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)

Thyrotoxicosis may present with a hyperkinetic clinical picture typically associated with Graves' or Plummer's disease, or in an apathetic form characterized by lethargy, weakness, and withdrawal. Both the hyperkinetic and apathetic forms of thyrotoxicosis may be associated with or masked by predominantly extrathyroidal manifestations, occasionally referable primarily to the abdomen. We present two cases of apathetic thyrotoxicosis that suggested the need for urgent surgical intervention, and review the literature on apathetic thyrotoxicosis as an abdominal emergency, as well as laboratory studies and possible etiology.
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PMID:Apathetic thyrotoxicosis presenting as an abdominal emergency: a diagnostic pitfall. 705 58

Two brothers had intermittent episodes of muscle weakness, lethargy, hyperammonemia, rhabdomyolysis, and elevated activities of creatine phosphokinase (CPK), lactic dehydrogenase, and SGOT in serum associated with low muscle carnitine but normal serum carnitine concentrations. These siblings represent a "mixed" form of carnitine deficiency with the elements of both systemic and myopathic carnitine deficiency. The older sibling died suddenly after a 24-hour fast. The younger boy has received carnitine for three years. During this period, serum CPK activity has remained elevated and increased further during illnesses, but no clinical symptoms of encephalopathy or myopathy have appeared.
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PMID:Encephalopathy and fatal myopathy in two siblings. Their association with partial deficiency of muscle carnitine. 709 Oct 87

A prospective study of the emotional reaction to interval sterilization was conducted by means of interviews 1 week prior to sterilization and 7 months postoperative with 155 Buddhist Thai women aged 35 years or under, living in Bangkok, and undergoing interval laparoscopic sterilizations for socioeconomic indications. The mean age of subjects was 27.8 years, with a range of 19-35, mean duration of marriage was 8.0 years, and mean number of children was 2.8. 56.1% of the women were housewives, 77.0% had a low educational level, and 100% were of lower socioeconomic status. 65 subjects reported psychophysiologic and emotional symptoms prior to operation, 51 continued to complain of the symptoms 6 months later, and 10 women developed new symptoms postoperatively. In the preoperative interviews, 26 women complained of irritability, 25 of headache and backache, 10 of weakness and lethargy, 11 of giddiness or fainting, 5 each of palpitation and breathing difficulty, 8 of insomnia, 4 each of anorexia and gastrointestinal upset, and 3 of other conditions. Of the 10 women developing symptoms postoperatively, 6 complained of irritability, 5 of headache, 3 of insomnia, and 1 each of weakness and lethargy, giddiness or fainting, and anorexia. Irritability and headache, which accounted for most of the symptoms, were mostly mild and few required medication. Further psychiatric investigation into personal backgrounds of subjects with psychophysiologic or emotional symptoms revealed that practically all had concurrent problems with their marriages, children, finances, or relatives, with marital problems the most frequent. 35% of subjects reported postoperative menstrual disturbances, but 72% of the sample had been on oral contraceptives or IUDs, which can influence menstrual patterns. 8 and 10 women respectively reported increased sexual drive and sexual satisfaction, 6 and 3 reported decreased drive and satisfaction, and 141 and 142 reported no change in desire or satisfaction. 5 reported postoperative dyspareunia. 145 husbands and 152 wives stated they were satisfied with the operation.
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PMID:Emotional reaction to female sterilization: a prospective study. 710 4

50% of hospitalized medical emergency cases are cardiological and respiratory emergencies. Myocardial infarction, cardiogenic shock, ventricular arrhythmias and left ventricular failure often cause sudden death occurring within 1 or 2 hours. Therefore immediate management is necessary already in the prehospital phase of cardiovascular events. This does also apply for acute respiratory failure due to obstructive ventilatory disorders. Acute exacerbations of chronic obstructive pulmonary disease frequently are masked and may be misinterpreted as encephalopathy or alcohol withdrawal syndrome. Sedation may be dangerous. Also neuroglucopenic syndrome and hyperosmolar coma are occasionally interpreted wrongly. Thyrotoxic crisis, adrenal crisis and hypercalcemia are characterized by lethargy, mental disturbance and weakness, by dehydration, myopathy, nausea, constipation, diarrhea or tenesms or arrhythmias. In this situation of varied symptoms the most important action is to think of endocrine emergency, which may have multiple etiologies.
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PMID:[Cardiovascular emergencies--endocrine and metabolic crises. Practical hints for the physician in emergency service]. 711 36

For the first time in American Samoa an outbreak of eosinophilic radiculomyeloencephalitis was related to eating giant African snails (Achatina fulica) infected with Angiostrongylus cantonensis. Among 24 Korean fisherman sharing the same infective meal, 16 who ate raw or partially cooked snails became ill; five who ate boiled snails and three who ate none remained well. The ensuing illnesses began within 1-6 days, persisted up to 10 weeks, and were characterized by both peripheral blood and spinal fluid eosinophilia, severe pains, weakness and hyporeflexia of the legs, and dysfunction of the bladder and bowels. Eight patients also had transient hypertension and/or lethargy, and three became comatose. One man died 17 days after eating the infected snails, and maturing larvae of A. cantonensis were found in his spinal cord. Enzyme-linked immunosorbent assay titers for antigens of A. cantonensis were elevated to 1:64 or greater (mean 1:128) in all 10 patients tested. Treatment with thiabendazole had no appreciable effect on the clinical course of the illness.
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PMID:Eosinophilic radiculomyeloencephalitis: an angiostrongyliasis outbreak in American Samoa related to ingestion of Achatina fulica snails. 714 98

Maytansine, a new ansa macrolide antitumor antibiotic, was administered to a total of 107 patients in a Phase I-II study. Dose-limiting toxic reactions which occurred at 0.75-1.0 mg/M2 in both Phase I and II were neurologic and consisted primarily of lethargy/weakness (a debilitation syndrome) and paresthesias. Gastrointestinal and neurologic toxic reactions increased in frequency and severity as a function of dose. Myelosuppression, while infrequent, occurred only in previously treated patients. Changes in liver function tests were subclinical. Two partial remissions were observed at a dose-level of 0.5 mg/M2 in Phase I:1 patient with squamous cell carcinoma of the lung responded for five weeks, while the other patient with adenocarcinoma of the lung responded for four weeks. One partial remission, lasting 14 weeks was seen in Phase II in a patient with malignant melanoma treated at dose-level of 1.0 mg/M2. All responses were in heavily pretreated patients. pairs of small bowel biopsy specimen used to define the mitotic index demonstrated peak mitotic arrest at 24 hours in contrast to vinca alkaloids which appear to have a peak mitotic arrest at 12-24 hours.
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PMID:A phase I-II study of maytansine utilizing a weekly schedule. 721 95

To study the biologic behavior and natural history of this rare but challenging tumor faced by oncologists, a clinicopathologic study of 42 patients with histologically proven adrenal cortical carcinoma from Roswell Park Memorial Institute (1929--1977) was done. These constituted .04% of all cancer cases and 0.2% of all autopsy cases. Age range was 3--74 years with median of 53 years; female to male ratio was 1.5 to 1. Clinical manifestations were: abdominal mass (36%), metastatic disease (30%), hormonal excess (17%) and weakness with lethargy (17%). Nine of ten functioning tumors were seen in female patients. Tumors arose in left adrenal in 26 patients, right adrenal in 12, and in four the site could not be determined because of bilateral presence of cancer. Median duration of symptoms was six months. At diagnosis, 52% had distant metastases, 41% had locally advanced tumor and 7% had tumor confined to adrenal. Sixteen patients underwent "curative" resection. Tumor diameter ranged from 1--30 cm with median of 10 cm. Of 28 patients who received different chemotherapeutic regimens, three (11%) had objective response; four of ten patients had objective response to radiation therapy. Overall median and five-year survival rates were 14 months and 24%. Prolonged survival (P less than .05) was noted in women, patients who had "curative" resection, a disease-free interval of more than 12 months, and tumor size greater than 10 cm diameter. Patients with functional tumors had longer median survival than those with non-functional ones (28 vs. 12), but P value was greater than .05. A second primary cancer was noted in 22.4% of cases, breast and lymphoma being the most common. At autopsy in 31 patients, the most common metastatic sites were retroperitoneal lymph nodes 68%, lung 71%, liver 42%, and bone 26%. To improve survival, an aggressive surgical approach is recommended to extirpate the tumor with involved organs and retroperitoneal lymph nodes. Adrenal carcinoma should be suspected in patients with metastatic cancer with an occult primary.
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PMID:Natural history of adrenal cortical carcinoma: a clinicopathologic study of 42 patients. 722 9

Dimethyl disulphide, a breakdown product of the amino acid S-methylcysteine sulphoxide present in high concentrations in the Brassica family, was fed to a group of adult fowls and the effects were studied haematologically and ultrastructurally. By the seventh day of the experiment Heinz bodies had appeared in most of the red blood cells and between the eighth and 12th days the birds showed leg weakness, feather ruffling and lethargy. The Heinz bodies were divided into two different morphological forms and many vacuoles were also present in these cells. The haemoglobin levels and packed cell volumes were significantly lower that those of the controls and in turn the mean cell haemoglobin and especially the mean cell haemoglobin concentration values were reduced.
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PMID:Production of Heinz body anaemia in the domestic fowl after ingestion of dimethyl disulphide: a haematological and ultrastructural study. 725 13

Hyperparathyroid crisis is a rare disease but should be suspected in acutely ill patients complaining of weakness, lethargy, nausea, vomiting, confusion and abdominal pain. Despite the variety of clinical manifestations, the syndrome forms a distinctive pattern which, in the presence of a serum calcium level greater than 16 mg/100 ml, should be recognized. The most difficult problem in diagnosis is the differentiation of hyperparathyroid crisis from ectopic parathyroid hormone-producing tumors. The disease is an endocrine emergency which requires prompt surgery after rapid correction of dehydration and hypercalcemia. The best results are achieved by removing offending parathyroid tissue within 72 hours after the onset of symptoms.
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PMID:Primary hyperparathyroidism: hyperparathyroid crisis. 730 6

Nineteen cases of primary autoimmune haemolytic anaemia are reported in the dog. The clinical features included pale mucous membranes, weakness, lethargy and collapse. The intravascular haemolytic type of the disease was seen in nine cases and was characterised by evidence of haemolysis (eg, marked bilirubinaemia). The other 10 cases were classed as the extravascular destructive type of autoimmune haemolytic anaemia. The presence of autoantibodies (of the IgG class) and complement (C3) on the red blood cells from affected patients was demonstrated by a commercial Coombs' (antiglobulin) test which, although it has disadvantages, is satisfactory providing it is interpreted in association with the clinical, haematological and biochemical features. Treatment of these 19 dogs was with prednisolone and was successful in most cases.
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PMID:Primary autoimmune haemolytic anaemia in the dog. 732 59


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