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)

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)
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PMID:Late onset reactions following venom immunotherapy and venom skin tests. 318 64

The diagnosis of cow's milk proteins allergy can only be established if the symptoms disappear with an elimination diet and if a later controlled challenge leads either to a recurrence of symptoms or to some other clearly identified changes. At the moment there is not a specific immunological test surely effective in all cases. Anyway the three Gooldmann's tests are not necessary. In fact a single challenge with a cow's milk meal will be sufficient when clinical observation is accompanied by monitoring some simple laboratory tests (serum and nasal eosinophils, steathorrea, coproleucocytes, hemoccult, xylosemia and leucocytes PMN). The challenge must be tested in a double-blind trial only in patients with non specific symptoms (such as tension fatigue syndrome, hyperactivity, ecc...). The double-blind challenge is not necessary generally for the diagnosis of cow's milk proteins allergy in childhood, because at this time of life not only the symptoms are very clear (diarrhea, vomiting, skin symptoms) but also there is a prevalence of non reaginic reactions: this kind of reactions are usually delayed and they generally occur after a relatively high dose of food allergens. In the group of patients with specific anti-cow's milk IgE (RAST and prick tests) and severe reactions (anaphylaxis), the challenge is not necessary to confirm the diagnosis, but is usefully to verify the acquired tolerance, generally after the first year of life.
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PMID:[Diagnosis of allergy to cow's milk proteins]. 332 Sep 92

In this review article on short term-effects of theophylline, results of studies with single administration of theophylline are compiled, supplemented by several studies with a therapeutic administration up to 4 Days. Data at hand show limited to moderate bronchodilatator effect of theophylline, which is comparable to beta 2-adrenergic drugs only in some studies using high dose regimen with theophylline levels of about 20 mg/l, i.e. with a considerable risk of unwanted side effects. In normal subjects no bronchodilatator effect is present at all, thus differing from beta 2-adrenergic drugs. In contrast, protection against allergic and non-allergic (exercise) stimuli is provided by theophylline already at serum levels about 3-4 mg/l, and with a dose-dependent increase of protection. These data are in accordance with in vitro-studies, demonstrating protection against leukocyte histamine release, rat passive cutaneous anaphylaxis, and mast cell degranulation. In man, there is a transient increase of alveolar ventilation via an increase of total ventilation VE, tidal column Vt, and respiratory frequency f. This phenomenon may, at least in part, be due to an increase of contractility of the respiratory muscles, as suggested by a recent study, demonstrating an inhibition of diaphragmatic fatigue by theophylline. In conclusion, theophylline seems to act via several mechanisms: bronchodilation, protection against various stimuli, increase of ventilation and muscular contractility, which might explain its clinical benefit, although less potent than other drugs as a bronchodilatator of prophylactic agent.
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PMID:Theophylline: short term treatment. 613 99

A 20-year-old female was brought to our emergency unit with generalized erythema and discomfort induced by running after having eaten wheat bread. The laboratory examinations, including eosinophils, total IgE, RAST score to wheat, heat challenge test and methacholine inhalation test were within normal limits. No anaphylactoid responses occurred after provocation tests of wheat bread intake or exercise alone. However, on provocation exercise test after eating pancakes, she developed hypotension, generalized itching and urticaria associated with an elevation of plasma histamine levels. These findings suggested wheat-dependent exercise-induced anaphylaxis. This was completely prevented by daily administration of terfenadine 120 mg p.o. without side effects such as fatigue or drowsiness.
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PMID:Successful prophylaxis of wheat-dependent exercise-induced anaphylaxis with terfenadine. 749 78

With increased popularity in exercise, the number of individuals with exercise-induced asthma (EIA), or 'exercise-induced bronchospasm', has increased due to an increased awareness among physicians of the clinical symptoms associated with EIA. EIA affects approximately 75 to 95% of asthmatic patients. 40% of children with allergic rhinitis have EIA, whereas only 3 to 11% of nonasthmatics have EIA. Although athletes with asthma have been recognised for years, EIA in nonasthmatic individuals has gained recognition since the 1984 Olympics. Vague symptoms of recurring poor performance, fatigue despite adequate conditioning, or 'getting winded' during an athlete's usual workout may be the presenting complaints. Athletes may be more likely to attribute these symptoms to poor conditioning or an upper respiratory infection, and not seek immediate assistance. Younger athletes may complain of stomach ache or refuse to participate in strenuous play because of an inability to keep up with other children. Additionally, an awareness of exercise-induced anaphylaxis needs to be considered when discussing aspects of airway compromise following exercise; however, its presentation is more urgent than those with EIA. Although the pathophysiology of EIA is somewhat controversial, the most likely explanation is a combination of heat and water loss leading to mediator release. The different medications that have been used to treat EIA are based on theories regarding the bronchial hyperreactivity of EIA.
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PMID:Exercise-induced asthma and anaphylaxis. 780 54

We tested paclitaxel (Taxol) and low dose hydroxyurea as second line therapy in 30 patients with non-small cell lung cancer since both drugs are active against non-small cell lung cancer in other settings, and since hydroxyurea may reverse chemotherapy resistance by disrupting double minute chromosomes. Hydroxyurea 500 mg was given orally each Monday, Wednesday, Friday starting 1 week before paclitaxel, and continuing until removal from study. Paclitaxel 135 mg/m2 was given i.v. over > or = 1 h every 3 weeks with dexamethasone, diphenhydramine, and ranitidine. Patients could have paclitaxel doses escalated to 175 mg/m2 in course 2 and to 200 mg/m2 in course 3, where tolerated. Sixteen males and 14 females were treated. All patients had previously received a single cisplatin-based chemotherapy regimen and 23 had previously received radiotherapy. Twelve patients had adenocarcinomas, six had squamous cell carcinomas, and 12 had large cell carcinomas. Eight patients had Stage IIIb cancers and 22 had Stage IV. Paclitaxel doses were 135 mg/m2 in 56 courses, 175 mg/m2 in 24, and 200 mg/m2 in 15. Treatment was well tolerated. Median granulocyte nadirs were 2.5 (x 10(9)/l) for paclitaxel 135 mg/m2, 1.8 for 175 mg/m2, and 1.3 for 200 mg/m2. No patient developed febrile neutropenia, and none required a dose reduction. Two patients had reversible anaphylaxis. Other toxicities were quite tolerable. They included fatigue, myalgias, dizziness, paresthesias, diarrhea, alopecia, mucositis, flushing, headache, swollen red hands, and anxiety. One patient had a partial remission and 15 had stable disease (including six with minor responses). Median survival was 20 (95% CI, 12-34) weeks, with 19% of patients remaining alive at 1 year from initiation of treatment. This is a well-tolerated regimen with modest activity as second line chemotherapy for patients with non-small cell lung cancer previously treated with cisplatin regimens. Higher doses would be feasible and other strategies are now being explored.
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PMID:Paclitaxel plus hydroxyurea as second line therapy for non-small cell lung cancer. 886 29

This study was aimed to determine the activity and toxicity of combination paclitaxel and carboplatin in stage III B and IV NSCLC. Eligibililty required performance status. Paclitaxel was administered at a dose of 200 mg/m2, 3-hour infusion, followed by carboplatin at a tartgeted area under the concentration-time curve (AUC) of 6. Treatment was repeated at 3-week intervals for 6 courses. G-CSF 5 micrograms/kg was subcutaneously injected during subsequent courses if there was grade 3-4 leukopenia or granulocytopenia in the previous course. From August 1996 through June 1997, 15 patients were enrolled. The median age was 47 years (range 20-68 years), 60 per cent were female. 73.3 per cent had adenocarcinoma, and 66.7 per cent had stage III B disease. Eighty three courses were administered; 13 patients (86.7%) completed all six cycles. The objective response rate was 53.3 per cent, with 1 (6.7%) complete response and 7 (46.7%) partial responses. Pleural effusion, lung lesion and lymph node were the three most common sites that responded to chemotherapy. The major toxicity was myelosuppression. Grade 3 or 4 granulocytopenia, anemia and thrombocytopenia were observed in 18 per cent, 7.2 per cent and 1.2 per cent, respectively, of 83 courses administered. Four episodes of febrile neutropenia (4.8%) occurred in 3 patients. There was one episode of anaphylaxis during Paclitaxel infusion. Other common toxicities were mild myalgia, paresthesias, alopecia and fatigue. Most of the toxicities showed cumulative effect. Paclitaxel plus carboplatin is a moderately active regimen in advanced NSCLC. Toxicities of this regimen are well tolerated.
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PMID:Paclitaxel and carboplatin in combination in the treatment of advanced non-small-cell lung cancer (NSCLC): a preliminary study. 980 67

We describe an unusual case of acute liver injury that followed food-dependent exercise-induced anaphylaxis (FDEIAn). A 45-year-old man who experienced anaphylactic shock induced by postprandial exercise and took alcohol that night was admitted the following day to our hospital because of general fatigue. Laboratory examinations revealed elevated hepatic enzymes (aspartate aminotransferase (AST) 6,110 IU, alanine aminotransferase (ALT) 4,178 IU). He had two similar episodes in the past. We speculated that acute liver injury in this case might be induced by interaction of anaphylactic shock and alcohol.
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PMID:Acute liver injury that followed food-dependent exercise-induced anaphylaxis. 1044 May 1

Twenty-one patients with recurrent or metastatic breast cancer were treated with paclitaxel (Taxol) as a 1-hour infusion on day 1 only of a 14-day cycle. This treatment was followed by 5-fluorouracil (5-FU) via a portable home pump, through a central venous catheter at 350 mg/m2 per day over 24 hours for a total of 96 hours, on days 1 to 5 and again on days 8 to 12. Based on reported phase I trials in other organ system cancers, the first 5 patients were treated with paclitaxel at 150 mg/m2 every 2 weeks, but this was associated with excessive toxicity. Subsequent patients received paclitaxel at 135 mg/m2. The FACT-B scale was used to assess quality of life for patients on entry of the study and after three cycles. Treatment was well tolerated, with no grade III or IV hematologic toxicities. Grade III nonhematologic toxicities comprised one patient with fatigue, one with mucositis, and one with diarrhea. Grade IV nonhematologic toxicities included 1 hypersensitivity reaction to paclitaxel. Four of the 16 patients (25%) had pump-related problems resulting in disrupted 5-FU dosing in the home setting. The patients had the following responses to the treatment: complete response 0 (0%), partial response 6 (37.5%), stable disease 4 (25%), progression 4 (25%), unassessable 2 (12.5%)-1 anaphylaxis and 1 thrombocytopenia; overall response rate 6 of 16 (0.37; 95% CI, of 0.57). The median duration of survival was 14 months, 95% CI (5.6-18.24). The FACT-B was assessed in 14 patients at baseline and in 8 patients after 3 cycles. Quality of Life improved in 6 patients, no patients remained stable, and worsened in 2 patients. Biweekly paclitaxel with weekly 4-day continuous infusion 5-FU was associated with minimal toxicity but did not meet the target response rate of 60%. This response rate does not justify use of a complex home infusion of 5-FU.
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PMID:Phase II study of low-dose infusional 5-fluorouracil and paclitaxel (Taxol) given every 2 weeks in metastatic breast cancer. 1194 2

Vaccines against Salmonella enterica serotype Typhi are used for prophylaxis of international travelers and have potential use as counterbioterrorism agents. The Vaccine Adverse Event Reporting System (VAERS) cannot usually establish causal relationships between vaccines and reported adverse events without further research but has successfully detected unrecognized side effects of vaccine. We reviewed reports to VAERS for US-licensed typhoid fever vaccines for the period of July 1990 through June 2002. We received 321 reports for parenteral Vi capsular polysaccharide vaccine and 345 reports for live, oral, attenuated Ty21a vaccine, with 7.5% and 5.5%, respectively, describing death, hospitalization, permanent disability, or life-threatening illness. Unexpected frequently reported symptoms included dizziness and pruritus for Vi vaccine and fatigue and myalgia for Ty21a vaccine. Gastroenteritis-like illness after receipt of Ty21a vaccine and abdominal pain after receipt of Vi vaccine, which are previously recognized events, occasionally required hospitalization. Nonfatal anaphylaxis was reported after both vaccines. VAERS reports do not indicate any unexpected serious side effects that compromise these vaccines' use for travelers' prophylaxis.
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PMID:Postmarketing safety surveillance for typhoid fever vaccines from the Vaccine Adverse Event Reporting System, July 1990 through June 2002. 1499 18


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