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)

Expected clinical manifestations of intussusception include paroxysmal abdominal pain, vomiting, abdominal mass, and with time, rectal bleeding. We report a case where lethargy and vomiting are the presenting complaints. Diagnostic delay was encountered for this infant who had altered sensorium without accompanying pain, melena, or mass on initial examination. Either plain radiographs, supplemented by ultrasonography of the abdomen, or a barium enema should be performed in infants with unexplained lethargy.
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PMID:Intussusception: a supplement to the mnemonic for coma. 361 30

A phase I clinical trial of the intravenous administration of a novel pyridyl imidazoline ethyl carboxy phenyl urea was carried out in 42 patients with advanced solid tumors. Five schedules were evaluated: I, daily X 5; II, daily X 10; III, daily X 15; IV, continuous infusion for 5 days; V, continuous infusion for 7 days. Toxicity was not seen in schedule I (maximum dose 3 g/m2/day) and was minimal in schedule IV (6 g/m2/day). In schedule II it was seen at 2 and 3 g/m2/day, in schedule III at 2 g/m2/day and in schedule V at 6 g/m2/day. Dose-limiting toxicity consisted of a syndrome of lethargy and fatigue. There were no definitely drug-related changes in hematologic or serum chemistry parameters. No responses were seen, but relief of pain in three patients with prostate cancer was noted. Pharmacokinetics indicate a short half-life, limited volume of distribution, and rapid renal clearance. The recommended dose for phase II studies is 3 g/m2/day X 10 or 2 g/m2/day X 15 days.
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PMID:Phase I clinical trial of 1-(2-[2-(4-pyridyl)-2-imidazoline-1-yl]-ethyl)-3-(4-carboxy-phenyl) urea (CGP 15720A). 366 34

A case is reported of a 55-yr-old man complaining of interscapular pain, lethargy, anorexia with weight loss and shallowness of breath following a recent traumatic blow to the abdomen. Radiographs revealed a marked and extensive aneurysm of the thoracic aorta. The importance of performing X-ray studies of the thoracic region is emphasized for all cases where histories of recent or past significant chest trauma is suspected and with older patients having hypertension and atherosclerotic heart disease.
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PMID:Thoracic aortic aneurysm--subtle but serious: a case report. 369 63

Few studies have been published about analgesic management practices during sickle cell pain crisis. Therefore, we reviewed the records of all hospitalized children with this complication during a recent five-year period. The 38 patients (98 painful episodes) who received intravenous narcotic therapy were the subjects of this review. In 76 patients, an initial intravenous bolus injection of morphine sulfate or meperidine hydrochloride was followed by a continuous intravenous infusion of one of these two drugs. To achieve adequate pain control, adjustments in infusion rates were made according to a written protocol. In 22 other patients, subsequent narcotic treatment consisted only of intermittent intravenous bolus injections of meperidine. Satisfactory pain relief was achieved in all 98 episodes. Patients given continuous infusions required more narcotic to control their pain and had more side effects than those treated with bolus injections alone, suggesting a dose-response relationship between narcotic dose and several known side effects. Common side effects included nausea and vomiting, lethargy, and abdominal distention. Although clinically evident respiratory depression was quite uncommon, chest syndrome was a frequent complication, and severe respiratory distress occurred in three patients. Narcotic withdrawal or addiction was not observed. With careful monitoring (including special attention directed to avoiding dosing error), continuous intravenous narcotic infusions are safe and provide effective pain relief for severe sickle cell pain crisis.
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PMID:Intravenous narcotic therapy for children with severe sickle cell pain crisis. 377 42

Sixty 3- to 14-year-old outpatients with positive streptococcal group A bacterial cultures and clinical signs and symptoms of pharyngitis were treated with a single intramuscular (IM) injection of penicillin G benzathine/penicillin G procaine in a multicenter study. At the first follow-up visit, usually within 48 hours of the injection, 60 children had negative cultures, and the mean body temperature had decreased from 100.2 +/- 1.6 degrees F to 98.5 +/- 0.5 degree F (P less than 0.05). At this time, the investigators rated 77% of the children clinically cured and the remaining 23% improved; major signs and symptoms (sore throat, difficulty swallowing, lethargy, and cervical node enlargement and tenderness) had disappeared in nearly all of the children. Initial injection site pain, noted in only 15% of the children 48 hours later, probably was secondary to the injection and not drug related. Most other adverse reactions (in seven children) also were injection related, were mild or moderate, and required no countermeasures. At the second follow-up visit approximately 10 days after injection, all children were considered clinically and bacteriologically cured. Thus, the combination of IM benzathine and procaine penicillin not only is safe and effective but eliminates compliance concerns.
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PMID:Rapid symptomatic relief of streptococcal pharyngitis in children. 379 63

Tiazofurin is a novel C-nucleoside with significant antitumor activity in murine tumor models. In a phase I clinical trial, patients received tiazofurin by bolus iv infusion daily for 5 days. Six doses ranging from 550 to 4100 mg/m2/day were evaluated. Thirty-one treatment courses were initiated in 21 patients. Tiazofurin induced multiple, transient toxic effects at all but the lowest dose level, and treatment interruption was a common result. Nine of 28 treatment courses initiated at doses greater than or equal to 1100 mg/m2/day were interrupted at less than 5 days; only five of eight courses initiated at 1100 mg/m2/day were completed. Symptoms leading to treatment interruption included headache, nausea and emesis, and lethargy and malaise. Other significant, transient toxic effects included skeletal muscle injury manifest as pain, weakness, or serum biochemical abnormalities; mucocutaneous effects; and mental or mood changes. One case each of transient pericarditis and fatal cardiomyopathy occurred at the highest dose. Myelosuppression was observed but was transient and not dose limiting. In addition to leukopenia and thrombocytopenia, unexpected declines in serum hemoglobin were observed, although these were of uncertain significance. Tiazofurin induced significant increases in uric acid production which could be reversed with coadministration of allopurinol. Pharmacokinetic analysis revealed tiazofurin plasma elimination to be at least biphasic, with a beta-half-time of 4.2 hours; most of an injected dose could be recovered from the urine as unaltered compound within 24 hours. From this study we conclude that an appropriate dose for phase II trials with this schedule is less than or equal to 1000 mg/m2/day. The schedule may be a difficult one for clinical evaluation of antitumor activity, however, because of the possibility of frequent treatment interruption due to multiple systemic toxic effects.
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PMID:Phase I trial of tiazofurin administered by i.v. bolus daily for 5 days, with pharmacokinetic evaluation. 380 11

Primary gastric impaction developed in a pony as a result of the ingestion of persimmon seeds and mesquite beans. Clinical signs included mild abdominal pain, prolonged recumbency, anorexia, and lethargy. When medical therapy was unsuccessful, an exploratory laparotomy was performed. Previously, gastric impaction has been associated with signs of severe abdominal pain. Gastric impaction should be considered in cases of abdominal crisis of long duration and mild pain.
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PMID:Primary gastric impaction in a pony. 405 77

During 1980 and 1981, we compared antibiotic regimens in 108 adult patients with early Lyme disease. Erythema chronicum migrans and its associated symptoms resolved faster in penicillin- or tetracycline-treated patients than in those given erythromycin (mean duration, 5.4 and 5.7 versus 9.2 days, F = 3.38, p less than 0.05). None of 39 patients given tetracycline developed major late complications (meningoencephalitis, myocarditis, or recurrent attacks of arthritis) compared with 3 of 40 penicillin-treated patients and 4 of 29 given erythromycin (chi square with 2 degrees of freedom = 5.33, p = 0.07). In 1982, all 49 adult patients were given tetracycline; again, none of them developed major complications. However, with all three antibiotic agents nearly half of the patients had minor late symptoms such as headache, musculoskeletal pain, and lethargy. These complications correlated significantly with the initial severity of illness. For patients with early Lyme disease, tetracycline appears to be the most effective drug, then penicillin, and finally erythromycin.
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PMID:Treatment of the early manifestations of Lyme disease. 640 78

Thalicarpine, a plant alkaloid of novel structure, was evaluated in a phase II clinical trial. Fourteen previously treated patients with advanced malignant disease were given thalicarpine at a dose of 1100 mg/m2 weekly as a constant 2-hour iv infusion. Common toxic effects included nausea, ECG changes, arm pain, and lethargy; less frequent effects included vomiting, tachycardia, hypotension, pain distant from infusion site, urticaria, chills, diarrhea, and mydriasis. There was no hematologic, hepatic, or renal toxicity. There were no complete or partial objective responses. Although the drug's true response rate in any given tumor type cannot be determined, its absence of activity in man, to date, and the recent closing of its IND, make further clinical investigation with thalicarpine unlikely.
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PMID:An abbreviated phase II trial of thalicarpine. 645 Dec 89

Hospital records were reviewed of almost 1,000 infants and children with intussusception during a 25 year period. Among the approximately 850 who had barium enemas, six had colonic perforations during the attempted hydrostatic barium enema reduction of the intussusception. All occurred in patients 6 months old or less. Most had preceding viral illness, four had pain, all vomited, five had rectal bleeding, and only one had a palpable mass. All were pale, dehydrated, lethargic, and had intermittent mottling of the skin and complete bowel obstruction. All had been ill for over 36 hr. The perforations occurred through areas of necrotic ischemic colon. All infants required a right hemicolectomy. These babies seem to fit a pattern in which they are younger and sicker longer than the average patient with intussusception and have complete bowel obstruction. These facts are a warning that such infants are at increased risk for a barium enema bowel perforation.
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PMID:Perforation of the intussuscepted colon. 697 81


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