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)

102 children with acute gastroenteritis were thought by the admitting junior doctors to be 5% or more dehydrated. As judged by subsequent weight recovery in hospital, the main indicators of mild to moderate dehydration were decreased peripheral perfusion, deep breathing, decreased skin turgor, high urea, low pH, and a large base deficit; a history of increased thirst was just short of statistical significance. Dehydration was not indicated by a history of oliguria, by the presence of restlessness or lethargy, sunken eyes, dry mouth, or a sunken fontanelle or by the absence of tears. Clinical signs of dehydration became apparent at 3-4% rather than 5% dehydration. The degree of dehydration was overestimated by a mean of 3.2%; this caused unnecessary hospital admissions and overtreatment with intravenous fluid.
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PMID:Clinical signs of dehydration in children. 257 63

A 10-yr-old female spayed bobcat (Felis rufus) presented with a 3-day history of lethargy, anorexia, and two episodes of vomiting. An emergency field visit was scheduled to perform abdominal radiography and ultrasonography. The bobcat was assessed to be approximately 5-10% dehydrated, on the basis of decreased skin turgor and tacky mucous membranes. Free peritoneal gas, reduced abdominal serosal detail, and an abnormal-appearing right-sided intestinal segment were identified in the abdominal radiographs. However, the emergency field clinicians were not knowledgeable of these abnormalities, because the radiographs could not be processed in the field. During an initial complete abdominal ultrasound evaluation, a nondependent hyperechoic interface with reverberation artifact suggestive of intestinal or free gas and focal intestinal changes indicative of marked enteritis or peritonitis were identified. Free peritoneal fluid was not present on initial examination. In a focused abdominal sonography for trauma (FAST) scan, made after subcutaneous fluid administration, a small volume of anechoic free fluid was present in the peritoneal space. With ultrasound guidance, the fluid was aspirated and appeared grossly turbid. This fluid was subsequently confirmed as septic suppurative effusion, secondary to a foreign body-associated intestinal perforation. The use of a FAST scan is well described in human medicine, and to a limited degree in veterinary literature. This case represents a novel application of FAST scanning in an emergency field setting in a nontraumatized patient. This case report illustrates the utility of the FAST scan in yielding critical clinical information after fluid resuscitation in a zoological setting.
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PMID:FOCUSED ASSESSMENT WITH SONOGRAPHY AS AN AID FOR THE DIAGNOSIS OF GASTROINTESTINAL PERFORATION IN A BOBCAT ( FELIS RUFUS ). 2666 52