Fatigue in XXXX : Prevalence, Pathogenesis and Management.

@entity2835 @entity1 @entity308 @entity73 @entity1295 @entity5433 @entity121 @entity25 @entity10055
UNASSIGNED: Fatigue is a significant problem in approximately 50% of @entity2835 ( @entity2835 ) @entity1 , with 20% of all @entity1 experiencing significant or life-altering @entity1295 . Large-scale population studies show that @entity1295 has a major impact on quality of life (QoL) in @entity2835 , and that it disproportionately affects younger @entity1 . The presence of social dysfunction that accompanies @entity1295 appears to be a major factor in determining whether @entity1295 of a particular severity impacts on QoL. The pathogenesis of @entity1295 in @entity2835 remains unclear, although it is unrelated to the severity of underlying disease and is unresponsive to @entity10055 . Perhaps, unsurprisingly, it appears to be complex in origin, probably multifactorial in the majority of @entity1 and associated with @entity308 , @entity5433 and @entity25 . Clinically, @entity1295 has both central and peripheral components. The central component is associated with @entity73 and @entity25 and characterised by neurophysiological abnormalities of activation and facilitation, together with CNS changes. Peripheral @entity1295 is associated with @entity121 and an inability to sustain exercise. One hypothesis is that the central processes result directly from cholestasis, which impacts autonomic centres in the brain; these processes then regulate peripheral muscle perfusion, leading to systemic peripheral effects. At present, there is no specific drug therapy for @entity1295 in @entity2835 and no significant improvement following transplantation. In managing @entity1 with @entity1295 , understanding their situation is crucial and advice regarding pacing and maintaining social interactions is critical. Most important of all is an understanding of the impact this symptom has on @entity1 ' lives and an empathetic clinical interaction.
