[Show abstract][Hide abstract] ABSTRACT: To investigate the relationship of fatigue severity to other clinical features in primary Sjögren's syndrome (SS) and to identify factors contributing to the physical and mental aspects of fatigue.
We identified 94 subjects who met the American-European Consensus Group criteria for the classification of primary SS. Fatigue was assessed with a visual analog scale, the Fatigue Severity Scale (FSS), and the Profile of Fatigue (ProF). Associations with fatigue were compared using multivariate regression.
Abnormal fatigue, defined as an FSS score >or=4, was present in 67% of the subjects. Pain, helplessness, and depression were the strongest predictors of fatigue according to the FSS and the somatic fatigue domain of the ProF (ProF-S), both with and without adjustment for physiologic and serologic characteristics. Depression was associated with higher levels of fatigue; however, the majority of subjects with abnormal fatigue were not depressed. Anti-Ro/SSA-positive subjects were no more likely to report fatigue than seronegative subjects. The regression models explained 62% of the variance in FSS and 78% of the variance in ProF-S scores. Mental fatigue was correlated with depression and helplessness, but the model predicted only 54% of the variance in mental fatigue scores.
Psychosocial variables are determinants of fatigue, but only partially account for it. Although fatigue is associated with depression, depression is not the primary cause of fatigue in primary SS. Investigation of the pathophysiologic correlates of physical and mental aspects of fatigue is needed to guide the development of more effective interventions.
[Show abstract][Hide abstract] ABSTRACT: As a person ages, falls and strokes each become more likely, and because stroke patients are independently at increased risk for falling, the risk of falls is compounded in this population.
There are a number of preventive measures that can be easily implemented to decrease the risk of falling. These are well known to physical and occupational therapists, so a consultation is well-advised. Four areas of focus are: (1) Exercise, to increase strength, balance, and coordination. (2) Vision, to assure that the subject sees as well as possible. (3) Medication, to minimize side effects that could influence falling. (4) Environment, to remove obstacles, add assists, and provide optimal lighting.
Falls among stroke patients are costly in terms of risk to the individual and treatment demands on the healthcare system. However, simple attention to details can reduce the risk of falling.
Journal of vascular and interventional neurology 04/2008; 1(2):61-2.
[Show abstract][Hide abstract] ABSTRACT: Clinical trials are essential for the development of new treatments. Whether a person should participate depends on their understanding of the risks and benefits for themselves and for society as a whole.
There are rules in place to protect human research subjects and all studies involving humans are reviewed locally to ensure that subjects are treated safely, fairly, and confidentially. Nevertheless, each subject should consider for themselves whether participation is consistent with their values.
Clinical trials, when well-designed, can benefit the participants as well as the investigators, the sponsors, and the medical community.
Journal of vascular and interventional neurology 01/2008; 1(1):31.