PURPOSE: To evaluate the clinical symptoms, useful diagnostic tools and radiological findings and results of treatment on naviculocuneiform coalition. MATERIALS AND METHODS: Nineteen cases, in 11 patients with naviculocuneiform coalition were reviewed by specific clinical manifestations. Radiological results, invasive degree and morphology of the coalition were measured on plain radiographs, CT, and bone scan. The suit-ability of bone scan and the characteristic morphology of coalition on the CT were reviewed. RESULTS: The chief complaints were fatigue, pain and tenderness on the plantar surface of the midfoot. The average degree of invasion was 37% and no difference was evident between the symptomatic and asymptomatic group in this respect. According to the morphology of coali-tion, there were cause of irregular (5 cases), cystic (2 cases), and mixed type (12 cases). CT was the most effective test for diagnosis and char-acterizing the morphology. If pain remained after conservative treatment for 6 months, fusion of the naviculocuneiform joint was performed (2cases), which proved effective. CONCLUSION: Disorders of the naviculocuneiform coalition are uncommon but the diagnosis may be established more frequently and earli-er with increasing awareness of the condition. CT was the most reliable test for evaluating naviculocuneiform coalitions and for demon-strating its characteristic morphology. Conservative treatment is effective in most patients.
Diagnosis ; Fatigue ; Humans ; Joints

This paper points out that the sub-health state is not equal to chronic fatigue syndrome (CFS) on basis of elaborating the concept and category of sub-health. And the present understanding on concepts of fatigue, chronic fatigue and CFS, as well as the diagnosis criteria and differential diagnosis of CFS are discussed systematically.
Chronic Disease ; Diagnosis, Differential ; Fatigue ; diagnosis ; Fatigue Syndrome, Chronic ; diagnosis ; Fibromyalgia ; diagnosis ; Humans ; Terminology as Topic

Heart rate variability (HRV) is an important point to judge a person's state in modern medicine. This paper is aimed to research a person's fatigue level connected with vagal nerve based on the HRV using the improved Welch method. The process of this method is that it firstly uses a time window function on the signal to be processed, then sets the length of time according to the requirement, and finally makes frequency domain analysis. Compared with classical periodogram method, the variance and consistency of the present method have been improved. We can set time span freely using this method (at present, the time of international standard to measure HRV is 5 minutes). This paper analyses the HRV's characteristics of fatigue crowd based on the database provided by Physio-Net. We therefore draw the conclusion that the accuracy of Welch analyzing HRV combining with appropriate window function has been improved enormously, and when the person changes to fatigue, the vagal activity is diminished and sympathetic activity is raised.
Fatigue ; diagnosis ; Heart Rate ; Humans ; Regression Analysis

BACKGROUND: Disabling fatigue is common in the working age population. It is essential that occupational health (OH) professionals are up-to-date with the management of fatigue in order to reduce the impact of fatigue on workplace productivity. Our aim was to evaluate the impact of one-day workshops on OH professionals' knowledge of fatigue and chronic fatigue syndrome (CFS), and their confidence in diagnosing and managing these in a working population. METHODS: Five interactive problem-based workshops were held in the United Kingdom. These workshops were developed and delivered by experts in the field. Questionnaires were self-administered immediately prior to, immediately after, and 4 months following each workshop. Questionnaires included measures of satisfaction, knowledge of fatigue and CFS, and confidence in diagnosing and managing fatigue. Open-ended questions were used to elicit feedback about the workshops. RESULTS: General knowledge of fatigue increased significantly after training (with a 25% increase in the median score). Participants showed significantly higher levels of confidence in diagnosing and managing CFS (with a 62.5% increase in the median score), and high scores were maintained 4 months after the workshops. OH physicians scored higher on knowledge and confidence than nurses. Similarly, thematic analysis revealed that participants had increased knowledge and confidence after attending the workshops. CONCLUSION: Fatigue can lead to severe functional impairment with adverse workplace outcomes. One-day workshops can be effective in training OH professionals in how to diagnose and manage fatigue and CFS. Training may increase general knowledge of fatigue and confidence in fatigue management in an OH setting.
Diagnosis ; Education* ; Efficiency ; Fatigue Syndrome, Chronic ; Fatigue* ; Great Britain* ; Occupational Health* ; Surveys and Questionnaires

BACKGROUND: The mechanism of fatigue in patients with fibromyalgia (FM) and CFS (CFS) has not been clarified, but recently there are opinions that chronic pain is a major factor causing chronic fatigue. We performed this study to identify major factors related to chronic fatigue. METHODS: The subjects were 37 patients aged over 18 who visited the primary care institute of a university hospital, whose major symptoms were chronic widespread pain and chronic fatigue and who were given the diagnosis of FM or CFS. The research was carried out through four weeks of symptomatic treatment. The correlation of fatigue severity with the intensity of pain, depression level and anxiety level was analyzed, and regression analysis was conducted to examine the relation between improvement of fatigue after the four weeks' treatment and changes in the intensity of pain, depression level and anxiety level. RESULTS: After the four week treatment, only the intensity of pain was significantly correlatied with fatigue severity. In addition, only change in the intensity of pain was statistically significantly correlatied with the improvement of fatigue. CONCLUSION: In patients who complained of chronic fatigue and chronic widespread pain, the improvement of fatigue after treatment was related to the reduction of pain but not emotional factors such as depression and anxiety.
Anxiety ; Chronic Pain ; Depression ; Diagnosis ; Fatigue Syndrome, Chronic ; Fatigue* ; Fibromyalgia ; Humans ; Primary Health Care

Fatigue is probably the most common symptom from both acute and chronic illnesses. It can be defined as a pervasive sense of tiredness or lack of energy that may not be related to exertion. Fatigue is transitory in most cases, however, if it is prolonged or disabling, a significant problem such as chronic fatigue syndrome (CFS) may be warranted. CFS is a complex, debilitating disorder characterized by severe persistent or relapsing fatigue for at least 6 months and a group of characteristic but nonspecific symptoms. Many researchers have proposed that CFS has a specific underlying cause. Currently, however, there is no evidence that supports this view. In addition, since there is no specific physical findings or definitive laboratory tests for consistent biological markers, the diagnosis of CFS depends on operational criteria that do not afford validity and is primarily a diagnosis by exclusion. The prognosis is poor and often the disability and impairment of daily function and performance may be prolonged. The limited understanding of CFS has complicated the management of this disorder. Therefore, the treatment of CFS may be variable and should be tailored to each patient-it should include exercise, diet, good sleep hygiene, antidepressants, and other medications, depending on the patient's clinical presentation.
Antidepressive Agents ; Biomarkers ; Chronic Disease ; Diagnosis ; Diet ; Fatigue ; Fatigue Syndrome, Chronic* ; Hygiene ; Prognosis

PURPOSE: This study investigated the degree of fatigue of hemodialysis patients, and finds the relationship between fatigue and self-efficacy, family support, and sleep factor. Also, this study was purposed to provide fundamental data to help set up a nursing plan and intervention for recovery and mitigation of hemodialysis patient's fatigue. METHOD: The subjects in this study were patients treated as hemodialysis patients in Kwangjoo City. Data, subjects are 143 patients. Fatigue was measured using Lee's scale(1991), Self-efficacy using Kim's scale(1995), and Family support using Kim's scale(1993). For the analysis of collected data, Cronbach alpha, descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, Stepwise multiple regression were used for statistical analysis by SPSSwin(version 11.0) program. RESULT: Fatigue degree of hemodialysis patients averaged 4.22. Among 143 hemodialysis patients, 70.63% patients answered that they had felt fatigue as noted in this study. The weariest time was after hemodialysis for 21.0% patients. There was significant difference according to the diagnosis period. The patients who were diagnosed over one year had felt more fatigue than ones who were diagnosed within one year. Fatigue was significantly associated with self-efficacy, family support, and sleep factor. Self-efficacy could explain 14.6% of fatigue. CONCLUSION: The fatigue degree relates with all, self-efficacy, family support, and sleep factor. Especially, it is affected by self-efficacy among them. Thus, the program should be developed to mitigate fatigue as the self-efficacy of hemodialysis is enhanced.
Diagnosis ; Fatigue* ; Humans ; Nursing ; Renal Dialysis* ; Self Efficacy*

PURPOSE: As the number of infertile couples has grown, many infertile women have experienced depression during the diagnosis and treatment of their infertility. This study aimed to identify the factors related to depression in infertile women who underwent reproductive treatments. METHODS: The study subjects were 149 infertile women who underwent reproductive treatments. The data were collected by self-administered questionnaires from August 1 to December 24, 2018. The questionnaire consisted of questions about fatigue, health-promoting behavior, and depression. Analyses of the descriptive statistics, t-tests, one-way analysis of variance, correlation, and multiple regression were conducted using the SPSS 25.0 Windows program. RESULTS: Thirty-six of the women in the study (24.2%) were in the probably depressed group and 113 (75.8%) were in the definitely depressed group and 100% of the subjects experienced symptoms of depression. Depression was positively correlated with fatigue and negatively correlated with health-promoting behavior. Multiple regression analysis revealed that fatigue and interpersonal relationships were factors significantly related to depression in the model (p<.001), with an explanatory power of 42.6%. CONCLUSION: The results confirmed that fatigue and interpersonal relationships, which is a subfactor of health-promoting behavior, were factors related to depression. To alleviate depression in infertile women, efforts should be made to identify and reduce psychological and physical fatigue. In addition, minimizing relational difficulties that they experience during an infertility diagnosis and treatment and strengthening positive interpersonal relationships can be positive strategies to alleviate depression.
Depression ; Diagnosis ; Family Characteristics ; Fatigue ; Female ; Health Promotion ; Humans ; Infertility

The chronic fatigue immune dysfunction syndrome (abbreviated CFIDS or CFS) is a disorder characterized by debilitating fatigue(over 6 months), along with cognitive, musculoskeletal, and sleep abnormalities. The etiology of this illness is unlikely to be a single agent. Findings to date suggest that physiological and psychological factors work together to predispose and perpetuate the illness. Diagnosis is made difficult by the nonspecific clinical findings and no available diagnostic testing. With no known cause or cure for the chronic fatigue and immune dysfunction syndrome, treatment is based on relieving symptoms and improving the quality of life of affected patients. There is emerging evidence that chronic fatigue syndrome may be familial. In the future, studies will examine the extent to which genetic and environmental factors play a role in the development of chronic fatigue syndrome. Most patients with CFS have psychiatric problems such as a generalized anxiety disorder, or major or minor depression, therefore, these mental health disorders may be correlated with the pathophysiology of the CFS. The treatment for CFS must be individualized, due to the heterogeneity of the CFS population. Also the treatment of CFS is built on a foundation of patient-physician relationship, respect and advocacy.
Anxiety Disorders ; Depression ; Diagnosis ; Diagnostic Tests, Routine ; Fatigue ; Fatigue Syndrome, Chronic* ; Humans ; Mental Health ; Population Characteristics ; Psychology ; Quality of Life

OBJECTIVE: To evaluate the sensitivity and specificity of Pollard' s classification criteria(2010) for the diagnosis of rheumatoid arthritis (RA) patients withfibromyalgia (FM) in Chinese patients, and to assess the clinical features and psychological status of RA-FM patients in a real-world observational setting. METHODS: Two hundred and two patients with rheumatoid arthritis were enrolled from the outpatients in Rheumatology and Immunology Department in Peking University People' s Hospital. All the patients were evaluated whether incorporating fibromyalgia translation occured using the 1990 American College of Rheumatolgy (ACR)-FM classification criteria. Forty two RA patients were concomitant with FM, while the other one hundred and sixty RA patients without FM were set as the control group. RESULTS: There was no significant difference in general demography between the two groups (P>0.05). In this study, the Pollard' s classification criteria (2010) for RA-FM in Chinese patients had a high sensitivity of 95.2% and relatively low specificity of 52.6%. Compared with those patients without FM, RA patients with FM (RA-FM patients) had higher Disease Activity Scale in 28 joints (DAS-28) score (5.95 vs. 4.38, P=0.011) and much more 28-tender joint counts (TJC) (16.5 vs.4.5, P < 0.001).RA-FM patients had worse Health Assessment Questionnaire (HAQ) score (1.24 vs. 0.66, P < 0.001) and lower SF-36 (28.63 vs. 58.22, P < 0.001). Fatigue was more common in RA-FM patients (88. 1% vs. 50.6%, P < 0.001) and the degree of fatigue was significantly increased in RA-FM patients (fatigue VAS 5.55 vs. 3.55, P < 0.001). RA-FM patients also had higher anxiety (10 vs.4, P < 0.001) and depression scores (12 vs.6, P < 0.001). erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), morning stiffness time and 28-swollen joint counts (SJC) showed no difference between these two groups. CONCLUSION The Pollard' s classification criteria (2010) for RA-FM are feasible in Chinese rheumatoid arthritis patients. The Pollard' s classification criteria is highly sensitive in clinical application, while the relativelylow specificity indicates that various factors need to be considered in combination. RA patients with FM result in higher disease activity, worse function aland psychological status. RA patients with FM also have poorer quality of life. DAS-28 scores may be overestimated in RA patients with FM. In a RA patient thatdoes not reach remission, the possibility of fibromyalgia should be con-sidered.
Arthritis, Rheumatoid/diagnosis* ; Fatigue/etiology* ; Fibromyalgia/diagnosis* ; Humans ; Quality of Life ; Severity of Illness Index