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

The pattern of breathing was studied in 8 patients with acute severe asthma on admission to hospital and during recovery to determine how chest wall motion varied with the degree of air-flow obstruction (AO), the relationship between degree of AO and respiratory timing and ventilation, and whether the pattern suggested respiratory muscle fatigue when asthma was most severe. Pattern was assessed by simultaneous measurement of respired volumes (pneumotachygraph) and anteroposterior (AP) motion of lower rib cage and abdomen (magnetometers). There was a phase lag of AP rib cage relative to AP abdominal motion that was greatest in those with lowest FEV1 and progressively decreased during recovery. Fractional inspiratory time was decreased in severe asthma. Mean inspiratory flow was increased in moderately severe asthma but decreased when FEV1 was less than 25% predicted. Breathing pattern was no more variable during severe asthma than during recovery. We conclude that during severe AO the magnitude of phase lag of AP rib cage relative to AP abdominal motion reflects severity of asthma; respiratory drive is increased but is not associated with increased ventilation below an FEV1 of 25% predicted, and analysis of the breathing pattern provides no clear evidence of respiratory muscle fatigue.
 ...
PMID:The pattern of breathing in acute severe asthma. 293 28

This report describes patients who had late onset reactions following venom immunotherapy and venom skin tests. Six adult patients had symptoms of fatigue, malaise, fever, headache, and joint ache, starting four to six hours after venom immunotherapy and lasting up to four days. Two of the patients had prolonged reactions at or adjacent to the skin test sites. All of these patients had a history of venom anaphylaxis; four had severe cardiovascular symptoms. All received yellow jacket venom immunotherapy and four honeybee venom immunotherapy. In four patients, the reactions occurred following small venom doses, 0.1 to 2 micrograms. Two patients reacted after maintenance doses of 50 micrograms. There was no relationship to the serum IgE or IgG antibody titers. All but one patient had serum venom-specific IgE but the titers covered a wide range. Serum venom-specific IgG was present in four patients. There was no response in lymphocyte culture to bee venom stimulation in two patients. Two of these patients stopped venom immunotherapy; one had reached the maintenance dose. In three patients, prophylactic parenteral steroids have ameliorated the reactions. After a temporary dose reduction, the sixth patient is now asymptomatic. A seventh patient developed asthma, 12 hours following a maintenance dose of 50 micrograms of yellow jacket venom. Concomitant steroid administration has effectively prevented the reaction. Another patient, a 6-year-old boy, developed fever, edema of the face and lips, erythema of the leg, and a large, tender right inguinal node eight hours following venom skin tests.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Late onset reactions following venom immunotherapy and venom skin tests. 318 64

We have assessed the feasibility and value of measuring nonspecific bronchial responsiveness to methacholine in investigation of asthma in the elderly. Results from duplicated tests in 20 subjects aged 65-82 years were expressed as dose provoking a 20% decrement in 1 second forced expiratory volume (PD20.FEV1) or peak expiratory flow (PD20.PEF). Repeatability for PD20.FEV1 was satisfactory but less good than in younger subjects, 95% confidence limits being 0.39-2.57 and 0.52-1.91, respectively, x initial PD20. For PD20.PEF, confidence limits were wider (0.26-3.91 x initial PD20) but multiple PEF measurements were better tolerated than those of FEV1, which commonly caused fatigue and dizziness. PD20.FEV1 and PD20.PEF correlated closely (r = 0.95, P less than 0.0001) and both predicted bronchodilatation following a 6-week course of inhaled corticosteroid and beta agonist. This was not predicted by the response to a single dose of beta agonist. We conclude that measurement of bronchial responsiveness is feasible and clinically valuable in elderly subjects.
 ...
PMID:An assessment of methacholine inhalation tests in elderly asthmatics. 328 41

Eight diurnally active (approximately 0730-1100 hr) adults (41-61 yr) suffering from nocturnal asthma volunteered for a double-blind, cross-over randomized study of a once-daily dosing (600-900 mg/24 hr) of Armophylline (Rorer s.a., France), a sustained-release theophylline given either at 0800 hr or 2000 hr for 8-day durations. Study variables monitored daily were: (a) self-measured peak expiratory flow (PEF), heart rate, oral temperature and self-rated fatigue checked every 2 hr during the waking span as well as upon spontaneous nocturnal awakenings and (b) duration and subjective characteristics of sleep rated every morning. In addition, serum theophylline concentration (STC) plus the variables in (a) were sampled every 2 hr during the 24 hr of the eighth day of each timed treatment span. Rx at 0800 hr was associated with a nocturnal dip in PEF of 20 +/- 2.8% (X +/- S.E.M.) from the level achieved at the time of the diurnal crest; Rx at 2000 hr moderated the nocturnal fall; it was only 10 +/- 2.1% and within the physiologic limits of non-asthmatic persons. The STC peak height (Cmax) was greater (P less than 0.05) and time-to-peak (Tmax) shorter (P less than 0.005) with Rx at 0800 hr than at 2000 hr. With Rx at 2000 hr an STC plateau of approximately 12 hr resulted. A statistically significant correlation (r = 0.86; P less than 0.01) between PEF and the corresponding-in-time STC was observed with Rx at 2000 hr but not with Rx at 0800 hr. A small, but statistically significant, higher heart rate resulted from 2000 hr dosings in five out of eight subjects relative to the 0800 hr dosing. There were no differences in the sleep characteristics nor in oral temperature between dosing times. Once-daily (600-900 mg) SRT dosing at 2000 hr controlled the nocturnal dip of bronchial patency with no major side-effects in diurnally active adult patients with nocturnal allergic asthma.
 ...
PMID:Comparison of once-daily evening versus morning sustained-release theophylline dosing for nocturnal asthma. 331 70

Rare upper airway lesions may be mistaken for asthma. A 16-year-old Hispanic male athlete presented to our allergy clinic with a 4-month history of wheezing and snoring with hoarseness and progressive fatigue on exertion or during sleep. His mother taped periods of harsh stridor and sleep apnea. There was no family history of vocal cord abnormalities. A year before the onset of symptoms, he suffered injury to his oral cavity with a loss of consciousness during a wrestling match. He denied dysphagia or dysphonia. He failed to respond to bronchodilators, cromolyn, or prednisone therapy during 4 weeks. On referral to our clinic, his physical examination and tape recording were characterized by harsh inspiratory stridor. His pulmonary function tests were significant for peak flow depressed out of proportion to FEV1 with reduced FVC, no response to bronchodilator, and flattened inspiratory loop unresponsive to cough or panting. Fluoroscopy and endoscopy of the upper airway was consistent with "marked bilateral limitation of vocal cord abduction." Sleep study demonstrated desaturation with CO2s in the 60s during sleep. He was started on continuous positive airway pressure, 10 cm at night, with no desaturation or sleep disturbance on follow-up.
 ...
PMID:Bilateral abductor paresis masquerading as asthma. 337 24

One hundred consecutive patients, 74 women and 26 men, aged between 18 and 83 years (mean = 54.8 years), referred with complaints related to oral galvanism were investigated and treated and the treatment results were evaluated after 2-3 years. Forty of the patients reported facial pain, pain from the teeth, temporomandibular joints (TMJ) and masticatory muscles and TMJ clicking and locking and 26 reported headache. Smarting in the oral mucosa, smarting of the tongue and xerostomia were reported by 26, 21 and 24 patients, respectively, and 30 patients reported an unpleasant taste, a metallic taste or a battery taste. The same patient often reported several symptoms. The patients also reported various general symptoms, above all joint symptoms, pain in the back, neck and shoulders and general muscular pain but also tiredness, weakness, difficulty in concentrating, depression and insomnia. After clinical and radiological examination, salivary tests, determination of the maximum galvanic current at metallic contacts and screening for contact allergy to dental materials, various oral diagnoses could be established. Most of the patients exhibited functional disturbances of the masticatory system, periodontitis, smarting of the oral mucosa, xerostomia, pulpitis and pulpal necrosis and mucosal lesions. The medical illnesses the patients reported themselves to be suffering from or had been treated for included cardiovascular disorders, high and low blood pressure, asthma, rheumatic disorders, diabetes, pernicious anaemia, gastritis and peptic ulcer. Seventy-six patients took drugs regularly. In most cases there were several oral, dental and medical explanations for the symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Results obtained from patients referred for the investigation of complaints related to oral galvanism. 345 16

This study compared recalled physical and emotional sensations during episodes of acute dyspnea across pulmonary disease groups. The convenience sample consisted of 68 subjects with emphysema-bronchitis, asthma, vascular, and restrictive disease. Temporal patterns of physical and emotional sensations before and during episodes of dyspnea were identified. The frequency of sensations was remarkably similar across disease categories with few significant differences identified. Rather than the disease category, the frequency, intensity, and periodicity of the symptom of dyspnea had the greatest effect on the quality and frequency of sensations reported. The intensity of usual dyspnea reported on a visual analog scale varied significantly among groups, p = .026, with asthmatics having the lowest mean score and vascular subjects the highest. Females reported significantly greater usual dyspnea than males, p = .005. The variables of pulmonary disease group, gender, fatigue, and total network of social support were significantly related to usual dyspnea, and pulmonary group, gender, and attendance at Better Breathers classes were significantly related to worst dyspnea.
 ...
PMID:The sensations of pulmonary dyspnea. 363 51

Thorough and ongoing clinical assessment is the foundation of modern asthma management. The history delineates the severity, circumstances, and time course of the present attack, placing it in the clinical context of the patient and his disease. A physical examination disclosing airflow obstruction, tissue hypoxia, respiratory muscle fatigue, and complications of therapy, in conjunction with simple objective measures of airflow obstruction and arterial gas tensions, allows the physician to make informed management decisions in the care of these severely ill patients.
 ...
PMID:The clinical assessment of severe asthma. 397 93

Labetalol is a combined alpha- and beta-adrenoceptor blocking agent for oral and intravenous use in the treatment of hypertension. It is a nonselective antagonist at beta-adrenoceptors and a competitive antagonist of postsynaptic alpha 1-adrenoceptors. Labetalol is more potent at beta that at alpha 1 adrenoceptors in man; the ratio of beta-alpha antagonism is 3:1 after oral and 6.9:1 after intravenous administration. Labetalol is readily absorbed in man after oral administration, but the drug, which is lipid soluble, undergoes considerable hepatic first-pass metabolism and has an absolute bioavailability of approximately 25%. There are no active metabolites, and the elimination half-life of the drug is approximately 6 hours. Unlike conventional beta-adrenoceptor blocking drugs without intrinsic sympathomimetic activity, labetalol, when given acutely, produces a decrease in peripheral vascular resistance and blood pressure with little alteration in heart rate or cardiac output. However, like conventional beta-blockers, labetalol may influence the renin-angiotensin-aldosterone system and respiratory function. Clinical studies have shown that the antihypertensive efficacy of labetalol is superior to placebo and to diuretic therapy and is at least comparable to that of conventional beta-blockers, methyldopa, clonidine and various adrenergic neuronal blockers. Labetalol administered alone or with a diuretic is often effective when other antihypertensive regimens have failed. Studies have shown that labetalol is effective in the treatment of essential hypertension, renal hypertension, pheochromocytoma, pregnancy hypertension and hypertensive emergencies. In addition, preliminary studies indicate that labetalol may be of value in the management of ischemic heart disease. The most troublesome side effect of labetalol therapy is posture-related dizziness. Other reported side effects of the drug include gastrointestinal disturbances, tiredness, headache, scalp tingling, skin rashes, urinary retention and impotence. Side effects related to the beta-adrenoceptor blocking effect of labetalol, including asthma, heart failure and Raynaud's phenomenon, have been reported in rare instances.
 ...
PMID:Labetalol: a review of its pharmacology, pharmacokinetics, clinical uses and adverse effects. 631 May 29

A double-blind, crossover, randomized, placebo-controlled chronotherapeutic study was designed in which eight patients (two men, 20 and 48 yr old, and six women, 22 to 58 yr old) suffering from corticosteroid-dependent allergic asthma were socially synchronized, with a diurnal activity from about 7:30 A.M. to about 11 P.M. and a nocturnal rest. During an 8 day span they were treated on a Dutimelan 8-15 regimen, labeled DTM 8-15: at 8 A.M. a pill containing 7 mg of prednisolone acetate and 4 mg of prednisolone alcohol, at 3 P.M. a pill with 15 mg of cortisone acetate and 3 mg of prednisolone alcohol, and a placebo at 8 P.M. During another 8 day span they were given a placebo at 8 A.M. and at 3 P.M. a pill with 15 mg of cortisone acetate and 3 mg of prednisolone alcohol and at 8 P.M. another pill with 7 mg of prednisolone acetate and 4 mg of prednisolone alcohol, a regimen labeled Rx 15-20. During wakefulness (between 7 A.M. and 11 P.M.), every 2 hr at eight fixed clock hours, peak expiratory flow (PEF), grip strength, and oral temperature were self-measured and dyspnea, cough, and fatigue were self-rated. The PEF 24 hr mean as well as the nocturnal dip were lower (p less than 0.05 to p less than 0.0005) with Rx 15-20 than with DTM 8-15, while the nocturnal increase of dyspnea was greater with Rx 15-20 than with DTM 8-15. Long-term administration of corticosteroids at 8 A.M. and 3 P.M. was more effective to control asthma and enhance PEF values than the same agents and dose given at 3 and 8 P.M.
 ...
PMID:Circadian changes in effectiveness of corticosteroids in eight patients with allergic asthma. 633 95


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>