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)

During neurophysiologic studies in the rat [Crl:COBS CD(SD)BR], chloral hydrate was given intraperitoneally to produce anesthesia for brain electrode implantation. The incidental occurrence of adynamic ileus in six of these rats, 5-16 days after surgery, prompted further investigation. Pathological evaluations and transmission experiments using ingesta and viscera from affected rats failed to reveal an infectious agent. Subsequently chloral hydrate-induced adynamic ileus leading to morbidity or death was experimentally produced in 14 of 27 rats, 3--36 days after intraperitoneal administration of the anesthetic at a dose of 400 mg/kg body weight and concentrations of 125--275 mg/ml. The experimentally produced condition was characterized by lethargy, anorexia, abdominal distension, ruffled hair coat, inactivity, drowsy expression, constipation, and death. Gross pathologic findings included gaseous distension and atony of the cecum and segments of the small intestine. Small intestine contents varied from liquid to solid. The colon and rectum contained only a few dry hard fecal pellets. A few animals showed excess abdominal fluid. Microscopic findings were limited to focal chronic serositis and serosal fibrosis affecting the visceral peritoneum. On the basis of the experimental studies, it was concluded that the condition described was not an infectious disease but was an abnormal physiologic condition produced by the irritating or pharmacologic action of chloral hydrate given at high concentrations in the abdominal cavity.
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PMID:Adynamic ileus in the rat induced by chloral hydrate. 85 88

The prevalence, presentation, and outcome of bacteremia due to Shigella and other gram-negative bacteria were determined by review of records of 2,018 inpatients with shigellosis who had their blood cultured in a Bangladeshi hospital in 1976-1983. Shigella bacteremia occurred in 82 (4.1%) patients; other bacteremia occurred in 102 (5.1%) patients. Patients with shigella sepsis more frequently (P less than .02) manifested severe dehydration, abdominal tenderness or ileus, agitation or lethargy, and leukocytosis than did nonbacteremic controls; they developed more frequently (P less than .05) renal failure (26%), leukemoid reaction (22%), thrombocytopenia (20%), and hemolytic-uremic syndrome (6%). The prevalence of all bacteremia was highest in the first year of life. Protein-energy malnutrition was a strong risk factor for shigella sepsis (P less than .01). The fatality rate in shigella bacteremia (21%) was higher (P less than .005) than in nonbacteremic shigellosis (10%) but lower (P less than .001) than in other bacteremia (51%). At highest risk of death from shigella bacteremia (P less than .01) were patients less than one year old, non-breast-fed, malnourished, and afebrile.
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PMID:Shigella septicemia: prevalence, presentation, risk factors, and outcome. 404 31

Maytansine is an experimental antitumor agent that has shown minimal efficacy against breast cancer with minimal myelosuppression in phase I trials. Forty-one patients with advanced drug-resistant breast cancer were treated with a 5-day intermittent iv infusion of maytansine repeated every 21 days. All patients had been heavily pretreated with cyclophosphamide, methotrexate, 5-fluorouracil, or doxorubicin, and 12 had received vinblastine, mitomycin C, or investigational drugs. All patients had measurable disease and an expected survival of 6 weeks. The average performance status was 2.5. Twelve patients did not complete one full cycle of therapy, leaving 29 evaluable for response. One patient had a partial regression of pulmonary disease, seven had transient responses of less than 50% reduction in tumor or stable disease, and 21 had progressive disease. Toxic effects (vomiting, diarrhea, ileus, lethargy, and altered mentation) were considerable. Since maytansine is a relatively nonmyelotoxic metaphase inhibitor, we feel that even minimal efficacy in heavily pretreated patients justifies further evaluation of the agent in combination therapy.
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PMID:Minimal single-agent activity of maytansine in refractory breast cancer: a Southwest Oncology Group study. 742 53

In 1977 it was reported that chloral hydrate could cause adynamic ileus in rats, leading to morbidity and death. The symptoms were a swollen abdomen, lethargy and anorexia. However, chloral hydrate is still used as an anaesthetic, particularly in Equithesin mixture. We report that Equithesin without chloral hydrate is an effective anaesthetic, with a slightly reduced potency compared to Equithesin itself, and anaesthesia may be maintained for several hours by supplemental doses.
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PMID:Equithesin without chloral hydrate as an anaesthetic for rats. 874 54

A 76-year-old woman was referred to our hospital for unresponsiveness and hypotension. She had developed constipation that had led to ileus and had received 34 g of magnesium citrate (Magcolol P) orally the day before. She was lethargic, her blood pressure was less than 50 mmHg, and electrocardiogram (ECG) revealed sinus arrest with junctional escape rhythm. Her serum concentration of magnesium (Mg) was markedly elevated (16.6 mg/dl =13.7 mEq/l). Emergency colonoscopy revealed ischemic colitis. As her condition ameliorated, her renal function returned to normal. Hence, the present case suggests that severe hypermagnesemia can occur in the absence of pre-existing renal dysfunction in elderly patients with gastrointestinal diseases.
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PMID:Hypermagnesemia induced by massive cathartic ingestion in an elderly woman without pre-existing renal dysfunction. 1594 92

A 14-year-old girl was referred to our hospital with lethargy and hypotension and was found to have a serum magnesium level of 14.9 mg/dL after having received an magnesium hydroxide (Magnesie Calcinee) for 7 days because of constipation. She was lethargic, her blood pressure was 70/40 mm Hg, and electrocardiogram revealed prolonged corrected QT interval and first-degree atrioventricular block. She has no renal dysfunction. Emergency hemodialysis after her condition ameliorated, her serum magnesium levels returned to normal. The present case suggests that massive oral magnesium ingestion with severe constipation and ileus may result severe hypermagnesemia without renal dysfunction.
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PMID:Severe hypermagnesemia as a result of excessive cathartic ingestion in a child without renal failure. 1772 19

Necrotizing enterocolitis (NEC) is primarily a disease process of the gastrointestinal (GI) tract of premature neonates that results in inflammation and bacterial invasion of the bowel wall. Despite advances in the care of premature infants, NEC remains one of the leading causes of morbidity and mortality in this population. It occurs in 1-5% of all neonatal intensive care admissions and 5-10% of all very low birthweight (<1500 g) infants. Although research has presented an interesting array of potential contributing factors, the precise aetiology of this multifactorial disease process remains elusive. Historically, it was believed that NEC arose predominantly from ischaemic injury to the immature GI tract, yet alternate plausible hypotheses indicate that many factors are likely to be involved. These may include issues related to the introduction and advancement of enteric feeding, alterations in the normal bacterial colonization of the GI tract, bacterial translocation and activation of the cytokine cascade, decreased epidermal growth factor, increased platelet activating factor, and mucosal damage from free radical production. Clinical manifestations of NEC may be vague, including increased episodes of apnoea, desaturations, bradycardia, lethargy and temperature instability. There may also be GI-specific symptoms such as feeding intolerance, emesis, bloody stools, abdominal distention and tenderness, and abdominal wall discolouration. Laboratory values may be indicative of infection, coagulation abnormalities and fluid retention. Radiographic signs may include ileus, dilated or fixed intestinal loops, air in the intestinal wall or free air in the abdomen. Medical treatment typically consists of bowel rest and decompression, antibacterial therapy, and management of other haematological or electrolyte imbalances. Increased respiratory and cardiovascular support is sometimes needed. In neonates who do not respond adequately to medical management, or if pneumoperitoneum is present, surgical intervention may occur with either use of a peritoneal drain or laparotomy. Advances in antenatal and neonatal care have resulted in increased survival of extremely preterm neonates. As this at-risk population continues to increase, an effective preventative strategy for NEC is needed. One preventative strategy is the use of antenatal corticosteroids to enhance maturation of the fetus if preterm delivery is likely. Recommendation of use of breast milk, early initiation of trophic feeds and judicoius advancement of enteric feeds are current postnatal strategies. Other preventative strategies that have been investigated include the use of oral antibacterials, antioxidants, supplementation of arginine and epidermal growth factor, none of which have changed clinical practice. Recent promising data indicate that prophylactic use of probiotics may play a role in preventing the onset of NEC. However, more large-scale, definitive studies are needed.
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PMID:Necrotizing enterocolitis in newborns: pathogenesis, prevention and management. 1854 33

This paper describes three cases of liver lobe torsion in rabbits presenting with anorexia, lethargy, jaundice and abdominal pain. This condition was associated with anaemia and elevation of alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase. Abnormal radiological findings included hepatomegaly, gas-filled intestinal loops consistent with gastrointestinal ileus and ascites. Ultrasonographic findings included heterogeneous liver parenchyma, free abdominal fluid and reduced bowel motility. Diagnosis was confirmed by histopathological examination of the liver in all three cases.
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PMID:Liver lobe torsion in three adult rabbits. 1979 19

An 8-yr-old intact female African lion (Panthera leo) presented with a 3-day history of lethargy, anorexia, and vomiting. Hematologic and biochemical abnormalities included a leukocytosis, 41,700/microl (4,700-15,300) with a neutrophilia (37,530/microl; 2,000-9,200) and a left shift (1,250/microl bands; 0-300), and mild hypokalemia of 2.1 mEq/L (2.8-4.8). Abdominal radiographs revealed evidence of intestinal ileus, peritonitis, and the presence of effusion. An exploratory laparotomy was performed, and septic peritonitis due to a pyometra was diagnosed. The lion was treated with an ovariohysterectomy, abdominal lavage, fluid therapy, and a subcutaneous injection of cefovecin. The lion recovered, and clinical signs associated with septic peritonitis resolved within 36 hr. It was returned to conspecifics 3 wk later. Three months postoperatively, the lion showed no residual signs of septic peritonitis.
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PMID:Cefovecin (Convenia) for the treatment of septic peritonitis in a female lion (Panthera leo). 2308 42

The ingestion of large amounts of boric acid, a component of household insecticides, is a rare occurrence, characterized by a diffuse desquamative skin eruption, neutropenia, thrombocytopenia, delirium, acute renal failure and prolonged ileus. A 56-year-old male with a history of multiple previous suicide attempts was witnessed ingesting household roach killer and 4 days later presented to the hospital with lethargy, stiffness and a diffuse erythematous and desquamative eruption with bullous formation. He subsequently developed erythema of both palms as well as alopecia totalis. Histopathology from a right arm shave biopsy revealed a mostly intact epidermis with subtle vacuolar alteration of the basal layer, scattered intraepidermal apoptotic keratinocytes, parakeratosis with alternating layers of orthokeratosis and considerable superficial exfoliation; accompanying dermal changes included vasodilatation and mild perivascular inflammation. This report describes the cutaneous and systemic complications in a rare case of boric acid ingestion. There is little published material on the symptoms and histopathology following boric acid ingestion, but knowledge of this entity is important, both to differentiate it from other causes of desquamative skin rashes and to allow the initiation of appropriate clinical care.
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PMID:Boric acid ingestion clinically mimicking toxic epidermal necrolysis. 2399 46


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