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)

An open randomized study was conducted in mild to moderate hypertensive patients to evaluate, over a 3 months treatment period, the efficacy and tolerability of carvedilol 25 mg OD and to compare, in case of insufficient results with 25 mg, the efficacy and tolerance of carvedilol 50 mg and carvedilol 25 mg coadministered with diuretics. Mean office blood pressure (sitting) of the 91 patients who completed the study according to the protocol was reduced from 161/100 to 147/91 mm Hg after 4 weeks of treatment carvedilol 25 mg OD. Continuation of carvedilol 25 mg produced no further reduction in blood pressure. Increasing carvedilol to 50 mg OD or addition of diuretics further reduced blood pressure. Ambulatory blood pressure measurements showed a significant reduction in both SBP and DBP after 3 months treatment in the three groups, as well as with respect to the circadian profile of blood pressure and heart rate. Large differences between ambulatory and office blood pressure were observed: 37% of the patients diagnosed as mild to moderate hypertensives according to office blood pressure before treatment had mean daytime DBP < 90 mm Hg and 39% mean daytime SBP < 140 mm Hg. Twenty-eight percent of the patients experienced adverse events; they occurred mainly at the beginning of treatment; less than 5% of participants withdrew due to adverse events. The most frequent adverse events were fatigue, vertigo and asthenia. This study showed that carvedilol is safe and effective in the treatment of mild to moderate hypertension and that there is a high prevalence (nearly 40%) of low ambulatory blood pressure means in a population labelled as mild to moderate hypertensive.
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PMID:Carvedilol in the treatment of mild to moderate hypertension: experience with ambulatory blood pressure monitoring. 805 82

We have investigated a 15 year old girl with progressive external ophthalmoplegia, including bilateral ptosis and retinal rod and cone cell dysfunction with atypical retinal pigmentation, complicated by cerebellar ataxia, partial cardiac conduction block, and diabetes mellitus. In infancy she had a severe crisis of bone marrow depression, and as a child she suffered from hypersensitivity to light, increasing fatigue, and vertigo, signs that were initially though to be psychosomatic. Histological examination showed mitochondrial myopathy, and subsequent mitochondrial DNA (mtDNA) analysis showed a deletion of approximately 5500 base pairs in 35 to 40% of her muscle mtDNA. We therefore conclude that this patient has developed the Kearns-Sayre syndrome after a Pearson syndrome-like crisis in her first year of life.
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PMID:Juvenile Kearns-Sayre syndrome initially misdiagnosed as a psychosomatic disorder. 815 37

Interferon-alpha (IFN-alpha) exhibits a clear platelet reductive effect in patients with essential thrombocythemia as well as in other chronic myeloproliferative disorders with thrombocytosis. In a total of 51 patients with chronic myeloproliferative disorders with thrombocytosis we analyzed the effect of IFN-alpha in respect to platelet reduction, remission rates, induction- and maintenance dosage, long term tolerance and side effects. According to our classification CML 6, chronic mega-karyocytic granulocytic myelosis 5, essential thrombocythemia 26 and polycythemia vera 15 patients were treated. Treatment consisted of induction with 3 or 5 MU IFN-alpha daily followed by a maintenance therapy with 3 or 5 MU thrice weekly. Platelet reduction was found in all patients, CR (platelets < 450 G/l) in 78%. Within 2 months of induction therapy, CR in patients treated with 5 MU IFN daily was found in 75% compared to 52% in patients treated with 3 MU IFN daily. Dosage reduction in maintenance periode caused an increase of platelets to more than 450 G/l in 39% of patients. Out of 40 Philadelphia-negative chronic myeloproliferative disorders treated for more than 3 months in 10 patients treatment was disrupted after 5 to 18 months because of the following side effects: nausea, fatigue, vertigo, fever, headache, diarrhea, anorexia, heartburn, hairloss, myalgia, and thrombocytopenia. Due to the mutagenic effect of alkylating cytostatics and Radiophosphorus, IFN-alpha treatment represents a first line strategy for chronic myeloproliferative disorders with thrombocytosis especially in younger patients who are symptomatic and in those who suffered from episodes of bleeding or thrombosis.
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PMID:[Interferon therapy in essential thrombocythemia]. 827 65

A female patient is described who had a four year long period of unilateral chronic paroxysmal hemicrania (CPH) which then became bilateral. For some years before the CPH started she suffered from periods of about one month with chronic hemicrania without nerve involvement. She also suffered from chronic fatigue, back pain, arthralgia, vertigo, chronic constipation and spontaneous ecchymoses. Blood tests showed chronic leukocytosis, low serum iron, and signs of inflammation in serum electrophoresis during the five years she was studied. CPH attacks could be provoked by breathing 6% carbon dioxide in air. Lumbar cerebrospinal fluid pressure was pathologically increased (30 cm water). The attacks decreased during indomethacin treatment but 275 mg was needed for satisfactory control of the attacks, i.e., more than the 150 mg which, according to the criteria for CPH, should be absolutely effective. Sumatriptan was found to suppress the CPH attacks as well as indomethacin. Due to these findings CPH is considered to be another manifestation of venous vasculitis. The beneficiary mechanism of indomethacin in CPH is considered to be due partly to its anti-inflammatory effects and partly to its reduction of the intracranial blood flow.
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PMID:Intracranial hypertension and sumatriptan efficacy in a case of chronic paroxysmal hemicrania which became bilateral. (The mechanism of indomethacin in CPH). 839 1

Associations between tinnitus and craniomandibular disorders (CMD) were investigated in an epidemiological sample, in tinnitus patients, and in patients attending a 'CMD-clinic'. Natural course of tinnitus was explored in a longitudinal epidemiological study of an elderly population. Several findings indicating a relatively strong relationship between CMD, tinnitus and subjective hearing loss were noted. This relationship seemed to be independent of objectively assessed degree of hearing loss, occupational noise exposure, general morbidity, medication or socioeconomic status. The prevalence of frequent headaches and fatigue or tenderness in jaw muscles was higher in tinnitus patients than would be expected if these conditions were unrelated. About one third of the individuals affected by tinnitus reported influence on tinnitus by jaw movements or pressure on the temporomandibular joint (TMJ). Diurnal bruxism and jaw fatigue appeared to be related to fluctuating tinnitus, vertigo, and hyperacusis. Stomatognathic and biofeedback treatment seemed to be able to reduce or eliminate tinnitus in some patients. Relatively low severity of tinnitus, normal hearing, fluctuating tinnitus, and some signs and symptoms of CMD are believed to constitute predictors of successful treatment outcome. Substantial longitudinal fluctuations with a high occurrence of spontaneous remissions of tinnitus were found in elderly people.
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PMID:Tinnitus and craniomandibular disorders--is there a link? 850 98

A 71-year-old man was admitted to our hospital with vertigo and general fatigue. Examination of his blood and bone marrow showed pure red cell aplasia. His chest X-ray film revealed an anterior mediastinal mass and a nodular shadow in the right lower lobe. Extended thymothymectomy and right lower lobectomy were done. The mediastinal mass appeared to be an invasive thymoma and the nodular shadow in the right lower lobe proved to be from an adenocarcinoma. The patient was treated with radiation and steroids. Thymoma, pure red cell aplasia, and lung cancer had not recurred and he was alive and well as of 2 years after surgery.
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PMID:[Invasive thymoma associated with pure red cell aplasia and lung cancer]. 862 84

The orthostatic test was administered to 134 dizzy patients (37 males and 97 females) who were identified as having orthostatic dysregulation from December 1990 through November 1994. The mean age of the male and female patients was 42.5 and 44.6 years, respectively, and the peak age decade was the 50s. Among the questionnaire items for orthostatic dysregulation, orthostatic dizziness was the most frequent major symptom and occurred in 116 of the patients (86.6%). Fatigue was the most frequent minor symptom and was found in 97 (72.4%). The incidence of positive orthostatic test results in the patients with orthostatic dysregulation (50.7%) was significantly higher (P < 0.01) than that in the control subjects (27.8%). There was also a significant difference (P < 0.01 or P < 0.05) between systolic pressure decrease during the orthostatic test procedure in the patients with orthostatic dysregulation and that in the control subjects. These results suggest that autonomic imbalance as reflected by the orthostatic dysregulation questionnaire and orthostatic test results is closely related to the occurrence of dizziness or vertigo.
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PMID:The relationship between orthostatic dysregulation and the orthostatic test in dizzy patients. 873 83

An epidemiologic investigation was conducted to characterize and evaluate the possibility of a viral aetiology of an outbreak of acute vertigo in Hot Springs Country, Wyoming, during autumn 1992. Case-finding identified Hot Springs County residents who sought medical attention for new onset vertigo during 1 August, 1992-31 January 1993. Thirty-five case-patients and 61 matched controls were interviewed and serum specimens were obtained during January 1993. Case-patients were more likely than controls to report symptoms (e.g. fatigue, sore throat, fever, diarrhoea) of antecedent acute illness. Case-patients did not have a significantly greater prevalence or mean titre of IgG antibodies to respiratory syncytial virus, parainfluenza viruses, Epstein-Barr virus, and cytomegalovirus than controls. Serologic evidence of recent enterovirus infection (IgM antibodies) was found for 74% of case-patients compared with 54% of controls (P < 0.05), suggesting a possible association between vertigo and enterovirus infection. Future studies are needed to define the role of enteroviruses in innerear diseases.
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PMID:Outbreak of vertigo in Wyoming: possible role of an enterovirus infection. 876 Sep 63

Abnormal sensations in the throat (AST) are commonly encountered in general and otolaryngological practice, especially among middle aged women. These sensation may occur alone, or more often, in combination with the systemic symptoms, including those of menopause. We analyzed 26 Japanese women with a complaint of an abnormal sensation in the throat who were taking a synthetic sex hormone (Methermon-F). Multianalysis of variance (MANOVA) was used to evaluate the efficacy of the treatment using the quantitative scores of Kupperman's climacteric symptoms. The presence of the excessive perspiration and vertigo, insomnia, and the absence of fatigue were associated with clinical efficacy of the hormone, while the presence of hyposthenia and tingling sensation were associated with a poor response. Results suggested that the clinical efficacy of this hormone in treating middle-aged menopausal women with AST was related to the menopausal symptoms.
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PMID:Relationship between abnormal sensation in the throat and menopause. 880 26

1. The aim of this study was to investigate the analgesic effect and its duration of a new sustained-release preparation of tramadol in an experimental pain model based on pain-related chemosomatosensory evoked potentials (CSSEPs) and subjective intensity estimates of painful phasic and tonic stimuli. 2. Twenty volunteers participated in a randomised, double-blind, three-fold cross-over study. Measurements were obtained before and 0.5, 1, 4, 6, and 12 h after administration of the drug (100 mg, 200 mg and placebo orally). CSSEPs were recorded after stimulation of one nostril with phasic, painful CO2 pulses. The other nostril was stimulated with a constant stream of dry air, which produced a tonic painful sensation. Subjects rated the perceived intensity of phasic and tonic stimuli via visual analogue scales. In order to test for nonspecific effects, acoustic evoked potentials (AEPs) were recorded, the spontaneous EEG was analysed in the frequency domain, the subject's vigilance was assessed in a tracking task, and the side effects of the drug were monitored. 3. The sustained-release preparation of tramadol produced a significant dose-related decrease in CSSEP amplitudes when compared with placebo. The reduction in amplitudes outlasted the observation period of 12 h, demonstrating the prolonged duration of the analgesic effect. 4. A dose-related significant decrease could be observed for the estimates of tonic pain. Similar to the decrease of amplitudes of the CSSEP, the reduction of the ratings of tonic pain outlasted the observation period of 12 h. The observed slight decrease in the estimates of phasic pain under medication did not reach a statistically significant level when compared with placebo. No significant effect could be demonstrated for the perception of the phasic and the tonic pain as determined by the McGill-Questionnaire. 5. A significant dose-related increase in the estimates of the side effects 'drowsiness', 'vertigo' and 'sickness' but not for 'tiredness' could be demonstrated.
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PMID:Dose dependent time course of the analgesic effect of a sustained-release preparation of tramadol on experimental phasic and tonic pain. 883 37


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