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Query: UMLS:C0015672 (
fatigue
)
51,768
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 69-year-old Japanese female was admitted because of general
fatigue
. Laboratory data showed elevation of serum total bilirubin, transaminase, gamma-glutamyl transpeptidase, and
creatinine
levels. An immunological study revealed hypergammaglobulinemia, low titer of complement, and high titers of antinuclear antibody, anti-DNA antibody, and circulating immune complexes. Antibodies to parainfluenza virus 3 were positive. Histology of the liver disclosed numerous giant cell hepatocyte transformations with the lobular architecture being slightly distorted by portal inflammation and fibrosis. These findings led us to make a diagnosis of giant cell hepatitis associated with systemic lupus erythematosus. Prednisolone was effective in improving the anemia and the serum immunoglobulin, immune complex, and antinuclear antibody levels. The addition of cyclosporine to the initial corticosteroid therapy was also beneficial in decreasing the transaminase level and in improving liver histology. The patient died of acute pneumonitis and renal failure on the 166th day after admission. Parainfluenza virus 3 and autoimmune mechanisms were thus considered to be the causes of the giant cell hepatitis.
...
PMID:Post-infantile giant cell hepatitis in an elderly female patient with systemic lupus erythematosus. 806 7
A disease-specific questionnaire to assess the quality of life of renal transplant recipients was developed. A list of items of potential relevance to these patients was created and 50 transplant recipients rated the importance of each item. A combination of factor analysis and clinical judgment was then used to create the final questionnaire which consists of 25 questions in 5 dimensions (physical symptoms,
fatigue
, uncertainty/fear, appearance and emotions). The physical symptoms dimension is patient specific. All questions are scored on a 7-point Likert scale. The reproducibility of the questionnaire when it was administered to stable transplant recipients was high (intraclass correlation coefficients between 0.82 and 0.91 for the 5 dimensions). The scores of all dimensions except appearance improved 6 months after transplantation, when compared to pretransplantation scores. Patients who had a well-functioning graft (
creatinine
< 250 mmol/l) had higher scores than those with poorly functioning grafts. This questionnaire is easy to administer and is valid, reproducible in stable patients and responsive to change.
...
PMID:Disease-specific questionnaire for patients with a renal transplant. 832 55
A patient-reported checklist was used to assess adequacy of dialysis as measured by 24-hour
creatinine
clearance in 40 patients on chronic peritoneal dialysis. The checklist consisted of 13 symptoms, each scored from 0-5 with 0 = absent and 5 = severe. The total possible score was 0-65. Patients completed the checklist at the time of 24-hour dialysate and urine collections (in those with residual function) for
creatinine
clearance (CrCl). Arbitrary grouping by total CrCl in liters/week/1.73 m2 placed patients in one of two groups: those with CrCl < or = 48 L/week (n = 12) and those with CrCl > 48 L/week (n = 28). Patient age, sex, diabetes mellitus, months on peritoneal dialysis, mode of peritoneal dialysis, and hematocrit were not different between the two patient groups. More patients with CrCl > 48 L/week had endogenous renal function (19/28 vs 2/12, p = 0.004). The median total scores for the two patient groups were not significantly different (17 in those with CrCl < or = 48 L/week vs 13.5 in those with CrCl > 48 L/week, p = 0.40). The correlation between total score and CrCl was negative in both patient groups and stronger in those with the lower CrCl (-0.55 vs -0.44). Nausea/vomiting,
fatigue
, and weakness were the best predictors of CrCl < or = 48 L/week (-0.53, -0.56, -0.49, respectively). The checklist can identify patients with low CrCl and may be useful for following patients over time and altering dialysis prescriptions.
...
PMID:Patient-reported symptoms and adequacy of dialysis as measured by creatinine clearance. 839 70
Serum albumin (SA) is a powerful predictor of patient morbidity and mortality in hemodialysis, but data are limited for continuous ambulatory peritoneal dialysis (CAPD). SA was monitored in 76 new CAPD patients over 222 6-month periods and mean SA was correlated with morbidity and mortality during those periods. The influence of initial SA on duration of technique survival was also investigated. To determine which factors best predict SA, correlations with patient demographics and with 6-month measurements of dialytic dose, protein intake, and peritoneal transport were sought. Mean SA overall was 34.1 +/- 3.3 g/L, and mean initial SA was 33.4 +/- 3.1 g/L. Mean SA was lower in diabetics and in those aged 65 or over. Mean SA tended to increase during the first year on CAPD, and this increase was maintained, except in patients aged 65 or over, where it tended to revert to initial values. SA correlated with hospital days (r = -0.20; P < 0.005),
fatigue
index (r = -0.20; P < 0.005), nerve conduction (P < 0.001), and a variety of laboratory values, and lower SA was associated with technique failure (P < 0.03) and death (P < 0.07). Initial, as well as ongoing, SA was predictive of technique failure (P < 0.05) and Cox proportional hazards regression showed that this predictive power was independent of age, sex, diabetes, and other factors (P = 0.05). The strongest predictors of low SA by stepwise multiple regression were diabetes, a higher dialysate-to-plasma
creatinine
equilibration ratio, older age, lower body weight, and shorter time on CAPD.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Serum albumin in patients on continuous ambulatory peritoneal dialysis--predictors and correlations with outcomes. 849 Jan 20
Chronic hepatitis C is a common cause of viral liver disease in kidney transplant recipients. To assess the efficacy and the safety of therapy with interferon alpha (IFN alpha) in such a population we conducted a prospective study where 16 kidney transplant recipients with chronic hepatitis C received recombinant IFN alpha 3 million units three times weekly scheduled for 24 consecutive weeks. All the patients had stable renal function for at least 1 year (mean serum
creatinine
125.4 +/- 41 mumol/l). Fifteen patients had a positive HCV viraemia at the beginning of the study. In 15 patients serum alanine aminotransferase (ALT) levels decreased rapidly and normalized (48 +/- 44 vs 98.5 +/- 46 IU/l; P = 0.0044). ALT remained in the normal range as long as IFN alpha was continued. Serum levels of gamma glutamyl transpeptidase decreased from 129.75 +/- 111.2 to 88 +/- 85 IU/l; P = 0.012). After discontinuation of IFN alpha therapy seven responders relapsed within 1-9 weeks. HCV viraemia assessed 1 month after the end of IFN alpha therapy remained positive in all the patients who scored positive at the beginning, i.e. 15. Side effects of IFN alpha (
fatigue
, anorexia, weight loss) were frequent leading to four patients dropping out of the study. The haematological tolerance was moderate. The major concern was the increase in serum
creatinine
(162.5 +/- 57.6 vs 125.4 +/- 41 mumol/l; P < 0.05). In fact only six patients experienced renal failure occurring 45-168 days after the beginning of IFN alpha. Kidney transplant biopsies showed oedema, scarce scattered interstitial inflammatory cellular infiltration and moderate mesangial hypertrophy.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Preliminary results of treatment of chronic hepatitis C with recombinant interferon alpha in renal transplant patients. 852 7
It is now well established that strenuous engagement in aerobic endurance sports may cause menstrual problems and hypoestrogenemia-related phenomena, such as osteoporosis. The present study was designed to assess whether the competitive practice of female judoists produces specific physiological changes in menstruation and bone and muscle metabolism. A test group of 17 white female judoists (mean VO2max, 50.9 +/- 2.8 mL/kg.min; mean percent body fat, 16.3 +/- 3.3%), a reference group of oarswomen, and a group of sedentary women participated in this study. Specific metabolic parameters were determined before and after a heavy 5-week pre-Olympic training period. With regard to anthropometrical characteristics, after a period of intensive training, female judoists significantly differed (P < 0.05) from their pretraining values for percent body fat (-2.2%) and number of oligomenorrheic individuals (+28.4%). Mean baseline posttraining luteal phase plasma levels of estrone (78 +/- 26 pmol/L), estradiol (85 +/- 70 pmol/L), LH (7.6 +/- 2.8 IU/L), and progesterone (13.4 +/- 3.1 nmol/L) were significantly lower than those in both reference groups, although pretraining values did not significantly differ from those in a group of oarswomen. Luteal phase posttraining urinary parameters of muscular catabolism (3-methylhistidine, 367 +/- 30 mmol/day) and collagen turnover (hydroxyproline, 678 +/- 14 mumol/L) were significantly higher than those in a group of oarswomen (3- methylhistidine, 183 +/- 18 mmol/day; hydroxyproline, 196 +/- 21 micrograms/mL). Total plasma spontaneous monocyte interleukin-1 activity, an experimental parameter for bone turnover and formation, was significantly higher (P < 0.05) in both female judoists (15.8 +/- 3.0% max) and oarswomen (7.1 +/- 1.8% max) than in sedentary women (5.2 +/- 2.2% max). These findings were accompanied by a subjective feeling of musculotendinous soreness and
fatigue
. Posttraining values for blood diagnostic enzymes, such as
creatinine
phosphokinase, glutamic oxalacetic transaminase, lactic dehydrogenase, and uric acid exceeded 2-5 times maximal normal laboratory reference values. We believe that these overtraining-like findings should be further examined to study the eventual causal relationship between hypoestrogenemia and rhabdomyelysis (myoglobinuria) and to fully understand the extent of these results and their importance to the female athlete's health.
...
PMID:Hypoestrogenemia and rhabdomyelysis (myoglobinuria) in the female judoist: a new worrying phenomenon? 853 Jun 13
The purpose of this study was to analyse the presenting clinical and laboratory features and the outcome of 72 patients with multiple myeloma (MM) who were younger than 40 years. The records of all Mayo Clinic patients with MM younger than 40 years who were seen between 1 January 1956 and 31 December 1992 were reviewed. Survival was measured from the date when treatment was required to the date of last follow-up or death. The frequency of MM in patients younger than 40 and 30 years in 3278 Mayo Clinic patients was 2.2% and 0.3%, respectively. The main presenting clinical features were bone pain (66%),
fatigue
(26%), extramedullary plasmacytomas (19%) and bacterial infection (11%). Renal function impairment (
creatinine
level > or = 177 micromol/l) and hypercalcaemia (serum calcium value > or = 2.75 mmol/l) occurred in 29% and 30% of patients, respectively. Among the 57 patients evaluable for response the objective response rate was 54%. 14/35 patients treated with a single alkylating agent achieved an objective response, whereas 17/22 patients given combination chemotherapy had an objective response (P=0.013). However, this higher response rate did not result in a significantly longer survival. The median survival for the 72 patients was 54 months. Patients with good prognostic features (normal renal function or low beta 2-microglobulin level) had a median survival of 8 years. The actuarial survival at 5 and 10 years after initiation of therapy was 43% and 13%, respectively. In summary, survival in very young patients with myeloma is longer than that observed in series of patients of all ages, especially in those with good prognostic factors.
...
PMID:Presenting features and prognosis in 72 patients with multiple myeloma who were younger than 40 years. 863 27
A 60-year-old male was admitted to our hospital complaining abdominal pain and
fatigue
. Complete blood count showed as follows; WBC 3,900/microliters (48% of monocytes), Hb 11.5 g/dl, Plt 0.9 x 10(4)/microliters. Marrow smears showed the presence of phagocytic histiocytes that consist 22.4% of total nuclear cells. Laboratory findings showed as follows; BUN 109.5 mg/dl,
Creatinine
7.4 mg/dl, CPK 1,259 IU/l, Aldolase 195 IU/l, Myoglobin 4,200 mg/dl. Serological studies showed a 16-fold increase in herpes-simplex virus (HSV) antibody titers 4 weeks after admission. So we diagnosed his illness as virus-associated hemophagocytic syndrome (VAHS) and rhabdomyolysis that were associated with HSV. We performed three times of hemodialysis for acute renal failure and used prednisolone for VAHS. These treatments were successful, and he made a complete recovery from illness. VAHS complicated by rhabdomyolysis is very rare, and we think this case is full of suggestions.
...
PMID:[A case of virus-associated hemophagocytic syndrome (VAHS) complicated by rhabdomyolysis which were associated with herpes-simplex virus infection]. 868 66
At 10 centers in 7 countries, researchers conducted a clinical trial of weekly intramuscular injections of 200 mg testosterone (T) enanthate in 271 healthy fertile men, 21-45 years old, to evaluate the secondary impact of this prototype male contraceptive regimen on various physical, metabolic, and behavioral variables. They also focused on the differences between Chinese men and non-Chinese men as well as their similarities. At baseline, Chinese men were shorter, weighed less, and had lower levels of hemoglobin, plasma lipids, and liver enzymes than non-Chinese men (p 0.05). The overall leading side effects were acne (80),
fatigue
(22), painful injections (15), and weight gain (12). 24 men, all of whom were non-Chinese men, experienced excessive development of the male mammary glands (gynecomastia). Nine men (1 Chinese, 8 non-Chinese) had prostate problems. No man discontinued T enanthate injections for gynecomastia or prostate problems, however. T enanthate contributed to an increased body weight (by 5% at 360 days) and increased levels of hemoglobin (by 7.6% at 360 days) and
creatinine
while it contributed to a decrease in testicular volume (by 26.2% at 360 days) and in urea level. T enanthate appeared to have no effect on plasma triglyceride, cholesterol, and low density lipoprotein (HDL) cholesterol. It was associated with a decrease of 14-18% in HDL-cholesterol in non-Chinese men but it had no effect on HDL-cholesterol in Chinese men. T enanthate increased liver transaminase by 36-51% in Chinese men but it had no effect on these enzymes in non-Chinese men. Regardless of length of exposure to T enanthate, the T enanthate-induced changes were reversible within 6 months. These findings suggest that T enanthate produced significant but reversible metabolic and physical effects that differed between Chinese and non-Chinese men. These effects are a result of the relatively high peak levels and fluctuations of plasma T produced by the weekly injections rather than an inherent feature of hormonal male contraception.
...
PMID:Effects of testosterone enanthate in normal men: experience from a multicenter contraceptive efficacy study. World Health Organization Task Force on Methods for the Regulation of Male Fertility. 877 99
We refer in the present article, the first case found in our laboratory of Monoclonal gammapathy of the IgD type. A 47-year-old man presented at the emergency department with a history of malaise, lethargy,
tiredness
, thirstiness and obscure depositions. Clinical examination revealed a normocytic anaemia. The plasma urea was 423 mg/dl and the plasma
creatinine
was 15, 3 mg/dl. He was admitted to hospital with a diagnosis of acute renal failure. The later electrophoresis in serum revealed a little monoclonal band that was identified as IgD-lambda type by immunofixation electrophoresis. In urine electrophoresis was observed a beta-band. Bone marrow biopsy revealed a 20% of plasmocytic cells. Renal biopsy was compatible with myelomatose lesions. Osteolytic lesions were observed.
...
PMID:[A case of monoclonal gammapathy type IgD]. 901 14
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