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)

Sarcoidosis is a multisystem disease of unknown etiology that is rarely diagnosed in children. When mass screening is performed, the incidence of the disease in children approaches that of adults with similar demographics. Most childhood cases occur around ages 9 to 15 years, with small clusters of cases occurring in children under age 4 years. The disease in these two age groups has very different clinical features. Children under age 4 have a clinical triad of rash, arthritis, and uveitis. The classic syndrome in older children involves primarily lungs, lymph nodes, and eyes. In older children, constitutional symptoms (fatigue, lethargy, malaise) and pulmonary symptoms (cough, dyspnea) predominate. Mortality in childhood sarcoidosis is about 5%, with long-term sequelae in 10% to 20%. Early recognition may prevent complications such as blindness, pulmonary insufficiency, and renal impairment.
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PMID:Sarcoidosis in children. 332 85

The combination of nifedipine and atenolol must be evaluated in terms of risks and benefits to the hypertensive patient. Disadvantages with single-agent therapy justify trials of combination regimens. beta-Blockers may be unacceptable to some patients because of gastrointestinal upset, musculoskeletal symptoms, tiredness, malaise, insomnia, depression or confusion, sweating, breathlessness or cold extremities. The side effect profile varies from patient to patient and between different beta-blockers. Calcium antagonists also have characteristic side effects, including severe headaches, flushing and oedema, tachycardia and possibly worrying palpitations, and polyuria. Combining a calcium antagonist and a beta-blocker can reduce some side effects; for example, tachycardia is offset by addition of beta-blocker to calcium antagonist therapy, and beta-blocker-induced cold extremities may be reversed with a drug such as nifedipine. Moreover, the antihypertensive efficacy is increased, which is useful in previously resistant patients. However, an excessive fall in blood pressure is a possible adverse effect of the combination. There is also the possibility of precipitating heart failure in patients with cardiomegaly and severely compromised left ventricular function. The combination of nifedipine and atenolol was evaluated in 25 patients in a randomised, crossover trial following a month's treatment with atenolol 50mg twice daily. Patients received either atenolol 50mg twice daily alone, or atenolol 50mg twice daily with sustained release nifedipine 20mg or 40mg twice daily, or placebo twice daily during three 4-week treatment periods. Additional antihypertensive benefit was obtained by addition of the low dose of nifedipine compared with atenolol alone, but no further advantage was obtained with the higher nifedipine dose.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Aims of combination therapy--improved quality of life or better blood pressure control? 337 14

We conducted a trial of a murine monoclonal antimelanoma antibody-ricin A chain immunotoxin (XOMAZYME-MEL) in 22 patients with metastatic malignant melanoma. The dose of immunotoxin administered ranged from 0.01 mg/kg daily for 5 days to 1 mg/kg daily for 4 days (total dose: 3.2 to 300 mg). Side effects observed in most patients were a transient fall in serum albumin with an associated fall in serum protein, weight gain, and fluid shifts resulting in edema. In addition, patients experienced mild to moderate malaise, fatigue, myalgia, decrease in appetite, and fevers. There was a transient decrease in voltage on electrocardiograms without clinical symptoms, change in serial echocardiograms or elevation of creatine phosphokinase MB isozyme levels. Symptoms consistent with mild allergic reactions were observed in three patients. The side effects were related to the dose of immunotoxin administered and were generally transient and reversible. Encouraging clinical results were observed, even after a single course of a low dose of immunotoxin. In addition, localization of antibody and A chain to sites of metastatic disease was demonstrated by immunoperoxidase staining of biopsy specimens. Additional studies are being conducted to continue the evaluation of safety and efficacy of immunotoxin therapy for malignancy.
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PMID:Therapy of patients with malignant melanoma using a monoclonal antimelanoma antibody-ricin A chain immunotoxin. 349 66

This double-blind, placebo-controlled study evaluated the efficacy and safety of sc administered recombinant alpha 2 interferon (IFN-alpha 2) in the suppression of frequently recurrent genital herpes simplex virus (HSV) infection. Seventy-six otherwise healthy subjects who had eight or more recurrences during the preceding year received 1 X 10(6) IU of IFN-alpha 2, 3 X 10(6) IU of IFN-alpha 2, or placebo three times per week for 12 weeks. Recipients of the higher dose of IFN-alpha 2, had fewer outbreaks during the study (2 vs. 3), a shorter period of viral shedding (2 vs. 4 days), less itching (1 vs. 3 days), and a faster healing time (6 vs. 8 days). The lower dose of IFN-alpha 2 was not effective. Significant side effects (fever, malaise, myalgia, fatigue, and arthralgia) occurred after the first injection of 3 X 10(6) IU of IFN-alpha 2 in 91% of the subjects, but subsequent injections produced only mild and intermittent side effects that were well tolerated. Mild leukopenia was noted in subjects treated with IFN-alpha 2. Treatment with IFN-alpha 2 resulted in moderate suppression and decreased duration of recurrent genital HSV infection in patients with frequent recurrences.
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PMID:Suppression of recurrent genital herpes simplex virus infection with recombinant alpha 2 interferon. 352 95

Nine patients with hormone-resistant prostate carcinoma were treated with subcutaneous injection of recombinant human interferon-alpha 2 (rHuIFN-alpha 2), 5-10 X 10(6) U/m2, three times a week. One patient had a mixed clinical response with reduction of bone pain. The study was closed due to intolerable grade III and IV toxicities including weight loss (8/9), fatigue/malaise (7/9), central nervous system toxicity (4/9), leukopenia (3/9), and uncontrollable nausea and vomiting (2/9). These toxicities resulted in deterioration of performance status. It is concluded that rHuIFN-alpha 2, at least at the dose and schedule studied, should not be used for the treatment of patients with hormone-resistant prostate carcinoma.
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PMID:Toxicities of human recombinant interferon-alpha 2 in patients with advanced prostate carcinoma. 357 90

Betaseron (beta ser17-interferon) was administered to 19 patients (17 evaluable) with advanced melanoma by two schedules. Patients received either 30 X 10(6) units (mU) by intravenous bolus 5 days a week for 2 weeks followed by 2 weeks rest, or 30 mU daily for 5 days in week 1, 60 mU daily for 5 days in week 2, then twice-weekly doses escalating from 90 to 270 mU. Toxicity commonly included malaise, fatigue, fever, and weight loss. Mild hematologic, gastrointestinal, and hepatic toxicity were also seen, as well as an episode of atrial fibrillation in a patient with mitral valvular disease. No responses to therapy occurred.
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PMID:Phase II study of betaseron (beta ser17-interferon) as treatment of advanced malignant melanoma. 362 29

Eighteen women with metastatic breast cancer entered a phase I-II study of high-dose mitoxantrone (MXT). They were heavily pretreated (mean, 2.3 prior regimens) with drugs including both doxorubicin (14 patients) and MXT at usual doses (three). Doses studied were 16, 20, 25, and 30 mg/m2, repeated every 3-4 weeks. Marked leukopenia was seen at all dose levels (four episodes of infection were successfully treated). Fatigue and malaise were the most common nonhematologic toxic effects. At 25 mg/m2, six of 13 courses resulted in severe fatigue and malaise. MXT is tolerated at doses up to 25 mg/m2 every 3-4 weeks. Cardiac function must be closely monitored. No responses were seen in these heavily pretreated patients.
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PMID:High-dose mitoxantrone in metastatic breast cancer: a phase I-II trial. 371 83

Seventeen patients with metastatic renal cancer were treated with human lymphoblastoid cell-derived alpha interferon, 30 X 10(6) U/m2, which was given intravenously for 3 consecutive days of each week for 6 weeks. On the days of interferon treatment only, patients received prednisone, 15 mg t.i.d., in order to minimize toxicity. Of the 16 evaluable patients, one had a minor regression of disease, eight had stable metastatic disease, and seven progressed. Constitutional symptoms, such as fever, anorexia, and fatigue, were common. Debilitating degrees of malaise were a treatment-limiting factor.
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PMID:A phase II trial of high-dose human lymphoblastoid alpha interferon in patients with advanced renal carcinoma. 373 46

In a study of bacteriuria in elderly (mean age 85 years, range 69 to 101), mostly middle- and upper-class Jewish subjects, attempts were made to determine if bacteriuria without dysuria is otherwise asymptomatic. Seventy-two subjects (59 women and 13 men) without dysuria were questioned about other urinary symptoms (incontinence, frequency, urgency, suprapubic pain, flank pain, fever) and symptoms indicating a lack of well-being (anorexia, difficulty in falling asleep, difficulty in staying asleep, fatigue, malaise, weakness) when they were with and without bacteriuria. Twenty-two subjects had bacteriuria that resolved spontaneously; bacteriuria subsequently developed in 24 nonbacteriuric subjects; and 26 subjects had bacteriuria that resolved with antimicrobial therapy. Subjects occasionally reported urinary symptoms (especially incontinence) and commonly reported symptoms indicating a lack of well-being when they were with and/or without bacteriuria. However, no differences in symptoms were found when bacteriuric subjects were compared with themselves when they were nonbacteriuric. Thus, bacteriuria without dysuria in the elderly appears to be asymptomatic.
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PMID:Lack of association between bacteriuria and symptoms in the elderly. 379 58

Over a seven-year period, we identified 23 patients who had prolonged or recurrent, severe, systemic, cat-scratch disease (CSD). Compared with the usual, benign course in 1,038 patients with typical CSD, the course in these 23 patients included prolonged (two or more weeks) morbidity (fever, malaise, fatigue, myalgia, arthralgia, skin eruptions, weight loss, and splenomegaly). Five patients with systemic CSD had either neuroretinitis, pleurisy, arthralgia or arthritis, splenic abscesses, and mediastinal masses or enlarged nodes of the head of the pancreas. Recurrent CSD in two of three adults was confirmed by finding typical CSD bacilli in lymph nodes removed during separate episodes. The majority of patients were adult males, and all patients recovered completely without sequelae. Histopathologic studies of five skin and 18 lymph node biopsy specimens were diagnostic. CSD bacilli were detected in lymph nodes from 15 patients and in the primary skin lesions of four patients. CSD bacilli were found in both skin and lymph nodes of three patients.
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PMID:Systemic cat scratch disease: report of 23 patients with prolonged or recurrent severe bacterial infection. 380 68


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