Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We investigated specific subjective effects of naltrexone pretreatment or placebo during various intervals on the breath alcohol level (BAL) curve in nonalcoholic volunteers. Fifteen high-risk (social drinkers with an alcoholic father) and 14 low-risk (no alcoholic relatives in at least two generations) subjects were tested in a double-blind placebo-controlled study of the effects of 50 mg oral naltrexone on response to a moderate dose of alcohol. Dependent measures included subjective stimulation and sedation subscales from the Biphasic Alcohol Effects Scale (BAES) and mood subscales from the Profile of Mood States (POMS). At rising BALs, high-risk subjects showed a naltrexone-related attenuation of BAES stimulation. This effect was not evident in low-risk subjects, who directionally showed the opposite effect, although nonsignificant. For both groups, there were no significant naltrexone-related effects for BAES sedation; however, naltrexone did affect several POMS scales on alcohol response, such as decreased vigor, and increased fatigue, tension, and confusion. Confusion was significantly elevated for the high-risk group during rising BALs of the naltrexone session. The results suggest a differential response to naltrexone, based on paternal history of alcoholism and level of stimulation experienced during alcohol drinking.
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PMID:Effect of naltrexone on subjective alcohol response in subjects at high and low risk for future alcohol dependence. 912 58

A 19-year-old patient presented with exercise-related myalgia, fatigue and elevated creatine kinase levels. Histology of a muscle biopsy was characterized by the presence of very large amounts of tubular aggregates. Both his father and paternal grandfather had elevated creatine kinase and large amounts of tubular aggregates in their muscle biopsies. The aggregates consisted of closely packed vesicles and tubules filled with electron-dense material or with one to several smaller tubules. Disorders with tubular aggregates in the muscle fibres such as hyperornithinaemia with gyrate atrophy of the retina, hypokalaemic periodic paralysis, hyperkalaemic periodic paralysis, myotonia congenita, alcoholism, osteomalacic myopathy etc. have been excluded. Tubular aggregates can be found in muscle disorders characterized by exercise-induced cramps, pain and stiffness. They also represent the predominant histological feature of some familial myopathies due to a yet unidentified genetic defect. In our family, there was male-to-male transmission, confirming dominant inheritance.
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PMID:On a dominantly inherited myopathy with tubular aggregates. 944 9

The opiate antagonist naltrexone (NTX) blocks relapse drinking in alcoholics and modifies some of the subjective effects of alcohol intoxication. Benzodiazepines have demonstrated cross-dependence and cross-tolerance to alcohol. Furthermore, benzodiazepine intoxication has effects on mood and psychomotor performance that are similar to alcohol intoxication. The effects of NTX on diazepam intoxication were investigated in non-drug abusing individuals. Eighteen men and eight women were randomly assigned to receive either 50 mg NTX or placebo PO, on two different occasions in a within-subjects, crossover, double-blind protocol. Diazepam was taken by mouth, 90 min after NTX. At -90, 45, 75, 135, 210 min, subjects were tested with repeated assessments of several mood and sensation scales and a computer-generated psychomotor test battery (CTB). Blood samples were also obtained and analyzed for serum diazepam levels. Diazepam induced several sensations and mood effects similar to those induced by alcohol. Negative mood states such as sedation, fatigue, and anxiety were higher for NTX than for placebo. Positive mood states such as friendliness, vigor, liking the effects of diazepam, and feeling high from diazepam were all lower for NTX than for placebo. There were no group differences on the CTB performance. NTX delayed the time to reach peak diazepam levels, so that peak levels occurred at 75 min for placebo compared to 135 min for NTX. A sub-analysis was conducted with 14 subjects who were FHP for alcoholism, but no differences were found on these outcome measures.
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PMID:Naltrexone effects on diazepam intoxication and pharmacokinetics in humans. 949 28

The seasonal pattern of L-tryptophan was studied in a Fairbanks, Alaska, population that was unadapted to the extreme light variations of the North. Previously, this population was shown to exhibit seasonal behavior effects such as increases in fatigue and sleep duration, as well as endocrine effects such as increases in melatonin levels and phase shifting. Caloric and macronutrient intake have been reported to vary seasonally in humans, thereby potentially influencing the plasma levels of L-tryptophan, which is a precursor of serotonin and melatonin. Plasma levels of L-tryptophan from volunteers, whose average duration of stay in Alaska was eight months, were determined by automated amino acid analysis. Prominent results included finding increased levels in the winter at several different diurnal time points. These findings support hypotheses which relate underlying physiological adaptations to the North to the increased incidence of behavioral disorders such as depression and alcoholism.
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PMID:Seasonal variation of the amino acid, L-tryptophan, in interior Alaska. 1009 12

Constrained arthroplasty is occasionally needed to salvage a destroyed glenohumeral joint when the rotator cuff is nonfunctioning and when an unconstrained prosthesis will not suffice. There is a high failure rate because of the severe forces between such a device and the contiguous bone. Accordingly, it is essential to know the limitations of constrained arthroplasty and when it should be avoided. For example, when the bone of the glenoid vault is highly demineralized or deficient or if there is a history of seizure disorder or alcoholism, use of such a device is contraindicated. Postoperatively, excessive force and extremes of motion should also be avoided during the rehabilitation program to avoid bone fracture or dislocation of the prosthesis. Various complications have been observed with constrained arthroplasty, including dislocation, bone fracture, pullout of the glenoid, infection, radial nerve injury after extrusion of bone cement through the humeral cortex when the cement has been pressurized, and screw breakage in a relative small number of cases after metal fatigue and loosening of the glenoid component. When the glenoid component has pulled away from the glenoid vault, it may be necessary to remove this component; the humeral head may be fitted with a bipolar 40- to 44-mm acetabular component, thereby allowing at least preservation, if not the active function of the shoulder contour.
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PMID:Constrained arthroplasty: its use and misuse. 1014 68

Disulfiram is known to cause hepatitis, which is sometimes fatal. The best estimate of the frequency of disulfiram-induced fatal hepatitis is 1 case in 30,000 patients treated/year. Its appears to be more common in patients given disulfiram for the treatment of nickel sensitivity. Frequent blood testing for liver function is probably not necessary, but patients taking disulfiram should be in regular contact with a physician. There are rare reports of psychosis and confusional states in conjunction with disulfiram treatment and peripheral neuropathy and optic neuritis have been reported; these effects are dose-related. Psychiatric complications appear to be more common with the use of disulfiram in India than in Western countries. Of the less serious adverse effects, tiredness, headache and sleepiness are the most common. Deaths from the disulfiram-alcohol (ethanol) interaction have not been reported in recent years, possibly because the dosages used are lower than those used 40 years ago, and patients with cardiac disease are now excluded from treatment. There is no evidence to suggest that disulfiram causes cancer. Of note, there are drug interactions with compounds that utilise the cytochrome P450 enzyme system. Disulfiram can be viewed as a drug with a moderate record of adverse effects. Alcohol dependence, for which it can be a helpful treatment, is associated with a high morbidity and mortality.
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PMID:Safety issues concerning the use of disulfiram in treating alcohol dependence. 1034 93

In this retrospective study, the charts of 100 consecutive cancer patients who had been referred to a palliative care consult team within a tertiary acute care hospital were reviewed. Demographic characteristics, including reason for admission and disease status upon admission, length of stay, and discharge and admission location, were recorded. Symptom acuity, cognitive status, and risk for substance abuse were evaluated. Medications before and after the consult were tabulated and compared to recommended medications; compliance with the recommendations was assessed. Five patients were not palliative at the time of the consult. Only 46/95 (48%) were known to have untreatable cancer at the time of their admission. The CAGE questionnaire for alcoholism and the Mini-Mental State Questionnaire (MMSQ) were abnormal in 19/78 (24%) and 40/91 (44%), respectively. The most intense symptoms, as measured by the 100-mm scales of the Edmonton Symptom Assessment Scale (ESAS) were fatigue (72 +/- 24), appetite (60 +/- 32), and well-being (50 +/- 29). Eighty-nine of the 95 patients were living at home prior to admission and 34/95 were able to return home. Twenty died during hospitalization, 23 were transferred to a palliative care unit, and the remaining 18 were discharged to another hospital or long-term care. The patient's physician complied with the palliative care consult team's recommendation in 122/137 cases (89%).
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PMID:Demographic, symptom, and medication profiles of cancer patients seen by a palliative care consult team in a tertiary referral hospital. 1076 Jun 22

The elderly population is increasing as baby boomers are beginning to approach retirement. People 65 years of age or older already constitute approximately one eighth of the U.S. population; this proportion is expected to double in the next 50 years. Older Americans have their own population-specific health challenges, such as Alzheimer's disease, osteoporosis, adult-onset diabetes, prostate cancer, menopause, and hypertension. Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are seldom discussed within this community. Prevention, counseling, testing, and education efforts are not being directed their way. In addition, few practitioners are experts both in HIV and health problems associated with aging, resulting in misdiagnosis, especially in the early stages when AIDS symptoms such as fatigue, weight loss, night sweats, and diminished appetite are dismissed as part of the aging process. Very few HIV-related social support services have been aimed at the needs of the elderly, perhaps because older Americans are not suspected to be sexually active or are assumed to be in a monogamous, heterosexual relationship. Older Americans are not suspected of drug use. Yet many are sexually active, often demonstrating risky sexual behavior, such as dispensing with the use of condoms; and the isolation that frequently accompanies old age can lead to alcoholism and injectable drug use. This article examines methods suggested in the literature both in terms of primary and secondary prevention of HIV/AIDS in older Americans. The cost of these efforts is enumerated, and organizations who gear their efforts in reaching and educating older Americans regarding their risks are described.
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PMID:HIV in older Americans: an epidemiologic perspective. 1081 63

Road traffic crashes (RTCs) are responsible for a substantial fraction of morbidity and mortality and are responsible for more years of life lost than most of human diseases. In this review, we have tried to delineate behavioral factors that collectively represent the principal cause of three out of five RTCs and contribute to the causation of most of the remaining. Although sharp distinctions are not always possible, a classification of behavioral factors is both necessary and feasible. Thus, behavioral factors can be distinguished as (i) those that reduce capability on a long-term basis (inexperience, aging, disease and disability, alcoholism, drug abuse), (ii) those that reduce capability on a short-term basis (drowsiness, fatigue, acute alcohol intoxication, short term drug effects, binge eating, acute psychological stress, temporary distraction), (iii) those that promote risk taking behavior with long-term impact (overestimation of capabilities, macho attitude, habitual speeding, habitual disregard of traffic regulations, indecent driving behavior, non-use of seat belt or helmet, inappropriate sitting while driving, accident proneness) and (iv) those that promote risk taking behavior with short-term impact (moderate ethanol intake, psychotropic drugs, motor vehicle crime, suicidal behavior, compulsive acts). The classification aims to assist in the conceptualization of the problem that may also contribute to behavior modification-based efforts.
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PMID:Human factors in the causation of road traffic crashes. 1129 24

A component of ATP, phosphate is at the hub of the energy-related mechanisms operative in muscle cells. Together with calcium, phosphate is involved in bone tissue mineralization: thus, a chronic alteration in the metabolism of phosphate can induce bone and joint disorders. Diagnosis of chronic hypophosphatemia. Serum phosphate, calcium, and creatinine should be assayed simultaneously. Serum calcium is increased in hypophosphatemia caused by hyperparathyroidism and decreased in osteomalacia. Urinary phosphate excretion should be measured in patients with a normal serum calcium level and a serum phosphate level lower than 0.80 mmol/L. A decrease in urinary phosphate excretion to less than 10 mmol/24 h strongly suggests a gastrointestinal disorder, such as malabsorption, antacid use, or chronic alcohol abuse. In patients with a urinary phosphate excretion greater than 20 mmol/24 h, the maximal rate of tubular reabsorption of phosphate (TmPO4) and the ratio of TmPO4 over glomerular filtration rate (GFR) should be determined to look for phosphate diabetes. Manifestations and causes of phosphate diabetes in adults. Moderately severe phosphate diabetes in adults manifests as chronic fatigue, depression, spinal pain, and polyarthralgia, with osteoporosis ascribable to increased bone resorption. Although many cases are idiopathic, investigations should be done to look for X-linked vitamin D-resistant rickets missed during childhood, a mesenchymatous tumor, or Fanconi's syndrome with renal wasting of phosphate, glucose, and amino acids. Management of phosphate diabetes. Phosphate supplementation and, in patients with normal urinary calcium excretion, calcitriol produce some improvement in the symptoms and increase the bone mineral density. Whether dipyramidole is clinically effective remains unclear.
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PMID:Phosphate, the renal tubule, and the musculoskeletal system. 1139 20


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