Fatigue and asthenia

2015 ◽  
Author(s):  
Sriram Yennurajalingam ◽  
Eduardo Bruera
Keyword(s):  
Sleep Disturbances ◽  
Symptomatic Treatment ◽  
Future Research ◽  
Optimal Management ◽  
Pharmacological Agents ◽  
Factors Associated ◽  
Short Course ◽  
Underlying Causes ◽  
Individualized Management ◽  
Anxiety Depression

Fatigue is the most frequent, complex, multidimensional, and debilitating symptom in patients with advanced medical conditions. In the majority of palliative care patients, the aetiology of fatigue is multifactorial and the most common factors associated with fatigue include anorexia/cachexia, anxiety, depression, shortness of breath, sleep disturbances, anaemia, and inflammation. Routine screening for fatigue is essential for optimal assessment of fatigue and history and investigations should always be individualized. Management should initially aim towards identification and treatment of the reversible/underlying causes; however, if there are no reversible causes identified or if the fatigue is not responsive to specific treatments, symptomatic treatment should be considered. For optimal management the multidimensional components of fatigue should be assessed and future research is needed on the use of non-pharmacological treatment such as physical activity, counselling, and/or pharmacological agents such as a trial of psychostimulants or short course of corticosteroids.

Fatigue

2021 ◽  
pp. 685-697
Author(s):  
Sriram Yennurajalingam ◽  
Eduardo Bruera
Keyword(s):  
Palliative Care ◽  
Sleep Disturbances ◽  
Common Factors ◽  
Symptomatic Treatment ◽  
Shortness Of Breath ◽  
Initial Management ◽  
Pain Anxiety ◽  
Underlying Causes ◽  
Recent Activity ◽  
Anxiety Depression

Fatigue is the most frequent, complex, multidimensional, and debilitating symptom in patients with advanced life-limiting diseases. In cancer patients, it is defined as ‘distressing persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning’. In the majority of patients receiving palliative care, the aetiology of fatigue is multifactorial. The most common factors associated with fatigue include anorexia/cachexia, pain, anxiety, depression, shortness of breath, sleep disturbances, anaemia, and inflammation. Routine screening for fatigue is essential for optimal assessment of fatigue. Initial management should aim towards identification and treatment of the reversible/underlying causes However, if there are no reversible causes identified or if the fatigue is not responsive to specific treatments, symptomatic treatment should be considered.

scholarly journals Neuropsychiatric Adverse Events During 12 Months of Treatment with Efavirenz in a Treatment-Naïve HIV-Infected Population in China: A Prospective Cohort Study

2020 ◽  
Author(s):  
Lili Dai ◽  
Sen Wang ◽  
Ying Shao ◽  
Yali Wang ◽  
Jiangzhu Ye ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Adverse Events ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Sleep Disturbances ◽  
Neuropsychiatric Disorders ◽  
Factors Associated ◽  
Anxiety Depression

Abstract Background: Efavirenz (EFV) is a widely used antiretroviral therapy (ART), but side effect risks of neuropsychiatric adverse events (NPAEs) have not been investigated in Chinese populations receiving rapid ART. Methods: This prospective cohort study assessed HIV-infected patients initiating antiretroviral treatment with EFV to determine prevalence of and factors associated with NPAEs over a 12-month follow-up period using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Results: A total of 546 patients were enrolled. Prevalence of anxiety, depression, and sleep disturbances at baseline were 30.4%, 22.7%, and 68.1%, respectively. Six patients discontinued treatment due to drug related NPAEs. Treatment was associated with improvements in HADS-A, HADS-D, and PSQI scores over the 12-month follow-up, and the frequencies of patients with anxiety, depression, and sleep disturbances significantly decreased after 12 months. Abnormal baseline HADS-A, HADS-D, and PSQI scores and other factors, including high school education or lower, unemployment, divorce, and WHO III/IV stages, were associated with severe neuropsychiatric disorders over the 12 months. Conclusions: These findings suggested EFV-based first-line antiretroviral therapy was well-tolerated and associated with improvements in HADS-A, HADS-D, and PSQI scores. Certain risk factors associated with neuropsychiatric disorders may be useful in identifying HIV-infected patients at higher NPAE risk.

Hypnotic Use in the Elderly

1995 ◽  
Vol 8 (5) ◽  
pp. 208-216
Author(s):  
Judith L. Beizer
Keyword(s):  
Sleep Disturbances ◽  
The Elderly ◽  
Initial Therapy ◽  
Geriatric Population ◽  
Sleep Complaints ◽  
Psychiatric Illnesses ◽  
Short Course ◽  
Underlying Causes ◽  
Nocturnal Myoclonus ◽  
Systemic Side Effects

Sleep disturbances are a common complaint in the geriatric population. Studies have shown that older people have a different sleep architecture as compared with that of younger people. Older patients with sleep complaints should be evaluated for underlying causes of sleep disturbances such as medication use, medical or psychiatric illnesses. Common sleep disorders in the elderly include sleep apnea, nocturnal myoclonus, restless leg syndrome, and insomnia. To treat insomnia, initial therapy should be nonpharmacological measures such as good sleep hygiene. If pharmacological treatment is necessary, a short course with a low dose of a short or intermediate-acting benzodiazepine or Zolpidem can be attempted. Because of pharmacokinetic and pharmacodynamic alterations, elderly patients are particularly susceptible to the central nervous systemic side effects of hypnotic agents and should be closely monitored.

Unusual sleep experiences, dissociation, and schizotypy

2010 ◽  
Author(s):  
Erin Koffel ◽  
David Watson
Keyword(s):  
Substance Use ◽  
Personality Traits ◽  
Personality Trait ◽  
Sleep Disturbances ◽  
Higher Order ◽  
Future Research ◽  
Common Domain ◽  
State Boundaries ◽  
Anxiety Depression ◽  
Wake State

This paper reviews studies that have examined associations between unusual sleep experiences (including nightmares, vivid dreaming, narcolepsy symptoms, and complex nighttime behaviors) and dissociation and schizotypy. Using correlational studies and structural analyses, evidence is provided that unusual sleep experiences, dissociation, and schizotypy belong to a common domain. It is demonstrated that unusual sleep experiences show specificity to dissociation and schizotypy compared to other daytime symptoms (e.g., anxiety, depression, substance use) and other sleep disturbances (e.g., insomnia, lassitude/fatigue). The paper also outlines the methodological limitations of the existing evidence and makes suggestions for future research. Finally, three models for the overlap of daytime and nighttime symptoms are reviewed, including biological abnormalities, trauma, and personality traits. Although further research is needed, it is suggested that daytime and nighttime symptoms result from problems with sleep-wake state boundaries, which may be precipitated by stress or trauma. In addition, association between daytime and nighttime symptoms can be attributed to the higher order personality trait of Oddity.

scholarly journals Neuropsychiatric Adverse Events During 12 Months of Treatment With Efavirenz in Treatment-Naïve HIV-Infected Patients in China: A Prospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Wei Hua ◽  
Sen Wang ◽  
Xi Wang ◽  
Ying Shao ◽  
Yali Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Adverse Events ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Sleep Disturbances ◽  
Neuropsychiatric Disorders ◽  
Factors Associated ◽  
Anxiety Depression

Background: Efavirenz (EFV) is widely used in antiretroviral therapy (ART), but the incidence and risk factors of neuropsychiatric adverse events (NPAEs) after EFV treatment have rarely been studied in Chinese ART naïve patients.Methods: This prospective cohort study assessed HIV-infected patients initiating antiretroviral treatment with EFV to determine prevalence of and factors associated with NPAEs over a 12-month follow-up period using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI).Results: A total of 546 patients were enrolled. Prevalence of anxiety, depression, and sleep disturbances at baseline were 30.4, 22.7, and 68.1%, respectively. Six patients discontinued treatment due to drug related NPAEs. Treatment was associated with improvements in HADS-A, HADS-D, and PSQI scores over the 12-month follow-up, and the frequencies of patients with anxiety, depression, and sleep disturbances significantly decreased after 12 months. Abnormal baseline HADS-A, HADS-D, and PSQI scores and other factors, including high school education or lower income, unemployment, divorce, and WHO III/IV stages, were associated with severe neuropsychiatric disorders over the 12 months.Conclusions: These findings suggested EFV discontinuation due to NAPEs was low, and the HADS-A, HADS-D, and PSQI scores after 12 months of EFV treatment were associated with several risk factors. The clinicians should keep in mind and routinely screen for the risk factors associated with neuropsychiatric disorders in HIV-infected patients.

scholarly journals Hypnotherapy for Procedural Pain and Distress in Children: A scoping Review Protocol

Pain Medicine ◽  
2021 ◽  
Author(s):  
Daly Geagea ◽  
Zephanie Tyack ◽  
Roy Kimble ◽  
Lars Eriksson ◽  
Vince Polito ◽  
...  
Keyword(s):  
Scoping Review ◽  
Grey Literature ◽  
Cochrane Library ◽  
Procedural Pain ◽  
Future Research ◽  
Theoretical Frameworks ◽  
Eligibility Criteria ◽  
Pharmacological Agents ◽  
Review Protocol ◽  
Meta Analyses

Abstract Objective Inadequately treated pain and distress elicited by medical procedures can put children at higher risks of acute and chronic biopsychosocial sequelae. Children can benefit from hypnotherapy, a psychological tailored intervention, as an adjunct to pharmacological agents to address the multiple components of pain and distress. Despite providing evidence on the effectiveness and potential superiority of hypnotherapy to other psychological interventions, research on hypnotherapy for paediatric procedural pain and distress has been predominantly limited to oncology and needle procedures. Plus, there is a lack of reporting of intervention manuals, factors influencing hypnotic responding, pain unpleasantness outcomes, theoretical frameworks, adverse events, as well as barriers and facilitators to the feasibility of delivering the intervention and study procedures. The proposed review aims to map the range and nature of the evidence on hypnotherapy for procedural pain and distress in children to identify gaps in literature and areas requiring further investigation. Methods This review will follow the Arksey and O'Malley (2005) methodology and incorporate additional scoping review recommendations by The Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses. Relevant studies will be identified through searching published literature databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus and Web of Science) and grey literature in addition to hand-searching of reference lists and key journals. Two authors will independently screen titles and abstracts of search results followed by full-texts review against eligibility criteria. Conclusion Findings are anticipated to guide future research and inform the development of tailored hypnotic interventions in children.

A Scoping Review of Resilience in Survivors of Human Trafficking

2021 ◽  
pp. 152483802098556
Author(s):  
Logan Knight ◽  
Yitong Xin ◽  
Cecilia Mengo
Keyword(s):  
Interpersonal Relationships ◽  
Scoping Review ◽  
National Origin ◽  
Future Research ◽  
Research Needs ◽  
Standardized Measures ◽  
Factors Associated ◽  
Current State ◽  
Case Files ◽  
Sexual Trafficking

Resilience is critical among survivors of trafficking as they are mostly vulnerable populations who face multiple adversities before, during, and after trafficking. However, resilience in survivors of trafficking is understudied. This scoping review aims to clarify the current state of knowledge, focusing on definitions of resilience, how resilience has been studied, and factors associated with resilience among survivors. Five databases were searched using key words related to trafficking and resilience. Studies were included if they were published in English between 2000 and 2019 and focused on resilience with the study design including at least one of these four features: (a) use of standardized measures of resilience, (b) qualitative descriptions of resilience, (c) participants were survivors or professionals serving survivors, and (d) data sources such as case files or program manuals directly pertained to survivors. Eighteen studies were identified. Findings indicated that resilience was primarily described as emergent from interactions between the survivor and the environment. Resilience in trafficking appeared largely similar to resilience in other kinds of victimization. Nonetheless, trafficking survivors also may display resilience in alternative ways such as refusing treatment. Positive interpersonal relationships were the most commonly mentioned resilience factor. In addition, current research lacks studies featuring longitudinal designs, interventions, participatory methods, types of trafficking other than sexual trafficking, and demographic characteristics such as age, gender, and national origin. Future research needs to establish definitions and measures of resilience that are culturally and contextually relevant to survivors and build knowledge necessary for designing and evaluating resilience-enhancing interventions.

scholarly journals AB0862 CONSENSUS STATEMENT ON INTRA-ARTICULAR INJECTIONS OF PLATELET-RICH PLASMA FOR THE MANAGEMENT OF KNEE OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1738.3-1738
Author(s):  
F. Eymard ◽  
P. Ornetti ◽  
J. Maillet ◽  
E. Noel ◽  
P. Adam ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Task Force ◽  
Platelet Rich Plasma ◽  
Symptomatic Treatment ◽  
Future Research ◽  
List Type ◽  
Clinical Practices ◽  
Efficient Treatment ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee

Background:There has been much debate regarding the use of intra-articular injections of platelet-rich plasma (PRP) as symptomatic treatment for knee osteoarthritis. The heterogeneity of the preparation and injection protocols limits the extrapolation of data from randomized controlled trials and meta-analyses.Objectives:The objective of this expert consensus was to develop the first clinical practice recommendations for PRP injections in knee osteoarthritis.Methods:Fifteen physicians (10 rheumatologists, 4 specialists in rehabilitation and sport medicine and 1 interventional radiologist) from different countries were selected given to their expertise in the fields of PRP and osteoarthritis. Twenty-five recommendations were finally retained after several meetings using the modified Delphi method to establish clinical consensus. All experts voted their agreement or not for each recommendation using a score between 1 (totally inappropriate) and 9 (totally appropriate). Depending on the median value and extreme scores, recommendations were judged as appropriated or unappropriated with a strong or relative agreement but could also be judged as uncertain due to indecision or absence of consensus.Results:The main recommendations are listed below:- Intra-articular injections of PRP constitute an efficient treatment of early or moderate symptomatic knee osteoarthritis. Median = 8 [6-9] – Appropriate. Relative agreement.- Intra-articular injections of PRP may be useful in severe knee osteoarthritis (Kellgren-Lawrence grade IV). Median = 7 [6-7] – Appropriate. Relative agreement.- Intra-articular injections of PRP in knee osteoarthritis should be proposed as second-line therapy, after failure of non-pharmacological and pharmacological (oral and topic) symptomatic treatment. Median = 9 [5-9] – Appropriate. Relative agreement.- Intra-articular injections of PRP should not be performed in osteoarthritis flare-up with significant effusion. Median = 7 [5-9] – Appropriate. Relative agreement.- Intra-articular PRP treatment may include 1 to 3 consecutive injections. Median = 9 [7-9] – Appropriate. Strong agreement.- Leukocyte-poor PRP should be preferred for knee OA treatment. Median = 8 [5-9] – Appropriate. Relative agreement.- PRP injections should be performed under ultrasound or fluoroscopic guidance. Median = 8 [3-9] – Uncertain. No consensus.- PRP should not be mixed with injectable anesthetic or corticosteroid. Median = 9 [6-9] – Appropriate. Relative agreement.Conclusion:Twenty-five recommendations were discussed by an international multidisciplinary task force group in order to provide a basis for standardization of clinical practices and future research protocols.Disclosure of Interests:Florent Eymard Consultant of: Regenlab, Paul Ornetti: None declared, Jérémy Maillet Consultant of: Regenlab, Eric Noel Consultant of: Regenlab, Philippe Adam Consultant of: Regenlab, Virginie Legré Boyer Consultant of: Regenlab, Thierry Boyer Consultant of: Regenlab, Fadoua Allali: None declared, Vincent Grémeaux Bader: None declared, Jean-François Kaux: None declared, Karine Louati: None declared, Martin Lamontagne Consultant of: Pendopharm, Fabrice Michel: None declared, Pascal Richette: None declared, Hervé Bard Consultant of: Regenlab

scholarly journals Impact of Shift Work and Long Working Hours on Worker Cognitive Functions: Current Evidence and Future Research Needs

2021 ◽  
Vol 18 (12) ◽  
pp. 6540
Author(s):  
Veruscka Leso ◽  
Luca Fontana ◽  
Angela Caturano ◽  
Ilaria Vetrani ◽  
Mauro Fedele ◽  
...  
Keyword(s):  
Circadian Rhythm ◽  
Cognitive Impairment ◽  
Sleep Disturbances ◽  
Working Hours ◽  
Night Work ◽  
Current Evidence ◽  
Future Research ◽  
Negative Effects ◽  
Long Working Hours ◽  
Main Determinants

Particular working conditions and/or organization of working time may cause important sleep disturbances that have been proposed to be predictive of cognitive decline. In this regard, circadian rhythm misalignment induced by exposure to night work or long working hours would be responsible for cognitive impairment. Nevertheless, evidence supporting this correlation is limited and several issues still need to be elucidated. In this regard, we conducted a systematic review to evaluate the association between shift/night work and cognitive impairment and address its main determinants. Information provided by the reviewed studies suggested that night work might have serious immediate negative effects especially on cognitive domains related to attention, memory and response inhibition. Furthermore, cognitive performance would progressively worsen over consecutive night shifts or following exposure to very long work shifts. Otherwise, conflicting results emerged regarding the possible etiological role that night work chronic exposure would have on cognitive impairment. Therefore, circadian rhythm desynchronization, lack of sleep and fatigue resulting from night work may negatively impact worker’s cognitive efficiency. However, in light of the considerable methodological variability of the reviewed studies, we proposed to develop a standardized research and evaluation strategy in order to obtain a better and comprehensive understanding of this topic.

Psychopathological Factors Associated With Burnout in Intensive Care Nurses: A Cross-Sectional Study

2021 ◽  
pp. 107839032199972
Author(s):  
Erman Yıldız
Keyword(s):  
Intensive Care ◽  
Emotional Exhaustion ◽  
Cross Sectional Study ◽  
Personal Accomplishment ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Anxiety Depression ◽  
The Relationship

BACKGROUND: Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses. AIMS: To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses. METHOD: A cross-sectional study was conducted with ICU nurses ( N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis. RESULTS: The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment. CONCLUSIONS: While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.

Sign in / Sign up

Export Citation Format

Share Document