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

In three patients, the first manifestation of Wilson's disease was a syndrome in which acute intravascular hemolysis and acute liver failure were associated. This syndrome developed in three periods; the first, lasting 3 to 14 days, was characterized by fatigue, fever, and jaundice; the second, lasting 1 or 2 days, by severe intravascular hemolysis; and the third, lasting 2 to 6 days, by hepatic encephalopathy. All of the patients died from liver failure 7 to 21 days after the onset of the syndrome. The association of acute intravascular hemolysis and acute live failure is a characteristic manifestation of Wilson's disease; it is rarely associated with other liver diseases. This association might result from hepatic cell necrosis due to accumulation of copper, the consequences being acute liver failure and destruction of erythrocytes by the large amounts of copper released from the necrotic hepatic cells to the plasma.
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PMID:Acute intravascular hemolysis and acute liver failure associated as a first manifestation of Wilson's disease. 84 89

Recently, the author has identified 19 patients who have complained of marked fatigue that had abnormal responses to copper test bracelets or necklaces. At this time, 8 have been shown to have at least one enzyme deficiency in the heme pathway. These patients have been diagnosed with multiple sclerosis, chronic fatigue syndrome and other non-specific diagnoses. A lengthy but still limited review of the literature was performed regarding the following conditions: multiple sclerosis (MS), hepatic porphyria (HP), chronic fatigue syndrome (CFS) and paralytic polio (PP). The text will focus on similar epidemiologies, laboratory findings and clinical courses. Copper as a common but not unique etiologic agent will be discussed; as will the heme pathway, a biologic process that may be disordered in all.
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PMID:Fatigue syndromes: new thoughts and reinterpretation of previous data. 146 Nov 85

Triceps skin fold, arm muscular performance and fatigue were quantified, haematocrit measured and haemoglobin, serum total protein, albumin, transferrin, zinc and copper concentrations determined in 60 patients (36 women, 24 men) before and 3-45 days after surgery. On days 3 and 9 after surgery, there was a significant (P less than 0.05) decrease in serum zinc concentrations but by 45 days concentrations had return to pre-operative values. In contrast, serum copper concentrations were significantly (P less than 0.05) elevated until day 45. Haematocrit and haemoglobin and albumin concentrations were decreased significantly (P less than 0.05) 3 and 9 days after surgery, whereas serum total protein concentrations remained significantly (P less than 0.05) lower for 45 days compared with concentrations prior to surgery.
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PMID:Changes in serum trace elements after surgery: value of copper and zinc in predicting post-operative fatigue. 156 16

A 36-year-old woman was admitted to our hospital because of general fatigue. The physical and laboratory findings on admission revealed splenomegaly, pancytopenia, hypocoagulopathy, liver hypofunction with a hepaplastin test of 55% and ICG Rmax of 0.6 mg/kg/min. Diagnostic imaging showed a hypoechoic mass 1.5 in diameter a low density area on the CT scan and a faint tumor stain on the AAG in the posterior inferior area of the liver. On a diagnosis of hepatocellular carcinoma with liver cirrhosis and hypersplenism, partial hepatectomy and splenectomy were performed. The resected hepatic specimen revealed a small liver cancer of 1.9 x 1.5 x 1.3 cm with liver cirrhosis. The specimen consisted of a firm rubbery mass. Macroscopically, the tumor appeared oval and was lobulated with a thin capsule. A fibrous scar was observed in the central area. Microscopically, malignant hepatocytes showed various shapes, ranging from polygonal to spindle form, with eosinophilic granular cytoplasm and were surrounded by abundant fibrous stroma. Orcein stain, revealed that these malignant hepatocytes contained many black granules of copper-binding protein. Immunoperoxidase staining for alpha 1-antitrypsin was also positive in the malignant hepatocytes. However, within this lamellar fibrous regions, there were many cords of tumor cells in which nucleoli were absent and abortive biliary differentiation was suggested. Consequently this tumor was diagnosed as an atypical fibrolamellar hepatocellular carcinoma. We think that this case is the 3rd case reported in Japan and the 2nd case in a Japanese person.
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PMID:Fibrolamellar carcinoma of the liver--a case report. 165 47

Although consequences of zinc deficiency have been recognized for many years, it is only recently that attention has been directed to the potential consequences of excessive zinc intake. This is a review of the literature on manifestations of toxicity at several levels of zinc intake. Zinc is considered to be relatively nontoxic, particularly if taken orally. However, manifestations of overt toxicity symptoms (nausea, vomiting, epigastric pain, lethargy, and fatigue) will occur with extremely high zinc intakes. At low intakes, but at amounts well in excess of the Recommended Dietary Allowance (RDA) (100-300 mg Zn/d vs an RDA of 15 mg Zn/d), evidence of induced copper deficiency with attendant symptoms of anemia and neutropenia, as well as impaired immune function and adverse effects on the ratio of low-density-lipoprotein to high-density-lipoprotein (LDL/HDL) cholesterol have been reported. Even lower levels of zinc supplementation, closer in amount to the RDA, have been suggested to interfere with the utilization of copper and iron and to adversely affect HDL cholesterol concentrations. Individuals using zinc supplements should be aware of the possible complications attendant to their use.
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PMID:Zinc toxicity. 240 97

This study was designed to determine whether the mechanical cyclic stressing that occurs during normal mastication contributes to margin breakdown of dental amalgam restorations. The method used appears to duplicate the mechanical stresses developed in vivo during mastication, as the result of tooth flexing. We evaluated one low-copper alloy--NTD--and three high-copper alloys--Dispersalloy, Phasealloy, and Tytin. We prepared simple amalgam restorations in a cavity centrally located in an aluminum beam. Each specimen received five periods of three-point cyclical loading (1.7 hertz, 4200 cycles at 37 degrees C). The margin area was subjected to SEM examination prior to and at the completion of each period of cycling. At the beginning of each period of cycling, beam deflection was set to establish a maximum theoretical stress of 1, 2, 4, 6, or 8 MPa. For all brands, cycling resulted in margin gap formation and surface wrinkling. Wrinkling in Dispersalloy occurred as a wide band of shallow wrinkles, whereas that in NTD occurred as a narrow band of deep wrinkles. At 21,000 cycles, very little void formation and fracturing had occurred in the Dispersalloy or NTD restorations. In contrast, the Phasealloy and Tytin restorations developed extensive fracturing even after 4200 cycles. Fracture surface analyses of Phasealloy and Tytin indicated that creep fatigue rupture was the fracture mechanism responsible for margin breakdown in these amalgam restorations, when subjected to cyclic compressive loading similar to that experienced during mastication.
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PMID:Amalgam margin breakdown caused by creep fatigue rupture. 263 4

Copper refinery workers exposed to selenium were studied before, during, and after a shutdown period. Urine selenium levels were 83 +/- 30 mumol/mol creatinine and 69 +/- 27 mumol/mol creatinine when measured on two occasions during exposure compared with 56 +/- 17 mumol/mol creatinine when the workers had been free of exposure for 10 wk during a shutdown. The refinery workers reported more nose and eye irritation, indigestion, stomach pain, and fatigue than controls. "Garlic-like" breath odor was reported to be personally and socially offensive by many of the workers. Reporting of symptoms, pulmonary function indices, and laboratory test results did not change with exposure except for hemoglobin level, which rose during the shutdown. Hemoglobin levels were found to be inversely correlated with the urine selenium level, and there was a positive correlation noted for the interactive effect of urine selenium and urine arsenic levels on hemoglobin.
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PMID:Health status of copper refinery workers with specific reference to selenium exposure. 268 43

To study the effects of a copper-releasing intrauterine contraceptive device (IUCD) and a prostaglandin (PG) synthesis inhibitor, ibuprofen, on menstrual blood loss, 28 healthy women received either a Fincoid 350 or a ML Cu375 device and were then treated in a double-blind randomized manner with ibuprofen (1200 mg daily) or a placebo during their next three menstruations. The preinsertion menstrual blood loss (2 cycles) was normal for healthy women (median 38 ml) with no difference between women who subsequently received either Fincoid 350 or ML Cu375 and ibuprofen or placebo treatment. The median increase in menstrual blood loss after the insertion of an IUCD was 74% (P less than 0.01) in women receiving placebo treatment, and this rise was not dependent on the type of IUCD. Ibuprofen treatment prevented the increase in blood loss following IUCD insertion, but it failed to shorten the duration of menstruation. Four women reported side-effects (tiredness, irritability, sweating, dyspepsia) during ibuprofen treatment, and two women did so during placebo treatment. It is concluded that IUCDs with a large copper surface also increase menstrual blood loss, but that this increase can be prevented with ibuprofen treatment.
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PMID:Ibuprofen prevents IUCD-induced increases in menstrual blood loss. 351 3

A cross-sectional epidemiological study was carried out among 141 male subjects exposed to inorganic manganese (Mn) in a Mn oxide and salt producing plant (mean age 34.3 years; duration of exposure, mean 7.1 years, range 1-19 years). The results were compared with those of a matched control group of 104 subjects. The intensity of Mn exposure was moderate as reflected by the airborne Mn levels and the concentrations of Mn in blood (Mn-B) and in urine (Mn-U). A significantly higher prevalence of cough in cold season, dyspnea during exercise, and recent episodes of acute bronchitis was found in the Mn group. Lung ventilatory parameters (forced vital capacity, FVC; forced expiratory volume in one second, FEV1; peak expiratory flow rate, PEFR) were only mildly altered in the Mn group (smokers) and the intensity and the prevalence of these changes were not related to Mn-B, Mn-U, or duration of exposure. There was no synergistic effect between Mn exposure and smoking on the spirometric parameters. Except for a few nonspecific symptoms (fatigue, tinnitus, trembling of fingers, increased irritability), the prevalence of the other subjective complaints did not differ significantly between the control and Mn groups. Psychomotor tests were more sensitive than the standardized neurological examination for the early detection of adverse effects of Mn on the central nervous system (CNS). Significant alterations were found in simple reaction time (visual), audioverbal short-term memory capacity, and hand tremor (eye-hand coordination, hand steadiness). A slight increase in the number of circulating neutrophils and in the values of several serum parameters (ie, calcium, ceruloplasmin, copper, and ferritin) was also found in the Mn group. There were no clear-cut dose-response relationships between Mn-U or duration of Mn exposure and the prevalence of abnormal CNS or biological findings. The prevalences of disturbances in hand tremor and that of increased levels of serum calcium were related to Mn-B. The response to the eye-hand coordination test suggests the existence of a Mn-B threshold at about 1 microgram Mn/100 ml of whole blood. This study demonstrates that a time-weighted average exposure to airborne Mn dust (total dust) of about 1 mg/m3 for less than 20 years may present preclinical signs of intoxication.
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PMID:Epidemiological survey among workers exposed to manganese: effects on lung, central nervous system, and some biological indices. 357 89

An analysis of reported symptoms and their relationship with indicators of lead absorption--blood lead (Pb-B) and zinc protoporphyrin (ZPP)--and of arsenic absorption--urinary arsenic (As-U)--was undertaken among 680 active copper smelter workers. Lead and arsenic absorption in the copper smelter employees were characterized by the median values of 30.4 micrograms/dl for Pb-B, 41.5 micrograms/dl for ZPP, and 26 micrograms/L for As-U. Blood lead was 40 micrograms/dl or higher in 16.7% of cases, ZPP was 50 micrograms/dl or higher in 31.2%, and urinary arsenic was 50 micrograms/L or higher in 16.4% of currently active copper smelter workers. The number of reported symptoms (from a total of 14 symptoms) increased with ZPP levels; the relationship with Pb-B was less marked. Arsenic contributed relatively little. Mean Pb-B, ZPP, and As-U levels for subjects reporting each of the 14 symptoms were compared with those of subjects who did not report the symptoms. Mean Pb-B was found to differ significantly for one symptom, fatigue. Significant differences in mean ZPP levels were found for fatigue, sleep disturbances, weakness, paresthesia, and joint pain. Prevalence rates for these symptoms rose more markedly with increasing ZPP than with Pb-B levels. The results indicate a relationship between certain CNS and musculo-skeletal symptoms and increased lead absorption in this population. Adherence to exposure standards that preclude undue lead absorption and appropriate biological monitoring including ZPP levels, are necessary to prevent adverse, especially long-term, health effects.
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PMID:Effects of low-level lead and arsenic exposure on copper smelter workers. 387 20


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