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)

There are no clear criteria for administration of blood to premature infants. In the past, indications for transfusion have included tachypnea, tachycardia, poor weight gain, apnea, bradycardia, pallor, lethargy, decreased activity, or poor feeding. Some have suggested that erythropoietin levels may also be useful in determining the need for transfusion. Data were studied from 11 premature infants with birth weights less than 1500 g collected throughout 469 hospital days. During that period the infants received a total of 37 blood transfusions. No overall relationship was found between hematocrit of 19% to 64% and heart rate, respiratory rate, or the occurrence of bradycardia; ie, these variables proved to be clinically unreliable as indicators of hematocrit. Furthermore, no predictable effect of transfusion could be identified on heart rate, respiratory rate, or on the incidence of apnea or bradycardia. It was anticipated that frequent episodes of apnea or bradycardia might increase serum erythropoietin concentration. To the contrary, more frequent bradycardia was associated with the low erythropoietin levels because those infants tended to receive transfusions for "symptomatic" anemia. The data are consistent with the concept that "anemia of prematurity" is not predictably associated with symptoms classically attributed to anemia. Possible reasons for this are that the premature infant has a different inherent response to anemia; that it is inappropriate to extrapolate symptoms of severe acute anemia to persons with mild or moderate chronic anemia; or, most likely, that other determinants of heart rate, respiratory rate, and apnea/bradycardia are of more importance than mild or moderate anemia.
Pediatrics 1989 Sep
PMID:Assessing the need for transfusion of premature infants and role of hematocrit, clinical signs, and erythropoietin level. 277 44

4-Hydroxyandrostenedione (4-OHA), a potent new aromatase inhibitor, was given i.m. (500-1000 mg) to 58 patients with advanced postmenopausal breast cancer. Of 52 assessable patients 14 responded (27%), in 10 (19%) the disease stabilized, and in 28 (54%) the disease progressed. Sterile abscesses occurred at the injection site in 6 patients and painful lumps were found in a further 3 patients. Two patients developed allergic-type reactions and 4 developed lethargy, suspected to be treatment induced. Plasma estradiol levels were suppressed from a mean of 7.2 +/- 0.8 (SE) pg/ml before treatment to 2.6 +/- 0.2, 2.7 +/- 0.2, and 2.8 +/- 0.3 pg/ml after 1, 2, and greater than 4 months, respectively, of treatment and remained suppressed in patients whose disease relapsed. No significant fall in estrone levels was seen. Similarly, dehydroepiandrosterone sulfate, sex hormone binding globulin, and gonadotrophin levels were unaltered after 6 months of treatment. Plasma 4-OHA levels were measured in a radioimmunoassay for androstenedione after chromatographic separation of 4-OHA from androstenedione. Drug concentrations ranged from 0.7 to 23.2 (7.8 +/- 1.1) ng/ml after 2 months on treatment. 4-OHA is an effective drug in the management of postmenopausal patients with breast cancer and does not produce notable systemic side effects.
Cancer Res 1986 Sep
PMID:Treatment of advanced postmenopausal breast cancer with an aromatase inhibitor, 4-hydroxyandrostenedione: phase II report. 294 41

The radioprotective capacity of the phosphorothioate compounds, WR2721, WR77913, and WR3689, in the CNS is being evaluated following injection of the drugs into the lateral cerebral ventricle or the cisterna magna of F-344 rats. This approach circumvents the blood-brain barrier and permits an assessment of the CNS toxicity and regional distribution of these compounds. Following intraventricular injection in 150-200 gm female rats, the LD50 doses for WR2721, WR77913, and WR3689 were respectively 0.60 +/- 0.07 mg (S.E.), 2.36 +/- 0.13 mg, and 3.56 +/- 0.26 mg. Following intracisternal injection the LD50 doses were 0.71 +/- 0.18 mg, 4.12 +/- 1.09 mg and 3.03 +/- 0.68 mg, respectively. WR 2721 produced lethargy, unsteady gait, and dishevelment but these signs all resolved completely within 1-3 days in survivors. In addition to these signs, WR77913 and WR3689 produced severe convulsions. At high doses, following intraventricular administration, all three drugs were associated with cerebral and diencephalic periventricular necrosis and ipsilateral necrosis of the lateral hippocampus. Biodistribution studies were performed with [S-35]-labeled derivatives of the drugs and tissue sampling. The three drugs demonstrated similar patterns. Forty-five minutes following either the intraventricular or intracisternal route of drug delivery the highest drug concentrations were in the brainstem, cerebellum, and cervical cord. Additional studies with autoradiography revealed that intraventricular injection was associated with high drug uptake in the cerebral white matter, the periventricular diencephalon, and the periaqueductal mesencephalon. The biodistribution and toxicity data together suggest that the drugs can be ranked, WR3689 greater than WR77913 greater than WR2721, according to the level of drug thiol that can be achieved in the CNS tissues with intraventricular or intracisternal injection. Tissue levels achievable with WR2721 following these two routes of administration are as high as levels others have reported as radioprotective in rodent skin and gut.
Int J Radiat Oncol Biol Phys 1986 Sep
PMID:Toxicity and biodistribution of the radioprotectors, WR2721, WR77913, and WR3689, in the CNS following intraventricular or intracisternal administration. 301 70

This article attempts to cover the more specific pruritic problems encountered in rabbits, rodents, and ferrets. There are certainly other causes of pruritus in these animals. Dermatophytes in guinea pigs are not reported to be pruritic, but because they are pruritic in other species, they should be considered in a differential diagnosis. A cryptococcal dermatitis in a guinea pig that was pruritic has been reported. Although mites were not seen on scraping, the animal was treated for sarcoptid mites and apparently the pruritus lessened. Because the cryptococcis was still present, it is questionable whether it was causing the pruritus. Pruritic ulcerative dermatitis over the back and shoulders has been seen in some lines of rats. Staphylococcus aureus was cultured from many of the lesions. Clipping the toenails on the feet helped lessen the severity of the lesions. Syphacia spp. have been reported in rats, gerbils, and hamsters and should be considered if there is perineal pruritus. MOBS, or "move over buddy syndrome," is seen especially in mice and may be seen in hamsters, gerbils, and rats that are overcrowded or stressed. The lesions are actually bite wounds that have been inflicted around the tail base and the perineum and on the tail, but these wounds can be mistaken for self-inflicted trauma from pruritus. All of the recommended treatments are extralabel, and clients should be informed of this. I have observed a guinea pig become lethargic and anorexic after only one application of a flea powder approved for use in cats. Brushing most of the powder off and offering dandelion greens to stimulate appetite helped. The second dusting was done with the same flea powder diluted with baby powder. Whenever these animals are dipped, it is important to let them dry in a warm, draft-free area. Again, it is important to be aware that the ratio of surface area to body weight is much higher in these small animals than in the species routinely seen in veterinary practice especially to prevent toxicoses from topically applied medications and iatrogenic hypothermia or hyperthermia.
Vet Clin North Am Small Anim Pract 1988 Sep
PMID:Pruritus in rabbits, rodents, and ferrets. 305 47

Intravenous nitroglycerin is frequently used in the treatment of acute myocardial infarction for its vasodilating effect on lowering both preload and afterload and in the control of ischemic heart pain. The end point for doses of nitroglycerin infusion is either relief of persistent or recurrent angina or controlling congestive heart failure by lowering left ventricular end diastolic pressure and volume. Nitroglycerin accomplishes these end points primarily through its venodilating property. Intolerable headaches or symptomatic hypotension may prevent achieving the clinical end point. Nevertheless, high doses of intravenous nitroglycerin may need to be administered to achieve a desired hemodynamic and therapeutic effect. Changes in mental status, i.e., lethargy and confusion, should be a warning sign of possible ethanol intoxication. An alcohol blood level verifies the clinical impression and gradually withdrawing the intravenous nitroglycerin is all that is necessary to effect a total recovery from this reaction.
Heart Lung 1986 Sep
PMID:An unusual complication of intravenous nitroglycerin. 309 6

Eleven residents receiving long-term thioridazine treatment were studied while receiving their previous dose, standardized low and high doses (1.25 and 2.50 mg/kg per day), and placebo conditions. For theoretical reasons, subjects were also classified by degree of stereotypic behavior on the Fairview Problem Behavior Checklist (Barron & Sandman, 1983). Ratings of hyperactivity and self-injury were significantly lower during the higher as compared with the lower dose condition. Subjects classified as in the high-stereotypy group had significantly and substantially higher levels of maladaptive behavior on several other clinical variables. When all four drug conditions were compared, no significant drug effects were detected. However, high-stereotypy subjects responded significantly better to the drug than low-stereotypy subjects on ratings of Lethargy/Social Withdrawal and Hyperactivity on the Aberrant Behavior Checklist (Aman, Singh, Stewart, & Field, 1985a). The findings were related to previous dosage research and the literature on stereotypic behavior.
J Autism Dev Disord 1988 Sep
PMID:Thioridazine dose effects with reference to stereotypic behavior in mentally retarded residents. 317 Apr 54

To evaluate the health effects of occupational phosphine exposure, 22 workers engaged in fumigation of stored grains were subjected to a clinical and environmental study. These workers were used to placing aluminum phosphide tablets on the stacks of grains and covering it with a gas-proof plastic cover. The mean age of the workers was 48 years (range 24-60) and mean duration of exposure 11.1 years (range 0.5-29). After fumigation they reported minor symptoms, which included cough (18.2%), dyspnoea (31.8%), tightness around the chest (27.3%), headache (31.8%), giddiness, numbness and lethargy (13.6% each), anorexia and epigastric pain (18.2% each). The abnormal physical signs included bilateral diffuse rhonchi and absent ankle reflex each occurring in one worker. Motor nerve conduction velocity of median and peroneal nerves, and sensory conduction velocity of median and sural nerves were normal. Phosphine concentration in the work environment ranged from 0.17 to 2.11 ppm. Occupational phosphine exposure in the workers was associated with mild to moderate symptoms, which were transient. However, to assess the chronic effects, long-term follow-up is recommended.
Toxicol Lett 1988 Sep
PMID:Occupational phosphine exposure in Indian workers. 317 55

Differentiating acute appendicitis from other causes of acute abdominal pain in children frequently remains unsatisfactory. To determine whether initial historical and physical examination findings might predict final diagnoses, 246 patients with complaints of nontraumatic and nonrecurrent acute abdominal pain were studied. All were between three and 18 years of age and had presented to a hospital-based pediatric emergency department. Each family was telephoned an average of 5.1 days after the visit to determine the patient's subsequent clinical course; operative notes and pathology reports were reviewed for patients receiving surgery. Of these patients with acute abdominal pain, both fever and vomiting were present in 18 of the 24 who eventually had diagnoses of appendicitis, compared with 49 of 222 patients with other final diagnoses (P less than 0.01, with negative predictive value 0.97, sensitivity 0.75, and specificity 0.78, but positive predictive value only 0.27). The duration of the pain at presentation and the frequency of other symptoms (eg, diarrhea, dysuria, anorexia, and lethargy) were unrelated, however, to final diagnosis, as was the duration of the pain and whether abdominal tenderness initially was localized or generalized. Nonruptured appendicitis was generally indistinguishable from ruptured appendicitis preoperatively, by both duration and symptoms. Boys were found more likely to have appendicitis (with or without rupture) than girls (18/118 or 15%, vs. 6/128 or 5%, P less than 0.05). In conclusion, fever and vomiting were noted at presentation more frequently in children with appendicitis than in children with other causes of acute abdominal pain.(ABSTRACT TRUNCATED AT 250 WORDS)
Pediatr Emerg Care 1988 Sep
PMID:Diagnosing appendicitis in children with acute abdominal pain. 318 19

A case of lactobezoar is described in a toddler with an acute history of abdominal pain, vomiting, and lethargy. Despite normal dietary habits, he had developed a gastric milk coagulum which led to a palpable epigastric tumor. Intussusception was suspected but disproven by barium enema. In retrospect, plain abdominal radiographs demonstrated characteristic mottled filling defects in the stomach from a lactobezoar. Conservative therapy led to prompt disintegration of the lactobezoar.
Pediatr Emerg Care 1988 Sep
PMID:Lactobezoar causing an abdominal triad of colicky pain, emesis, and mass. 318 25

The relationship of symptoms and signs to age and the reasons for consulting a physician were analyzed in 110 cases of culture-proven childhood bacterial meningitis. H. influenzae caused 74, meningococci 28, pneumococci 6 and streptococci 2 of the cases. Apart from fever (present in 94%), the most common symptoms according to age were as follows: 1-5 months: irritability (85%), 6-11 months: impaired consciousness (79%), 12 months or more: vomiting (82%) and neck rigidity (78%). Absence of neck rigidity at diagnosis was associated with young age (less than 12 months, P less than 0.001) and, in older children, to a short duration of symptoms (P less than 0.01) but not to the degree of CSF pleocytosis. Symptoms of meningitis caused by H. influenzae differed from those of meningococcal meningitis. Meningitis should be suspected in irritable or lethargic febrile children despite absence of neck rigidity. Fever and vomiting were the most frequent reasons for consulting a physician (60% and 31%, respectively). Despite the frequency and alarming character of irritability, impaired consciousness and neck rigidity, their presence led infrequently to a consultation (6%, 22% and 3%, respectively). Parental ignorance of such symptoms or of their importance may cause treatment delay, despite readily available medical services.
Eur J Pediatr 1987 Sep
PMID:Childhood bacterial meningitis: initial symptoms and signs related to age, and reasons for consulting a physician. 331 86


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