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

In a prospective study, we investigated whether human immunodeficiency virus (HIV) infection alters the clinical presentation in patients with tuberculous pleuritis. One hundred twelve of 118 patients who presented with pleural effusion suffered from tuberculosis (TB); 65 patients (58%) were HIV seropositive. Evidence of disseminated TB was found more often in HIV-positive than in HIV-negative patients (30.8% vs 10.6%, p < 0.02). Dyspnea, fever, night sweat, fatigue, and diarrhea, severe tachypnea, hepatomegaly, splenomegaly, and lymphadenopathy were significantly more common in HIV-infected than in HIV-negative patients with TB. The same applied to a negative Mantoux reaction, lower hemoglobin, higher beta 2-microglobulin values, and in pleural fluid, lower albumin and higher gamma-globulin levels. Among HIV-infected patients, PPD skin test anergy was significantly associated with relative low albumin and gamma-globulin levels of pleural fluid. However, the radiographic features did not differ with respect to HIV status; they were predominantly those of primary pleuritis (78% in each group). We conclude that coexisting HIV infection affects clinical and laboratory features, but not the radiographic presentation of patients with TB pleuritis in Tanzania.
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PMID:Clinical features of HIV-seropositive and HIV-seronegative patients with tuberculous pleural effusion in Dar es Salaam, Tanzania. 795 5

Severe inspiratory elastic load terminated by respiratory arrest (RA) was studied in 24 anesthetized dogs (group 1, normal: n = 14; group 2, vagotomized: n = 10). The peripheral and central components of the decrease in diaphragmatic force generation and the events preceding RA were studied. We measured stimulated tetanic transdiaphragmatic pressure (Pdi), single twitch compound action potentials, integrated diaphragmatic electromyographic activity (iEMGdi), respiratory frequency (f), inspiratory time, inspiratory drive, overall diaphragmatic activation, and Pdi single twitch superimposed over peak Pdi. Imposed target pressure was -68.8 +/- 4.37 cmH2O for group 1 and -70.9 +/- 4.19 cmH2O for group 2, and the tension-time index of the diaphragm was the same for both groups (0.22 +/- 0.010). During load, 1) f increased in group 1 from 25.4 +/- 1.33 to 41.3 +/- 4.66 cycles/min, and tachypnea was prevented by vagotomy; 2) twitch occlusion persisted until RA and compound action potentials did not change; 3) iEMGdi and inspiratory drive increased and remained high until RA; 4) overall diaphragmatic activation increased 514 (group 1) and 260% (group 2) and then decreased to 228% of the basal value 10 s before RA in group 1 because of a fall in f; and 5) after RA, Pdi stimulated at 60 Hz fell to 39 (group 1; P < 0.0025) and 51% (group 2; NS with group 1) of the basal value. In summary, 1) peripheral fatigue developed without transmission failure; 2) diaphragmatic activation remained maximal until RA; 3) the fall in f appeared as a preterminal event only in group 1; and 4) vagus nerves are necessary for load-induced tachypnea.
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PMID:Central and peripheral diaphragmatic fatigue in loaded normal and vagotomized dogs. 836 86

Recently group A Streptococcus toxic shock like syndrome (TSLS) has been reported, but as for group B streptococcus (S. agalactiae) infection, there have been little documentation in the literature. We report a case of fluminant septic shock due to Streptococcus agalactiae (S. agalactiae). A 72-year-old male was admitted to our hospital because of general fatigue and azotemia. He was diagnosed as having MPO-ANCA related glomerulonephritis and treated with steroid therapy. Gradually he was doing well. On the 228th hospital day, he suddenly had tachypnea, transient conscious disturbance, and profound hypotension. About 16 hours later, he died despite intensive treatment. S. agalactiae was isolated from the blood. Autopsy revealed bilateral bronchopneumonia and shock liver. To our knowledge, this is the first report of septic shock caused by S. agalactiae.
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PMID:[A case of fluminant septic shock due to Streptococcus agalactiae in a patient with MPO-ANCA related glomerulonephritis]. 898 74

Pigeon breeder's disease is a common form of hypersensitivity pneumonitis, which is rarely diagnosed in children. We report a seven year old boy, who developed cough, easy fatigue, anorexia and weight loss over a period of two months after having contact with pigeons. The findings on physical examination were tachypnoea and reduced thoracic movements. Chest radiograph showed widespread fine nodular shadowing in both lung fields. Pulmonary function tests demonstrated a restrictive defect and an impaired diffusion. Lymphocytes were highly increased in bronchoalveolar lavage (BAL) fluid. Precipitating antibodies against pigeon excreta was found in the serum. Environmental control of pigeon protein and a course of systemic corticosteroids over 4 months resulted in clinical and lung function improvement. However clinical recovery stopped over several months after discontinuation of steroid therapy. Therefore steroid therapy was reinstalled and continued until complete clinical recovery and pulmonary function occurred, that was 20 months after onset of the disease. Essential for the patient was to avoid further contact with birds. However a prolonged steroid therapy was necessary to achieve complete resolution. Lung function tests were useful for follow up and decisions on further treatment.
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PMID:[Pigeon breeder's disease in childhood]. 987 98

Alveolar hypoventilation associated with neuromuscular disease can occur in acute and chronic forms. In the acute form, progressive weakness of respiratory muscles leads to rapid reduction in vital capacity followed by respiratory failure with hypoxemia and hypercarbia. Symptoms are those of acute respiratory failure, including dyspnea, tachypnea, and tachycardia. In the chronic form, impairment of the respiratory muscles affects mechanical properties of the lungs and chest wall, decreases the ability to clear secretions, and eventually may alter the function of the central respiratory centers. Symptoms include orthopnea, fatigue, disturbed sleep, and hypersomnolence. Treatment and outcome of the disease's chronic form are dependent on the underlying clinical cause of the alveolar hypoventilation. For chronic but stable diseases such as old polio, quadriplegia, or kyposcoliosis, mechanical support of minute ventilation can reverse symptoms. For chronic and progressive disease such as muscular dystrophy and amyotrophic lateral sclerosis, mechanical support of minute ventilation provides only symptomatic relief and is usually associated with deterioration to the point of complete ventilator dependency for survival. For the chronic progressive forms of alveolar hypoventilation, there is currently a need for quality randomized controlled clinical trials to define physiologic indicators and appropriate timing for mechanical support of minute ventilation.
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PMID:Neuromuscular disease and hypoventilation. 1057 Jul 36

This report describes a 14-year-old girl with fulminant myocarditis who was successfully treated with a percutaneous cardiopulmonary support (PCPS). She developed progressive cardiac failure after a 3-week history of progressive fatigue, fever, tachypnea, and dyspnea requiring inotropic support, mechanical ventilation, and intra-aortic balloon pumping. Her condition continued to deteriorate, and she was cannulated for PCPS using a right femoral artery/femoral vein approach, which resulted in rapid improvement and hemodynamic stabilization. This case documents that circulatory support with PCPS is effective for treating children with fulminant myocarditis.
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PMID:Rescue of a child with fulminant myocarditis using percutaneous cardiopulmonary support. 1075 88

Recently, a vagally mediated excitatory lung reflex (ELR) causing neural hyperpnea and tachypnea was identified. Because ventilation is regulated through both inspiratory and expiratory processes, we investigated the effects of the ELR on these two processes simultaneously. In anesthetized, open-chest, and artificially ventilated rabbits, we recorded phrenic nerve activity and abdominal muscle activity to assess the breathing pattern when the ELR was evoked by directly injecting hypertonic saline (8.1%, 0.1 ml) into lung parenchyma. Activation of the ELR stimulated inspiratory activity, which was exhibited by increasing amplitude, burst rate, and duty cycle of the phrenic activity (by 22 +/- 4, 33 +/- 9, and 57 +/- 11%, respectively; n = 13; P < 0.001), but suppressed expiratory muscle activity. The expiratory muscle became silent in most cases. On average, the amplitude of expiratory muscle activity decreased by 88 +/- 5% (P < 0.002). The suppression reached the peak at 6.9 +/- 1 s and lasted for 200 s (median). Injection of H(2)O(2) into the lung parenchyma produced similar responses. By suppressing expiration, the ELR produces a shift in the workload from expiratory muscle to inspiratory muscle. Therefore, we conclude that the ELR may contribute to inspiratory muscle fatigue, not only by directly increasing the inspiratory activity but also by suppressing expiratory activity.
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PMID:Excitatory lung reflex may stress inspiratory muscle by suppressing expiratory muscle activity. 1118 93

Despite being banned in many countries and having its use severely restricted in others, pentachlorophenol (PCP) remains an important pesticide from a toxicological perspective. It is a stable and persistent compound. In humans it is readily absorbed by ingestion and inhalation but is less well absorbed dermally. Its distribution is limited, its metabolism extensive and it is eliminated only slowly. Assessment of the toxicity of PCP is confounded by the presence of contaminants known to cause effects identical to those attributed to PCP. However, severe exposure by any route may result in an acute and occasionally fatal illness that bears all the hallmarks of being mediated by uncoupling of oxidative phosphorylation. Tachycardia, tachypnoea, sweating, altered consciousness, hyperthermia, convulsions and early onset of marked rigor (if death occurs) are the most notable features. Pulmonary oedema, intravascular haemolysis, pancreatitis, jaundice and acute renal failure have been reported. There is no antidote and no adequate data to support the use of repeat-dose oral cholestyramine, forced diuresis or urine alkalinisation as effective methods of enhancing PCP elimination in poisoned humans. Supportive care and vigorous management of hyperthermia should produce a satisfactory outcome. Chronic occupational exposure to PCP may produce a syndrome similar to acute systemic poisoning, together with conjunctivitis and irritation of the upper respiratory and oral mucosae. Long-term exposure has also been reported to result in chronic fatigue or neuropsychiatric features in combination with skin infections (including chloracne), chronic respiratory symptoms, neuralgic pains in the legs, and impaired fertility and hypothyroidism secondary to endocrine disruption. PCP is a weak mutagen but the available data for humans are insufficient to classify it more strongly than as a probable carcinogen.
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PMID:Pentachlorophenol poisoning. 1457 43

Inspiratory muscle fatigue (IMF) can develop during exhaustive exercise and cause tachypnea or rapid shallow breathing. We assessed the effects of rib cage muscle (RCM-F) and diaphragm fatigue (DIA-F) on breathing pattern and respiratory mechanics during high-intensity endurance exercise. Twelve healthy subjects performed a constant-load (85% maximal power) cycling test to exhaustion with prior IMF and a cycling test of similar intensity and duration without prior IMF (control). IMF was induced by resistive breathing and assessed by oesophageal and gastric twitch pressure measurements during cervical magnetic stimulation. Both RCM-F and DIA-F increased RCM and abdominal muscle force production during exercise compared to control. With RCM-F, tidal volume decreased while it increased with DIA-F. RCM-F was associated with a smaller increase in end-expiratory oesophageal pressure (i.e. decrease in lung volume) than DIA-F. These results suggest that RCM-F and not DIA-F is associated with rapid shallow breathing and that lowering the operating lung volume with DIA-F may help to preserve diaphragmatic function.
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PMID:Influence of diaphragm and rib cage muscle fatigue on breathing during endurance exercise. 1642 67

We report the case of an 18-year-old woman with arthralgia and swelling of distal joints at hands and feet, photosensitive reaction, butterfly rash, fatigue, tachypnea and unspecific cardiac pain three months after beginning a treatment with minocycline for acne. Recurrence of symptoms at a higher intensity occurred within hours of reexposition with minocycline. The antinuclear antibody test was positive. After withdrawal of minocycline, the symptoms improved and minocycline-induced lupus was diagnosed. In the Swissmedic and WHO adverse drug reaction databases 267 other cases of possible minocycline-induced lupus were identified. Typical clinical and laboratory features are arthralgia, arthritis, myalgia, increased transaminases and/or jaundice, unspecific symptoms like fatigue and fever, skin disorders and positive antinuclear antibodies.
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PMID:[Minocycline-induced lupus erythematodes]. 1697 Jan 39


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