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)

Daily torpor and hibernation are the most powerful measures of endotherms to reduce their energy expenditure. During entrance into these torpid states metabolic rate is suppressed to a fraction of euthermic metabolism, paralleled by reductions in ventilation and heart rate. Body temperature gradually decreases towards the level of ambient temperature. In deep torpor body temperature as well as metabolic rate are controlled at a hypothermic and hypometabolic level. Torpid states are terminated by an arousal where metabolic rate spontaneously returns to normal levels again and euthermic body temperature is established by a burst of heat production. In recent years some of the cellular mechanisms which contribute to hypometabolism have been disclosed. Transcription, translation, as well as protein synthesis are largely suppressed. Cell proliferation in highly proliferating epithelia like the intestine is suspended. ATP production from glucose is reduced and lipids serve as the major substrate for remaining energy requirements. All these changes are rapidly reverted to normometabolism during arousal. Hibernation and daily torpor are found in small mammals inhabiting temperate as well as tropical climates. It indicates that this behaviour is not primarily aimed for cold defense, instead points to a general role of hypometabolism, as a measure to cope with a timely limited or seasonal bottleneck of energy supply.
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PMID:Natural hypometabolism during hibernation and daily torpor in mammals. 1528 2

Carnitine is a small water-soluble molecule that is present in almost all animal species. It plays an indispensable role in fatty acid metabolism, where it is involved in the transport of activated fatty acids between different cellular compartments. Uremic patients, as well as patients with chronic renal failure, appear to have abnormal renal handling of carnitine leading to dyslipidemia, lethargy, muscular weakness, hypotension, cardiac dysfunction and arrhythmias, and recurrent cramps. It often is difficult to distinguish these symptoms from similar ones related to uremia and dialysis. Many investigators have advocated L-carnitine supplementation in an attempt to alleviate carnitine deficiencies, and good results from this therapy have been reported. Moreover, several studies have shown that L-carnitine supplementation improves the response to erythropoietin. Chronic inflammation is another particular aspect affecting these patients. Anti-inflammatory properties of L-carnitine in hemodialysis patients have been shown by our group. Treatment with L-carnitine (20 mg/kg, given intravenously at the end of each dialysis session for 6 mo), significantly decreased serum C-reactive protein (CRP) levels, a proinflammatory cytokine known to inhibit erythropoiesis. Moreover, data from published literature are indicative of L-carnitine modulation of the immune system by the activation of glucocorticoid receptors and the modulation of the transcription of glucocorticoid-responsive genes. Our study showed that in these patients, treatment with L-carnitine has been able to improve their body mass index, likely by promoting a positive protein balance. This aspect is strictly correlated with the status of insulin resistance, which is well described in patients with renal diseases. Many studies showed that carnitine allowed mitochondrial fatty acid usage to link to the rate of glucose usage, thus improving insulin resistance. In conclusion, clinical beneficial effects of L-carnitine treatment on patients suffering from renal diseases are supported by molecular evidence involving both inflammatory and metabolic aspects of the disease.
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PMID:Carnitine system in uremic patients: molecular and clinical aspects. 1549 Apr 12

Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated with the demyelination of extrapontine areas of the central nervous system. Although the etiology and pathogenesis are unclear, CPM is usually associated with hyponatremia or its rapid correction, and chronic alcoholism is also a common underlying condition. We observed a 43-year-old man with diabetes mellitus who developed central pontine and extrapontine myelinolysis with no apparent evidence of hyponatremia, serum hyperosmolality or associated rapid correction, or history of alcohol abuse. On admission, the patient was lethargic with dysarthria, dysphagia, and mild tetraparesis and his face and lower extremities were severely edematous. Laboratory examination showed normoglycemia and normonatremia, although hypokalemia, elevated HbA1c, and nephrotic syndrome were also present. Magnetic resonance imaging (MRI) revealed abnormal signal intensity in the pons, the deep layers of the cerebral cortex, and the adjacent white matter consistent with central pontine and extrapontine myelinolysis. Generalized edema was reduced by the use of diuretics and extracorporeal ultrafiltration without significant changes of serum sodium or osmolality. His consciousness level and paresis gradually improved within a few weeks. Our patient is a rare case of CPM associated with diabetes without apparent evidence of sodium or glucose imbalances.
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PMID:Central pontine and extrapontine myelinolysis associated with type 2 diabetic patient with hypokalemia. 1581 68

The hepatotoxic effect of carbon tetrachloride (CCl(4)) administered by gavage at 0.25 ml CCl(4) (1:1 in olive oil) per 100 g body weight was examined 24 h later in regular chow fed (RC) and 10% flax chow fed (FC) male and female Fischer 344 rats. CCl(4)-treated RC rats were subdued, lethargic and unkempt. CCl(4)-treated FC rats were much less affected. CCl(4) treatment resulted in loss of weight in RC and FC rats. In males, the weight loss was 6.7% body mass in RC rats compared to 5.6% body mass in FC rats. In females, the weight loss was 7.5% body mass in both RC and FC rats. While CCl(4) treatment increased the level of the liver injury marker plasma alanine aminotransferase (ALT) in RC rats, this CCl(4) effect was significantly attenuated in FC rats. In male rats, the ALT increase was 435-fold in RC rats and 119-fold in FC rats, over that of their respective controls. In female rats, the ALT increase was 454-fold in RC rats and 381-fold in FC rats, over that of their respective controls. These results provide evidence that flax consumption protects the liver against injury and that the extent of the protection is sex dependent. CCl(4) had no effect on the plasma level of gamma-glutamyltranspeptidase (gammaGT) in RC and FC rats supporting the contention that plasma gammaGT is not a useful marker for acute liver injury which is seen in this model. The activity of gammaGT was increased in the livers of FC rats compared to RC rats: 2.7-fold in males and 1.5-fold in females. In RC rats, the activity of liver gammaGT was decreased by CCl(4) treatment: 70% in the male and 25% in the female. However, this CCl(4) effect was reversed or abolished by flax consumption. Compared to RC rats: in male FC rats, CCl(4) actually increased the activity of liver gammaGT 1.28-fold; while in female FC rats, the depressing effect of CCl(4) treatment was abolished. The flax-induced preservation of gammaGT in the liver in response to injury may be involved in the observed hepatoprotection through generation of GSH. In RC male rats, CCl(4) treatment effected a 25% reduction in plasma glucose levels. There was no decrease in CCl(4)-treated FC male rats. In female rats, CCl(4) treatment effected a 21% decrease in plasma glucose levels in both RC and FC rats. In conclusion, multiple parameters for acute CCl(4)-induced injury were attenuated in the FC compared to the RC rat. That flaxseed consumption conferred greater protection against liver injury in the male than in the female suggests an involvement of the estrogenic lignan component of flaxseed. We discuss the possibility that this hepatoprotection is through a flax lignan-induced increase in reduced glutathione related to a flax effect on the activity of liver gammaGT in the resting state and the maintenance of its activity in response to injury.
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PMID:The effects of dietary flaxseed on the Fischer 344 rat. III. Protection against CCl(4)-induced liver injury. 1614 12

The purpose of this investigation was to determine the effects of an activated charcoal (AC) suspension containing propylene glycol and glycerol on serum osmolality, osmolal gap, and lactate concentration in dogs. Six healthy adult dogs were administered 4 g/kg AC in a commercially available suspension that contained propylene glycol and glycerol as vehicles. Blood samples were taken before and 1, 4, 6, 8, 12, and 24 hours after the administration of the test suspension. Samples were analyzed for osmolality, blood gases, and concentrations of lactate, sodium, potassium, serum urea nitrogen, and glucose. Osmolal gaps were calculated for each time point. Mean serum osmolality, osmolal gap, and lactate concentration were significantly increased after suspension administration compared to baseline. Serum osmolality increased from 311 mOsm/kg at baseline to 353 mOsm/kg, osmolal gap increased from 5 to 52 mOsm/kg, and lactate concentration increased from 1.9 to 4.5 mmol/L after suspension administration (all P < .01). Three of the 6 dogs vomited between 1 and 3 hours after the administration of the test suspension, and 4 of 6 dogs were lethargic. All dogs drank frequently after AC administration. Commercial AC suspension administered at a clinically relevant dose increases serum osmolality, osmolal gap, and lactate concentration in dogs. These laboratory measures and the clinical signs of vomiting, lethargy, and increased frequency of drinking might complicate the diagnosis or monitoring of some intoxications (such as ethylene glycol) in dogs that have previously received AC suspension containing propylene glycol, glycerol, or both as vehicles.
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PMID:Effects of oral administration of a commercial activated charcoal suspension on serum osmolality and lactate concentration in the dog. 1623 12

Rosiglitazone is a peroxisome proliferator active receptor. gamma agonist, which increases insulin sensitivity in adipose tissue, muscle, and liver. Rosiglitazone is a member of the thiazolidinedione group, and because of its significantly positive effect on glycemic control, it is especially preferred in type 2 diabetic patients with a high cardiovascular disease risk. This drug, because of its decreasing effect on insulin resistance, is used alone or combined with type 2 diabetic drugs. A 73-year-old female patient was admitted to the emergency department with dyspnea, pink frothing phlegm, cyanosis, and tiredness. She was lethargic, uncooperative, and had no orientation. In arterial blood gases, hypoxemia and hypercapnia were found. She was taken to the general intensive care unit, and oxygen was applied via mask. The patient had a history of 10 years of diabetes mellitus, hypertension, and atherosclerotic cardiac disease, and she was using rosiglitazone for the past 6 weeks. Her chest x-ray was taken, and acute pulmonary edema was diagnosed. In her last echocardiography, which was performed 1 year before, no signs indicating cardiac failure and pleural effusion could be found. Therefore, it was concluded that pulmonary edema occurred as a complication of rosiglitazone use. After stabilizing the patient's vital signs, blood glucose levels, and lactate levels, medical treatment of diabetes mellitus was rearranged, and she was discharged on the seventh day after her admittance. In a patient with diabetes mellitus who has been admitted to the intensive care unit because of acute pulmonary edema, for differential diagnosis, use of rosiglitazone should be kept in mind during the determination of treatment. Therefore, the authors aim to discuss the effect of rosiglitazone on creating acute pulmonary edema with a case report presentation.
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PMID:Acute pulmonary edema due to rosiglitazone use in a patient with diabetes mellitus. 1669 44

Metformin is a biguanide. Due to its effects in suppressing the hepatic production of endogenous glucose and in increasing insulin sensitivity in adipose tissue and skeletal muscle, the agent is used particularly in type 2 diabetes mellitus and metabolic syndrome, in which insulin resistance is especially pronounced. Lactic acidosis is one of the most important side effects of metformin. A male patient, born in 1923, was admitted to the emergency unit of our hospital for sudden vertigo, weakness, dyspnea, cyanosis, and lethargy. His history data showed that the patient had been suffering from type 2 diabetes mellitus for 10 years and taking Glargin (insulin), 12 U/kg, once daily and Glucophage (metformin), 850 mg thrice daily. The patient's general condition was fair; stupor, time and spatial orientation were absent. Analysis of arterial blood gases showed the presence of metabolic acidosis, hypokalemia, hypoxemia, and hypercapnia. Thereafter the patient was transferred to the intensive care unit of the hospital; intubated and connected to a T-bird ventilation apparatus. On the following day, an analysis of arterial blood gases indicated the proximity of the results to their physiological parameters. Ventilation was stopped; and monitoring of the patient continued by following the T-shape type of ventilation discontinuation. There were no X-ray signs of pneumonia or pulmonary edema. On the same day, the patient was extubated and oxygen inhalation in a dose of L/min was continued through a mask. On day 4 since therapy was initiated, the patient's vital signs, serum sugar and lactate levels became normal. By determining a new treatment regimen, the patient was discharged from the intensive care unit. Dyspnea, acidosis, and hypoxia developed in the patient resulted from lactic acidosis caused by the use of metformin. It should be remembered that dyspnea, acidosis, and hypoxia, which suddenly developed in metformin-treated patients with type 2 diabetes mellitus, may be caused by lactic acidosis.
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PMID:[A clinical case of development of lactic acid acidosis in a diabetic patient taking metformin]. 1675 49

Presented is an African giant rat (Cricetomys gambianus) following zinc ingestion. The sick rat was lethargic, withdrawn, had soft, mucus-impregnated faeces and diahorrea, foot twitching and icterus. Comparative age, sex and body weight (b.wt.)-matched analyses were made with a healthy giant rat. Twelve-hourly Urine volume (UV), Haematocrit (Hct), urinary glucose, plasma zinc and Alkaline Phosphatase (ALP) were performed over an 8-week period. Full blood counts were performed and differential WBC counts and microscopic observations were made on blood smears obtained from both healthy and sick rats. Consecutive blood samples were drawn at the end of each week (Weeks <2-6 treatment; Weeks 7-8 post-treatment). Treatment involved oral vitamin B12 supplement at 4 microg/day and 2 ml diethylenetriaminepentaacetic acid (DTPA) intramuscular injections at 1 ml/450g b.wt./5 wks (Week 2 - 6). Day 1 showed neutropaenia, Heinz bodies on RBCs (reticulocytes and immature forms). Zinc (Day 1 - end Week 7), glucose (Day 1 - end Week 4), ALP (Day 1 -Week 4) and UV were elevated (Day 1 - end Week 6). Indications of moderate zinc toxicosis following ingestion and stress-associated glucosuria were concluded.
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PMID:Hyperzincaemia in a pet African giant rat (Cricetomys gambianus Waterhouse, 1840). 1823 41

Six hundred sixty-five crossbred beef heifers initially weighing 225 kg were used in a completely randomized design to measure plasma glucose, lactate, and urea N concentrations at time of initial processing, determine the incidence of apparent bovine respiratory disease (BRD) in receiving cattle, and evaluate the effect of apparent BRD on subsequent cattle growth and carcass characteristics. Heifers were processed within 24 h of arrival, and processing included vaccination against common viral and clostridial diseases, recording rectal temperature, and sampling whole blood for subsequent measurement of plasma glucose, lactate, and urea concentrations. Heifers were monitored for clinical signs of apparent BRD, including depression, lethargy, anorexia, coughing, rapid breathing, and nasal or ocular discharge. Heifers exhibiting signs of apparent BRD received antibiotic therapy, and the number of times a heifer was treated for apparent BRD was recorded. Following the 36-d receiving period, heifers were transported to native grass pastures and allowed to graze for 136 d. At the end of the grazing season, heifers were transported to a commercial feedlot where they were adapted to a common finishing diet offered for ad libitum consumption. Following the 124-d finishing period, heifers were slaughtered and carcass data were collected. Heifers treated for apparent BRD had decreased plasma glucose (linear, P < 0.01), lactate (linear, P < 0.01), and urea N concentrations (linear, P < 0.06) measured at time of initial processing. Rectal temperature measured at time of initial processing tended to be greater (linear, P < 0.11) for heifers treated for apparent BRD. Heifers treated for apparent BRD during the receiving period had decreased overall ADG (linear, P < 0.10), final BW (linear, P < 0.01), HCW (linear, P < 0.01), fat thickness (linear, P < 0.01), and marbling score (linear, P < 0.03). These data suggest that initial plasma glucose and lactate concentrations might be affected by the health status of receiving cattle and that increased incidence of apparent BRD in cattle decreases ADG and carcass quality.
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PMID:Plasma metabolites of receiving heifers and the relationship between apparent bovine respiratory disease, body weight gain, and carcass characteristics. 1882 Jan 62

A 3-year-old male nanday conure (Nandayus nenday) was presented with acute lethargy, polyuria, and polydipsia. Marked persistent hyperglycemia, glycosuria, and ketonuria were also noted. The serum insulin concentration (< 3 microU/ml) was lower than reference ranges described for other psittacine birds. Initial treatment included insulin, antibiotics, and supportive care. Insulin therapy was adjusted based on results of serial blood glucose curves. Histopathologic examination of pancreatic biopsy samples revealed normal exocrine pancreatic tissue with rare lymphoplasmocytic infiltrates and absence of pancreatic islets, suggesting atrophy of endocrine pancreatic tissue. Resolution of clinical signs and a normalized blood glucose curve were obtained after administration of long-acting insulin (0.3 IU/kg IM AM and 0.25 IU/kg IM PM). One month after initial presentation, the conure was admitted for severe dyspnea and lethargy and died despite supportive care. Histopathologic examination of the pancreas revealed nearly total depletion of the endocrine pancreas with moderate lymphoplasmocytic pancreatitis. Immunohistochemical evaluation of the remaining pancreatic islets was negative for the presence of insulin and positive for glucagon. Results of polymerase chain reaction tests for Chlamydophila psittaci performed on tissues from the liver, spleen, and lung were negative. Transmission electron microscopy did not demonstrate viruses. Clinical and pathological findings observed in this case are consistent with insulin-dependant type 1 diabetes.
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PMID:Diabetes mellitus in a nanday conure (Nandayus nenday). 1901 99


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