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

Parathyroid carcinoma is a rare cause of hyperparathyroidism (rate of occurrence of 0.5% of all parathyroid neoplasms). In this report we describe three cases of parathyroid carcinoma seen in our Institution and we analyse the clinical, diagnostic, therapeutic and pathological findings of this disease. The three patients were 14, 22 and 45 year old respectively. Familial history was negative for endocrine diseases. The laboratory and instrumental findings of thyroid and adrenal glands were negative. Predominant symptoms were in all cases weakness, lethargy, bone and muscular pain, nausea, vomiting. The two young patients presented fractures of the inferior limb and of the forearm respectively, five years and one year before the diagnosis. X-ray examination and MNR easily demonstrated the "brown tumors". In two cases a symptomatic nephrolithiasis was present. The 14 year old child presented polyuria and polydipsia. In all cases a mass was palpable in the neck (two in the right side and one in the left one). The elevated serum calcium concentration (15, 18, and 20.2 mg/dl respectively) and the elevated serum PTH (480, 651, and 680 pg/ml respectively) allowed the diagnosis of hyperparathyroidism. Ultrasound scan and thallium-technetium scanning identified in all cases a mass adjacent the thyroid. A radical resection of the malignant parathyroid gland and the ipsilateral thyroid lobe was performed in two cases, while only a resection of the involved parathyroid gland in one case. The diagnosis of parathyroid cancer was established using pathologic criteria.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Carcinoma of the parathyroids. Surgical experience in 3 cases]. 774 59

A 9-year-old castrated male domestic shorthair cat with dysuria, anorexia, vomiting, and lethargy was admitted to the veterinary teaching hospital. A large, firm mass was palpable in the ventral cervical region. Hypercalcemia, azotemia, and nonregenerative anemia were evident on serum biochemical analysis and CBC, and multiple uroliths were detected by abdominal radiography. At necropsy, light microscopy of the ventral cervical mass revealed a parathyroid adenocarcinoma. Light microscopy of sections of the kidneys revealed multifocal, chronic, lymphocytic/plasmacytic, tubulointerstitial nephritis, as well as moderate multifocal acute tubular necrosis. On quantitative analysis, the uroliths were composed of calcium oxalate. Determination of serum calcium concentration is indicated in cats with calcium oxalate urolithiasis to aid in detection of primary hyperparathyroidism.
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PMID:Calcium oxalate urolithiasis in a cat with a functional parathyroid adenocarcinoma. 775 34

Efforts to increase livestock utilization of tarbush are being coupled with studies to examine tarbush toxicity. Thirty-eight (19/treatment) ewe lambs were assigned at birth to receive either tarbush or alfalfa (15%, dry matter basis) in a sorghum-based growing ration. Lambs were pen-fed this diet 60 d pre-weaning and 60 d post-weaning. No differences existed between treatments in feed consumption. In the tarbush group, 1 lamb died of unknown causes at 90 d of age, while 3 lambs died between 115 and 120 d of age. There were no deaths in the alfalfa group. Shortly before death, lambs fed tarbush appeared lethargic, disoriented and anorectic. At 122 d of age, 5 lambs were randomly selected from each group. Feces and jugular blood samples were obtained from each lamb before being euthanized and necropsied the following day. All fecal samples were negative for occult blood. Serum gamma glutamyl-transpeptidase (P < 0.001) and aspartate aminotransferase (P < 0.001) activities and platelet counts (P < 0.05) were elevated in lambs fed tarbush, while serum calcium concentrations tended (P < 0.10) to be greater. Histologic examination revealed diffuse liver apoptosis in lambs fed tarbush. These data indicate tarbush leaves cause liver damage when fed for extended periods of time.
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PMID:Effect of chronic ingestion of tarbush (Flourensia cernua) on ewe lambs. 783 64

An 85-year-old man who presented with depression and lethargy was found to have hypercalcemia, normal phosphorous, and low-normal intact parathyroid hormone level. Work-up revealed no evidence of a malignant or inflammatory process. However, 24-hour urinary calcium excretion was increased, 1,25 dihydroxy (OH2) vitamin D3 level was elevated, and angiotensin-converting enzyme (ACE) level was twice normal. The patient responded to a trial of steroids and his 1,25-OH2 vitamin D3 and ACE levels decreased to within normal limits. The patient has remained eucalcemic on low-dose steroids.
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PMID:Hypercalcemia associated with an elevated 1,25 dihydroxy vitamin D3 level and an elevated angiotensin-converting enzyme level in a patient without evidence of sarcoidosis or malignancy. 805 95

Goldberger discovered human pellagra was a non-infectious disease, affecting mostly the small and the timid in overcrowded institutions. Symptoms were diarrhoea, dermatitis and dementia. The staff and older children escaped the disease. They ate the meat and left the small and timid with the gravy. The 'Goldberger syndrome' is observed during competitive feeding of livestock, in ketotic animals and in the zinc depleted which are lethargic and pick all day at their feed. The pellagra preventative factor was later found to be nicotinic acid, derived from the amino acid tryptophan. Deficiencies of copper, magnesium, vitamin B6 (activated by a zinc kinase) inhibit the conversion of tryptophan to nicotinic acid. Stresses, including liver diseases, malabsorption, iron overload, porphyria, marasmus, cold stress, pregnancy, lactation, antibiotics and sulfa drugs, all increase dietary needs of nicotinic acid. Elevated free fatty acids and ketone bodies in the blood are associated with ketosis, zinc depletion and the pre-diabetic state. There is a diminished uptake of glucose by the tissues, a condition also found in parturient paresis of dairy cows when elevated hydrocortisone promotes insulin resistance and hyperglycaemia. This defect in insulin response leads to a diabetic-like state. The major predisposing factor in parturient paresis of dairy cows is hypocalcaemia. Gut absorption of dietary calcium may not meet the primary demands of lactation initiation until bone calcium mobilisation is established.
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PMID:Metabolic disorders of cattle. 839

Rickets is a common and paradoxical feature of infantile malignant osteopetrosis and results from the inability of osteoclasts to maintain a normal calcium-phosphorus balance in the extracellular fluid. Despite a markedly positive total body calcium balance, rickets arises when the serum calcium x phosphorus product is insufficient to mineralize newly formed chondroid and osteoid. In five children with malignant infantile osteopetrosis, there were clinical, radiographic, biochemical, and histologic findings of rickets. Characteristic biochemical abnormalities included hypocalcemia, hypophosphatemia, and elevated levels of serum acid phosphatase, alkaline phosphatase, c-terminal parathyroid hormone, and 1,25-dihydroxyvitamin D. The urinary calcium/creatinine ratio was markedly depressed. The serum calcium x phosphorus product was below 30 in all children at the time the rickets was diagnosed, and above 40 by the time the rickets had resolved. Baseline bone density measurements were markedly elevated in all children (> 5 standard deviation above normal) and showed even significant increases (> 7 SD) when the rickets was treated with vitamin D and calcium. The children showed marked clinical improvement, decreased lethargy, increase in mobility and activity, and stimulation of appetite, without any additional adverse hematologic or neurologic effects. The rickets was reversible in all children: in one by HLA-identical sibling bone marrow transplantation and in four by physiologic doses of vitamin D and calcium. The parathyroid and renal responses to hypocalcemia were appropriate, but glucocorticoids, used in treating the hematologic complications of the disease, may have blunted the intestinal response to maximal vitamin D stimulation. This latter blockade can be overcome by increasing dietary calcium. By liberalizing rather than by restricting calcium and phosphorus intake, hypocalcemia can be minimized, phosphorus metabolism can be improved, and rickets can be cured.
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PMID:Osteopetrorickets. The paradox of plenty. Pathophysiology and treatment. 839 71

Clinical signs that included lethargy, inappetence, diarrhea, and vomiting and that progressed to seizures were observed in 40 feeder pigs that were approximately 70 days old. The pigs were fed ground red wheat and whole milk and were housed in a barn that did not allow exposure to direct sunlight. Analysis of samples of feed obtained from the farm indicated inadequate quantities of calcium and phosphorus as well as a low ratio of these 2 nutrients. Serum and tissue concentrations of vitamin A were less than normal. Low serum calcium concentrations, high serum phosphorus concentrations, and high alkaline phosphatase and creatine kinase activities were compatible with low vitamin D concentrations.
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PMID:Seizures and acute death attributable to hypovitaminosis A and suspected hypovitaminosis D in feeder pigs. 849 85

The microcirculatory state (by the method of conjunctival biomicroscopy) and ADP-induced platelet aggregation were examined in 42 patients with atherosclerotic and 34 patients with involutional depression both before and after the treatment which included vasoactive preparations and calcium antagonists. It was determined vascular and intravascular alterations predominance and increase of platelet aggregation in patients with atherosclerotic depression independently of leading syndrome, in patients with involutional depression with anxiety prevalence as well as in patients in stuporous state. The tendency was revealed of such disturbances increasing as for as psychosis was extended. Trental and Cavinton antiplatelet and spasmolytic properties were potentiated by inclusion of Corinfar in complex therapy and that promoted earlier microcirculatory alterations removal as well as aggregatograms and patient mental state normalization.
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PMID:[Changes in the microcirculatory rheological properties of the blood and their correction in patients with atherosclerotic and involutional depressions]. 858 81

A study was undertaken to provide further information on the ruminal, cardiorespiratory and hypothalamo-pituitary-adrenocortical (HPAC) physiological sequelae of hypocalcaemia in dairy calves. The functional picture observed in standing calves experiencing Na2EDTA-induced progressive hypocalcaemia showed a biphasic pattern. During the first phase (Ca2+ varying between 1.20 +/- 0.09 and 0.64 +/- 0.15 mmol/L, mean +/- SD), the animals became dull and lethargic, shifting their weight from one hind limb to the other, with cool extremities and hypersalivation. Their ventilation was slightly increased but their heart rate, thoracoabdominal pressure, pulmonary mechanics, haemoglobin and temperature remained constant. Conversely, their systemic arterial pressure (SAP) and the amplitude of their ruminal contractions (RCA) were severely decreased. During the second phase (Ca2+ < 0.64 +/- 0.15 mmol/L), there was restlessness, tachycardia, hypertension, polycythaemia and, finally, inability to stay upright. It is suggested that the diminished Ca2+ availability caused smooth-muscle and myocardial dysfunctions which could explain the RCA and SAP changes recorded during the first phase, whereas neural and/or humoral sympathetic discharge probably accounted for the reversal in SAP and heart rate when Ca2+ was decreased further. Serum cortisol increased regularly and remained significantly correlated with Ca2+ in each animal. Moreover, regression of delta cortisol/delta Ca2+ on delta Ca2+/delta Na2EDTA was significant (p < or = 0.001). It was concluded that mild asymptomatic hypocalcaemia severely impairs ruminal function, which will progressively worsen the Ca2+ deficit; that the inability to maintain posture in hypocalcaemia is not due to hypotension; and that the higher the HPAC response to hypocalcaemia, the higher the resistance to its effects. An asymptomatic periparturient cow with barely detectable ruminal activity may merit preventive calcium borogluconate therapy. Also, the physiological role of hypotension in explaining the clinical picture may be less important than other processes, such as neuromuscular failure. Finally, the present results imply a possible HPAC exhaustion in cows with periparturient paretic hypocalcaemia.
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PMID:Ruminal, cardiorespiratory and adrenocortical sequelae of Na2EDTA-induced hypocalcaemia in calves. 869 1

A 9-year-old female ball python was evaluated for lethargy and respiratory compromise. Radiographic and endoscopic examination revealed a 1-cm intratracheal mass occluding the tracheal lumen. A partial tracheal resection and anastomosis was performed to remove the mass. On histologic examination, the mass was determined to be an intratracheal chondroma. Eosinophilic cytoplasmic inclusions observed within the tissue were calcium deposits. Electron microscopy was used to differentiate these from viral inclusion bodies often associated with neoplasms in reptiles. Endoscopic evaluation of the trachea 5 weeks after surgery revealed complete healing and minimal stenosis at the surgery site. Indications of tumor regrowth were not evident. Clinical signs of recurrence of respiratory compromise had not been observed 9 months after surgery.
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PMID:Tracheal resection and anastomosis for an intratracheal chondroma in a ball python. 875 80


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