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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We compared 10 episodes (8 patients) of Q fever endocarditis with 27 episodes (27 patients) of native valve endocarditis. Patients with Q fever endocarditis were more likely to have weight loss (p less than 0.003), experience fatigue (p less than 0.07), have clubbing of the fingers (p less than 0.005), have a diastolic murmur at the time of admission (p less than 0.03), be anemic (p less than 0.05), have a normal white blood cell count (p less than 0.005), and have a higher serum globulin concentration (p less than 0.007). While valve replacement was required for 50% of the episodes in both groups of patients, it was required later--mean 107 days following the onset of treatment--for the Q fever patients than for the native valve patients--mean 27 days. The mortality rates for these two diseases were not significantly different (30% for native endocarditis vs. 12.5% for Q fever endocarditis), but the Q fever patients experienced significantly fewer complications.
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PMID:A comparison of Q fever endocarditis with native valve endocarditis. 237 80

The aim of this paper is to review clinical and laboratory features of this unusual pathology and its complications, indicating transcatheter embolization as a first choice for its management. Our case report is of a seven year-old child, with complex pulmonary arteriovenous fistula of the anterior segment of right superior lobe, which was diagnosed mainly by cintilography and pulmonary angiogram. Clinically she had cyanosis, fatigue with exertion, clubbing of the fingers and polycythemia with low partial pressure of oxygen (PAO2: 68.1 mmHg; Sat O2: 92.4%; Hct: 47.5%; Hb: 16 gr%). She did not have Rendu-Osler-Weber disease. The anatomic structure and localization of the complex fistula was showed by cineangiographic study. We preferred to manage this fistula with transcatheter embolization with a 02 gauge stainless steel coil occluding device (Gianturco-Wallace), as it was single and the patient was too young for sustain surgical trauma and the outcome would be positively satisfactory. After the embolization cyanosis was relieved and we could see normal pulmonary circulation following the point of the pre-existing fistula. We concluded that a judicious assessment by cineangiography could help select the transcatheter embolization procedure as an attractive therapeutic approach instead of surgery.
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PMID:[Pulmonary arteriovenous fistula. A case report and review of the literature]. 269 20

From 1970 to 1986, 3 males and 6 females, ranging in age from 13 to 69 years (median 45 years), underwent heart surgery for a primary cardiac tumor. Six patients had a left atrial myxoma; a lipofibroma, a lymphosarcoma and a rhabdomyosarcoma were found each in 1 patient. The following complaints were present: congestive heart failure in 8, fatigue in 7, cardiac arrhythmia in 3, palpitations in 3, fever in 2 and finally weight loss, nocturnal perspiration and clubbing were each in one patient. The duration of symptoms ranged from 6 weeks to more than 2 years (median 10.8 months). All patients were operated with the aid of extracorporeal circulation as soon as they were diagnosed. One patient with extensive tumor growth died at the end of the procedure. During the follow-up period all patients with a primary malignant tumor died within 3 months. Those with myxoma or fibroma are still alive with a follow-up period extending to 13 years (median 7 years). All surviving patients are asymptomatic and well. Malignant cardiac tumors do have a very poor prognosis, they are only amenable for palliative resection and even then prognosis remains poor. When an endocardial biopsy confirms the diagnosis of a cardiac malignancy, the indication for operation is questionable, although there is an absolute indication in case of obstruction. Cardiac myxoma should be resected after diagnosis because the potential embolic complications may be debilitating or lethal. The operative risk is small, and the long term results are excellent.
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PMID:Primary cardiac tumors. 329 13

The classical symptoms of malabsorption syndrome are diarrhea, steatorrhea, weight loss, and fatigue. Tetany, ecchymosis, anorexia, bone pain, pallor, muscle wasting, hyperpigmentation, apathy, digital clubbing, abdominal distention which contrasts in view of the reduced common statement are other signs of malabsorption. Long before the onset of these symptoms there may be a disinterest in regular daily activities often associated with the passage of three soft stools per day and with the remarkable sign of difficulties in flushing bulky stools. Anamnesia, clinical examination in connection with common laboratory findings, small intestinal x-rays and endoscopic investigations associated with biopsies of the small (and large) bowel as well as estimation of stool fat excretion, xylose- and Schilling-test allow the diagnosis in most of the cases.
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PMID:[Clinical aspects and differential diagnosis of malabsorption]. 684 29

Liver disease affects the lungs. The majority of patients exhibit mild to moderate arterial hypoxaemia essentially attributable to an alteration in ventilation/perfusion matching and limited by an increase in ventilation. A minority (some 10%) of patients exhibit a "hepatopulmonary syndrome" defined by severe hypoxaemia with arterial PO2 below 60 mm Hg, dyspnoea, cyanosis, digital clubbing, orthodeoxia, platypnoea and demonstrable pulmonary vascular dilatations causing a true pulmonary shunt and a diffusion/perfusion imbalance. The hepatopulmonary syndrome is incurable but resolves over time after liver transplantation. An even lower proportion of patients, approximately 1%, develop pulmonary hypertension. Clinically this "portopulmonary hypertension" resembles primary pulmonary hypertension, with dyspnoea and fatigue as the main symptoms, histopathology and response to prostacyclin therapy. Portopulmonary hypertension is irreversible. Liver transplantation mortality in patients with portopulmonary hypertension ranges from 50 to 100%. The common cause of the hepatopulmonary syndrome and portopulmonary hypertension is portal hypertension and portosystemic shunting, indicating that vasoactive and angiogenetic factors originating from the liver normally control the pulmonary circulation.
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PMID:Hepatopulmonary syndrome and portopulmonary hypertension. 1271 85

Copa syndrome is a newly described autosomal dominant autoinflammatory disease that presents as pulmonary hemosiderosis and polyarticular arthritis. Twenty-one cases from five families have been reported to date. We present chest computed tomography (CT) and temporomandibular joint magnetic resonance (MR) findings of a 12-year-old boy presenting with dyspnea on exertion, fatigue and clubbing. Additional findings included a restrictive pattern of pulmonary involvement and positive inflammatory markers and autoantibodies. Genetic testing revealed a p.W240R variant of the COPA gene confirming the diagnosis of Copa syndrome. CT of the chest showed a nonspecific interstitial pneumonia pattern distributed mainly in the lower lobes. MR of the temporomandibular joints and follow-up CT three years later are also described.
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PMID:Imaging findings of Copa syndrome in a 12-year-old boy. 2895 95

Lemierre syndrome is characterized by septic thrombophlebitis of the internal jugular vein, after an oropharyngeal infection, with septic embolization to the lungs or other organs. This case report describes a 37-year-old female patient who presented with edema and pain in the right hemiface with onset 3 days previously and progressive fatigue and dyspnea since the previous day. She had had tooth 48 extracted 3 days previously. Physical examination at admission found tachypnea, with 60% saturation (in room air), edema at the angle of the right mandible, diffuse reduction of vesicular murmur, and calves free from clubbing. Angiotomography of the chest and laboratory tests were compatible with septic emboli, and cervical computed tomography confirmed a diagnosis of septic thrombophlebitis of the internal jugular vein. She was managed with antibiotics and given treatment for her symptoms. Lemierre syndrome most often occurs in young men and there is embolization to the lungs in up to 97% of cases. Rarely, the etiology of this syndrome may be tooth extraction. Computed tomography is the imaging method most often used for diagnosis and treatment is basically antibiotic. Surgery is thus rarely necessary.
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PMID:Lemierre syndrome: case report. 3078 54

Pulmonary arteriovenous malformations (PAVM) are generally congenital lesions caused by abnormal capillary development. Lesions can be in the form of isolated anomaly or as part of autosomal dominantly inherited hereditary hemorrhagic telengiectasia (HHT). HHT is the most common hereditary vascular disease characterized by mocucutaneuos telengiectasia and visceral arteriovenous malformations. PAVMs can be asymptomatic or can present with effort dyspnea, palpitations and fatigue especially in cases with HHT. Herein, we present a 13 year-old girl diagnosed with PAVM with polycythemia, clubbing, cyanosis and radiological features; and had accompanying history of epistaxis in family and telengiectasia in oral mucosa as parts of HHT. She was treated by endovascular embolization.
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PMID:Hereditary hemorrhagic telangiectasia and pulmonary arteriovenous malformations. 3263 8

Introduction Solitary fibrous tumors of the pleura (SFTP) are rare, slowly growing pleural neoplasms. Patients are usually diagnosed in their 5th to 8th decade, without associated symptoms. The best treatment consists of margin free surgical resection (R0). Objectives We analysed our center's surgical experience with SFTP, describing the demographic and individual patient/tumor characteristics, the surgical options and results over a period of 20 years. Materials and Methods The Department's database was searched for SFTP between January 2000 and July 2020, resulting in total of 58 cases. 51 patients were included in the final analysis. Results 31 were women (61%) and 20 men (39%). Most (88%) were diagnosed over age 50, the average age being 60.2 years (range 30 - 78). Symptoms were present in 43% of the patients (22 cases), most commonly coughing, dyspnea or unspecific symptoms (weight loss, tiredness, anorexia). Thoracalgia was present in 17.6% (9) and 7.8% (4) had finger clubbing and polyarthralgia. Doege-Potter syndrome was found in one case (1.9%) and completely resolved after surgery. The largest tumor diameter was 22 cm and the smallest one 2 cm, with an average size of 6,62 cm. Videothoracoscopy was performed in 35% (18 cases) and thoracotomy in the remaining 33 (65%). R0 ressection rate was 90.2%. Lung resection, along with the mass, was performed whenever the origin was the visceral pleura, to insure a safe margin: wedge resection in 49% (25 cases), lobectomy in 5.9% (3 cases) and bilobectomy and pneumonectomy each in 1.9% (one case). Other structural en-bloc resections were also necessary at times: ribs in one case (1.9%) and diaphragm in 2 (3.9%). Predictors of recurrency were present in 30 patients: pleural effusion (1 case, 1.9%), atypical localization (41.2%; 21 cases), histological criteria for malignancy (7 cases,13.7%) and border-line in 1 (1.9%). There were 4 recurrences (7.8%). 3 out of these 4 patients had an atypical localization of the tumor defined as parietal or costal/cisural pleura. In all cases the resection was deemed complete, none had histological criteria for malignancy, but necrosis was present in 3 cases and atypia in the other 2. Disease free survival was 49 months (range 13 - 105). Conclusions Solitary fibrous tumors of the pleura are characterized by uncertain behavior. They often present as large assymptomatic masses. En bloc complete resection is the most important prognostic factor. Relapse can occur more than a decade after the initial diagnosis.
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PMID:Solitary Fibrous Tumors Of The Pleura - 20-Year Experience. 3328 Mar 5