Fatigue is often described by patients as a lack of energy, mental or physical tiredness, diminished endurance, and prolonged recovery after physical activity. Etiologic mechanisms underlying fatigue are not well understood; however, fatigue is a hallmark symptom of mitochondrial disease, making mitochondrial dysfunction a putative biological mechanism for fatigue. Therefore, this review examined studies that investigated the association of markers of mitochondrial dysfunction with fatigue and proposes possible research directions to enhance understanding of the role of mitochondrial dysfunction in fatigue. A thorough search using PubMed, Scopus, Web of Science, and Embase databases returned 1,220 articles. After application of inclusion and exclusion criteria, a total of 25 articles meeting eligibility criteria were selected for full review. Dysfunctions in the mitochondrial structure, mitochondrial function (mitochondrial enzymes and oxidative/nitrosative stress), mitochondrial energy metabolism (ATP production and fatty acid metabolism), immune response, and genetics were investigated as potential contributors to fatigue. Carnitine was the most investigated mitochondrial function marker. Dysfunctional levels were reported in all the studies investigating carnitine; however, the specific type of carnitine that was dysfunctional varied. Genetic profiles were the second most studied mitochondrial parameter. Six common pathways were proposed: metabolism, energy production, protein transport, mitochondrial morphology, central nervous system dysfunction and post-viral infection. Coenzyme Q10 was the most commonly investigated mitochondrial enzyme. Low levels of Coenzyme Q10 were consistently associated with fatigue. Potential targets for further investigation were identified as well as gaps in the current literature.
Aim of the study-This pilot study was designed to examine the relationships among spirituality and psychosocial factors in a sample of 52 adult males living with human immunodeficiency virus (HIV) disease and to determine the most reliable spirituality measure for a proposed longitudinal study.
This study investigated the optimal time for measuring stress and immune function in 20 healthcare professionals (19 women and 1 man) following interaction with a therapy dog. A nonclinical sample of healthcare professionals was assigned to 20 min. of quiet rest, and 5 and 20 min. with a therapy dog. Serum cortisol, epinephrine, and norepinephrine were collected at baseline, 5, 15, 30, 45, and 60 min. postcondition. Salivary cortisol, salivary IgA, and blood for lymphocytes were collected at baseline, 30, 45, and 60 min. postcondition. Analysis indicated significant reductions in serum and salivary cortisol. The optimal time for measuring serum or salivary cortisol following interaction with a therapy dog was 45 min., with changes in salivary cortisol reflecting serum cortisol changes. Findings also suggest stress reduction in healthcare professionals may occur after as little as 5 min. of interaction with a therapy dog and warrants further investigation.
Cancer and its treatment are frequently associated with cancer-related cognitive impairment (CRCI). While CRCI has been linked to chemotherapy, there is increasing evidence that the condition may start prior to treatment and for some, remain unresolved after active treatment and into survivorship. Although the pathophysiology of the condition is complex, alterations in systemic cytokines, signaling molecules activated in response to infection or injury that trigger inflammation, are a possible mechanism linked to cognitive dysfunction in breast cancer and other conditions. Given the conflicting results in the literature, the lack of focus on domain-specific cognitive testing, and the need for a longer time period given the multiple modalities of standard treatments for early-stage breast cancer, this longitudinal study was conducted to address these gaps. Methods We assessed 75 women with early-stage breast cancer at five points over two years, starting prior to the initial chemotherapy through 24 months after chemotherapy initiation. Measures included a validated computerized evaluation of domain-specific cognitive functioning and a 17-plex panel of plasma cytokines. Linear mixed-effects models were applied to test the relationships of clinical variables and cytokine concentrations to each cognitive domain. Results: Levels and patterns of cytokine concentrations varied over time: six of the 17 cytokines (IL-6, IL-12, IL-17, G-CSF, MIPS-1β, and MCP-1) had the most variability. Some cytokine levels (e.g., IL-6) increased during chemotherapy but then decreased subsequently, while others (e.g., IL-17) consistently declined from baseline over time. There were multiple relationships among cytokines and cognition, which varied over time. At baseline, elevated concentrations of G-CSF and reduced concentrations of IL-17 were associated with faster psychomotor speed. At the second time-point (prior to the mid-chemotherapy), multiple cytokines had significant associations with psychomotor speed, complex attention, executive function, verbal memory, cognitive flexibility, composite memory and visual memory. Six months after chemotherapy initiation and at the one-year point, there were multiple, significant relationships among cytokines and multiple cognitive. At two years, fewer significant relationships were noted; however, lower concentrations of IL-7, a hematopoietic cytokine, were associated with better psychomotor speed, complex attention, and memory (composite, verbal and visual). MCP-1 was inversely associated with psychomotor speed and complex attention and higher levels of MIP-1β were related to better complex attention. Conclusion Levels and patterns of cytokines changed over time and demonstrated associations with domain-specific cognitive functioning that varied over time. The observed associations between cytokines and cognitive performance provides evidence that not only prototypical cytokines (i.e. IL-6, TNF-α, and IL1-β) but also cytokines from multiple classes may contribute to the inflammatory environm...
This exploratory study investigated the effect of visiting therapy dogs on college-student perceived and physiological stress the week prior to final exams. Students (n = 78) were randomly assigned to order of a therapydog intervention and attention-control condition, each 15 minutes long. Students completed the Perceived Stress Scale (PSS), a stress visual analog scale (SVAS), and provided saliva for measuring nerve growth factor (sNGF) and alpha amylase (sAA), prior to randomization. Saliva samples and SVAS were again collected after each condition. There was no effect of group order on demographics, PSS, or initial SVAS. Repeated measures models were used to analyze the complete data sets of 57 students. There were no significant differences in sAA between or within students completing the intervention and control conditions. sNGF was not subjected to analysis as most levels were undetectable. Significant differences in SVAS scores were found between the intervention and control condition, with large effect sizes. SVAS scores were lower following the intervention, regardless of condition order (intervention first, p = 0.0001, d = 1.87; intervention second, p = 0.0004, d = 1.63). No SVAS differences were found for the control condition. Based on these findings, campus events with visiting therapy dogs represent a costeffective, easily accessible activity to reduce perceived, but not physiological, stress for college students prior to final exams.Keywords: animal-assisted activities, exam stress, human-animal interaction, therapy dogs Offering students the opportunity to interact with friendly dogs during exam periods is gaining popularity at colleges and universities. Tufts University, Emory University Law School, Kent State University, Harvard Medical School, and Yale Law School are among those offering such opportunities (Turner 2012;Christensen 2013). While anecdotal accounts of the popularity and benefits of these dog visits are reported, no formal studies of efficacy have been published. Before advocating for dog visits to address exam-related stress in college students, we first need evidence that such activities are effective in reducing student stress.It is well known that exams are a major stressful experience for college students. Elevated exam stress has been associated with increased tension and depression (Gilbert et al. 1996), poorer academic performance (Ng, Koh and Chia 2003), and lower student expectations of their grades (Austin, Saklofske and Mastoras 2010). Exam stress has also been negatively associated with physiological indicators of stress and immune function. Preuß and colleagues (2010) used salivary cortisol to measure physiological stress responses in college students before and after taking written and oral exams. Cortisol concentrations were elevated before, but not after, written exams and were higher before and after oral exams. Based on their findings, the authors concluded that while written exams caused a mild anticipatory stress response, oral exams elicited a strong...
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