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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1982 and 1987 27 Nissen's fundoplications were carried out in our institution. Postoperatively 7 infants showed a typical dumping syndrome. The symptoms were irritability, pallor, sweating, tachycardia, lethargy, diarrhoea and vomiting. In all cases an absolute refusal of feeding was observed. The diagnosis was confirmed by a typical early postprandial hyperglycaemia with hyperinsulinaemia leading to a reactive hypoglycaemia. Additionally, we were able to demonstrate an increased HbA1c as an expression of recurrent hyperglycaemias in 3 infants. In 6 infants the dumping syndrome was of short duration and the symptoms disappeared after application of a so-called dumping diet. In this diet the easily resorbable carbohydrates are replaced by uncooked starch. But in one case we were forced to use continuous enteral nutrition because of persistence of the symptoms 1 year after the Nissen fundoplication. Complete refusal of feeding is an early symptom of the dumping syndrome. If this symptom is observed after a Nissen's fundoplication, a dumping syndrome must be excluded.
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PMID:[Diagnosis and therapy of dumping syndrome following Nissen fundoplication with reference to pathogenetic aspects]. 314 86

The authors present the case report of a child with abdominal epilepsy who had suffered from abdominal pain for several months under the label of psychogenic pain. The important historical clues were pallor and cold sweating during the paroxysm, followed by lethargy and prolonged sleep. An abnormal electroencephalogram and a remarkable response to anticovulsants confirmed the diagnosis. This condition must be considered in a child with undiagnosed recurrent abdominal pain.
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PMID:Abdominal epilepsy misdiagnosed as psychogenic pain. 318 70

Canine haemangiosarcoma was studied retrospectively in 31 cases recorded among 2,871 dogs presented for necropsy (1.08%). The German Shepherd breed was more frequently represented than other breeds. Affected dogs were older than 5 years (mean 9.1 years). Nineteen were males. Presenting signs often included episodic lethargy and weakness, with depression, anorexia and mucosal pallor. Spleen and lungs were the most frequently affected sites. Haematological findings in 9 dogs with splenic or hepatic haemangiosarcoma included a mild to moderate normochromic anaemia, neutrophilia, thrombocytopaenia, poikilocytosis and increased target cells. Acanthocytes occurred in 90% of cases, schizocytes in 80% and keratocytes and metarubyricytes in 70%. Fibrin split products were increased in 2 of the 3 cases in which they were measured. The changes in erythrocyte morphology are considered to be useful diagnostic features of canine haemangiosarcoma.
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PMID:Clinical and haematological features of haemangiosarcoma in dogs. 403 24

Two cases of infantile dumping syndrome which developed following Nissen fundoplication for gastroesophageal reflux are described. Both infants were fed postoperatively via a gastrostomy and showed the typical clinical picture of dumping with failure to thrive, intermittent diarrhea, lethargy and pallor postprandially. Several glucose tolerance tests were highly pathological with marked hyperglycemia immediately after a gastrostomy meal followed by hypoglycemia two hours later. In one case HbA1c was significantly elevated which is thought to be an expression of recurrent hyperglycemia. In both infants the first and most impressive clinical sign was absolute refusal or oral feeds. Normal oral food intake was slowly re-established after normalization of blood glucose homeostasis.
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PMID:Dumping syndrome following Nissen's fundoplication: a cause for refusal to feed. 642 40

A 54-year-old woman with short bowel syndrome was supported with home parenteral nutrition. Six months after receiving 2200 kcal/day of balanced home parenteral nutrition without biotin, she developed biotin deficiency with complete hair loss, eczematous dermatitis, waxy pallor, lethargy, and hypersthesias . Blood and urine samples were collected prior to treatment. Serum zinc was 64 micrograms/dl (nl 50-150 micrograms/dl), and the triene/tetraene ratio was 0.068 (nl 0.4), thereby ruling out zinc and essential fatty acid deficiencies. Serum biotin was 332 pg/ml (nl 520 +/- 220 pg/ml), and urine biotin was 5.22 ng/mg of creatinine (nl 4.3-95 with a mean of 30.2 ng/mg creatinine). The same parenteral nutrition regimen was contained and oral biotin was administered (10 mg/day). After 3 wk, serum and urine biotin levels were 650 pg/ml and 35.6 ng/mg creatinine, respectively. New hair growth was evident and all of her other symptoms resolved. Intravenous biotin was then provided (5 mg/day) for a month after which serum and urine biotin levels were 1316 pg/ml and 178 ng/mg creatine, respectively. The patient has been subsequently maintained on an intravenous multivitamin product containing 60 micrograms biotin per daily dose and remains free of signs and symptoms of biotin deficiency.
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PMID:Biotin deficiency in a patient with short bowel syndrome during home parenteral nutrition. 642 70

A 24-hour-old male infant was referred to the Eastern Maine Medical Center (EMMC) because of pallor, lethargy, and abdominal distention. Diagnostic abdominal paracentesis revealed free blood. At surgery hemisplenectomy removed the damaged part of the spleen followed by complete recovery of the infant. A liver-spleen scan, performed before discharge, revealed normal uptake in the remaining portion of the spleen.
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PMID:Splenic hemorrhage in a neonate of a mother on anticonvulsant therapy. 650 35

Nine piglets, 2-5 months old and weighing 12-15 kg were infected percutaneously with 5000 to 6000 cercariae of Schistosoma japonicum. Three similar piglets which were not infected served as controls. Infected animals were necropsied at 5, 10, 30, 40, 59, 90, 120, 150 and 180 days post-infection (PI) and the controls at 5, 60 and 180 days PI. The prepatent period varied from 27 to 33 days after infection. Clinical signs observed, coincident with egg production, were loss of appetite, lethargy, pallor of mucous membranes, diarrhea, progressive emaciation and dehydration. One piglet was moribund when killed for necropsy at 40 days and another piglet died 59 days PI. Pathological changes induced by S. japonicum included erythematous papules on the site of inoculation, petechial hemorrhages in the lungs, catarrhal to hemorrhagic enteritis, bluish-gray discoloration of the liver, and egg granulomas in the liver, lungs, spleen, intestines, pancreas and mesenteric lymph nodes. Endophlebitis with intimal hyperplasia was occasionally observed in veins harboring adult schistosomes.
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PMID:Clinical and pathologic features of experimental Schistosoma japonicum infection in pigs. 654 61

A 10-year-old Tennessee Walker gelding, with a history of progressive weight loss, intermittent colic and lethargy, had a slight fever, tachycardia, tachypnea, pallor, ascites and marked ventral edema. Blood analyses revealed anemia, leukocytosis, neutrophilia with a left shift, lymphopenia, monocytosis, hypoproteinemia and a slightly increased SDH level. Abdominocentesis produced red-orange fluid with many RBC and an increased fibrinogen content. Rectal palpation revealed a large mass in the left caudal abdominal quadrant. The animal died shortly after resection of the mass. The histopathologic diagnosis was lymphosarcoma, involving the spleen, liver and lung.
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PMID:Splenic lymphosarcoma in a horse. 654 5

Acute lymphoblastic leukemia was diagnosed in 30 dogs. Diagnosis was confirmed by examination of blood smears and bone marrow aspirates. The most common clinical signs were lethargy, anorexia, splenomegaly, and pallor of mucous membranes. Three dogs were not treated, 3 dogs were treated with prednisone, and 3 dogs were treated with cyclophosphamide; survival times in these 9 dogs ranged from 1 to 60 days. Twenty-one dogs were treated with vincristine and prednisone; of these, complete remission was achieved in 4 dogs and partial remission was achieved in 4 dogs, with survival times ranging from 8 to 241 days.
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PMID:Acute lymphoblastic leukemia in the dog: a review of 30 cases. 657 48

Aeromonas hydrophila caused severe disease in a group of Xenopus laevis within 3 weeks of receipt. The primary clinical signs were marked pallor of the skin, petechiation, lethargy, anorexia, and edema. The duration of the outbreak was approximately 45 days during which time 21 frogs became sick and 18 died, despite tetracycline therapy. Pale skin, subcutaneous edema and hemorrhages, ascites, and pale livers were seen at necropsy. Aeromonas hydrophila was isolated from skin, and the same organism was isolated in pure culture from skeletal muscle. Tetracycline treatment via stomach tube was effective if given early in the course of the disease. The outbreak was controlled by removing sick frogs, feeding twice per week, changing the water several hours after feeding, and maintaining the frogs where the ambient temperature was 22 degrees C or lower. The pallor of the skin and general malaise were produced experimentally by crowding normal frogs, changing the water infrequently, and increasing ambient temperatures. Mild disease was reproduced experimentally by subcutaneous injection of Aeromonas hydrophila into apparently healthy frogs.
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PMID:Aeromonas hydrophila infection in Xenopus laevis. 726 11


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