Background and Aims: The present study investigated the prevalence and severity of fatigue in patients with newly diagnosed and untreated ulcerative colitis (UC) and Crohn's disease (CD) and examined relevant disease variables that may influence the severity of fatigue. Methods: Eighty-one patients with inflammatory bowel disease (IBD) (60 with UC and 21 with CD) were assessed for fatigue using two fatigue instruments: the Fatigue Severity Scale (FSS) and a fatigue visual analogue scale (fVAS). Cut-off for fatigue was defined as ≥4 for FSS and ≥50 for fVAS. Results were compared with fatigue scores from age-and gender-matched healthy individuals. Disease activity was assessed by symptom scores using the Mayo score in UC patients and the Harvey-Bradshaw index for CD patients, as well as C-reactive protein (CRP) and faecal calprotectin. Results: The prevalence of fatigue based on FSS and fVAS was 47 and 42%, respectively, in UC and 62 and 48% in CD. In multivariate regression models, disease activity markers were not associated with fatigue, while a significant relationship was found with age and depression for both fatigue measures. Conclusions: Close to 50% of patients with IBD reported fatigue at the time of diagnosis. In newly diagnosed patients with active disease, the severity of fatigue was not associated with measures of disease activity.

BackgroundDistal radius is one of the most frequent sites for fractures in the elderly population. Despite this, there is a paucity of epidemiological data for distal radius fracture, in particular, distinguishing between high- and low-energy fractures. Our aim was to study the epidemiology of high- and low-energy distal radius fracture in middle-aged and elderly men and women in Southern Norway, and search for associates with high- or low-energy distal radius fracture in this population.Methodology/Principal FindingsPatients with distal radius fractures aged ≥50 years were identified from all four hospitals in Southern Norway between 2004 and 2005. Age-adjusted and age-specific incidence rates for men and women were calculated, and potential associates with high- and low-energy distal radius fracture were explored both in univariate and multivariate analyses. A total of 799 individuals (118 men and 681 women) aged ≥50 years with low-energy and 84 (48 men and 36 women) with high-energy distal radius fracture were identified. The overall age-adjusted incidence rate per 10,000 person-years was 18.9 for men (low energy, 12.8 vs. high-energy, 6.1) and 75.1 for women (low energy, 71.1 vs. high energy, 4.0). In multivariate model, younger age, male gender, summer season, and living in a rural area were independently associated with an increased risk of high-energy fracture.ConclusionAn approximately fourfold higher age-adjusted incidence rate for distal radius fracture was found among women, when compared with men. However, the proportion of patients with high-energy distal radius fracture was approximately fivefold higher in men than in women. Our data suggest that younger age, male gender, summer seasons, and living in rural areas are independent risk factors for increased risk of high-energy distal radius fracture.

Nearly 50% of patients with psoriasis suffered from substantial fatigue. Fatigue severity was associated with smoking, pain and depression, but not with psoriasis severity.

BackgroundHip fracture patients have, in several studies, been shown to have excessive mortality. There is, however, a lack of mortality data, in comparison to incidence data, from the last decade in particular.ObjectiveTo study short- and long-term mortality in a population-based cohort of hip fracture patients over the last decade and compare it to the background population.Patients and methodsFragility hip fracture patients in the two most southern counties in Norway who experienced fractures in 2004 and 2005 were studied. For each patient, three controls were randomly recruited from the background population matched for age, sex, and residency. Overall, age-, gender-, and group-specific mortality rates were calculated.ResultsA total of 942 (267 male and 675 female) patients with a fragility hip fracture were identified. In the hip fracture patients, overall mortality rate after 1 year was 21.3% (males 30.7% and females 19.1%, P < 0.005) and, after 5 years, 59.0% (males 70.0% and females 54.6%, P < 0.005). The corresponding figures for matched controls were 5.6% (males 5.9%, females 5.4%, P = 0.6) and 24.9% (males 25.9%, females 24.5%, P = 0.4), respectively. A statistically significant difference was seen in the log-rank statistical analysis between hip fracture patients and controls, both in males (P < 0.0005) and females (P < 0.0005), and for age groups 50–80 years (P < 0.0005) and 80 years and older (P < 0.0005).ConclusionMortality in males and females with hip fractures is high not only in the first year after fracture, but remains higher than in the background population during 5 years of follow-up. The high mortality in hip fracture patients remains a challenge both in middle-aged and elderly individuals. Optimization of post-fracture treatment and care could reduce mortality of hip fracture in middle-aged and elderly individuals.

Summary Fatigue is a prevalent and substantial phenomenon in many patients with chronic inflammatory diseases, often rated by patients as the most troublesome symptom and aspect of their disease. It frequently interferes with physical and social functions and may lead to social withdrawal, long‐standing sick leave and disability. Although psychological and somatic factors such as depression, sleep disorders, pain and anaemia influence fatigue, the underlying pathophysiological mechanisms by which fatigue is generated and regulated are largely unknown. Increasing evidence points towards a genetic and molecular basis for fatigue as part of the innate immune system and cellular stress responses. Few studies have focused on fatigue in dermatological diseases. Most of these studies describe fatigue as a phenomenon related to psoriatic arthritis and describe the beneficial effects of biological agents on fatigue observed in clinical studies. It is therefore possible that this problem has been underestimated and deserves more attention in the dermatological community. In this review, we provide a definition and explanation for chronic fatigue, describe some commonly used instruments for measuring fatigue, and present hypothetical biological mechanisms with an emphasis on activation of the innate immune system and oxidative stress. An overview of relevant clinical studies covering the theme ‘psoriasis and fatigue’ is given.