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

In order to determine the influence of hibernation depth upon the secretion and the effect of insulin, two groups of edible dormice were maintained in winter under different climatic and nutritional conditions, and their pancreatic B-cell function was tested during the spring arousal. The first group of animals was exposed to a moderate temperature and fed ad libitum. Their periods of hypothermia were short and irregular and the active periods sometimes lasted several days; their body weight increased during the winter months; in spring, the sensitivity of B cells to glucose was low, decreasing insulin secretion in vivo and in vitro, and the adipocytes were insulin resistant. The second group of fasting animals was exposed to a low and constant temperature (5 degrees). Their phases of lethargy were long and regular (about 15 days), separated by active periods (6-8 hr); their body weight decreased during the winter months; in spring the B-cell secretion was increased and the sensitivity of the tissues to insulin ensured a high peripheral glucose utilization. These data show that the winter climatic and nutritional conditions which influence the depth of hibernation modify the edible dormouse B-cell activity during the spring arousal.
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PMID:Hibernation depth influences the edible dormouse pancreatic B cell during the spring arousal. 637 92

Toxic irreversible encephalopathic syndromes developed in 2 patients treated with lithium carbonate and haloperidol. Symptoms consisted of lethargy, fever, tremulousness, confusion, and extrapyramidal and cerebellar dysfunction, accompanied by leucocytosis and elevated serum enzyme, blood urea nitrogen, creatinine and fasting blood glucose levels. One patient suffered widespread irreversible brain damage; the other was left with persistent dyskinesias. Although causal factors have not been identified, this report and others in the literature suggest that diffuse irreversible encephalopathy may occasionally develop in individuals with abnormal brain sensitivity to the lithium carbonate/haloperidol combination. Evidence for this is based on the fact that in our patients and others mentioned in the literature the dosage and blood levels of lithium were not high.
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PMID:Toxic irreversible encephalopathy induced by lithium carbonate and haloperidol. A report of 2 cases. 641 23

The benefit of any medical intervention, particularly drug therapy, must be weighed against its cost. These costs are not only dollar expenditures but effects on lifestyle and overall health. Diuretic therapy for hypertension has been in use long enough to allow long-term clinical evaluation. It is clear from the numerous prospective drug intervention trials involving hypertensive patients that diuretic therapy is not free of "costs." Aside from the fact that 15 to 20% of diuretic-treated patients reportedly drop out of trials because of side effects, including exertional dyspnea, fatigability, lethargy and impotence, numerous metabolic derangements have been reported with these drugs, i.e., potassium, uric acid, lipid, sodium, glucose and magnesium alterations. Perhaps most important are the changes in lipid fractions, which may be responsible for the failure of antihypertensive therapy to decrease the risk of coronary heart disease. Thus, although diuretics are somewhat less expensive than other antihypertensive drugs in terms of dollars, their overall costs are high. The major alternatives, such as the alpha-blocker prazosin or the central nervous system agent clonidine, are preferable, do not impair a patient's lifestyle and are recommended to be used along with changes in diet and an exercise program for control of mild to moderate hypertension.
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PMID:Diuretic therapy for mild hypertension: the "real" cost of treatment. 642 Nov 37

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

The main purpose of this work was to study changes in the balance of fluids, electrolytes and blood metabolites in neonatal piglets with severe transmissible gastroenteritis. Six two day old conventional piglets were infected with transmissible gastroenteritis virus while six others were used as normal controls. Blood samples were collected in heparin when the infected piglets were moribund. The following variables were measured: packed red cell volume, total plasma protein and bicarbonate, blood pH, blood urea nitrogen and plasma glucose, creatinine, chloride, inorganic phosphorus, sodium, potassium, magnesium and calcium. Vomiting and diarrhea appeared 12 to 24 hours postinoculation in the infected piglets and they were moribund one or two days later. Before becoming moribund, most of the piglets fell rapidly into a lethargic and comatose state. The most evident changes in their blood variables were an increase in packed cell volume, total protein, blood urea nitrogen, phosphorus and magnesium levels and a decrease in pH and bicarbonate concentration as well as a severe hypoglycemia. The results suggest that severe hypoglycemia coupled with metabolic acidosis and dehydration might be an important factor contributing to the high mortality rates caused by transmissible gastroenteritis in neonatal piglets. The hypoglycemia results from a combination of the inadequate glucose metabolism inherent to neonatal piglets and the acute maldigestion and malabsorption resulting from the diffuse and severe villous atrophy induced by the virus.
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PMID:Hypoglycemia: a factor associated with low survival rate of neonatal piglets infected with transmissible gastroenteritis virus. 647 97

To evaluate the efficacy of low-dose insulin therapy in cases of severe diabetic ketoacidosis (DKA), we examined admission clinical and biochemical parameters and responses to therapy in 48 diabetic patients who presented with DKA and were randomized to receive either high- or low-dose insulin. There were no differences in the initial clinical and biochemical parameters of the patients, regardless of assignment to low or high dose; however, a subgroup of 13 patients who were classified as severe DKA (based on their presentation in a comatose or stuporous state) had, as expected, more marked clinical and biochemical abnormalities than their alert cohorts. The responses to therapy (rate of glucose decrement and control of acidosis) were comparable in the high-dose and low-dose groups of comatose/stuporous patients and were not significantly different from the noncomatose cohorts. These data indicate that low-dose insulin therapy in severely ill comatose patients is as effective as high-dose.
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PMID:Efficacy of low-dose insulin therapy for severely obtunded patients in diabetic ketoacidosis. 677 27

Six infants with disseminated HSV had no mucocutaneous lesions at any time during the course of the illness. These infants presented with lethargy, poor feeding, apnea, acidosis, and hepatomegaly. The diagnosis of HSV was made by culturing the infant's oropharynx and blood, and the maternal cervix. Eight infants with HSV encephalitis had no skin, eye, or mucous membrane lesions. These infants presented with lethargy and low-grade fever, followed within 24 hours by the onset of focal partial motor seizures. The seizures were refractory to anticonvulsant therapy. The mean CSF white cell count was 131 cells/mm3;the glucose and protein concentrations were in the normal range. Brain biopsy was required for the early diagnosis of HSV encephalitis. These 14 cases presented 70% (14/20) of all infants with neonatal HSV diagnosed during the study period. HSV infection should be considered in infants with no mucocutaneous lesions who have signs usually associated with bacterial sepsis or who develop focal seizures during the first three weeks of life.
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PMID:Neonatal herpes simplex infection in the absence of mucocutaneous lesions. 706 32

Marked asterixis occurred in two patients following metrizamide myelography. One also suffered generalized seizures and the other had severe stuttering speech for seven days. The spectrum of toxic manifestations of metrizamide is reviewed with emphasis on the unusual lethargy and other depressive effects seen with this relatively safe agent. The hypothesis that metrizamide exerts a ouabain-like effect on the cortical surface was tested. Metrizamide in concentrations as high as 20 mM had no inhibitory effect on rat cerebral K+-para-nitrophenylphosphatase, a partial reaction of (Na+K+)-adenosine triphosphatase. Because metrizamide is a 2-deoxyglucose analogue, a competitive inhibition of hexokinase at the first step in glycolysis was also postulated. Metrizamide was found to competitively inhibit commercial (microbial) hexokinase. The Michaelis constant for glucose rises from 0.13 to 0.25 to 0.33 to 0.91 mM in the presence of 0, 0.4, 1.0, and 2.0 mM metrizamide, respectively. Since the concentration of metrizamide over the cerebral cortex after routine myelography may be approximately 50 mM compared with a glucose concentration of only 3.6 mM (65 mg/dl), it is postulated that impaired brain glucose metabolism may be responsible for some of the toxic effects of metrizamide.
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PMID:Asterixis and encephalopathy following metrizamide myelography: investigations into possible mechanisms and review of the literature. 722 1

Neurological findings and histopathology of the nervous system were studied in 30 patients with Kawasaki disease. As neurological manifestations, irritability, lethargy, meningeal signs such as nuchal rigidity, Kernig's sign, and opisthotonus, and facial nerve paralysis were present in 8 patients. In 9 out of 11 patients who had examination of cerebrospinal fluid, pleocytosis mainly consisting of lymphocytes and mononuclear cells was seen. Protein and glucose concentrations were within normal range. On histopathological investigation, aseptic chorio and/or leptomeningitis were present in 7 out of 14 patients. Severe edema, edema necrosis and localized status spongiosus were frequently observed. Atrophy, nonspecific degeneration and loss of neurons were detected, but pathognomonic changes were not evident. Marginal gliosis in the subpendimal region and superficial cerebral cortex and glial nodule formation surrounding the degenerated neurons were occasionally seen. Vascular changes such as endoarteritis, periarteritis and perivascular cuffing were present in 5 out 14 patients, though such lesions were geneally mild. Ganglionitis and neuritis in the various areas were seen in 13 patients.
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PMID:Neutral involvement in kawasaki disease. 739 11

The medical records of 23 American Miniature Horses with hyperlipidemia, hyperlipemia, or hepatic lipidosis were reviewed. The most common clinical signs were anorexia and lethargy. The mean duration of clinical signs was 2.4 days. A primary disease was identified in 19 cases. Enterocolitis was the most common primary disease (n = 10). Intentional feed restriction, as part of treatment for colic, resulted in hyperlipemia in 2 horses and hyperlipidemia in 1. Four horses had primary hyperlipemia, 3 of which had signs of hepatoencephalopathy secondary to hepatic lipidosis. Dextrose, heparin, and insulin were the most common treatments. The overall survival was 61% (14/23). All horses with peak serum triglyceride concentrations > 1,200 mg/dl died or were euthanatized, whereas all but 1 with peak serum triglyceride concentrations < 1,200 mg/dl survived. These findings suggest that when American Miniature Horses, like other ponies and donkeys, are in a negative energy balance, they can rapidly develop hyperlipidemia or hyperlipemia. Early detection and treatment may improve survival.
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PMID:Hyperlipidemia, hyperlipemia, and hepatic lipidosis in American miniature horses: 23 cases (1990-1994). 764 75


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