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)

In the community of Kungsbacka, Sweden, with about 48,000 inhabitants, all subjects with colorectal cancer were studied during a three-year period. The incidence was 30 per 100,000 inhabitants per year. In all there were 42 cases. Blood in the stools, anaemia, tiredness, and dizziness were common initial signs and symptoms. Diarrhoea and constipation were also rather frequent. Positive test for faecal occult blood was observed in 40%, negative tests in 12% while in 48% no such test had been performed. The majority of the subjects (64%) first visited a general practitioner (GP). Mean doctor's delay was five months. More than half the cancers were located in the rectal or sigmoid area. Subjects in whom no metastases were observed had a favourable prognosis, compared with those with distant metastases. Since most patients with colorectal cancer first visit a GP for their symptoms, the GP has an important role in the diagnosis of colorectal cancer.
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PMID:The diagnosis of colorectal cancer--experiences from the community of Kungsbacka, Sweden. 235 72

Despite decreasing cardiac mortality rates in the elderly since 1968, rates of health care service use by persons over age 65 years have progressively increased. The growing availability of potent and effective cardiovascular drugs, together with the high prevalence of untoward side effects in the elderly, make it important that we consider the influence of age on cardiovascular response to the calcium entry blockers. The age-related structural, functional, pharmacokinetic, and pharmacodynamic changes that occur in elderly patients suggest that careful monitoring, adjustment, and frequent reassessment of the medical regimen should be performed to minimize untoward effects. Nifedipine, diltiazem, and verapamil are all well absorbed orally, are extensively protein bound, and are metabolized by the liver. The age-associated attenuation in rates of hepatic metabolism and hepatic blood flow contribute to the decreased clearance and prolonged elimination half-lives of these drugs in the elderly. Advanced age can be associated with increased susceptibility to sinoatrial depression, fatigue, constipation, hypotension, and peripheral edema after calcium entry blockade, even at modest doses. It would be prudent, therefore, to administer these agents at lower doses and at less frequent intervals.
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PMID:Use of calcium entry blockers in elderly patients. Special considerations. 268 81

A total of 19,252 stool specimens from 12,136 patients were examined by direct microscopy and the ethyl acetate-Formalin concentration method during the last 2 years. All liquid specimens and those in which parasite identification was difficult or equivocal were also examined in trichrome-stained preparations. A total of 3,070 intestinal parasites were seen in 2,889 patients. Blastocystis hominis was found in fecal material from 647 patients (17.5%). A total of 132 cases (25.6%) were observed to be in association with other enteric pathogens. B. hominis in large numbers was present as the only parasite or with other commensals in 515 specimens from patients (79.6%). Of these patients, 239 (46.4%) had symptoms, the most common being abdominal pain (87.9%), constipation (32.2%), diarrhea (23.4%), alternating diarrhea and constipation (14.5%), vomiting (12.5%), and fatigue (10.5%). Forty-three (18%) of the patients were treated with metronidazole (0.5 to 1.0 g/day) because of recurrent symptoms and the presence of large numbers of B. hominis cells in repeated stool specimens. After 7 to 10 days of treatment, all patients became asymptomatic with negative stools on follow-up examinations for B. hominis.
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PMID:Clinical significance of Blastocystis hominis. 235 28

A modified version of the McCorkle & Young Symptom Distress Scale, based on a linear analogue self-assessment scoring system, was used to assess symptom distress in a heterogeneous sample of 53 cancer patients. The scale was simultaneously completed by the nurses caring for those patients, who were asked to rate the patient according to how they perceived he was feeling with regard to each particular symptom. The scores were compared for congruency. This preliminary study suggests that, although nurses appear able to estimate the degree of distress due to changes in mobility and appearance or the presence of diarrhoea, constipation and tiredness, they are less effective in perceiving the degree of distress due to the less 'visible' symptoms such as pain, nausea, anorexia, sleeping disturbances, concentration and mood. Perhaps surprisingly, the trend was for nurses to overestimate the degree of distress when this was compared with the patients' self-assessment.
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PMID:Patients' and nurses' perceptions of symptom distress in cancer. 280 38

A double-blind controlled study comparing the effects of bupropion to doxepin in outpatients with primary depression was conducted to evaluate efficacy and safety differences between the two drugs. Following a 7-day placebo washout period, patients could be treated for up to 13 weeks on either treatment. Antidepressant response was assessed by the Hamilton Depression and Anxiety Scales, Clinical Global Severity and Improvement Ratings, and the Zung Self-Rating Depression Scale. Comparable efficacy between the compounds was found across the 13-week study. Doxepin differed from bupropion mainly on the sleep factor of the Hamilton Depression Scale, with doxepin improving sleep to a greater extent than bupropion. Doxepin produced a greater incidence of anticholinergic side effects, including dry mouth, constipation, sleepiness, and tiredness, in comparison to bupropion. Also, increased appetite and weight gain were consistent side effects of doxepin relative to bupropion.
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PMID:Double-blind comparison of doxepin versus bupropion in outpatients with a major depressive disorder. 308

Orbital venous vasculitis has been suggested to cause characteristic periorbital pain in patients with pathologic changes in their orbital phlebograms. The orbital pain is characterized by being unilateral, not shifting side, boring and pressing, but not throbbing, increasing on eye strain, exposure to cold, or weather changes, and resistant to analgesics. It is ameliorated by steroids. Fifty patients with symptoms of orbital venous vasculitis were investigated for other symptoms that could be related to the vasculitis. When the 32 female patients were compared with a randomly selected age- and sex-matched control group, there was a significant increase of symptoms of chronic fatigue, cold feet, gut problems such as constipation and/or diarrhea, arthralgia, memory impairment, rotatory vertigo, spontaneous ecchymoses (all, p less than 0.0001), back pain (p less than 0.012), and thrombophlebitis (p less than 0.022) in the patient group. These symptoms, although commonly occurring, seem in these patients to be related to the vasculitis. Blood tests of the fifty patients showed signs of inflammation which did not disagree with the hypothesis of an immunologic cause of the orbital venous vasculitis.
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PMID:Systemic symptoms associated with orbital venous vasculitis. 321 27

In a double-blind, placebo-controlled study the authors found that fluoxetine, a potent and selective inhibitor of serotonin reuptake, was an effective antidepressant in moderately depressed, ambulatory outpatients. Typical adverse effects reported by patients treated with fluoxetine included agitation, nausea, fatigue, and insomnia. Compared to imipramine, fluoxetine was associated with fewer complaints of dry mouth, constipation, and dizziness.
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PMID:Fluoxetine, a selective serotonin uptake inhibitor, for the treatment of outpatients with major depression. 328 84

It is estimated that there are approximately six million patient-years of clinical experience with fenofibrate among physicians outside of the United States. A review of the European literature and unpublished studies supplied by the manufacturer (Laboratoires Fournier, Dijon, France) has been compiled with the data recently reported from a double-blind, placebo-controlled study completed in the United States. In general, fenofibrate has been found to reduce serum triglyceride levels by 30 to 60 percent in patients with type II B and IV hyperlipoproteinemia. Serum cholesterol levels were also reduced by 20 to 25 percent in this group of hypertriglyceridemic patients. A similar reduction in serum cholesterol levels was also found in type II A patients (normal triglyceride levels). Low-density lipoprotein levels were usually reduced in those patients with elevated levels and high-density lipoprotein levels increased when baseline levels were low. Fenofibrate also produced a 10 to 28 percent reduction in uric acid that was sustained for years. The incidence of unwanted effects ranged from 2 to 15 percent in the open trials lasting from a few months up to six years. Gastrointestinal problems (abdominal discomfort, diarrhea, and constipation) are most common, occurring in approximately 5 percent of patients. Reports including fatigue, headache, loss of libido, impotence, dizziness, and insomnia were grouped as neurologic and occurred with a total incidence of 3 to 4 percent. In about 1 percent of patients, muscle tenderness developed, often accompanied by elevated creatine phosphokinase levels. These and the gastrointestinal problems occurred with a similar frequency in the placebo-treated cohort in controlled studies. In approximately 2 percent of patients, a skin rash developed, an incidence that appears significantly higher than that of placebo control groups. Liver changes in rodents have included marked peroxisome proliferation and increased hepatic carcinomas with very high doses. In humans, only a small increase in incidence of elevated levels of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase seems to be present and is not clearly different from that of the control groups. Alkaline phosphatase, gamma-glutamyl transferase, and bilirubin levels are often decreased with no known undesirable effects. Investigations into the lithogenicity of bile indicated a significant increase in five studies. However, there has been no evidence of a significant rise in the incidence of cholelithiasis in the clinical trials completed to date.
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PMID:Comparative toxicity and safety profile of fenofibrate and other fibric acid derivatives. 331 50

The 24-hour duration of the antihypertensive effect of guanfacine, a centrally acting alpha 2-adrenoceptor agonist administered once a day, was demonstrated in a 12-week, multicenter, double-blind, placebo-controlled study. Two hundred and forty-nine patients who remained mildly to moderately hypertensive following a 5-week period, during which they had been weaned from previous antihypertensive medications and stabilized on 25-mg chlorthalidone taken once a day, were involved. Of the 249 patients, 126 received guanfacine as a step-2 agent and 123 received placebo. Both groups were further subdivided so that blood pressure (BP) measurements were determined either 12 or 24 hours after dosing. The initial dose of guanfacine was 1 mg/day, which could be raised 1 mg at 2-week intervals to a maximum daily dose of 3 mg/day at the discretion of each investigator. The daily dose could also be lowered by 1 mg at 2-week intervals, depending on patient response. The mean 24-hour reductions with guanfacine in sitting diastolic BP (-11 mm Hg), systolic BP (-14 mm Hg) and mean arterial pressure (-12 mm Hg) were statistically significant (p less than 0.01) compared with the reductions in BP with placebo. Heart rate also decreased with guanfacine, but no clinically relevant bradycardia (less than 60 beats/min) was observed. Dry mouth (47%), constipation (16%), fatigue (12%) and drowsiness (4%) were the most frequently reported side effects. The highly acceptable side-effects profile of guanfacine was also indicated by the small percentage of patients (7%) who prematurely left the study because of adverse reactions.
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PMID:Usefulness of low dose guanfacine, once a day, for 24-hour control of essential hypertension. 351 29

We compared verapamil and propranolol hydrochloride for monotherapy of hypertension. Verapamil lowered blood pressure (BP) more effectively than propranolol in black and white patients. Verapamil was equally effective in blacks and whites, whereas propranolol was more effective in whites. Heart rate was reduced by 6.0 beats per minute by verapamil, and by 13.6 beats per minute by propranolol. In blacks, verapamil lowered systolic BP 16.9 vs 8.1 mm Hg for propranolol; verapamil reduced diastolic BP 12.8 vs 8.6 mm Hg for propranolol. In whites, verapamil lowered systolic BP 19.0 vs 12.7 mm Hg for propranolol; verapamil reduced diastolic BP 16.7 vs 12.3 mm Hg for propranolol. Increases in systolic BP were observed in 22% and 3.4% of patients receiving propranolol and verapamil, respectively. The PR interval was increased from 163.5 to 174.9 ms for verapamil vs 160.3 to 164.4 ms for propranolol. Constipation (15%) and headaches (10%) were most frequent complaints for verapamil vs fatigue (18%) and dizziness (7%) for propranolol. Changes in blood biochemistry values were of small magnitude. We conclude that verapamil monotherapy is a safe and effective means of achieving BP control in patients with essential hypertension.
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PMID:A comparison of verapamil and propranolol for the initial treatment of hypertension. Racial differences in response. 353 60


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