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)

Cysteamine (2-aminoethanethiol) has been given orally to 19 patients with nephropathic cystinosis for periods of 8-24 months in doses ranging from 50 to 70 mg base/kg/day. Adverse reactions were noted in 3 patients early in the study when a rapidly increasing dosage schedule was followed. The reactions included hyperthermia, lethargy and rash. These reactions were not seen when patients were started on a very low dosage which was increased gradually at 3-week intervals to a level which depleted leukocytes of about 90% of their free cystine. All three reactions resolved within 24 h or cessation of therapy and in these cases successful readministration of drug was achieved. Chronic cysteamine administration to pediatric patients with cystinosis is feasible. The efficacy of this therapy is still being evaluated.
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PMID:Adverse reactions to oral cysteamine use in nephropathic cystinosis. 730 66

Aminoglutethimide (AG) with Dexamethasone has been utilized in 26 patients with metastatic breast cancer who had prior response to hormonal manipulation and/or positive estrogen receptor. Objective tumor response (CR + PR) has been achieved in 13 of 26 patients. Responses were seen in soft tissue, bone, and pleura. Six of 26 patients had stable disease and seven of 26 patients had progressive disease. The median duration of response is 12.8 months. The median survival for the responders has not been reached. Non-responding patients had a median survival of five months. Side effects were minimal, including mild lethargy, rash, fever, and weight gain. This regimen is well tolerated and can be used effectively in metastatic hormone-receptor-positive breast cancer.
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PMID:Aminoglutethimide in the management of metastatic breast cancer. 746 86

An 18-month-old boy presented with a 5-day history of lethargy, fever, vomiting and rash. He required intensive care for inotropic and ventilatory support. He developed a disseminated intravascular coagulopathy and gangrene of his extremities. In addition, he had severe neurological dysfunction and loss of vision, both of which recovered spontaneously with time. The potential severity of tick typhus caused by Rickettsia conorii is described as well as the importance of paired serological tests in the diagnosis of this condition.
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PMID:Severe illness caused by Rickettsia conorii. 750 54

Dengue fever is a viral disease, transmitted to man via mosquito bites. It is endemic in tropical regions (10 million infected annually) and is characterized by high fever, headache, myalgia, lethargy, vomiting, rash and neutropenia. The upward trend in the number of young Israelis visiting tropical countries increases the number of those potentially exposed to this disease. We present 4 Israelis who returned with dengue fever from Thailand.
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PMID:[Dengue fever]. 755 5

Acute arsenic toxicity is rare, and there have been no pediatric cases of acute arsenic poisoning in the recent literature. We report a pediatric case of acute arsenic ingestion treated initially with British antilewisite (BAL) and D-penicillamine (DP), and later with dimercaptosuccinic acid (DMSA). A 22-month-old girl ingested 1 oz 2.27% sodium arsenate and developed immediate vomiting and diarrhea. The patient presented to a community emergency department with the following vital signs: blood pressure 96/72 mm Hg, pulse 160 beats/min, respirations 22 breaths/min. She was pale and lethargic. Gastric lavage was performed, and abdominal X-ray was normal. She continued to have gastrointestinal symptoms and received 3 mg/kg BAL. Sinus tachycardia persisted, with heart rate increasing to 200 beats/min. In 12 hours, she was asymptomatic and was started on oral DP. On day 1, 24-hour urine arsenic was 4,880 micrograms/L. She remained asymptomatic and was discharged on day 6 on oral DP. She did well except for a rash that could have been a side effect of DP. On day 8, when the day 5 24-hour urine arsenic level was returned at 650 micrograms/L, the patient was readmitted and started on DMSA. After 4 days on DMSA, the 24-hour urine arsenic level was 96 micrograms/L. White blood cell count and renal and hepatic function remained normal. The excretion half-life was approximately 2.5 days, which is at least 2 to 3 times faster than the spontaneous excretion half-life expected in adults. Long-term follow-up was unavailable.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pediatric arsenic ingestion. 760 32

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

We studied 57 infants < or = 14 days of age referred for possible enterovirus (EV) infection to assess the accuracy of that clinical diagnosis and describe the natural history of neonatal EV infection. Twenty-nine neonates proved to have EV infection, 23 had illnesses compatible with (but not proven to be) EV infection, and 5 had alternative diagnoses: bacterial infections (2); herpes simplex virus infection (1); and metabolic disorders (2). Neonates with proved EV infection were generally full term and had uncomplicated immediate postnatal periods but high percentages of ill contacts. Neonatal symptoms and signs included fever, irritability, anorexia, lethargy, hypoperfusion, rash, jaundice and respiratory findings. Laboratory abnormalities included cerebrospinal fluid (CSF) pleocytosis, chest radiograph infiltrates, abnormal urinalyses and elevated transaminases. EVs were most commonly isolated from CSF and rectum/stool but also frequently from serum and urine. Five EV-infected patients had severe multisystem disease (pneumonitis, hepatitis, thrombocytopenia, bleeding and meningitis), requiring supportive care and lengthy hospitalizations. All survived, 2 with residual hepatic dysfunction. Markers of severe disease included: early age of illness onset (especially Day 1 of life); maternal viral symptoms at delivery; absence of fever and irritability; tachypnea; lethargy; abdominal distension; hepatomegaly; and positive serum viral culture. These data support conservative management of ill infants < or = 2 weeks of age and suggest that antiviral therapy for neonatal EV infection would be optimally targeted at infants with early onset illness, multisystem disease and/or viremia.
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PMID:Profile of enterovirus disease in the first two weeks of life. 828 18

A 14-year-old boy was seen because of irritability, insomnia, lethargy, and profuse sweating, together with hypertension (blood pressure: 160/120 mm Hg), tachycardia, and a diffuse erythematous rash with desquamation of the palms and soles. Initial biochemical investigation suggested a diagnosis of pheochromocytoma, but subsequently a history of exposure to mercury vapor was obtained. This case emphasizes the clinical and biochemical similarities between mercury poisoning (acrodynia) and pheochromocytoma.
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PMID:Acute mercury poisoning (acrodynia) mimicking pheochromocytoma in an adolescent. 841 May 28

Two cases of anti-neutrophil cytoplasmic antibody (ANCA)-associated necrotizing and crescentic glomerulonephritis are reported. A 12-year-old girl and a 10-year-old boy presented with polyarthritis, anaemia, haematuria, proteinuria, impaired renal function, anorexia, nausea, marked loss of weight and lethargy. The boy also had a vasculitic rash and anterior uveitis. Both children had diffuse cytoplasmic ANCA identified by indirect immunofluorescence and confirmed by specific enzyme-linked immunosorbent assay. Renal biopsies showed severe focal and segmental necrotizing glomerulonephritis with 100% crescents. They were treated with plasma exchange, prednisolone, cyclophosphamide and heparin. Within 1 month of commencing treatment, both had normal serum creatinine concentrations and ANCA was not detectable. Renal biopsies 6 weeks following commencement of treatment revealed quiescent disease, although up to 40% of glomeruli were sclerosed or had fibrous crescents. Following cessation of cyclophosphamide and heparin after 7 months and reduction in steroid dose, a biopsy at 10 months in the boy revealed quiescent disease, but the girl had recurrent disease associated with reappearance of a low titre of ANCA and small cellular crescents in 20% of the glomeruli. These cases reflect the potential usefulness of ANCA determination for categorizing paediatric patients, helping in the selection of therapy and as a possible marker of disease activity, similar to the experience in adults.
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PMID:Anti-neutrophil cytoplasmic antibody-associated glomerulonephritis in children. 843 72

A total of 28 male spinal cord injury (SCI) patients were enrolled in an open label study to evaluate the efficacy and safety of terazosin to improve voiding. All patients were started on 1 mg daily dose at bedtime. The dosage was gradually increased to 1-2 mg twice daily, depending upon patient tolerance and a minimum acceptable systolic blood pressure of 90 mm Hg. Urodynamic evaluation was done in 24 patients prior to and one week after a maximum tolerated dose was established for at least 48 hours. The maximum dose varied from 1 to 5 mg daily. Subjective improvement in voiding was noticed in 50 percent of patients. Objective assessment with urodynamics showed a mean drop in maximum voiding pressure of 35 cm H2O (range 9-65 cm H2O) in only 42 percent of patients. Subjective improvement in voiding occurred in 14 of 17 patients with absent detrusor sphincter dyssynergia. The drug was discontinued in three patients with side effects of syncope in one patient, lethargy in another and body rash in the third. Because the tolerance dose of terazosin is variable and the therapeutic response is unpredictable, urodynamic monitoring is recommended to accomplish a useful outcome.
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PMID:Efficacy and safety of terazosin to improve voiding in spinal cord injury patients. 859 Oct 69


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