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)

A 3-yr-old boy was investigated for numerous episodes of fatigue, irritability, pallor, and sweating, which began at 11 mo of age, when he had an episode of symptomatic hypoglycemia with ketonuria. He had euphoria, mental confusion, drowsiness, nausea, and vomiting 1-5 hr after oral administration of glycerol in doses of 0.5-1.0gm/kg. Orally administered MCT (1 gm/kg) had similar effects. On one occasion, oral glycerol also provoked hypoglycemia, as had a 16 1/2 hr fast. Intravenously administered glycerol (0.09 gm/kg) induced an immediate loss of consciousness from which he recovered spontaneously after 30 min; there were no changes in blood glucose values. Intravenously administered fructose (0.25 gm/kg) was tolerated normally. Leukocytes showed normal activities for FDPase, glycerol kinase, and glycerol phosphate dehydrogenase. The restriction of dietary intake of fat has been associated with a marked improvement in physical and mental activities. These observations suggest a unique, yet undifined intolerance to glycerol, which suggest caution in the diagnostic use of glycerol in the investigation of hypoglycemia as well as in the therapy of increased intracranial or intraocular pressure.
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PMID:Glycerol intolerance in a child with intermittent hypoglycemia. 16 54

A 3-year-old boy underwent corrective surgery for tetralogy of Fallot. During the operation, permanent epicardial pacemaker leads were implanted for complete A-V block, which was transient and a generator implantation was not necessary. The postoperative course was uneventful and he had been doing well until nine years of age, when he was admitted to our hospital with general fatigue. The data of echo cardiogram and cardiac catheterization showed the biventricular heart failure with right ventricular outflow tract obstruction (RVOTO). Because of his rapid deterioration refractory to the intensive medical therapy, semi-emergency surgery was recommended to relieve his RVOTO. It was found during the operation that the looped pacemaker leads had carved deeply in the atrioventricular groove, so that compressed the main pulmonary artery, left main coronary artery and encircled left ventricle. The pacemaker leads were dissected as long as possible, and cut segmentally. Additionally a patch enlargement of the main pulmonary artery was necessary to relieve the residual stenosis. Although IABP support was needed in a while, his postoperative course was uneventful, and postoperative examinations showed normal cardiac function. This rare complication, so called "cardiac strangulation", should be in mind when the implantation of permanent pacemaker leads is indicated in pediatric cases.
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PMID:[Cardiac strangulation with permanent epicardial pacemaker lead]. 159 23

A comparison of toluene and ethanol (EtOH) induced changes in central nervous system (CNS) function and symptoms were evaluated in two studies, and when possible the effects of toluene were expressed in EtOH equivalent units. The toluene concentrations were 0, 75, and 150 ppm, bracketing the American Conference of Governmental Industrial Hygienists threshold limit value (ACGIH TLV) of 100 ppm. The socially relevant EtOH doses were 0.00, 0.33, and 0.66 g EtOH/kg body weight, equivalent to two and four 3.5% 12 ounce beers. Forty two paid college students were used in each study. In the first study, subjects were exposed to toluene and an odour masking agent menthol (0.078 ppm) for seven hours over three days. In the second study EtOH or a placebo was administered at 1530 across three days also in the presence of menthol. Verbal and visual short term memory (Sternberg, digit span, Benton, pattern memory), perception (pattern recognition), psychomotor skill (simple reaction time, continuous performance, symbol-digit, hand-eye coordination, finger tapping, and critical tracking), manual dexterity (one hole), mood (profile on mood scales (POMS), fatigue (fatigue checklist), and verbal ability were evaluated at 0800, 1200, and 1600. Voluntary symptoms and observations of sleep were collected daily. A 3 x 3 latin square design evaluated solvent effects simultaneously controlling for learning and dose sequence. An analysis of variance and test for trend were performed on am-pm differences reflecting an eight hour workday and on pm scores for each solvent, in which subjects were their own control Intersubject variation in absorbance was monitored in breath. A 5 to 10% decrement was considered meaningful if consistent with a linear trend at p less than 0.05. At 150 ppm toluene, losses in performance were 6.0% for digit span, 12.1% for pattern recognition (latency), 5% for pattern memory (number correct), 6.5% for one hole, and 3% for critical tracking. The number of headaches and eye irritation also increased in a dose-response manner. The greatest effect was found for an increasing number of observations of sleep. A range of 2 to 7% decrements suggest the ACGIH TLV of 100 ppm toluene may be a good estimate of the biological threshold supporting a re-evaluation of the TLV. At 0.66 g EtOH/kg body weight symptoms and performance decrements were 6.6% for digit span, 9.2% for pattern recognition, 4.0% for continuous performance, 7.9% for symbol-digit, 16.5% for finger tapping, 6.2% for critical tracking, and 5.2% for the one hole test. The EtOH equivalents at 150 ppm toluene for digit span (0.56g EtOH/kg/body weight), the latency for pattern recognition (0.66 g EtOH kg body weight), and the one hole element "move" (0.37 g EtOH kg body weight) show that the first two measures would be affected at or above the 50 mg% blood alcohol concentration. This concentration is recognised as the lowest alcohol concentration associated with increased numbers of automobile accidents. The results suggest that EtOH may be a useful acute standard to compare the effects of various industrial solvents and support investigating an association between exposure to solvents and increased risk to safety in industry.
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PMID:Acute behavioural comparisons of toluene and ethanol in human subjects. 195 53

An acute inhalation chamber study of 42 college students was performed to investigate the relation between exposure to 0, 75, and 150 ppm of toluene and changes in central nervous system function and symptoms. Paid subjects were exposed for seven hours over three days. Verbal and visual short term memory (Sternberg, digit span, Benton, pattern memory); perception (pattern recognition); psychomotor skill (simple reaction time, continuous performance, digit symbol, hand-eye coordination, finger tapping, and critical tracking); manual dexterity (one hole); mood (profile of mood scales (POMS]; fatigue (fatigue checklist); and verbal ability were evaluated at 0800, 1200, and 1600 hours. Voluntary symptoms and observations of sleep were collected daily. An analysis of variance and test for trend was performed on the difference and score for each concentration reflecting an eight hour workday where each subject was their own control. A 3 x 3 Latin square study design evaluated toluene effects simultaneously, controlling for learning across the three days and the solvent order. Intersubject variation in solvent uptake was monitored in breath and urine. A 5-10% decrement in performance was considered significant if it was consistent with a linear trend at p less than 0.05. Adverse performance at 150 ppm toluene was found at 6.0% for digit span, 12.1% for pattern recognition (latency), 5.0% for pattern memory (number correct), 6.5% for one hole, and 3.0% for critical tracking. The number of headaches and eye irritation also increased in a dose response manner. The greatest effect was found for an increasing number of observations of sleep. Overall, no clear pattern of neurobehavioural effects was found consistent with the type 1 central nervous system as classified by the World Health Organisation. Subtle acute effects, however, were found just below and above the ACGIH TLV of 100 ppm toluene, supporting the position that the guideline be lowered since the biological threshold of behavioural effects may be comparable with the TLV.
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PMID:Acute neurobehavioural effects of toluene. 276 22

A continuously subject-paced and monetarily reinforced information-processing task was used to test whether caffeine might stimulate performance beyond the ceiling imposed by fatigue. A 3 X 2 design was adopted with the three doses 0, 150, and 450 mg caffeine and with decaffeinated coffee and fruit juice as vehicles. Two groups of 10 subjects selected to represent extremes on the extraversion-introversion scale participated in the experiment. The results revealed no differences between the two groups nor between the two drug vehicles, but caffeine at both dose levels improved performance significantly. Fatigue-induced performance decrements across the sessions reached significance, but no interaction was obtained between fatigue and drug action, supporting the view that caffeine can improve performance beyond a mere restoration of fatigue.
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PMID:Effect of coffee on the speed of subject-paced information processing. 358 71

High-dose acetaminophen (HDAC) produces hepatocellular necrosis and cytotoxic changes in other tissues that express mixed-function-oxidase (MFO) activity. N-acetylcysteine (NAC), administered within 8 hr of HDAC exposure, replenishes reduced glutathione and prevents these effects. Numerous cell culture and animal studies have demonstrated that NAC may differentially protect normal cells compared with malignant cells from the toxic effects of chemotherapeutic agents and radiation. It was therefore proposed that HDAC with NAC rescue may be effective in malignancies that express MFO activity. To test this hypothesis, a phase I trial of HDAC with NAC rescue was conducted on 19 patients with advanced cancer. HDAC was escalated from 6 to 20 g/m2 PO using a standard IV NAC rescue regimen. A total of 78 treatments were administered. Moderate fatigue, anorexia, and weight loss were the main toxicities observed. Transient grade 3 liver toxicity was noted following 1 treatment. Alopecia and renal and hematological toxicities were not observed. Responses after 4 courses administered weekly were as follows: response in at least 1 site-8 (partial 3, improved 3, mixed 2); stable disease-3; progressive disease-3; inevaluable-5. In conclusion, HDAC was tolerated with moderate fatigue, anorexia, and weight loss but few other effects using a standard IV NAC rescue regimen. A maximum tolerated dose was not reached at 20 g/m2. A 3/19 (15.8%) partial response rate was observed.
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PMID:Treatment of advanced malignancies with high-dose acetaminophen and N-acetylcysteine rescue. 863 Jun 80

An open, randomized, prospective study was carried out to compare the clinical efficacy and safety of phenoxymethylpenicillin with that of minocycline in the treatment of erythema migrans. Sixty patients (minocycline 30, penicillin 30) were enrolled in the study. The two groups of patients were statistically homogeneous regarding age and sex distribution. IgG and IgM antibodies against Borrelia burgdorferi were determined by ELISA before and after treatment and 1 year thereafter. Thirty-nine patients completed the study. All these patients (penicillin 21, minocycline 18) who received a 21-day course of treatment were free of clinical symptoms of late Lyme borreliosis after 1 year. Serum antibodies against B. burgdorferi could be detected before treatment in 6/21 patients treated with penicillin and 3/18 patients treated with minocycline. After 1 year 8/39 patients were seropositive without any evidence of ongoing disease. In the remaining 21 patients treatment could not be completed with the initial antibiotic due to side effects (penicillin 9/30, minocycline 12/30). One patient, who stopped penicillin treatment at day 14 and one patient who stopped minocycline at day 4, developed fatigue and memory impairment within the observation period. A 3-week course of treatment with penicillin or minocycline is equally effective in treating patients with erythema migrans and preventing late symptoms of Lyme borreliosis.
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PMID:Erythema migrans: three weeks treatment for prevention of late Lyme borreliosis. 885 74

The purpose of our investigation was to determine if the near infrared spectroscopy technique was sensitive to changes in tissue oxygenation at low levels of isometric contraction in the extensor carpi radialis brevis muscle. Nine subjects were seated with the right arm abducted to 45 degrees, elbow flexed to 85 degrees, forearm pronated 45 degrees, and wrist and forearm supported on an armrest throughout the protocol. Altered tissue oxygenation was measured noninvasively with near infrared spectroscopy. The near infrared spectroscopy probe was placed over the extensor carpi radialis brevis of the subject's right forearm and secured with an elastic wrap. After 1 minute of baseline measurements taken with the muscle relaxed, four different loads were applied just proximal to the metacarpophalangeal joint such that the subjects isometrically contracted the extensor carpi radialis brevis at 5, 10, 15, and 50% of the maximum voluntary contraction for 1 minute each. A 3-minute recovery period followed each level of contraction. At the end of the protocol, with the probe still in place, a value for ischemic tissue oxygenation was obtained for each subject. This value was considered the physiological zero and hence 0% tissue oxygenation. Mean tissue oxygenation (+/-SE) decreased from resting baseline (100% tissue oxygenation) to 89 +/- 4, 81 +/- 8, 78 +/- 8, and 47 +/- 8% at 5, 10, 15, and 50% of the maximum voluntary contraction, respectively. Tissue oxygenation levels at 10, 15, and 50% of the maximum voluntary contraction were significantly lower (p < 0.05) than the baseline value. Our results indicate that tissue oxygenation significantly decreases during brief, low levels of static muscle contraction and that near infrared spectroscopy is a sensitive technique for detecting deoxygenation noninvasively at low levels of forearm muscle contraction. Our findings have important implications in occupational medicine because oxygen depletion induced by low levels of muscle contraction may be directly linked to muscle fatigue.
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PMID:Forearm muscle oxygenation decreases with low levels of voluntary contraction. 937 59

The impact of GH on functional performance in GH-deficient adults is not well understood. To investigate the effects of GH on skeletal muscle, physical, and functional capacity, we randomized 28 GH-deficient adults to receive 3 months of recombinant human GH [rhGH: somatotropin, 6.25 microg/kg lean body mass (LBM) for 1 month, 12.5 microg/kg LBM thereafter] in a double-blind placebo-controlled crossover trial. We measured muscle fiber type, size, and insulin-like growth factor I messenger RNA, aerobic capacity [maximal oxygen uptake (VO2max), ventilation threshold (VeT)], isokinetic strength, oxygen-cost-of-walking at normal and fast speeds, and fatigue determined by the profile of mood states questionnaire. As expected, GH treatment decreased body fat, increased LBM, increased muscle fiber size, and increased muscle insulin-like growth factor-I messenger RNA 5-fold; however, muscle strength remained unchanged. At baseline, VeT occurred at a high percentage of maximal VO2max (73.3% +/-2.6) because of low VO2max (1.74+/-0.1 L/min or 20.7+/-1.3 mL/ kg x min). Walking required high oxygen consumptions representing from 83+/-4% of VeT at normal speeds to 120+/-5% of VeT at fast speeds. After rhGH, there was a significant (P = 0.03) increase in VeT (18%), compared with placebo. This was paralleled by a nonsignificant rise in VO2max. Functionally, rhGH treatment decreased the oxygen cost of walking, relative to VeT, at normal (14% decrease, P = 0.019) and fast (21% decrease, P = 0.004) SPW speeds. A 3-variable model (baseline fast SPW speed, VeT/VO2max, and VeT) accounted for 39% of the variance of change in self-reported fatigue. These data indicate that GH-deficient adults require a high fraction of VeT for daily activities, explaining the perception of increased fatigue and impaired physical performance. The actions ofrhGH on muscle fiber size translate into physiological improvement in submaximal aerobic capacity and result in functional improvement in walking ability but do not necessarily alter strength. Thus, measures of effort-independent submaximal aerobic performance provide novel objective determinants of functional impairment and fatigue and can be used to evaluate and predict response to GH treatment.
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PMID:Measures of submaximal aerobic performance evaluate and predict functional response to growth hormone (GH) treatment in GH-deficient adults. 1129 32

This study investigated the personal experiences of 144 high school coaches in terms of their perceptions of the causes of the home advantage. Surveys were distributed to varsity coaches of local high school sports asking them to assign a percentage value to each of the most common explanations of -the home advantage, reflecting the perceived importance of each, e.g., social support, travel or fatigue, site familiarity, officials' bias, and self-fulfilling prophecy. A 3 x 6 repeated-measures analysis of variance indicated that no differences were significant in attribution of the causes of home advantage for the combinations of sex of coach and sex of athlete. A significant difference was noted in the percentages assigned across the five explanations provided the coaches. Post hoc comparison indicated that site familiarity was seen as the most important explanation across the combinations of the sex of coach and sex of athlete.
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PMID:An investigation of coaches' perceptions of the causes of home advantage. 1145 26


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