Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-three steroid-dependent severely asthmatic patients, ranging in age from 20 to 67 years, tolerated reduction in their oral dosage of steroids during a one-year trial of triamcinolone acetonide aerosol. Sixteen patients maintained their initial one-second forced expiratory volume without oral therapy with steroids, two required resumption of daily steroid dosage because of lethargy and arthralgia, and four required 2.5 to 20 mg of prednisone every other day to control their asthma. Five-day oral courses of steroids were occasionally required because of episodes of asthma from a variety of external causes. One patient failed to benefit within two months and withdrew from the study. One patient had precipitins to Candida albicans prior to the study, and he developed transient oropharyngeal culture-positive thrush, which subsided with use of a gargle containing nystatin. None of the other patients had oral candidiasis, and laryngoscopic examination revealed no lesions attributed to the aerosol. The mean fasting cortisol level did not increase throughout the one-year trial. Thus, the use of triamcinolone acetonide aerosol (2,000 microgram or less daily) can eliminate or greatly reduce oral requirements for steroids in patients with severe steroid-dependent asthma. Side effects are mild, but adrenal recovery may be exceedingly slow.
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PMID:A one-year trial of triamcinolone acetonide aerosol in severe steroid-dependent asthma. 87 52

Forty-eight sequential narcoleptic patients were treated with propranolol (80-240 mg/day) for an average period of 18.4 months. Initially all patients received single drug therapy; after 10 days or longer, however, 50% of patients also received tricyclics or stimulants because propranolol alone did not sufficiently suppress the narcoleptic symptoms. Fifty percent of patients judged the initial effectiveness of propranolol on daytime sleepiness to be good to very good; in these patients the effects seemed comparable to that of pemoline. Within 6 months, however, the effectiveness started to decrease, and after 26 months only 8% (2 out of 24) of those patients taking the single drug were satisfied with propranolol therapy alone. Side effects included disturbed night sleep, decreased blood pressure, increased lethargy, allergic skin rash, and asthma; 58% of the patients dropped out of the study after 26 months. Vigilance tests during the first 4 months (16 patients) showed significant improvements in all test criteria, including a shorter reaction time. All-night polygraphic electroencephalogram recordings of 14 patients on the eighth and ninth day of medication showed that average total sleep time decreased by 5.7%, but other sleep characteristics did not change significantly.
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PMID:Propranolol: long-term treatment in narcolepsy-cataplexy. 392 25

A cross sectional survey investigating "building sickness" was carried out in two buildings with similar populations of office workers but differing ventilation systems, one being fully air conditioned with humidification and the other naturally ventilated. The prevalence of symptoms related to work was assessed by a questionnaire administered by a doctor. A stratified, randomly selected sample of workers was seen (84% response). Building sickness includes several distinct syndromes related to work, most of which were significantly more common in the air conditioned building than the naturally ventilated building--namely, rhinitis (28% v 5%), nasal blockage and dry throat (35% v 9%), lethargy (36% v 13%), and headache (31% v 15%). The prevalence of work related asthma and humidifier fever was low and did not differ significantly between the two buildings. An environmental assessment of the offices was performed to attempt to identify possible factors responsible for the differences in the prevalence of disease. Globe temperature, dry bulb temperature, relative humidity, moisture content, air velocity, positive and negative ions, and carbon monoxide, ozone, and formaldehyde concentrations were all measured. None of these factors differed between the buildings, suggesting that building sickness is caused by other factors.
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PMID:Comparison of health problems related to work and environmental measurements in two office buildings with different ventilation systems. 392 99

Ketotifen 1 mg b.d. (oral) and sodium cromoglycate 20 mg q.i.d. (inhalation) were compared in a double-blind crossover trial in 43 asthmatic outpatients. Comparison of diary card scores and pulmonary function tests showed significant improvement over a 12 week period on each drug. Comparison of the diary card scores and pulmonary function tests showed no significant difference between the drugs after 12 weeks of treatment. Twenty-six patients experienced sedation and/or lethargy whilst on ketotifen and 11 patients had similar side effects whilst on cromoglycate. Physician preferences based on diary card and pulmonary function data showed an approximately equal number of preferences for each medication and also a small group of patients in which no preference could be made. The present trial suggests that both ketotifen and cromoglycate are effective in the management of outpatient asthma. When all the patients are considered as a group no distinction can be made between the two drugs; on the basis of physician assessment of each patient, it appears that some patients may do better on ketotifen and others on cromoglycate.
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PMID:Evaluation of ketotifen (HC20-511) in bronchial asthma. 641 21

We studied the relation between the amount of textile and other soft fiber wall materials used in the office and the symptoms related to sick building syndrome in two identical, mechanically ventilated, eight-story office buildings. The study population consisted of 400 workers (85% of the source population): 264 males (66%) and 136 females (34%). A self-administered questionnaire inquired about the occurrence of symptoms and related personal and environmental determinants. The office environment was assessed concurrently. Exposure was defined as the surface area of textile or other soft wall material (SWM) in the office. The outcomes were formed using the 7-d prevalences of individual symptoms, including mucosal irritation score (eye irritation, nasal dryness, nasal congestion, pharyngeal irritation); allergic reaction score (eye irritation, nasal congestion, nasal excretion, sneezing); asthma reaction score (wheezing, breathlessness, cough); skin reaction score (dryness, itch, or irritation, rash); and general symptom score (headache, lethargy). In the logistic regression controlling for potential confounders, the adjusted odds ratio for the symptoms of mucosal irritation was 1.82 (95% confidence interval [95% CI] = 1.14, 2.90) in the low-exposure group, compared with the unexposed reference group; and 2.46 (95% CI = 1.15, 5.28) in the high-exposure group, compared with the reference group. Corresponding odds ratios for the symptoms of allergic reaction were 1.82 (95% CI = 1.14, 2.90) and 3.16 (95% CI = 1.41, 7.09). No difference was found in the risk for asthmatic or skin reactions or general symptoms. The results support a hypothesis that textile and other soft-fiber wall materials used in the office environment are possible determinants of sick building syndrome.
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PMID:Textile wall materials and sick building syndrome. 818 88

Lung lobe torsion, although rare in cats, can be seen as a sequela to chronic respiratory disease. Clinical signs may include lethargy, coughing, hemoptysis, and respiratory distress. Lung lobe torsion may be diagnosed using radiography, ultrasonography, contrast bronchography, bronchoscopy, or thoracoscopy. Stabilization with fluids, oxygen, and supportive care followed by thoracotomy and lobectomy of the affected lobe(s) are necessary for a successful outcome. Diagnosis and treatment of lung lobe torsion is described in a 12.5-year-old cat with a history of feline asthma.
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PMID:Lung lobe torsion in a cat with chronic feline asthma. 982 85

Four cases of asthma (one adult, three children) developing acute adrenal crisis after introduction of high-dose inhaled fluticasone proprionate are presented. The three children, aged 7-9 yrs, had been prescribed inhaled fluticasone, dosage 500-2,000 microg x day(-1) and duration 5 months-5 yrs. All presented with convulsions due to hypoglycaemia (blood glucose 1.3-1.8 mM). The fourth case was a male of 33 yrs with difficult-to-control asthma and had been taking fluticasone propionate 1,000-2,000 microg x day(-1) for 3 yrs. He presented with fatigue, lethargy, nausea and postural hypotension. Acute adrenal crisis in each case was confirmed by investigations which included measurement of acute phase cortisol levels, short and long Synacthen stimulation tests and glucagon stimulation tests. Other cases of hypthoalamic-pituitary-adrenal axis suppression were excluded.
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PMID:Acute adrenal crisis in asthmatics treated with high-dose fluticasone propionate. 1210 82

Although posterior reversible encephalopathy syndrome (PRES) is caused by various conditions, there have been no reports on PRES associated with bronchial asthma. We report a case with PRES during the treatment for severe asthmatic attack. A 4-year-old girl was treated for asthmatic attack with steroids. From the 10th hospital day, hypertension, pulmonary edema, and cardiomegaly were observed. In spite of treatment with furosemide, she became lethargic and had a generalized convulsion on the 23rd hospital day. CT showed low density areas in the bilateral occipital white matter and MRI on the 28th hospital day demonstrated high intensity areas in the same regions on T2-weighted and FLAIR images. After discontinuation of corticosteroid and further antihypertensive therapy, her consciousness improved. MRI on the 67th hospital day had no abnormalities and no neurological sequelae were seen at 2 years after the event. We should be aware that PRES is a rare but important adverse event related to steroid therapy, because hypertension and water retention are major adverse effects of steroids.
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PMID:Posterior reversible encephalopathy syndrome in a child with bronchial asthma. 1661 1

Presence of nocturnal symptoms is related to asthma severity. Clinically stable asthmatic children, too, report frequent nocturnal symptoms and sleep disturbances. The study determined these parameters in stable, asthmatic children, in their home environment. This case-control, questionnaire-based study in 70 school-going children comprised 40 asthmatics (Group 1) and 30, age/gender matched, healthy children (Group 2). Parents maintained peak expiratory flow (PEF) and sleep diaries for one week. Group 1 had significantly lower mean morning (250.3 vs. 289.1 I/minute) and mean evening PEF values (261.7 vs. 291.3 I/minute). Group 1 (38.95%), reported frequent nocturnal symptoms like cough (36.90%), breathlessness (32.80%), wheeze (27.68%) and chest tightness (14.35%). Sleep disturbances, significant in Group 1 (38, 95% vs. 14.35%), included daytime sleepiness (24.60%), daytime tiredness (20.50%), difficulty in maintaining sleep (15.38%), early morning awakening (14.35%), struggle against sleep during daytime (12.30%), and involuntarily falling asleep (17.43%). On a scale of 1-6, Group 1 scored significant sleep disturbances/patient (3 vs. 0.8); lethargy/tiredness in morning (2.9 vs. 2.2), poorer sleep quality (4.7 vs. 5.4), less parents' satisfaction with child's sleep (4.5 vs. 5.5) and daytime fitness (4.1 vs. 5.3). Group 1, when exposed to environmental tobacco smoke (22, 55%), reported significant nocturnal symptoms (18/22, 81%) and reduced mean morning and evening PEF values (17/22, 77%). It is concluded that clinically stable, asthmatic children reported increased nocturnal symptoms, sleep disturbances and poorer sleep quality. Lack of awareness of asthma-sleep association and its clinical implications could lead to poor asthma control and impaired daytime activity.
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PMID:Nocturnal symptoms and sleep disturbances in clinically stable asthmatic children. 1713 79

Angina pectoris is usually the first clinical sign of underlying myocardial ischemia, which results from an imbalance between oxygen supply and oxygen demand in the heart. This report describes the pharmacology of beta-adrenoceptor antagonists as it relates to the treatment of angina. The beta-adrenoceptor antagonists are widely used in long-term maintenance therapy to prevent acute ischemic episodes in patients with chronic stable angina. Beta-adrenoceptor antagonists competitively inhibit the binding of endogenous catecholamines to beta1-adrenoceptors in the heart. Their anti-ischemic effects are due primarily to a reduction in myocardial oxygen demand. By decreasing heart rate, myocardial contractility and afterload, beta-adrenoceptor antagonists reduce myocardial workload and oxygen consumption at rest as well as during periods of exertion or stress. Predictable adverse effects include bradycardia and cardiac depression, both of which are a direct result of the blockade of cardiac beta1-adrenoceptors, but adverse effects related to the central nervous system (eg, lethargy, sleep disturbances, and depression) may also be bothersome to some patients. Beta-adrenoceptor antagonists must be used cautiously in patients with diabetes mellitus, peripheral vascular disease, heart failure, and asthma or other obstructive airway diseases. Beta-adrenoceptor antagonists may be used in combination with nitrates or calcium channel blockers, which takes advantage of the diverse mechanisms of action of drugs from each pharmacologic category. Moreover, concurrent use of beta-adrenoceptor antagonists may alleviate the reflex tachycardia that sometimes occurs with other antianginal agents.
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PMID:Antianginal actions of beta-adrenoceptor antagonists. 1799 92


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