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)

The results of a serosurvey of Oklahomans for the presence of antibody to Ehrlichia canis is reported. Paired serum specimens, from patients lacking the serologic criteria for diagnosis of Rocky Mountain spotted fever (RMSF), were tested. A four-fold increase in E. canis-IFA antibody was found in 16/144 (11 percent) of these paired serum samples. Patients with serologic evidence of E. canis infection had a mean age of 34 years, 69 percent were male, and 63 percent lived in a town less than 10,000 population. Signs and symptoms included: fever 94 percent, headache 94 percent, fatigue 94 percent, anorexia 81 percent, nausea 60 percent, and rash 44 percent. When compared to control patients, whose sera were submitted for RMSF testing but did not meet serologic criteria for RMSF or E. canis, case-patients were more likely to have had leukopenia (OR = 4.9, 95 percent Cl = 1.2, 19.0) and tick exposure (OR = 9.5, 95 percent Cl = 1.4, 62.7). The results suggest E. canis, or a closely related agent, is a cause of human illness. Ticks are probable vector.
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PMID:Epidemiologic and clinical characteristics of persons with serologic evidence of E. canis infection. 231 66

Altitude sickness is a clinical syndrome that occurs with abrupt ascents to altitudes of 3000 metres and above. Symptoms include headache, malaise, fatigue, dizziness, anorexia, nausea and vomiting, and oliguria. At higher altitudes more severe illness resulting from pulmonary oedema or cerebral oedema can occur.
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PMID:Altitude sickness. 232 86

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

In a prospective inventory analysis of 169 irradiated patients concerning the incidence and course of Acute Radiation Sickness (fatigue, loss of appetite, nausea and vomiting), it was found that 2/3 of the patients had these complaints. The complaints started during the first week of treatment and mostly even within a few hours after each radiotherapy session. All complaints were progressive during the radiotherapy course, but disappeared spontaneously within one week after completion of the treatment. The possible occurrence of these symptoms soon after the start of radiotherapy should be kept in mind, especially since they can be reduced by simple regimens.
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PMID:[Radiation sickness; prospective study of incidence and course]. 235 62

The first case was a 63-year-old man with edema in the lower extremities, and the second case was a 78-year-old man complaining of general fatigue and loss of appetite. Both cases had bilateral hydronephrosis and renal failure due to ureteric obstruction. Both patients with histologically proven idiopathic retroperitoneal fibrosis were studied by magnetic resonance imaging (MRI). MRI was performed using a superconducting magnet operating at 0.5 tesla and spin echo images were obtained. The retroperitoneal fibrous plaque appeared at an intermediate intensity on T1 weighted image and at a high intensity on T2 weighted image. They underwent intraperitoneal ureteral transposition and postoperative administration of prednisolone. Although their renal functions and hydronephrosis improved after the treatments, the fibrous plaque was still observed on MRI. It was considered that MRI was an excellent method of choice in the diagnosis and follow-up of retroperitoneal fibrosis.
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PMID:[Magnetic resonance imaging for retroperitoneal fibrosis: report of two cases]. 237 36

Preclinical data suggest synergy of interleukin-2 (IL-2) combined with alpha-interferon (IFN). In addition, toxicities of IL-2 may be decreased by intermittent continuous infusion. The purpose of this trial was to determine the maximum tolerated dose (MTD) of recombinant IL-2 combined with alpha-IFN in patients with renal cancer, colon cancer, melanoma, and malignant B-cell disease. IL-2 was given by continuous i.v. infusion at an initial dose of 5 X 10(5) units (U)/m2/d for 4 days plus IFN at 6 X 10(6) U/m2/d intramuscularly days 1 and 4 weekly for 4 weeks. Patients who achieved a response or stable disease received an additional 4 weeks of therapy. IL-2 doses were increased to 1, 2, 3, 5, and 7 X 10(6) U/m2/d with three to eight patients at each dose level, at each of the two participating institutions. The dose of IFN was 6 X 10(6) U/m2 days 1 and 4 for all but five patients whose IFN dose was doubled to 12 X 10(6) U/m2/d. Forty-three patients were entered on this study with 34 completing at least 4 weeks of therapy. Six patients were taken off study because of Grades III or IV pulmonary, neurologic, or cardiac toxicity; one for progressive disease; one for CNS metastases, and one for personal reasons. All of the toxicities were reversible. Chills and fever were universal, especially on days 1 and 4. Mild and moderate nausea, vomiting, diarrhea, anorexia, malaise, and cutaneous erythema were present in most patients. Fluid retention and occasional pleural effusions were observed at the higher IL-2 doses but were not dose-limiting. Significant hypotension associated with oliguria was seen, and these patients were treated with vasopressors and colloids. None of the patients required ICU admission. Thirty-four patients were evaluable for response. There were 4/18 (22%) renal cell patients who experienced a partial response. No responses were seen in patients with melanoma, lymphoma, or colorectal cancer. The combined debilitating symptoms of fatigue, diarrhea, hypotension, fluid retention, and anorexia defined the MTD as 5 X 10(6) U/m2/d of IL-2 and 6 X 10(6) U/m2 of alpha-IFN.
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PMID:A phase I study of recombinant human interleukin-2 and alpha-interferon-2a in patients with renal cell cancer, colorectal cancer, and malignant melanoma. 238 96

Twenty patients with metastatic renal cell cancer were treated with a combination of recombinant interferon-alpha 2a (Roferon-A), 18 MU intramuscularly three times weekly and vinblastine 0.1 mg/kg intravenously once every 3 weeks. Three patients experienced a complete response (CR) (15%) and three a partial response (PR) (15%). The response duration was 3, 13, and 15 months in the CR group, and PRs lasted 11, 13, and 14 months. Constitutional symptoms like fever, anorexia, and fatigue were the most common side effects. One patient had reversible hepatitis, which was probably unrelated to antineoplastic therapy. Dose modifications had to be made in seven patients due to leukopenia or thrombocytopenia. No very serious side effects were noticed. In view of what has been reported previously, the overall response rate (30%) of this regimen is good and tolerance of the treatment is acceptable.
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PMID:Recombinant interferon-alpha 2a and vinblastine in advanced renal cell cancer: a clinical phase I-II study. 239 8

Travelers' diarrhea is only mild or moderate in the majority of cases. Consequently, severe fluid and electrolyte losses are encountered only rarely. Secretory, osmotic, and inflammatory processes in the intestine result in increased losses of fluid and electrolytes due to diarrhea. Disorders of intestinal motor activity, coupled with fluid secretion, may also have a role in causing an increase in the frequency of bowel movements. Several systemic symptoms, such as malaise, fatigue, anorexia, nausea, and fever, are commonly associated with diarrhea and contribute to significant morbidity, which is often sufficient to compromise effective participation in a vacation or business trip. Several putative mechanisms for the systemic symptoms associated with travelers' diarrhea are discussed in light of recent understanding of the enteric nervous system, intestinal neuropeptides and hormones, and other inflammatory mediators released from the bowel wall during enteric infections.
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PMID:Pathophysiology of diarrheal disorders. 240 54

Many drugs are applied in local treatment for skin malignant tumors. These drugs are living-BCG, OK-432, MY-1, WPG, interferon preparation (alpha, beta and gamma), TNF, IL-2, peplomycin, bleomycin and others. Some of them already have completed clinical trials and others are under clinical observation. In local administration of these drugs, skin lesions (malignant melanoma, CTL-mainly mycosis fungoides, carcinoma in situ and others) show good improvement. The effects were more observed in the tumors with diameters of 1 cm or less and appeared 3 to 10 injections in most cases. As complications, there are fever, general fatigue, vomiting, anorexia, leucopenia and others. Among them, the fever was most observed immediately after injections without any more severe complications. It may be concluded that treatment by intratumoral administration is useful for skin malignant tumors.
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PMID:[Clinical effects induced by intratumoral administration of anti-cancerous drugs in skin malignant tumors]. 246 39

The effects and toxicities of interferon alfa are described, and the role of the pharmacist in making decisions and providing education about biologic response modifiers (BRMs) is discussed. Interferons have both direct antitumor activity and extensive effects on the immune system. Two recombinant interferon alfa products--interferon alfa-2a and interferon alfa-2b are available commercially. Indications in FDA-approved labeling for interferon alfa include the treatment of hairy-cell leukemia, acquired immunodeficiency syndrome-related Kaposi's sarcoma, and genital warts; however, it also is being used successfully against early chronic myelogenous leukemia, low-grade non-Hodgkin's lymphoma, cutaneous T-cell lymphoma, and previously untreated multiple myeloma. Other malignancies that respond to treatment with interferon alfa are malignant melanoma, ovarian carcinoma, and renal cell carcinoma. The toxic pattern of interferon alfa consists of flu-like symptoms, which are seen at all doses, on all schedules, and in virtually all patients. After repeated dosing, the chronic toxicities of anorexia, weight loss, and malaise and fatigue may develop. Myelosuppression, central nervous system toxicity, increased hepatic enzyme concentrations, nausea and vomiting, and cardiovascular toxicity also are possible. Serum neutralizing antibodies may be formed during therapy; this phenomenon may affect the clinical outcome. Numerous BRMs are being investigated for clinical use, and pharmacists must become conversant in the issues that surround these agents. Areas in which pharmacist involvement and knowledge are important include overall cost, product similarities and differences, dosing and scheduling, drug delivery systems, ways to minimize waste, adverse effects and their management, drug interactions, storage requirements, differences in production and purification techniques among manufacturers, and education of patients and staff.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Biologic response modifiers: the interferon alfa experience. 248 96


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