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)

Central adrenal insufficiency (CAI) is a life-threatening condition caused by either pituitary disease (secondary adrenal insufficiency) or impaired hypothalamic function with inadequate CRH production (tertiary adrenal insufficiency). ACTH deficiency may be isolated or, more frequently, occur in conjunction with other pituitary hormone deficiencies and midline defects. Genetic mutations of the TBX19 causing isolated CAI are rare but a number of genes encoding transcription factors involved in hypothalamic-pituitary gland development, as well as other genes including POMC and PC1, are associated with ACTH deficiency. CAI is frequently identified in congenital, malformative, genetic, and epigenetic syndromes as well as in several acquired conditions of different etiologies. The signs and symptoms vary considerably and depend on the age of onset and the number and severity of associated pituitary defects. They may include hypoglycemia, lethargy, apnea, poor feeding, prolonged cholestatic jaundice, jitteriness, seizures, and sepsis in the neonate, or nonspecific signs such as fatigue, hypotension, vomiting and hyponatremia without hyperkalemia in children. The diagnosis of CAI relies on the measurement of morning cortisol concentrations along with dynamic test for cortisol release with different stimulating agents. Early recognition of CAI and its correct management are mandatory in order to avoid both morbidity and mortality in affected neonates, children and adolescents.
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PMID:Central adrenal insufficiency in children and adolescents. 3008 67

Pain causes altered arousal and specific behaviours that are rare at other times (pain indicators). We examined whether beef cows (mean age 6 years) are sensitive to pain indicators in addition to arousal following ear tagging and rubber ring castration (males only, n = 31) of their calf (n = 58). Behavioural pain indicators and activity were recorded continuously for 20 min before and 2 h after handling. The 30 min period posthandling captured the peak of behavioural change during this window. Cow maternal and maintenance behaviours were recorded for 20 min before and for 30 min after calf handling. Principal component (PC) analysis identified two dimensions (48% of the variance) in calf behaviour. Arousal and two active pain indicators loaded onto PC1 were shown by linear mixed models to positively affect some maternal behaviours. Lethargy, passive pain indicators and further active pain indicators loaded onto PC2 did not affect cow behaviour. Castration did not result in male calves receiving more maternal attention. Cows alter maternal behaviour in response to calf activity but not behaviours previously shown to indicate pain. Maternal care peaks soon after calving, but recent calving stress or the subtlety of neonatal behavioural expression may constrain cows in responding to the individual behavioural expression of their calf. Future studies exploring empathy should be aware of the constraints on behavioural expression associated with the neonatal and periparturient period.
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PMID:The Effect of Behavioural Indicators of Calf Discomfort Following Routine Procedures on Cow Maternal Care. 3193 88