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 June 1983, an outbreak of waterborne giardiasis occurred in a group of 93 university students and faculty participating in a geology field course in Colorado. All cases occurred in one subgroup of persons who were heavily exposed to untreated stream water on a field trip, and the risk of illness was strongly related to the amount of untreated stream water consumed. The median incubation period from a brief exposure to the first symptom was 7 days. The authors compared symptoms and stool sample results among 31 Giardia-positive persons in the exposed group and 36 Giardia-negative participants in an unexposed group to assess several case definitions for acute giardiasis. Diarrhea, abdominal cramps, flatulence, foul-smelling stools, nausea, excessive tiredness, bloating, anorexia, and chills were each significantly more common in the first group than in the second. A giardiasis case definition of 5 days or more of diarrhea--the definition used in many epidemiologic studies of giardiasis--had a specificity of 100 percent but a sensitivity of only 32.2 percent compared with a definition based on results of stool examinations. When a case was defined as an illness lasting 7 days or more, with a combination of two or more of six symptoms (diarrhea, flatulence, foul-smelling stools, nausea, abdominal cramps, and excessive tiredness), sensitivity rose to 73 percent, with a specificity of 88 percent. Such a case definition may be an improvement over that of 5 days of diarrhea, especially in outbreaks where there is good laboratory documentation that Giardia is the etiologic agent. The definition should be validated in other outbreaks and in situations where giardiasis must be distinguished from gastrointestinal disease caused by other agents.
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PMID:Acute giardiasis: an improved clinical case definition for epidemiologic studies. 199 3

In a prospective, double-blind comparison, we assessed the efficacy of transdermal clonidine with that of chlordiazepoxide in the treatment of moderately severe acute alcohol withdrawal syndrome. While having significant withdrawal symptoms, 50 hospitalized men were randomly assigned to receive either transdermal clonidine or chlordiazepoxide over a 4-day study period. Outcome was evaluated daily, medically and psychiatrically, using both objective and subjective measurements for dependent variables. No patient in either study group had seizures or progression to delirium tremens. The group receiving transdermal clonidine had a more significant response globally for the signs and symptoms of alcohol withdrawal, as measured by the Alcohol Withdrawal Assessment Scale. Also, clonidine more effectively lowered elevated systolic and diastolic blood pressure and heart rate. The core target symptom, anxiety, decreased significantly more in the patients receiving transdermal clonidine when measured by the Hamilton Anxiety Rating Scale and its subscale for somatic anxiety. Cognitive function responded equally in both study populations. Clonidine-treated patients reported less diarrhea, dizziness, headache and fatigue, and the chlordiazepoxide-treated patients reported less nausea and vomiting. We conclude that transdermal clonidine is effective treatment for the acute alcohol withdrawal syndrome.
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PMID:Transdermal clonidine versus chlordiazepoxide in alcohol withdrawal: a randomized, controlled clinical trial. 200 May 17

Ranitidine was first marketed in 1981; since then many patients have been treated such that much experience has been accumulated on the safety of this histamine H2-receptor antagonist in the treatment of gastroduodenal disease. A wide array of ranitidine-associated side effects has been described, but infrequently. As so much information is now available, the aim of this review is to assess the weight of evidence for a causal link between ranitidine and the reported side effects. Overall, ranitidine is well tolerated. The incidence of general side effects at less than 2% is very similar to placebo. Headaches, tiredness, dizziness and mild gastrointestinal disturbance (e.g. diarrhoea, constipation and nausea) are among the most frequent complaints, but have very seldom resulted in stopping treatment. Cardiovascular side effects are extremely rare and unpredictable with the usual doses of oral ranitidine (at most 1 in 1 million patients). They mostly comprise sinusal bradycardia and atrioventricular blockade, especially after rapid intravenous administration, receding after cessation of the drug. Clinical studies, however, have not shown a significant pharmacological effect of ranitidine on the cardiovascular system via H2-receptors, even though individual sensitivities cannot be ruled out in a few isolated reports. Ranitidine is unlikely to be directly hepatotoxic: a transient change in liver function tests has been noted in only 1 in 100 to 1 in 1000 patients. Several cases of mixed hepatitis have been reported, but very few were fully documented. The incidence of ranitidine-associated acute hepatitis has been estimated to be less than 1 in 100,000 patients. Neuropsychiatric complications may be less common and clinically quite similar to those reported with cimetidine, i.e. confusion, disorientation, hallucinations, delirium. These side effects have occurred especially in critically ill and multiple-therapy patients, or patients with chronic renal or hepatic failure, so that the direct causal link with ranitidine treatment was often difficult to ascertain. Even though an H2-receptor-mediated effect is an attractive hypothesis (since similar complications were noted with other H2-receptor antagonists), other mechanisms have been suggested to play a role, e.g. cholinergic or histaminic effects. The overall incidence of neuropsychiatric complications is probably markedly less than 1%. White cell injury (i.e. agranulocytosis) appears to be the most frequent haematological complication, even though case reports are very few and poorly documented.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Side effects of ranitidine. 204 87

The present paper reports on the results of an experimental study on man-cattle-man infection of Sarcocystis hominis, found in Yunnan Province. About ten thousand sporocysts collected from the feces of persons naturally infected with Sarcocystis hominis were fed to a calf, which was dissected 150 days later. Numerous cysts of Sarcocystis hominis were found in the cardiac and skeletal muscles. By light microscopy, the cyst wall of fresh preparation showed numerous thick, finger-like projections, with maximum length of 7.9 microns. By electron microscopy, the cyst had a regularly folded, with primary wall forming palisade-like protrusions. Numerous sharp invaginations found in the protrusions were sawtooth-shaped, covering the whole surface of the protrusions. No fine fibrils were observed within the zone of ground substance beneath the primary cyst wall. Two rhesus monkeys were fed with beef infected with Sarcocystis hominis and sporocysts and oocysts were found in their feces 29 and 31 days later, the patent period of sporocyst excretion being 5 and 7 days, respectively. The senior author had taken voluntarily 60 g beef of the experimentally infected calf, and presented clinical symptoms such as anaemia, abdominal pain, diarrhoea, fatigue and dizziness on d3 post infection with sporocysts and oocysts found in the feces on d8. The patent period of sporocyst excretion was more than 42 days. The mean size of 50 sporocysts was 11.90 +/- 0.04 x 15.88 +/- 0.03 micron and that of 50 oocysts, 15.56 +/- 0.05 x 19.76 +/- 0.04 micron. On d50 he took acetylspiramycin tablets, the initial dose being 0.4 g, followed by 0.2g qid. for 15 days.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Studies on man-cattle-man infection cycle of Sarcocystis hominis in Yunnan]. 211 30

The prevalence, risk factors, and incidence of hepatitis C virus (HCV) infection were studied in a cohort of drug users in Amsterdam. In intravenous drug users, the seroprevalence was 74% (224/304) versus 10% (4/42) in nonintravenous drug users. Risk factors independently associated with HCV antibody seropositivity were history and duration of intravenous drug use and frequency of injections. Daily smoking of heroin in the previous 6 months was independently associated with the absence of HCV antibodies. Periods of fever, tiredness, and diarrhea in the preceding 6 months were associated with HCV antibodies even after correction for human immunodeficiency virus infection. The incidence rate of HCV infection appeared high and stable over the years 1986 to 1989. Thus, HCV infections are common among intravenous drug users and are mainly due to the intravenous use of drugs.
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PMID:Prevalence, incidence, and risk factors of hepatitis C virus infection among drug users in Amsterdam. 211

Morbidity due to infection with Schistosoma mansoni was investigated in a recently discovered highland focus around Lake Cohoha, Burundi. The distribution of the infection was very focal and morbidity patterns in populations from an endemic area A (prevalence 38%, mean egg load of positive subjects 231 eggs per gram [epg]), a less affected area B (16%, 90 epg) and a virtually non-endemic area C (5%, 45 epg), were compared; apart from schistosomiasis, the profiles of these populations were highly similar. The overall frequencies of diarrhoea were 36%, 25%, and 19%, respectively; of abdominal pain 86%, 78%, and 83%; of fatigue 7%, 2%, and 1%; of left lobe hepatomegaly 30%, 18%, and 9%; of right lobe hepatomegaly 18%, 10%, and 5%; of splenomegaly 18%, 10%, and 7%. Organomegaly was generally mild, even in area A. Within area A, the association between the presence of infection and diarrhoea, fatigue, hepatomegaly and splenomegaly was significant, but far less impressive than the results of the community-based comparison with areas B and C. The correlation with intensity was limited to an increased prevalence of diarrhoea and fatigue in the highest egg count group, and a more gradual increase (varying with age) in hepatomegaly and splenomegaly. The data are compared to other morbidity studies in subsaharan Africa, in particular one in the nearby Rusizi Plain. The lesser impact of malaria, the higher egg loads, the recent establishment of the focus and possibly parasite strain differences may account for the more apparent and more important schistosomiasis morbidity in the Cohoha focus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The morbidity of schistosomiasis mansoni in the highland focus of Lake Cohoha, Burundi. 212 66

In a randomized four-way crossover study, 32 women with primary dysmenorrhea were treated with transcutaneous electrical nerve stimulation (TENS) for two cycles, placebo (sham) TENS for one cycle, or ibuprofen 400 mg four times a day for one cycle. The TENS setting used was 100 pulses per second with 100-microsecond pulse widths. The subjects were allowed to adjust the amplitude to a comfortable level. The pain rescue medication was ibuprofen 400 mg as needed, up to 1600 mg/day. Significantly more subjects who had TENS treatment did not require rescue medication or required less backup ibuprofen at 0-4, 4-8, and 8-12 hours after the onset of dysmenorrhea and starting treatment, as well as during the first 24 hours and for the duration of the menstrual flow, when compared with placebo TENS or ibuprofen-treated cycles (Tukey multiple comparison, P less than .01). Transcutaneous electrical nerve stimulation significantly delayed the need for ibuprofen by an average of 5.9 hours, compared with 0.7 hours when using ibuprofen alone (P less than .05, paired t test). Transcutaneous electrical nerve stimulation alone provided good to excellent subjective pain relief in 42.4% of subjects, compared with 3.2% with placebo TENS, and significantly reduced diarrhea, menstrual flow, clot formation, and fatigue compared with placebo TENS. Transcutaneous electrical nerve stimulation plus less ibuprofen provided pain relief equivalent to that obtained with ibuprofen alone (71 and 75% of the subjects, respectively). We conclude that TENS is a safe, effective, non-medication method for managing primary dysmenorrhea and that TENS plus ibuprofen was the best overall treatment, as indicated by pain relief.
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PMID:Transcutaneous electrical nerve stimulation (TENS) for the treatment of primary dysmenorrhea: a randomized crossover comparison with placebo TENS and ibuprofen. 217 80

As part of a multicenter trial 12 patients with myelodysplastic syndromes (MDS) were treated with 14-day-cycles of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF; 250 micrograms/m2 day s.c.). In addition, all patients received 20 mg/m2/day s.c. cytosine-arabinoside (Ara-C) 12 h after GM-CSF except for patients suffering from refractory anemia (RA) according to FAB classification. Courses were repeated after 4 weeks. In 11 evaluable patients, results according to FAB-classified MDS were as follows: RA, 1/2 response (R), 1/2 stable disease (SD); RAEB, 2/3 R, 1/3 SD; RAEB-T, 1/6 CR, 1/6 PR, 2/6 R, 2/6 progression; CMML, 1/2 SD. In 2 patients with RAEB-T, overt acute myeloid leukemia was observed 2 and 10 weeks after initiation of treatment. With few exceptions, treatment resulted in a prompt increase in granulocytes and eosinophiles. This was associated with improvement of infectious complications. Increases in red cells and platelets occurred variably and was apparently associated with responses of the underlying disease. Dose limiting side effects consisted of fever, severe fatigue and dolent local reactions at the site of GM-CSF injection. In addition, nausea and diarrhoea occurred frequently. Less often, respiratory and cardiovascular side effects were encountered. In summary, GM-CSF +/- Ara-C in MDS results in objective remission with manageable toxicity. Conceivably, this regimen will serve as a base for future treatment strategies against MDS.
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PMID:Recombinant human granulocyte-macrophage colony-stimulating factor and low-dose cytosine-arabinoside in the treatment of patients with myelodysplastic syndromes. A phase II study. 218 22

The Isoparaffins covered in this manuscript are branched aliphatic hydrocarbons with a carbon skeleton length ranging from approximately C10 to C15. They are used in the manufacture of liquid imaging toners, paint formulations, charcoal lighter fluid, furniture polishes and floor clearners. Potential exposure exists in the petroleum, printing and paint industries. Isoparaffins have a very low order of acute toxicity, being practically non-toxic by oral, dermal and inhalation routes. However, aspiration of liquid isoparaffins into the lungs during oral ingestion could result in severe pulmonary injury. Dermally, isoparaffins have produced slight to moderate irritation in animals and humans under occluded patch conditions where evaporation cannot freely occur. However, they are not irritating in non-occluded tests, which are a more realistic simulation of human exposure. They have not been found to be sensitizers in guinea pig or human patch testing. However, occasional rare idiosyncratic sensitization reactions in humans have been reported. Instillation of isoparaffins into rabbit eyes produces only slight irritation. Several studies have evaluated sensory irritation in laboratory animals or odor or sensory response in humans. When evaluated by a standard procedure to assess upper airway irritation, isoparaffins did not produce sensory irritation in mice exposed to up to 400 ppm isoparaffin in air. Human volunteers were exposed for six hours to 100 ppm isoparaffin. The subjects were given a self-administered questionnaire to evaluate symptoms, which included dryness of the mucous membranes, loss of appetite, nausea, vomiting, diarrhea, fatigue, headache, dizziness, feeling of inebriation, visual disturbances, tremor, muscular weakness, impairment of coordination or paresthesia. No symptoms associated with solvent exposure were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Toxicology update isoparaffinic hydrocarbons: a summary of physical properties, toxicity studies and human exposure data. 219 78

Vitamin B12 deficiency develops over a slowly progressive continuum. Early manifestations may be generalized weakness or fatigue, indigestion, diarrhea, or depression. Pernicious anemia is considered the classic cause, but others include malabsorption because of achlorhydria or other gastric dysfunction, fish tapeworm infection, and strict vegetarianism. Iron deficiency often coexists. Because presentation is often atypical, vitamin B12 deficiency is a diagnostic consideration whenever neuropsychiatric signs or symptoms are unexplained.
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PMID:Vitamin B12 deficiency. Important new concepts in recognition. 220 95


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