Fatigue and anhedonia are commonly reported, co-occurring clinical symptoms associated with chronic illnesses. Fatigue is a multidimensional construct that is defined as a distressing, persistent, subjective sense of physical, cognitive, or emotional tiredness that interferes with usual functioning. Anhedonia is a component of depressive disorders and other psychiatric conditions, such as schizophrenia, and is defined by the reduced ability to experience pleasure. Both symptoms greatly affect the health-related quality of life of patients with chronic illnesses. Although fatigue and anhedonia are commonly associated with each other, understanding the differences between the two constructs is necessary for diagnosis and clinical treatment. A scoping review was conducted based on published guidance, starting with a comprehensive search of existing literature to understand the similarities and differences between fatigue and anhedonia. An initial search of PubMed using fatigue and anhedonia as medical subject headings yielded a total of 5254 articles. A complete full-text review of the final 21 articles was conducted to find articles that treated both constructs similarly and articles that presented fatigue and anhedonia as distinct constructs. About 60% of the reviewed articles consider both constructs as distinct, but a considerable number of the reviewed articles found these constructs indistinguishable. Nomenclature and biology were two themes from the reviewed articles supporting the idea that anhedonia and fatigue are indistinguishable constructs. The information generated from this review is clinically relevant to optimize the management of fatigue related to anhedonia from other fatigue subtypes.

Background Cancer‐related fatigue (CRF) is a debilitating symptom frequently reported by patients during and after treatment for cancer. CRF is a multidimensional experience and is often solely assessed by self‐report measures. The goal of the study is to examine the physical and cognitive aspects of self‐reported CRF using a cognitive function test and a physical fatigue index in order to provide objective measures that can characterize the CRF phenotype. Methods A total of 59 subjects with nonmetastatic prostate cancer receiving external beam radiation therapy were included in the study. Fatigue was measured using the Functional Assessment of Cancer Therapy‐Fatigue (FACT‐F) questionnaire. Cognitive characteristics of CRF was measured using the Stroop Color‐Word Interference computerized test and the motor aspect of fatigue was measured using the static fatigue test using a handgrip dynamometer. Findings Functional Assessment of Cancer Therapy‐Fatigue scores significantly correlated with the Stroop Interference score, but not performance accuracy in all test conditions. Fatigued subjects exhibited a more rapid decline to 50% of maximal strength and increased static fatigue index in the handgrip test, whereas maximal grip strength was not affected. Conclusions The results suggest that CRF exhibits both cognitive and physical characteristics. Subjective fatigue was associated with increased time required to overcome cognitive interference, but not cognitive performance accuracy. Fatigued patients exhibited decreased physical endurance and the ability to sustain maximal strength over time. These objective measures may serve as valuable tools for clinicians to detect cognitive and physical impairment associated with CRF.

Background The impact of obesity on outcomes of prepectoral vs subpectoral implant based reconstruction (IBR) is not well-established. Objectives The goal of this study is to assess the surgical and patient-reported outcomes of prepectoral vs subpectoral IBR. The authors hypothesized that obese patients would have similar outcomes regardless of device plane. Methods We conducted a retrospective review of obese patients who underwent 2-stage IBR from January 2017 to December 2019. Primary endpoint was the occurrence of any breast-related complication; secondary endpoint was device explantation. Results The authors identified a total of 284 reconstructions (184 prepectoral, 100 subpectoral) in 209 patients. Subpectoral demonstrated higher rates of overall complications (50% vs 37%, p = 0.047) and device explantation (25% vs. 12.5%, p = 0.008) than prepectoral reconstruction. In multivariable regression, subpectoral reconstruction was associated with higher risk of infection (HR, 1.65; p = 0.022) and device explantation (HR, 1.97; p = 0.034). Subgroup analyses demonstrated significantly higher rates of complications and explantation in the subpectoral group in those with body mass index (BMI) ≥ 35 and BMI ≥40. The authors found no significant differences in mean scores for satisfaction with the breast (41.57 ± 13.19 vs 45.50 ± 11.91, p = 0.469), psychosocial well-being (39.43 ± 11.23 vs 39.30 ± 12.49, p = 0.914), and sexual well-being (17.17 ± 7.83 vs 17.0 ± 9.03, p = 0.931) between subpectoral and prepectoral reconstruction. Conclusions Prepectoral reconstruction was associated with significantly decreased overall complications, infections, and device explantation in obese patients compared to subpectoral reconstruction. Prepectoral reconstruction provides superior outcomes to subpectoral reconstruction with comparable patient-reported outcomes.