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

A 45-year-old Italian woman, who was admitted to the Royal Free Hospital in London, England, with a 14-day history of general malaise, lethargy, epigastric pain after meals, and night sweats, had had an IUD inserted 13 years earlier which had not been changed. The patient was pyrexial on examination; she had a temperature of 38 degrees Centigrade but no jaundice or enlarged lymph nodes. There was mild epigastric tenderness, and a tender indurated rectal stricture involving the posterior fornix of the vagina was palpable on pelvic examination. The rectal stricture was confirmed on sigmoidoscopy. The biopsy revealed a chronic inflammatory cell infiltrate with lymphocytes, extending from the submucosa through to the muscularis mucosae. A preoperative barium enema showed a long irregular rectal stricture. A large mass of inflammatory tissue was found adherent to the uterus, rectum, fallopian tubes, and ovaries at laparotomy. Bilateral retrograde ureterograms showed complete obstructions of the left ureter at 5 cm and a long irregular stricture was seen at the same level on the right. The histological examination revealed actinomycosis of the uterus, fallopian tubes, and ovaries. 12 weeks postoperatively the patient was well; sigmoidoscopy to 25 cm showed complete resolution of the rectal stricture. The antibiotic treatment was stopped. The most likely source of this patient's actinomycosis was the IUD for the relationship between the two is well established. In this patient a prolonged course of antibiotics proved effective in treating the infection.
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PMID:Rectal stricture due to actinomycosis. 373 Jul 97

A female, stray crossbreed dog, approximately four years old, was presented for routine spaying during a charity neutering programme in Romania. On clinical examination the bitch was lethargic and pyrexic (40.6 degrees C), but no other signs of illness were detected. Laparotomy revealed an enlarged uterus, severed at the cervix, with no communication to the vagina. Abdominal inspection showed an apparently normal, ligated vaginal stump. An ovariohysterectomy was performed and the dog was treated with a seven-day course of netilmicine. It subsequently made a full recovery.
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PMID:Pyometra in a bitch following unusual sterilisation. 1568 40

ABSTRACT Body packers are people who illegally carry drugs, mostly cocaine as well as opium and/or heroin, concealed within their bodies. The packets are inserted in the mouth, rectum, or vagina in order to get across borders without being detected. In this presentation we report a case of an opium body packer and review the available scientific literature by focusing on mechanisms of toxicity and treatment approach. The patient was a 35-year-old man who had lethargy, respiratory depression, tachycardia, normal blood pressure, hyperthermia, and pinpoint pupils on presentation. No past medical history was obtained and the only positive history was his travel from Afghanistan 2 days earlier, which he had given to emergency personnel before arriving at our hospital. Complete blood cells and kidney and liver tests were all in normal range. In the emergency department, the patient was treated with oxygen, naloxone, and hypertonic glucose. One dose of activated charcoal (1 g/kg) was administered orally. After intravenous injection of naloxone (4 mg), the lethargy, respiratory depression, and miosis were resolved. The patient was admitted to the intensive care unit and 90 min after admission, the patient redeveloped respiratory distress and lost consciousness. He was intubated and mechanically ventilated due to the suspicious of body packing. Plain abdominal x-ray showed multiple packets throughout the gastrointestinal tract; 81 packets were removed by surgery and three of them were left due to leaking. After removing the packets, the patient was treated conservatively. He suffered a pulmonary infection (aspiration pneumonia) and he regained consciousness after 4 days. Upon recovery the patient was seen by a psychiatrist prior to going to prison. Surgery is recommended for body packers who have significant signs or symptoms.
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PMID:A case report of opium body packer; review of the treatment protocols and mechanisms of poisoning. 2002 Sep 70

A 1-year-old sexually intact female Labrador Retriever was evaluated for malodorous vaginal discharge, lethargy, and vomiting. A diagnosis of pyometra was suspected based on signalment, clinical signs, and abdominal ultrasonography. The dog underwent an exploratory celiotomy revealing a palpably enlarged cervix and edematous, fluid-filled vagina with an otherwise normal uterus. The ovaries, uterus, cervix, and cranial vagina were surgically resected. Histopathology revealed mild to moderate regionally extensive subacute neutrophilic cervicovaginitis due to an unknown underlying etiology. The dog did not exhibit any postoperative complications or recurrence of clinical signs in 6 months. This case represents an unusual disease condition, which presented in a manner typical for pyometra, yet required more extensive surgical resection.
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PMID:Ovariohysterectomy and Partial Vaginectomy for Treatment of Cervicovaginitis in a Dog. 3193 91