity, bactericide capacity, and opsonic capacity of serum; - an increase of the number of leucocyte particularly of the granulocyte in peripheral blood, produced especially when medullar toxic agents like caryolysine are used; - it hinders the effect of lowering the number of erythrocytes in peripheral blood produced by experimentally induced chronic inflammation; - an increase of nonspecific immunity defence capacity against specific bacterial aggression of both Gram-positive bacteria (Streptococcus pneumoniae 558 ) and of the Gram-negative ones (Klebsiella pneumoniae 507 ); - an increase of immunity - stimulating activity (proinflamatory), like that of levamisole as evidenced by the test of stimulation of experimentally induced inflammation by means of carrageenan. The following advantages of the immunity booster are stressed: - it is toxicity free and side effect free; - can be orally administrated as

  4. Mental Fatigue Affects Visual Selective Attention

    NARCIS (Netherlands)

    Faber, Leon G.; Maurits, Natasha M.; Lorist, Monicque M.

    2012-01-01

    Mental fatigue is a form of fatigue, induced by continuous task performance. Mentally fatigued people often report having a hard time keeping their attention focussed and being easily distracted. In this study, we examined the relation between mental fatigue, as induced by time on task, and

  5. The role of central and peripheral muscle fatigue in postcancer fatigue: a randomized controlled trial

    NARCIS (Netherlands)

    Prinsen, Hetty; van Dijk, Johannes P.; Zwarts, Machiel J.; Leer, Jan Willem H.; Bleijenberg, Gijs; van Laarhoven, Hanneke W. M.

    2015-01-01

    Postcancer fatigue is a frequently occurring problem, impairing quality of life. Little is known about (neuro)physiological factors determining postcancer fatigue. It may be hypothesized that postcancer fatigue is characterized by low peripheral muscle fatigue and high central muscle fatigue. The

  6. Hypertension and sexual dysfunction

    African Journals Online (AJOL)

    Review Article: Hypertension and sexual dysfunction. 117. Vol 54 No 2. S Afr Fam Pract 2012. Introduction. Hypertension is a major independent cardiovascular risk factor, and also a marker of survival risk. Quality of life during the treatment of hypertension is an important health issue, as one in every five treated patients ...

  7. Temporomandibular Joint Dysfunction

    Science.gov (United States)

    The temporomandibular joint (TMJ) connects your jaw to the side of your head. When it works well, it enables you to talk, chew, and yawn. For people with TMJ dysfunction, problems with the joint and muscles around it may cause Pain that travels through the face, jaw, ...

  8. Postirradiation cardiovascular dysfunction

    International Nuclear Information System (INIS)

    Hawkins, R.N.; Cockerham, L.G.

    1987-01-01

    Cardiovascular dysfunction may be defined as the inability of any element of the cardiovascular system to perform adequately upon demand, leading to inadequate performance and nutritive insufficiency of various parts of the body. Exposure to supralethal doses of radiation (accidental and therapeutic) has been show to induce significant alterations in cardiovascular function in man. These findings indicate that, after irradiation, cardiovascular function is a major determinant of continued performance and even survival. For the two persons who received massive radiation doses (45 and 88 Gy, respectively) in criticality accidents, the inability to maintain systematic arterial blood pressure (AP) was the immediate cause of death. In a study of cancer patients given partial-body irradiation, two acute lethalities were attributed to myocardial infarction after an acute hypotensive episode during the first few hours postexposure. Although radiation-induced cardiovascular dysfunction has been observed in many species, its severity, duration, and even etiology may vary with the species, level of exposure, and dose rate. For this reason, our consideration of the effects of radiation on cardiovascular performance is limited to the circulatory derangements that occur in rat, dog, and monkey after supralethal doses and lead to radiation-induced cardiovascular dysfunction in these experimental models. The authors consider other recent data as they pertain to the etiology of cardiovascular dysfunction in irradiated animals

  9. Female sexual dysfunction

    DEFF Research Database (Denmark)

    Giraldi, Annamaria; Wåhlin-Jacobsen, Sarah

    2016-01-01

    Female sexual dysfunction (FSD) is a controversial condition, which has prompted much debate regarding its aetiology, components, and even its existence. Our inability to work together as clinicians, psychologists, patients, and advocates hinders our understanding of FSD, and we will only improve...

  10. Mitochondrial dysfunction in epilepsy

    Czech Academy of Sciences Publication Activity Database

    Folbergrová, Jaroslava; Kunz, W.S.

    2012-01-01

    Roč. 12, č. 1 (2012), s. 35-40 ISSN 1567-7249 R&D Projects: GA ČR(CZ) GA309/05/2015; GA ČR GA309/08/0292 Institutional research plan: CEZ:AV0Z50110509 Keywords : epilepsy * mitochondrial dysfunction * neurodegeneration Subject RIV: FH - Neurology Impact factor: 4.025, year: 2012

  11. Mitochondrial Dysfunction in Gliomas

    Czech Academy of Sciences Publication Activity Database

    Katsetos, C.D.; Anni, H.; Dráber, Pavel

    2013-01-01

    Roč. 20, č. 3 (2013), s. 216-227 ISSN 1071-9091 R&D Projects: GA MŠk LH12050 Institutional support: RVO:68378050 Keywords : gliomas * mitochondrial dysfunction * microtubule proteins Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.883, year: 2013

  12. Fatigue Performance under Multiaxial Loading

    Science.gov (United States)

    1990-01-01

    Abramov and H. Nagler. "Investigation of Effect of Welding on the Fatigue Properties of HY-80 Steel," New York Naval Shipyard, Material Laboratory...Project 6160-2, Progress Report 3, July 1961. 4-23.Stern, I., R. Wolfe, H. Nagler and P. Abramov . "Effects of Various Weld Flaws on Fatigue Properties of...V., P. Abramov and E. Lewis. "Investigation of the Effect of Welding on the Fatigue Properties of HY- 80 Steel," New York Naval Shipyard, Material

  13. Fatigue Reliability of Offshore Wind Turbine Systems

    DEFF Research Database (Denmark)

    Marquez-Dominguez, Sergio; Sørensen, John Dalsgaard

    2012-01-01

    Optimization of the design of offshore wind turbine substructures with respect to fatigue loads is an important issue in offshore wind energy. A stochastic model is developed for assessing the fatigue failure reliability. This model can be used for direct probabilistic design and for calibration...... of appropriate partial safety factors / fatigue design factors (FDF) for steel substructures of offshore wind turbines (OWTs). The fatigue life is modeled by the SN approach. Design and limit state equations are established based on the accumulated fatigue damage. The acceptable reliability level for optimal...... fatigue design of OWTs is discussed and results for reliability assessment of typical fatigue critical design of offshore steel support structures are presented....

  14. Pattern recognition receptors in immune disorders affecting the skin.

    NARCIS (Netherlands)

    Koning, H.D. de; Simon, A.; Zeeuwen, P.L.J.M.; Schalkwijk, J.

    2012-01-01

    Pattern recognition receptors (PRRs) evolved to protect organisms against pathogens, but excessive signaling can induce immune responses that are harmful to the host. Putative PRR dysfunction is associated with numerous immune disorders that affect the skin, such as systemic lupus erythematosus,

  15. Scapular kinematic and shoulder muscle activity alterations after serratus anterior muscle fatigue.

    Science.gov (United States)

    Umehara, Jun; Kusano, Ken; Nakamura, Masatoshi; Morishita, Katsuyuki; Nishishita, Satoru; Tanaka, Hiroki; Shimizu, Itsuroh; Ichihashi, Noriaki

    2018-02-23

    Although the serratus anterior muscle has an important role in scapular movement, no study to date has investigated the effect of serratus anterior fatigue on scapular kinematics and shoulder muscle activity. The purpose of this study was to clarify the effect of serratus anterior fatigue on scapular movement and shoulder muscle activity. The study participants were 16 healthy men. Electrical muscle stimulation was used to fatigue the serratus anterior muscle. Shoulder muscle strength and endurance, scapular movement, and muscle activity were measured before and after the fatigue task. The muscle activity of the serratus anterior, upper and lower trapezius, anterior and middle deltoid, and infraspinatus muscles was recorded, and the median power frequency of these muscles was calculated to examine the degree of muscle fatigue. The muscle endurance and median power frequency of the serratus anterior muscle decreased after the fatigue tasks, whereas the muscle activities of the serratus anterior, upper trapezius, and infraspinatus muscles increased. External rotation of the scapula at the shoulder elevated position increased after the fatigue task. Selective serratus anterior fatigue due to electric muscle stimulation decreased the serratus anterior endurance at the flexed shoulder position. Furthermore, the muscle activities of the serratus anterior, upper trapezius, and infraspinatus increased and the scapular external rotation was greater after serratus anterior fatigue. These results suggest that the rotator cuff and scapular muscle compensated to avoid the increase in internal rotation of the scapula caused by the dysfunction of the serratus anterior muscle. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. SI:FatiguePro 4 Advanced Approach for Fatigue Monitoring

    International Nuclear Information System (INIS)

    Evon, Keith; Gilman, Tim; Carney, Curt

    2012-01-01

    Many nuclear plants are making commitments to implement fatigue monitoring systems in support of license renewal. Current fatigue monitoring systems use the methodology of ASME Code Subarticle NB-3200, which is a design code intended to compute a bounding cumulative usage factor (CUF). The first generation of fatigue monitoring software utilized a simplified, single stress term assumption and classical stress cycle-counting methods that take order into account such as Rainflow or Ordered Overall Range counting. Recently, the NRC has indicated in Regulatory Issue Summary 2008-30 that any fatigue analyses in support of License Renewal should use ASME Code Section III methodologies considering all six stress components. In addition, fatigue calculations for the license renewal term are required to consider the effects of environment. The implementation of a six stress term NB-3200 fatigue calculation to a Boiling Water Reactor (BWR) feedwater nozzle, including environmental effects, is the topic of this paper. Differences in results between the advanced methodology and the simplified methodology are discussed. (author)

  17. Muscle fatigue: general understanding and treatment

    Science.gov (United States)

    Wan, Jing-jing; Qin, Zhen; Wang, Peng-yuan; Sun, Yang; Liu, Xia

    2017-01-01

    Muscle fatigue is a common complaint in clinical practice. In humans, muscle fatigue can be defined as exercise-induced decrease in the ability to produce force. Here, to provide a general understanding and describe potential therapies for muscle fatigue, we summarize studies on muscle fatigue, including topics such as the sequence of events observed during force production, in vivo fatigue-site evaluation techniques, diagnostic markers and non-specific but effective treatments. PMID:28983090

  18. Muscle fatigue: general understanding and treatment

    OpenAIRE

    Wan, Jing-jing; Qin, Zhen; Wang, Peng-yuan; Sun, Yang; Liu, Xia

    2017-01-01

    Muscle fatigue is a common complaint in clinical practice. In humans, muscle fatigue can be defined as exercise-induced decrease in the ability to produce force. Here, to provide a general understanding and describe potential therapies for muscle fatigue, we summarize studies on muscle fatigue, including topics such as the sequence of events observed during force production, in vivo fatigue-site evaluation techniques, diagnostic markers and non-specific but effective treatments.

  19. Fatigue Monitoring Tool for Airline Operators (FMT

    Directory of Open Access Journals (Sweden)

    Gislason Sigurdur Hrafn

    2017-12-01

    Full Text Available A Fatigue Monitoring Tool (FMT model was constructed for an operational airline in order to manage the fatigue levels of their crews in accordance with Fatigue Risk Management System (FRMS practices. This article describes the implementation of the Fatigue Monitoring Tool model and the airline’s aims to put the recent scientific findings on aviation fatigue into practical use. The model consists of proxy points allotted to various duties and rest periods.

  20. Pharmacological treatments for fatigue in patients with multiple sclerosis: A systematic review and meta-analysis.

    Science.gov (United States)

    Yang, Ting-Ting; Wang, Li; Deng, Xiao-Yang; Yu, Gang

    2017-09-15

    Multiple sclerosis (MS) is a chronic immune-mediated inflammatory disease. Fatigue is the most common symptom of MS patients, affecting >80% subjects. Medical treatment is an important method for managing fatigue. Currently, although many drugs have been tested in treatment of MS fatigue, the efficacy of these drugs remain largely unclear. We researched available literatures in PubMed, Embase, Medline, Google Scholar, Cochrane Library (August 31, 2016). Search terms included multiple sclerosis, fatigue, medication treatments, amantadine, modafinil, aspirin, acetyl-l-carnitine, pemoline, 4-aminopyridine and randomized controlled trial (RCT). Two researchers were required to independently assess the quality of literatures, and finish data extraction. Meta-analysis was conducted using RevMan 5.3 software. A total of 11 RCTs involving 723 patients were included. The therapeutic effects were quantified by different scales, such as Modified Fatigue Impact Scale (MFIS) or Fatigue Severity Scale (FSS). Here, meta-analysis suggested that amantadine, not modafinil, was effective for treating the fatigue in MS. Moreover, two studies implied that l-carnitine might have similar therapeutic effect with amantadine. However, the reliability of this finding was greatly weakened by the limited sample sizes. Additionally, current data could not answer whether treatment of MS fatigue using aspirin or 4-aminopyridine was beneficial. Finally, we found that all drugs except pemoline were relatively safe for treating MS fatigue. Current limited data suggest that amantadine may be the only drug that has relatively sufficient evidences in treatment of fatigue symptoms in MS. Further RCT studies recruiting larger samples sizes are required to validate the therapeutic effect of these candidate drugs. Copyright © 2017. Published by Elsevier B.V.

  1. Dysfunctions in public psychiatric bureaucracies.

    Science.gov (United States)

    Marcos, L R

    1988-03-01

    The author describes common dysfunctions in public psychiatric organizations according to the model of bureaucracy articulated by Max Weber. Dysfunctions are divided into the categories of goal displacement, outside interference, unclear authority structure and hierarchy, and informal relations in the work place. The author emphasizes the bureaucratic nature of public psychiatry and the need for mental health professionals to understand the dysfunctions of the organizations in which they work, including the impact of these dysfunctions on the provision of quality care.

  2. Fatigue crack closure: A review

    Science.gov (United States)

    Kemp, R. M. J.

    1990-09-01

    The phenomenon of fatigue crack closure is now recognized as one of the most influential mechanisms operating during fatigue. This literature survey traces the development of research into fatigue crack closure and has been divided to present the two major approaches. The first part covers early work carried out between 1970 to 1980 which, broadly speaking, adopted a 'continuum' approach. The second part covers the period 1980 to 1988 when a mechanistic approach was widely adopted. The survey has highlighted, firstly, the critical nature of experimental technique in the achievement of a meaningful measurement of crack closure load and secondly, that a diversity of mechanisms may operate to produce closure. Particular attention has been given to crack closure in aluminum alloys and also to work relating crack closure to the corrosion fatigue situation.

  3. Fatigue with HIV/AIDS

    Science.gov (United States)

    ... hormones such as DHEA (see Fact Sheet 724) , cortisol or thyroid can cause similar problems. Hormone levels ... fatigue and a lack of interest in daily activities. There is no blood test ... sexual functioning. Also, some antidepressants interact with some ARVs, ...

  4. Fatigue life prediction in composites

    CSIR Research Space (South Africa)

    Huston, RJ

    1994-01-01

    Full Text Available epoxy were used to test residual strength and residual stiffness models. Further fatigue tests were carried out under spectrum loading so that the results could be correlated with the cumulative damage predicted by the residual strength model....

  5. Fatigue and Corrosion in Metals

    CERN Document Server

    Milella, Pietro Paolo

    2013-01-01

    This textbook, suitable for students, researchers and engineers, gathers the experience of more than 20 years of teaching fracture mechanics, fatigue and corrosion to professional engineers and running experimental tests and verifications to solve practical problems in engineering applications. As such, it is a comprehensive blend of fundamental knowledge and technical tools to address the issues of fatigue and corrosion. The book initiates with a systematic description of fatigue from a phenomenological point of view, since the early signs of submicroscopic damage in few surface grains and continues describing, step by step, how these precursors develop to become mechanically small cracks and, eventually, macrocracks whose growth is governed by fracture mechanics. But fracture mechanics is also introduced to analyze stress corrosion and corrosion assisted fatigue in a rather advanced fashion. The author dedicates a particular attention to corrosion starting with an electrochemical treatment that mechanical e...

  6. Fatigue of internal combustion engines

    Science.gov (United States)

    Dumanois, P

    1924-01-01

    The above conditions enable the employment of a criterion of general fatigue which simultaneously takes account of both mechanical and thermal conditions, for the sake of comparing any projected engine with engines of the same type already in use.

  7. Evaluation of anti-fatigue and immunomodulating effects of quercetin in strenuous exercise mice

    Science.gov (United States)

    Zhang, Wei-qiang

    2017-04-01

    The purpose of the present study was to investigate the anti-fatigue and immunomodulating effects of quercetin in strenuous exercise mice. Mice were given orally either corn oil or quercetin (20, 40 and 60 mg/kg body weight suspended in corn oil) by gavage once a day for 28 day. All mice were sacrificed after rotarod test and the major biochemical parameters were analyzed in serum and liver. The results indicated that quercetin possessed anti-fatigue effects by prolonging retention times, decreasing levels of blood lactate and serum urea nitrogen, and increasing levels of blood glucose, tissue glycogen and serum glucagon. Furthermore, quercetin could improve the immune function of fatigue mice by decreasing tumor necrosis factor-α levels, and elevated interleukin-10 levels. Quercetin possessed anti-fatigue effects may be related to its immunomodulating effects.

  8. Fatigue Perceived by Multiple Sclerosis Patients Is Associated With Muscle Fatigue

    NARCIS (Netherlands)

    Steens, Anneke; de Vries, Astrid; Hemmen, Jolien; Heersema, Thea; Heerings, Marco; Maurits, Natasha; Zijdewind, Inge

    Background. Fatigue is a debilitating symptom in multiple sclerosis (MS). Previous studies showed no association between fatigue as perceived by the patient and physiological measures of fatigability. Objective. The authors investigated associations between perceived fatigue and measures of

  9. Testing methodologies for corrosion fatigue

    OpenAIRE

    Delmotte, Edward; Micone, Nahuel; De Waele, Wim

    2015-01-01

    Offshore constructions are subjected to cyclic loading conditions. This situation is combined with the corrosive nature of the surrounding environment. It is of actual concern whether the combined effect is more damaging or not than the superposition of each effect independently. This literature review first introduces the reader to corrosion fatigue. Thereafter a critical comparison of some typical lab-scale fatigue corrosion test setups is given. Special emphasis is devoted to the instru...

  10. Sleep, immunity and shift workers: A review

    Directory of Open Access Journals (Sweden)

    Carlos Mauricio Oliveira de Almeida

    2016-07-01

    Full Text Available To date, shift workers represent between 15% and 25% of the modern day workforce. Work time poses a great challenge to workers as it requires that they balance productivity and sleep time between shifts. As a result, these workers experience chronic sleep deprivation with increased fatigue and drowsiness due to this sleep deprivation. The impact of this kind of work on the immune system is not yet known. We conducted a literature review with the aim of evaluating articles on this specific type of work's effects on sleep and immunity.

  11. [Thyroid dysfunction and amiodarone].

    Science.gov (United States)

    Lima, Jandira; Carvalho, Patrícia; Molina, M Auxiliadora; Rebelo, Marta; Dias, Patrícia; Vieira, José Diniz; Costa, José M Nascimento

    2013-02-01

    Although most patients remain clinically euthyroid, some develop amiodarone-induced hyperthyroidism (HPEAI) or hypothyroidism (HPOAI). The authors present a retrospective analysis of ten patients with amiodarone-induced thyroid dysfunction. Six patients were female and mean amiodarone intake was 17.7 months. HPOIA was more common (six patients). From all the patients with HPEAI, two had type 2, one had type 1, and one had type 3 hyperthyroidism. Symptoms suggestive of thyroid dysfunction occurred in five patients, most of them with HPOAI. In HPEAI, the most frequent symptom was exacerbation of arrhythmia (three patients). Discontinuation of amiodarone and treatment with levothyroxine was chosen in 83.3% of the HPOAI cases, while thyonamide treatment with corticosteroids and without amiodarone was the option in 75% of the HPEAI cases. There were three deaths, all in patients with HPEAI. HPEAI is potentially fatal. The clinical picture may be vague, so the thyroid monitoring is mandatory.

  12. 'Trained immunity': consequences for lymphoid malignancies.

    Science.gov (United States)

    Stevens, Wendy B C; Netea, Mihai G; Kater, Arnon P; van der Velden, Walter J F M

    2016-12-01

    In hematological malignancies complex interactions exist between the immune system, microorganisms and malignant cells. On one hand, microorganisms can induce cancer, as illustrated by specific infection-induced lymphoproliferative diseases such as Helicobacter pylori-associated gastric mucosa-associated lymphoid tissue lymphoma. On the other hand, malignant cells create an immunosuppressive environment for their own benefit, but this also results in an increased risk of infections. Disrupted innate immunity contributes to the neoplastic transformation of blood cells by several mechanisms, including the uncontrolled clearance of microbial and autoantigens resulting in chronic immune stimulation and proliferation, chronic inflammation, and defective immune surveillance and anti-cancer immunity. Restoring dysfunction or enhancing responsiveness of the innate immune system might therefore represent a new angle for the prevention and treatment of hematological malignancies, in particular lymphoid malignancies and associated infections. Recently, it has been shown that cells of the innate immune system, such as monocytes/macrophages and natural killer cells, harbor features of immunological memory and display enhanced functionality long-term after stimulation with certain microorganisms and vaccines. These functional changes rely on epigenetic reprogramming and have been termed 'trained immunity'. In this review the concept of 'trained immunity' is discussed in the setting of lymphoid malignancies. Amelioration of infectious complications and hematological disease progression can be envisioned to result from the induction of trained immunity, but future studies are required to prove this exciting new hypothesis. Copyright© Ferrata Storti Foundation.

  13. Mitochondrial dysfunction in obesity.

    Science.gov (United States)

    de Mello, Aline Haas; Costa, Ana Beatriz; Engel, Jéssica Della Giustina; Rezin, Gislaine Tezza

    2018-01-01

    Obesity leads to various changes in the body. Among them, the existing inflammatory process may lead to an increase in the production of reactive oxygen species (ROS) and cause oxidative stress. Oxidative stress, in turn, can trigger mitochondrial changes, which is called mitochondrial dysfunction. Moreover, excess nutrients supply (as it commonly is the case with obesity) can overwhelm the Krebs cycle and the mitochondrial respiratory chain, causing a mitochondrial dysfunction, and lead to a higher ROS formation. This increase in ROS production by the respiratory chain may also cause oxidative stress, which may exacerbate the inflammatory process in obesity. All these intracellular changes can lead to cellular apoptosis. These processes have been described in obesity as occurring mainly in peripheral tissues. However, some studies have already shown that obesity is also associated with changes in the central nervous system (CNS), with alterations in the blood-brain barrier (BBB) and in cerebral structures such as hypothalamus and hippocampus. In this sense, this review presents a general view about mitochondrial dysfunction in obesity, including related alterations, such as inflammation, oxidative stress, and apoptosis, and focusing on the whole organism, covering alterations in peripheral tissues, BBB, and CNS. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Fatigue monitoring desktop guide

    International Nuclear Information System (INIS)

    Woods, K.; Thomas, K.

    2012-01-01

    The development of a program for managing material aging (MMG) in the nuclear industry requires a new and different perspective. The classical method for MMG is cycle counting, which has been shown to have limited success. The classical method has been successful in satisfying the ductile condition per the America Society of Mechanical Engineers' (ASME) design criteria. However, the defined material failure mechanism has transformed from through-wall cracking and leakage (ASME) to crack initiation (NUREG-6909). This transformation is based on current industry experience with material degradation early in plant life and can be attributed to fabrication issues and environment concerns where cycle counting has been unsuccessful. This new perspective provides a different approach to cycle counting that incorporates all of the information about the material conditions. This approach goes beyond the consideration of a static analysis and includes a dynamic assessment of component health, which is required for operating plants. This health definition should consider fabrication, inspections, transient conditions and industry operating experience. In addition, this collection of information can be transparent to a broader audience that may not have a full understanding of the system design or the potential causes of early material degradation. This paper will present the key points that are needed for a successful fatigue monitoring desktop guide. (authors)

  15. Fatigue after Stroke: The Patient's Perspective

    Directory of Open Access Journals (Sweden)

    Victoria Louise Barbour

    2012-01-01

    Full Text Available Background. Fatigue after stroke is common and distressing to patients. Aims. Our aims were to explore patients' perceptions of post-stroke fatigue, including the causes of fatigue and the factors that alleviate fatigue, in a mixed methods study. Results. We interviewed 15 patients who had had a stroke and were inpatients on stroke rehabilitation wards. A substantial proportion of patients reported that their fatigue started at the time of their stroke. Various different factors were reported to improve fatigue, including exercise, good sleep, rehabilitation and rest. Fatigue influences patients' sense of “control” after their stroke. Conclusion. Our results are consistent with the possibility that poststroke fatigue might be triggered by factors that occur at the time of the stroke (e.g., the stroke lesion itself, or admission to hospital and then exacerbated by poor sleep and boredom. These factors should be considered when developing complex interventions to improve post-stroke fatigue.

  16. Biaxial fatigue of metals the present understanding

    CERN Document Server

    Schijve, Jaap

    2016-01-01

    Problems of fatigue under multiaxial fatigue loads have been addressed in a very large number of research publications. The present publication is primarily a survey of biaxial fatigue under constant amplitude loading on metal specimens. It starts with the physical understanding of the fatigue phenomenon under biaxial fatigue loads. Various types of proportional and non-proportional biaxial fatigue loads and biaxial stress distributions in a material are specified. Attention is paid to the fatigue limit, crack nucleation, initial micro crack growth and subsequent macro-crack in different modes of crack growth. The interference between the upper and lower surfaces of a fatigue crack is discussed. Possibilities for predictions of biaxial fatigue properties are analysed with reference to the similarity concept. The significance of the present understanding for structural design problems is considered. The book is completed with a summary of major observations.

  17. Comparison of mechanical fatigue with thermal fatigue in ceramics

    International Nuclear Information System (INIS)

    Wilson, B.A.; Case, E.D.

    1993-01-01

    Thermal fatigue studies have shown a saturation of damage accumulation with cycling. Similar damage saturation has been observed for mechanical fatigue. This study compares damage saturation behavior for mechanical fatigue with thermal fatigue in ceramics. Studies of thermal fatigue of ceramics show that the accumulation of thermal shock cycling damage depends on the magnitude of the thermal shock, ΔΤ (where ΔΤ is the temperature change of the specimen from the initial temperature to the temperature of the quenching medium). Three distinct regimes of damage accumulation exist depending on the magnitude of ΔΤ. For the first regime where the thermal shock cycling is below ΔΤ c , a critical thermal shock value, there is no thermal damage detected. In the second regime where ΔΤ is higher than ΔΤ c but lower than ΔΤ 1 , the accumulating microcrack damage initially induces a rapid change in material property P. As the number of cycles increases a steady state value of properties is reached. For the third regime ΔΤ is higher than ΔΤ 1 and rapid crack growth results in fracture of the specimen. Each regime depends on ΔΤ since, for a given specimen and quenching medium, the maximum thermal shock stress is proportional to ΔΤ. So characterization of each regime by ΔΤ is indicative of the maximum stress applied by the thermal shock

  18. Vibration fatigue using modal decomposition

    Science.gov (United States)

    Mršnik, Matjaž; Slavič, Janko; Boltežar, Miha

    2018-01-01

    Vibration-fatigue analysis deals with the material fatigue of flexible structures operating close to natural frequencies. Based on the uniaxial stress response, calculated in the frequency domain, the high-cycle fatigue model using the S-N curve material data and the Palmgren-Miner hypothesis of damage accumulation is applied. The multiaxial criterion is used to obtain the equivalent uniaxial stress response followed by the spectral moment approach to the cycle-amplitude probability density estimation. The vibration-fatigue analysis relates the fatigue analysis in the frequency domain to the structural dynamics. However, once the stress response within a node is obtained, the physical model of the structure dictating that response is discarded and does not propagate through the fatigue-analysis procedure. The structural model can be used to evaluate how specific dynamic properties (e.g., damping, modal shapes) affect the damage intensity. A new approach based on modal decomposition is presented in this research that directly links the fatigue-damage intensity with the dynamic properties of the system. It thus offers a valuable insight into how different modes of vibration contribute to the total damage to the material. A numerical study was performed showing good agreement between results obtained using the newly presented approach with those obtained using the classical method, especially with regards to the distribution of damage intensity and critical point location. The presented approach also offers orders of magnitude faster calculation in comparison with the conventional procedure. Furthermore, it can be applied in a straightforward way to strain experimental modal analysis results, taking advantage of experimentally measured strains.

  19. DNA methylation modifications associated with chronic fatigue syndrome.

    Directory of Open Access Journals (Sweden)

    Wilfred C de Vega

    Full Text Available Chronic Fatigue Syndrome (CFS, also known as myalgic encephalomyelitis, is a complex multifactorial disease that is characterized by the persistent presence of fatigue and other particular symptoms for a minimum of 6 months. Symptoms fail to dissipate after sufficient rest and have major effects on the daily functioning of CFS sufferers. CFS is a multi-system disease with a heterogeneous patient population showing a wide variety of functional disabilities and its biological basis remains poorly understood. Stable alterations in gene function in the immune system have been reported in several studies of CFS. Epigenetic modifications have been implicated in long-term effects on gene function, however, to our knowledge, genome-wide epigenetic modifications associated with CFS have not been explored. We examined the DNA methylome in peripheral blood mononuclear cells isolated from CFS patients and healthy controls using the Illumina HumanMethylation450 BeadChip array, controlling for invariant probes and probes overlapping polymorphic sequences. Gene ontology (GO and network analysis of differentially methylated genes was performed to determine potential biological pathways showing changes in DNA methylation in CFS. We found an increased abundance of differentially methylated genes related to the immune response, cellular metabolism, and kinase activity. Genes associated with immune cell regulation, the largest coordinated enrichment of differentially methylated pathways, showed hypomethylation within promoters and other gene regulatory elements in CFS. These data are consistent with evidence of multisystem dysregulation in CFS and implicate the involvement of DNA modifications in CFS pathology.

  20. Muscle fatigue in fibromyalgia is in the brain, not in the muscles: a case-control study of perceived versus objective muscle fatigue.

    Science.gov (United States)

    Bandak, Elisabeth; Amris, Kirstine; Bliddal, Henning; Danneskiold-Samsøe, Bente; Henriksen, Marius

    2013-06-01

    To investigate relationships between perceived and objectively measured muscle fatigue during exhausting muscle contractions in women with fibromyalgia (FM) compared with healthy controls (HC). Women with FM and HC completed an isometric muscle exhaustion task at 90° shoulder abduction. Surface electromyographic (EMG) activity in the deltoid muscle was recorded together with self-reported level of muscle fatigue. 25 participants with FM and 23 HC were included. Average time to exhaustion was 254 s shorter in participants with FM than in HC. Participants with FM did not exhibit the same level of objective signs of muscle fatigue, seen as fewer changes in the EMG activity, as the HC during the exhaustion task. The task did not provoke pain in the HC, while participants with FM reported a doubling of pain. Women with FM had shorter exhaustion times and showed fewer objective signs of muscle fatigue during an exhausting isometric shoulder abduction compared with younger HC. This indicates that perceived muscle fatigue may be of central origin and supports the notion of central nervous dysfunction as basic pathological changes in FM.

  1. Fatigue analysis of aluminum drill pipes

    Directory of Open Access Journals (Sweden)

    João Carlos Ribeiro Plácido

    2005-12-01

    Full Text Available An experimental program was performed to investigate the fundamental fatigue mechanisms of aluminum drill pipes. Initially, the fatigue properties were determined through small-scale tests performed in an optic-mechanical fatigue apparatus. Additionally, full-scale fatigue tests were carried out with three aluminum drill pipe specimens under combined loading of cyclic bending and constant axial tension. Finally, a finite element model was developed to simulate the stress field along the aluminum drill pipe during the fatigue tests and to estimate the stress concentration factors inside the tool joints. By this way, it was possible to estimate the stress values in regions not monitored during the fatigue tests.

  2. Sleep complaints and fatigue of airline pilots.

    Science.gov (United States)

    Reis, Cátia; Mestre, Catarina; Canhão, Helena; Gradwell, David; Paiva, Teresa

    2016-01-01

    This work aimed to determine daytime sleepiness and sleep complaints prevalence and the corresponding influence on perceived fatigue and to evaluate the influence of sociodemographic parameters and labour variables on sleep complaints, sleepiness and fatigue. A questionnaire was developed including socio-economic and labour issues and instruments, focused in sleep and fatigue. The response rate was 32% and the final sample had 435 pilots. The prevalence of sleep complaints was 34.9%, daytime sleepiness 59.3% and fatigue 90.6%. The high prevalence of sleep complaints, sleepiness and fatigue was disclosed in pilots, with those who fly short/medium having an added risk of fatigue.

  3. Adipose Tissue Immunity and Cancer

    Directory of Open Access Journals (Sweden)

    Victoria eCatalan

    2013-10-01

    Full Text Available Inflammation and altered immune response are important components of obesity and contribute greatly to the promotion of obesity-related metabolic complications, especially cancer development. Adipose tissue expansion is associated with increased infiltration of various types of immune cells from both the innate and adaptive immune systems. Thus, adipocytes and infiltrating immune cells secrete proinflammatory adipokines and cytokines providing a microenvironment favourable for tumour growth. Accumulation of B and T cells in adipose tissue precedes macrophage infiltration causing a chronic low-grade inflammation. Phenotypic switching towards M1 macrophages and Th1 T cells constitutes an important mechanism described in the obese state correlating with increased tumour growth risk. Other possible synergic mechanisms causing a dysfunctional adipose tissue include fatty acid-induced inflammation, oxidative stress, endoplasmic reticulum stress, and hypoxia. Recent investigations have started to unravel the intricacy of the cross-talk between tumour cell/immune cell/adipocyte. In this sense, future therapies should take into account the combination of anti-inflammatory approaches that target the tumour microenvironment with more sophisticated and selective anti-tumoural drugs.

  4. Treatment of sleep dysfunction and psychiatric disorders.

    Science.gov (United States)

    Becker, Philip M; Sattar, Muhammad

    2009-09-01

    Patients with neurologic disorders commonly experience sleep dysfunction and psychiatric disorders. The most common sleep dysfunction is insomnia, which is a primary symptom in 30% to 90% of psychiatric disorders. Insomnia and fatigue are prominent symptoms of anxiety disorders and major depression that may occur in patients who are treated but have residual sleep dysfunction. Anxiety and depressive disorders account for 40% to 50% of all cases of chronic insomnia. It is also recognized that primary insomnia and other primary sleep disorders produce symptoms that are similar to those reported by patients with psychiatric disorders. A clinician must judge whether sleep deprivation causes mood disturbance or whether depressive or anxiety disorder represents the primary reason for sleep dysfunction. When insomnia is comorbid with mild to moderate depression, therapy should begin with bedtime dosing of sedating antidepressants such as mirtazapine, nefazodone, or tricyclic antidepressants, which are preferred because of their sedative effects. Often side effects limit their usefulness. Intervention for chronic insomnia is similar in nonpsychiatric and psychiatric patients. Behavioral therapies, particularly multicomponent cognitive-behavioral therapy, and lifestyle changes show significant long-term efficacy as treatments for chronic insomnia. The most studied pharmacologic agents to treat insomnia are sedative hypnotic agents, particularly those that are active through the benzodiazepine receptor-GABA (gamma-aminobutyric acid) complex, such as benzodiazepines, eszopiclone, zaleplon, and zolpidem. Melatonin and the melatonin-receptor agonist ramelteon have not had adequate study in psychiatric patients to define their use, but small studies suggest benefit. Prescription of adjunctive trazodone (50-150 mg) is a common clinical practice to treat comorbid insomnia during antidepressant therapy, but published data are surprisingly limited, considering its frequent use

  5. Fatigue technology assessment and strategies for fatigue avoidance in marine structures. Appendices

    Science.gov (United States)

    Capanoglu, Cuneyt C.

    This report provides an up-to-date assessment of fatigue technology, directed specifically toward the marine industry. A comprehensive overview of fatigue analysis and design, a global review of fatigue including rules and regulations and current practices, and a fatigue analysis and design criteria are provided as a general guideline to fatigue assessment. A detailed discussion of all fatigue parameters is grouped under three analysis blocks: fatigue stress model, covering environmental forces, structure response and loading, stress response amplitude operations (RAO's) and hot-spot stresses; fatigue stress history model covering long-term distribution of environmental loading; and fatigue resistance of structures and damage assessment methodologies. The analyses and design parameters that affect fatigue assessment are discussed together with uncertainties and research gaps, to provide a basis for developing strategies for fatigue avoidance. Additional in-depth discussions of wave environment, stress concentration factors, etc. are presented in the appendixes. Assessment of fatigue technology, fatigue stress models, fatigue stress history models, fatigue resistance, fatigue parameters, and fatigue avoidance strategies.

  6. The role of central and peripheral muscle fatigue in postcancer fatigue: a randomized controlled trial.

    Science.gov (United States)

    Prinsen, Hetty; van Dijk, Johannes P; Zwarts, Machiel J; Leer, Jan Willem H; Bleijenberg, Gijs; van Laarhoven, Hanneke W M

    2015-02-01

    Postcancer fatigue is a frequently occurring problem, impairing quality of life. Little is known about (neuro)physiological factors determining postcancer fatigue. It may be hypothesized that postcancer fatigue is characterized by low peripheral muscle fatigue and high central muscle fatigue. The aims of this study were to examine whether central and peripheral muscle fatigue differ between fatigued and non-fatigued cancer survivors and to examine the effect of cognitive behavioral therapy (CBT) on peripheral and central muscle fatigue of fatigued cancer survivors in a randomized controlled trial. Sixteen fatigued patients in the intervention group (CBT) and eight fatigued patients in the waiting list group were successfully assessed at baseline and six months later. Baseline measurements of 20 fatigued patients were compared with 20 non-fatigued patients. A twitch interpolation technique and surface electromyography were applied, respectively, during sustained contraction of the biceps brachii muscle. Muscle fiber conduction velocity (MFCV) and central activation failure (CAF) were not significantly different between fatigued and non-fatigued patients. Change scores of MFCV and CAF were not significantly different between patients in the CBT and waiting list groups. Patients in the CBT group reported a significantly larger decrease in fatigue scores than patients in the waiting list group. Postcancer fatigue is neither characterized by abnormally high central muscle fatigue nor by low peripheral muscle fatigue. These findings suggest a difference in the underlying physiological mechanism of postcancer fatigue vs. other fatigue syndromes. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Ischemia causes muscle fatigue

    Science.gov (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D. M.

    2001-01-01

    The purpose of this investigation was to determine whether ischemia, which reduces oxygenation in the extensor carpi radialis (ECR) muscle, causes a reduction in muscle force production. In eight subjects, muscle oxygenation (TO2) of the right ECR was measured noninvasively and continuously using near infrared spectroscopy (NIRS) while muscle twitch force was elicited by transcutaneous electrical stimulation (1 Hz, 0.1 ms). Baseline measurements of blood volume, muscle oxygenation and twitch force were recorded continuously, then a tourniquet on the upper arm was inflated to one of five different pressure levels: 20, 40, 60 mm Hg (randomized order) and diastolic (69 +/- 9.8 mm Hg) and systolic (106 +/- 12.8 mm Hg) blood pressures. Each pressure level was maintained for 3-5 min, and was followed by a recovery period sufficient to allow measurements to return to baseline. For each respective tourniquet pressure level, mean TO2 decreased from resting baseline (100% TO2) to 99 +/- 1.2% (SEM), 96 +/- 1.9%, 93 +/- 2.8%, 90 +/- 2.5%, and 86 +/- 2.7%, and mean twitch force decreased from resting baseline (100% force) to 99 +/- 0.7% (SEM), 96 +/- 2.7%, 93 +/- 3.1%, 88 +/- 3.2%, and 86 +/- 2.6%. Muscle oxygenation and twitch force at 60 mm Hg tourniquet compression and above were significantly lower (P muscle oxygenation (r = 0.78, P muscle oxygenation causes decreased muscle force production in the forearm extensor muscle. Thus, ischemia associated with a modest decline in TO2 causes muscle fatigue.

  8. Cognitive Dysfunction in Fibromyalgia

    Directory of Open Access Journals (Sweden)

    Tuba Tulay Koca

    2015-03-01

    Full Text Available The primary symptom of fibromyalgia is widespread pain with muscle tenderness to light palpation. Howeover many patients report a wide range of symptoms including pain, dyscognition, sleep disturbances, fatigue and mood disorders (frequently depression. Such symptoms seem to be related to one another. Besides, a decrease in concentration and memory disorder has recognised as an independent symptom yet; added into literature under the terms and lsquo;dyscognition' and and lsquo;fibrofog'. Recently clinicians interested in investigations about dyscognition in fibromyalgia syndrome. Cognitive symptoms may be exacerbated by the presence of depression, anxiety, sleep dysorders, endocrine disregulations and pain; but the relationship is unclear. Additionally some of recent studies suggest that insulin resistance may represent a risk factor for memory impairment in these patients. There is lack of standardized tests, treatment methods and studies for understanding pathophysiologic pathways of cognitive problems (memory, concentration in fibromyalgia.

  9. Fatigue and pain limit independent mobility and physiotherapy after hip fracture surgery

    DEFF Research Database (Denmark)

    Münter, Kristine H.; Clemmesen, Christopher G.; Foss, Nicolai B.

    2017-01-01

    ; pain, motor blockade, dizziness, fatigue, nausea, acute cognitive dysfunction and “other limitations”, for not achieving a full Cumulated Ambulation Score or inability to complete planned physiotherapy sessions were noted by the physiotherapist on each of the three first postoperative days. This period...... was chosen, because of its importance on how well the patients had regained their pre-fracture functional level. Results: Fatigue and hip fracture-related pain were the most frequent reasons for patients not achieving an independent basic mobility level (> 85%) or not fully completing their planned...... physiotherapy (> 42%) on all three days. At hospital discharge (median day 10), only 54% of the patients had regained their pre-fracture basic mobility level. Conclusion: Based on the patient’s perception, fatigue and pain are the most frequent limitations in not achieving independent basic mobility...

  10. Fatigue as it Affects Nursing.

    Science.gov (United States)

    2016-08-01

    : Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times.In this month's article from the January 1935 issue, Lillian M. Gilbreth, a highly respected psychologist and industrial engineer, examines the problem of fatigue in nursing. A nonnurse expert, Gilbreth notes the negative effects of fatigue on skills, a problem "enormously more serious when the product of the work is human comfort and sometimes even human life, as it often is with the work of the nurse." In their article in this issue, "Health Care Worker Fatigue," Lea Anne Gardner and Deborah Dubeck of the Pennsylvania Patient Safety Authority share examples of fatigue-related adverse events and discuss the need for both personal and institutional fatigue risk management strategies.

  11. High speed rails. Fatigue behaviour

    International Nuclear Information System (INIS)

    Duart, J. M.; Pero-Sanz, J. A.; Verdeja, J. I.

    2005-01-01

    In recent years, passenger train speed and freight train load have increased to enhance efficiency of rail road transportation. These trends have increased the severity of rail service conditions, calling for rails with greater wear resistance, strength and fatigue behaviour. In the United Stated and Europe, track site weld rails are made entirely by aluminothermic process. This work describes the results of experimental study conducted on bending fatigue strength of plain rails and aluminothermic welded rails with preheating procedures (oxipropane and air-induced propane) approved by railways authorities. Compliance with the required fatigue strength shall be ascertained by 4 point pulsating bending test in accordance with European standards by aluminothermic welding in rails. The locati method, based in the empirical Miner's law about the cumulative damage on a fatigue tested material, allows, once known the Wohler curve of the welding process in use to settle the fatigue tensile limit at 50% with only one test. The values obtained at 2.10''6 cycles for plain rails (S f =353 MPa), oxipropane preheated aluminothermic weld rails (S f =225 MPa), and propane-air induced aluminothermic weld rails (S f =210 MPa) are very similar to those resulting from test method stated in the European Standard. From our point of view and due to its ease, speediness and savings, this is the most suitable test to check the quality and compare the aluminothermic processes in use. (Author) 15 refs

  12. Mechanisms of conduction block in immune-mediated polyneuropathies

    NARCIS (Netherlands)

    Straver, D.C.G.

    2013-01-01

    Multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP) are immune-mediated neuropathies. Despite treatment being available, patients suffer from disabling weakness of arm and leg muscles and fatigue. Pathogenesis of MMN and CIDP is unclear, but the development

  13. Diastolic dysfunction in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiese, Signe Skovgaard; Halgreen, Hanne

    2016-01-01

    stiffness of the cirrhotic heart may decrease the compliance and result in DD. The prevalence of DD in cirrhotic patients averages about 50 %. It can be evaluated by transmitral Doppler echocardiography, tissue Doppler echocardiography, and cardiac magnetic resonance imaging. There seems to be a relation...... between DD and the severity of liver dysfunction and the presence of ascites. After liver transplantation, DD worsens the prognosis and increases the risk of graft rejection, but DD improves after few months. Insertion of a transjugular intrahepatic portosystemic shunt increases left ventricular diastolic...

  14. Nutrient and immune sensing are obligate pathways in metabolism, immunity, and disease.

    Science.gov (United States)

    Iyer, Abishek; Brown, Lindsay; Whitehead, Jonathan P; Prins, Johannes B; Fairlie, David P

    2015-09-01

    The growth and survival of multicellular organisms depend upon their abilities to acquire and metabolize nutrients, efficiently store and harness energy, and sense and fight infection. Systems for sensing and using nutrients have consequently coevolved alongside systems for sensing and responding to danger signals, including pathogens, and share many of the same cell signaling proteins and networks. Diets rich in carbohydrates and fats can overload these systems, leading to obesity, metabolic dysfunction, impaired immunity, and cardiovascular disease. Excessive nutrient intake promotes adiposity, typically altering adipocyte function and immune cell distribution, both of which trigger metabolic dysfunction. Here, we discuss novel mechanistic links between metabolism and immunity that underlie metabolic dysfunction in obesity. We aim to stimulate debate about how the endocrine and immune systems are connected through autocrine, paracrine, and neuroendocrine signaling in sophisticated networks that are only now beginning to be resolved. Understanding the expression and action of signaling proteins, together with modulating their receptors or pattern recognition using agonists or antagonists, will enable rational intervention in immunometabolism that may lead to novel treatments for obesity and metabolic dysfunction. © FASEB.

  15. Vaccines (immunizations) - overview

    Science.gov (United States)

    Vaccinations; Immunizations; Immunize; Vaccine shots; Prevention - vaccine ... component) of the vaccine. VACCINE SCHEDULE The recommended vaccination (immunization) schedule is updated every 12 months by ...

  16. Role of the Ca2+-Calcineurin-Nuclear Factor of Activated T cell Pathway in Mitofusin-2-Mediated Immune Function of Jurkat Cells

    Directory of Open Access Journals (Sweden)

    Xiu-Ping Xu

    2018-01-01

    Conclusions: Our findings suggest that MFN2 may regulate T cell immune functions primarily through the Ca2+-calcineurin-NFAT pathway. MFN2 may represent a potential therapeutic target for T cell immune dysfunction-related diseases.

  17. Biological phenotypes underpin the physio-somatic symptoms of somatization, depression, and chronic fatigue syndrome.

    Science.gov (United States)

    Anderson, G; Berk, M; Maes, M

    2014-02-01

    Somatization is a symptom cluster characterized by 'psychosomatic' symptoms, that is, medically unexplained symptoms, and is a common component of other conditions, including depression and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This article reviews the data regarding the pathophysiological foundations of 'psychosomatic' symptoms and the implications that this has for conceptualization of what may more appropriately be termed physio-somatic symptoms. This narrative review used papers published in PubMed, Scopus, and Google Scholar electronic databases using the keywords: depression and chronic fatigue, depression and somatization, somatization and chronic fatigue syndrome, each combined with inflammation, inflammatory, tryptophan, and cell-mediated immune (CMI). The physio-somatic symptoms of depression, ME/CFS, and somatization are associated with specific biomarkers of inflammation and CMI activation, which are correlated with, and causally linked to, changes in the tryptophan catabolite (TRYCAT) pathway. Oxidative and nitrosative stress induces damage that increases neoepitopes and autoimmunity that contribute to the immuno-inflammatory processes. These pathways are all known to cause physio-somatic symptoms, including fatigue, malaise, autonomic symptoms, hyperalgesia, intestinal hypermotility, peripheral neuropathy, etc. Biological underpinnings, such as immune-inflammatory pathways, may explain, at least in part, the occurrence of physio-somatic symptoms in depression, somatization, or myalgic encephalomyelitis/chronic fatigue syndrome and thus the clinical overlap among these disorders. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Advanced methods of fatigue assessment

    CERN Document Server

    Radaj, Dieter

    2013-01-01

    The book in hand presents advanced methods of brittle fracture and fatigue assessment. The Neuber concept of fictitious notch rounding is enhanced with regard to theory and application. The stress intensity factor concept for cracks is extended to pointed and rounded corner notches as well as to locally elastic-plastic material behaviour. The averaged strain energy density within a circular sector volume around the notch tip is shown to be suitable for strength-assessments. Finally, the various implications of cyclic plasticity on fatigue crack growth are explained with emphasis being laid on the DJ-integral approach.   This book continues the expositions of the authors’ well known reference work in German language ‘Ermüdungsfestigkeit – Grundlagen für Ingenieure’ (Fatigue strength – fundamentals for engineers).

  19. Compassion Fatigue in Pediatric Nurses.

    Science.gov (United States)

    Berger, Jill; Polivka, Barbara; Smoot, Elizabeth Ann; Owens, Heather

    2015-01-01

    Compassion fatigue in nursing has been shown to impact the quality of patient care and employee satisfaction and engagement. The aims of this study were to determine the prevalence and severity of compassion fatigue among pediatric nurses and variations in prevalence based on respondent demographics using a cross-sectional survey design. Nurses under 40 years of age, with 6-10 years of experience and/or working in a medical-surgical unit had significantly lower compassion satisfaction and higher levels of burnout. Secondary traumatic stress from caring for children with severe illness or injury or end of life was a key contributor to compassion fatigue. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Peridynamic model for fatigue cracking.

    Energy Technology Data Exchange (ETDEWEB)

    Silling, Stewart Andrew; Abe Askari (Boeing)

    2014-10-01

    The peridynamic theory is an extension of traditional solid mechanics in which the field equations can be applied on discontinuities, such as growing cracks. This paper proposes a bond damage model within peridynamics to treat the nucleation and growth of cracks due to cyclic loading. Bond damage occurs according to the evolution of a variable called the "remaining life" of each bond that changes over time according to the cyclic strain in the bond. It is shown that the model reproduces the main features of S-N data for typical materials and also reproduces the Paris law for fatigue crack growth. Extensions of the model account for the effects of loading spectrum, fatigue limit, and variable load ratio. A three-dimensional example illustrates the nucleation and growth of a helical fatigue crack in the torsion of an aluminum alloy rod.

  1. Assessing Fatigue in Late-Midlife

    DEFF Research Database (Denmark)

    Fieo, Robert A; Mortensen, Erik Lykke; Lund, Rikke

    2014-01-01

    Previous methods examining the Multiple Fatigue Inventory-20 (MFI-20) fatigue questionnaire have been limited to classical test theory, for example, factor analytic approaches. We employed modern test theory to further strengthen the construct validity of the MFI-20 fatigue in a sample of healthy...... late-midlife subjects. Five subdimensions of perceived fatigue were examined in n = 7,233 subjects: general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue. Fatigue burden was compared across age groups (aged 48-52 vs. 57-63) and gender. Mokken item response theory...... was used to investigate dimensionality, monotonicity, and invariant item ordering (IIO). In both age groups, as well as by gender, the Motivation domain presented with weak scalability, suggesting that caution be exercised when interpreting sum scores. For all groupings, the strongest scaling properties...

  2. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Treatment

    Science.gov (United States)

    ... Search Controls Search Form Controls Cancel Submit Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Note: Javascript is disabled or ... is no cure or approved treatment for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). However, some symptoms ...

  3. Development of an in situ fatigue sensor.

    Science.gov (United States)

    2011-01-01

    A prototype in situ fatigue sensor has been designed, constructed and evaluated experimentally for its ability to monitor the accumulation of fatigue damage in a cyclically loaded steel structure, e.g., highway bridge. The sensor consists of multiple...

  4. Getting the Facts: Cancer-Related Fatigue

    Science.gov (United States)

    ... and depression, that can cause cancer-related fatigue. Cancer treatment such as chemotherapy, radiation therapy, stem cell transplantation, and biologic therapy are often associated with fatigue. Anemia (a ...

  5. The role of central and peripheral muscle fatigue in postcancer fatigue: a randomized controlled trial

    NARCIS (Netherlands)

    Prinsen, H.; Dijk, J.P. van; Zwarts, M.J.; Leer, J.W.H.; Bleijenberg, G.; Laarhoven, H.W.M. van

    2015-01-01

    CONTEXT: Postcancer fatigue is a frequently occurring problem, impairing quality of life. Little is known about (neuro)physiological factors determining postcancer fatigue. It may be hypothesized that postcancer fatigue is characterized by low peripheral muscle fatigue and high central muscle

  6. Circadian rhythm sleep disorders in patients with multiple sclerosis and its association with fatigue: A case-control study

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Najafi

    2013-01-01

    Full Text Available Background: Circadian rhythm sleep disorders are a presentation of sleep disorders in patients with multiple sclerosis (MS. This study aims to compare this problem in MS patients with healthy people and to determine its association with chronic fatigue in MS patients. Materials and Methods: A case-control study was performed on 120 MS patients and 60 healthy subjects matched for age and sex, in 2009 in MS Clinic Alzahra Hospital. Sleep quality, rhythm and fatigue severity were assessed using PSQI (Pittsburgh sleep quality index and FSS (Fatigue severity Scale questionnaires, respectively. Its reliability and validity has been confirmed in several studies (Cronbach′s alpha = 0.83. This index has seven sections including patient′s assessment of his/her sleep, sleep duration, efficacy of routine sleep, sleep disorders, use of hypnotic medication, and dysfunction in daily activities. Results: Circadian rhythm sleep disorder was more frequent in MS patients relative to healthy subjects (P: 0.002. It was higher in MS patients with severe fatigue relative to MS patients with mild fatigue (P: 0.05. Fatigue severity was 49.9 ± 8.2 and 22.5 ± 7.4 in the first and second group, respectively. PSQI index was 7.9 ± 4.5 in patients with severe fatigue and 5.9 ± 4.5 in patients with mild fatigue and 4.5 ± 2.4 in the control group (P: 0.0001. Conclusion: Circadian rhythm sleep disorders are more frequent in MS patients and those with fatigue. Recognition and management of circadian rhythm sleep disorders in MS patients, especially those with fatigue may be helpful in improving care of these patients.

  7. Cytosolic nucleic acid sensors and innate immune regulation.

    Science.gov (United States)

    Ori, Daisuke; Murase, Motoya; Kawai, Taro

    2017-03-04

    During viral and bacterial infections, pathogen-derived cytosolic nucleic acids are recognized by the intracellular RNA sensors retinoic acid-inducible gene I and melanoma-differentiated gene 5 and intracellular DNA sensors, including cyclic-di-GMP-AMP synthase, absent in melanoma 2, interferon (IFN)-gamma inducible protein 16, polymerase III, and so on. Binding of intracellular nucleic acids to these sensors activates downstream signaling cascades, resulting in the production of type I IFNs and pro-inflammatory cytokines to induce appropriate systematic immune responses. While these sensors also recognize endogenous nucleic acids and activate immune responses, they can discriminate between self- and non-self-nucleic acids. However, dysfunction of these sensors or failure of regulatory mechanisms causes aberrant activation of immune response and autoimmune disorders. In this review, we focus on how intracellular immune sensors recognize exogenous nucleic acids and activate the innate immune system, and furthermore, how autoimmune diseases result from dysfunction of these sensors.

  8. Managing female sexual dysfunction.

    Science.gov (United States)

    Buster, John E

    2013-10-01

    Female sexual dysfunctions (FSDs) range from short-term aggravations to major emotional disturbances adversely affecting family and workplace. This review highlights diagnosis and management of the four most widely diagnosed FSDs. It initially focuses on hypoactive sexual desire disorder (HSDD) as a driving force at the heart of all other FSDs; nothing happens without sexual desire. Successful resolution of HSDD frequently facilitates resolution of other disorders. Central to understanding HSDD is the impact of aging female sexual endocrinology and its effect on both prevalence and expression patterns of FSD. Advances in this field have enabled introduction of some the most effective treatments yet described for HSDD. Sexual arousal disorder, though commonly affected by the same factors as HSDD, is heavily associated with psychotropic drugs and mood elevators. Orgasmic disorder is frequently the downstream result of other sexual dysfunctions, particularly HSDD, or the result of a major psychosexual trauma. Successful management of the underlying disorder often resolves orgasmic disorder. Sexual pain disorder is frequently the result of a gynecologic disorder, such as endometriosis, that can be substantially managed through successful treatment of that disorder. This article ends with the article's most important note: how to initiate the conversation. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Peripheral muscle dysfunction in COPD: lower limbs versus upper limbs.

    Science.gov (United States)

    Miranda, Eduardo Foschini; Malaguti, Carla; Corso, Simone Dal

    2011-01-01

    In patients with COPD, the degree of functional impairment appears to differ between the upper and lower limbs. Significant dyspnea and fatigue have been reported by these patients when performing tasks with unsupported upper limbs and two mechanisms have been proposed to explain this fact: neuromechanical dysfunction of respiratory muscles; and changes in lung volume during such activities. The neuromechanical dysfunction seen in COPD patients during this type of exercise is related to changes in the breathing pattern, as well as to the simultaneity of afferent and efferent muscle stimuli, resulting in respiratory muscle asynchrony. In addition, the increased ventilation during upper limb exercise in patients with COPD leads to dynamic hyperinflation at different workloads. During lower limb exercises, the strength and endurance of the quadriceps muscle is lower in COPD patients than in healthy subjects. This could by explained by abnormal muscle metabolism (decreased aerobic capacity), dependence on glycolytic metabolism, and rapid accumulation of lactate during exercise. In comparison with lower limb exercises, upper limb exercises result in higher metabolic and ventilatory demands, as well as in a more intense sensation of dyspnea and greater fatigue. Because there are differences between the upper and lower limb muscles in terms of the morphological and functional adaptations in COPD patients, specific protocols for strength training and endurance should be developed and tested for the corresponding muscle groups.

  10. Neuroendocrine dysfunction in Sjogren's syndrome.

    Science.gov (United States)

    Tzioufas, Athanasios G; Tsonis, John; Moutsopoulos, Haralampos M

    2008-01-01

    Interactions among the immune, nervous and endocrine systems, which are mediated by hormones, neuropeptides, neurotransmitters, cytokines and their receptors, appear to play an important role in modulating host susceptibility and resistance to inflammatory disease. The neuroendocrine system has two main components: the central and the peripheral. The central compartment is located in the locus ceruleus, the brainstem centers of the autonomic system and the paraventricular nucleus; the peripheral mainly consists of the sympathetic/adrenomedullary system, the hypothalamic-pituitary-adrenal axis (HPA), the hypothalamic-pituitary-gonadal (HPG) axis, and the neuroendocrine tissue located in several organs throughout the body. Hormones and neuropeptides may influence the activities of lymphoid organs and cells via endocrine and local autocrine/paracrine pathways or alter the function of different cell types in target organs. Recent studies highlighted alterations of the neuroendocrine system in systemic autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus and Sjogren's syndrome (SS). SS, a prototype autoimmune disorder, has a wide clinical spectrum, extending from organ involvement (autoimmune exocrinopathy) to systemic disease and B cell lymphoma. In SS, several functions of the neuroendocrine system are impaired. First, the HPA axis appears to be disturbed, since significantly lower basal ACTH and cortisol levels were found in patients with SS and were associated with a blunted pituitary and adrenal response to ovine corticotropin-releasing factor compared to normal controls. Second, HPG axis is also involved, since lack of estrogens is associated with human disease and the development of autoimmune exocrinopathy in several experimental models. Finally, exocrine glands are enriched with neuroendocrine-related molecules, adjacent to local autoimmune lesions. Certain clinical manifestations of the disease, including the sicca manifestations

  11. Fatigue behavior of ADI: Some specific features

    Energy Technology Data Exchange (ETDEWEB)

    Svejcar, J.; Vechet, S.; Pokluda, J. [Technical Univ. of Brno (Czech Republic). Faculty of Mechanical Engineering

    1997-12-31

    The paper summarizes the results of fatigue tests on austempered ductile iron. Attention is mainly focused on the effect of graphite on crack propagation and on some irregularities exhibited by ADI and other ductile irons, e.g., some specific features of fatigue fracture (especially the occurrence of fatigue striations on intergranular facets), decrease of fatigue limit with increasing UTS, and anomalous dependence of loading cycle amplitude on mean cycle stress.

  12. Statistical distribution analysis of rubber fatigue data

    Science.gov (United States)

    DeRudder, J. L.

    1981-10-01

    Average rubber fatigue resistance has previously been related to such factors as elastomer type, cure system, cure temperature, and stress history. This paper extends this treatment to a full statistical analysis of rubber fatigue data. Analyses of laboratory fatigue data are used to predict service life. Particular emphasis is given to the prediction of early tire splice failures, and to adaptations of statistical fatigue analysis for the particular service conditions of the rubber industry.

  13. Multispecimen fatigue crack propagation testing

    International Nuclear Information System (INIS)

    Ermi, A.M.; Bauer, R.E.; Chin, B.A.; Straalsund, J.L.

    1981-01-01

    Chains of miniature center-cracked-tension specimens were tested on a conventional testing machine and on a prototypic in-reactor fatigue machine as part of the fusion reactor materials alloy development program. Annealed and 20 percent cold-worked 316 stainless steel specimens were cycled under various conditions of temperature, frequency, stress ratio and chain length. Crack growth rates determined from multispecimen visual measurements and from an electrical potential technique were consistent with those obtained by conventional test methods. Results demonstrate that multispecimen chain testing is a valid method of obtaining fatigue crack propagation information for alloy development. 8 refs

  14. Risk Based Optimal Fatigue Testing

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Faber, M.H.; Kroon, I.B.

    1992-01-01

    Optimal fatigue life testing of materials is considered. Based on minimization of the total expected costs of a mechanical component a strategy is suggested to determine the optimal stress range levels for which additional experiments are to be performed together with an optimal value of the maxi......Optimal fatigue life testing of materials is considered. Based on minimization of the total expected costs of a mechanical component a strategy is suggested to determine the optimal stress range levels for which additional experiments are to be performed together with an optimal value...

  15. Muscle glycogen stores and fatigue

    DEFF Research Database (Denmark)

    Ørtenblad, Niels; Westerblad, Håkan; Nielsen, Joachim

    2013-01-01

    function during fatigue is not well understood and a direct cause-and-effect relationship between glycogen and muscle function remains to be established. The use of electron microscopy has revealed that glycogen is not homogeneously distributed in skeletal muscle fibres, but rather localized in distinct...... the sarcoplasmic reticulum (SR). We and others have provided experimental evidence in favour of a direct role of decreased glycogen, localized within the myofibrils, for the reduction in SR Ca2+ release during fatigue. This is consistent with compartmentalized energy turnover and distinctly localized glycogen...

  16. Fatigue data bases in Europe

    International Nuclear Information System (INIS)

    Olivier, R.; Koettgen, V.B.; Seeger, T.; Boller, C.

    1988-01-01

    Based on an inquiry with well-known European fatigue institutions the paper describes existing more or less extensive collections and data bases of S-N and crack growth data, mainly on unwelded and welded steel and aluminium in organizations and countries as follows: CEC, ESA, Federal Republic of Germany, GDR, Italy, Norway, Republic of Ireland, Switzerland, UK. This documentation of the present state is completed by a short survey on available European fatigue standards and design rules, serving as a data base for nominal materials data. Requirements for data base concepts, contents, user interface and data structure are presented in a short overview. (orig./HP)

  17. The Representation of Inflammatory Signals in the Brain – A Model for Subjective Fatigue in Multiple Sclerosis

    Science.gov (United States)

    Hanken, Katrin; Eling, Paul; Hildebrandt, Helmut

    2014-01-01

    In multiple sclerosis (MS) patients, fatigue is rated as one of the most common and disabling symptoms. However, the pathophysiology underlying this fatigue is not yet clear. Several lines of evidence suggest that immunological factors, such as elevated levels of pro-inflammatory cytokines, may contribute to subjective fatigue in MS patients. Pro-inflammatory cytokines represent primary mediators of immune-to-brain-communication, modulating changes in the neurophysiology of the central nervous system. Recently, we proposed a model arguing that fatigue in MS patients is a subjective feeling, which is related to inflammation. Moreover, it implies that fatigue can be measured behaviorally only by applying specific cognitive tasks related to alertness and vigilance. In the present review, we focus on the subjective feeling of MS-related fatigue. We examine the hypothesis that the subjective feeling of MS-related fatigue may be a variant of inflammation-induced sickness behavior, resulting from cytokine-mediated activity changes within brain areas involved in interoception and homeostasis including the insula, the anterior cingulate, and the hypothalamus. We first present studies demonstrating a relationship between pro-inflammatory cytokines and subjective fatigue in healthy individuals, in people with inflammatory disorders, and particularly in MS patients. Subsequently, we discuss studies analyzing the impact of anti-inflammatory treatment on fatigue. In the next part of this review, we present studies on the transmission and neural representation of inflammatory signals, with a special focus on possible neural concomitants of inflammation-induced fatigue. We also present two of our studies on the relationship between local gray and white matter atrophy and fatigue in MS patients. Finally, we discuss some implications of our findings and future perspectives. PMID:25566171

  18. The representation of inflammatory signals in the brain – a model for subjective fatigue in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Katrin eHanken

    2014-12-01

    Full Text Available In multiple sclerosis (MS patients, fatigue is rated as one of the most common and disabling symptoms. However, the pathophysiology underlying this fatigue is not yet clear. Several lines of evidence suggest that immunological factors, such as elevated levels of proinflammatory cytokines, may contribute to subjective fatigue in MS patients. Proinflammatory cytokines represent primary mediators of immune-to-brain-communication, modulating changes in the neurophysiology of the central nervous system. Recently, we proposed a model arguing that fatigue in MS patients is a subjective feeling which is related to inflammation. Moreover, it implies that fatigue can be measured behaviorally only by applying specific cognitive tasks related to alertness and vigilance. In the present review we focus on the subjective feeling of MS-related fatigue. We examine the hypothesis that the subjective feeling of MS-related fatigue may be a variant of inflammation-induced sickness behavior, resulting from cytokine-mediated activity changes within brain areas involved in interoception and homeostasis including the insula, the anterior cingulate and the hypothalamus. We first present studies demonstrating a relationship between proinflammatory cytokines and subjective fatigue in healthy individuals, in people with inflammatory disorders, and particularly in MS patients. Subsequently, we discuss studies analyzing the impact of anti-inflammatory treatment on fatigue. In the next part of this review we present studies on the transmission and neural representation of inflammatory signals, with a special focus on possible neural concomitants of inflammation-induced fatigue. We also present two of our studies on the relationship between local gray and white matter atrophy and fatigue in MS patients. Finally, we discuss some implications of our findings and future perspectives.

  19. Client attributions for sexual dysfunction.

    Science.gov (United States)

    Fichten, C S; Spector, I; Libman, E

    1988-01-01

    This investigation examined attributions for sexual dysfunctions made by 63 individuals and 21 of their partners who presented at a sex therapy service for the following problems: erectile dysfunction, premature ejaculation, and female orgasmic dysfunctions. All participants completed measures of marital adjustment, locus of control, depression and a questionnaire which assessed: attributions of responsibility for the sexual problem, perceived control over sexual functioning, distress, effort made to improve the sexual relationship, and expectations about the efficacy of sex therapy for the problem. Results indicate that both identified patients and their partners, regardless of the dysfunction, blamed the sexual problem on the "dysfunctional individual" rather than on the circumstances or the partner. With respect to the partners, husbands of women with orgasmic dysfunction were more likely to blame themselves than the circumstances, while the opposite was true for wives of males with erectile difficulties. Individuals experiencing the dysfunction perceived themselves and their partners as having little, but equal control over the identified patient's sexuality. Correlational analyses indicate that in identified patients, the better the quality of the marital relationship, the greater the self-blame and the lower the partner blame. Those with happy marriages also made greater efforts to improve their sexual relationship and had higher expectations of success with therapy. The implications of the results for research on the role of attributions in sexual dysfunction and for assessment of cognitive factors in sexually dysfunctional individuals and their partners is discussed.

  20. Pilot fatigue survey: exploring fatigue factors in air medical operations.

    Science.gov (United States)

    Gregory, Kevin B; Winn, William; Johnson, Kent; Rosekind, Mark R

    2010-01-01

    Humans confront significant physiological challenges with sleep and alertness when working in 24/7 operations. A web-based national survey of air medical pilots examined issues relevant to fatigue and sleep management. Six hundred ninety-seven responses were received, with a majority of rotor wing pilots working 3/3/7 and 7/7 duty schedules. Over 84% of the pilots reported that fatigue had affected their flight performance; less than 28% reported "nodding off" during flight. More than 90% reported a separate work site "rest" room with a bed available. Over 90% reported no company policies restricting on-duty sleep. Approximately half of the pilots reported getting 4 hours or more sleep during a typical night shift. Approximately half reported that sleep inertia had never compromised flight safety. Over 90% reported that it was better to sleep during the night and overcome sleep inertia if necessary. Survey results reflected practices that can mitigate the degrading effects of fatigue, including the availability of designated work-site sleep rooms. As demands continue to evolve, the need remains for sustained efforts to address fatigue-related risks in the air medical transport industry. This includes further study of sleep inertia issues and the need for alertness management programs. Copyright © 2010 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  1. [Dutch language area definition of chronic fatigue].

    NARCIS (Netherlands)

    Korenromp, I.H.; Meeus, M.; Bleijenberg, G.

    2012-01-01

    Chronic fatigue is a frequent but unspecific characteristic of many diseases. However, a clear definition of 'chronic fatigue' is still lacking. The Flemish-Dutch Research Group - Chronic Fatigue (VNO-CHROVER) has taken the opportunity to formulate such a definition that can be widely applied. This

  2. [Epidemiology of fatigue in general practice].

    Science.gov (United States)

    Fuhrer, R

    1994-11-01

    The epidemiology of fatigue is not well known in France, and this study reports on factors associated with fatigue in a sample of 3,784 general practice patients. Prevalence rates according to several definitions of fatigue are presented and factors are examined that have been reported to be associated with fatigue. Although 41.2% of the sample report having experienced symptoms of fatigue for at least three days, only 7.6% declare fatigue as a reason for consulting a doctor. Women report more symptoms of fatigue, but they do not consult more often than men for this reason. Age is strongly correlated with fatigue, but this is found only for men. Socioprofessional category bears no relationship to fatigue as a reason for consultation, however, the diagnosis of fatigue is more often attributed to professionals and upper management than it is to office staff or skilled and unskilled workers. We do find a strong relationship between depressive symptomatology as measured by the Center for Epidemiologic Studies (CES-D) and fatigue; nonetheless, fatigue is neither sensitive nor specific to the diagnosis of depression.

  3. Chronic fatigue syndrome: diagnosis and treatment | Revelas ...

    African Journals Online (AJOL)

    Chronic fatigue syndrome (CFS) refers to marked and prolonged fatigue, for which no indentifiable cause can be found. Despite the presence of extensive symptoms, diagnosis is made when there is profound fatigue, lasting for a duration of six months, or longer. CFS is frequently seen in association with psychiatric ...

  4. Adult Immunization

    Directory of Open Access Journals (Sweden)

    Omer Coskun

    2008-04-01

    Full Text Available Despite the many advances in modern medicine, each year thousands of people in the world die from diseases that are easily prevented by safe and effective vaccines. Few measures in preventive medicine are of such proven value and as easy to implement as routine immunization against infectious diseases. Prevention of infection by immunization is a lifelong process. There are a number of vaccines that all adults (¡I18 years require. There are also other vaccines that need to be tailored to meet individual variations in risk resulting from occupation, foreign travel, underlying illness, lifestyle and age. In this study, we tried to review this important subject. [TAF Prev Med Bull 2008; 7(2.000: 159-166

  5. Adult Immunization

    Directory of Open Access Journals (Sweden)

    Omer Coskun

    2008-04-01

    Full Text Available Despite the many advances in modern medicine, each year thousands of people in the world die from diseases that are easily prevented by safe and effective vaccines. Few measures in preventive medicine are of such proven value and as easy to implement as routine immunization against infectious diseases. Prevention of infection by immunization is a lifelong process. There are a number of vaccines that all adults (¡I18 years require. There are also other vaccines that need to be tailored to meet individual variations in risk resulting from occupation, foreign travel, underlying illness, lifestyle and age. In this study, we tried to review this important subject. [TAF Prev Med Bull. 2008; 7(2: 159-166

  6. Epigallocatechin gallate ameliorates chronic fatigue syndrome in mice: behavioral and biochemical evidence.

    Science.gov (United States)

    Sachdeva, Anand Kamal; Kuhad, Anurag; Tiwari, Vinod; Chopra, Kanwaljit

    2009-12-28

    Three decades after the coining of the term chronic fatigue syndrome, the diagnosis of this illness is still symptom based and the aetiology remains elusive. Chronic fatigue syndrome pathogenesis seems to be multifactorial and the possible involvement of immune system is supported. The present study was designed to evaluate the effects of the epigallocatechin gallate in a mouse model of immunologically induced chronic fatigue. On 19th day, after lipopolysaccharide/Brucella abortus administration, the mice showed significant increase in immobility period, post swim fatigue and thermal hyperalgesia. Behavioral deficits were coupled with enhanced oxidative-nitrosative stress as evident by increased lipid peroxidation, nitrite levels and decreased endogenous antioxidant enzymes (superoxide dismutase, reduced glutathione and catalase) and inflammation (increased levels of tumor necrosis factor-alpha and tissue growth factor-beta). Chronic treatment with epigallocatechin gallate restored these behavioral and biochemical alterations in mice. The present study points out towards the beneficial effect of epigallocatechin gallate in the amelioration of chronic fatigue syndrome and thus may provide a new, effective and powerful strategy to treat chronic fatigue syndrome.

  7. Sexual dysfunction in women partners of men with erectile dysfunction.

    Science.gov (United States)

    Greenstein, A; Abramov, L; Matzkin, H; Chen, J

    2006-01-01

    We evaluated 113 female partners of men with erectile dysfunction (ED) attending a sexual dysfunction clinic in order to define sexual dysfunction among these women. In all, 51 (45%) women denied having any sexual dysfunction. The other 62 (55%) responded to questions classifying their complaint(s) according to the international classification of female sexual dysfunction (FSD) in the following topics (40/62, 65%, reported having more than one problem): decreased sexual desire (n=35, 56%), sexual aversion (none), arousal (n=23, 37%) and orgasmic disorders (n=39, 63%), dyspareunia (n=19, 31%), vaginismus (n=3, 5%), and noncoital sexual pain (none). Many female partners of men with ED report having some form of sexual disorder, mostly orgasmic problems and decreased sexual desire. Therefore, for optimal outcome of ED treatment, evaluation and treatment of male and FSD should be addressed as one unit within the context of the couple, and be incorporated into one clinic of sexual medicine.

  8. Impact of yoga in a case of vocal cord dysfunction with dysautonomia

    OpenAIRE

    Wadhwania, Rozina

    2017-01-01

    A 23-year-old female with a past medical history of gastroesophageal reflux disease presented with shortness of breath induced by exercise and certain odors. She reported the symptoms of autonomic dysfunction including fatigue, chest pain, lightheadedness, headaches, numbness/tingling in the arms and legs, and exercise intolerance. Vital signs were significant for orthostatic intolerance. Volume flow loop in the pulmonary function tests showed a flattening of the inspiratory portion character...

  9. Hormone levels in radiotherapy treatment related fatigue

    International Nuclear Information System (INIS)

    Biswal, B.M.; Mallik, G.S.

    2003-01-01

    Radiotherapy is known to cause debilitating treatment related fatigue. Fatigue in general is a conglomeration of psychological, physical, hematological and unknown factors influencing the internal milieu of the cancer patient. Radiotherapy can add stress at the cellular and somatic level to aggravate further fatigue in cancer patients undergoing radiotherapy. Stress related hormones might be mediating in the development of fatigue. This is an ongoing prospective study to evaluate if the hormonal profile related to stress is influenced by radiotherapy treatment related fatigue. The study was conducted from September 2002 onwards in the division of Radiotherapy and Oncology of our Medical School. Previously untreated patients with histopathology proof of malignancy requiring external beam radiotherapy were considered for this study. Selection criteria were applied to exclude other causes of fatigue. Initial fatigue score was obtained using Pipers Fatigue Score questionnaire containing 23 questions, subsequently final fatigue score was obtained at the end of radiotherapy. Blood samples were obtained to estimate the levels of ACTH, TSH, HGH, and cortisol on the final assessment. The hormone levels were compared with resultant post radiotherapy fatigue score. At the time of reporting 50 patients were evaluable for the study. The total significant fatigue score was observed among 12 (24%) patients. The individual debilitating fatigue score were behavioral severity 14 (28%), affective meaning 14(28%), Sensory 13 (26%) and cognitive mood 10 (20%) respectively. From the analysis of hormonal profile, growth hormone level > 1 ng/mL and TSH <0.03 appears to be associated with high fatigue score (though statistically not significant); whereas there was no correlation with ACTH and serum cortisol level. In our prospective study severe radiotherapy treatment related fatigue was found among our patient population. Low levels of TSH and high levels of GH appear to be associated

  10. Cycling and erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Ina Šibli

    2015-01-01

    Full Text Available Abstract: For many years medical studies have implicated bicycle riding is causing erectile dysfunction (ED in association with higher perineal pressure. This review focuses upon epidemiological studies assesing the impact of cycling on ED, pathogenesis of ED in cyclists  as well as on research considering changes of perineal pressure, hemodynamics, and nerve conduction when cycling. Investigestors were also interested in different saddle sizes, materials and geometry and also in the impact of saddle and riders position on changes to the perineum. Research on female cyclists is very limited but indicates similar genitourinary disorders as in male cyclists. We also review  research on preventative and therapeutic options regarding bicycle riding and ED.

  11. Progressive posterior cortical dysfunction

    Directory of Open Access Journals (Sweden)

    Fábio Henrique de Gobbi Porto

    Full Text Available Abstract Progressive posterior cortical dysfunction (PPCD is an insidious syndrome characterized by prominent disorders of higher visual processing. It affects both dorsal (occipito-parietal and ventral (occipito-temporal pathways, disturbing visuospatial processing and visual recognition, respectively. We report a case of a 67-year-old woman presenting with progressive impairment of visual functions. Neurologic examination showed agraphia, alexia, hemispatial neglect (left side visual extinction, complete Balint's syndrome and visual agnosia. Magnetic resonance imaging showed circumscribed atrophy involving the bilateral parieto-occipital regions, slightly more predominant to the right . Our aim was to describe a case of this syndrome, to present a video showing the main abnormalities, and to discuss this unusual presentation of dementia. We believe this article can contribute by improving the recognition of PPCD.

  12. Epilepsy and Mitochondrial Dysfunction

    Directory of Open Access Journals (Sweden)

    Russell P. Saneto DO, PhD

    2017-10-01

    Full Text Available Epilepsy is a common manifestation of mitochondrial disease. In a large cohort of children and adolescents with mitochondrial disease (n = 180, over 48% of patients developed seizures. The majority (68% of patients were younger than 3 years and medically intractable (90%. The electroencephalographic pattern of multiregional epileptiform discharges over the left and right hemisphere with background slowing occurred in 62%. The epilepsy syndrome, infantile spasms, was seen in 17%. Polymerase γ mutations were the most common genetic etiology of seizures, representing Alpers-Huttenlocher syndrome (14%. The severity of disease in those patients with epilepsy was significant, as 13% of patients experienced early death. Simply the loss of energy production cannot explain the development of seizures or all patients with mitochondrial dysfunction would have epilepsy. Until the various aspects of mitochondrial physiology that are involved in proper brain development are understood, epilepsy and its treatment will remain unsatisfactory.

  13. A gene signature for post-infectious chronic fatigue syndrome

    Science.gov (United States)

    Gow, John W; Hagan, Suzanne; Herzyk, Pawel; Cannon, Celia; Behan, Peter O; Chaudhuri, Abhijit

    2009-01-01

    Background At present, there are no clinically reliable disease markers for chronic fatigue syndrome. DNA chip microarray technology provides a method for examining the differential expression of mRNA from a large number of genes. Our hypothesis was that a gene expression signature, generated by microarray assays, could help identify genes which are dysregulated in patients with post-infectious CFS and so help identify biomarkers for the condition. Methods Human genome-wide Affymetrix GeneChip arrays (39,000 transcripts derived from 33,000 gene sequences) were used to compare the levels of gene expression in the peripheral blood mononuclear cells of male patients with post-infectious chronic fatigue (n = 8) and male healthy control subjects (n = 7). Results Patients and healthy subjects differed significantly in the level of expression of 366 genes. Analysis of the differentially expressed genes indicated functional implications in immune modulation, oxidative stress and apoptosis. Prototype biomarkers were identified on the basis of differential levels of gene expression and possible biological significance Conclusion Differential expression of key genes identified in this study offer an insight into the possible mechanism of chronic fatigue following infection. The representative biomarkers identified in this research appear promising as potential biomarkers for diagnosis and treatment. PMID:19555476

  14. A gene signature for post-infectious chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Cannon Celia

    2009-06-01

    Full Text Available Abstract Background At present, there are no clinically reliable disease markers for chronic fatigue syndrome. DNA chip microarray technology provides a method for examining the differential expression of mRNA from a large number of genes. Our hypothesis was that a gene expression signature, generated by microarray assays, could help identify genes which are dysregulated in patients with post-infectious CFS and so help identify biomarkers for the condition. Methods Human genome-wide Affymetrix GeneChip arrays (39,000 transcripts derived from 33,000 gene sequences were used to compare the levels of gene expression in the peripheral blood mononuclear cells of male patients with post-infectious chronic fatigue (n = 8 and male healthy control subjects (n = 7. Results Patients and healthy subjects differed significantly in the level of expression of 366 genes. Analysis of the differentially expressed genes indicated functional implications in immune modulation, oxidative stress and apoptosis. Prototype biomarkers were identified on the basis of differential levels of gene expression and possible biological significance Conclusion Differential expression of key genes identified in this study offer an insight into the possible mechanism of chronic fatigue following infection. The representative biomarkers identified in this research appear promising as potential biomarkers for diagnosis and treatment.

  15. Risk Based Optimal Fatigue Testing

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Faber, M.H.; Kroon, I.B.

    1992-01-01

    Optimal fatigue life testing of materials is considered. Based on minimization of the total expected costs of a mechanical component a strategy is suggested to determine the optimal stress range levels for which additional experiments are to be performed together with an optimal value...

  16. Fatigue of superalloys and intermetallics

    International Nuclear Information System (INIS)

    Stoloff, N.S.

    1993-01-01

    The fatigue behavior of intermetallic alloys and their composites is contrasted to that of nickel-base superalloys. The roles of microstructure and slip planarity are emphasized. Obstacles to use of intermetallics under cyclic loading conditions are described and future research directions are suggested

  17. Ultrasonic absortion in fatigued materials

    Science.gov (United States)

    Dugan, S.; Arnold, W.

    2013-01-01

    Non-destructive detection of fatigue damage, allowing an estimate of the residual life-time of components, could contribute to a safe and reliable operation of components and installations. Ultrasonic absorption, i.e. the internal friction, of a material increases with increasing fatigue or creep damage and there are many theories trying to explain the physics behind this phenomenon. Measurement of ultrasonic absorption directly on components could provide information on the degree of damage. A laser ultrasonic method, using laser-generated pulses and optical detection, was applied to study ultrasonic absorption in fatigue specimens of different metals. A characteristic behavior of the ultrasonic absorption coefficient with increasing levels of fatigue damage was found for the titanium alloy Ti-6Al-4V. Another aim of this study was to relate the absorption mechanisms to the behavior of ultrasonic absorption observed in metals with complex microstructure. To achieve this, different ultrasonic absorption mechanisms were analyzed with respect to experimental data. A thermoelastic effect related to the size and elasticity of the microstructure is discussed as the origin of the increased ultrasonic absorption.

  18. Fatigue in the shipping industry

    NARCIS (Netherlands)

    Houtman, I.; Miedema, M.; Jettinghoff, K.; Starren, A.; Heinrich, J.; Gort, J.

    2005-01-01

    Fatigue is a 'reduction in physical and/or mental capacity as the result of physical, mental, or emotional exertion which may impair nearly all physical abilities including: strength, speed, reaction time, coordination, decision making or balance'. The literature is quite clear on the debilitating

  19. Fatigue Reliability under Random Loads

    DEFF Research Database (Denmark)

    Talreja, R.

    1979-01-01

    We consider the problem of estimating the probability of survival (non-failure) and the probability of safe operation (strength greater than a limiting value) of structures subjected to random loads. These probabilities are formulated in terms of the probability distributions of the loads and the...... propagation stage. The consequences of this behaviour on the fatigue reliability are discussed....

  20. Targeting Immune Cell Checkpoints during Sepsis

    Directory of Open Access Journals (Sweden)

    Naeem K. Patil

    2017-11-01

    Full Text Available Immunosuppression is increasingly being recognized as one of the causes of increased morbidity and mortality during sepsis. Both innate and adaptive immune system dysfunction have been shown to cause an impaired ability to eradicate the primary infection and also lead to frequent occurrence of secondary opportunistic infections. Pre-clinical and clinical studies have shown that inhibitory immune checkpoint molecules, including programmed death-1 (PD-1, programmed death ligand-1 (PD-L1, cytotoxic T lymphocyte antigen-4 (CTLA-4, T cell membrane protein-3 (TIM-3, Lymphocyte activation-gene-3 (LAG-3 and 2B4, are upregulated during the course of sepsis. Engagement of these inhibitory molecules on various immune cells has been consistently shown to inhibit innate immune cell functions (e.g., phagocytosis, cytokine production and pathogen clearance and also lead to impaired T cell competence. In numerous pre-clinical models of sepsis, therapeutic agents aimed at blocking engagement of inhibitory immune checkpoints on immune cells have been shown to improve innate and adaptive immune cell functions, increase host resistance to infection and significantly improve survival. Therefore, immunotherapy with immune cell checkpoint inhibitors holds significant potential for the future of sepsis therapy and merits further investigation.

  1. Variable amplitude fatigue, modelling and testing

    International Nuclear Information System (INIS)

    Svensson, Thomas.

    1993-01-01

    Problems related to metal fatigue modelling and testing are here treated in four different papers. In the first paper different views of the subject are summarised in a literature survey. In the second paper a new model for fatigue life is investigated. Experimental results are established which are promising for further development of the mode. In the third paper a method is presented that generates a stochastic process, suitable to fatigue testing. The process is designed in order to resemble certain fatigue related features in service life processes. In the fourth paper fatigue problems in transport vibrations are treated

  2. Fatigue and workload among Danish fishermen

    DEFF Research Database (Denmark)

    Remmen, Line Nørgaard; Herttua, Kimmo; Riss-Jepsen, Jørgen

    2017-01-01

    . Highest levels of fatigue were observed among fishermen at Danish seiners (mean 10.21), and fatigue scores decreased with more days at sea. However, none of these results were significant. Adjusted analyses showed that physical workload was significantly related to general fatigue (b = 0.20, 95% CI: 0...... was additionally significantly associated to the levels of physical and mental fatigue. Fishermen had a lower average score for all fatigue dimensions compared to those seen in general Danish working population. Prospective studies are required to assess whether the identified associations are causal....

  3. MULTIAXIAL FATIGUE OF A RAILWAY WHEEL STEEL

    Directory of Open Access Journals (Sweden)

    CHIN-SUNG CHUNG

    2015-09-01

    Full Text Available Uniaxial and biaxial torsional fatigue specimens were extracted from a railway wheel steel. The fatigue tests were performed with the stress ratio of R= -1 by using uniaxial and biaxial torsional fatigue test specimens at room temperature in air. The ultimate and yield strengths of the steel were evaluated. The uniaxial fatigue limit was 422.5 MPa, which corresponds to 67% of the ultimate tensile strength. The ratio of e  e  / was 0.63. Appropriate parameters to predict the fatigue life of the steel under multiaxial stress states were reviewed.

  4. Sexual dysfunction associated with infertility'

    African Journals Online (AJOL)

    1989-07-15

    Jul 15, 1989 ... In the present study 50% of women had a statistically increased incidence of sexual dysfunction during the fertile phase compared with the non-fertile phase. Loss of libido was found to be the most common dysfunction in 45% either alone or in combination with a decreased frequency of orgasm in.

  5. Organizational Dysfunctions: Sources and Areas

    Directory of Open Access Journals (Sweden)

    Jacek Pasieczny

    2016-12-01

    Full Text Available Objective:The purpose of this article is to identify and describe various types and sources of organizational dysfunctions. Research Design & Methods: The findings are based on literature review and an ongoing empirical research project conducted in private sector organisations. The empirical study can be situated within interpretative approach. In this qualitative project open interviews and observations were used to collect data. Findings: The study indicates that various types and sources of organizational dysfunctions can be identified in organizations operating in Poland. The sources of dysfunctions may be found both within the organization and its environment. Regardless of its specific features, most of the dysfunctions may be interpreted as an undesirable goal displacement. Very often areas of these dysfunctions are strongly interconnected and create a system that hinders organizational performance. Yet, it is difficult to study these phenomena as respondents are unwilling, for various reasons, to disclose the problems faced by their organizations. Implications & Recommendations: The results imply that the issue of organisational dysfunctions requires open, long-lasting and comparative studies. Recommendations for further studies are formulated in the last section of the paper. Contribution & Value Added: The paper provides insight into "the dark side of organising" by identifying sources and areas of dysfunctions. It also reveals difficulties connected with conducting research on dysfunctions in the Polish context.

  6. Bladder Dysfunction and Vesicoureteral Reflux

    Directory of Open Access Journals (Sweden)

    Ulla Sillén

    2008-01-01

    Full Text Available In this overview the influence of functional bladder disturbances and of its treatment on the resolution of vesicoureteral reflux (VUR in children is discussed. Historically both bladder dysfunction entities, the overactive bladder (OAB and the dysfunctional voiding (DV, have been described in conjunction with VUR. Treatment of the dysfunction was also considered to influence spontaneous resolution in a positive way. During the last decades, however, papers have been published which could not support these results. Regarding the OAB, a prospective study with treatment of the bladder overactivity with anticholinergics, did not influence spontaneous resolution rate in children with a dysfunction including also the voiding phase, DV and DES (dysfunctional elimination syndrome, most studies indicate a negative influence on the resolution rate of VUR in children, both before and after the age for bladder control, both with and without treatment. However, a couple of uncontrolled studies indicate that there is a high short-term resolution rate after treatment with flow biofeedback. It should be emphasized that the voiding phase dysfunctions (DV and DES are more severe than the genuine filling phase dysfunction (OAB, with an increased frequency of UTI and renal damage in the former groups. To be able to answer the question if treatment of bladder dysfunction influence the resolution rate of VUR in children, randomized controlled studies must be performed.

  7. Cognitive dysfunction in pediatric multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Suppiej A

    2014-07-01

    Full Text Available Agnese Suppiej,1 Elisa Cainelli1,2 1Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy; 2Lifespan Cognitive Neuroscience Laboratory (LCNL, Department of General Psychology, University of Padua, Italy Abstract: Cognitive and neuropsychological impairments are well documented in adult ­multiple sclerosis (MS. Research has only recently focused on cognitive disabilities in pediatric cases, highlighting some differences between pediatric and adult cases. Impairments in several functions have been reported in children, particularly in relation to attention, processing speed, visual–motor skills, and language. Language seems to be particularly vulnerable in pediatric MS, unlike in adults in whom it is usually preserved. Deficits in executive functions, which are considered MS-specific in adults, have been inconsistently reported in children. In children, as compared to adults, the relationship between cognitive dysfunctions and the two other main symptoms of MS, fatigue and psychiatric disorders, was poorly explored. Furthermore, data on the correlations of cognitive impairments with clinical and neuroimaging features are scarce in children, and the results are often incongruent; interestingly, involvement of corpus callosum and reduced thalamic volume differentiated patients identified as having a cognitive impairment from those without a cognitive impairment. Further studies about pediatric MS are needed in order to better understand the impact of the disease on brain development and the resulting effect on cognitive functions, particularly with respect to different therapeutic strategies. Keywords: central nervous system, child, deficit, IQ, inflammatory demyelination, neuropsychological

  8. Does Ramadan Fasting Affect Fatigue in Nurses?

    Science.gov (United States)

    Ovayolu, Özlem; Ovayolu, Nimet; Taşan, Emel

    2016-01-01

    The purpose of this study was to evaluate the effect of Ramadan fasting on fatigue in nurses. The study was conducted between June 19 and July 27, 2014, with a descriptive design. This study was completed with 99 nurses working in a public hospital in the city of Gaziantep located in the Southeastern Anatolia Region of Turkey. The data of the study were collected by using a questionnaire and the Piper Fatigue Scale. The Piper Fatigue Scale includes 4 subscale/dimensional scores and total fatigue scores. Higher scores indicate more fatigue. Statistical significance levels were set at P Ramadan (P .05). The Ramadan fasting increased fatigue levels of nurses. Therefore, it is of vital importance to evaluate fatigue levels of nurses especially in the month of Ramadan and take the necessary precautions in terms of patient and personnel safety.

  9. Fatigue processes in thermoplastic fibres; Les mecanismes de fatigue dans les fibres thermoplastiques

    Energy Technology Data Exchange (ETDEWEB)

    Herrera Ramirez, J.M.

    2004-09-15

    The present study examines and compares the behaviour of the two types of PA66 fibres and two types of PET fibres under fatigue loading up to failure, and the correlation between the fibres (nano)structures and their structural heterogeneities, with fatigue lifetimes. Several techniques have been used to analyze the materials, such as scanning electron microscopy (SEM), microanalysis (EDS), differential scanning calorimetry (DSC), wide angle X-ray diffraction (WAXD) and micro-Raman spectroscopy. A meticulous analysis by scanning electron microscopy of the fracture morphology of fibres broken in tension and in fatigue, as well as a study of the fatigue life, were undertaken. The fatigue process occurs when the cyclic load amplitude is sufficiently large, however a condition for fatigue failure is that the minimum load each cycle must be lower than a threshold stress level. Failure under fatigue conditions leads to distinctive fracture morphologies which are very different from those seen after tensile or creep failure and this allows easy identification of the fatigue process. The fibres have been analyzed in the as received state and after fatigue failure in order to observe the microstructural changes resulting from the fatigue loading. The results will be compared with those obtained for fibres loaded under conditions where the fatigue process was hindered. The role of the microstructure of the fibres in determining fatigue will be discussed in this work and the possibility of improving their resistance to fatigue or eliminating the fatigue process will be discussed. (author)

  10. Immune Regulation during Chronic Visceral Leishmaniasis

    Science.gov (United States)

    Faleiro, Rebecca J.; Kumar, Rajiv; Hafner, Louise M.; Engwerda, Christian R.

    2014-01-01

    Visceral leishmaniasis is a chronic parasitic disease associated with severe immune dysfunction. Treatment options are limited to relatively toxic drugs, and there is no vaccine for humans available. Hence, there is an urgent need to better understand immune responses following infection with Leishmania species by studying animal models of disease and clinical samples from patients. Here, we review recent discoveries in these areas and highlight shortcomings in our knowledge that need to be addressed if better treatment options are to be developed and effective vaccines designed. PMID:25010815

  11. The problem of fatigue in patients suffering from neoplastic disease

    Directory of Open Access Journals (Sweden)

    Agnieszka Kolak

    2017-06-01

    Full Text Available Modern therapeutic management of patients with cancer is associated with many adverse side effects, including fatigue defined as weariness, burnout, lassitude, malaise, apathy, impatience, and/or inability to perform daily activities. It occurs frequently before the diagnosis of cancer and may persist for a long time after the end of cancer therapy. It is a common problem that occurs regardless of the type of cancer and applied therapeutic procedure. The appearance of this symptom significantly affects the quality of life of patients and often reduces the effectiveness of implemented treatment. The symptom of fatigue occurs among approximately 80% of patients treated with chemotherapy and/or radiotherapy, as well as among more than 75% of patients with metastatic disease. Causes of fatigue include metabolic and immune system disorders as well as increased level of tumour necrosis factor  (TNF-. Recent studies also indicate a significant contribution of other cytokines, especially pro-inflammatory ones, i.e. interleukin-1 (IL-1, interleukin-6 (IL-6, soluble tumour necrosis factor receptor type II (sTNF type II and C-reactive protein (CRP. A patient reporting fatigue should be properly diagnosed and thoroughly interviewed by doctors. Patients are mostly treated non-pharmacologically (by means of physical exercise and psychotherapy and pharmacologically (by applying methylphenidate and methylprednisolone. What is also extremely important is proper education of the patient and their closest family/friends on the symptoms, which significantly reduces anxiety and stress. On the other hand therapeutic management hinders the subjectivity of feeling and lack of standardised scales to rate symptoms.

  12. Characterization of the Effects of Fatigue on the Central Nervous System (CNS) and Drug Therapies

    National Research Council Canada - National Science Library

    Mery, Laura

    2007-01-01

    .... The model focused on central fatigue. Central fatigue associated with sleep disruption may precede peripheral fatigue, and therefore may predict impaired performance earlier than peripheral fatigue...

  13. Relationship between female pelvic floor dysfunction and sexual dysfunction: an observational study.

    Science.gov (United States)

    Bortolami, Arianna; Vanti, Carla; Banchelli, Federico; Guccione, Andrew A; Pillastrini, Paolo

    2015-05-01

    The ability to express one's sexuality and engage in sexual activity requires multisystemic coordination involving many psychological functions as well as the integrity of the nervous, hormonal, vascular, immune, and neuromuscular body structures and functions. The purpose of this study was to investigate the associations among pelvic floor function, sexual function, and demographic and clinical characteristics in a population of women initiating physical therapy evaluation and treatment for pelvic floor-related dysfunctions (urinary incontinence, pelvic organ prolapse, vulvodynia, vaginismus, and constipation). We consented and collected completed demographic data and data related to symptoms and clinical condition on 85 consecutive patients in an outpatient physical therapy clinic. Clinical and anthropometric characteristics were analyzed descriptively. Analysis of variance and linear regression analyses were used to analyze Female Sexual Function Index (FSFI) scale ratings, whereas zero-inflated beta-binomial regression was applied to the pain subscale. Main outcome measure was FSFI score, whereas the secondary outcome measure was the FSFI subscale score related to pain. Women in our sample were 38 years old on average, 33% of whom had given birth and 82% of whom had high tone pelvic floor. Being in the middle-tercile age group and exhibiting low pelvic floor tone (Beta = 6.8; 95% confidence interval [CI] = [1.4; 12.0]) were significantly associated with lower levels of sexual dysfunction. Women with low tone pelvic floor also reported lower pain (odds ratio = 4.0; 95% CI = [1.6; 9.6]), whereas younger aged and physically unsatisfied subjects were more likely not to have sexual activity in the month prior to scale measurement. In female patients with pelvic floor muscle dysfunction undergoing physical therapy and rehabilitation, sexual dysfunction appears to be significantly correlated with age and high pelvic floor muscle tone. © 2015

  14. A review of treatment approaches of Myofascial Pain Dysfunction Syndrome

    Directory of Open Access Journals (Sweden)

    Arash Mansuorian

    2017-03-01

    Full Text Available Masticatory muscle pain is the second most frequent cause of orofacial pain after dental pain. Myofascial pain dysfunction syndrome (MPDS is the most common form of temporomandibular joint dysfunction. MPDS is a pain that triggers from [sensitive] points in the muscles and fascia and is followed by spasm, tenderness to palpation, restricted movement, fatigue, and sometimes dysfunction. The researchers intended to collect comprehensive information about therapeutic interventions for myofascial pain through the conduction of a critical study based on evidence in the literature. In this review, 51 English articles, published between 1981 and 2013, were extracted from PubMed, Medline, Ovid, and Google Scholar. These articles were then reviewed in detail in two categories, namely pharmaceutical and non-pharmaceutical treatments. MPDS treatment should be first focused on the identification and correction of underlying causes. Thiocolchicoside (TCC, non-steroidal anti-inflammatory drugs (NSAIDs, and Cox-2 inhibitors are among promising pharmaceutical methods. On the other hand, ultrasound and laser therapy are among promising non-pharmaceutical methods. The complex mechanism of MPDS, along with its underlying peripheral and central nervous mechanisms may make MPDS, difficult to treat, especially in its chronic form.

  15. Assessment of early onset of driver fatigue using multimodal fatigue measures in a static simulator.

    Science.gov (United States)

    Jagannath, M; Balasubramanian, Venkatesh

    2014-07-01

    Driver fatigue is an important contributor to road accidents. This paper reports a study that evaluated driver fatigue using multimodal fatigue measures, i.e., surface electromyography (sEMG), electroencephalography (EEG), seat interface pressure, blood pressure, heart rate and oxygen saturation level. Twenty male participants volunteered in this study by performing 60 min of driving on a static simulator. Results from sEMG showed significant physical fatiguefatigue. This will help us understand the influence of physical and mental fatigue on driver during monotonous driving. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  16. The inflammatory hypothesis of mood spectrum broadened to fibromyalgia and chronic fatigue syndrome.

    Science.gov (United States)

    Dell'Osso, Liliana; Bazzichi, Laura; Baroni, Stefano; Falaschi, Valentina; Conversano, Ciro; Carmassi, Claudia; Marazziti, Donatella

    2015-01-01

    The present paper aimed at reviewing literature data on the inflammatory hypothesis of mood spectrum, as well as the overlapping features with some chronic rheumatologic disorders, in particular fibromyalgia and chronic fatigue syndrome. A literature search was carried out for English papers published in the years 2000-2014, while using the following words: mood spectrum, depression, bipolar disorders, fibromyalgia, chronic fatigue syndrome, neurotransmitters, inflammation, neuroinflammation, cytokines. Overlapping features were highlighted between mood spectrum, fibromyalgia and chronic fatigue syndrome suggesting common underlying mechanisms at pathophysiological level involving both central nervous and the immune systems. Taken together, the literature would suggest that the borders between different medical domains should be reconsidered in the light of common processes linking them.

  17. Primary graft dysfunction.

    Science.gov (United States)

    Suzuki, Yoshikazu; Cantu, Edward; Christie, Jason D

    2013-06-01

    Primary graft dysfunction (PGD) is a syndrome encompassing a spectrum of mild to severe lung injury that occurs within the first 72 hours after lung transplantation. PGD is characterized by pulmonary edema with diffuse alveolar damage that manifests clinically as progressive hypoxemia with radiographic pulmonary infiltrates. In recent years, new knowledge has been generated on risks and mechanisms of PGD. Following ischemia and reperfusion, inflammatory and immunological injury-repair responses appear to be key controlling mechanisms. In addition, PGD has a significant impact on short- and long-term outcomes; therefore, the choice of donor organ is impacted by this potential adverse consequence. Improved methods of reducing PGD risk and efforts to safely expand the pool are being developed. Ex vivo lung perfusion is a strategy that may improve risk assessment and become a promising platform to implement treatment interventions to prevent PGD. This review details recent updates in the epidemiology, pathophysiology, molecular and genetic biomarkers, and state-of-the-art technical developments affecting PGD. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. [Testosterone and erectile dysfunction].

    Science.gov (United States)

    Diemer, T

    2010-01-01

    Primary hypogonadism represents a classic but rare cause of erectile dysfunction (ED) in men. Therapy with testosterone as monotherapy is therefore unlikely to cure ED in the typical ED patient. However, recent developments indicate a much greater role of testosterone in erectile function than has been supposed in the past. Serum testosterone levels decline in men with increasing age. Aging men might develop late-onset hypogonadism (LOH) associated with characteristic symptoms. Typical symptoms of LOH are represented by decreased libido and sexual function, osteoporosis, altered distribution of body fat, overall reduction in physical strength, and alterations in the general mood. Experimental and clinical studies over the last few years have also pointed out that hypogonadism results in characteristic alterations of the erectile tissue of the penis. These alterations might be reversible in response to hormone therapy with testosterone. Particularly testosterone might be a helpful supportive therapy in cases where PDE-5 antagonists have tended to lose their effectiveness on the erectile tissue in the treatment of ED.

  19. Markers of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Kelvin P Davies

    2008-01-01

    Full Text Available With the development and marketing of oral pharmacotherapy that is both noninvasive and successful in treating erectile dysfunction (ED, the quest to identify markers of organic ED lost ground. Indeed, the multi-factorial nature of ED may have led many researchers to conclude that searching for a universal marker of ED was futile. However, the realization that ED is strongly correlated with the overall health of men, and may act as a predictor for the development of cardiovascular disease (CVD and diabetes, has stimulated interest in identifying genes that can distinguish organic ED. In addition, the potential ability to suggest to the patient that ED is reversible (i.e., psychogenic with a simple test would be of significance to both the physician and patient, as well as for reimbursement issues for therapy by insurance companies. Such a marker may also act as a non-subjective measure of the degree of ED and the efficacy of treatment. This review discusses the importance of identifying such markers and recent work identifying potential markers in human patients.

  20. [Thyroid dysfunction during pregnancy].

    Science.gov (United States)

    Díez, Juan J; Iglesias, Pedro; Donnay, Sergio

    2015-10-21

    Recent clinical practice guidelines on thyroid dysfunction and pregnancy have changed health care provided to pregnant women, although their recommendations are under constant revision. Trimester- and area-specific reference ranges for serum thyroid-stimulating hormone are required for proper diagnosis of hypothyroidism and hyperthyroidism. There is no doubt on the need of therapy for overt hypothyroidism, while therapy for subclinical hypothyroidism is controversial. Further research is needed to settle adverse effects of isolated hypothyroxinemia and thyroid autoimmunity. Differentiation between hyperthyroidism due to Graves' disease and the usually self-limited gestational transient thyrotoxicosis is critical. It is also important to recognize risk factors for postpartum thyroiditis. Supplementation with iodine is recommended to maintain adequate iodine nutrition during pregnancy and avoid serious consequences in offspring. Controversy remains about universal screening for thyroid disease during pregnancy or case-finding in high-risk women. Opinions of some scientific societies and recent cost-benefit studies favour universal screening. Randomized controlled studies currently under development should reduce the uncertainties that still remain in this area. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  1. Maintenance of systemic immune functions prevents accelerated presbycusis.

    Science.gov (United States)

    Iwai, Hiroshi; Baba, Susumu; Omae, Mariko; Lee, Shinryu; Yamashita, Toshio; Ikehara, Susumu

    2008-05-07

    There is no effective therapy for progressive hearing loss such as presbycusis, the causes of which remain poorly understood because of the difficulty of separating genetic and environmental contributions. In the present study, we show that the age-related dysfunctions of the systemic immune system in an animal model of accelerated presbycusis (SAMP1, senescence-accelerated mouse P1) can be corrected by allogeneic bone marrow transplantation (BMT). We also demonstrate that this presbycusis can be prevented; BMT protects the recipients from age-related hearing impairment and the degeneration of spiral ganglion cells (SGCs) as well as the dysfunctions of T lymphocytes, which have a close relation to immune senescence. No donor cells are infiltrated to the spiral ganglia, confirming that this experimental system using BMT is connected to the systemic immune system and does not contribute to transdifferentiation or fusion by donor hematopoietic stem cells (HSCs), or to the direct maintenance of ganglion cells by locally infiltrated donor immunocompetent cells. Therefore, another procedure which attempts to prevent the age-related dysfunctions of the recipient immune system is the inoculation of syngeneic splenocytes from young donors. These mice show no development of hearing loss, compared with the recipient mice with inoculation of saline or splenocytes from old donors. Our studies on the relationship between age-related systemic immune dysfunctions and neurodegeneration mechanisms open up new avenues of treatment for presbycusis, for which there is no effective therapy.

  2. Parallels in Immunometabolic Adipose Tissue Dysfunction with Ageing and Obesity

    Directory of Open Access Journals (Sweden)

    William Trim

    2018-02-01

    Full Text Available Ageing, like obesity, is often associated with alterations in metabolic and inflammatory processes resulting in morbidity from diseases characterised by poor metabolic control, insulin insensitivity, and inflammation. Ageing populations also exhibit a decline in immune competence referred to as immunosenescence, which contributes to, or might be driven by chronic, low-grade inflammation termed “inflammageing”. In recent years, animal and human studies have started to uncover a role for immune cells within the stromal fraction of adipose tissue in driving the health complications that come with obesity, but relatively little work has been conducted in the context of immunometabolic adipose function in ageing. It is now clear that aberrant immune function within adipose tissue in obesity—including an accumulation of pro-inflammatory immune cell populations—plays a major role in the development of systemic chronic, low-grade inflammation, and limiting the function of adipocytes leading to an impaired fat handling capacity. As a consequence, these changes increase the chance of multiorgan dysfunction and disease onset. Considering the important role of the immune system in obesity-associated metabolic and inflammatory diseases, it is critically important to further understand the interplay between immunological processes and adipose tissue function, establishing whether this interaction contributes to age-associated immunometabolic dysfunction and inflammation. Therefore, the aim of this article is to summarise how the interaction between adipose tissue and the immune system changes with ageing, likely contributing to the age-associated increase in inflammatory activity and loss of metabolic control. To understand the potential mechanisms involved, parallels will be drawn to the current knowledge derived from investigations in obesity. We also highlight gaps in research and propose potential future directions based on the current evidence.

  3. Fatigue Life Prediction in Journal Bearing

    Directory of Open Access Journals (Sweden)

    Irsyadi Yani

    2017-03-01

    Full Text Available Failure of fatigue is damaged materials where caused frequent load. Fatigue owing to some factors, which is Stress concentration on fatigue, Stress life, Effect size and surface, and Change properties of surface. The fatigue failure of a material is dependent on the interaction of a large stress with a critical flow. In essence, fatigue is controlled by the weakest link of the material, with the probability of a weak link increasing with material volume. This phenomenon is evident in the fatigue test results of a material using specimens of varying diameters. From this research we can get effect of concentration stress on strength fatigue with S-N method. On this method only count fatigue life or endurance limit from Journal bearing housing. By Finite Element Analysis, it is not so easy to determine fatigue life. When we find the first yield point, it means this point is in the highest stress state. Then we can refer S-N curve. In this paper, the effect of bearing and housing elasticity on the stress field, which could result in surface fatigue in journal bearing, has been investigated. This condition is proved with occurred slip lines on surface of specimen. These slip lines are caused on some thousands stress cycles. Additional crack is happened immediately and finally long enough crack. So that formed unstable crack that caused fracture of brittleness or fracture of toughness because section of specimen cannot keep

  4. Fatiguing exercise enhances hyperalgesia to muscle inflammation.

    Science.gov (United States)

    Sluka, Kathleen A; Rasmussen, Lynn A

    2010-02-01

    Since many people with chronic fatigue present with pain and many people with chronic pain present with fatigue, we tested if fatigue would enhance the response to pain in male and female mice. We further tested for the activation of brainstem nuclei by the fatigue task using c-fos as a marker. Fatigue was induced by having mice spontaneously run in running wheel for 2h. Carrageenan (0.03%) was injected into the gastrocnemius muscle either 2h before or 2h after the fatigue task. The mechanical sensitivity of the paw (von Frey filaments), muscle (tweezers), grip force and running wheel activity was assessed before and 24h after injection of carrageenan. Both male and female mice that performed the fatigue task, either before or after intramuscular injection of carrageenan, showed an enhanced mechanical sensitivity of the paw, but not the muscle. Ovariectomized mice showed a similar response to male mice. There was a decrease in running wheel activity after carrageenan injection, but no change in grip force suggesting that mice had no deficit in motor performance induced by the carrageenan. C-fos expression was observed in the nucleus raphe pallidus, obscurus, and magnus after the fatigue task suggesting an increased activity in the raphe nuclei in response to the fatigue task. Therefore, widespread hyperalgesia is enhanced by the fatigue response but not hyperalgesia at the site of insult. We suggest that this effect is sex-dependent and involves mechanisms in the brainstem to result in an enhanced hyperalgesia.

  5. Fatigue of Dental Implants: Facts and Fallacies

    Directory of Open Access Journals (Sweden)

    Keren Shemtov-Yona

    2016-05-01

    Full Text Available Dental implants experience rare yet problematic mechanical failures such as fracture that are caused, most often, by (time-dependent metal fatigue. This paper surveys basic evidence about fatigue failure, its identification and the implant’s fatigue performance during service. We first discuss the concept of dental implant fatigue, starting with a review of basic concepts related to this failure mechanism. The identification of fatigue failures using scanning electron microscopy follows, to show that this stage is fairly well defined. We reiterate that fatigue failure is related to the implant design and its surface condition, together with the widely varying service conditions. The latter are shown to vary to an extent that precludes devising average or representative conditions. The statistical nature of the fatigue test results is emphasized throughout the survey to illustrate the complexity in evaluating the fatigue behavior of dental implants from a design perspective. Today’s fatigue testing of dental implants is limited to ISO 14801 standard requirements, which ensures certification but does not provide any insight for design purposes due to its limited requirements. We introduce and discuss the random spectrum loading procedure as an alternative to evaluate the implant’s performance under more realistic conditions. The concept is illustrated by random fatigue testing in 0.9% saline solution.

  6. Fatigue in cancer: A review of literature

    Directory of Open Access Journals (Sweden)

    Vijayakumar Narayanan

    2009-01-01

    Full Text Available Fatigue is a common symptom of advanced cancer limiting one′s activity and affecting the quality of life. It is a multidimensional symptom complex with subjective and objective components. Hence, its definition and assessment seems arbitrary, incomplete, and elusive. Components of fatigue often merge with other ′disease states′ as anemia, depression and so on, compounding difficulty to assess it separately. Fatigue has a high prevalence rate, and lasts longer in chronic diseases like cancer. Its association with treatment modalities like chemotherapy, radiotherapy alongside the primary disease process makes it seemingly ubiquitous in many cases. Systemic manifestation of cancer causes excess demand on body resources on cell repair, uncontrolled growth with metabolite accumulation causing fatigue. Co-morbid conditions of organic and psychological nature causes fatigue. There are many assessment tools for fatigue with different uses and objectives, simple and reproducible tools like Brief Fatigue Inventory, Edmonton Symptom assessment scale seem feasible in everyday practice. Management of fatigue is not straightforward and rewarding. Although treatment of cause appears to be an attractive option, it is not possible in all cases. Therapeutic agents targeting cytokine load is in early stages of study and available results are not favorable. Specific measures aimed at pain relief, prevention/treatment of sepsis, management of depression, avoidance of drugs causing fatigue, restoring the metabolic profile are important. Methyl phenidate, megestrol, and modafinil are some drugs with promising effect to treat fatigue, though confirmatory studies are yet to be established. Non-pharmacological methods are also helpful. Forewarning patients on upcoming fatigue, active regular exercise, and stress management are some of them. Fatigue being a multidimensional entity, single mode of therapy is insufficient. Combined modality tailored to individual

  7. Fatigue Strength of Titanium Risers - Defect Sensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Babalola, Olusegun Tunde

    2001-07-01

    This study is centred on assessment of the fatigue strength of titanium fusion welds for deep-water riser's applications. Deep-water risers are subjected to significant fatigue loading. Relevant fatigue data for titanium fusion welds are very scarce. Hence there is a need for fatigue data and life prediction models for such weldments. The study has covered three topics: Fatigue testing, Fractography and defect assessment, and Fracture Mechanics modelling of fatigue crack growth. Two series of welded grade of titanium consisting of 14 specimens in each series were fatigue tested under constant amplitude loading. Prior to fatigue testing, strain gauge measurements of some specimens was conducted to enable the definition of stress range in the fatigue assessment procedure. The results were compared with finite solid element analysis and related to fatigue stresses in a riser pipe wall. Distribution and geometry of internal and surface defects both in the as-welded and in the post-weld machined conditions were assessed using fractography. This served as a tool to determine the fatigue initiation point in the welds. Fracture mechanics was applied to model fatigue strength of titanium welds with initiation from weld defects. Two different stress intensity factor formulations for embedded eccentrically placed cracks were used for analysis of elliptical cracks with the major axis parallel and close to one of the free surfaces. The methods were combined to give a satisfactory model for crack growth analysis. The model analyses crack growth of elliptical and semi-elliptical cracks in two directions, with updating of the crack geometry. Fatigue strength assessment was conducted using two crack growth models, the Paris-Erdogan relation with no threshold and the Donahue et al. relation with an implied threshold. The model was validated against experimental data, with a discussion on the choice of crack growth model. (author)

  8. Mesoscopic scale thermal fatigue damage

    International Nuclear Information System (INIS)

    Robertson, C.; Fissolo, A.; Fivel, M.

    2001-01-01

    In an attempt to better understand damage accumulation mechanisms in thermal fatigue, dislocation substructures forming in 316L steel during one specific test were examined and simulated. Hence, thin foils taken out of massive, tested specimens were first observed in transmission electron microscopy (TEM). These observations help in determining one initial dislocation configuration to be implemented in a 3-D model combining 3D discrete dislocation dynamics simulation (DDD) and finite element method computations (FEM). It was found that the simulated mechanical behaviour of the DDD microstructure is compatible with FEM and experimental data. The numerically generated dislocation microstructure is similar to ladder-like dislocation arrangements as found in many fatigued f.c.c. materials. Distinct mechanical behaviour for the two active slip systems was shown and deformation mechanisms were proposed. (authors)

  9. Nutritional strategies to optimize dairy cattle immunity.

    Science.gov (United States)

    Sordillo, L M

    2016-06-01

    Dairy cattle are susceptible to increased incidence and severity of both metabolic and infectious diseases during the periparturient period. A major contributing factor to increased health disorders is alterations in bovine immune mechanisms. Indeed, uncontrolled inflammation is a major contributing factor and a common link among several economically important infectious and metabolic diseases including mastitis, retained placenta, metritis, displaced abomasum, and ketosis. The nutritional status of dairy cows and the metabolism of specific nutrients are critical regulators of immune cell function. There is now a greater appreciation that certain mediators of the immune system can have a reciprocal effect on the metabolism of nutrients. Thus, any disturbances in nutritional or immunological homeostasis can provide deleterious feedback loops that can further enhance health disorders, increase production losses, and decrease the availability of safe and nutritious dairy foods for a growing global population. This review will discuss the complex interactions between nutrient metabolism and immune functions in periparturient dairy cattle. Details of how either deficiencies or overexposure to macro- and micronutrients can contribute to immune dysfunction and the subsequent development of health disorders will be presented. Specifically, the ways in which altered nutrient metabolism and oxidative stress can interact to compromise the immune system in transition cows will be discussed. A better understanding of the linkages between nutrition and immunity may facilitate the design of nutritional regimens that will reduce disease susceptibility in early lactation cows. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  10. Multiaxial creep-fatigue rules

    International Nuclear Information System (INIS)

    Spindler, M.W.; Hales, R.; Ainsworth, R.A.

    1997-01-01

    Within the UK, a comprehensive procedure, called R5, is used to assess the high temperature response of structures. One part of R5 deals with creep-fatigue initiation, and in this paper we describe developments in this part of R5 to cover multiaxial stress states. To assess creep-fatigue, damage is written as the linear sum of fatigue and creep components. Fatigue is assessed using Miner's law with the total endurance split into initiation and growth cycles. Initiation is assessed by entering the curve of initiation cycles vs strain range using a Tresca equivalent strain range. Growth is assessed by entering the curve of growth cycles vs strain range using a Rankine equivalent strain range. The number of allowable cycles is obtained by summing the initiation and growth cycles. In this way the problem of defining an equivalent strain range applicable over a range of endurance is avoided. Creep damage is calculated using ductility exhaustion methods. In this paper we address two aspects; first, the nature of stress relaxation and, hence, accumulated creep strain in multiaxial stress fields; secondly, the effect of multiaxial stress on creep ductility. The effect of multiaxial stress state on creep ductility has been examined using experimental data and mechanistic models. Good agreement is demonstrated between an empirical description of test data and a cavity growth model, provided a simple nucleation criterion is included. A simple scaling factor is applied to uniaxial creep ductility, defined as a function of stress state. The factor is independent of the cavity growth mechanisms and yields a value of equivalent strain which can be conveniently used in determining creep damage by ductility exhaustion. (author). 14 refs, 4 figs

  11. Study of the neuroendocrine and immunologic mechanism of fatigue caused by military operations

    Directory of Open Access Journals (Sweden)

    Xin LI

    2012-01-01

    Full Text Available Objective  To observe the regularity of the changes in neuroendocrine-immune system caused by fatigue due to military operations, and explore the mechanism by which fatigue occurs in military operations. Methods  The subjects were 240 soldiers belonging to a field artillery force. The medical history and physical examination were taken before military operations, and fatigue assessment scale was accomplished as well. The following variables were measured in all the subjects: pituitary-adrenal [adrenocorticotropic hormone (ACTH, cortical hormone (B, 24-h urinary free cortisol (UFC], pituitary-gonadal [luteinizing hormone (LH, testosterone (T, estradiol (E2], pituitary-thyroid functions [serum thyroid stimulating hormone (TSH, tetraiodothyronine (TT4, triiodothyronine (TT3, free thyroxine (FT4, and free triiodothyronine (FT3], and cellular immune parameters (CD3+, CD4+, CD8+, CD4+/CD8+, B, NK. After 7 d of large-scale and high-intensity field exercises, the above variables were again measured in all the subjects. Results  After high-intensity military operations, the unpleasant feelings were significantly increased, and the compulsive and psychotic scores significantly decreased in the soldiers. In addition, the pituitary-adrenal and pituitary-gonadal hormone levels also decreased (all PPPConclusion  The depressed psychological tolerance in soldiers is the psychological factor of fatigue after a high-intensity military operation. The hypocorticoidism and inhibition of hypothalamic-pituitary-gonadal axis are the pathophysiological basis of military operation fatigue. Suppression of immune function is an important reason for an increase of susceptibility to disease after high-intensity military operations.

  12. Fatigue Management in Spaceflight Operations

    Science.gov (United States)

    Whitmire, Alexandra

    2011-01-01

    Sleep loss and fatigue remain an issue for crewmembers working on the International Space Station, and the ground crews who support them. Schedule shifts on the ISS are required for conducting mission operations. These shifts lead to tasks being performed during the biological night, and sleep scheduled during the biological day, for flight crews and the ground teams who support them. Other stressors have been recognized as hindering sleep in space; these include workload, thinking about upcoming tasks, environmental factors, and inadequate day/night cues. It is unknown if and how other factors such as microgravity, carbon dioxide levels, or increased radiation, may also play a part. Efforts are underway to standardize and provide care for crewmembers, ground controllers and other support personnel. Through collaborations between research and operations, evidenced-based clinical practice guidelines are being developed to equip flight surgeons with the tools and processes needed for treating circadian desynchrony (and subsequent sleep loss) caused by jet lag and shift work. The proper implementation of countermeasures such as schedules, lighting protocols, and cognitive behavioral education can hasten phase shifting, enhance sleep and optimize performance. This panel will focus on Fatigue Management in Spaceflight Operations. Speakers will present on research-based recommendations and technologies aimed at mitigating sleep loss, circadian desynchronization and fatigue on-orbit. Gaps in current mitigations and future recommendations will also be discussed.

  13. Randomized controlled trial of Qigong/Tai Chi Easy on cancer-related fatigue in breast cancer survivors.

    Science.gov (United States)

    Larkey, Linda K; Roe, Denise J; Weihs, Karen L; Jahnke, Roger; Lopez, Ana Maria; Rogers, Carol E; Oh, Byeongsang; Guillen-Rodriguez, Jose

    2015-04-01

    Many breast cancer survivors experience fatigue, mood, and sleep disturbances. This study aims to compare a meditative movement practice, Qigong/Tai Chi Easy (QG/TCE) with sham Qigong (SQG), testing effects of meditation/breath aspects of QG/TCE on breast cancer survivors' persistent fatigue and other symptoms. This double-blind, randomized controlled trial tested 12 weeks of QG/TCE versus SQG on fatigue, depression, and sleep among 87 postmenopausal, fatigued breast cancer survivors, stages 0-III, age 40-75. Fatigue decreased significantly in the QG/TCE group compared to control at post-intervention (p = 0.005) and 3 months follow-up (p = 0.024), but not depression and sleep quality. Improvement occurred over time for both interventions in depression and sleep quality (all p < 0.05). QG/TCE showed significant improvement over time compared to SQG for fatigue, but not depression or sleep. Both QG/TCE and SQG showed improvement for two prevalent symptoms among breast cancer survivors, depression and sleep dysfunction.

  14. Impact of yoga in a case of vocal cord dysfunction with dysautonomia

    Directory of Open Access Journals (Sweden)

    Rozina Wadhwania

    2017-01-01

    Full Text Available A 23-year-old female with a past medical history of gastroesophageal reflux disease presented with shortness of breath induced by exercise and certain odors. She reported the symptoms of autonomic dysfunction including fatigue, chest pain, lightheadedness, headaches, numbness/tingling in the arms and legs, and exercise intolerance. Vital signs were significant for orthostatic intolerance. Volume flow loop in the pulmonary function tests showed a flattening of the inspiratory portion characteristic of vocal cord dysfunction. Laryngoscopy showed dyskinesia of the left vocal cord, especially after exercise. Multifactorial approach was used including increased fluid intake and breathing exercises. After 6 weeks of breathing and isometric exercises, the patient reported improvement in dyspnea after exercise. This case report demonstrates the therapeutic role of breathing and isometric exercises in the management of vocal cord and autonomic dysfunction.

  15. Impact of yoga in a case of vocal cord dysfunction with dysautonomia.

    Science.gov (United States)

    Wadhwania, Rozina

    2017-01-01

    A 23-year-old female with a past medical history of gastroesophageal reflux disease presented with shortness of breath induced by exercise and certain odors. She reported the symptoms of autonomic dysfunction including fatigue, chest pain, lightheadedness, headaches, numbness/tingling in the arms and legs, and exercise intolerance. Vital signs were significant for orthostatic intolerance. Volume flow loop in the pulmonary function tests showed a flattening of the inspiratory portion characteristic of vocal cord dysfunction. Laryngoscopy showed dyskinesia of the left vocal cord, especially after exercise. Multifactorial approach was used including increased fluid intake and breathing exercises. After 6 weeks of breathing and isometric exercises, the patient reported improvement in dyspnea after exercise. This case report demonstrates the therapeutic role of breathing and isometric exercises in the management of vocal cord and autonomic dysfunction.

  16. Fatigue, psychosocial adaptation and quality of life one year after traumatic brain injury and suspected traumatic axonal injury; evaluations of patients and relatives: a pilot study.

    Science.gov (United States)

    Esbjörnsson, Eva; Skoglund, Thomas; Sunnerhagen, Katharina S

    2013-09-01

    To describe fatigue and its relationship to cognition, psychosocial adjustment, quality of life (QoL), work status and relative's experiences 12 months after suspected traumatic axonal injury (TAI). Eighteen patients were assessed with the Daily Fatigue Impact Scale (D-FIS), the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS), the European Questionnaire 5 Dimensions health-related quality of life, the Glasgow Coma Outcome Scale Extended, and the European Brain Injury Questionnaire (EBIQ) (patient and relative). Return to work was registered. At 1 year, fatigue still caused great problems in daily life. Although fatigue and cognition (BNIS) did not correlate, the more fatigued patients subjectively experienced significantly more cognitive dysfunction. Although D-FIS and QoL did not correlate, most patients reported that feelings of tiredness and dullness related to having lower QoL. However, lower QoL was associated with cognitive and attention disability (BNIS), subjective perception of executive dysfunction, lack of motivation, and mood disturbances (EBIQ). Neither fatigue nor cognition associated with return to work. The general consequences of TAI showed good agreement between patients' and relatives' experiences. The patient's subjective experience of the impact of TAI seems to be most essential, as it is the objective reality that the patient responds to, and this should therefore be assessed and treated.

  17. Iodine-induced thyroid dysfunction

    Science.gov (United States)

    Leung, Angela M.; Braverman, Lewis E.

    2017-01-01

    Purpose of review To summarize the mechanisms of iodine-induced hypothyroidism and hyperthyroidism, identify the risk factors for thyroid dysfunction following an iodine load, and summarize the major sources of excess iodine exposure. Recent findings Excess iodine is generally well tolerated, but individuals with underlying thyroid disease or other risk factors may be susceptible to iodine-induced thyroid dysfunction following acute or chronic exposure. Sources of increased iodine exposure include the global public health efforts of iodine supplementation, the escalating use of iodinated contrast radiologic studies, amiodarone administration in vulnerable patients, excess seaweed consumption, and various miscellaneous sources. Summary Iodine-induced thyroid dysfunction may be subclinical or overt. Recognition of the association between iodine excess and iodine-induced hypothyroidism or hyperthyroidism is important in the differential diagnosis of patients who present without a known cause of thyroid dysfunction. PMID:22820214

  18. Cognitive dysfunction after cardiovascular surgery

    DEFF Research Database (Denmark)

    Funder, K S; Steinmetz, J; Rasmussen, L S

    2009-01-01

    This review describes the incidence, risk factors, and long-term consequences of cognitive dysfunction after cardiovascular surgery. Postoperative cognitive dysfunction (POCD) is increasingly being recognized as an important complication, especially in the elderly. A highly sensitive neuropsychol......This review describes the incidence, risk factors, and long-term consequences of cognitive dysfunction after cardiovascular surgery. Postoperative cognitive dysfunction (POCD) is increasingly being recognized as an important complication, especially in the elderly. A highly sensitive...... neuropsychological test battery must be used to detect POCD and a well-matched control group is very useful for the analysis and interpretation of the test RESULTS: Cardiovascular surgery is associated with a high incidence of POCD. Cardiopulmonary bypass was thought to explain this difference, but randomized...

  19. Muscle dysfunction in cancer patients

    DEFF Research Database (Denmark)

    Christensen, Jesper Frank; Jones, L W; Andersen, J L

    2014-01-01

    dysfunction in cancer patients lies in the correlation to vital clinical end points such as cancer-specific and all-cause mortality, therapy complications and quality of life (QoL). Such associations strongly emphasize the need for effective therapeutic countermeasures to be developed and implemented......BACKGROUND: Muscle dysfunction is a prevalent phenomenon in the oncology setting where patients across a wide range of diagnoses are subject to impaired muscle function regardless of tumor stage and nutritional state. Here, we review the current evidence describing the degree, causes and clinical...... dysfunction is evident across all stages of the cancer trajectory. The causes of cancer-related muscle dysfunction are complex, but may involve a wide range of tumor-, therapy- and/or lifestyle-related factors, depending on the clinical setting of the individual patient. The main importance of muscle...

  20. How do women with lupus manage fatigue?

    DEFF Research Database (Denmark)

    Kier, Anne Ørnholt; Midtgaard, Julie; Hougaard, Karin Sørig

    2016-01-01

    , and learning to accept fatigue) and six sub-themes (i.e., the search for recognition, legitimization, planning and prioritizing, the body’s limits and self-indulgence, adjusting life to comply with resources, and acceptance of dependence). Conclusion: Fatigue is the controlling element in everyday life......Objective: Half of patients with systemic lupus erythematosus (SLE) consider fatigue to be the most disabling disease symptom. To develop and promote strategies to prevent and control fatigue, this study aimed to describe how women with SLE manage the experience of fatigue. Methods: Four focus...... groups were conducted with 27 women with SLE, and data were analyzed by means of framework analysis. Two patient representatives with SLE were part of the investigator team. Results: The analysis revealed three main themes (i.e., learning how to be open about fatigue, learning to listen to the body...

  1. Low cycle fatigue of irradiated LMFBR materials

    International Nuclear Information System (INIS)

    Blackburn, L.D.

    1976-01-01

    A review of low cycle fatigue data on irradiated LMFBR materials was conducted and extensive graphical representations of available data are presented. Representative postirradiation tensile properties of annealed 304 and 316 SS are selected and employed in several predictive methods to estimate irradiated material fatigue curves. Experimental fatigue data confirm the use of predictive methods for establishing conservative design curves over the range of service conditions relevant to such CRBRP components as core former, fixed radial shielding, core barrel, lower inlet module and upper internals structures. New experimental data on fatigue curves and creep-fatigue interaction in irradiated 20 percent cold worked (CW) 316 SS and Alloy 718 would support the design of removable radial shielding and upper internals in CRBRP. New experimental information on notched fatigue behavior and cyclic stress-strain curves of all these materials in the irradiated condition could provide significant design data

  2. IEA Joint Action. Wind turbine fatigue

    Energy Technology Data Exchange (ETDEWEB)

    Maribo Pedersen, B. [ed.

    1996-09-01

    Fatigue research on wind turbine blade material has been an important issue over the years in many countries and in the E.U. As a result of the effort the knowledge on fatigue properties of fibre reinforced materials has been expanded enormously. Practical fatigue design properties are available for constant amplitude tests at ambient temperatures. A lack of knowledge can be shown in several other fields, such as variable amplitude and multi-axial testing and the influence of the environment and carbon fibres. Fatigue is seen as dominant for the blade design, improvements in both the load prediction and material fatigue properties should be strove for. In discussions with blade manufacturers and subsidy agencies (E.U. DGXII, NOVEM, ETSU, etc.) on the importance of continuous materials fatigue research the improvement in reliability should be stressed. (au)

  3. Fatigue in Steel Structures under Random Loading

    DEFF Research Database (Denmark)

    Agerskov, Henning

    1999-01-01

    test results. Both the fracture mechanics analysis and the fatigue test results indicate that Miner's rule, which is normally used in the design against fatigue in steel structures, may give results, which are unconservative, and that the validity of the results obtained from Miner's rule will depend......Fatigue damage accumulation in steel structures under random loading is studied. The fatigue life of welded joints has been determined both experimentally and from a fracture mechanics analysis. In the experimental part of the investigation, fatigue test series have been carried through on various...... types of welded plate test specimens and full-scale offshore tubular joints. The materials that have been used are either conventional structural steel with a yield stress of ~ 360-410 MPa or high-strength steel with a yield stress of ~ 810-1010 MPa. The fatigue tests and the fracture mechanics analyses...

  4. Monitoring and Managing Fatigue in Basketball

    Directory of Open Access Journals (Sweden)

    Toby Edwards

    2018-02-01

    Full Text Available The sport of basketball exposes athletes to frequent high intensity movements including sprinting, jumping, accelerations, decelerations and changes of direction during training and competition which can lead to acute and accumulated chronic fatigue. Fatigue may affect the ability of the athlete to perform over the course of a lengthy season. The ability of practitioners to quantify the workload and subsequent fatigue in basketball athletes in order to monitor and manage fatigue levels may be beneficial in maintaining high levels of performance and preventing unfavorable physical and physiological training adaptations. There is currently limited research quantifying training or competition workload outside of time motion analysis in basketball. In addition, systematic research investigating methods to monitor and manage athlete fatigue in basketball throughout a season is scarce. To effectively optimize and maintain peak training and playing performance throughout a basketball season, potential workload and fatigue monitoring strategies need to be discussed.

  5. Thyroid dysfunction and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Sima Nazarpour

    2015-07-01

    Full Text Available Background: Pregnancy has a huge impact on the thyroid function in both healthy women and those that have thyroid dysfunction. The prevalence of thyroid dysfunction in pregnant women is relatively high. Objective: The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction including hyperthyroidism, hypothyroidism and thyroid autoimmune positivity on pregnancy outcomes. Materials and Methods: In this review, Medline, Embase and the Cochrane Library were searched with appropriate keywords for relevant English manuscript. We used a variety of studies, including randomized clinical trials, cohort (prospective and retrospective, case-control and case reports. Those studies on thyroid disorders among non-pregnant women and articles without adequate quality were excluded. Results: Overt hyperthyroidism and hypothyroidism has several adverse effects on pregnancy outcomes. Overt hyperthyroidism was associated with miscarriage, stillbirth, preterm delivery, intrauterine growth retardation, low birth weight, preeclampsia and fetal thyroid dysfunction. Overt hypothyroidism was associated with abortion, anemia, pregnancy-induced hypertension, preeclampsia, placental abruption, postpartum hemorrhage, premature birth, low birth weight, intrauterine fetal death, increased neonatal respiratory distress and infant neuro developmental dysfunction. However the adverse effect of subclinical hypothyroidism, and thyroid antibody positivity on pregnancy outcomes was not clear. While some studies demonstrated higher chance of placental abruption, preterm birth, miscarriage, gestational hypertension, fetal distress, severe preeclampsia and neonatal distress and diabetes in pregnant women with subclinical hypothyroidism or thyroid autoimmunity; the other ones have not reported these adverse effects. Conclusion: While the impacts of overt thyroid dysfunction on feto-maternal morbidities have been clearly

  6. Psychological model of adolescent dysfunctionality

    Directory of Open Access Journals (Sweden)

    Cvetkov A. V.

    2016-05-01

    Full Text Available teenage dysfunctionality could be caused by a number of factors, which are an integral part of modern life. Particularly, in this work we considered such factors as uncertainty, frustration, and a mismatch of sexual behavior setting. The path analysis based on using structural equations. The results proved that teenage dysfunctionality is a consequence of the direct effect of the interconnection between moral reflection and moral and ethical responsibility on the perception level of social frustration, corporeality and sexual mismatch.

  7. Fatigue mechanisms during physical exercise

    Directory of Open Access Journals (Sweden)

    Monique Gevaerd

    2006-03-01

    Full Text Available Fatigue can be defined as incapacity to maintain the required power output, with concomitant impairment of exercise performance, and it can be divided into chronic or acute. In acute fatigue a subdivision has been used to delimitate experimental studies. Thus, acute fatigue can be central or peripheral. We began the review process with a search on the Pubmed database, followed by selection of classical and more recent articles. As the fatigue mechanisms are linked to the predominant energy metabolism in the activity, the purpose of this paper was to review the main acute fatigue theories in activities with different metabolic demands. From this literature review, it was possible to infer that important metabolic alterations occurring during exercise, impair normal cellular activities,therefore, decreasing the speed of contraction and as well as energy replenishment. Many of those alterations give information to the central nervous system, limiting the time length of exercise. Theoretically, the elongation of exercise beyond biological limits can cause irreversible damages to the organism. RESUMO Fadiga pode ser definida como uma incapacidade na manutenção de uma determinada potência, com conseqüente redução no desempenho, podendo ser considerada como crônica ou aguda. Na fadiga aguda, uma subdivisão vem sendo utilizada para maior delimitação dos estudos experimentais. Nesse sentido, fadiga aguda pode ser descrita como central ou periférica. Nós iniciamos o processo de revisão sobre o assunto com uma busca no banco de dados Pubmed, seguido da seleção dos artigos clássicos e mais recentes. Como os mecanismos de fadiga estão intimamente ligados ao metabolismo energético predominante da atividade, a presente revisão destinou-se a levantar as principais teorias sobre fadiga aguda em atividades com diferentes exigências metabólicas. A partir desse apanhado bibliográfico podemos inferir que importantes alterações metab

  8. Immune Dysfunction in Transition Dairy Cows: Pharmacologic and Dietary Immune Modulation

    Science.gov (United States)

    With a $40.5 billion Gross Domestic Value for milk produced in the U.S. during 2013, the dairy industry was the third largest sector of the 2013 U.S. animal agriculture economic engine. The value of milk produced in 2013 represented 24% of the total value of animal agriculture production; this figu...

  9. Immune dysfunction in periparturient dairy cows: Insight into pharmacologic and dietary immune treatments

    Science.gov (United States)

    With a $40.5 billion Gross Domestic Value for milk produced in the U.S. during 2013, the dairy industry was the third largest sector of the 2013 U.S. animal agriculture economic engine. The value of milk produced in 2013 represented 24% of the total value of animal agriculture production; this figu...

  10. Obesity, inflammation and endothelial dysfunction.

    Science.gov (United States)

    Iantorno, M; Campia, U; Di Daniele, N; Nistico, S; Forleo, G B; Cardillo, C; Tesauro, M

    2014-01-01

    Cardiovascular disease is the leading cause of morbidity and mortality in obese individuals. Obesity dramatically increases the risk of development of metabolic and cardiovascular disease. This risk appears to originate from disruption in adipose tissue function leading to a chronic inflammatory state and to dysregulation of the endocrine and paracrine actions of adipocyte-derived factors. These, in turn, impair vascular homeostasis and lead to endothelial dysfunction. An altered endothelial cell phenotype and endothelial dysfunction are common among all obesity-related complications. A crucial aspect of endothelial dysfunction is reduced nitric oxide (NO) bioavailability. A systemic pro-inflammatory state in combination with hyperglycemia, insulin resistance, oxidative stress and activation of the renin angiotensin system are systemic disturbances in obese individuals that contribute independently and synergistically to decreasing NO bioavailability. On the other hand, pro-inflammatory cytokines are locally produced by perivascular fat and act through a paracrine mechanism to independently contribute to endothelial dysfunction and smooth muscle cell dysfunction and to the pathogenesis of vascular disease in obese individuals. The promising discovery that obesity-induced vascular dysfunction is, at least in part, reversible, with weight loss strategies and drugs that promote vascular health, has not been sufficiently proved to prevent the cardiovascular complication of obesity on a large scale. In this review we discuss the pathophysiological mechanisms underlying inflammation and vascular damage in obese patients.

  11. Fatigue strength tests of layered steel

    OpenAIRE

    Michal Černý; Pavel Mazal; Josef Filípek; Petr Dostál

    2013-01-01

    The work deals with original measurement of fatigue properties of formed layered steel material – damask steel. This is a material that exhibits a fine micro-structure as well as a regular composition of many material layers with complementary properties. The article experimentally verifies high-cycle fatigue properties of layered steel and evaluates them from the point of view of fatigue tests of conventional steel materials and a parallel application of a non-destructive – acoustic emission...

  12. Fatigue in patients with erythema migrans.

    Science.gov (United States)

    Wormser, Gary P; Sudhindra, Praveen; Lopez, Eliana; Patel, Lisa; Rezai, Sara; Brumbaugh, Aaron D; McKenna, Donna; Scavarda, Carol; Shapiro, Eugene D; Karmen, Carol L; Visintainer, Paul

    2016-11-01

    Fatigue is a common symptom in patients with Lyme disease. The purpose of this study was to characterize fatigue in untreated adult patients presenting with erythema migrans. Selected variables were assessed to determine if any correlated with the presence or severity of fatigue. Fatigue was assessed on the day of the evaluation by a Visual Analogue Scale (VAS), over the past 14days by the 11-item Fatigue Severity Scale (FSS-11) and over the past 28days based on a question from the 36-item Short Form General Health Survey version 2. Fifty-one patients with erythema migrans whose mean age was 49.8years, and 33 (64.7%) of whom were male, were evaluated in this study. The 3 measures of fatigue were positively correlated with one another (P≤0.01). Twenty-six (51%) had fatigue based on a VAS score above 0. Ten (19.6%) had severe fatigue based on an FSS-11 score of ≥4. The strongest correlate for higher fatigue scores was having a greater total number of symptoms. Based on the FSS-11 assessment tool, approximately 20% of early Lyme patients have severe fatigue. Having a high total number of symptoms was associated with both the presence and severity of fatigue. Because prior studies have demonstrated the presence of elevated levels of proinflammatory cytokines and other molecules in the serum of highly symptomatic patients with erythema migrans, the symptom of fatigue in early Lyme disease may be a component of what has been referred to as the acute sickness response. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Fatigue lifetime estimation of railway axles

    Czech Academy of Sciences Publication Activity Database

    Náhlík, Luboš; Pokorný, Pavel; Ševčík, Martin; Fajkoš, R.; Matušek, P.; Hutař, Pavel

    2017-01-01

    Roč. 73, MAR (2017), s. 139-157 ISSN 1350-6307 R&D Projects: GA MŠk LM2015069; GA MŠk(CZ) ED1.1.00/02.0068 Institutional support: RVO:68081723 Keywords : Residual fatigue lifetime * Railway axle * Variable amplitude loading * Fatigue crack propagation * Damage tolerance methodology Subject RIV: JL - Materials Fatigue, Friction Mechanics OBOR OECD: Audio engineering , reliability analysis Impact factor: 1.676, year: 2016

  14. Innate immunity in Sjögren's syndrome.

    Science.gov (United States)

    Kiripolsky, Jeremy; McCabe, Liam G; Kramer, Jill M

    2017-09-01

    Sjögren's syndrome (SS) is an autoimmune disease of exocrine tissue that primarily affects women. Although patients typically experience xerostomia and xerophthalmia, numerous systemic disease manifestations are seen. Innate immune hyperactivity is integral to many autoimmune diseases, including SS. Results from SS mouse models suggest that innate immune dysregulation drives disease and this is a seminal event in SS pathogenesis. Findings in SS patients corroborate those in mouse models, as innate immune cells and pathways are dysregulated both in exocrine tissue and in peripheral blood. We will review the role of the innate immune system in SS pathogenesis. We will discuss the etiology of SS with an emphasis on innate immune dysfunction. Moreover, we will review the innate cells that mediate inflammation in SS, the pathways implicated in disease, and the potential mechanisms governing their dysregulation. Finally, we will discuss emerging therapeutic approaches to target dysregulated innate immune signaling in SS. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Retinoic Acid and Its Role in Modulating Intestinal Innate Immunity.

    Science.gov (United States)

    Czarnewski, Paulo; Das, Srustidhar; Parigi, Sara M; Villablanca, Eduardo J

    2017-01-13

    Vitamin A (VA) is amongst the most well characterized food-derived nutrients with diverse immune modulatory roles. Deficiency in dietary VA has not only been associated with immune dysfunctions in the gut, but also with several systemic immune disorders. In particular, VA metabolite all-trans retinoic acid ( at RA) has been shown to be crucial in inducing gut tropism in lymphocytes and modulating T helper differentiation. In addition to the widely recognized role in adaptive immunity, increasing evidence identifies at RA as an important modulator of innate immune cells, such as tolerogenic dendritic cells (DCs) and innate lymphoid cells (ILCs). Here, we focus on the role of retinoic acid in differentiation, trafficking and the functions of innate immune cells in health and inflammation associated disorders. Lastly, we discuss the potential involvement of at RA during the plausible crosstalk between DCs and ILCs.

  16. Disease tolerance and immunity in host protection against infection.

    Science.gov (United States)

    Soares, Miguel P; Teixeira, Luis; Moita, Luis F

    2017-02-01

    The immune system probably evolved to limit the negative effects exerted by pathogens on host homeostasis. This defence strategy relies on the concerted action of innate and adaptive components of the immune system, which sense and target pathogens for containment, destruction or expulsion. Resistance to infection refers to these immune functions, which reduce the pathogen load of an infected host as the means to preserve homeostasis. Immune-driven resistance to infection is coupled to an additional, and arguably as important, defence strategy that limits the extent of dysfunction imposed on host parenchymal tissues during infection, without exerting a direct negative effect on pathogens. This defence strategy, known as disease tolerance, relies on tissue damage control mechanisms that prevent the deleterious effects of pathogens and that uncouples immune-driven resistance mechanisms from immunopathology and disease. In this Review, we provide a unifying view of resistance and disease tolerance in the framework of immunity to infection.

  17. [Influence of acupuncture on the motor ability in training-induced fatigue mice].

    Science.gov (United States)

    Gu, Yi-Huang; Ren, Jian-Ning; Wu, Yun-Chuan; Li, Shou-Dong; Shi, Shu-Sheng

    2010-10-01

    To observe the influence of acupuncture on the motor ability of training-induced fatigue mice so as to explore its mechanism underlying acupuncture-induced improvement of physical training fatigue. Sixty Kunming mice were divided into normal control, training model and acupuncture groups, with 20 mice in each. The training-fatigue model was established by forcing the mouse to swim in a water tank for 30 min/d in the 1st week, 60 min/d in the 2nd week, 90 min/d in the 3rd week and 120 min/d in the 4th and 5th weeks. "Guanyuan" (CV 4), and bilateral "Zusanli" (ST 36) and "Shenshu" (BL 23) were punctured with filiform needles, and with the needle twirled for about 30 s and retained for 5 min. Thetreatment was conducted once daily for 2 weeks. The duration of exhaustion training was recorded. Serum lactic acid (LA), lactate dehydrogenase (LDH) and creatine kinase (CK) contents were detected by LA oxidase method, immune-suppressive assay and enzyme-linked immunoassay, respectively. Compared with the training-fatigue (model) group, the duration of the exhausted swimming of the acupuncture group was obviously longer (P 0.05). Acupuncture can effectively improve the motor ability of the training-fatigue mice, which may be closely relevant to its effects in upregulating LDH activity and reducing serum CK.

  18. Bioactivity-guided fractionation of physical fatigue-attenuating components from Rubus parvifolius L.

    Science.gov (United States)

    Chen, Jianhong; Wang, Xianfeng; Cai, Yongqing; Tang, Ming; Dai, Qing; Hu, Xiaogang; Huang, Mingchun; Sun, Fengjun; Liu, Yao; Xia, Peiyuan

    2013-09-23

    Alleviation of fatigue has been emerging as a serious issue that requires urgent attention. Health professionals and sports physiologists have been looking for active natural products and synthetic compounds to overcome fatigue in humans. This study was designed to define the anti-fatigue property of Rubus parvifolius L. (RPL) by characterization of active constituents using a mouse forced swimming test model. Four RPL fractions with different polarities containing anti-fatigue activity were sequentially isolated from the n-butanol RPL extract, followed by elution of 50% ethanol-water fraction from D101 macroporous resin chromatography to obtain nigaichigoside F1, suavissimoside R1 and coreanoside F1. Active constituents of the 50% ethanol-water eluate of RPL were total saponins. The fractions were examined based on the effect on weight-loaded swimming capacity of mice. Serum levels of urea nitrogen (SUN), triglyceride fatty acids (TG), lactate dehydrogenase (LDH), lactic acid (LA), ammonia and hepatic glycogen (HG) were also examined for potential mechanisms underlying the anti-fatigue effect of RPL extracts. During the experiment, two inflammatory markers, interleukin-6 (IL-6) and tumor necrosis factor (TNF-α) in serum, were measured. We found that total saponins from RPL possess potent capabilities to alleviate mouse fatigue induced by forced swimming and that nigaichigoside F1 was responsible for the pharmacological effect. The underlying mechanisms include delays of SUN and LA accumulation, a decrease in TG level by increasing fat consumption, increases in HG and LDH so that lactic acid accumulation and ammonia in the muscle were reduced, and suppression of increased immune activation and inflammatory cytokine production. Our findings will be helpful for functional identification of novel anti-fatigue components from natural medicinal herbs.

  19. Bioactivity-Guided Fractionation of Physical Fatigue-Attenuating Components from Rubus parvifolius L.

    Directory of Open Access Journals (Sweden)

    Peiyuan Xia

    2013-09-01

    Full Text Available Alleviation of fatigue has been emerging as a serious issue that requires urgent attention. Health professionals and sports physiologists have been looking for active natural products and synthetic compounds to overcome fatigue in humans. This study was designed to define the anti-fatigue property of Rubus parvifolius L. (RPL by characterization of active constituents using a mouse forced swimming test model. Four RPL fractions with different polarities containing anti-fatigue activity were sequentially isolated from the n-butanol RPL extract, followed by elution of 50% ethanol-water fraction from D101 macroporous resin chromatography to obtain nigaichigoside F1, suavissimoside R1 and coreanoside F1. Active constituents of the 50% ethanol-water eluate of RPL were total saponins. The fractions were examined based on the effect on weight-loaded swimming capacity of mice. Serum levels of urea nitrogen (SUN, triglyceride fatty acids (TG, lactate dehydrogenase (LDH, lactic acid (LA, ammonia and hepatic glycogen (HG were also examined for potential mechanisms underlying the anti-fatigue effect of RPL extracts. During the experiment, two inflammatory markers, interleukin-6 (IL-6 and tumor necrosis factor (TNF-α in serum, were measured. We found that total saponins from RPL possess potent capabilities to alleviate mouse fatigue induced by forced swimming and that nigaichigoside F1 was responsible for the pharmacological effect. The underlying mechanisms include delays of SUN and LA accumulation, a decrease in TG level by increasing fat consumption, increases in HG and LDH so that lactic acid accumulation and ammonia in the muscle were reduced, and suppression of increased immune activation and inflammatory cytokine production. Our findings will be helpful for functional identification of novel anti-fatigue components from natural medicinal herbs.

  20. Modafinil treatment for fatigue in HIV/AIDS: a randomized placebo-controlled study.

    Science.gov (United States)

    Rabkin, Judith G; McElhiney, Martin C; Rabkin, Richard; McGrath, Patrick J

    2010-06-01

    To evaluate the efficacy and safety of modafinil in the treatment of fatigue in patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and to assess effect on depressive symptoms. Patients who were HIV+ and had clinically significant fatigue (according to the Fatigue Severity Scale [FSS]) were included in a 4-week randomized, placebo-controlled, double-blind trial. This was followed by an additional 8 weeks of open-label treatment for modafinil responders and 12 weeks for placebo nonresponders. The primary outcome measure for fatigue and depression was the Clinical Global Impressions-Improvement scale, supplemented by the FSS, Hamilton Depression Rating Scale, and Beck Depression Inventory. Safety was assessed with assays of CD4 cell count and HIV ribonucleic acid (RNA) viral load. Visits were weekly for 4 weeks, then biweekly, with a follow-up visit at 6 months. Maximum trial dose of modafinil was 200 mg/d. Data for this study were collected between December 2004 and December 2008. 115 patients were randomly assigned. In intention-to-treat analyses, fatigue response rate to modafinil was 73% and to placebo, 28%. Attrition was 9%. Modafinil did not have an effect on mood alone in the absence of improved energy. At week 4, CD4 cell counts did not change significantly; HIV RNA viral load showed a trend decline for patients taking modafinil but not for those taking placebo. At 6 months, those still taking modafinil had more energy and fewer depressive symptoms than patients who were not taking modafinil, and only those still taking modafinil showed a significant decline from baseline in their HIV RNA viral load. Modafinil appears to be effective and well tolerated in treating fatigue in HIV+ patients. Consideration of its use is warranted considering the high prevalence of fatigue in the HIV community, its minimal side effects, and overall patient acceptance. clinicaltrials.gov Identifier: NCT00118378. 2010 Physicians Postgraduate

  1. [Chronic fatigue syndrome--study of 51 cases treated at the Second Tokyo National Hospital].

    Science.gov (United States)

    Nishikai, M

    1992-11-01

    Fifty-one patients with chronic fatigue syndrome (CFS) were studied. Tender points, which are a characteristic clinical feature of fibromyalgia, were found in all but two of the patients at 11.4 points (mean) per patient. IgG antibody titers to EB virus viral capsid antigen were more elevated in the CFS patient group compared to that of the control (p immunity may be important factors in the pathogenesis of CFS.

  2. Exercise and Sleep Deprivation Do Not Change Cytokine Expression Levels in Patients with Chronic Fatigue Syndrome

    OpenAIRE

    Nakamura, Toru; Schwander, Stephan; Donnelly, Robert; Cook, Dane B.; Ortega, Felix; Togo, Fumiharu; Yamamoto, Yoshiharu; Cherniack, Neil S.; Klapholz, Marc; Rapoport, David; Natelson, Benjamin H.

    2013-01-01

    A major hypothesis regarding the cause of chronic fatigue syndrome (CFS) is immune dysregulation, thought to be reflected in upregulated proinflammatory cytokines leading to the symptoms that are characteristic of this illness. Because the symptoms worsen with physical exertion or sleep loss, we hypothesized that we could use these stressors to magnify the underlying potential pathogenic abnormalities in the cytokine systems of people with CFS. We conducted repeat blood sampling for cytokine ...

  3. Fatigue behaviour of synthetic nodular cast irons

    Directory of Open Access Journals (Sweden)

    A. Vaško

    2015-01-01

    Full Text Available The paper shows the influence of charge composition on microstructure, fatigue properties and failure micromechanisms of nodular cast irons. The additive of metallurgical silicon carbide (SiC in analysed specimens increases the content of ferrite in the matrix, decreases the size of graphite and increases the average count of graphitic nodules per unit of area. Consequently, the mechanical and fatigue properties of nodular cast iron are improved. The best fatigue properties (fatigue strength were reached in the melt which was created by 60 % of steel scrap and 40 % of pig iron in the basic charge with SiC additive.

  4. Detection of fatigue cracks in cladded blocks

    International Nuclear Information System (INIS)

    Singh, G.P.; Cervantes, R.A.; Manning, R.C.; Takama, S.

    1986-01-01

    A nuclear reactor pressure vessel (RPV) operates at high temperatures. Feedwater nozzles are susceptible to thermal fatigue; and, after a large number of plant startup/shutdown cycles, thermal fatigue cracking may be initiated at these nozzles. In order to address this problem, ultrasonic data were acquired from five cladded specimens with overall approximate 4-mm thick stainless steel cladding; the specimens contained one fatigue crack each. The study evaluates the application of signal processing and pattern recognition methods to discriminate between base metal-to-clad interface signals and fatigue crack signals. Details are presented

  5. Fatigue and radiotherapy. A literature review

    International Nuclear Information System (INIS)

    Dilhuydy, J.M.; Ouhtatou, F.; Laporte, C.; Nguyen, T.V.F.; Vendrely, V.; Dilhuydy, J.M.; Dilhuydy, M.S.

    2001-01-01

    Fatigue is a common complaint for the cancer patient during and after radiotherapy, according to the published studies. Fatigue is a subjective symptom mostly underestimated by oncologists and other care givers. Etiology is complex, poorly understood in spite of obvious causes like insomnia, nausea, pain, depression, psychological distress, anemia, hypothyroidism, menopause disturbances, treatment adverse effects. Fatigue presents multi-factorial and multidimensional aspects. To evaluate it, many tools can be used as single-item, unidimensional and multidimensional instruments. Practically, the open discussion with the patient throughout radiotherapy is essential to define it. Taking charge fatigue requires its acknowledgement by radiotherapist, treatment of associated symptoms with a multidisciplinary approach. (authors)

  6. Survivorship: Fatigue, Version 1.2014

    Science.gov (United States)

    Denlinger, Crystal S.; Ligibel, Jennifer A.; Are, Madhuri; Baker, K. Scott; Demark-Wahnefried, Wendy; Friedman, Debra L.; Goldman, Mindy; Jones, Lee; King, Allison; Ku, Grace H.; Kvale, Elizabeth; Langbaum, Terry S.; Leonardi-Warren, Kristin; McCabe, Mary S.; Melisko, Michelle; Montoya, Jose G.; Mooney, Kathi; Morgan, Mary Ann; Moslehi, Javid J.; O’Connor, Tracey; Overholser, Linda; Paskett, Electra D.; Raza, Muhammad; Syrjala, Karen L.; Urba, Susan G.; Wakabayashi, Mark T.; Zee, Phyllis; McMillian, Nicole; Freedman-Cass, Deborah

    2015-01-01

    Many cancer survivors report that fatigue is a disruptive symptom even after treatment ends. Persistent cancer-related fatigue affects quality of life, because individuals become too tired to fully participate in the roles and activities that make life meaningful. Identification and management of fatigue remains an unmet need for many cancer survivors. This section of the NCCN Guidelines for Survivorship provides screening, evaluation, and management recommendations for fatigue in survivors. Management includes education and counseling, physical activity, psychosocial interventions, and pharmacologic treatments. PMID:24925198

  7. Fatigue in Breakwater Concrete Armour Units

    DEFF Research Database (Denmark)

    Burcharth, Hans F.

    1985-01-01

    The reliability of rubble mound breakwaters depends on the hydraulic stability and the mechanical strength of the armour units. The paper deals with the important aspect of fatigue related to the strength of concrete armour units. Results showing significant fatigue from impact tests with Dolosse...... made of unreinforced and steel fibre reinforced flyash concrete are presented. Moreover universal graphs for fatigue in armour units made of conventional unreinforced concrete exposed to impact load and pulsating load are presented. The effect of fibre reinforcement and the implementation of fatigue...

  8. Experimental fatigue curves for aluminium brazed areas

    Science.gov (United States)

    Dimitescu, A.; Babiş, C.; Niţoi, D. F.; Radu, C.

    2017-08-01

    An important factor for the quality of joints is the brazed area. The fatigue check occupies a major position among many test procedures and methods, especially by the joining technologies. The results of processing the fatigue data experiments for aluminium brazed samples are used to find the regression function and the response surface methodology. The fatigue process of mechanical components under service loading is stochastic in nature. The prediction of time-dependent fatigue reliability is critical for the design and maintenance planning of many structural components.

  9. Fatigue modeling of materials with complex microstructures

    DEFF Research Database (Denmark)

    Qing, Hai; Mishnaevsky, Leon

    2011-01-01

    with the phenomenological model of fatigue damage growth. As a result, the fatigue lifetime of materials with complex structures can be determined as a function of the parameters of their structures. As an example, the fatigue lifetimes of wood modeled as a cellular material with multilayered, fiber reinforced walls were...... determined for different parameters of wood microstructures. In so doing, 3D hierarchical finite element models of softwood, and a computational technique, including the repeating restart and model change procedures, have been employed to model the fatigue response of latewood....

  10. Fatigue in Multiple Sclerosis: (An update

    Directory of Open Access Journals (Sweden)

    Hossein Zarei

    2007-10-01

    Full Text Available BACKGROUND:To study the dimensions of fatigue in multiple sclerosis, its pathophysiology, the efficacy, tolerability and safety of drug and non-drug treatments and measurement of fatigue. METHODS: Relevant articles from PubMed and Google scholar search engines from January 1987 until September 2006 were studied to compose a short clinical update (not a systematic review and make the required clinical information available for the clinicians. RESULTS: There is evidence that fatigue is very common in all types and stages of multiple sclerosis, but its pathophysiology is not well explained. Consequently, few drug options have been offered for its treatment. Amantadine is the bestknown drug, though its efficacy and duration of action are limited. Pemoline and modafinil are alternatives and have
    some effects on fatigue. DAP (diaminopyridine, ASA (acetylsalicylic acid, methylphenidate and fluoxetine are other possible options but await further confirmation. Neurorehabilitation, regular exercise and cooling are confirmed to be of value in MS treatment. Measurement of fatigue is a complicated issue. At present fatigue does not have a laboratory marker. CONCLUSIONS: The results of this short clinical update provide guidelines for diagnosing MS-related fatigue and differentiating
    it from other similar physical and psychological conditions. It also examines prescription drug options and other therapies for MS patients with fatigue.
    KEYWORDS: Multiple sclerosis, fatigue, pathophysiology, treatment, measurement.

  11. Immunization Schedules for Adults

    Science.gov (United States)

    ... ACIP Vaccination Recommendations Why Immunize? Vaccines: The Basics Immunization Schedule for Adults (19 Years of Age and ... diseases that can be prevented by vaccines . 2018 Immunization Schedule Recommended Vaccinations for Adults by Age and ...

  12. Instant Childhood Immunization Schedule

    Science.gov (United States)

    ... Recommendations Why Immunize? Vaccines: The Basics Instant Childhood Immunization Schedule Recommend on Facebook Tweet Share Compartir Get ... date. See Disclaimer for additional details. Based on Immunization Schedule for Children 0 through 6 Years of ...

  13. Immunizations and African Americans

    Science.gov (United States)

    ... Data > Minority Population Profiles > Black/African American > Immunizations Immunizations and African Americans African American adults are less ... 19 to 35 months had comparable rates of immunization. African American women are as likely to have ...

  14. Immune System Quiz

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Quiz: Immune System KidsHealth / For Kids / Quiz: Immune System Print How much do you know about your immune system? Find out by taking this quiz! Partner Message ...

  15. Proximal and distal muscle fatigue differentially affect movement coordination

    Science.gov (United States)

    Cowley, Jeffrey C.

    2017-01-01

    Muscle fatigue can cause people to change their movement patterns and these changes could contribute to acute or overuse injuries. However, these effects depend on which muscles are fatigued. The purpose of this study was to determine the differential effects of proximal and distal upper extremity muscle fatigue on repetitive movements. Fourteen subjects completed a repetitive ratcheting task before and after a fatigue protocol on separate days. The fatigue protocol either fatigued the proximal (shoulder flexor) or distal (finger flexor) muscles. Pre/Post changes in trunk, shoulder, elbow, and wrist kinematics were compared to determine how proximal and distal fatigue affected multi-joint movement patterns and variability. Proximal fatigue caused a significant increase (7°, p fatigue caused small but significant changes in trunk angles (2°, p fatigue protocols (p fatigue at either proximal or distal joints. The identified differences between proximal and distal muscle fatigue adaptations could facilitate risk assessment of occupational tasks. PMID:28235005

  16. Cardiovascular Autonomic Dysfunction: Link Between Multiple Sclerosis Osteoporosis and Neurodegeneration.

    Science.gov (United States)

    Sternberg, Zohara

    2018-03-01

    The high prevalence of osteoporosis, observed in multiple sclerosis (MS) patients, has been attributed to reduced mobility and or the use of disease-modifying drugs. However, MS-impaired cardiovascular autonomic nervous system (ANS) function has the potential of reducing bone mass density (BMD) by altering the expression and/or function of the neuronal, systemic, and local mediators of bone remodeling. This review describes the complex regulation of bone homeostasis with a focus on MS, providing evidence that ANS dysfunction and low BMD are intertwined with MS inflammatory and neurodegenerative processes, and with other MS-related morbidities, including depression, fatigue, and migraine. Strategies for improving ANS function could reduce the prevalence of MS osteoporosis and slow the rate of MS progression, with a significant positive impact on patients' quality of life.

  17. Uncertainty on Fatigue Damage Accumulation for Composite Materials

    DEFF Research Database (Denmark)

    Toft, Henrik Stensgaard; Sørensen, John Dalsgaard

    2009-01-01

    In the present paper stochastic models for fatigue damage accumulation for composite materials are presented based on public available constant and variable amplitude fatigue tests. The methods used for estimating the SN-curve and accumulated fatigue damage are presented.......In the present paper stochastic models for fatigue damage accumulation for composite materials are presented based on public available constant and variable amplitude fatigue tests. The methods used for estimating the SN-curve and accumulated fatigue damage are presented....

  18. Fatigue in osteoarthritis: a qualitative study

    Directory of Open Access Journals (Sweden)

    French Melissa R

    2008-05-01

    Full Text Available Abstract Background Fatigue is recognized as a disabling symptom in many chronic conditions including rheumatic disorders such as rheumatoid arthritis (RA and lupus. Fatigue in osteoarthritis (OA is not routinely evaluated and has only been considered in a very limited number of studies. To date, these studies have focused primarily on patients with OA under rheumatological care, which represent the minority of people living with OA. The purpose of this study was to increase our understanding of the fatigue experience in community dwelling people with OA. Methods In 2004, 8 focus groups were conducted with 28 men and 18 women (mean age 72.3 with symptomatic hip or knee OA recruited from a population-based cohort. Participants completed a self-administered questionnaire, which included demographics, measures of OA severity (WOMAC, depression (CES-D and fatigue (FACIT. Sessions were audio taped and transcribed verbatim. Two researchers independently reviewed the transcripts to identify themes. Findings were compared and consensus reached. Results Mean pain, disability, depression and fatigue scores were 8.7/20, 27.8/68, 15.4/60, and 30.9/52, respectively. Participants described their fatigue as exhaustion, being tired and "coming up against a brick wall". Participants generally perceived fatigue as different from sleepiness and distinguished physical from mental fatigue. Factors believed to increase fatigue included OA pain and pain medications, aging, various types of weather and poor sleep. Mental health was identified as both affecting fatigue and being affected by fatigue. Participants described fatigue as impacting physical function, and their ability to participate in social activities and to do household chores. Rest, exercise, and avoiding or getting assistance with activities were cited as ways of coping. Participants generally did not discuss their fatigue with anyone except their spouses. Conclusion Participants with OA described

  19. Recent advances in fatigue crack growth

    International Nuclear Information System (INIS)

    McEvily, A.J.

    2011-01-01

    Many of the recent advances in the understanding of the fatigue crack growth process have resulted from an improved realization of the importance of fatigue crack closure in the crack growth process. Two basic crack closure processes have been identified. One of which is known as plasticity-induced fatigue crack closure (PIFCC), and the other is roughness-induced fatigue crack closure (RIFCC). Both forms occur in all alloys, but PIFCC is a surface-related process which is dominant in aluminum alloys such as 2024-T3, whereas RIFCC is dominant in most steels and titanium alloys. A proposed basic equation governing fatigue crack growth is derived where K/sub max/ is the maximum stress intensity factor in a loading cycle and K/sub op/ is the stress intensity factor at the crack opening level. is the range of the stress intensity factor at the threshold level which is taken to correspond to a crack growth rate of 10-11 m/cycle. The material constant A has units of (MPa)-2, and therefore Eq. 1 is dimensionally correct. Eq.1 has been successfully used in the analysis of both long and short cracks, but in the latter case modification is needed to account for elastic-plastic behavior, the development of crack closure, and the Kitagawa effect which shows that the fatigue strength rather than the threshold level is the controlling factor determining the rate of fatigue crack growth in the very short fatigue crack growth range. Eq. 1 is used to show that The non-propagating cracks observed by Frost and Dugdale resulted from crack closure. The behavior of cracks as short as 10 microns in length can be predicted. Fatigue notch sensitivity is related to crack closure. Very high cycle fatigue (VHCF) behavior is also associated with fatigue crack closure. (author)

  20. Rapid Assessment of the Role of Microstructural Variability in the Fatigue Behavior of Structural Alloys using Ultrasonic Fatigue

    National Research Council Canada - National Science Library

    Jones, J. W

    2007-01-01

    Ultrasonic fatigue (20kHz) has been used to investigate the role of microstructural variability on fatigue life variability for very long fatigue lives, between 10(to the 7th power) and 10(to the 9th power...

  1. Increased brain white matter axial diffusivity associated with fatigue, pain and hyperalgesia in Gulf War illness.

    Science.gov (United States)

    Rayhan, Rakib U; Stevens, Benson W; Timbol, Christian R; Adewuyi, Oluwatoyin; Walitt, Brian; VanMeter, John W; Baraniuk, James N

    2013-01-01

    Gulf War exposures in 1990 and 1991 have caused 25% to 30% of deployed personnel to develop a syndrome of chronic fatigue, pain, hyperalgesia, cognitive and affective dysfunction. Gulf War veterans (n = 31) and sedentary veteran and civilian controls (n = 20) completed fMRI scans for diffusion tensor imaging. A combination of dolorimetry, subjective reports of pain and fatigue were correlated to white matter diffusivity properties to identify tracts associated with symptom constructs. Gulf War Illness subjects had significantly correlated fatigue, pain, hyperalgesia, and increased axial diffusivity in the right inferior fronto-occipital fasciculus. ROC generated thresholds and subsequent binary regression analysis predicted CMI classification based upon axial diffusivity in the right inferior fronto-occipital fasciculus. These correlates were absent for controls in dichotomous regression analysis. The right inferior fronto-occipital fasciculus may be a potential biomarker for Gulf War Illness. This tract links cortical regions involved in fatigue, pain, emotional and reward processing, and the right ventral attention network in cognition. The axonal neuropathological mechanism(s) explaining increased axial diffusivity may account for the most prominent symptoms of Gulf War Illness.

  2. Increased brain white matter axial diffusivity associated with fatigue, pain and hyperalgesia in Gulf War illness.

    Directory of Open Access Journals (Sweden)

    Rakib U Rayhan

    Full Text Available Gulf War exposures in 1990 and 1991 have caused 25% to 30% of deployed personnel to develop a syndrome of chronic fatigue, pain, hyperalgesia, cognitive and affective dysfunction.Gulf War veterans (n = 31 and sedentary veteran and civilian controls (n = 20 completed fMRI scans for diffusion tensor imaging. A combination of dolorimetry, subjective reports of pain and fatigue were correlated to white matter diffusivity properties to identify tracts associated with symptom constructs.Gulf War Illness subjects had significantly correlated fatigue, pain, hyperalgesia, and increased axial diffusivity in the right inferior fronto-occipital fasciculus. ROC generated thresholds and subsequent binary regression analysis predicted CMI classification based upon axial diffusivity in the right inferior fronto-occipital fasciculus. These correlates were absent for controls in dichotomous regression analysis.The right inferior fronto-occipital fasciculus may be a potential biomarker for Gulf War Illness. This tract links cortical regions involved in fatigue, pain, emotional and reward processing, and the right ventral attention network in cognition. The axonal neuropathological mechanism(s explaining increased axial diffusivity may account for the most prominent symptoms of Gulf War Illness.

  3. Electrical stimulation of human forearm extensor muscles as an indicator of handgrip fatigue and recovery.

    Science.gov (United States)

    Byström, S; Kilbom, A

    1991-01-01

    A set-up for percutaneous electrical stimulation of the forearm extensor muscles and measurement of wrist extension force is described. The frequency-force relationship and pulse duration-force relationship are described together with an experimental protocol showing that brief electrical test stimulations do not produce fatigue. In another set of experiments carried out a few weeks later, the subjects performed handgrip contractions: protocol A at 25% of maximal voluntary contraction (MVC) continuously until exhaustion, protocol B at 25% MVC intermittent (contraction + relaxation = 10 + 2 s) until exhaustion, and protocol C at 25% MVC intermittent until half the time to exhaustion. In all experiments, brief electrical stimulations were used to test the degree of fatigue during and up to 24 h after the experiments. There were marked changes in the force during stimulation at 20 and 100 Hz and these changes did not correlate with the increase in intramuscular temperature. Low frequency fatigue persisted for at least 24 h after protocol A and 1 h after protocols B and C. The significance of this is discussed and it is suggested that low frequency fatigue could be used as a sensitive indicator of muscle dysfunction after low and medium intensity exercise.

  4. Complement activation, endothelial dysfunction, insulin resistance and chronic heart failure

    DEFF Research Database (Denmark)

    Bjerre, M.; Kistorp, C.; Hansen, T.K.

    2010-01-01

    Objectives. Patients with chronic heart failure (CHF) have an exaggerated immune response, endothelial damage/dysfunction, and increased risk of diabetes mellitus (DM). The inter-relationship(s) between indices of complement activation (soluble membrane attack complex, sMAC), inflammation (hs......CRP), endothelial activation (soluble E-selectin, sEsel)), endothelial damage/dysfunction (von Willebrand factor, vWf) and insulin resistance (IR) and prognosis in CHF remains unknown. Design. We investigated the association(s) between plasma sMAC, hsCRP, sEsel, vWf and IR (assessed by homeostatic model assessment......, HOMA) in a prospective study including a total of 193 patients with CHF, and assessed whether high levels of these biomarkers had a prognostic impact. Biomarker levels in CHF patients were compared to 100 age-matched controls. Results. Plasma sMAC levels were elevated in patients with CHF due...

  5. TREM-1 Promotes Pancreatitis-Associated Intestinal Barrier Dysfunction

    Directory of Open Access Journals (Sweden)

    Shengchun Dang

    2012-01-01

    Full Text Available Severe acute pancreatitis (SAP can cause intestinal barrier dysfunction (IBD, which significantly increases the disease severity and risk of mortality. We hypothesized that the innate immunity- and inflammatory-related protein-triggering receptor expressed on myeloid cells-1 (TREM-1 contributes to this complication of SAP. Thus, we investigated the effect of TREM-1 pathway modulation on a rat model of pancreatitis-associated IBD. In this study we sought to clarify the role of TREM-1 in the pathophysiology of intestinal barrier dysfunction in SAP. Specifically, we evaluated levels of serum TREM-1 and membrane-bound TREM-1 in the intestine and pancreas from an animal model of experimentally induced SAP. TREM-1 pathway blockade by LP17 treatment may suppress pancreatitis-associated IBD and ameliorate the damage to the intestinal mucosa barrier.

  6. Fatigue Analysis of Large-scale Wind turbine

    Directory of Open Access Journals (Sweden)

    Zhu Yongli

    2017-01-01

    Full Text Available The paper does research on top flange fatigue damage of large-scale wind turbine generator. It establishes finite element model of top flange connection system with finite element analysis software MSC. Marc/Mentat, analyzes its fatigue strain, implements load simulation of flange fatigue working condition with Bladed software, acquires flange fatigue load spectrum with rain-flow counting method, finally, it realizes fatigue analysis of top flange with fatigue analysis software MSC. Fatigue and Palmgren-Miner linear cumulative damage theory. The analysis result indicates that its result provides new thinking for flange fatigue analysis of large-scale wind turbine generator, and possesses some practical engineering value.

  7. Sexual Dysfunction in Interstitial Cystitis.

    Science.gov (United States)

    Tonyali, Senol; Yilmaz, Mehmet

    2017-11-01

    Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a debilitating disease characterized with urgency, frequency, and pelvic pain affecting especially women. Sexual dysfunction in female patients with IC/BPS consists of dyspareunia, altered sexual desire and orgasm frequency and insufficient lubrication is reported to negatively affect the patient's quality of life. In the present study, we aimed to determine the association between IC/BPS and sexual dysfunction and improvement in sexual dysfunction related to given treatments. A PubMed/Medline and EMBASE search was conducted using keywords: "interstitial cystitis", "sexual dysfunction", and "bladder pain syndrome". Several studies have been conducted to determine the relation between IC/BPS and sexual dysfunction. And also limited studies focusing on IC/BPS specific treatments reported significant improvements in sexual function after either oral or intravesical treatment. However, given the used different questionnaires, study protocols, patient characteristics, previous treatments and follow-up period, it is not possible to make a head-to-head comparison of the treatment effects on sexual function. Further, randomized controlled studies are needed to confirm these results and make a comparison between effects of various treatment modalities on sexual functioning in IC/BPS.

  8. ON THE ROLE OF IMMUNOLOGICAL ABNORMALITIES IN THE PATHOGENESIS OF COGNITIVE DYSFUNCTION IN MAJOR DEPRESSIVE DISORDER

    Directory of Open Access Journals (Sweden)

    Roman Aleksandrovich Bekker

    2016-08-01

    Full Text Available Major depression correlates to several known immune and endocrine abnormalities (e.g. HPA axis hyperactivity, thymus atrophy, thymic hormone hyposecretion, among others and is often leading to diminished resistance to infections and oncologic diseases. On the other hand, major depression is one of the leading causes of cognitive decline, and it is well–known fact that functional and social recovery correlates better to cognitive functioning than to general improvement in depressive symptoms. This article thoroughly reviews different correlations between immune functions and cognition, and the existing evidence base for immune correction of cognitive dysfunctions commonly seen in depressions.

  9. Multiscale feature based analysis of surface EMG signals under fatigue and non-fatigue conditions.

    Science.gov (United States)

    Navaneethakrishna, M; Ramakrishnan, S

    2014-01-01

    In this work, an attempt has been made to differentiate sEMG signals under muscle fatigue and non-fatigue conditions using multiscale features. Signals are recorded from biceps brachii muscle of 50 normal adults during repetitive dynamic contractions. After prescribed preprocessing, each signal is divided into six segments out of which first and last segments are considered in this analysis. Multiscale RMS (MSRMS) and Multiscale Permutation Entropy (MSPE) are computed for each subject in the time scales ranging from 1 to 50. The median values of the MSRMS and MSPE are calculated for further analysis. The results show an increase in amplitude for sEMG signals under fatigue condition. MSRMS values are found to be significantly higher in fatigue. An approximately constant difference in MSRMS value between fatigue and non-fatigue condition is observed over the entire time scale with a negative slope. Further, the median of MSRMS values for each subject is able to distinguish fatigue and non-fatigue conditions. Similar analysis on MSPE showed significant difference between fatigue and non-fatigue cases and lower values of MSPE is observed in fatigue. It is also observed that the median value of MSRMS and MSPE are able to distinguish these conditions. t-test for MSRMS, MSPE and their median value show high statistical significance. It appears that this method of analysis can be used for clinical evaluation of muscles.

  10. Fatigue of coated and laser hardened steels

    International Nuclear Information System (INIS)

    La Cruz, P. de.

    1990-01-01

    In the present work the effect of ion nitriding, laser hardening and hot dip galvanizing upon the fatigue limit and notch sensitivity of a B-Mn Swedish steel SS 2131 have been investigated. The fatigue tests were performed in plane reverse bending fatigue (R=1). The quenched and tempered condition was taken as the reference condition. The microstructure, microhardness, fracture surface and coating appearance of the fatigue surface treated specimens were studied. Residual stress and retained austenite measurements were also carried out. It was found that ion nitriding improves the fatigue limit by 53 % for smooth specimens and by 115 % for notched specimens. Laser hardening improves the fatigue limit by 18 % and 56 % for smooth and notched specimen respectively. Hot dip galvanizing gives a slight deterioration of the fatigue limit (9 % and 10 % for smooth and notched specimen respectively). Ion nitriding and laser hardening decrease the value of the notch sensitivity factor q by 78 % and 65 % respectively. Hot dip galvanizing does not modify it. A simple schematic model based on a residual stress distribution, has been used to explain the different effects. It seems that the presence of the higher compressive residual stresses and the higher uniformity of the microstructure may be the causes of the better fatigue performance of ion nitrided specimens. (119 refs.) (author)

  11. Fatigue in tension perpendicular to the grain

    DEFF Research Database (Denmark)

    Clorius, Christian Odin; Pedersen, Martin Bo Uhre; Hoffmeyer, Preben

    1999-01-01

    Traditinally fatigue resistance is quantified as number of cycles to failure at a given stress level. A previous study by the authors showed that fatigue in compression parallel to the grain is governed partly by duration of load and partly by an effect of loading, i.e. a combination of a creep...

  12. Driver fatigue through nightshifts in succession

    Energy Technology Data Exchange (ETDEWEB)

    Mabbott, N.; Lloyd, B. [ARRB Group Ltd., Leederville, WA (United States)

    2005-07-01

    Coal Services (Health and Safety Trust) funded ARRB Transport Research Ltd. to investigate fatigue and performance of truck drivers over consecutive shifts. The main questions were to assess: What is the most important contributor to acute fatigue in mining? Is it length of shift or is it time of day? What is the limit of successive day or night shifts before chronic fatigue affects operator performance in open cut mines? The project methodology included utilising ARRB Fatigue Monitoring Devices in eight haul trucks, testing 24 subjects over several weeks. Each subject filled in a Fatigue Risk Questionnaire on lifestyle and health. Operators worked a 14 night, 1 day off, 13 day roster of 12-hour shifts in a fly-in, fly-out operation with excellent opportunities for restorative sleep between shifts. A total of 3,500 hours of real-time data was collected, representing the first set of objective, real-time driver performance data for Australian mining. The major finding within this study is the combined influence of circadian rhythms and individual variability on performance. The lifestyle habits and the health of individuals have a profound effect on operator performance as shown by the strong positive correlation between high fatigue risk scores from the Fatigue Risk Questionnaire and poor performance. An individualistic approach would appear to have the best chance of reducing high potential incidents due to fatigue through successive nightshifts. 9 refs., 14 figs.

  13. A critical evaluation on the fatigue problem

    International Nuclear Information System (INIS)

    Rosa, E. da; Costa Machado Leal, L. da

    1978-01-01

    A review of the different aspects of approaches to the fatigue problems since the Woehler curves till the crack propagation is presented. The interrelationship among each one of the aspects is then carried out as well as the relation of the aspects to the different fatigue phases, since the crack nucleation till the final rupture in an attempt to unify the design procedure. (Author)

  14. Standard guide for fretting fatigue testing

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This guide defines terminology and covers general requirements for conducting fretting fatigue tests and reporting the results. It describes the general types of fretting fatigue tests and provides some suggestions on developing and conducting fretting fatigue test programs. 1.2 Fretting fatigue tests are designed to determine the effects of mechanical and environmental parameters on the fretting fatigue behavior of metallic materials. This guide is not intended to establish preference of one apparatus or specimen design over others, but will establish guidelines for adherence in the design, calibration, and use of fretting fatigue apparatus and recommend the means to collect, record, and reporting of the data. 1.3 The number of cycles to form a fretting fatigue crack is dependent on both the material of the fatigue specimen and fretting pad, the geometry of contact between the two, and the method by which the loading and displacement are imposed. Similar to wear behavior of materials, it is important t...

  15. Does cerebral hypoxia facilitate central fatigue?

    DEFF Research Database (Denmark)

    Siebenmann, Christoph; Rasmussen, Peter

    2016-01-01

    Central fatigue originates within the central nervous system and is characterized by a decreasein voluntary muscle activation. Reduced systemic O2availability can facilitate central fatigue byenhancing the afferent input of the chemosensitive nerves that play a pivotal role in developmentof centr...

  16. Neuromuscular frequency-coding and fatigue

    NARCIS (Netherlands)

    Kernell, D; Gandevia, SC; Enoka, RM; McComas, AJ; Stuart, DG; Thomas, CK

    1995-01-01

    In daily life, muscle fatigue often becomes noticeable as an apparent decline in the efficiency of force production by central commands, making it necessary to increase drive (or ''effort'') to produce a constant motor output. Such aspects of fatigue may be caused by changes in the way in which

  17. Assessment of fatigue in multiple sclerosis

    NARCIS (Netherlands)

    Sander, C.; Voelter, H.U.; Schlake, H.P.; Eling, P.A.T.M.; Hildebrandt, H.

    2017-01-01

    One of the most frequent symptoms in multiple sclerosis (MS) is fatigue. It has a major impact on quality of life as well as on professional activity. Even nowadays it is still unclear what constitutes an adequate assessment of the perceived fatigue. The following overview will discuss different

  18. 10 CFR 26.211 - Fatigue assessments.

    Science.gov (United States)

    2010-01-01

    ... personnel who are trained under §§ 26.29 and 26.203(c) may conduct a fatigue assessment. The fatigue assessment must be conducted face to face with the individual whose alertness may be impaired. (1) In the...

  19. Treating fatigue in post-polio syndrome

    NARCIS (Netherlands)

    Koopman, F.S.

    2016-01-01

    The general aim of this thesis was to expand the knowledge on treatment of fatigue in post-polio syndrome (PPS). It was demonstrated that fatigue is severe and persistent in this population due to both physical and psychologic factors. These factors can potentially be modified, which may provide an

  20. MR spectroscopy studies of human muscle fatigue

    International Nuclear Information System (INIS)

    Miller, R.G.; Carson, P.J.; Moussavi, R.S.; Weiner, M.W.

    1987-01-01

    To investigate the relationship between fatigue and metabolism, P-31 MR spectra of human muscle were obtained while simultaneously monitoring force production, before, during, and following aerobic and anaerobic exercise. Changes of PCr and Pi showed a nonlinear relationship to fatigue

  1. Fatigue in adults with traumatic brain injury

    DEFF Research Database (Denmark)

    Mollayeva, Tatyana; Kendzerska, Tetyana; Mollayeva, Shirin

    2013-01-01

    , assess, and critically appraise studies that assessed predictors for fatigue and the consequences of fatigue on at least two separate time points following traumatic brain injury. METHODS/DESIGN: MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, CINAHL, and PsycINFO will be systematically...

  2. High temperature fatigue behaviour of intermetallics

    Indian Academy of Sciences (India)

    M. Senthilkumar (Newgen Imaging) 1461 1996 Oct 15 13:05:22

    brittle to ductile transition temperature, mean stress and environment on fatigue behaviour of same γ-TiAl alloys are discussed. Keywords. Nickel aluminides; titanium aluminides; low cycle fatigue; micro- alloying. 1. Introduction. Ordered intermetallic alloys have undergone extensive development over the past two decades.

  3. Statistical treatment of fatigue test data

    International Nuclear Information System (INIS)

    Raske, D.T.

    1980-01-01

    This report discussed several aspects of fatigue data analysis in order to provide a basis for the development of statistically sound design curves. Included is a discussion on the choice of the dependent variable, the assumptions associated with least squares regression models, the variability of fatigue data, the treatment of data from suspended tests and outlying observations, and various strain-life relations

  4. Thermomechanical fatigue – Damage mechanisms and mechanism ...

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    test. Furthermore, fatigue crack growth was studied using single edge notch specimens loaded in 4-point bending. Microstructural changes were characterized ..... da. dN. ∣. ∣. ∣. ∣. Hydrogen . (13). Figures 10a–c represent the maximum stress values observed in fatigue tests at various tem- peratures in vacuum and ...

  5. Fatigue and Depressive Symptoms in Older People

    DEFF Research Database (Denmark)

    Mänty, Minna; Rantanen, Taina; Era, Pertti

    2014-01-01

    Fatigue is considered an important indicator of aging-related declines in health and functional abilities. Previous studies have indicated strong associations between fatigue and depressive symptoms among younger populations and in patient groups with specific diseases. However, it is not known h...

  6. [Fatigue in patients with laryngeal cancer].

    Science.gov (United States)

    Coelho, F M; Sawada, N O

    1999-12-01

    This study searched for subjective elements in the fatigue of laryngectomized patients. The authors used an instrument proposed by YOSHITAKE that investigates the symptoms of physical indisposition, mental weariness and a specific sensation of fatigue. Data were analysed considering the literature, demonstrating that the psychological factors, the treatment and phases of the disease are directly related.

  7. Fatigue Reliability under Multiple-Amplitude Loads

    DEFF Research Database (Denmark)

    Talreja, R.

    1979-01-01

    A method to determine the fatigue of structures subjected to multiple-amplitude loads is presented. Unlike the more common cumulative damage methods, which are usually based on fatigue life data, the proposed method is based on tensile strength data. Assuming the Weibull distribution for the init...

  8. Fatigue Specimens for Sheet and Plate Material

    NARCIS (Netherlands)

    Schijve, J.

    1998-01-01

    The usefulness of simple sheet and plate specimens is discussed for various experimental research purposes. Specimens should be representative as much as possible for the conditions of fatigue problems in practice, which is more difficult to achieve for the fatigue crack initiation phase than for

  9. Wake up to fatigue risk management

    CSIR Research Space (South Africa)

    Schutte, PC

    2009-06-01

    Full Text Available There have been several high-profile accidents in industry where fatigue was identified as either causal or contributory. The risk of fatigue is inherent in any worktime arrangement involving shift work, long hours of work, irregular hours, extended...

  10. Equivalent configurations for notch and fretting fatigue

    Directory of Open Access Journals (Sweden)

    J. A. Araújo

    2015-07-01

    Full Text Available Under the typical partial slip conditions under which fretting fatigue takes place, the amount of superficial damage is small. Therefore, the substantial reduction in fatigue life caused by fretting, when compared to plain fatigue, may well be more associated with the stress concentration and the stress gradient phenomena generated by the contact problem than to the superficial loss of material. In this setting, notch stress-based methodologies could, in principle, be applied to fretting in the medium/high cycle fatigue regime. The aim of this work was to investigate whether it is possible to design fretting and notch fatigue configurations, which are nominally identical in terms of damage measured by a multiaxial fatigue model. The methodology adopted to carry out this search considered a cylindrical on flat contact and a V-notch. Load and geometry dimensions of both configurations were adjusted in order to try to obtain the “same” decay of the Multiaxial Fatigue Index from the hot spot up to a critical distance. Positive results of such simulations can lead us to design an experimental program that can bring more firm conclusions on the use of pure stress-based approaches, which do not include the wear damage, in the modeling of fretting fatigue.

  11. Fatigue In Tension Perpendicular to the Grain

    DEFF Research Database (Denmark)

    Clorius, Christian Odin; Pedersen, Martin Uhre; Hoffmeyer, Preben

    2004-01-01

    Traditionally fatigue resistance is quantified as number of cycles to failure at a given stress level. A previous study by the authors showed that fatigue in compression parallel to the grain is governed partly by duration of load and partly by an effect of loading, i.e. a combination of a creep...

  12. Work fatigue in urban bus drivers

    Directory of Open Access Journals (Sweden)

    Teresa Makowiec-Dąbrowska

    2015-10-01

    Full Text Available Background: Bus drivers are a special group of professional drivers who are at a very high risk of fatigue. The aim of the study was to examine whether the driver’s subjective assessment of fatigue allows for the determination of its level and identification of its causes. Material and Methods: The study group comprised 45 randomly selected bus drivers (mean age – 43.7±7.9 years, period of employment as drivers – 14.7±8.6 years. Examinations were performed in all subjects four times – before and after work on the “easy” route (outside the city center, small traffic intensity and before and after work on the “difficult” route (city center, heavy traffic. The fatigue test questionnaire, based on the list of symptoms of fatigue prepared by the Japan Research Committee of Fatigue, was used in the study. Results: The rating of fatigue after the work was significantly higher than that before the work. The profile of fatigue after work was not influenced by the type of route, but the assessment of most symptoms of fatigue reached a higher level after the “difficult” routes and the differences were statistically significant for 7 symptoms. Only the ratings of leg fatigue, feeling of heaviness, and the necessity to squint eyes and gaze with effort reached the higher levels after driving the “easy” routes. It has been found that the level of fatigue was significantly correlated with the job characteristics (driving time, the length of the route, number of stops, etc. and with the abundance of food ingested and type of beverage (coffee vs. others drunk prior to driving. Conclusions: The questionnaire used in our study to assess the subjective feeling of fatigue has proved to be a sensitive and useful tool for indicating the level and causes of fatigue. The relationship between the symptoms of fatigue and the characteristics of job and lifestyle shows that actions must be taken by both the employers and employees to prevent fatigue

  13. Assessment of muscle fatigue using electromygraphm sensing

    Science.gov (United States)

    Helmi, Muhammad Hazimin Bin; Ping, Chew Sue; Ishak, Nur Elliza Binti; Saad, Mohd Alimi Bin Mohd; Mokhtar, Anis Shahida Niza Binti

    2017-08-01

    Muscle fatigue is condition of muscle decline in ability after undergoing any physical activity. Observation of the muscle condition of an athlete during training is crucial to prevent or minimize injury and able to achieve optimum performance in actual competition. The aim of this project is to develop a muscle monitoring system to detect muscle fatigue in swimming athlete. This device is capable to measure muscle stress level of the swimmer and at the same time provide indication of muscle fatigue level to trainer. Electromyography signal was recorded from the muscle movement while practicing the front crawl stroke repetitively. The time domain data was processed to frequency spectra in order to study the effect of muscle fatigue. The results show that the recorded EMG signal is able to sense muscle fatigue.

  14. On the Fatigue Analysis of Wind Turbines

    Energy Technology Data Exchange (ETDEWEB)

    Sutherland, Herbert J.

    1999-06-01

    Modern wind turbines are fatigue critical machines that are typically used to produce electrical power from the wind. Operational experiences with these large rotating machines indicated that their components (primarily blades and blade joints) were failing at unexpectedly high rates, which led the wind turbine community to develop fatigue analysis capabilities for wind turbines. Our ability to analyze the fatigue behavior of wind turbine components has matured to the point that the prediction of service lifetime is becoming an essential part of the design process. In this review paper, I summarize the technology and describe the ''best practices'' for the fatigue analysis of a wind turbine component. The paper focuses on U.S. technology, but cites European references that provide important insights into the fatigue analysis of wind turbines.

  15. Psychosocial factors involved in memory and cognitive failures in people with myalgic encephalomyelitis/chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Attree EA

    2014-02-01

    Full Text Available Elizabeth A Attree,1 Megan A Arroll,1 Christine P Dancey,1 Charlene Griffith,1 Amolak S Bansal1,2 1Chronic Illness Research Team, School of Psychology, University of East London, London, UK; 2Department of Immunology and the Sutton CFS Service, St Helier Hospital, Carshalton, UK Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS is characterized by persistent emotional, mental, and physical fatigue accompanied by a range of neurological, autonomic, neuroendocrine, immune, and sleep problems. Research has shown that psychosocial factors such as anxiety and depression as well as the symptoms of the illness, have a significant impact on the quality of life of people with ME/CFS. In addition, individuals may suffer from deficits in memory and concentration. This study set out to explore the relationships between variables which have been found to contribute to cognitive performance, as measured by prospective and retrospective memory, and cognitive failures. Methods: Eighty-seven people with ME/CFS answered questionnaires measuring fatigue, depression, anxiety, social support, and general self-efficacy. These were used in a correlational design (multiple regression to predict cognitive function (self-ratings on prospective and retrospective memory, and cognitive failures. Results: Our study found that fatigue, depression, and general self-efficacy were directly associated with cognitive failures and retrospective (but not prospective memory. Conclusion: Although it was not possible in this study to determine the cause of the deficits, the literature in this area leads us to suggest that although the pathophysiological mechanisms of ME/CFS are unclear, abnormalities in the immune system, including proinflammatory cytokines, can lead to significant impairments in cognition. We suggest that fatigue and depression may be a result of the neurobiological effects of ME/CFS and in addition, that the neurobiological effects of the illness

  16. Immune System (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Immune System KidsHealth / For Parents / Immune System What's in this ... can lead to illness and infection. About the Immune System The immune system is the body's defense against ...

  17. Our Immune System

    Science.gov (United States)

    Our Immune System A story for children with primary immunodeficiency diseases Written by Sara LeBien IMMUNE DEFICIENCY FOUNDATION A note ... who are immune deficient to better understand their immune system. What is a “ B-cell, ” a “ T-cell, ” ...

  18. Fatigue Characteristics of Selected Light Metal Alloys

    Directory of Open Access Journals (Sweden)

    Cieśla M.

    2016-03-01

    Full Text Available The paper addresses results of fatigue testing of light metal alloys used in the automotive as well as aerospace and aviation industries, among others. The material subject to testing comprised hot-worked rods made of the AZ31 alloy, the Ti-6Al-4V two-phase titanium alloy and the 2017A (T451 aluminium alloy. Both low- and high-cycle fatigue tests were conducted at room temperature on the cycle asymmetry ratio of R=-1. The low-cycle fatigue tests were performed using the MTS-810 machine on two levels of total strain, i.e.Δεc= 1.0% and 1.2%. The high-cycle fatigue tests, on the other hand, were performed using a machine from VEB Werkstoffprufmaschinen-Leipzig under conditions of rotary bending. Based on the results thus obtained, one could develop fatigue life characteristics of the materials examined (expressed as the number of cycles until failure of sample Nf as well as characteristics of cyclic material strain σa=f(N under the conditions of low-cycle fatigue testing. The Ti-6Al-4V titanium alloy was found to be characterised by the highest value of fatigue life Nf, both in lowand high-cycle tests. The lowest fatigue life, on the other hand, was established for the aluminium alloys examined. Under the high-cycle fatigue tests, the life of the 2017A aluminium and the AZ31 magnesium alloy studied was determined by the value of stress amplitude σa. With the stress exceeding 150 MPa, it was the aluminium alloy which displayed higher fatigue life, whereas the magnesium alloy proved better on lower stress.

  19. Fatigue diminishes motoneuronal excitability during cycling exercise.

    Science.gov (United States)

    Weavil, Joshua C; Sidhu, Simranjit K; Mangum, Tyler S; Richardson, Russell S; Amann, Markus

    2016-10-01

    Exercise-induced fatigue influences the excitability of the motor pathway during single-joint isometric contractions. This study sought to investigate the influence of fatigue on corticospinal excitability during cycling exercise. Eight men performed fatiguing constant-load (80% W peak ; 241 ± 13 W) cycling to exhaustion during which the percent increase in quadriceps electromyography (ΔEMG; vastus lateralis and rectus femoris) was quantified. During a separate trial, subjects performed two brief (∼45 s) nonfatiguing cycling bouts (244 ± 15 and 331 ± 23W) individually chosen to match the ΔEMG across bouts to that observed during fatiguing cycling. Corticospinal excitability during exercise was quantified by transcranial magnetic, electric transmastoid, and femoral nerve stimulation to elicit motor-evoked potentials (MEP), cervicomedullary evoked potentials (CMEP), and M waves in the quadriceps. Peripheral and central fatigue were expressed as pre- to postexercise reductions in quadriceps twitch force (ΔQ tw ) and voluntary quadriceps activation (ΔVA). Whereas nonfatiguing cycling caused no measureable fatigue, fatiguing cycling resulted in significant peripheral (ΔQ tw : 42 ± 6%) and central (ΔVA: 4 ± 1%) fatigue. During nonfatiguing cycling, the area of MEPs and CMEPs, normalized to M waves, similarly increased in the quadriceps (∼40%; P fatiguing cycling. As a consequence, the ratio of MEP to CMEP was unchanged during both trials (P > 0.5). Therefore, although increases in muscle activation promote corticospinal excitability via motoneuronal facilitation during nonfatiguing cycling, this effect is abolished during fatigue. We conclude that the unaltered excitability of the corticospinal pathway from start of intense cycling exercise to exhaustion is, in part, determined by inhibitory influences on spinal motoneurons obscuring the facilitating effects of muscle activation.

  20. Assessment of surgeon fatigue by surgical simulators

    Directory of Open Access Journals (Sweden)

    Tuwairqi K

    2015-04-01

    Full Text Available Khaled Tuwairqi,1 Jessica H Selter,2 Shameema Sikder3 1College of Medicine, University of Utah, Salt Lake City, UT, 2Johns Hopkins School of Medicine, 3Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA Background: The impact of fatigue on surgical performance and its implications for patient care is a growing concern. While investigators have employed a number of different tools to measure the effect of fatigue on surgical performance, the use of the surgical simulator has been increasingly implemented for this purpose. The goal of this paper is to review the published literature to achieve a better understanding of evaluation of fatigue on performance as studied with surgical simulators. Methods: A PubMed and Cochrane search was conducted using the search terms “simulator”, “surgery”, and “fatigue”. In total, 50 papers were evaluated, and 20 studies were selected after application of exclusion criteria. Articles were excluded if they did not use the simulator to assess the impact of fatigue on surgeon performance. Systematic reviews and case reports were also excluded. Results: Surgeon fatigue led to a consistent decline in cognitive function in six studies. Technical skills were evaluated in 18 studies, and a detrimental impact was reported in nine studies, while the remaining nine studies showed either no change or positive results with regard to surgical skills after experience of fatigue. Two pharmacological intervention studies reversed the detrimental impact of fatigue on cognitive function, but no change or a worsening effect was recognized for technical skills. Conclusion: Simulators are increasingly being used to evaluate the impact of fatigue on the surgeon's performance. With regard to the impact of fatigue in this regard, studies have demonstrated a consistent decline in cognitive function and mixed outcomes for technical skills. Larger studies that relate the simulator's results to real surgical

  1. Temperament vs. chronic fatigue in police officers

    Directory of Open Access Journals (Sweden)

    Ewa Stępka

    2015-12-01

    Full Text Available Background: Chronic fatigue is a problem affecting a still growing number of people. Among them there are representatives of different professions who are forced to cope not only with occupational stress, but also with the problem of fatigue. The police is one of such occupational groups, in which exposure to stressful and often traumatic situations, contact with those who violate the law, shift work and contact with superiors can play a key role in the development of chronic fatigue. However, chronic fatigue, induced by the above mentioned factors, does not affect all police officers since its occurrence also depends on many personal traits, including temperament. Material and methods: We studied a group of 61 police officers of the Kuyavian-Pomeranian garrison. The study was conducted using the Buss and Plomin EAS (emotionality, activity, sociability Temperament Questionnaire, CIS-20R (community, innovation, survey Questionnaire, developed by Vercoulen et al. and a questionnaire on socio-demographic data. Results: The results indicated the relationship between chronic fatigue and emotionality. Statistical analyses showed a negative correlation between the nature of emotional components, distress, fear, anger, and the general rate of chronic fatigue. There was no statistically significant correlation between age, and service experience and the level of chronic fatigue. Conclusions: The results indicate that the officers of the study group show dramatically high levels of chronic fatigue. The results also revealed that temperament characteristics, such as sociability and activity, reported in the literature as factors reducing fatigue and stress, did not show relevance to chronic fatigue in the study group. Med Pr 2015;66(6:793–801

  2. GASTROINTESTINAL MANIFESTATIONS OF MITOCHONDRIAL DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    A. A. Ziganshina

    2016-01-01

    Full Text Available Objective: to highlight the current concepts of gastrointestinal manifestations of mitochondrial dysfunction. The data available in Russian and foreign literature on the gastrointestinal manifestations of mitochondrial dysfunction were analyzed. Functional digestive diseases are common in pediatric practice; however, their etiopathogenesis has not been adequately explored today. According to the literature, impaired cellular energy metabolism may underlie gastrointestinal motility disorders in cyclic vomiting syndrome, gastroesophageal reflux, gastric stasis, chronic diarrhea, constipation, intestinal pseudoobstruction, malabsorption syndrome, irritable bowel syndrome, as well as diseases of the liver and pancreas.

  3. Hormonal Changes and Sexual Dysfunction.

    Science.gov (United States)

    Zhou, Eric S; Frederick, Natasha N; Bober, Sharon L

    2017-11-01

    Sexual dysfunction is a common concern for many patients with cancer after treatment. Hormonal changes as a result of cancer-directed therapy can affect both male and female sexual health. This has the potential to significantly impact patients' quality of life, but is underreported and undertreated in the oncology setting. This review discusses commonly reported sexual issues and the role that hormonal changes play in this dysfunction. Although medical and psychosocial intervention strategies exist, there is a clear need for further research to formally develop programming that can assist people whose sexual health has been impacted by cancer treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Bladder Dysfunction and Urinary Incontinence

    OpenAIRE

    F. faizi

    2009-01-01

      "nIn the name of God. Dear colleagues, ladies and gentlemen, it is a great honor to be here. Bladder dysfunction is serious enough to seek serious help. If you may know I am working in a private clinic which it is impossible to follow the patients so this lecture is based on unusual and rare cases who came to me. Bladder dysfunction (BD) is common among 30% of young and old people who are suffering from it, however it is more common in old ages. According to a research, women ...

  5. Lysosomal dysfunction in neurodegenerative diseases

    Directory of Open Access Journals (Sweden)

    Klaudia Tomala

    2017-05-01

    Full Text Available Recent data advocate for the implication of lysosomes in the development of programmed cell death. Lysosomal dysfunction decreased the efficiency of autophagosome/lysosome fusion that leads to vacuolation of cells. Autophagic vacuoles containing damaged organelles and altered proteins are hallmarks in most neurodegenerative disorders. These aggregates consequently disrupt cellular homeostasis causing neuronal cell death due apoptosis or necrosis. Moreover calpain mediated or mutation inducted lysosomal rupture result in release of lysosomal cathepsins into the cytoplasm and inducing neuronal cell death. In this review we emphasize the pathophysiological mechanism connecting disrupting autophagy – lysosomal pathway and lysosomal dysfunction in neuronal cell death called lysosomal cell death.

  6. Understanding the Association of Fatigue With Other Symptoms of Fibromyalgia: Development of a Cluster Model.

    Science.gov (United States)

    Lukkahatai, Nada; Walitt, Brian; Espina, Alexandra; Gelio, Alves; Saligan, Leorey N

    2016-01-01

    To develop a symptoms cluster model that can describe factors of fibromyalgia syndrome (FMS) associated with fatigue severity as reported by the sample and to explore FMS clinical symptom subclusters based on varying symptom intensities. FMS individuals (n = 120, 82% ages 31-60 years, 90% women, 59% white) diagnosed with the 1990 or 2010 American College of Rheumatology diagnostic criteria were enrolled. Participants completed multiple validated self-report questionnaires to measure fatigue, pain, depression, anxiety, pain catastrophizing, daytime sleepiness, cognitive function, and FMS-related polysymptomatic distress. Cluster analysis using SPSS 19.0 and structural equation modeling using AMOS 17.0 were used. Final structural equation modeling the symptoms cluster model showed good fit and revealed that FMS fatigue was associated with widespread pain, symptoms severity, pain intensity, pain interference, cognitive dysfunction, catastrophizing, anxiety, and depression (χ(2)  = 121.72 (98df), P > 0.05, χ(2) /df = 1.242, comparative fit index = 0.982, root mean square error of approximation = 0.045). Two distinct clinical symptom subclusters emerged: subcluster 1 (78% of total subjects), defined by widespread pain, unrefreshed waking, and somatic symptoms, and subcluster 2 (22% of total subjects), defined by fatigue and cognitive dysfunction with pain being a less severe and less widespread occurrence. Overall, subcluster 1 had more intense symptoms than subcluster 2. FMS symptoms may be categorized into 2 clinical subclusters. These findings have implications for an illness whose diagnosis and management are symptom dependent. A longitudinal study capturing the variability in the symptom experience of FMS subjects is warranted. © 2016, American College of Rheumatology.

  7. Dysregulation of metabolic-associated pathways in muscle of breast cancer patients: preclinical evaluation of interleukin-15 targeting fatigue.

    Science.gov (United States)

    Bohlen, Joseph; McLaughlin, Sarah L; Hazard-Jenkins, Hannah; Infante, Aniello M; Montgomery, Cortney; Davis, Mary; Pistilli, Emidio E

    2018-03-26

    Breast cancer patients report a perception of increased muscle fatigue, which can persist following surgery and standardized therapies. In a clinical experiment, we tested the hypothesis that pathways regulating skeletal muscle fatigue are down-regulated in skeletal muscle of breast cancer patients and that different muscle gene expression patterns exist between breast tumour subtypes. In a preclinical study, we tested the hypothesis that mammary tumour growth in mice induces skeletal muscle fatigue and that overexpression of the cytokine interleukin-15 (IL-15) can attenuate mammary tumour-induced muscle fatigue. Early stage non-metastatic female breast cancer patients (n = 14) and female non-cancer patients (n = 6) provided a muscle biopsy of the pectoralis major muscle during mastectomy, lumpectomy, or breast reconstruction surgeries. The breast cancer patients were diagnosed with either luminal (ER + /PR + , n = 6), triple positive (ER + /PR + /Her2/neu + , n = 5), or triple negative (ER - /PR - /Her2/neu - , n = 3) breast tumours and were being treated with curative intent either with neoadjuvant chemotherapy followed by surgery or surgery followed by standard post-operative therapy. Biopsies were used for RNA-sequencing to compare the skeletal muscle gene expression patterns between breast cancer patients and non-cancer patients. The C57BL/6 mouse syngeneic mammary tumour cell line, E0771, was used to induce mammary tumours in immunocompetent mice, and isometric muscle contractile properties and fatigue properties were analysed following 4 weeks of tumour growth. RNA-sequencing and subsequent bioinformatics analyses revealed a dysregulation of canonical pathways involved in oxidative phosphorylation, mitochondrial dysfunction, peroxisome proliferator-activated receptor signalling and activation, and IL-15 signalling and production. In a preclinical mouse model of breast cancer, the rate of muscle fatigue was greater in mice exposed to mammary tumour

  8. Fatigue

    Science.gov (United States)

    ... the adrenal glands don't produce enough hormones) Anorexia or other eating disorders Arthritis, including juvenile rheumatoid ... Get enough sleep each night. Make sure your diet is healthy and well-balanced, and drink plenty ...

  9. National Network for Immunization Information

    Science.gov (United States)

    ... everyone who needs to know the facts about immunization. NNii believes that immunization is one of the most important ways to ... published... What's New for 2002? The Recommended Childhood Immunization Schedule Download the 2002 Recommended Childhood Immunization... Immunization ...

  10. Immune System Dysregulation and Herpesvirus Reactivation Persist During Long-Duration Spaceflight

    Science.gov (United States)

    Crucian, B. E.; Mehta, S.; Stowe, R. P.; Uchakin, P.; Quiriarte, H.; Pierson, D.; Sams, C. F.

    2011-01-01

    This poster presentation reviews a study that is designed to address immune system dysregulation and the risk to crewmembers in long duration exploration class missions. This study will address these objectives: (1) Determine the status of adaptive immunity physiological stress, viral immunity, latent herpesvirus reactivation in astronauts during 6 month missions to the International Space Station; (2) determine the clinical risk related to immune dysregulation for exploration class spaceflight; and (3) determine an appropriate monitoring strategy for spaceflight-associated immune dysfunction that could be used for the evaluation of countermeasures. The study anticipates 17 subjects, and for this presentation, (midpoint study data) 10 subjects are reviewed.

  11. Investigation of the effects of vanilloids in chronic fatigue syndrome.

    Science.gov (United States)

    Sarvaiya, Kuldeep; Goswami, Sunita

    2016-10-01

    To assess the effectiveness of TRPV1 modulators in animal model of Chronic fatigue syndrome (CFS). To assess central and peripheral behavioral activity of TRPV1 modulators. CFS was induced by forcing the rats to swim for 10min for 21 consecutive days. The rats were treated with capsaicin (TRPV1 agonist, 2.5mg/kg) and n-tert-butylcyclohexanol (TRPV1 antagonist, 10mg/kg) for 21days 30min before the exposure to stress procedure. The behavioral consequence of CFS was measured in terms of immobility time, grip strength, locomotor activity, and anxiety level using Rota rod, Actophotometer, and Elevated plus maze model respectively. The other parameters include Plasma corticosterone, adrenal gland and spleen weight, complete blood count, blood urea niterogen (BUN), Lactate dehydrogenase (LDH), Lipid peroxidation, catalase and reduced glutathione (GSH). TRPV1 modulators reversed (pimmobility period, anxiety, spleen weight, BUN and LDH levels, and MDA levels along with decrease in grip strength, locomotor activity, plasma corticosterone, adrenal gland weight, catalase, and GSH. There was also significant increase in total WBC count when compared with the disease control group. The reversal was attributed to modulation of HPA axis, oxidative stress, anaerobic respiration product, muscle degradation product. The present study reveals the effectiveness of n-tert-butylcyclohexanol and capsaicin against chronic fatigue syndrome. The mechanism of action can be attributed to inhibition of TRPV1 channel and thereby modulating pain perception, neuroendocrine function, oxidative stress and immune function. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Keeping the immune system in check: a role for mitophagy.

    Science.gov (United States)

    Lazarou, Michael

    2015-01-01

    Mitochondria play a central role in many facets of cellular function including energy production, control of cell death and immune signaling. Breakdown of any of these pathways because of mitochondrial deficits or excessive reactive oxygen species production has detrimental consequences for immune system function and cell viability. Maintaining the functional integrity of mitochondria is therefore a critical challenge for the cell. Surveillance systems that monitor mitochondrial status enable the cell to identify and either repair or eliminate dysfunctional mitochondria. Mitophagy is a selective form of autophagy that eliminates dysfunctional mitochondria from the population to maintain overall mitochondrial health. This review covers the major players involved in mitophagy and explores the role mitophagy plays to support the immune system.

  13. Sepsis-induced immunosuppression: from cellular dysfunctions to immunotherapy

    Science.gov (United States)

    Hotchkiss, Richard S.; Monneret, Guillaume; Payen, Didier

    2014-01-01

    Sepsis — severe life-threatening infection with organ dysfunction — initiates a complex interplay of host pro- and anti-inflammatory processes. In a real sense, sepsis can be considered a race to the death between the pathogens and the host immune system. It is the proper balance between the often competing pro- and anti-inflammatory pathways that determines the fate of the individual. Although the field of sepsis research has witnessed the failure of many highly-touted clinical trials, a better understanding of the pathophysiological basis of the disorder and the mechanisms responsible for the associated pro- and anti-inflammatory responses is leading to a novel approach to treat this highly lethal condition. Biomarker-guided immunotherapy administered to patients at the proper immune phase of sepsis represents a potential major advance in the treatment of sepsis and more broadly in the field of infectious disease. PMID:24232462

  14. Urinary Tract Infection in Children with Neurogenic Bladder Dysfunction

    Directory of Open Access Journals (Sweden)

    Yu.B. Bielan

    2016-04-01

    Full Text Available Introduction. Among all the diseases of the urinary system, microbial-inflammatory lesions dominate, their prevalence is 29 per 1,000 of child population. Neurogenic bladder dysfunction leads to the chronicity and recurrence of urinary tract infections. Objective. To study the etiologic spectrum in children with urinary tract infection associated with neurogenic bladder dysfunction. Materials and methods. The study involved 434 children aged 4 to 15 years, who were hospitalized and out-patient treatment in Omsk from 2008 to 2014. Bacteriological urine culture on the microflora with determining the sensitivity to antibiotics was performed using Urin System Plus (Liofilchem, Italy. At the same time, the urine was examined for the presence of Cytomegalovirus, Herpes simplex virus I–II, Mycoplasma genitalium, Chlamydiae trachomatis, Ureaplasma urealyticum by polymerase chain reaction and enzyme immunoassay. Data processing was performed using Statistica 10.0 software package. Results. It was found that in the urine microbial landscape of children with urinary tract infection and neurogenic bladder dysfunction, Staphylococcus family dominated, unlike the spectrum of uropathogens in patirnts with urinary tract infection without functional obstruction, which is characterized by the predominance of Escherichia coli. The detection rate of cytomegalovirus in the urine indicates a significant decrease in the immunity of children with urinary tract infection and neurogenic bladder dysfunction. Conclusion. The shown differences in microbial landscape of the urine in urinary tract infection associated with neurogenic bladder dysfunction and without functional obstruction must be considered in the selection of an adequate therapy for patients of different groups, including immunocorrective approaches.

  15. Validation of Procedures for Monitoring Crewmember Immune Function SDBI-1900, SMO-015 - Integrated Immune

    Science.gov (United States)

    Crucian, Brian; Stowe, Raymond; Mehta, Satish; Uchakin, Peter; Nehlsen-Cannarella, Sandra; Morukov, Boris; Pierson, Duane; Sams, Clarence

    2007-01-01

    There is ample evidence to suggest that space flight leads to immune system dysregulation. This may be a result of microgravity, confinement, physiological stress, radiation, environment or other mission-associated factors. The clinical risk from prolonged immune dysregulation during space flight are not yet determined, but may include increased incidence of infection, allergy, hypersensitivity, hematological malignancy or altered wound healing. Each of the clinical events resulting from immune dysfunction has the potential to impact mission critical objectives during exploration-class missions. To date, precious little in-flight immune data has been generated to assess this phenomenon. The majority of recent flight immune studies have been post-flight assessments, which may not accurately reflect the in-flight condition. There are no procedures currently in place to monitor immune function or its effect on crew health. The objective of this Supplemental Medical Objective (SMO) is to develop and validate an immune monitoring strategy consistent with operational flight requirements and constraints. This SMO will assess the clinical risks resulting from the adverse effects of space flight on the human immune system and will validate a flight-compatible immune monitoring strategy. Characterization of the clinical risk and the development of a monitoring strategy are necessary prerequisite activities prior to validating countermeasures. This study will determine, to the best level allowed by current technology, the in-flight status of crewmembers immune system. Pre-flight, in-flight and post-flight assessments of immune status, immune function, viral reactivation and physiological stress will be performed. The in-flight samples will allow a distinction between legitimate in-flight alterations and the physiological stresses of landing and readaptation which are believed to alter landing day assessments. The overall status of the immune system during flight (activation

  16. Random non-proportional fatigue tests with planar tri-axial fatigue testing machine

    Directory of Open Access Journals (Sweden)

    T. Inoue

    2016-10-01

    Full Text Available Complex stresses, which occur on the mechanical surfaces of transport machinery in service, bring a drastic degradation in fatigue life. However, it is hard to reproduce such complex stress states for evaluating the fatigue life with conventional multiaxial fatigue machines. We have developed a fatigue testing machine that enables reproduction of such complex stresses. The testing machine can reproduce arbitrary in-plane stress states by applying three independent loads to the test specimen using actuators which apply loads in the 0, 45, and 90 degree directions. The reproduction was tested with complex stress data obtained from the actual operation of transport machinery. As a result, it was found that the reproduced stress corresponded to the measured stress with an error range of less than 10 %. Then, we made a comparison between measured fatigue lives under random non-proportional loading conditions and predicted fatigue lives. It was found that predicted fatigue lives with cr, stress on critical plane, were over a factor of 10 against measured fatigue lives. On the other hand, predicted fatigue lives with ma, stress in consideration of a non-proportional level evaluated by using amplitude and direction of principal stress, were within a factor of 3 against measured fatigue lives

  17. Cumulative fatigue and creep-fatigue damage at 3500C on recrystallized zircaloy 4

    International Nuclear Information System (INIS)

    Brun, G.; Pelchat, J.; Floze, J.C.; Galimberti, M.

    1985-06-01

    An experimental programme undertaken by C.E.A., E.D.F. and FRAGEMA with the aim of characterizing the fatigue and creep fatigue behaviour of zircaloy-4 following annealing treatments (recrystallized, stress-delived) is in progress. The results given below concern only recrystallized material. Cyclic properties, low-cycle fatigue curves and creep behaviour laws under stresses have been established. Sequential tests of pure fatigue and creep-fatigue were performed. The cumulative life fractions at fracture depend on the sequence of leading, stress history and number of cycles of prestressing. The MINER's rule appears to be conservative with regard to a low-high loading sequence whereas it is not for the reverse high-low loading sequences. Fatigue and creep damage are not interchangeable. Pre-creep improves the fatigue resistance. Pre-fatigue improves the creep strength as long as the beneficial effect of cyclic hardening overcomes the damaging effect of surface cracking. The introduction of a tension hold time into the fatigue cycle slightly increases cyclic hardening and reduces the number of cycles to failure. For hold times of less than one hour, the sum of fatigue and creep life fractions is closed to one

  18. Predictors and Trajectories of Morning Fatigue Are Distinct From Evening Fatigue.

    Science.gov (United States)

    Wright, Fay; D'Eramo Melkus, Gail; Hammer, Marilyn; Schmidt, Brian L; Knobf, M Tish; Paul, Steven M; Cartwright, Frances; Mastick, Judy; Cooper, Bruce A; Chen, Lee-May; Melisko, Michelle; Levine, Jon D; Kober, Kord; Aouizerat, Bradley E; Miaskowski, Christine

    2015-08-01

    Fatigue is the most common symptom in oncology patients during chemotherapy. Little is known about the predictors of interindividual variability in initial levels and trajectories of morning fatigue severity in these patients. An evaluation was done to determine which demographic, clinical, and symptom characteristics were associated with initial levels as well as the trajectories of morning fatigue and to compare findings with our companion paper on evening fatigue. A sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer (n = 586) completed demographic and symptom questionnaires a total of six times over two cycles of chemotherapy. Fatigue severity was evaluated using the Lee Fatigue Scale. Hierarchical linear modeling was used to answer the study objectives. A large amount of interindividual variability was found in the morning fatigue trajectories. A piecewise model fit the data best. Patients with higher body mass index, who did not exercise regularly, with a lower functional status, and who had higher levels of state anxiety, sleep disturbance, and depressive symptoms reported higher levels of morning fatigue at enrollment. Variations in the trajectories of morning fatigue were predicted by the patients' ethnicity and younger age. The modifiable risk factors that were associated with only morning fatigue were body mass index, exercise, and state anxiety. Modifiable risk factors that were associated with both morning and evening fatigue included functional status, depressive symptoms, and sleep disturbance. Using this information, clinicians can identify patients at higher risk for more severe morning fatigue and evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  19. Cardiorespiratory and neuromuscular deconditioning in fatigued and non-fatigued breast cancer survivors.

    Science.gov (United States)

    Neil, Sarah E; Klika, Riggs J; Garland, S Jayne; McKenzie, Donald C; Campbell, Kristin L

    2013-03-01

    Fatigue is one of the most commonly reported side effects during treatment for breast cancer and can persist following treatment completion. Cancer-related fatigue after treatment is multifactorial in nature, and one hypothesized mechanism is cardiorespiratory and neuromuscular deconditioning. The purpose of this study was to compare cardiorespiratory and neuromuscular function in breast cancer survivors who had completed treatment and met the specified criteria for cancer-related fatigue and a control group of breast cancer survivors without fatigue. Participants in the fatigue (n = 16) and control group (n = 11) performed a maximal exercise test on a cycle ergometer for determination of peak power, power at lactate threshold, and VO(2) peak. Neuromuscular fatigue was induced with a sustained submaximal contraction of the right quadriceps. Central fatigue (failure of voluntary activation) was evaluated using twitch interpolation, and peripheral fatigue was measured with an electrically evoked twitch. Power at lactate threshold was lower in the fatigue group (p = 0.05). There were no differences between groups for power at lactate threshold as percentage of peak power (p = 0.10) or absolute or relative VO(2) peak (p = 0.08 and 0.33, respectively). When adjusted for age, the fatigue group had a lower power at lactate threshold (p = 0.02) and absolute VO(2) peak (p = 0.03). There were no differences between groups in change in any neuromuscular parameters after the muscle-fatiguing protocol. Findings support the hypothesis that cardiorespiratory deconditioning may play a role in the development and persistence of cancer-related fatigue following treatment. Future research into the use of exercise training to reduce cardiorespiratory deconditioning as a treatment for cancer-related fatigue is warranted to confirm these preliminary findings.

  20. The innate immune response during urinary tract infection and pyelonephritis.

    Science.gov (United States)

    Spencer, John David; Schwaderer, Andrew L; Becknell, Brian; Watson, Joshua; Hains, David S

    2014-07-01

    Despite its proximity to the fecal flora, the urinary tract is considered sterile. The precise mechanisms by which the urinary tract maintains sterility are not well understood. Host immune responses are critically important in the antimicrobial defense of the urinary tract. During recent years, considerable advances have been made in our understanding of the mechanisms underlying immune homeostasis of the kidney and urinary tract. Dysfunctions in these immune mechanisms may result in acute disease, tissue destruction and overwhelming infection. The objective of this review is to provide an overview of the innate immune response in the urinary tract in response to microbial assault. In doing so, we focus on the role of antimicrobial peptides-a ubiquitous component of the innate immune response.

  1. Thyroid dysfunction in the elderly

    African Journals Online (AJOL)

    1997-09-09

    thirds of the subjects in this study. The serum TSH concentration is a reliable screening test for thyroid dysfunction in the elderly, but is less useful if used to identify biochemical thyroid disease. An elevated TSH concentration is a ...

  2. Sweating dysfunction in Parkinson's disease

    NARCIS (Netherlands)

    Swinn, L; Schrag, A; Viswanathan, R; Lees, A; Quinn, N; Bloem, Bastiaan R.

    2003-01-01

    We sought to determine the prevalence and nature of sweating disturbances in patients with Parkinson's disease (PD), and investigated their correlation with other clinical features and with Quality of Life (QoL) measures. A questionnaire on symptoms and consequences of sweating dysfunction was

  3. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, Judith E.; Brennan, Mike T.; Leeuw, Irma M. Verdonck-de; Gibson, Rachel J.; Eilers, June G.; Waltimo, Tuomas; Bots, Casper P.; Michelet, Marisol; Sollecito, Thomas P.; Rouleau, Tanya S.; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C.; Silverman, Sol; Spijkervet, Fred K. L.

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  4. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; Verdonck- de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  5. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose: Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  6. Medical therapy and smell dysfunction

    NARCIS (Netherlands)

    Hellings, P. W.; Rombaux, P.

    2009-01-01

    Olfactory dysfunction is deemed to be a significant contributor to poor quality of life in different nasal inflammatory conditions like common cold, allergic rhinitis, and acute and chronic rhinosinusitis with and without nasal polyps (NP). The mechanism underlying olfactory impairment in

  7. COGNITIVE FATIGUE FACILITATES PROCEDURAL SEQUENCE LEARNING

    Directory of Open Access Journals (Sweden)

    Guillermo eBorragán

    2016-03-01

    Full Text Available Enhanced procedural learning has been evidenced in conditions where cognitive control is diminished, including hypnosis, disruption of prefrontal activity and non-optimal time of the day. Another condition depleting the availability of controlled resources is cognitive fatigue. We tested the hypothesis that cognitive fatigue, eventually leading to diminished cognitive control, facilitates procedural sequence learning. In a two-day experiment, twenty-three young healthy adults were administered a serial reaction time task (SRTT following the induction of high or low levels of cognitive fatigue, in a counterbalanced order. Cognitive fatigue was induced using the Time load Dual-back (TloadDback paradigm, a dual working memory task that allows tailoring cognitive load levels to the individual's optimal performance capacity. In line with our hypothesis, reaction times in the SRTT were faster in the high- than in the low-level fatigue condition, and performance improvement showed more of a benefit from the sequential components than from motor. Altogether, our results suggest a paradoxical, facilitating impact of cognitive fatigue on procedural motor sequence learning. We propose that facilitated learning in the high-level fatigue condition stems from a reduction in the cognitive resources devoted to cognitive control processes that normally oppose automatic procedural acquisition mechanisms.

  8. Prevalence of fatigue in general practice.

    Science.gov (United States)

    Cullen, W; Kearney, Y; Bury, G

    2002-01-01

    Fatigue is an important symptom in general practice due to its association with physical, psychological and social problems. To determine the prevalence of fatigue as an unsolicited symptom during general practice consultations. A random sample of GPs practising in Ireland was invited to provide data on consultations held over one day. Data were recorded on the presence of fatigue as a main or supporting symptom, social and demographic characteristics. Data were recorded by 89 GPs on 1,428 consultations. The prevalence of fatigue was 25%. It was the main reason for attending the doctor in 6.5% and a secondary reason in 19%. Sixty-two per cent of patients were female and 48% were eligible for free GP services. The mean age was 47.1 years. The presence of fatigue was associated with: attending a female GP, being female, attending a GP who had been qualified for fewer years and attending the GP frequently. The prevalence of fatigue reported in this study is over three times higher than that reported in earlier work. Doctor characteristics appear to be as important as patient characteristics in determining fatigue.

  9. Fatigue studies of superalloys in Japan

    International Nuclear Information System (INIS)

    Kitagawa, Masaki

    1985-01-01

    In the past 15 years, several national projects were advanced to develop high temperature machinery, such as high temperature gas-cooled reactors, gas turbines and fusion reactors. Before, the studies on the strength of superalloys were rarely carried out, however, by the above research works, superalloys are in rapid progress. Because these machinery are subjected to temperature cycles and vibration stress, the fatigue failure is the main concern in the safety analysis of the components. The purpose of this paper is to summarize the present status of the fatigue research on the alloys for high temperature use in Japan. The superalloys used for gas turbine and HTGR components are listed, and the materials tested were mostly the alloys of nickel base, cobalt base or iron base. In the above national projects, the main purpose was to clarify the high temperature properties including fatigue properties, to develop the method of forecasting the life span and to develop better materials. As the topics about the fatigue research on superalloys, the development of the method for forecasting the life span, the effect of directional solidification, coating and HIP process on the fatigue strength of gas turbine materials, the effect of helium and aging on the fatigue strength of HTGR materials, the fatigue strength of weldment of HTGR materials and others are reported. (Kako, I.)

  10. [Cardiological aspects of fatigue states in athletes].

    Science.gov (United States)

    Bigard, A X; Koulmann, N

    2006-11-01

    The physical load increase during training can lead to the development of clinical patterns of intolerance differing according to their severity, prognosis and reversibility. However, they always include fatigue as a key symptom. The aim of this paper is to review recent data on fatigue states in sportsmen, their clinical presentation and diagnostic orientations. A continuum exists, from acute fatigue states after one or several highly-intensive training sessions, to overreaching, associated to performances alteration which can be easily reversed, and to overtraining, representing a severe clinical pattern which can hardly be reversed. Overreaching and overtraining are characterized by a persisting fatigue state, associated to performances alteration and mood disorders. In an athlete with unexplained alteration of performances associated to physical fatigue, the medical interrogation is critical, in order to check the durable character of sportive performances alteration, to describe the fatigue and identify risk factors of occurrence of overtraining (training program intensity, mental stress, diet factors, hypoxic training, etc.). The use of a validated and adapted questionnaire as the one proposed by the French Society of Sports Medicine is valuable. In majority, in athletes and those doing sports regularly, the cardiological alert signs are rare, and the clinical examination by a specialist is poorly contributive, except for eliminating an organic cause of fatigue.

  11. Does Corruption Cause Aid Fatigue?

    DEFF Research Database (Denmark)

    Bauhr, Monika; Charron, Nicholas; Nasiritousi, Naghmeh

    2013-01-01

    Does perceived corruption in recipient countries reduce support for foreign aid in donor countries? This under-explored yet salient question is examined using the 2009 Eurobarometer survey for the 27 EU countries. We suggest that perceived corruption can cause aid fatigue but that this relationship...... is highly contextualized. The results show that perceptions about corruption in developing countries reduce overall support for aid among respondents in donor countries. However, this effect is mitigated by country and contextual-level effects and different understandings of what we call the “aid-corruption...... paradox,” namely that the need for foreign aid is often the greatest in corrupt environments. Three different dynamics of the aid-corruption paradox influence support for aid: moral, pragmatic, and strategic understandings. In EU-15 countries, the effect of perceived corruption in recipient states on aid...

  12. MIDAS (Modafinil in Debilitating Fatigue After Stroke)

    Science.gov (United States)

    Lillicrap, Thomas; Krishnamurthy, Venkatesh; Holliday, Elizabeth; Attia, John; Pagram, Heather; Nilsson, Michael; Parsons, Mark; Levi, Christopher R.

    2017-01-01

    Background and Purpose— This study aimed to assess the efficacy of modafinil, a wakefulness-promoting agent in alleviating post-stroke fatigue ≥3 months after stroke. We hypothesized that 200 mg of modafinil daily for 6 weeks would result in reduced symptoms of fatigue compared with placebo. Methods— This single-center phase 2 trial used a randomized, double-blind, placebo-controlled, crossover design. The key inclusion criterion was a multidimensional fatigue inventory score of ≥60. Patients were randomized to either modafinil or placebo for 6 weeks of therapy, then after a 1 week washout period swapped treatment arms for a second 6 weeks of therapy. The primary outcome was the multidimensional fatigue inventory; secondary outcomes included the Montreal cognitive assessment, the Depression, Anxiety, and Stress Scale (DASS), and the Stroke-Specific Quality of Life (SSQoL) scale. The multidimensional fatigue inventory is a self-administered questionnaire with a range of 0 to 100. Treatment efficacy was assessed using linear regression by estimating within-person, baseline-adjusted differences in mean outcomes after therapy. This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615000350527). Results— A total of 232 stroke survivors were screened and 36 were randomized. Participants receiving modafinil reported a significant decrease in fatigue (multidimensional fatigue inventory, −7.38; 95% CI, −21.76 to −2.99; Pmodafinil therapy during the study period (P>0.05). Conclusions— Stroke survivors with nonresolving fatigue reported reduced fatigue and improved quality of life after taking 200 mg daily treatment with modafinil. Clinical Trial Registration— URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368268. Unique identifier: ACTRN12615000350527. PMID:28404841

  13. Chronic fatigue syndrome: aetiology, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Palacín Delgado Cecilia

    2009-10-01

    Full Text Available Abstract Chronic fatigue syndrome is characterised by intense fatigue, with duration of over six months and associated to other related symptoms. The latter include asthenia and easily induced tiredness that is not recovered after a night's sleep. The fatigue becomes so severe that it forces a 50% reduction in daily activities. Given its unknown aetiology, different hypotheses have been considered to explain the origin of the condition (from immunological disorders to the presence of post-traumatic oxidative stress, although there are no conclusive diagnostic tests. Diagnosis is established through the exclusion of other diseases causing fatigue. This syndrome is rare in childhood and adolescence, although the fatigue symptom per se is quite common in paediatric patients. Currently, no curative treatment exists for patients with chronic fatigue syndrome. The therapeutic approach to this syndrome requires a combination of different therapeutic modalities. The specific characteristics of the symptomatology of patients with chronic fatigue require a rapid adaptation of the educational, healthcare and social systems to prevent the problems derived from current systems. Such patients require multidisciplinary management due to the multiple and different issues affecting them. This document was realized by one of the Interdisciplinary Work Groups from the Institute for Rare Diseases, and its aim is to point out the main social and care needs for people affected with Chronic Fatigue Syndrome. For this, it includes not only the view of representatives for different scientific societies, but also the patient associations view, because they know the true history of their social and sanitary needs. In an interdisciplinary approach, this work also reviews the principal scientific, medical, socio-sanitary and psychological aspects of Chronic Fatigue Syndrome.

  14. Fatigue in adults with post-infectious fatigue syndrome: a qualitative content analysis.

    Science.gov (United States)

    Stormorken, Eva; Jason, Leonard A; Kirkevold, Marit

    2015-01-01

    Fatigue is a major problem among individuals with post-infectious fatigue syndrome (PIFS), also known as chronic fatigue syndrome or myalgic encephalomyelitis. It is a complex phenomenon that varies across illnesses. From a nursing perspective, knowledge and understanding of fatigue in this illness is limited. Nurses lack confidence in caring for these patients and devalue their professional role. The aim of this study was to explore in-depth the experiences of fatigue among individuals with PIFS. A detailed description of the phenomenon of fatigue is presented. Increased knowledge would likely contribute to more confident nurses and improved nursing care. A qualitative study with open interviews was employed. In-depth interviews with patients were fully transcribed and underwent a qualitative content analysis. A maximum variation sample of 26 affected adults between 26-59 years old was recruited from a population diagnosed at a fatigue outpatient clinic. The fatigue was a post-exertional, multidimensional, fluctuating phenomenon with varying degrees of severity and several distinct characteristics and was accompanied by concomitant symptoms. Fatigue was perceived to be an all-pervasive complex experience that substantially reduced the ability to function personally or professionally. A range of trigger mechanisms evoked or worsened the fatigue, but the affected were not always aware of what triggered it. There was an excessive increase in fatigue in response to even minor activities. An increase in fatigue resulted in the exacerbation of other concomitant symptoms. The term fatigue does not capture the participants' experiences, which are accompanied by a considerable symptom burden that contributes to the illness experience and the severe disability. Although some aspects of the fatigue experience have been reported previously, more were added in our study, such as the dimension of awakening fatigue and the characteristic beyond time, when time passes unnoticed

  15. Unravelling Mitochondrial Dysfunction in Rheumatoid Arthritis patients

    Directory of Open Access Journals (Sweden)

    Shweta Khanna

    2017-10-01

    function of mitochondria to produce ATP and various other functions. Results depict dysfunction in basic mitochondrial activities which may be a reason for abrupt functioning of immune cells, leading to autoimmunity in RA patients.

  16. Role of the Immune System in Hypertension.

    Science.gov (United States)

    Rodriguez-Iturbe, Bernardo; Pons, Hector; Johnson, Richard J

    2017-07-01

    High blood pressure is present in more than one billion adults worldwide and is the most important modifiable risk factor of death resulting from cardiovascular disease. While many factors contribute to the pathogenesis of hypertension, a role of the immune system has been firmly established by a large number of investigations from many laboratories around the world. Immunosuppressive drugs and inhibition of individual cytokines prevent or ameliorate experimental hypertension, and studies in genetically-modified mouse strains have demonstrated that lymphocytes are necessary participants in the development of hypertension and in hypertensive organ injury. Furthermore, immune reactivity may be the driving force of hypertension in autoimmune diseases. Infiltration of immune cells, oxidative stress, and stimulation of the intrarenal angiotensin system are induced by activation of the innate and adaptive immunity. High blood pressure results from the combined effects of inflammation-induced impairment in the pressure natriuresis relationship, dysfunctional vascular relaxation, and overactivity of the sympathetic nervous system. Imbalances between proinflammatory effector responses and anti-inflammatory responses of regulatory T cells to a large extent determine the severity of inflammation. Experimental and human studies have uncovered autoantigens (isoketal-modified proteins and heat shock protein 70) of potential clinical relevance. Further investigations on the immune reactivity in hypertension may result in the identification of new strategies for the treatment of the disease. Copyright © 2017 the American Physiological Society.

  17. Fatigue crack growth detect, assess, avoid

    CERN Document Server

    Richard, Hans Albert

    2016-01-01

    This book offers a concise introduction to fatigue crack growth, based on practical examples. It discusses the essential concepts of fracture mechanics, fatigue crack growth under constant and variable amplitude loading and the determination of the fracture-mechanical material parameters. The book also introduces the analytical and numerical simulation of fatigue crack growth as well as crack initiation. It concludes with a detailed description of several practical case studies and some exercises. The target group includes graduate students, researchers at universities and practicing engineers.

  18. Study on Standard Fatigue Vehicle Load Model

    Science.gov (United States)

    Huang, H. Y.; Zhang, J. P.; Li, Y. H.

    2018-02-01

    Based on the measured data of truck from three artery expressways in Guangdong Province, the statistical analysis of truck weight was conducted according to axle number. The standard fatigue vehicle model applied to industrial areas in the middle and late was obtained, which adopted equivalence damage principle, Miner linear accumulation law, water discharge method and damage ratio theory. Compared with the fatigue vehicle model Specified by the current bridge design code, the proposed model has better applicability. It is of certain reference value for the fatigue design of bridge in China.

  19. Corrosion Fatigue in District Heating Water Tanks

    DEFF Research Database (Denmark)

    Maahn, Ernst Emanuel

    1996-01-01

    Three candidate materials for construction of buffer tanks for district heating water have been tested for corrosion fatigue properties in a district heating water environment. The investigation included Slow Strain Rate Testing of plain tensile specimens, crack initiation testing by corrosion...... fatigue of plain tensile specimens and crack growth rate determination for Compact Tensile Specimens under corrosion fatigue conditions. The three materials are equal with respect to stress corrosion sensibility and crack initiation. Crack growth rate is increased with a factor of 4-6 relative to an inert...

  20. Load dependent diastolic dysfunction in heart failure

    NARCIS (Netherlands)

    Gillebert, T. C.; Leite-Moreira, A. F.; de Hert, S. G.

    2000-01-01

    Congestive heart failure may result from cardiovascular overload, from systolic or from diastolic dysfunction. Diastolic left ventricular dysfunction may result from structural resistance to filling such as induced by pericardial constraint, right ventricular compression, increased chamber stiffness