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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The first autopsy of a case of multiple sclerosis from the District of Hokuriku was reported. The patient, a 50-year-old house-wife, born in Toyama Prefecture, had noticed a paresthesia of her face, fatigue, numbness and weakness in the right limbs, dimness of vision and gait disturbance at ave 44. Furthermore, in the course of the disease, she had suffered from visual disorder, tetraplegia, hyperreflexia, pyramidal signs and cerebellar syndroms such as dysarthria, nystagmus, intention tremor and ataxia. She also showed symptoms of euphoria and dementia. After a course of six years she died of bronchopneumonia. Remissions and exacerbations were noted four times during her clinical history. Histopathologically, there were many recent and old demyelinating lesions of varying sizes and shapes in all parts of the central nervous system, namely the cerebrum, brainstem, spinal cord and optic nerve. In contrast to the clinical symptoms, the cerebellum itself revealed less plaques than the other areas of the brain. According to the observed distributions of the lesions, our case can be classified as belonging to the optico-cerebro-spinal type in the Ikuta and Zimmerman classification. The demyelinated lesions were characterized by a perivenular distribution of the plaques, lack of tissue necrosis, paucity of inflammatory reaction and marked fibrous gliosis of varying degrees.
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PMID:First autopsy report of a multiple sclerosis case in Hokuriku District of Japan. 53 38

A 25-year-old farm worker developed acute bronchopneumonia after heavy exposure to a respiratory irritant in a silo. He recovered from the acute episode but then experienced chronic dyspnea and fatigue. Pulmonary function testing showed small lung volumes with a normal ratio of 1 s forced expiratory volume/forced vital capacity (restrictive defect). This defect improved markedly with bronchodilator treatment and changed to a mixed obstructive/restrictive defect with methacholine challenge. We believe that this is an example of the reactive airways dysfunction syndrome manifested by a restrictive rather than obstructive defect. Constriction of airways at the bronchiole or alveolar duct level is the most likely cause of the syndrome.
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PMID:Reactive airways dysfunction syndrome presenting as a reversible restrictive defect. 249 35

The effects of necrotic laryngitis on the mechanics of breathing and gas exchange were investigated in five Belgian blue double muscled calves two to three months old. All the animals showed the typical clinical picture of the respiratory syndrome associated with naturally occurring necrotic laryngitis. Highly significant increases in total pulmonary resistance, minute viscous work of breathing and alveolar-arterial oxygen gradient, and highly significant decreases in dynamic lung compliance and arterial oxygen tension were recorded in the infected animals, when compared to reference values for healthy cattle. The ratio of inspiratory to expiratory viscous work of breathing was also significantly increased probably because of a partial collapse of the extrathoracic trachea during inspiration. It was concluded that necrotic laryngitis disturbs pulmonary function to such an extent that it impedes the growing process and predisposes the infected animals to secondary bronchopneumonia and ventilatory failure due to respiratory muscle fatigue.
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PMID:Functional changes induced by necrotic laryngitis in double muscled calves. 368 95

Cefotaxime (CTX) was used for 129 cases in respiratory tract and other infections; 57 cases of pneumonia, 20 cases of bronchopneumonia, 20 cases of acute bronchitis, 14 cases of chronic bronchitis, 7 cases of acute exacerbation of bronchiectasia or pulmonary emphysema, 4 cases of suppurative diseases of the lung, 1 case of pyothorax, 1 case of retropharyngeal abscess, 3 cases of pleurisy and 1 case of urinary tract infection. (A case was excepted on clinical evaluation.) CTX was administered by intravenous injection or drip infusion at a daily dose ranging from 0.5 to 8 g, for a term of 2 to 61 days. The total dose patients received ranged from 3 to 226 g. The results obtained were as follows. Clinical effects; excellent in 45 cases, good in 63 cases, fair in 9 cases, poor in 7 cases and unevaluable in 4 cases. The efficacy rate was 87.1% (108/124). Bacteriological effects; eliminated in 30 cases, decreased in 8 cases, unchanged in 2 cases and replaced in 1 case. The elimination rate was 75.6% (31/41). Side effects and abnormal laboratory findings; general itching, fatigue in lower extremities and albuminuria in 1 case each, and anemia in 2 cases. Increased number of eosinophiles and elevated GOT in 1 case each, elevated GOT and GPT in 3 cases and elevated GOT, GPT and A1-P in 2 cases. These symptoms or abnormal laboratory findings disappeared after the discontinuation or termination of CTX therapy. In view of the above, CTX may be considered to be a clinically useful antibiotic against respiratory tract infections.
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PMID:[Clinical evaluation of cefotaxime in internal medicine]. 631 10

This paper presents a case in which treatment of acquired immunodeficiency syndrome (AIDS) was attempted with thymic humoral factor (THF). The capacity of THF for immunoenhancement and modulation of the immune response has been demonstrated in other conditions. The patient, a 24-year old black male homosexual from San Francisco, had experienced fever spikes, malaise, fatigue, anorexia, gradual vision loss, and weight loss over an 8-month period. Lymphopenia, T cell deficiencies, and imbalances in T cell subpopulations established the diagnosis of AIDS. Treatment with arabinoside A and fibroblast interferon was not effective. THF was then administered by daily injections for 3 weeks. At the end of the 2nd week of treatment, increased alertness and appetite were noted. Also documented was a transient increase in circulating lymphocytes, T cells, and helper cells. However, at the end of the 3rd week, the patient developed bronchopneumonia followed by renal failure and died in an acute encephalopathic state. Only 1 other (unsuccessful) attempt to treat an advanced case of AIDS with a thymic hormone has been reported. It is suggested that THF treatment might be more effective if offered at a very early stage of AIDS. It is hypothesized that a sufficient pool of precursor T cells is required to serve as target cells for immune modifiers such as THF. This precursor pool probably shrinks beyond rescue in the advanced stages of AIDS. The authors are currently involved in trials of immunomodulation with THF at early stages of immune impairment in pre-AIDS patients.
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PMID:Attempted treatment of acquired immunodeficiency syndrome (AIDS) with thymic humoral factor. 654 6

Diagnosing of alveolitis is a puzzle of many pieces, based on clinical experience and keeping in mind the criteria of extrinsic allergic alveolitis. They are antigen-exposure, typical delayed postexpositional symptoms (cough, chills, fever, dyspnea, tiredness), and serological tests of precipitating antibodies. Helpful findings are X-ray of the chest, high resolution computer tomography, auscultation findings, lowered diffusing capacity, bronchoalveolar lavage with lymphocytes > 50% and low T4/T8-ratio, histology of periphere lung specimens, and occasional inhaled provocation. Differential diagnosis are toxic lung disorders, drug adverse effects, sarcoidosis, silicosis, autoimmune alveolitis, idiopathic fibrosing alveolitis. The most frequent failure in diagnosis are common viral cold, bronchopneumonia, sarcoidosis, chronic bronchitis, and miliar tuberculosis.
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PMID:[Diagnostic process of alveolitis--state of the art]. 787 67

Recently group A Streptococcus toxic shock like syndrome (TSLS) has been reported, but as for group B streptococcus (S. agalactiae) infection, there have been little documentation in the literature. We report a case of fluminant septic shock due to Streptococcus agalactiae (S. agalactiae). A 72-year-old male was admitted to our hospital because of general fatigue and azotemia. He was diagnosed as having MPO-ANCA related glomerulonephritis and treated with steroid therapy. Gradually he was doing well. On the 228th hospital day, he suddenly had tachypnea, transient conscious disturbance, and profound hypotension. About 16 hours later, he died despite intensive treatment. S. agalactiae was isolated from the blood. Autopsy revealed bilateral bronchopneumonia and shock liver. To our knowledge, this is the first report of septic shock caused by S. agalactiae.
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PMID:[A case of fluminant septic shock due to Streptococcus agalactiae in a patient with MPO-ANCA related glomerulonephritis]. 898 74

Pulmonary mycotoxicosis (PM), also termed organic dust toxic syndrome or silo unloader's syndrome, is an acute illness resulting from massive inhalation of microbial toxins in organic dusts. It has not been well described histologically. Three cases of PM are presented in this report. Open lung biopsies were examined in each case. All of the patients were farmers with no prior lung disease. One had burning in his eyes, throat, and chest after exposure to moldy silage; chills, fever, dry cough, malaise, and weakness developed within 24 hours. Two patients presented with fever, progressive dyspnea, cough, and fatigue within 24 hours of emptying a corncrib, cleaning a chicken coop, and baling hay. Bilateral alveolar and interstitial infiltrates on chest roentgenograms and leukocytosis with neutrophilia were observed in all of the three patients. Two patients became hypoxemic and required mechanical ventilation. Histologic examination showed acute and organizing diffuse alveolar damage in two biopsy specimens and an acute bronchopneumonia in the third. One specimen had 1- to 10-microm ovoid organisms demonstrable with methenamine silver stains; cultures grew Fusarium and Penicillium species. The other two biopsy specimens had negative tissue cultures and special stains for organisms, although Penicillium species were grown from a preoperative bronchoalveolar lavage in one case. The two patients on mechanical ventilation recovered completely with high-dose steroids. The third patient recovered without steroids. No patient had residual functional deficits or chest radiographic abnormalities. PM can be distinguished from allergic and infectious diseases common in individuals exposed to large amounts of organic dust by its clinicopathologic features.
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PMID:Pulmonary mycotoxicosis: a clinicopathologic study of three cases. 961 95

In the period 1998-, we registered four sudden and unexpected cardiac deaths in male athletes due to myopericarditis during or after physical exercise. Three of them were professional soccer players and the fourth was engaged in swimming. One aged 29, had symptoms of tiredness, heart enlargement and left ventricular premature beats during training. Three of them, aged 17-18-18, were without symptoms. Three died during training and the fourth died in the hospital after head trauma at training. In the first one, aged 29, forensic autopsy showed chronic myopericarditis, thickening of the left ventricular wall of 15 mm and enlargement of the whole heart. The second one, aged 17, had subacute diffuse myopericarditis, suppurative tonsillitis and narrowed ascending aorta. The third, aged 18, had chronic myopericarditis and cardiac aneurysm of the left ventricle. The fourth, aged 18, had fibrinous pericarditis, thickening of the left ventricle 20 mm, hypoplastic ascending aorta, bilateral bronchopneumonia and cerebral contusion with edema. In Croatia, death rate among athletes, including all its causes, reached 0.15/100,000, in athletes suffering from myopericarditis it was 0.34/100,000, in others who practice exercise recreatively it amounted to 0.57/100,000 (p=0.0068), and in all males who practice exercise it measured 0.75/100,000 (p=0.0014). Physical exercise has to be contraindicated in cases of myopericarditis for at least six months from the onset of the illness.
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PMID:Myopericarditis and sudden cardiac death due to physical exercise in male athletes. 1875 88

To elucidate the epidemic status, clinical profile, and current diagnostic issues of scrub typhus in Shandong Province, we analyzed the surveillance data of scrub typhus from 2006 to 2011 and conducted a hospital-based disease survey in 2010. Scrub typhus was clustered in mountainous and coastal areas in Shandong Province, with an epidemic period from September to November. The most common manifestations were fever (100%), eschar or skin ulcer (86.3%), fatigue (71.6%), anorexia (71.6%), and rash (68.6%). Predominant complications included bronchopneumonia, toxic hepatitis, and acute cholecystitis in 21.6%, 3.9%, and 2.9% of the cases, respectively. Severe complications including toxic myocarditis, heart failure, pneumonedema, pleural effusion, and emphysema were first reported in Shandong. Missed and delayed diagnosis of scrub typhus was common in local medical institutions. Alarm should be raised for changes of clinical features and current diagnostic issues of scrub typhus in newly developed endemic areas.
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PMID:Scrub typhus: surveillance, clinical profile and diagnostic issues in Shandong, China. 2309 Nov 93


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