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)

An 8-year-old, neutered, male, domestic shorthaired cat is admitted to your clinic with a complaint of lethargy and anorexia. The cat was last examined 2 months previously with a urinary tract infection and severe cellulitis at the site of a ventral abdominal urethrostomy. The urethrostomy was performed several years ago at another clinic. Euthanasia was recommended during your first examination, but the owner insisted on treatment. The cat improved after receiving fluids and systemic and topical antibiotics, but its condition suddenly deteriorated 2 days ago. Physical examination reveals severe dehydration, bradycardia, hypothermia, and an infected and fly-blown urethrostomy opening. Euthanasia is again recommended. The owner refuses and leaves the clinic, apparently intending to seek a second opinion.
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PMID:An ethicist's commentary on the case of a client who refuses euthanasia for a sick cat. 758 30

Timed-pregnant CD-1 outbred albino Swiss mice and CD Sprague-Dawley rats were administered hydrochlorothiazide (HCTZ, USP) in corn oil by gavage during major organogenesis, Gestational Days (GD) 6 through 15. The doses administered were 0, 300, 1000, or 3000 mg/kg/day for mice and 0, 100, 300, or 1,000 mg/kg/day for rats. Maternal clinical status was monitored daily during treatment. At termination (GD 17, mice; GD 20, rats), confirmed pregnant females (20-27 per group, mice; 36-39 per group, rats) were evaluated for clinical status and gestational outcome; each live fetus was examined for external, visceral, and skeletal malformations. In mice, no maternal mortality was observed. However, clinical signs including dehydration, piloerection, lethargy, and single-day weight loss appeared to be dose-related. HCTZ had no effect on maternal weight gain or water consumption, gravid uterine weight, relative maternal liver weight, or relative maternal kidney weight. There was no definitive evidence of embryotoxicity or fetal toxicity for mice on GD 17. Thus, the no observed adverse effect level (NOAEL) for both maternal and developmental toxicity was 3000 mg/kg/day. In rats, HCTZ had no effect on maternal survival, clinical signs, or water consumption. Clinical signs were not dose-related. Maternal weight gain during treatment was depressed at 1000 mg/kg/day. Gravid uterine weight and relative maternal liver weight were unaffected. Relative maternal kidney weight was slightly (7-8%) increased at all dose levels, but there was no evidence of a dose response. Thus, the maternal NOAEL for rats was 300 mg/kg/day, based on decreased maternal weight gain during treatment at 1000 mg/kg/day.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The evaluation of the developmental toxicity of hydrochlorothiazide in mice and rats. 758 6

Thirty-six male mink were fed diets that contained 0, 1, 2 or 4% supplemental salt (sodium chloride) and were given drinking water ad libitum for 7 d. Three mink on each diet were then placed on ad libitum, 50% ad libitum or 25% ad libitum drinking water for the next 14 d. Ad libitum water consumption was directly proportional to the salt content of the diets. Feed consumption was inversely related to the level of dietary salt, although water restriction had a greater effect in reducing feed consumption than did the supplemental salt. The clinical signs of salt toxicity-water restriction observed were increased thirst, mild dehydration, decreased feed consumption, decreased body weight, rough coat, crusty nose and eyes, irritability in the early stage, and lethargy in the later stages. In general, serum and urinary sodium and chloride ion concentrations increased with increasing dietary salt concentrations. Expressed as a percent of brain weight, liver, spleen, kidney and heart weights of mink fed supplemental salt were less than the control weights. Adrenal gland weights increased in response to water restriction. Brain sodium concentrations were not affected by salt supplementation when drinking water was provided ad libitum. However, restricting drinking water generally resulted in increased brain sodium concentrations. Mild to moderate micro- or macrovesicular vacuolar changes were observed in the livers of some mink fed each level of dietary salt, but were especially prominent in the mink restricted in drinking water.
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PMID:Effects of supplemental dietary sodium chloride and restricted drinking water on mink. 770 90

In India, 48 mothers with at least one child aged less than 5 years living in two villages of Raipur Rani block in Haryana were interviewed to determine whether their beliefs and practices had changed after the diarrheal diseases control program was implemented. The researchers planned to use the findings to improve the program's promotional strategy. 23% believed that eating uncovered food, eating dirty or stale food, eating mud, and dirty feeding bottles were causes of diarrhea. Other perceived causes of diarrhea to be excessive heat (75%), specific foods (52%), over-eating (22.9%), excessive cold (14.5%), teething (14.5%), side effects of medication (6.2%), top milk (4.2%), and constipation (4.1%). Only 10.4% knew specific ways to prevent diarrhea. 85.5% approved of continuing breast feeding during diarrhea, while, before the program, most mothers withheld breast milk. Previously, 98.1% would restrict foods during diarrhea, now only 35% would do so. 50% believed less fluids than the normal amount should be given during diarrhea. 65% thought that the usual amount of food should be given. 68.8% would administer home remedies to treat diarrhea. 18.8% would begin oral rehydration therapy at home. If diarrhea is serious or home remedies do not work, 83.7% would seek a local medical practitioner and 16.3% would go to government health facilities. 54% had used oral rehydration solution in the past. 42.9% of them knew how to prepare it correctly and 70.5% knew how to administer it correctly. Recognized danger signs during diarrhea included lethargy (54.1%), at least eight watery stools/day (41.6%), frequent vomiting (27.1%), weakness (20.8%), dry and sunken eyes (16.6%), anorexia (12.5%), loose skin (6.2%), fever (4.2%), noisy breathing (2.1%), convulsions (2.1%), dehydration (2.1%), facial edema (2.1%), and sunken fontanelle (2%). These findings emphasize the need to focus on preventive measures by educating the public about causes and methods of diarrhea prevention while considering the existing culture.
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PMID:Mothers' beliefs and practices regarding prevention and management of diarrheal diseases. 788 22

This study reviews all childhood intussusceptions treated over a 6 year period in a regional centre with six visiting general surgeons and two paediatricians. Clinical presentation, management, complications and outcomes were noted and an attempt was made to follow up all cases. There were 20 patients, with a median age of 6 months (range 10 weeks to 17 months). Only one patient had all four classical features of intussusception (pain, vomiting, 'red currant jelly' stools and abdominal mass). Seven patients were managed successfully by barium enema reduction, but 14 required operation, four following failed radiological reduction. There was one intestinal perforation due to attempted barium enema reduction and one patient required a reoperation for ileal gangrene following operative reduction. There were no deaths and there have been no subsequent recurrent intussusceptions although three cases were lost to follow up. There was a delay in diagnosis in some cases (average duration from onset to diagnosis was 34 h). Although delay was incurred by parents in some cases and in peripheral hospitals in others, there is a need for greater awareness by surgeons of the significance of subtle features such as pallor and lethargy in a child with persistent vomiting. Delay in diagnosis is likely to lead to an increased need for primary surgical intervention. Adverse features (age > 3 months or < 2 years; symptoms > 24 h; small bowel obstruction; dehydration > 5%) were predictive of an increased likelihood of surgical resection, and may help avoid inappropriate attempts at radiological reduction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Childhood intussusception in a regional hospital. 794 69

Megaesophagus was diagnosed in 9 adult ferrets. Clinical history of the ferrets included regurgitation, difficulty in swallowing, partial anorexia, and lethargy. Cachexia, dehydration, weakness, and ptyalism were observed on physical examination. Radiography revealed the esophagus of each ferret to be dilated in the thoracic and cervical regions. Of 4 ferrets that had lymphocytopenia, 2 had concurrent leukopenia. Serum biochemical analysis revealed high activity of alanine transaminase (4 ferrets) and aspartate transaminase (3), and hypoglycemia (4). Treatment included administration of fluid, antibiotics, and agents directed against possible primary causes of megaesophagus. Treatments were ineffective, and all of the ferrets died or were euthanatized. All 6 ferrets that were submitted for necropsy had bronchopneumonia, hepatic lipidosis, mild esophagitis, and gastritis. The etiopathogenesis of megaesophagus in the ferrets was not determined.
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PMID:Megaesophagus in nine ferrets. 796 Oct 71

Cytauxzoonosis is a rapidly and highly fatal disease in cats that is caused by the protozoan Cytauxzoon felis, which may be transmitted by Ixodid ticks (Dermacentor variabilis) from parasitemic bobcats (Lynx rufus). During an 8-year period, cytauxzoonosis was diagnosed in 8 cats, 7 cats within 14 months. Risk factors for these cats were warm weather, access to a wooded environment, and exposure to ticks. The most consistent clinical signs were acute lethargy, anorexia, decreased response to external stimuli (depression), icterus, dehydration, and capillary refill time > 2 seconds. Pertinent clinicopathologic findings were normocytic normochromic anemia, leukopenia, and thrombocytopenia; high serum concentrations of total bilirubin and glucose, low serum concentrations of albumin and potassium, high serum alanine transaminase activity; and, bilirubinuria. Confirmation of cytauxzoonosis was made by cytologic or histologic identification of the C felis organism. Splenic, lymph node, and bone marrow aspirates can provide an antemortem diagnosis when the number of parasitized erythrocytes is low on blood smears. Supportive treatment of 6 cats was temporarily palliative in some, but all 8 cats either died (3) or were euthanatized (5) when they became moribund. Survival time from observed onset of illness to death was < 5 days. Necropsy of 4 cats revealed predominately pulmonary involvement with venous congestion. Histologic examination revealed venous occlusion by parasitized mononuclear phagocytes in all tissue specimens, but only minimal inflammatory infiltrates.
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PMID:Cytauxzoonosis in cats: eight cases (1985-1992). 796 Oct 73

One hundred fifty lactating mink on one ranch in southern Ontario were monitored over the lactation period in 1989 for evidence of clinical disease, and serial blood samples were collected for biochemical analysis. Antemortem blood samples were collected and necropsies performed on the 17 females that developed nursing disease and on 17 controls matched to the same stage of lactation and on ten nonlactating controls. Twenty-two additional nursing disease cases were selected from seven ranches in the following year and processed similarly. The clinical signs typically observed in affected females were sudden onset lethargy and anorexia followed by dehydration, ataxia, and a reluctance to move. The major clinical-pathologic findings were a marked increase in serum osmolality and total protein, urea nitrogen, creatinine, phosphorus, glucose, and potassium concentrations and a decrease in sodium and chloride concentration. In addition, the animals were acidotic, there was a reduction in the urine specific gravity, and the hemogram was consistent with a stress response. Emaciation and dehydration were the only pathologic changes consistently present in cases of nursing disease and not in controls. In almost all cases, bacteria were not cultured from the liver, spleen, and mammary gland, but Campylobacter jejuni was cultured from the intestinal contents of 15/17 affected mink and 2/5 controls. Aleutian disease virus antibody was not present in any of the affected mink. Lipid vacuoles in hepatocytes and renal tubular epithelium, hypertrophy of cells in the adrenal cortex, and pulmonary congestion and atelectasis were present in both diseased females and controls, as were various sporadic inflammatory lesions. Nursing disease may result from energy depletion due to lactation. All lactating females are affected by this process; clinical disease reflects the terminal physiologic decompensation of the most susceptible individuals.
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PMID:Nursing disease in mink: clinical and postmortem findings. 811 44

Medical records of 35 cattle with small-intestinal volvulus were reviewed. Surgical correction was performed on 32 cattle, and 17 of these cattle were discharged from the hospital. Mean duration of clinical signs for survivors was not significantly different from that for nonsurvivors, and the most commonly recorded clinical signs were abdominal pain, anorexia, lethargy, abdominal distention, and dehydration. Physical examination of cattle with intestinal volvulus revealed tachycardia, tachypnea, and normothermia. Rectal examination findings included distended small intestine, scant feces or mucus, and tight bands coursing dorsoventrally in the middle portion of the abdomen. Clinicopathologic testing revealed azotemia, hypocalcemia, hyperglycemia, and leukocytosis with a left shift. Nonsurvivors had significantly lower mean preoperative venous blood pH and mean base excess and higher mean serum potassium concentration than did survivors. A diagnosis of volvulus of the entire small intestine was made during surgery in 25 cattle, whereas volvulus of the distal jejunum and ileum was diagnosed during surgery in 7 cattle. Survival rate following surgical correction of volvulus of the entire small intestine (44%) was not significantly different from survival rate following surgical correction of volvulus of the distal jejunum and ileum (86%). However, survival rate for dairy cattle (63%) was significantly higher than survival rate for beef cattle (22%). To determine potential risk factors for the development of small-intestinal volvulus, epidemiologic data from cattle admitted to veterinary teaching hospitals throughout North America were collected by searching records entered into the Veterinary Medical Data Base.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Small-intestinal volvulus in cattle: 35 cases (1967-1992). 824 69

Mannitol is an osmotic diuretic used in acute oliguric renal failure, acute cerebral edema, and acute glaucoma. It is metabolically inert and is excreted through the kidneys. So once renal function is impaired, mannitol accumulates and the movement of water into the intravascular space with resultant cellular dehydration. Two patients suffered reversible acute oliguric renal failure following mannitol infusion given as treatment for intracranial hypertension. Both patients experienced nausea and vomiting and became increasingly lethargic with edema of general body. Congestive heart failure occurred. Laboratory data showed severe dilutional hyponatremia with hyperosmolality. We successfully treated them with extracorporeal ultrafiltration method (ECUM) and hemodialysis (HD). Some discussions were presented about acute renal failure following mannitol infusion.
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PMID:[Acute renal failure following mannitol infusion]. 837 73


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