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)

In the course of a prospective immunoepidemiological study of homosexual men in Sydney, seroconversion to the AIDS-associated retrovirus (ARV) was observed in 12 subjects. Review of the clinical files defined an acute infectious-mononucleosis-like illness in 11 subjects. The illness was of sudden onset, lasted from 3 to 14 days, and was associated with fevers, sweats, malaise, lethargy, anorexia, nausea, myalgia, arthralgia, headaches, sore throat, diarrhoea, generalised lymphadenopathy, a macular erythematous truncal eruption, and thrombocytopenia. In 1 subject an incubation period of 6 days after presumed exposure to ARV was determined and in 3 subjects seroconversion took place 19, 32, and 56 days after onset. Comparison of T-cell subsets before and after the acute illness showed inversion of T4:T8 ratio in 8 subjects, due to increased numbers of circulating T8+ cells. These findings support the notion of an acute clinical, immunological, and serological response to infection with ARV which should be considered in the differential diagnosis of mononucleosis-like syndromes in groups at high risk for the development of AIDS.
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PMID:Acute AIDS retrovirus infection. Definition of a clinical illness associated with seroconversion. 285 99

The clinical and serologic features and immune status of 39 homosexual men who had seroconversion to human immunodeficiency virus positivity were compared with 26 homosexual men who remained seronegative during a six-month period. An acute clinical illness occurred in 92.3% of seroconverted subjects and 40% of controls. The duration of illness was significantly greater in the seroconverters than the controls (10 + 4.4 days). A general practitioner was consulted by 87.2% of the seroconverters because of the illness, including 12.8% who were admitted to hospital, compared with 20% of controls. The most frequently reported symptoms in the seroconversion group were fever (76.9%); lethargy and malaise (66.7%); anorexia, sore throat, and myalgias (56.4% each); headaches and arthralgias (48.7% each); weight loss (46.2%); swollen glands (43.5%); retro-orbital pain (38.5%); and dehydration and nausea (30.8% each). Lymphadenopathy developed in 75% of seroconverters compared with 4% of controls. Changes in T-cell subsets were not found in controls, but the number of T4+ cells and the T4+/T8+ ratio decreased significantly in seroconverters.
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PMID:Characterization of the acute clinical illness associated with human immunodeficiency virus infection. 325 8

Sarcoidosis is a multisystem disease of unknown etiology that is rarely diagnosed in children. When mass screening is performed, the incidence of the disease in children approaches that of adults with similar demographics. Most childhood cases occur around ages 9 to 15 years, with small clusters of cases occurring in children under age 4 years. The disease in these two age groups has very different clinical features. Children under age 4 have a clinical triad of rash, arthritis, and uveitis. The classic syndrome in older children involves primarily lungs, lymph nodes, and eyes. In older children, constitutional symptoms (fatigue, lethargy, malaise) and pulmonary symptoms (cough, dyspnea) predominate. Mortality in childhood sarcoidosis is about 5%, with long-term sequelae in 10% to 20%. Early recognition may prevent complications such as blindness, pulmonary insufficiency, and renal impairment.
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PMID:Sarcoidosis in children. 332 85

A 45-year-old Italian woman, who was admitted to the Royal Free Hospital in London, England, with a 14-day history of general malaise, lethargy, epigastric pain after meals, and night sweats, had had an IUD inserted 13 years earlier which had not been changed. The patient was pyrexial on examination; she had a temperature of 38 degrees Centigrade but no jaundice or enlarged lymph nodes. There was mild epigastric tenderness, and a tender indurated rectal stricture involving the posterior fornix of the vagina was palpable on pelvic examination. The rectal stricture was confirmed on sigmoidoscopy. The biopsy revealed a chronic inflammatory cell infiltrate with lymphocytes, extending from the submucosa through to the muscularis mucosae. A preoperative barium enema showed a long irregular rectal stricture. A large mass of inflammatory tissue was found adherent to the uterus, rectum, fallopian tubes, and ovaries at laparotomy. Bilateral retrograde ureterograms showed complete obstructions of the left ureter at 5 cm and a long irregular stricture was seen at the same level on the right. The histological examination revealed actinomycosis of the uterus, fallopian tubes, and ovaries. 12 weeks postoperatively the patient was well; sigmoidoscopy to 25 cm showed complete resolution of the rectal stricture. The antibiotic treatment was stopped. The most likely source of this patient's actinomycosis was the IUD for the relationship between the two is well established. In this patient a prolonged course of antibiotics proved effective in treating the infection.
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PMID:Rectal stricture due to actinomycosis. 373 Jul 97

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

A 42-year-old man was admitted because of episodic attack of general malaise. He was lethargic and had a severe lactic acidosis and hypoglycemia. Blood chemistry and endocrinological data were normal. Glucose administration led to an improvement in the hypoglycemia but not the lactic acidosis. At autopsy, there was a massive infiltration of leukemic cells in both kidneys and in liver. Phosphoenolpyruvate carboxykinase, pyruvate carboxylase and glucose-6-phosphatase activities in patient's liver were much the same as in the control liver, but fructose-1, 6-diphosphatase activity was slightly reduced. Since circulatory failure was absent, type B lactic acidosis has to be considered. Since hypoglycemia was associated with acidosis, the severe lactic acidosis in our patient may have been due to an overproduction of lactic acid as well as to an impaired hepatic gluconeogenesis in the presence of leukemic cells.
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PMID:Lactic acidosis and hypoglycemia associated with acute leukemia. 386 4

Nineteen patients with advanced, previously treated breast cancer received treatment with vincristine 2 mg i.v., mitomycin-C 6 mg/m2 and mitoxantrone (Novantrone; dihydroxyanthracenedione) 12 mg/m2 i.v. every three weeks. Thirteen patients are evaluable for response and toxicity. Partial remission was seen in six patients, with soft tissue, bone and visceral metastases and static disease in a further four patients. Median duration of response has not yet been reached (8+ months). Toxicity was mild and predictable, with no patient experiencing severe nausea and vomiting, and only four of the patients requiring a wig for alopecia. Malaise and lethargy were common in those patients receiving more than three courses, and an increase in the mean corpuscular volume (MCV) together with a fall in haemoglobin were seen in patients receiving multiple courses of treatment. The study suggests that this combination is active, and may prove useful with other agents in the treatment of breast cancer.
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PMID:Phase II study of vincristine, mitomycin-C and mitoxantrone in advanced breast cancer: a preliminary report of response and toxicity. 392 13

A Phase II study of interferon alfa-2a was conducted in 64 patients with multiple myeloma (42 IgG, 16 IgA, 5 Bence-Jones type, and 1 IgD) in a multi-institutional cooperative trial. Partial remission was obtained in 10 (21.3%) of 47 evaluable patients, and minor responses in 5 (10.6%) of 47. Remission was reached at 22 to 89 days (median, 29 days) after the initiation of interferon alfa-2a and lasted 4 to 55 weeks (median, 8 weeks). Side effects were noted in more than two-thirds of patients, and included fever (58%), malaise (20%), anorexia (52%), nausea-vomiting (26%), lethargy (2%), and myelosuppression (56%). They were all reversible on discontinuation of interferon alfa-2a. Antibody to interferon alfa-2a was detected in 1 of 20 patients tested during the course of treatment. Thus, interferon alfa-2a was effective in multiple myeloma, producing unequivocal response in 21.3% of patients without unacceptable side effects.
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PMID:Treatment of multiple myeloma with recombinant interferon alfa-2a. 394 39

A phase II study of recombinant human leukocyte A interferon was conducted in 64 patients with multiple myeloma in a multi-institutional cooperative trial. Partial remission was achieved in ten (21.3%) of 47 evaluable patients and minor response was observed in five (10.6%). Side effects were noted in more than two-thirds of the patients. They included fever (58%), malaise (20%), anorexia (52%), nausea and vomiting (26%), lethargy (2%), and myelosuppression (56%). An antibody to recombinant human leukocyte A interferon was detected in one of 20 patients.
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PMID:Treatment of multiple myeloma with recombinant human leukocyte A interferon. 407 17

Sarcoidosis is a multisystem disease of unknown etiology characterized by non-caseating granulomatous inflammation of various organs, but most frequently involving the lungs of young adults. Sarcoidosis is rare in the pediatric age group, however numerous extensive reviews have been published. The most commonly seen initial manifestations in childhood are non-specific constitutional symptoms such as lethargy, fatigue and malaise, followed by cough, dyspnea, fever, weight loss, and lymphadenopathy in order of decreasing frequency. The diagnosis is one of exclusion and is established when clinical and radiological findings are supported by histological evidence of widespread non-caseating epithelial cell granulomas in more than one organ, or a positive Kveim test. Laryngeal involvement is usually part of the systemic disease, but isolated laryngeal sarcoidosis has been reported in adults. We report here a case of isolated laryngeal sarcoidosis in a 13 year old girl. The differential diagnosis and management are discussed.
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PMID:Sarcoidosis of the larynx in a child. 407 58


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