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)

The case of a 3-week-old male infant is described. After receiving an iatrogenic overdose of metoclopramide (1.0 mg/kg every six hours) throughout a 36-hour period for the treatment of suspected gastroesophageal reflux, he became cyanotic, lethargic, and irritable, he fed poorly, and he had diarrhea and respiratory distress. Methemoglobinemia (20.5%) and reduced oxyhemoglobin saturation (79%) were identified. The patient had an excellent clinical response following a single IV dose of methylene blue. Subsequently, methemoglobin reductase activity was normal and there was no measurable hemoglobin M. The diagnosis of methemoglobinemia should be considered in any infant receiving large doses of metoclopramide who has clinical findings of cyanosis, ashen color, or a history of lethargy and/or motor restlessness.
Pediatrics 1988 Sep
PMID:Metoclopramide-induced methemoglobinemia. 340 65

Recombinant human tumor necrosis factor (rH-TNF) is a cytokine with direct antitumor properties. In a phase I trial we continuously infused rH-TNF for 24 hours. We gave a total of 115 courses of therapy to 50 patients. Doses ranged from 4.5 to 645 micrograms of rH-TNF/m2. Systemic toxicity, including fever, chills, fatigue, and hypotension, increased with the dose of rH-TNF administered. Doses greater than 454 micrograms/m2 frequently caused severe lethargy and fatigue, which precluded hospital discharge of the patient at the completion of therapy. The dose-limiting toxicity was hypotension, and five patients treated at the two highest dose levels required dopamine treatment. Other organ-specific toxicity was modest and spontaneously resolved after 48 hours. The 24-hour infusions of rH-TNF were associated with significant decreases in serum cholesterol and high-density lipoprotein levels. Pharmacokinetic studies using an enzyme-linked immunosorbent assay demonstrated peak plasma rH-TNF levels of 90-900 pg/mL. Despite continuous infusion of rH-TNF, no steady-state level was achieved. The recommended phase II dose for rH-TNF as a 24-hour continuous infusion is 545 micrograms/m2.
J Natl Cancer Inst 1988 Sep 07
PMID:Recombinant human tumor necrosis factor administered as a 24-hour intravenous infusion. A phase I and pharmacologic study. 341 18

This was a double-blind, placebo-controlled crossover trial of imipramine (3 mg/kg/day) in 10 profoundly retarded residents. Two groups were formulated: one with depressivelike (or affective) symptoms and one with acting-out behaviors. Measures of drug response included ratings of ward behavior using the Aberrant Behavior Checklist, interval samples of behavior in the living units, and observations of behavior in a playroom situation. Results indicated that the drug caused behavioral deterioration in the Irritability, Lethargy/social withdrawal, and Hyperactivity dimensions of the rating scale, irrespective of subgroup. In addition, gross motor activity was significantly increased on the wards due to imipramine, and it was found that the affective group became less active and the acting-out group more active during free play. Physical side effects were uncommon. These unexpected adverse behavioral effects were discussed with respect to dosage and diagnostic considerations.
J Autism Dev Disord 1986 Sep
PMID:Preliminary study of imipramine in profoundly retarded residents. 354 81

Two full-term neonates, one with convulsions and intermittent generalized hypotonia and one with poor sucking, temperature instability, and lethargy, are reported. CT scan findings suggested cerebral arterial infarction. Arteriography revealed occlusion of the middle cerebral artery, unilaterally in the first and bilaterally in the second patient. The evolution of the infarct could be followed on serial CT scans. No predisposing factors during pregnancy or delivery were found, and serious neurologic deficits developed in both children. These cases demonstrate that, even in full-term neonates with discrete or moderate neurologic symptoms and born after normal pregnancy and delivery, the possibility of vasoocclusive brain infarction should be considered. The diagnosis is suggested by imaging techniques, of which CT scanning seems to have the greatest value at present. This technique also permits the follow-up of the lesions. The prognosis for neurologic development appears to be variable: minor neurologic deficits as well as unexplained spastic hemiplegia in older children may be the consequence of inapparent cerebral arterial infarction in the neonatal period.
Pediatrics 1987 Sep
PMID:Idiopathic cerebral arterial infarction with paucity of symptoms in the full-term neonate. 362 89

A child with an intractable, nonfocal seizure disorder, progressive lethargy, and psychomotor retardation had a malformation involving rhombencephalic structures deriving from the embryonic basal plate. Its principal component was a mature neuroepithelial hamartomatous mass arising from the pontine tegmentum. Diencephalic, metencephalic, and myelencephalic derivatives of the alar plate were remarkably spared. To our knowledge, the morbid anatomy and embryopathology of this central nervous system malformation has not been previously described.
Arch Pathol Lab Med 1987 Sep
PMID:Basal plate dysplasia presenting as a hamartoma of the pontine tegmentum. 363 4

Dogs, naturally infected with Dirofilaria immitis, were treated with the residues of the alcoholic extracts of the rhizomes of Zingiber officinale (ginger). Twelve subcutaneous injections of the extract given at 100 mg/kg reduced microfilarial concentration in blood by a maximum of 98%. Fifty five days after the last injection there was 83% reduction in microfilarial concentration suggesting partial destruction of adult worms. Half of the treated dogs showed some lethargy at the beginning of treatment possibly due to the mass annihilation of microfilariae in blood.
J Helminthol 1987 Sep
PMID:Antifilarial effect of Zingiber officinale on Dirofilaria immitis. 366 17

We report the broad spectrum of clinical manifestations in 23 infants with positive cultures for Listeria monocytogenes who were treated in our hospital during a recent epidemic. The majority of infants (70%) were preterm and none was small for gestational age. Thirteen (56%) had respiratory distress at birth with evidence of congenital pneumonia. Four of the 5 deaths occurred among these infants. Four infants considered healthy after resuscitation developed fever and lethargy within 36 hours after birth. Only one of these infants had evidence of pneumonia. We conclude that congenital pneumonia with respiratory distress at birth is the major cause of mortality and morbidity from L. monocytogenes infection in the neonate.
Pediatr Infect Dis J 1987 Sep
PMID:Clinical manifestations of epidemic neonatal listeriosis. 367 Sep 48

The purpose of this study was to explore the contributions of audiologic and nonaudiologic factors, including medical, social, economic, and psychological, towards understanding hearing handicap in black elderly. One hundred hearing-impaired black elderly subjects from Harlem Hospital were given audiologic evaluations, including speech recognition tests under varied conditions. Audiologic factors were significantly related to hearing handicap, measured by the Hearing Handicap Scale (HHS) and the Hearing Handicap Inventory for the Elderly (HHIE), with stronger correlations for speech recognition measured at 50 dB HL in a sound field than at 40 dB SL under earphones. Once hearing loss was taken into consideration, nonaudiologic factors (measured on the Multidimensional Functional Assessment Questionnaire), particularly the dependability dimension of social support and the lethargy and paranoid dimensions of mental health, emerged as contributing predictor variables for HHS and HHIE scores. These findings suggest that a multidimensional approach is key to understanding and remediating hearing handicap in black elderly.
J Speech Hear Res 1986 Sep
PMID:Audiologic and nonaudiologic correlates of hearing handicap in black elderly. 376 94

Four hundred thirty-four febrile infants two months of age or younger were evaluated in the emergency departments of five major teaching hospitals over a one-year period. A culture-proven bacterial infection was present in 3.5% of the infants; bacteremia was detected in 3.3%. Bacterial meningitis was present in 2.4%, and aseptic meningitis was noted in 13.4%. Twenty-one percent had clinically apparent serious disease including pneumonia, otitis media, and gastroenteritis with dehydration. Six variables (age less than 1 month, lethargy, no contact with an ill individual, breast-feeding, total polymorphonuclear greater than or equal to 10,000/mm3 and band count greater than or equal to 500/mm3) were correlated with bacterial infection by step-wise discriminant analysis. However, these findings were neither sensitive nor specific enough to be clinically useful. Management varied, and 62% of the infants were hospitalized. Fifty-four percent, some of whom were managed as outpatients, received antibiotics. Febrile infants two months of age or younger require a comprehensive emergency department assessment, including appropriate laboratory studies (CBC, differential, urinalysis and culture, lumbar puncture, and blood culture), since 3.5% have bacterial infection that may be life-threatening. Hospitalization is warranted if the infant appears ill, laboratory studies indicate serious infection, or follow-up care is uncertain.
Pediatr Emerg Care 1985 Sep
PMID:Fever in infants less than two months of age: spectrum of disease and predictors of outcome. 384 82

Phorbol esters, in particular 12-O-tetradecanoyl-phorbol-13-acetate (TPA), have been shown to have profound effects on most biological systems including tumor promotion. Presented here are studies on the acute toxic effects of TPA, and the effects of phorbol esters on the in vivo and in vitro, T cell-dependent, antigen-specific antibody response in the mouse. The LD50 of a single i.v. dose of TPA in the mouse was 309 micrograms/kg. Acute toxic effects included lethargy, hypothermia and enlarged, hemorrhagic spleens at the higher doses. TPA was shown to be a potent inhibitor of the in vivo primary antibody response as measured by the IgM antibody-forming cell (AFC) response to sheep red blood cells (sRBC). The ED50 of a cumulative i.v. dose was 145 micrograms/kg administered the day before and the day of immunization (72.5 micrograms/kg/day). A cumulative dose of 500 micrograms/kg (250 micrograms/kg/day) resulted in a 100% suppression of the response. This in vivo exposure to TPA did not alter B cell/T cell ratio in the spleen. Phorbol ester analogs inactive in other biological systems were also inactive in the in vivo AFC response. The in vitro AFC assay was used to determine what cell type was being affected by TPA. Separation of the adherent spleen cells into B and T cell populations was done using nylon wool columns and anti-theta plus complement treatment. Experiments with these cell populations indicated that TPA produced suppression of the response due to an effect on the nylon wool adherent cell population.
Agents Actions 1985 Sep
PMID:Suppression of the antibody response by phorbol esters in the mouse is due to an effect on the nylon wool adherent cell population. 387 72


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