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)

A 75 year old patient was hospitalized because of acute dyspnea. For two weeks she suffered from a flu-like illness with low-grade fever, cough, and fatigue. On auscultation systolic and diastolic murmurs were found whose intensity changed depending on the position assumed by the patient. Transthoracic and transoesophageal echocardiography showed a tumor in the left atrium obstructing the left ventricular inflow tract. The tumor was removed surgically because of this obstruction and the imminent danger of embolism to the peripheral arteries. The diagnosis of an atrial myxoma was confirmed intraoperatively and by histology.
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PMID:[Acute dyspnea]. 896 31

Chronic fatigue syndrome (CFS) is a heterogeneous disorder characterized by severe prolonged unexplained fatigue and a variety of associated symptoms such as arthralgias, myalgias, cognitive dysfunction, and severe sleep disturbances. Many patients initially present with an acute onset of apparent infectious origin with either an upper respiratory or gastrointestinal illness, fever, chills, tender lymphadenopathy, and malaise suggestive of a flu-like illness. In some cases, specific viral infections can be identified at the outset, particularly herpes viruses such as Epstein-Barr virus (EBV), human herpes virus-6 (HHV-6), and cytomegalovirus (CMV). Transfer factors (TF) with specific activity against these herpes viruses has been documented. With some studies suggesting that persistent viral activity may play a role in perpetuation of CFS symptoms, there appears to be a rationale for the use of TF in patients with CFS and recent reports have suggested that transfer factor may play a beneficial role in this disorder. This report focuses on the heterogeneity of CFS, the necessity for randomized coded studies, the importance of patient selection and sub-classification in clinical trials, and the need to utilize specific end-points for determining efficacy of treatment.
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PMID:The use of transfer factors in chronic fatigue syndrome: prospects and problems. 899 62

rHuTNF was locally applied to 26 patients with diverse advanced tumours and malignant pleural effusions following maximum possible drainage of their pleural cavities. 46 instillations (an average of 1.8 per patient) with doses between 0.10 mg and 0.50 mg were carried out. The total doses ranged from 0.15 mg to 1.01 mg per patient. 41% of the instillations resulted in flu-like symptoms, 35% fever/chill, 24% fatigue/malaise, 11% nausea/vomiting and 11% chest pain. All toxicities were fully reversible and could be treated successfully. There was no apparent relation between dose and side-effects. Of those patients treated primarily with TNF, 87% did not suffer from any recurrent effusion within 4 weeks after treatment. In patients who had already been treated employing other methods, this figure was 86%. Complete drainage of the pleural cavity was not absolutely necessary before application of TNF. Intrapleural instillation of TNF appears to be an effective method for achieving pleurodesis with relatively few side-effects and can be successful even after other methods have failed. It is a method which can also be applied to patients who have a poor general state of health.
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PMID:Recombinant tumour necrosis factor in the local therapy of malignant pleural effusion. 913 93

Following a previous EORTC GU-Group study, in which linomide showed some activity in poor prognosis patients, this study was initiated to determine the effect of linomide in more favourable patients. 35 patients with metastatic renal cell carcinoma with good prognostic factors, i.e. good performance status, prior nephrectomy, no prior systemic therapy, and no liver, bone or brain metastases, were treated with linomide, a quinoline derivative with immunomodulating properties, at a dose of 10 mg daily, after an initial dose escalation during the first 4 weeks of treatment. In 29 evaluable patients, no responses were observed (95% confidence interval 0-10%). Best overall response was no change in 9 patients, for a median duration of 4 months. Linomide in this schedule was poorly tolerated, with 17% (6 patients) of patients being withdrawn and 23% (8 patients) having dose reductions due to adverse events, mostly influenza-like symptoms of myalgia, arthralgia and fatigue. Several cases of pericarditis and neuropathy were observed. In spite of selection of favourable prognosis patients and an optimal daily dosing schedule, linomide was not an effective treatment in renal cell carcinoma. In view of toxicity and lack of efficacy, there is no rationale in further testing the drug in this disease.
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PMID:EORTC phase II study of daily oral linomide in metastatic renal cell carcinoma patients with good prognostic factors. 915 37

The aim of this study was to investigate the possible therapeutic effect of 13-cis-retinoic acid plus interferon alpha-2a in patients with inoperable squamous cancer of the esophagus. Patients with advanced, measurable, histologically confirmed squamous carcinoma of the esophagus with an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2 who had adequate bone marrow, liver, and renal function were eligible for study. Patients were given cis-retinoic acid 1 mg/kg/day per mouth continuously and interferon alpha-2a 3 Mu/day for 3 days followed by 6 Mu subcutaneously daily thereafter. Seventeen patients were entered on study. Fifteen patients were evaluable for toxicity. The most common toxicities were grade 1 and 2 cheilitis, dry skin and flu-like symptoms which occurred in all patients. Two patients had grade 3 toxicity (1 anorexia and 1 fatigue). No grade 4 toxicity occurred. Fifteen patients were evaluable for response. No objective response was documented. The median survival time was 15 weeks. With no response seen it is unlikely that the combination of treatment as used in this study will be of benefit in patients with advanced squamous cancer of the esophagus.
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PMID:13-Cis-retinoic acid and interferon alpha-2a in patients with advanced esophageal cancer: a phase II trial. 915 75

To minimize the symptoms of antidepressant discontinuation, gradual tapering is necessary for all serotonin reuptake inhibitors (SRIs) except fluoxetine, which has an extended half-life. Agents with shorter half-lives such as venlafaxine, fluvoxamine, and paroxetine should be tapered gradually. Discontinuation symptoms, which frequently emerge after abrupt discontinuation or intermittent non-compliance and, less frequently, during dose reduction, are generally mild, short-lived, and self-limiting but can be distressing and may lead to missed work days and decreased productivity. The symptoms may be somatic (e.g., dizziness and light-headedness; nausea and vomiting; fatigue, lethargy, myalgia, chills, and other flu-like symptoms; sensory and sleep disturbances) or psychological (anxiety and/or agitation, crying spells, irritability). Mild symptoms can often be treated by simply reassuring the patient that they are usually transient, but for more severe symptoms, it may be necessary to reinstitute the dosage of the original antidepressant and slow the rate of taper. Symptoms of discontinuation may be mistaken for physical illness or relapse into depression; misdiagnosing the symptoms may lead to unnecessary, costly tests and treatment. Thus, health care professionals need to be educated about the potential adverse effects of SRI discontinuation.
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PMID:Clinical management of antidepressant discontinuation. 981 35

In October 1993 and 1994, respectively, 77 and 76 third-year veterinary students visited a swine farm to work with pigs for 3 h. On both occasions, a large number of students reported flu-like symptoms after the visit. To further investigate this, the students were presented with a questionnaire modeled after the standard questionnaire used for evaluating organic dust exposure. General and/or respiratory symptoms were reported by 103/142 (72.5%) students. General symptoms, such as eye irritation, headache and tiredness were experienced by 60/103 (42.2%) students. Cough, nasal and throat irritation, and sinus trouble were the most prevalent respiratory symptoms and were reported by 94/103 (91%) of the students. Symptoms mostly developed the same day and disappeared within 3 d after exposure. The presence of respiratory and/or general symptoms was not significantly different between students who wore a mask during the lab or those who did not. Students with pre-existing allergies were more likely to develop respiratory symptoms than non-allergic students.
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PMID:Health problems in veterinary students after visiting a commercial swine farm. 944 39

Interleukin-12 (IL-12) is a cytokine that stimulates T cells and NK cells. It induces interferon-gamma and plays a unique role in promoting type 1 T helper cell responses. In various animal models, IL-12 has shown a therapeutic effect controlling growth of primary and metastatic tumors at nontoxic doses. On the basis of these findings, IL-12 is now under clinical trial. Fever, flu-like, general fatigue, arthralgia, myalgia, leukopenia, liver dysfunction and so on are the reported toxicities of IL-12. A dramatic decrease of IL-12 AUC after consecutive dosing of IL-12, production of IL-10 and temporal elevation of NK and LAK activities after IL-12 administration have also been observed. Several patients achieve PRs after the administration, but dramatic clinical responses have never been reported. Intensive research on the mechanisms of antitumor response of IL-12 in cancer patients should be very important to the successful development of IL-12 as an anti-cancer agent.
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PMID:[Clinical trial of IL-12 for cancer patients]. 947 26

Interferons (IFNs) are potent biologic response modifiers with antiviral and antiproliferative effects. The successful clinical application of IFNs for the treatment of chronic viral infections and malignancies has resulted in improved quality and quantity of life for thousands of patients, and the number of new indications for IFN therapy continues to grow. However, the therapeutic effectiveness of IFNs, including IFN-alpha, is often compromised by a variety of dose-related side effects that can be dose limiting. These side effects include flu-like symptoms, fatigue, anorexia, and depression, which may be mild or severe. A better understanding of the mechanisms by which IFN-alpha causes these side effects will facilitate the development of effective strategies to lessen their effects on the patient's quality of life and allow the maximum therapeutic dose of IFN-alpha to be administered.
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PMID:A perspective on the clinical effectiveness and tolerance of interferon-alpha. 948 34

Two forms of recombinant interferon-alpha (IFN-alpha2a and IFN-alpha2b) have been approved by the Food and Drug Administration for a variety of clinical indications, including hairy cell leukemia, hepatitis, acquired immunodeficiency syndrome-related Kaposi's sarcoma, chronic myelogenous leukemia (IFN-alpha2a only), and adjuvant therapy for melanoma (IFN-alpha2b only), based on their proven clinical efficacy and acceptable safety profiles. The continued postmarketing monitoring of adverse reactions associated with IFN-alpha therapy has revealed some new toxicities. The most common adverse events associated with IFN-alpha therapy are flu-like symptoms, fatigue, anorexia, and central nervous system and psychiatric reactions. In particular, the incidence of depression has only recently been fully appreciated. Some of these side effects, particularly chronic fatigue, anorexia, and neuropsychiatric reactions, may become dose limiting. New approaches to minimize and manage the side effects of IFN-alpha therapy are needed.
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PMID:Safety profile of interferon-alpha therapy. 948 35


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