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)

Seven highly trained female cyclists (age 22 +/- 5 yr, height 165 +/- 6 cm, weight 60 +/- 5 kg, VO2max 55 +/- 6 ml.min-1.kg-1, mean +/- SD) consumed, for 1 wk each, isocaloric diets containing varying levels of carbohydrate, protein, and fat designated as low carbohydrate (LCHO), moderate carbohydrate (MCHO), and high carbohydrate (HCHO). Diets were administered in random order, and each subject consumed all three diet treatments. At the end of each weekly diet treatment, subjects rode on a cycle ergometer at 80% VO2max until fatigued. Cyclists continued light training during the diet treatments. Following each diet treatment and immediately prior to the fatiguing cycle ergometer ride, cyclists completed a Profile of Mood States (POMS) questionnaire. The POMS yields measures of tension (T), depression (D), anger (A), vigor (V), fatigue (F), and confusion (C), as well as providing a total mood score (TMS). Results indicated that subjects on LCHO had significantly (P less than or equal to 0.05) greater T, D, A, and TMS and less V compared with MCHO and HCHO. There were no significant differences between MCHO and HCHO. In the present study, LCHO in conjunction with training and exercise adversely affected the mood state of trained female cyclists as compared with MCHO and HCHO diets.
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PMID:Alterations in dietary carbohydrate, protein, and fat intake and mood state in trained female cyclists. 201 17

Ranitidine was first marketed in 1981; since then many patients have been treated such that much experience has been accumulated on the safety of this histamine H2-receptor antagonist in the treatment of gastroduodenal disease. A wide array of ranitidine-associated side effects has been described, but infrequently. As so much information is now available, the aim of this review is to assess the weight of evidence for a causal link between ranitidine and the reported side effects. Overall, ranitidine is well tolerated. The incidence of general side effects at less than 2% is very similar to placebo. Headaches, tiredness, dizziness and mild gastrointestinal disturbance (e.g. diarrhoea, constipation and nausea) are among the most frequent complaints, but have very seldom resulted in stopping treatment. Cardiovascular side effects are extremely rare and unpredictable with the usual doses of oral ranitidine (at most 1 in 1 million patients). They mostly comprise sinusal bradycardia and atrioventricular blockade, especially after rapid intravenous administration, receding after cessation of the drug. Clinical studies, however, have not shown a significant pharmacological effect of ranitidine on the cardiovascular system via H2-receptors, even though individual sensitivities cannot be ruled out in a few isolated reports. Ranitidine is unlikely to be directly hepatotoxic: a transient change in liver function tests has been noted in only 1 in 100 to 1 in 1000 patients. Several cases of mixed hepatitis have been reported, but very few were fully documented. The incidence of ranitidine-associated acute hepatitis has been estimated to be less than 1 in 100,000 patients. Neuropsychiatric complications may be less common and clinically quite similar to those reported with cimetidine, i.e. confusion, disorientation, hallucinations, delirium. These side effects have occurred especially in critically ill and multiple-therapy patients, or patients with chronic renal or hepatic failure, so that the direct causal link with ranitidine treatment was often difficult to ascertain. Even though an H2-receptor-mediated effect is an attractive hypothesis (since similar complications were noted with other H2-receptor antagonists), other mechanisms have been suggested to play a role, e.g. cholinergic or histaminic effects. The overall incidence of neuropsychiatric complications is probably markedly less than 1%. White cell injury (i.e. agranulocytosis) appears to be the most frequent haematological complication, even though case reports are very few and poorly documented.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Side effects of ranitidine. 204 87

The new fluorinated adenine analog, fludarabine, has been tested for efficacy in many tumor types over the past ten years. Two other similar nucleoside analogs are currently available for commercial use. Cytarabine is used principally as an antileukemic agent, and vidarabine as an antiviral. Unlike vidarabine, fludarabine is resistant to deactivation by adenosine deaminase. Data from Phase I and II trials suggest that fludarabine is potentially effective in a number of leukemias, including acute lymphocytic leukemia, acute nonlymphocytic leukemia, and chronic lymphocytic leukemia (CLL). Unfortunately, the doses required to achieve adequate response in the acute leukemias (greater than 75 mg/m2) were above the maximum tolerated dose, resulting in intolerable granulocytopenia, thrombocytopenia, and a life-threatening neurotoxic syndrome. In CLL: however, the dose required to achieve a satisfactory response is well within tolerated limits. Long-term survival statistics are not yet available, but historical perspective strongly correlates response to other agents with increased survival times. Toxicities seen at dose regimens of 15-40 mg/m2/d for five consecutive days include somnolence, metabolic acidosis, confusion, fatigue, nausea, vomiting, increase in serum creatinine and aminotransferase concentrations, and pulmonary and hepatic abnormalities. Mild to severe hematologic toxicity has been observed at all dose levels.
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PMID:Fludarabine: a review. 206 37

Hypercalcemia is a potentially lethal endocrine disorder occurring in 10% to 20% of cancer patients at some time during the course of their disease. Clinical manifestations vary in severity, depending on the degree and duration of hypercalcemia, rapidity of onset, patient's age, performance status, sites of metastases, previous antineoplastic therapy, and the presence of hepatic or renal dysfunction. The clinical features of hypercalcemia are protean and affect multiple organ systems, resulting most prominently in neurologic, gastrointestinal, renal, cardiovascular, and musculoskeletal morbidity. Recognition of the disorder requires a high index of suspicion because many of its symptoms, such as nausea, anorexia, weakness, fatigue, lethargy, and confusion, are non-specific and, in the patient with a malignancy, can result from other complications of the primary disorder. If identified appropriately as being related to hypercalcemia, such symptomatology is potentially reversible with treatment. Whereas in the ambulatory general medical population the most common cause of hypercalcemia is primary hyperparathyroidism, in cancer patients and hospitalized patients in general, the most common cause is malignancy. Hypercalcemia in cancer patients is, in most cases, due to advanced metastasized disease. Diagnostic tests are useful in the differential diagnosis of hypercalcemia, and such tests, together with an accurate history and careful clinical observation, permit the best therapeutic approach to an individual patient.
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PMID:Clinical manifestations of cancer-related hypercalcemia. 218 49

The purpose of this study was to compare patterns of self-reported mood states of women having chorionic villus sampling (CVS) (n = 151) to those of women electing amniocentesis (n = 30) with the indication of advanced maternal age. Mood states were defined as scores on the 6 subscales of the Profile of Mood States (POMS). Women at 4 U.S. prenatal diagnostic facilities completed the POMS at 4 assessment periods. These were a) at their initial genetic counseling session, b) 2 weeks post CVS results (or an equivalent time), c) 2 weeks post amniocentesis results (or an equivalent time), and d) at 30 weeks gestation. Repeated measures analysis of variance revealed that anxiety, fatigue, and confusion decreased, and vigor increased in both groups as the pregnancy progressed. Depression decreased in both groups and then increased at assessment 4 in women in the amniocentesis group but not in those electing CVS. Results should be interpreted in conjunction with obstetrically and genetically-oriented findings regarding safety and accuracy to help women decide between the 2 procedures.
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PMID:Patterns of mood states in pregnant women undergoing chorionic villus sampling or amniocentesis. 224 85

A polyethylene glycol conjugate of L-asparaginase (PEGLA) was administered to 21 patients with refractory non-Hodgkin's lymphoma. The dose given was 2,000 mu/m2 intramuscularly every 2 weeks. Eligibility required at least one prior trial of chemotherapy and ambulatory performance status. At entry, all patients had measurable lesions and documented disease progression. The median age of the patients was 61 years; 18 (86%) were ambulatory with minimal symptoms, 12 patients (57%) had 3 or more prior regimens, and 13 (62%) had stage IV disease. Histologic subtype was low grade in 11 patients (52%), intermediate in 7 (33%), high grade in 2 (10%) and unclassifiable in one (5%). There were two partial responses (11%) noted (95% confidence interval of response of 1-30%). Eleven patients (52%) were removed from study due to disease progression. Nine patients (43%), required removal for toxicity (7 for protracted nausea and vomiting and 2 for confusion). One patient died of sepsis while on study but this was not considered drug related. Almost one third of patients complained of fatigue or loss of appetite. Nausea and vomiting occurred in approximately half the patients and was moderate to severe in 9. Diarrhea and abdominal pain were also noted in one-third of those treated. Changes in the partial thromboplastin time and fibrinogen were noted in most patients but resulted in no bleeding complications. In this trial, PEGLA displayed modest activity in a heterogenous group of patients with progressive non-Hodgkin's lymphoma.
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PMID:A phase II trial of PEG-L-asparaginase in the treatment of non-Hodgkins lymphoma. 234 67

To establish a quantitative method for the diagnosis of premenstrual syndrome (PMS), a simple prospective inventory, the calendar of premenstrual experiences, was constructed. The validity and reliability of this instrument were assessed by administering it throughout two consecutive ovulatory cycles to 36 rigidly screened women with PMS and to 18 controls. To establish concurrent validity, scores on behavioral items were correlated with simultaneously obtained scores on lengthier, well-validated psychiatric inventories designed to measure depression rather than PMS, the Beck Depression Inventory and the Profile of Mood States. The results showed that the calendar of premenstrual experiences luteal phase score distinguished PMS women from controls correctly in 104 of 108 cycles, with a 2.8% false-negative rate and no false positives when used for two consecutive cycles. An upper limit follicular phase score was observed beneath which all PMS and normal control subjects fell, suggesting that a higher score is not consistent with PMS. Correlation coefficients of calendar item scores with Profile of Mood States scale scores were 0.58 for tension, 0.51 for depression, 0.46 for anger, 0.61 for fatigue, and 0.57 for confusion (P less than .0001 for all correlations). The correlation of the calendar depression item with the Beck Depression Inventory score was 0.56 (P less than .0001). The test-retest reliability of the calendar given in the same phase of two consecutive menstrual cycles was high (r = 0.78, P less than .0001). We conclude that this instrument is a valid, reliable, and practical PMS inventory, applicable to clinical and some research settings.
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PMID:Diagnosis of premenstrual syndrome by a simple, prospective, and reliable instrument: the calendar of premenstrual experiences. 237 Oct 35

We evaluated the immediate and long-term effects on psychological distress and coping methods of a 6-week, structured, psychiatric group intervention for postsurgical patients with malignant melanoma. The intervention consisted of health education, enhancement of problem-solving skills, stress management (eg, relaxation techniques), and psychological support. In spite of good prognosis, most patients had high levels of psychological distress at baseline, comparable with other patients with cancer. However, at the end of brief psychiatric intervention, the experimental subjects (n = 38), while not without some distress, exhibited higher vigor and greater use of active-behavioral coping than the controls (n = 28). At 6 months' follow-up, the group differences were even more pronounced. The intervention-group patients then showed significantly lower depression, fatigue, confusion, and total mood disturbance as well as higher vigor. They were also using significantly more active-behavioral and active-cognitive coping than the controls. These results indicate that a short-term psychiatric group intervention for patients with malignant melanoma effectively reduces psychological distress and enhances longer-term effective coping.
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PMID:A structured psychiatric intervention for cancer patients. I. Changes over time in methods of coping and affective disturbance. 237 43

Well trained subjects (N = 12) were studied before and after losing approximately 6% of body weight to determine whether physical performance could be maintained while consuming a hypocaloric, high percentage carbohydrate diet. During a 4-d period of weight loss, subjects were randomly assigned to a high carbohydrate (HC) or low carbohydrate (LC) diet. A crossover design was used; subjects were measured before (PRE) and after (POST) weight loss on both diets for a 6-min bout of high intensity arm cranking, weight, skinfold thickness, and profile of mood states (POMS). Hemoglobin, hematocrit, and glycerol concentrations were analyzed for resting blood samples, while lactate, pH, and base excess were analyzed for blood samples drawn at rest and 1, 3, and 5 min after arm cranking. A three-way ANOVA of sprint work revealed a weight loss effect, a diet by weight loss interaction, and an order by diet by weight loss interaction (P less than 0.05). Total sprint work (mean +/- SE) PRE and POST HC was 37.7 +/- 2.1 kJ and 37.4 +/- 2.2 kJ, respectively. Sprint work was higher for PRE LC vs POST LC, with mean values of 37.4 +/- 2.1 kJ and 34.4 +/- 2.2 kJ, respectively. Post-arm cranking lactate was significantly higher PRE compared to POST for both HC and LC. Post-exercise blood pH was lower (P less than 0.05) at PRE vs POST, with no diet effect. Regardless of the diet, POMS variables tension, depression, anger, fatigue, and confusion were significantly elevated from PRE to POST; vigor was significantly lower.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Weight loss, dietary carbohydrate modifications, and high intensity, physical performance. 240 6

Sick sinus syndrome (SSS) is usually a disease of the elderly produced by idiopathic degeneration of the sinoatrial node. Its initial manifestations range from asymptomatic to nonspecific and include palpitations, fatigue, confusion, and even syncope and sudden death. Electrocardiographic evidence of SSS includes inappropriate sinus bradycardia, sinus pause or arrest, or sinus exit block. These bradyarrhythmias may alternate with tachyarrhythmias, especially atrial fibrillation, to create the tachycardia-bradycardia syndrome. The diagnosis of SSS may be established by electrocardiography or ambulatory monitoring in the majority of cases. Medications such as digoxin, beta-blockers, and calcium blockers may initiate or worsen the manifestations of SSS. Permanent pacing is indicated for symptomatic bradyarrhythmias. Progression of SSS is mostly dependent on the presence and severity of associated coronary or hypertensive heart disease.
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PMID:Update on sick sinus syndrome, a cardiac disorder of aging. 240 55


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