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Lupus Jun 2024In this pilot study, we used untargeted metabolomics to identify biochemical mechanisms or biomarkers potentially underlying SLE-related fatigue.
OBJECTIVE
In this pilot study, we used untargeted metabolomics to identify biochemical mechanisms or biomarkers potentially underlying SLE-related fatigue.
METHODS
Metabolon conducted untargeted metabolomic plasma profiling using ultrahigh performance liquid chromatography/tandem mass spectrometry on plasma samples of 23 Black females with systemic lupus erythematosus (SLE) and 21 no SLE controls. Fatigue phenotypes of general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation were measured with the reliable and valid Multidimensional Fatigue Inventory (MFI).
RESULTS
A total of 290 metabolites were significantly different between the SLE and no SLE groups, encompassing metabolites related to glycolysis, TCA cycle activity, heme catabolism, branched chain amino acids, fatty acid metabolism, and steroids. Within the SLE group, controlling for age and co-morbidities, TCA cycle metabolites of alpha-ketoglutarate (AKG) and succinate were statistically significantly associated ( < .05) with physical and general fatigue.
CONCLUSION
While pervasive perturbations in the entire TCA cycle have been implicated as a potential mechanism for fatigue, our results suggest individual metabolites of AKG and succinate may be potential biomarkers or targets of intervention for fatigue symptom management in SLE. Additionally, perturbations in heme metabolism in the SLE group provide additional insights into mechanisms that promote systemic inflammation.
PubMed: 38885489
DOI: 10.1177/09612033241260334 -
Discover Oncology Jun 2024Patients with non-small cell lung cancer (NSCLC) in the postoperative recovery period often experience reduced exercise capacity and impaired lung function, which...
UNLABELLED
Patients with non-small cell lung cancer (NSCLC) in the postoperative recovery period often experience reduced exercise capacity and impaired lung function, which affects their overall quality of life. This paper investigated the effect of exercise interventions on exercise capacity, lung function, quality of life, and symptoms in these patients.
METHODS
We performed a literature search across Cochrane, Embase, PubMed, Web of Science, and EBSCO databases were comprehensively searched for randomized controlled trials (RCTs) from inception to September 2023, all English RCTs were eligible if they assessed the effects of exercise interventions on postoperative NSCLC patients.
RESULTS
Twelve articles met our inclusion criteria, evidencing that exercise interventions could significantly improve the functional capacity of NSCLC patients in postoperative recovery. Notably, Forced Expiratory Volume in 1 s (FEV1) was improved, indicating enhanced lung function. Furthermore, exercise improved the physical and mental health scores of SF-36, along with increased quadriceps strength and relieved dyspnea. However, fatigue levels were not significantly changed.
CONCLUSIONS
Exercise interventions of NSCLC patients in the postoperative recovery are associated with improved functional capacity, lung function, quality of life, and quadriceps strength, as well as alleviated symptoms of dyspnea. These findings underscore the potential benefits of incorporating exercise into postoperative care for NSCLC patients. Nonetheless, further large-scale RCTs are required to solidify the evidence base on the clinical outcomes of exercise following pneumonectomy.
PubMed: 38884823
DOI: 10.1007/s12672-024-01079-w -
Acta Oncologica (Stockholm, Sweden) Jun 2024The Region of Southern Denmark has recently established four late effects clinics to help cancer survivors suffering from complex and severe late effects. This study...
PURPOSE
The Region of Southern Denmark has recently established four late effects clinics to help cancer survivors suffering from complex and severe late effects. This study aimed to capture and analyze the full range of physical, mental, and psychosocial issues using patient-reported outcomes. Moreover, we aimed to describe demographic data and the type and severity of the late effects.
METHODS
A prospective cohort study was conducted among cancer survivors referred to a late effects clinic. Before their first appointment, patients completed the European Organization for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire (EORTC QLQ-SURV100). We compared mean scores of the EORTC QLQ-SURV100 scales that were comparable to the scales/items from the EORTC QLQ-C30 questionnaire with norm data for the Danish population and EORTC reference values.
RESULTS
All patients referred to the clinic within its first 2 years were included (n = 247). The mean age was 57 [23-85] years and 74% were females. The most common cancer diagnoses was breast cancer (39%). The five most commonly reported late effects were fatigue (66%), pain (51%), cognitive impairment (53%), sleep problems (42%), and neuropathy (40%). A total of 236 of the patients entering the clinic completed QLQ-SURV100. They reported significantly worse mean scores on all scales compared to the Danish norm population and EORTC reference values for pretreatment cancer patients, p < 0.001. Effect sizes were moderate or large for all scales.
INTERPRETATION
In this study, we collected demographic data and described the late effects presented by the patents referred to the clinic. Moreover, we captured and analyzed the full range of physical, mental, and psychosocial issues using QLQ-SURV100. Patients referred to the Late Effects Clinic (LEC) had a number of late effects and reported a significantly lower health-related quality of life compared to the general Danish population and patients who have just been diagnosed with cancer, suggesting the aim of helping patients suffering from late effects gain a better quality of life is in dire need.
Topics: Humans; Quality of Life; Female; Male; Prospective Studies; Denmark; Middle Aged; Aged; Adult; Cancer Survivors; Aged, 80 and over; Neoplasms; Young Adult; Surveys and Questionnaires; Patient Reported Outcome Measures; Fatigue; Sleep Wake Disorders
PubMed: 38881340
DOI: 10.2340/1651-226X.2024.39937 -
BMC Public Health Jun 2024In the working population, there are risks of overload due to physical, mental, and emotional demands. No instrument is available in Spanish to measure these three types...
BACKGROUND
In the working population, there are risks of overload due to physical, mental, and emotional demands. No instrument is available in Spanish to measure these three types of work fatigue (WF) separately. This paper adapts the Three-Dimensional Work Fatigue Inventory (3D-WFI) (2015), which is of American origin and measures and differentiates these three different types of WF. It has adequate psychometric properties at its root, as do the subsequent German (2018), Lebanese (2022), and Chinese (2023) adaptations.
METHODS
A total of 1100 workers (average age = 40 years) from economic sectors such as security and transportation of valuables, secondary and university educational institutions, and healthcare centers participated. They responded to the 3D-WFI, the Health-Related Quality of Life Index, and the Individual Strength Checklist for concurrent validity effects, together with items with sociodemographic and lifestyle variables.
RESULTS
A confirmatory factor analysis with the total sample 3D-WFI supports its three-dimensionality; Cronbach's alpha and Omega values are adequate by dimensions: for physical work fatigue (α = 0.92, Ω = 0.92), for mental work fatigue (α = 0.94. Ω = 0.94), and emotional work fatigue (α = 0.95, Ω = 0.95). The 3D-WFI correlates significantly with the Checklist Individual Strength (0.743), and a pattern of significant relationships is found between WF and antecedent variables (e.g., being exposed to heat and noise, emotional labor, concentration, and workwear), as well as some consequences of WF (for example, mental health, absenteeism, work satisfaction, and sleep quality).
CONCLUSIONS
We contribute here to the cross-cultural validity of the 3D-WFI, which can be used reliably and validly in the Chilean and probably Latin American working population. Some WF predictor variables are confirmed, as well as WF impacts on the absenteeism, health, and quality of life among workers.
Topics: Humans; Adult; Male; Female; Psychometrics; Fatigue; Factor Analysis, Statistical; Middle Aged; Reproducibility of Results; Surveys and Questionnaires; Spain; Young Adult; Quality of Life
PubMed: 38880877
DOI: 10.1186/s12889-024-19120-6 -
Psycho-oncology Jun 2024Following a cancer diagnosis, restricted participation in daily life is common. Restricted participation can be temporary or long lasting. The aim of this study was to...
"If I have a limited amount of time left, this is not how I want to spend it": A qualitative descriptive study of factors influencing daily life participation following a cancer diagnosis.
OBJECTIVE
Following a cancer diagnosis, restricted participation in daily life is common. Restricted participation can be temporary or long lasting. The aim of this study was to characterize how daily life participation is impacted following a cancer diagnosis.
METHODS
Eligible individuals included adults (>18 years) with any stage/grade brain, breast, colorectal, or lung cancer in any phase of treatment or post-treatment. Participants completed a semi-structured interview about how their life participation was impacted following their cancer diagnosis. Data were analyzed through team-based thematic analysis.
RESULTS
Forty adults, 10 per disease category, participated. Four themes were identified that supported or hindered daily life participation: (1) self-expectations, (2) expectations of others, (3) awareness of mortality, and (4) symptoms and side effects of cancer. Participants discussed how their cancer experience resulted in a reprioritization of what they valued doing in their life. However, many survivors struggled to adapt and described a tension between their need to adapt to their current life circumstances and their contrasting desire to stay connected with their pre-cancer selves through daily life participation. The mental health challenges associated with decreased participation were also outlined by participants.
CONCLUSIONS
Cancer survivors' daily life participation is influenced by expectations from themselves and others, awareness of mortality, and disease symptoms/side effects. Future interventions can target these domains to supports survivors' life participation.
Topics: Humans; Female; Male; Middle Aged; Qualitative Research; Neoplasms; Aged; Adult; Activities of Daily Living; Adaptation, Psychological; Cancer Survivors; Quality of Life; Aged, 80 and over; Interviews as Topic
PubMed: 38880761
DOI: 10.1002/pon.6366 -
Multiple Sclerosis and Related Disorders Jun 2024Chronic fatigue is one of the most common, disabling, and least understood symptoms of many chronic health conditions including multiple sclerosis (MS). A...
BACKGROUND
Chronic fatigue is one of the most common, disabling, and least understood symptoms of many chronic health conditions including multiple sclerosis (MS). A multidisciplinary rehabilitative treatment approach is recommended for MS-related fatigue, but few people with MS have access to such treatment. In-person and telehealth cognitive behavioral therapy (CBT) for fatigue is an emerging acceptable and effective treatment for MS-related fatigue in civilians that has not been studied in Veterans with MS, a population that is more likely to be older, male, unemployed, and disabled. The present study aimed to understand how Veterans with MS (1) describe their fatigue and (2) manage their fatigue, and (3) perceive telehealth CBT for MS-related fatigue.
METHOD
Twenty-four Veterans with MS completed semi-structured interviews and a brief survey. For descriptive purposes, the survey included questionnaires on demographics, fatigue, psychosocial functioning, depression, and pain. Thematic analysis with a combined deductive and inductive approach was used to analyze interview transcripts.
RESULTS
Three themes emerged. First, "experience of MS fatigue as 'one big tapestry'" described fatigue as deficits in physical and mental energy that were fluctuating and complex in their interaction with biological factors. Veterans described that MS fatigue negatively impacted daily activities of living, emotions, and cognitive functioning. Second, "managing MS fatigue through trial and error" revealed that Veterans expend significant time and effort learning and trialing fatigue management strategies based on their personal beliefs, military training/experiences, provider recommendations, and iterative learning. Most Veterans described energy management, relaxation, exercise, and adaptive thinking as helpful for managing fatigue. Interestingly, the helpfulness of medication for fatigue was highly variable, and none of the Veterans described medication as a standalone fatigue treatment. The third theme, "practicing flexibility with telehealth CBT for MS fatigue" revealed Veteran's enthusiasm about telehealth CBT for MS-related fatigue and highlighted the importance of flexible delivery to meet individual needs.
CONCLUSION
Veteran participants shared their experience of MS-related fatigue as well as management strategies that are consistent with previous research in civilians with MS fatigue. Notably, Veterans' preference for flexible nonpharmacological intervention can inform adaptation of telehealth CBT for Veterans with MS fatigue.
PubMed: 38880030
DOI: 10.1016/j.msard.2024.105716 -
BMC Pregnancy and Childbirth Jun 2024Postpartum depression is a complex mental health condition that often occurs after childbirth and is characterized by persistent sadness, anxiety, and fatigue. Recent...
BACKGROUND
Postpartum depression is a complex mental health condition that often occurs after childbirth and is characterized by persistent sadness, anxiety, and fatigue. Recent research suggests a metabolic component to the disorder. This study aims to investigate the causal relationship between blood metabolites and postpartum depression using mendelian randomization (MR).
METHODS
This study used a bi-directional MR framework to investigate the causal relationship between 1,400 metabolic biomarkers and postpartum depression. We used two specific genome-wide association studies datasets: one with single nucleotide polymorphisms data from mothers diagnosed with postpartum depression and another with blood metabolite data, both of which focused on people of European ancestry. Genetic variants were chosen as instrumental variables from both datasets using strict criteria to improve the robustness of the MR analysis. The combination of these datasets enabled a thorough examination of genetic influences on metabolic profiles associated with postpartum depression. Statistical analyses were conducted using techniques such as inverse variance weighting, weighted median, and model-based estimation, which enabled rigorous causal inference from the observed associations. postpartum depression was defined using endpoint definitions approved by the FinnGen study's clinical expert groups, which included leading experts in their respective medical fields.
RESULTS
The MR analysis identified seven metabolites that could be linked to postpartum depression. Out of these, one metabolite was found to be protective, while six were associated with an increased risk of developing the condition. The results were consistent across multiple MR methods, indicating a significant correlation.
CONCLUSIONS
This study emphasizes the potential of metabolomics for understanding postpartum depression. The discovery of specific metabolites associated with the condition sheds new insights on its pathophysiology and opens up possibilities for future research into targeted treatment strategies.
Topics: Humans; Depression, Postpartum; Female; Mendelian Randomization Analysis; Genome-Wide Association Study; Polymorphism, Single Nucleotide; Metabolomics; Biomarkers; Adult; White People; Pregnancy
PubMed: 38877415
DOI: 10.1186/s12884-024-06628-3 -
La Revue de Medecine Interne Jun 2024Functional somatic disorders (FSD) are common conditions that result in a significant deterioration of the quality of life. Their origin is multifactorial and poorly... (Review)
Review
Functional somatic disorders (FSD) are common conditions that result in a significant deterioration of the quality of life. Their origin is multifactorial and poorly understood, and their management is often inadequately defined. Medications typically show limited effectiveness, while mind-body approaches play a central role, guided by three key principles: establishing an empathetic, respectful, and sincere doctor-patient relationship; promoting regular and gradual physical activity; and implementing cognitive behavioral therapy (CBT). Special attention must be devoted to establishing a trustworthy relationship between the physician and the patient. Recognizing the reality and severity of symptoms and providing a positive diagnosis as well as an explanatory model to account for them rationally are fundamental aspects of patient management. Cognitive and behavioral maintenance factors should be investigated and constitute therapeutic targets. Cognitive factors include focused attention on body functioning and catastrophizing. Patients frequently display avoidance behaviors, particularly in relation to physical exertion, and it is crucial to motivate them to reintroduce gradual physical activity customized to their abilities. This approach has demonstrated efficacy in improving fatigue, pain, and the physical and mental quality of life for patients with FSD. Among psychotherapeutic approaches, the benefit of CBT is well-established. The combination of gradual physical activity and CBT appears to be complementary. Other mind-body approaches such as mindfulness meditation might help although their level of evidence is weaker. Given the prevalence of FSD in the general population, it seems necessary for all physicians to be trained in managing this condition.
PubMed: 38876948
DOI: 10.1016/j.revmed.2024.05.025 -
European Journal of Sport Science Jun 2024Perception of Velocity (PV) is the ability to estimate single repetition velocity during resistance training (RT) exercises. The main purpose of the study was to...
Perception of Velocity (PV) is the ability to estimate single repetition velocity during resistance training (RT) exercises. The main purpose of the study was to evaluate the effects of Mental Fatigue (MF) on the accuracy of barbell PV. The secondary aims were to evaluate whether MF affected RT performance and ratings of perceived exertion (RPE; OMNI-RES) in the back squat. Twenty-four (14 Females, 10 Males) resistance-trained participants underwent 2 familiarization sessions and 1RM test for the back squat. In two separate sessions, PV was tested for light, medium, and heavy loads in 2 conditions in random order: at rest (REST) and in MF condition (POST-MF) induced by previous incongruent Stroop color-word task. MF and Motivation were assessed through visual analog scales (VAS; 0-100) before and after the Stroop task. For each load subjects performed 2 repetitions and reported the RPE value. Mean propulsive velocity (Vr) of the barbell was recorded with a linear encoder, while the perceived velocity (Vp) of the subjects was self-reported using the Squat-PV scale. The PV accuracy was calculated through the delta score (ds: Vp-Vr). Following the Stroop task MF increased significantly (p < 0.001; F (1, 23) = 52.572), while motivation decreased (p < 0.05; F (1, 23) = 7.401). Ds, Vr, and RPE did not show significant differences between conditions (p > 0.05) for the three loads analyzed. MF induced by previous demanding cognitive task did not affect PV accuracy. Furthermore, subjects maintained unchanged both RT performance and RPE values associated with each load, even when mentally fatigued.
Topics: Humans; Male; Female; Resistance Training; Mental Fatigue; Young Adult; Adult; Perception; Physical Exertion; Stroop Test; Motivation; Weight Lifting
PubMed: 38874957
DOI: 10.1002/ejsc.12105 -
Journal of Evaluation in Clinical... Jun 2024Autogenic training (AT) is a structured meditative-style practice, consisting of a sequence of simple mental exercises intended to induce a relaxed state in patients....
BACKGROUND
Autogenic training (AT) is a structured meditative-style practice, consisting of a sequence of simple mental exercises intended to induce a relaxed state in patients. There is some emerging evidence to suggest that AT can be effective in treating certain chronic conditions, however, further evidence is required. A service evaluation of AT services at the Royal London Hospital for Integrated Medicine was conducted to evaluate the impact of AT on patients with chronic conditions.
METHODS
The service evaluation consisted of the completion of validated quantitative outcome measures pre and posttreatment to explore the impact of AT. AT patients were asked to complete the Measure Yourself Medical Outcomes Profile (MYMOP) and Perceived Stress Scale (PSS) at their first hospital appointment (baseline) and then again 8 weeks later following completion of their AT sessions. Pre- and posttreatment scores for each outcome measure were analysed in SPSS using the Wilcoxon signed-rank test.
RESULTS
One hundred ninety-nine patients completed both initial and follow-up MYMOP forms and were included in the evaluation. The most common presenting complaints for MYMOP symptom 1 were prolonged anxiety/stress and depression (n = 70, 35.2%), chronic pain and migraine headache (n = 44, 22.1%), chronic insomnia and sleep problems (n = 42, 21.1%) and, long-term exhaustion and fatigue (n = 18, 9%). The change in median score pre- and posttreatment for all MYMOP categories (symptoms, activity and well-being) were statistically highly significant p < 0.001. Anxiety, stress, depression, pain and insomnia were the symptoms that had the largest statistically significant difference between the median score pre- and posttreatment. Fifty-five patients completed the PSS questionnaire at two time points (pre- and posttreatment). It showed a highly statistically significant change in PSS median score in patients experiencing stress (p < 0.001).
DISCUSSION
The findings of the evaluation indicate that 8 weeks of AT appears to be effective in improving symptoms of concern to patients and enhancing patients' overall well-being. In particular, AT was found to be beneficial for patients with symptoms of anxiety, stress, depression, pain and insomnia.
PubMed: 38873764
DOI: 10.1111/jep.14014