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Fatigue
Published in Silvia Bonino, Coping with Chronic Illness, 2020
The sense of fatigue is an inseparable companion of most chronic diseases and in some of them, such as multiple sclerosis, it can be one of the main symptoms. Asthenia, as it is defined in medical language, is not the simple fatigue that all people experience after a strenuous activity and to which a good sleep and adequate rest can remedy. Instead, it is exhaustion that makes all the actions of daily life difficult, even the simplest, and this often contributes to patient isolation: one does not have the strength to go out, to meet others, to speak, to listen, to read, sometimes not even to watch television. In a society that has made efficiency its banner, patient fatigue is one of the symptoms least accepted and most misunderstood.
Pharmacological Management of Amyotrophic Lateral Sclerosis
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Shalini Mani, Chahat Kubba, Tanya Sharma, Manisha Singh
Data generated in the clinical trials revealed that patients treated with riluzole had more frequent nausea occurrences in comparison to the placebo group (Lacomblez et al., 1996). Tends of asthenia were also observed in some patients (Bensimon et al., 2002). Patients also developed an elevated enhanced concentration of alanine transferase (serum) in comparison to the control or placebo group of patients (Lacomblez et al., 1996).
Drug-induced eosinophilia and systemic symptoms
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Rajesh Verma, Pradeesh Arumugam
DRESS develops 2–6 weeks after initiation of the culprit drug on first exposure. The median time interval after drug intake is 22 days (interquartile range 17–31 days) [3]. With reexposure of the same drug there can be shorter latency. The patient may present with nonspecific symptoms in the early phase with asthenia, malaise, and fatigue. Rash and facial swelling are usually the presenting complaints. Fever and a cutaneous eruption are the most common symptoms, seen in 90% and 75% of patients, respectively [3]. Other symptoms related to the organ affected may be present at the time of presentation. Certain drugs have more propensities to affect particular organs. Phenytoin, minocycline, and dapsone can cause severe hepatic damage, while allopurinol causes renal damage. Chest pain and dyspnea should prompt detailed cardiological evaluation. Pulmonary and neurological symptoms are rarely reported. The cutaneous and visceral involvement may persist for months after drug withdrawal, and additional sites of involvement (e.g., cardiac, thyroid) may develop weeks or months later. Family history of similar rash for a similar drug can give a diagnostic clue of HLA polymorphism. Familial cases of DRESS to carbamazepine, linked to HLA-A3101, have been described [19]. The cutaneous and visceral involvement may persist for several weeks or months after drug withdrawal, and additional sites of involvement (e.g., cardiac, thyroid) may develop weeks or months later.
Anxiety, depression, and fatigue in middle-aged and older persons with spina bifida: a cross-sectional study
Published in Disability and Rehabilitation, 2022
Ingeborg Beate Lidal, Kerstin Lundberg Larsen
To our knowledge, this is the first study to address depression, anxiety, and fatigue symptomatology in persons with SB aged 50 years or older. These are the main findings: The study population had significantly higher HADS scores compared to the GP and adults with chronic (>20 years duration) SCI. In total eleven persons (36%) scored above the thresholds for clinically relevant anxiety or depression. However, few of these persons reported receiving any kind of follow-up; one person had follow-up by a psychologist, one person had followed up by a psychiatric nurse, while none reported using antidepressant medications. The results also indicated a high rate of moderate to severe fatigue, and fatigue seemed to be associated with the use of medications that have possible fatigue or asthenia side effects. The HADS-D and FSS scores were correlated, and both variables were also correlated with pain intensity experienced the past week.
Evaluating new treatments for anaplastic thyroid cancer
Published in Expert Review of Anticancer Therapy, 2022
Andrés Coca-Pelaz, Juan P. Rodrigo, Fernando Lopez, Jatin P. Shah, Carl E. Silver, Abir Al Ghuzlan, C.Willemien Menke-van der Houven van Oordt, Robert C. Smallridge, Ashok R. Shaha, Peter Angelos, William M. Mendenhall, Cesare Piazza, Kerry D. Olsen, June Corry, Ralph P. Tufano, Alvaro Sanabria, Sandra Nuyts, Cherie-Ann Nathan, Vincent Vander Poorten, Fernando Luiz Dias, Carlos Suarez, Nabil F. Saba, Pim de Graaf, Michelle D. Williams, Alessandra Rinaldo, Alfio Ferlito
Sunitinib is an oral multitargeted TKI against VEGFRs (1 and 2), PDGFRs (α and β), c KIT, FMS-like tyrosine kinase-3 (FLT3), glial cell-line derived neurotrophic factor receptor (RET), and the receptor of macrophage colony-stimulating factor (CSF1R) [25]. Ravaud et al. published in 2017 the data from the THYSU study, which investigated the use of sunitinib in locally uncontrolled recurrent disease or advanced metastases in thyroid cancer [26]. They included 71 patients (45 differentiated follicular carcinomas or ATC and 26 medullary carcinomas). There were 4 ATC patients treated with sunitinib, and these patients died at 3.3, 3.5, 7.8, and 26.5 months. Asthenia was the most frequent side effect in 83.1% of patients including 25.4% of patients with grade 3 and 1.4% with grade 4 fatigue. Of all patients, 14.1% had a cardiac event. Nine unexpected side effects were reported, of which 5 were fatal. The authors concluded that the treatment with sunitinib is effective in medullary and differentiated thyroid cancer but did not seem to improve the natural history of the disease in ATC patients.
Patients in general practice share a common pattern of symptoms that is partly independent of the diagnosis
Published in Scandinavian Journal of Primary Health Care, 2021
Mona Kjeldsberg, Hedda Tschudi-Madsen, Ibrahimu Mdala, Dag Bruusgaard, Bård Natvig
As expected, the mean number of symptoms increased with an increasing number of chronic conditions [14]. The differences in the number of symptoms among the most prevalent diagnoses are clinically explainable. Patients with the diagnoses asthenia and depression/anxiety report a high number of symptoms. Asthenia (A04) is a symptom diagnosis according to ICPC-2 and may be used for tiredness/asthenia symptoms alone. However, asthenia is also associated with medically unexplained symptoms [25], which in turn are strongly associated with the reporting of multiple symptoms [29]. Mental health problems are also associated with a high number of symptoms [30]. Diabetes can result in complications in several different organs, but diabetes patients in general practice are often in an early stage, have few diagnosis-specific symptoms, and report good health [31]. Hypertension among general practice patients is as much an asymptomatic risk factor as a disease diagnosis, and most patients with hypertension also rate their health as good [32]. In our study, participants with hypertension had fewer symptoms than the overall mean.