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 acute and sub-chronic effects of moclobemide and mianserin on driving and psychometric performance were compared to those of placebo in a double-blind, cross-over study involving 17 healthy volunteers. Mianserin, moclobemide and placebo were administered for 8 days. Subjects' performance was measured on days 1 and 8 of each treatment series; subjective sleep parameters, mood, and possible side-effects were recorded each treatment day on questionnaires or visual analog scales. Mianserin affected most of the performance measures, while moclobemide affected none; mianserin also impaired driving and tracking performance and decreased CFF. Whilst receiving mianserin, subjects reported depressed levels of alertness, calmness, and contentment; the quality of their sleep was unaffected, but its duration increased, together with feelings of drowsiness and fatigue during the day. No statistical interactions between the factors Drugs and (Treatment) Days were found, indicating that little pharmacological tolerance developed over time during mianserin treatment. Mianserin's sedative properties are held responsible for all performance and subjective effects of the drug. It is concluded that moclobemide 200 mg b.i.d. has no important sedative properties.
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PMID:Effects of moclobemide and mianserin on highway driving, psychometric performance and subjective parameters, relative to placebo. 154 44

Based on recent preclinical data suggesting synergism between 5-fluorouracil (5-FU) and interferon alpha (IFN-alpha) and clinical activity of the combination therapy in colon cancer, 14 patients with advanced gastric cancer were treated with combination therapy of 5-FU and recombinant interferon alpha-2b (rIFN alpha-2b) (Intron A, Schering, Kenilworth, NJ, U.S.A.). The maximum tolerated dose was 5-FU 750 mg/m2/day given as a continuous infusion daily for 5 days followed by weekly bolus injection of the same initial daily dose, plus rIFN alpha-2b 5 X 10(6) U given subcutaneously 3 times weekly starting day 1 of 5-FU infusion. The dose-limiting toxicities were fatigue/weakness, diarrhea, and neurologic toxicities such as somnolence and confusion. The other common side effects were nausea, fever, leukocytopenia, thrombocytopenia, and the darkening of the skin. Of 13 evaluable patients, 4 had a partial response (duration 6, 14, 24, and 28 weeks). These data suggest that combination therapy of 5-FU plus rIFN alpha-2b is tolerable and has manageable side effects in patients with advanced gastric cancer. Further Phase II study will be needed to define the antitumor activity of this combination.
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PMID:Combination of 5-fluorouracil and recombinant interferon alpha-2B in advanced gastric cancer. A phase I study. 155 2

The amplitude and phasing of circadian rhythms are under discussion as possible predictors of tolerance to night work. In a field study, subjective sleepiness and oral temperature of 147 female nurses were measured at 2-hour intervals during a period with one morning shift and two consecutive night shifts. The nurses also filled out a questionnaire. Two types of tolerance indices were constructed: The "health index" was based on questions referring to general fatigue, gastrointestinal symptoms, and sleep disturbances, and the "sleepiness index" on the actual subjective ratings of sleepiness. According to the health index, the group with good tolerance had a larger circadian amplitude of the oral temperature rhythm on the day of the morning shift than the group with poor tolerance. However, with regard to the sleepiness index, the corresponding difference between the groups with good or poor tolerance was not significant. The data did not confirm the hypothesis that predicts a quick adjustment of the circadian rhythm when the circadian amplitude is small before the change to night work. The contradictory results found in this and in other studies do not yet permit prediction of tolerance to night work.
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PMID:The relation of shift work tolerance to the circadian adjustment. 155 61

Two hundred one patients diagnosed as having obstructive sleep apnea (OSA) were interviewed 12-24 months after their evaluation regarding those daytime symptoms associated with sleep apnea: sleepiness, fatigue, impaired memory, and snoring. Continuous positive airway pressure (CPAP) was the treatment most often used by severe sleep apnea patients, and this improved daytime alertness in 84% of the patients. Patients with moderate obstructive sleep apnea often had surgery which led to 85% reporting improved daytime alertness. Patients with mild obstructive sleep apnea usually were treated with weight loss or changing sleep position and also improved 64% and 66%. Patients who declined or failed treatment did not improve. Guidelines for the treatment of sleep apnea are suggested.
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PMID:Treatment outcome of sleep apnea. 158 4

Cerebral blood velocity (CBV) was measured with transcranial Doppler in 6 normal right-handed male volunteers before and for 50 min after an intravenous injection of 0.1 mg/kg of diazepam and normal saline during 2 separate visits to the laboratory. Blood pressure, pulse rate, end tidal levels of carbon dioxide and mood changes were quantified before and after the injections. Diazepam injection was associated with significant increases in fatigue and sleepiness. There were no significant changes in end tidal carbon dioxide, respiration, pulse rate, and blood pressure after the injection. Postdiazepam CBV was significantly lower following diazepam compared to CBV following placebo.
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PMID:Changes in cerebral blood velocity after intravenous diazepam. 159 86

Although there is an abundant literature on the health effects of occupational heat exposure, very few authors have addressed the question of the effects of heat stress on women workers. Knowledge about the effects of work in hot environments is mainly derived from the study of "heavy" muscular activity and current heat exposure standards are based on an energy criterion according to metabolic load. Metabolic load does not reflect cardiac strain associated with sedentary, repetitive work, involving static effort. The research presented here was conducted in an industrial laundry with 11 women mangle operators exposed to moderate heat stress during the summer months and whose work activity is classified as light on the basis of energy expenditure. Physiological and symptomatological responses, work activity and ambient temperature were assessed over 3 complete work days in summer and in winter. Recorded and perceived temperature, discomfort, feelings of fatigue and symptoms of thermal stress were significantly higher in summer than in winter. Symptoms of drowsiness and musculo-skeletal aches were reported equally in both seasons. Heart rate was high in both seasons, as were calculated indices of cardiac strain. Recommended limits for cardiac strain were surpassed significantly more often in summer than in winter. It is suggested that threshold levels should be redefined to include the prevention of cardiac strain resulting from cumulative effects of heat stress and sedentary, repetitive activity, typical of many women's job with low energy requirement.
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PMID:Heat exposure standards and women's work: equitable or debatable? 161 88

The effect of a 3-week treatment with Loderix is examined in an open study in 40 patients suffering from allergic rhinoconjunctivitis. Side-effects, mainly sleepiness, fatigue, weakness, were observed in nearly half of the patients. These were, in general, mild and of a transient character. Treatment had to be stopped in 2 patients due to developed adverse effects. Safety parameters as blood picture, liver function tests, renal function parameters showed no alterations during the study course. During the treatment periods rhinoconjunctivitis symptoms disappeared or significantly decreased in 22 patients out of 40. Moderate effect was registered in 14 patients, and treatment was ineffective in 4 cases. In 6 patients the doses were doubled from the 2nd week of treatment causing an increase in effectivity without a change in side-effect profile.
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PMID:Loderix (setastine) tablets in the treatment of allergic rhinoconjunctivitis. 167

The use of benzodiazepines for generalized anxiety disorder (GAD) is a safe and effective treatment; however, their potential to produce dependence and impair psychomotor and cognitive functions is a drawback. In this study the efficacy and safety of alpidem, a nonbenzodiazepine, was assessed. Thirty patients who met DSM-III-R criteria for GAD were randomized to either alpidem (225 mg), lorazepam (4.5 mg), or placebo. The primary efficacy measure was the Hamilton Rating Scale for Anxiety (HAM-A). A repeated measures multivariate analysis of variance (MANOVA) was used to determine differences in HAM-A scores over time. The results showed a trend for alpidem to be more effective. Half of the alpidem group had a decrease of 50 percent or greater in their HAM-A scores with an almost equal effect on psychic and somatic symptoms. The most common side effects with alpidem and lorazepam were lightheadedness, drowsiness, and daytime tiredness. Moreover, treatment with alpidem did not manifest any withdrawal symptoms. Thus nonbenzodiazepine treatments are effective and safe for GAD.
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PMID:A comparative study of alpidem, a nonbenzodiazepine, and lorazepam in patients with nonpsychotic anxiety. 167 74

In this 3-week randomized, double-blind, double-dummy multicenter, crossover study terfenadine, 120 mg, was compared with cetirizine, 10 mg, both given once daily in the treatment of perennial allergic rhinitis in sixty patients. Compared with the investigators' pretreatment assessment, both terfenadine and cetirizine significantly reduced the severity of all five symptoms (P less than .001). The two treatments were equally effective in controlling eye irritation, sneezing, nasal congestion and itchy nose, throat and palate, but cetirizine improved rhinorrhea more than terfenadine (P less than .05). Daily symptom assessments by the patients for the last 14 days of each treatment period showed no difference in efficacy between the two drugs for any of the symptoms. There were also no differences between the two drugs for overall assessments of efficacy or patient preference. Adverse events were recorded more frequently while taking cetirizine, with 14 attributable events compared with only five with terfenadine. Four of the cetirizine-related events were drowsiness or tiredness, but none was reported while patients were taking terfenadine. There was a tendency to increased weight (greater than 1 kg) with both treatments.
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PMID:Multicenter, crossover study of the efficacy and tolerability of terfenadine, 120 mg, versus cetirizine, 10 mg, in perennial allergic rhinitis. 168 90

Fludarabine phosphate is the 2-fluoro, 5'-monophosphate derivative of vidarabine (ara-A) with the advantages of resistance to deamination by adenosine deaminase (ADA) and improved solubility. The mechanism of cytotoxic action of the compound appears to involve metabolic conversion to the active triphosphate. Fludarabine phosphate has substantial activity against lymphoid malignancies, particularly chronic lymphocytic leukemia (CLL) and low-grade non-Hodgkin's lymphoma (NHL). Its single-agent activity in CLL appears at least comparable to those of other conventional combination regimens. Its activity in Hodgkin's disease, mycosis fungoides, and macroglobulinemia, although suggestive, needs to be further defined and clinical trials are warranted in hairy cell leukemia, prolymphocytic leukemia, and previously untreated myeloma. The compound does not appear active against most common solid tumors. Early clinical trials indicated significant myelosuppression and the potential for severe neurotoxicity. Toxicity on the currently used low-dose schedules includes transient and reversible myelosuppression, nausea and vomiting, diarrhea, somnolence/fatigue, and elevations of liver enzymes and/or serum creatinine. Possible pulmonary toxicity has been suggested in several patients. The currently used low-doses of fludarabine phosphate, even with repeated administration, are well tolerated and appear safe with a negligible risk for severe neurotoxicity. Based on its single-agent activity and tolerability, the Food and Drug Administration recently granted group C designation of the drug for the treatment of patients with refractory CLL outside the clinical trials setting. The use of fludarabine phosphate in combination regimens and its impact on the natural history of the lymphoid malignancies is yet to be determined. Fludarabine phosphate may well occupy a pivotal role in the management of CLL and low-grade NHL.
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PMID:Fludarabine phosphate: a synthetic purine antimetabolite with significant activity against lymphoid malignancies. 170 43


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