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)

Migraine is an episodic pain disorder whose pathophysiology is related to deficiency of serotonin signaling and abnormal function of the P/Q-type calcium channel, CACNA1A. Because the relationship of the CACNA1A channel to serotonin signaling is unknown and potentially of therapeutic interest we have used genetic analysis of the Caenorhabditis elegans ortholog of this calcium channel, UNC-2, to help identify candidate downstream effectors of the human channel. By genetic dissection of the lethargic mutant phenotype of unc-2, we have established an epistasis pathway showing that UNC-2 function antagonizes a transforming growth factor (TGF)-beta pathway influencing movement rate. This same UNC-2/TGF-beta pathway is required for accumulation of normal serotonin levels and stress-induced modulation of tryptophan hydroxylase (tph) expression in the serotonergic chemosensory ADF neurons, but not the NSM neurons. We also show that transgenic expression of the migraine-associated Ca2+ channel, CACNA1A, in unc-2 animals can functionally substitute for UNC-2 in stress-activated regulation of tph expression. The demonstration that these evolutionarily related channels share a conserved ability to modulate tph expression through their effects on TGF-beta signaling provides the first specific example of how CACNA1A function may influence levels of the critical migraine neurotransmitter serotonin.
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PMID:The voltage-gated calcium channel UNC-2 is involved in stress-mediated regulation of tryptophan hydroxylase. 1467 54

A 12-year-old boy was admitted with electrical burn and loss of consciousness. On physical examination his general condition was poor. Extensive burn areas, second and third degree, were present on his face, scalp, bilateral auricles, right cervical region, shoulders, right axilla, upper region of the thorax, and proximal region of the upper extremities. The total burned surface area was about 25%. Pupils were isocoric, but response to light was bilateral poor. He was stuporous and responsive only to pain. Deep tendon reflexes were exaggerated and plantar responses were bilateral extensor. Bilateral decorticate rigidity was noted. Computerized tomography of brain revealed brain edema and right thalamic hemorrhage. Magnetic resonance imaging of brain, examined 25 days after admission, revealed right thalamic hemorrhage and mild right subdural effusion. He was discharged form hospital 40 days after admission. However, spastic quadriplegia and severe mental retardation remained as sequela. On the 4th month of follow-up, no improvement was noted in his neurological examination. On the 9th month of follow-up, his clinical condition was better, but bilateral electric cataract was diagnosed. Both eyes were operated on and intraocular lenses were implanted with good results. Now he is 16th month of follow-up: neurological examination revealed only mild hemiparesis on the left side and mild articulation disorder. His school performance was moderate and intelligence quotient was 71. Magnetic resonance imaging of brain showed markedly improvement of the hemorrhage. To our best knowledge thalamic hemorrhage resulting from high-voltage electrical injury has not previously been reported in the literature.
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PMID:Right thalamic hemorrhage resulting from high-voltage electrical injury: a case report. 1503 34

We present a rare case of necrotizing fasciitis in an 5-year-old infant with preexisting varicella infection. Initially, the patient showed acute pain and swelling of the left thorax with high inflammatory parameters and varicella-specific skin affections. MRT presented diffuse soft tissue swelling of the left chest consistent with necrotizing fasciitis. After aggressive surgical debridement of necrotic tissue and extirpation of axillary lymph nodes, the clinical course improved under appropriate parenteral antimicrobial therapy using penicillin and clindamycin. In conclusion, necrotizing fasciitis should be suspected in any child with a history of varicella infection and increasing complaints of pain and swelling in an extremity or other body area associated with increasing fever, erythema, lethargy, and irritability. Shock, multiorgan failure, and death will ensue if the diagnosis is not promptly recognized.
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PMID:[Varicella associated necrotizing fasciitis in a child]. 1505 73

A newborn of a SSRI-treated mother presented with lethargy, no crying, and no response to tactile stimulation. EEG findings were abnormal. Laboratory and clinical evaluations were normal. He recovered at the age of two weeks. Serotonin is a neurotransmitter that has an important roll in pain modulation during fetal neurodevelopment. We suspect these symptoms are attributed to the intrauterine exposure to paroxetine, through modulation of pain signals.
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PMID:Paroxetine use throughout pregnancy: does it pose any risk to the neonate? 1508 45

Hydrogen peroxide is an oxidising agent that is used in a number of household products, including general-purpose disinfectants, chlorine-free bleaches, fabric stain removers, contact lens disinfectants and hair dyes, and it is a component of some tooth whitening products. In industry, the principal use of hydrogen peroxide is as a bleaching agent in the manufacture of paper and pulp. Hydrogen peroxide has been employed medicinally for wound irrigation and for the sterilisation of ophthalmic and endoscopic instruments. Hydrogen peroxide causes toxicity via three main mechanisms: corrosive damage, oxygen gas formation and lipid peroxidation. Concentrated hydrogen peroxide is caustic and exposure may result in local tissue damage. Ingestion of concentrated (>35%) hydrogen peroxide can also result in the generation of substantial volumes of oxygen. Where the amount of oxygen evolved exceeds its maximum solubility in blood, venous or arterial gas embolism may occur. The mechanism of CNS damage is thought to be arterial gas embolisation with subsequent brain infarction. Rapid generation of oxygen in closed body cavities can also cause mechanical distension and there is potential for the rupture of the hollow viscus secondary to oxygen liberation. In addition, intravascular foaming following absorption can seriously impede right ventricular output and produce complete loss of cardiac output. Hydrogen peroxide can also exert a direct cytotoxic effect via lipid peroxidation. Ingestion of hydrogen peroxide may cause irritation of the gastrointestinal tract with nausea, vomiting, haematemesis and foaming at the mouth; the foam may obstruct the respiratory tract or result in pulmonary aspiration. Painful gastric distension and belching may be caused by the liberation of large volumes of oxygen in the stomach. Blistering of the mucosae and oropharyngeal burns are common following ingestion of concentrated solutions, and laryngospasm and haemorrhagic gastritis have been reported. Sinus tachycardia, lethargy, confusion, coma, convulsions, stridor, sub-epiglottic narrowing, apnoea, cyanosis and cardiorespiratory arrest may ensue within minutes of ingestion. Oxygen gas embolism may produce multiple cerebral infarctions. Although most inhalational exposures cause little more than coughing and transient dyspnoea, inhalation of highly concentrated solutions of hydrogen peroxide can cause severe irritation and inflammation of mucous membranes, with coughing and dyspnoea. Shock, coma and convulsions may ensue and pulmonary oedema may occur up to 24-72 hours post exposure. Severe toxicity has resulted from the use of hydrogen peroxide solutions to irrigate wounds within closed body cavities or under pressure as oxygen gas embolism has resulted. Inflammation, blistering and severe skin damage may follow dermal contact. Ocular exposure to 3% solutions may cause immediate stinging, irritation, lacrimation and blurred vision, but severe injury is unlikely. Exposure to more concentrated hydrogen peroxide solutions (>10%) may result in ulceration or perforation of the cornea. Gut decontamination is not indicated following ingestion, due to the rapid decomposition of hydrogen peroxide by catalase to oxygen and water. If gastric distension is painful, a gastric tube should be passed to release gas. Early aggressive airway management is critical in patients who have ingested concentrated hydrogen peroxide, as respiratory failure and arrest appear to be the proximate cause of death. Endoscopy should be considered if there is persistent vomiting, haematemesis, significant oral burns, severe abdominal pain, dysphagia or stridor. Corticosteroids in high dosage have been recommended if laryngeal and pulmonary oedema supervene, but their value is unproven. Endotracheal intubation, or rarely, tracheostomy may be required for life-threatening laryngeal oedema. Contaminated skin should be washed with copious amounts of water. Skin lesions should be treated as thermal burns; surgery may be required for deep burns. In the case of eye exposure, the affected eye(s) shod eye(s) should be irrigated immediately and thoroughly with water or 0.9% saline for at least 10-15 minutes. Instillation of a local anaesthetic may reduce discomfort and assist more thorough decontamination.
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PMID:Hydrogen peroxide poisoning. 1529 93

A 4-year-old, neutered male Chihuahua was presented with inappetance, lethargy, and a tense abdomen attributed to pain. Abdominal radiographs revealed a large cystic calculus and small urethral calculi. Urethral hydropulsion followed by cystotomy were performed successfully. Dietary management was initiated as the primary means of preventing recurrence.
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PMID:Calcium oxalate urolithiasis in the canine: surgical management and preventative strategies. 1531 94

Several studies have shown that atmospheric conditions can affect well-being or disease, and that some individuals seem to be more sensitive to weather than others. Since epidemiological data on the prevalence of weather-related health effects are lacking, two representative weather sensitivity (WS) surveys were conducted independently in Germany and Canada. The objectives of this paper are: (1) to identify the prevalence of WS in Germany and Canada, (2) to describe weather-related symptoms and the corresponding weather conditions, and (3) to compare the findings in the two countries. In Germany 1,064 citizens (age >16 years) were interviewed in January 2001, and in Canada 1,506 persons (age >18 years) were interviewed in January 1994. The results showed that 19.2% of the German population thought that weather affected their health "to a strong degree," 35.3% that weather had "some influence on their health" (sum of both = 54.5% weather sensitive), whereas the remaining 45.5% did not consider that weather had an effect on their health status. In Canada 61% of the respondents considered themselves to be sensitive to the weather. The highest prevalence of WS (high + some influence) in Germans was found in the age group older than 60 years (68%), which was almost identical in the Canadian population (69%). The highest frequencies of weather-related symptoms were reported in Germany for stormy weather (30%) and when it became colder (29%). In Canada mainly cold weather (46%), dampness (21%) and rain (20%) were considered to affect health more than other weather types. The most frequent symptoms reported in Germany were headache/migraine (61%), lethargy (47%), sleep disturbances (46%), fatigue (42%), joint pain (40%), irritation (31%), depression (27%), vertigo (26%), concentration problems (26%) and scar pain (23%). Canadian weather-sensitive persons reported colds (29%), psychological effects (28%) and painful joints, muscles or arthritis (10%). In Germany 32% of the weather-sensitive subjects reported themselves to be unable to do their regular work because of weather-related symptoms at least once in the previous year, and 22% of them several times. Co-morbidity was significantly higher in weather-sensitive subjects both in Germany and Canada. These results clearly showed the important impact of WS on public health and the economy. These findings prompted us to start studies on the causal factors of weather-related health effects.
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PMID:Prevalence of weather sensitivity in Germany and Canada. 1533 86

A seven-and-a-half-year-old dog presented with anorexia, lethargy and haematurla. A 1.8 kg abdominal mass was excised and determined to be a primary renal osteosarcoma. Haematuria was observed five months after surgery and the tumour was radiographically determined to have recurred locally. The dog was euthanased 12 days later due to refractory pain and anorexia. Although osteosarcomas are expected to develop distant metastases, this dog was euthanased due to clinical evidence of local tumour recurrence. Haematuria was an indication both of initial tumour development and later recurrence.
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PMID:Renal osteosarcoma in a dog. 1560 Feb 74

Recombinant preparations of the cytokine interferon (IFN)-alpha are increasingly used to treat a number of medical conditions, including chronic viral hepatitis and several malignancies. Although frequently effective, IFN alpha induces a variety of neuropsychiatric adverse effects, including an acute confusional state that develops rapidly after initiation of high-dose IFN alpha, a depressive syndrome that develops more slowly over weeks to months of treatment, and manic conditions most often characterised by extreme irritability and agitation, but also occasionally by euphoria. Acute IFN alpha-induced confusional states are typically characterised by disorientation, lethargy, somnolence, psychomotor retardation, difficulties with speaking and writing, parkinsonism and psychotic symptoms. Strategies for managing delirium should be employed, including treatment of contributing medical conditions, use of either typical or atypical antipsychotic agents and avoidance of medications likely to worsen mental status. Significant depressive symptoms occur in 21-58% of patients receiving IFN alpha, with symptoms typically manifesting over the first several months of treatment. The most replicated risk factor for developing depression is the presence of mood and anxiety symptoms prior to treatment. Other potential, but less frequently replicated, risk factors include a past history of major depression, being female and increasing IFN alpha dosage and treatment duration. The available data support two approaches to the pharmacological management of IFN alpha-induced depression: antidepressant pretreatment or symptomatic treatment once IFN alpha has been initiated. Pretreatment might be best reserved for patients already receiving antidepressants or for patients who endorse depression or anxiety symptoms of mild or greater severity prior to therapy. Several recent studies demonstrate that antidepressants effectively treat IFN alpha-induced depression once it has developed, allowing the vast majority of subjects to complete treatment successfully. Recent data suggest that IFN alpha-induced depression may be composed of two overlapping syndromes: a depression-specific syndrome characterised by mood, anxiety and cognitive complaints, and a neurovegetative syndrome characterised by fatigue, anorexia, pain and psychomotor slowing. Depression-specific symptoms are highly responsive to serotonergic antidepressants, whereas neurovegetative symptoms are significantly less responsive to these agents. These symptoms may be more effectively treated by agents that modulate catecholaminergic functioning, such as combined serotonin-noradrenaline (norepinephrine) antidepressants, bupropion, psychostimulants or modafinil. Additional factors to consider in selecting an antidepressant include potential drug-drug interactions and adverse effect profile. Finally, IFN alpha appears capable of inducing manic symptoms. Mania, especially when severe, is a clinical emergency. When this occurs, IFN alpha and antidepressants should be stopped, an emergency psychiatric consultation should be obtained, and treatment with a mood stabilizer should be initiated.
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PMID:Neuropsychiatric adverse effects of interferon-alpha: recognition and management. 1569 25

With the growing incidence of infertility in the modern world, artificial fertilization techniques provide new hope for many would-be parents. However, side-effects of the treatment can have a huge impact on patients and their families. This article employs Roy's adaptation model to study a patient with ovarian hyperstimulation syndrome who had undergone artificial fertilization treatment. Under careful assessment and examination, the author discovered that the patient suffered from such problems as malnutrition, fluid overload, pain and lethargy, etc. By employing skillful communication techniques and the display of empathy, the author helped to alleviate the patient's sufferings during treatment, as well as providing professional knowledge and advice. To help the patient in resolving difficulties that might have been encountered in the family, the author also exercised the idea of the family as core. The author hopes to share the knowledge that, in the care of patients with infertility, it is vital that health care professionals look after their psychological requirements as well as their physical care, in order to provide optimum care.
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PMID:[An experience nursing a patient with ovarian hyperstimulation syndrome who has undergone artificial fertilization treatment]. 1598 8


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