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)

All antihypertensive treatments, including placebo, are associated with cognitive side effects. These side effects are rarely clear-cut and involve mood, quality of sleep, daytime sedation, and various neuropsychologic functions. This review article reflects on the vast literature on this topic and comments on substantive findings, as well as methodologic difficulties in sorting through findings from quality-of-life studies. Hypertension itself is associated with many of the above changes, and some cognitive functions actually improve with treatment. Nonetheless, many medications are accused of causing side effects, despite the fact that side effects with placebo are common, particularly for nonspecific complaints, such as fatigue. Side effects are not limited to sympatholytic antihypertensive agents and are commonly reported even by patients who are treated with diuretics. It is not at all clear that side effects are more commonly reported in patients who are treated with lipophilic beta-blockers. The patient may be a relatively poor observer of these subtle changes. The spouse is an important source of additional information with regard to side effects. The virtual absence of any standardization in quality-of-life measures makes comparisons across studies extremely difficult.
 ...
PMID:Reflections on the impact of antihypertensive medications on mood, sedation, and neuropsychologic functioning. 172 26

In a retrospective study of 632 patients with pituitary disease we diagnosed pituitary insufficiency without hypersecretion of any pituitary hormone in 122 patients. Patients were substituted with sex hormones (76%), hydrocortisone (74%) and/or L-thyroxine (77%). 76% had additional growth hormone deficiency, as shown by an increase of growth hormone of less than 5 ng/ml after i.v. administration of L-arginine. In 17% of all patients the diagnosis of osteoporosis was proven or suspected radiologically. 57% had low bone mass of lumbar spine (dualphotonabsorptiometry) and 73% had low bone mass of the proximal forearm (singlephotonabsorptiometry). BMD values of pituitary insufficient patients were in the same range as those of patients with established osteoporosis. More than half of all patients (53%) complained of tiredness, exhaustion and muscle weakness. 40% suffered from adipositas. 77% had hyperlipidemia (68% hypertriglyceridemia and 42% hypercholesterinemia), 18% had hypertension. 14% of the patients had arteriosclerotic events in their history (myocardial infarction or stroke). These figures are higher than incidences shown in the German PROCAM-study. These data show an increased prevalence of osteoporosis and vascular diseases. This is in contrast to the general opinion, that patients with pituitary insufficiency are adequately treated by substitution with adrenal, thyroid and sex hormones. Whether other factors such as the additional growth hormone deficiency are responsible for these diseases has to be examined in prospective studies.
 ...
PMID:[Increased prevalence of osteoporosis and arteriosclerosis in conventionally substituted anterior pituitary insufficiency: need for additional growth hormone substitution?]. 176 81

Felodipine, a dihydropyridine calcium-channel antagonist, significantly reduces systolic and diastolic blood pressure (BP) in patients with hypertension and has been associated with beneficial hemodynamic effects in patients with chronic stable angina pectoris or congestive heart failure (CHF). In hypertensive patients, felodipine does not appear to significantly affect glomerular filtration rate, creatinine clearance, glucose tolerance, or plasma lipoprotein concentrations. Studies comparing felodipine with other agents as monotherapy in mild to moderate hypertension have demonstrated felodipine to be at least as efficacious as hydrochlorothiazide (HCTZ) and HCTZ plus amiloride hydrochloride in combination. Comparisons of felodipine with other agents as adjuncts to beta-blocker or diuretic therapy have shown felodipine to be at least as effective as HCTZ, propranolol hydrochloride, prazosin hydrochloride, and nifedipine. Evaluations of patients with chronic stable angina are limited, and additional studies are needed before felodipine can be recommended for the routine management of angina pectoris. Similarly, additional studies are essential to delineate the role of felodipine, if any, in the management of CHF. In the management of hypertension, felodipine 5-40 mg/d significantly reduces systolic and diastolic BP. Although some patients may be controlled throughout the entire dosing interval when felodipine is administered bid, many patients will require more frequent dosing to obtain adequate BP control. Adverse effects associated with felodipine are similar to those of other dihydropyridine calcium-channel antagonists and include peripheral edema, headache, dizziness, flushing, and fatigue. A potentially clinically important drug interaction was observed when felodipine was administered concomitantly with theophylline aminopropanol; significant decreases in theophylline concentrations were noted. In summary, felodipine appears to be safe and effective for the management of hypertension when used alone or in combination with other antihypertensive agents. The efficacy of felodipine in the management of chronic stable angina pectoris and CHF requires further investigation.
 ...
PMID:Felodipine: a new dihydropyridine calcium-channel antagonist. 176 37

Over the last 25 years, the perceived clinical spectrum of primary hyperparathyroidism (HPT) has changed dramatically from a disorder characterized by severe bone and renal disease to one typically manifested by few or mild symptoms and little evidence of organ damage. Reasons for this change in spectrum include changing demographics (primary HPT is primarily a disease of the middle-aged and elderly), diffusion of medical knowledge leading to a higher index of suspicion, and improved clinical laboratory technology (especially inexpensive and accurate determination of serum calcium and parathyroid hormone). In the first 343 cases of primary HPT seen at the Massachusetts General Hospital, 57% had renal stones, 23% had hyperparathyroid bone disease, and less than 1% had no symptoms. By contrast, studies dating from the availability of automated serum calcium measurement found renal stones and hyperparathyroid bone disease in less than 5% of cases, and about half of cases had few or no symptoms. Most patients with primary HPT today have mild, nonspecific symptoms, such as weakness, fatigue, and mental depression, and such signs as arterial hypertension and osteopenia, and detection of their hypercalcemia is generally serendipitous. The mildness and slow progression seen in many cases of primary HPT has resulted in much controversy about appropriate management.
 ...
PMID:Clinical spectrum of primary hyperparathyroidism: evolution with changes in medical practice and technology. 176 71

The exposure of divers to hyperbaric conditions under pressure of 4.6 MPa induced development of astheno-neurotic disorders with cardiovascular component against a background of pronounced fatigue. A decrease of the pulmonary ventilation function in the form of bronchial obstruction syndrome was observed as well. On the 10-15th day of the postdiving period asthenia phenomena extinguished and the pulmonary function tended to restoration. On the 30th day of postdiving period all the functional systems were normalized. The professional activity of divers for many years gives rise to the formation of adaptive reaction (increase of vital capacity of lungs and maximal ventilation of lungs), on the one hand, and to pathological disorders, such as arterial hypertension and bronchial obstruction syndrome, on the other hand.
 ...
PMID:[Status of the main functional systems in humans after long-term exposure to hyperbaric medium]. 177 61

In order to determine whether the clinical features of obstructive sleep apnoea (OSA) are the same in men and women we reviewed the records of 22 women with OSA. The women were matched with 44 men of similar age (+/- 5 years) and frequency of respiratory events (less than or equal to 15/hr, 16-40/hr, 41-70/hr and greater than 70/hr). The degree of daytime somnolence was similar in men and women. Women are more likely than men to complain of morning fatigue and morning headache, and less likely to report restless sleep or to have been told of apnoea during sleep. Difficulty initiating sleep (DIS) was twice as common in women as in men (p less than 0.05). Most of these differences were also seen when women and men who snored but did not have OSA were compared. Arterial hypertension was less common in women (3/22) than in men (18/44), (p less than 0.001). More striking than the differences between men and women in the prevalence of single symptoms was the existence of a subgroup of women (9/22) with no complaint of either apnoea, choking arousals or restless sleep, and normal blood pressure, complaining only of fatigue and morning headache, and in three cases DIS as well. We concluded that OSA may be commoner in women than previous reports suggest, and that the clinical features may be misleading in women.
 ...
PMID:Differences in the symptoms of men and women with obstructive sleep apnoea. 181 45

A 22-year old unmarried healthy woman was admitted to the Swedish department with low fever, tiredness, SR 75 mm, positive uricult, but no urinary tract symptoms. Urinary tract infection was suspected and treatment was started with norfloxacin. Nevertheless, the urine culture proved to be negative. A few weeks later she had increasing trouble with stiff knee and shoulder joints and the left foot became swollen. The subfebrile status continued, and tonsillitis was suspected and diagnosed. V-penicillin and cefaklor treatment was applied. She was transferred to the infectious diseases ware, where fever was confirmed with leukocytosis (19 x 1 billion/1), C-reactive protein at 66 (normal value 10) mcg/ml, pronounced blood pressure increase (160/130 mm Hg), anemic signs, and pathological liver status with increased transaminases (ASAT 6.3-10.4 and ALAT 8.,8-16 ukat/1). ALP increased slightly to 6 ukat/1. The symptoms of weight loss indisposition, and muscles and joints aches, especially in foot ache continued. Collagen disease was suspected, and she was transferred to the internal medicine department. She regularly had tachycardia and high blood pressure. She had to use crutches for mobility because of the pain. S-albumin was 32 (normal 36- 50) g/l and S-hepatoglobin was 2.7 (normal value .4-1.8) g.l. Various others tests were normal. Ulnaris neuropathy was suspected on the left hand. Intensive blood pressure reducing combination treatment was started with 200 mg x 1 of metoprolol, 10 mg x 2 nifedipin, and 20 mg x 1 enalapril. The Desolett oral contraceptive (containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel) she had been taking for a few months were discontinued. Quick improvement of clinical and laboratory parameters followed. SR and leukocytosis became normal. The values of ALP, ASAT, and ALAT became normal some days later. She was discharged shortly thereafter, and blood pressure medication was gradually discontinued. In the 1940s there were reports about the hepatotoxic effects of synthetic estrogens followed by carbohydrate, lipid, and protein metabolism alterations. Jaundice has also been reported, and the Swedes have an ethnic susceptibility to it. The global incidence rate is 1/10.000 vs. 1/100 and 1/4000 in Sweden induced by high-dose OCs containing more than 50 mcg ethinyl estradiol, but with low-dose OCs this rate is much lower. Both estrogens and gestagens can increase blood pressure. A 1969 study reported that 22 young women developed arthritis, arthralgia, and myalgia after taking pills for 3- 12 months. Rheumatic symptoms were also recorded with pill use. Thus, it is very likely that OCs were responsible for the patient's symptoms, especially since her status rapidly improved after discontinuing them.
 ...
PMID:[Were the severe adverse effects on several organs and the marked blood pressure increase caused by oral contraceptives?]. 182 62

The relations between insomnia and blood pressure were investigated in 151 patients (56 men and 95 women). It was found that 37.1% of the patients were normotensive, whereas 31.8% suffered from arterial hypertension and 31.1% from arterial hypotension. There was practically no difference between normotensives and hypertensives in respect of disturbed behavioral patterns of sleep, but an entirely different picture was presented by the arterial hypotensives. Characteristic features of hypotonic insomnias were (mostly in women) prolonged time before falling asleep, frequent awakening at night associated with tachycardia and long-lasting increased excitability, starting difficulties in the morning, depressive conditions, compulsive yawning and falling asleep during daytime, tiredness, lack of "drive" and reduced physical and mental efficiency. This pattern of signs and symptoms was enhanced by hypnotics and tranquilisers. During sleep blood pressures down to 50/35 Torr were measured. It is assumed that the low blood pressure results in hypoxic and hypoglycaemic conditions in the brain. Spontaneous awakening is considered to be an emergency reaction triggered by the deficient cerebral blood flow.
 ...
PMID:[Relationship between insomnia and arterial hypotension]. 186 93

Many current health status instruments either are too long to use in many acquired immune deficiency syndrome (AIDS) clinical trials or omit important concepts. In this study, human immunodeficiency virus (HIV)-relevant items developed for the Medical Outcomes Study (MOS) from subscales for cognitive function, energy/fatigue, health distress, and a single quality of life item were added to a portion of the MOS Short-form General Health Survey. The resulting 30-item questionnaire reliably and distinctly measured ten aspects of health and took less than 5 minutes to complete. To test its validity, this modified measure was used to compare the health of 73 subjects with asymptomatic HIV infection and 44 with early AIDS-related complex (ARC). Compared with ARC subjects, asymptomatic individuals reported superior overall health, less pain, and better physical function, role function, cognitive function, and quality of life (rank-sum, P less than 0.02). Asymptomatic subjects' scores were higher on most subscales than the age-adjusted scores of MOS outpatients with hypertension, diabetes, recent myocardial infarction, or depression; ARC patients scored closest to hypertensive patients. This instrument, containing a subset of the MOS measures of health-related quality of life, may be a useful outcome measure for AIDS clinical trials.
 ...
PMID:A health status questionnaire using 30 items from the Medical Outcomes Study. Preliminary validation in persons with early HIV infection. 187 45

Data from clinical trials with benazepril suggest that the safety profile of benazepril is similar to that of other angiotensin-converting enzyme (ACE) inhibitors. Treatment-related side effects occurred in 20% of benazepril-treated patients and in 18% of patients receiving placebo. The most commonly reported side effects with benazepril were headache, dizziness, and fatigue. The incidence of side effects was not affected by the degree of hypertension, age, gender, race, dosage, or the degree of renal impairment. Side effects believed to be related to the pharmacologic action of ACE inhibitors as a class include symptomatic hypotension, which occurred at a relatively low rate with benazepril, and hyperkalemia and elevation of serum creatinine, which occurred to the same extent with benazepril as has been noted with other ACE inhibitors. The mechanism of cough as an ACE inhibitor side effect is unknown; the incidence was similar to that with other ACE inhibitors. Rash and taste disturbance have occurred rarely with benazepril. The incidence of neutropenia and of proteinuria was the same in both the benazepril and placebo groups. Renal failure in hypertensive patients treated with benazepril has not been reported. Overall, benazepril is generally well tolerated by hypertensive patients. The incidence of most side effects is comparable to that with other ACE inhibitors and placebo.
 ...
PMID:Safety profile of benazepril in essential hypertension. 189 40


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