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

Rhinocerebral mucormycosis is a rare and fatal deep fungus infection occurring in debilitated patients. Its reports have been recently increased because of the increase of such conditions as uncontrolled diabetics, leukemia, and cancer. A 60-year-old male suffering from continuous headache and fever was diagnosed as meningitis, and repeated culture of cerebrospinal fluid was negative. Antibiotic therapy was ineffective. CT scan revealed brain abscess in the right frontal lobe and bone defect over the right posterior ethmoidal sinuses. Both maxillary and ethmoidal sinuses were operated on 38 years ago. The patient was suspected to have rhinologic brain abscess. We intended to remove the source of infection in the right posterior ethmoidal sinuses beneath the base of the skull and to repair the defect of dura mater. The operation was tried on the 6th hospital day. There was a cyst in the posterior ethmoidal sinuses and an intact denuded dura mater over the cyst. The causative organism was not detected by smear test, bacteriological and fungal culture. He relapsed into lethargy, and died on the 21st hospital day due to the vast cerebral infarction. Autopsy revealed rhinocerebral mucormycosis. The literature on this disease was also reviewed and discussed.
Nihon Jibiinkoka Gakkai Kaiho 1990 Dec
PMID:[Phinocerebral mucormycosis--report of a case]. 229 52

Mice injected intracerebrally with infectious influenza virus (60 hemagglutinin units) developed lethargy, seizures, comas, and died 2 to 5 days postinfection. As early as 6 h after infection, the cerebrospinal fluid (CSF) in these animals was infiltrated with polymorphonuclear cells, mononuclear leukocytes, and large granular lymphocytes. Potent natural killer (NK) cell activity was observed for both CSF and spleen cell populations over the same period. This NK cell activity correlated with interferon (IFN) levels in the CSF and serum. Treatment of lethally infected mice with either anti-IFN alpha-IFN beta or anti-ganglio-n-tetraoglyceramide antiserum ameliorated the disease, reduced mortality, and effected changes in the relative proportions of inflammatory cell populations infiltrating the CSF. The possible significance of IFN and NK cell activity in the development of this influenza virus-induced encephalopathy is discussed.
J Virol 1986 Dec
PMID:Influenza virus-induced encephalopathy in mice: interferon production and natural killer cell activity during acute infection. 243 Nov 59

Weakness, lethargy, ataxia, lateral recumbency, limb paddling, tremors, salivation, and diarrhea were observed in newborn pigs on a commercial swine farm. Many pigs became moribund and died. All had been treated with an aerosol wound spray containing 2.5% chlorpyrifos. A controlled study was undertaken to determine whether the aerosol spray was the cause of these clinical signs. Pigs exposed to aerosol spray containing 2.5% chlorpyrifos at 3 hours (n = 4) and 6 hours (n = 3) after birth developed clinical signs similar to those on the farm; none survived. Pigs exposed at 24 hours (n = 5) after birth developed clinical signs consistent with those that had developed in pigs on the farm; 3 died and 2 survived. Of 3 pigs exposed to the same spray at 36 hours after birth, 1 developed tremors 7.5 hours later and diarrhea 9 hours later, then returned to normal.
J Am Vet Med Assoc 1987 Dec 01
PMID:Toxicosis in newborn pigs associated with cutaneous application of an aerosol spray containing chlorpyrifos. 244 44

Twenty-four patients with caudate hemorrhage, in whom such definite organic lesions as arteriovenous malformations or ruptured cerebral aneurysms could not be proved, were analyzed. These cases comprise 2.0% of 1202 cases of hypertensive intracerebral hemorrhage diagnosed by computed tomography and experienced from 1976 through 1987. Thirteen patients were male and 11 were female. Their average age was 61 years. Headache (67%) and nausea and vomiting (50%), which were often the initial symptoms, were similar to those of subarachnoid hemorrhage. The main clinical symptoms were signs of meningeal irritation. Ten patients (42%) had transient disturbance of consciousness, and nine (38%) of these were somnolent; only one patient, who had a massive hematoma, was stuporous. When the hematoma extended to the internal capsule, the patient showed motor disturbance (38%). Two patients (8%) had Horner's sign, five (21%) exhibited diminished activity, and one (4%) suffered anosognosia. The volume of the intracerebral hematoma averaged 4.7 ml and was less than 5 ml in 17 patients (71%). In 20 patients (83%), the hematoma was confined to the head of the caudate nucleus. The hemorrhage tended to rupture into the anterior horn of the lateral ventricle, and in nearly all cases (96%), intraventricular hematoma was observed. Seventeen patients (71%) underwent cerebral angiography. There were no instances of dilation of the recurrent artery of Heubner. Twenty patients (83%) were treated conservatively. Continuous ventricular drainage was employed in four patients (17%), and ventriculoperitoneal shunting in three (13%). However, it was judged retrospectively that continuous ventricular drainage had been necessary in only two cases in which disturbance of consciousness was progressed due to acute hydrocephalus.(ABSTRACT TRUNCATED AT 250 WORDS)
Neurol Med Chir (Tokyo) 1989 Dec
PMID:[Clinical analysis of 24 cases of caudate hemorrhage]. 248 89

A 13-month-old boy admitted with lethargy and hydrocephalus was found to have a right thalamic mass. Ventricular drainage was instituted, and the tumor mass was reduced by partial resection and local irradiation. A ventriculoperitoneal shunt was then placed. However, the tumor recurred 16 months later, with extensive ventricular seeding and peritoneal metastasis through the shunt tube. The child died 22 months after onset. Histological study of surgical specimens of the primary tumor and autopsy specimens of the brain and peritoneal metastatic tumors revealed poorly differentiated, small, round cells with numerous mitotic figures. In addition, autopsy specimens of the brain tumor contained areas of ependymal, oligodendroblastic, and spongioblastic differentiation. On immunohistochemical study, the tumor cells of each specimen were positive for anti-neuron specific enolase and anti-neurofilament antibodies, but negative for anti-glial fibrillary acidic protein antibodies. Electron microscopy revealed some zonulae adherens. These findings strongly suggest that the tumor originated from primitive multipotential cells capable of differentiating into ependymal, glial, and neuronal lines.
Neurol Med Chir (Tokyo) 1989 Dec
PMID:[Primitive neuroectodermal tumor with peritoneal metastasis through a ventriculoperitoneal shunt. Case report]. 248 94

An 8-year-old sexually intact male llama was euthanatized because of obstruction of the penile portion of the urethra and rupture of the urinary bladder. Clinical signs of obstruction included anorexia, lethargy, teeth grinding, straining to defecate, inability to urinate, and tense abdomen. Laboratory findings included anemia, leukocytosis with left shift, high serum urea nitrogen, creatinine, and phosphorus concentrations, and low serum chloride concentration. Necropsy revealed ruptured urinary bladder and acute fibrinous peritonitis. A firm, gray, nonmineralized urethral plug occluded the penile portion of the urethra for a distance of 14 cm in the midpenile region, distal to the sigmoid flexure of the penis. The urinary bladder mucosa and the urethra had microscopic evidence of chronic inflammation. Escherichia coli, Klebsiella sp, and alpha-streptococci were isolated from the urethral plug.
J Am Vet Med Assoc 1989 Dec 01
PMID:Urethral obstruction in a male llama. 259 47

The records of 15 dogs diagnosed as having juvenile cellulitis (juvenile pyoderma, puppy strangles) were evaluated for clinical, laboratory, and therapeutic results. Mandibular lymphadenopathy was observed in 14 dogs, and was not associated with skin lesions in 5 dogs. Edema, pustules, papules, or crusts were noticed periorally, periocularly, on the chin or muzzle, or in the ears of those dogs with skin lesions. Eight dogs were lethargic; fever and anorexia were inconsistent findings. Four dogs had signs of pain on manipulation of their joints. Complete blood counts revealed leukocytosis with neutrophilia in 4 dogs, and normocytic, normochromic anemia in 6 dogs. Three dogs had suppurative lymphadenitis with many neutrophils. Cytology of the aspirate of pustules or abscesses in 6 dogs revealed many neutrophils without bacteria. Coagulase-positive Staphylococcus spp were isolated from draining lesions in 2 dogs. Intact abscesses and lymph nodes were negative for bacterial growth in 4 dogs. Three of these dogs were being administered antibiotics at the time of bacterial culturing. Cytology of the aspirates of joints in 3 of the 4 dogs with joint pain revealed suppurative arthritis with no bacteria, and the aspirates were negative for bacterial growth on culturing, although all 3 dogs were being administered antibiotics at the time of culturing. Of 12 dogs initially treated with antibiotics, only 4 (33%) responded favorably; the other 8 dogs were then given antibiotics and corticosteroids. Three dogs were initially given antibiotics and corticosteroids. All dogs treated concurrently with antibiotics and corticosteroids responded favorably. One of these dogs had a relapse after treatment was discontinued. The concurrent arthritis in 4 of the dogs resolved with treatment of the juvenile cellulitis and did not redevelop once the medication was discontinued. Concurrent treatment with antibiotics (cephalosporins) and prednisone (2.2 mg/kg of body weight/day) was the most consistently effective treatment in the dogs in this study.
J Am Vet Med Assoc 1989 Dec 01
PMID:Juvenile cellulitis in dogs: 15 cases (1979-1988). 259 49

Previous reports of accidental ingestion of cannabis by children are rare. None has reported coma, although one described a stuporous state that required assisted ventilation. Over the past four years, the staff of British Columbia's Children's Hospital has managed six children with cannabis toxicity, three of whom presented in coma, including one with airway obstruction. Recurring diagnostic features included rapid onset of drowsiness, moderate pupil dilation, hypotonia, lid lag, and the presence of small granules or leaves in the mouth. Confirmation was obtained by positive urine screening for cannabinoids. The six cases described emphasize the need for emergency physician awareness of possible diagnostic criteria, the potential severity of intoxication, and the need for prevention through parent education.
Pediatr Emerg Care 1989 Dec
PMID:Ingestion of cannabis: a cause of coma in children. 260 98

Neurological symptoms including lethargy, obtundation, and confusion are early and common findings in patients with sepsis. The etiology of the mental status changes that occur during severe infection is not known. We investigated the effects of sepsis on the levels of high-energy phosphates to determine whether decreased energy metabolism was a factor in the depressed neurological state. The time course of changes in brain pH and brain high-energy phosphate metabolites during an Escherichia coli infusion was determined from sequential phosphorus-31 nuclear magnetic resonance (31P-NMR) spectra of ketamine-xylazine-anesthetized rats. A second group of rats received 0.9% saline infusion and served as a control group. Despite severe obtundation and near loss of righting reflex, the rats in the septic group had no significant differences in the brain pH, the ratio of phosphocreatine (PCr) to beta-adenosine 5'-triphosphate (beta-ATP), or in the ratio of PCr to Pi. The only significant decrease in brain high-energy phosphates or pH occurred terminally in the septic rat group and corresponded with a rapidly falling arterial blood pressure. We conclude that the severe neurological depression that is characteristic of sepsis is not due to decreased levels of brain high-energy phosphates or brain acidosis.
Am J Physiol 1989 Dec
PMID:An in vivo examination of rat brain during sepsis with 31P-NMR spectroscopy. 261 Feb 45

Twenty patients with supratentorial, intracerebral lesions defined by computed tomographic scan or magnetic resonance imaging were treated by surgery and adoptive immunotherapy with lymphokine-activated killer (LAK) cells and recombinant Interleukin-2 (rIL-2, Cetus). Seventeen patients had glioblastoma, two had high-grade oligodendroglioma, and one patient had two metastatic sarcoma lesions. LAK cells were produced from blood mononuclear cells (MNC) obtained by 2 to 3 leukapheresis procedures and cultured (2.5 x 10(6) MNC/ml) 3 to 5 days with 1000 units rIL-2/ml. Although LAK cells could be produced from MNC of all patients, those taking steroids or with a low Karnofsky functional status generated, on average, suboptimal LAK cell activity. Age, sex, and serum anticonvulsant levels do not seem to influence a patient's ability to produce LAK cells in vitro. For therapy, cultured MNC (1-15 x 10(9] containing LAK cells were suspended in saline containing 10(6) units rIL-2 and injected into tissue surrounding the tumor cavity during craniotomy. For 3 days after their operations, patients received 10(6) units rIL-2 into the tumor cavity through an Ommaya reservoir. The treatment protocol was tolerated well by all patients, although they all experienced some degree of headache, fever, or lethargy that cleared within a few days of the last rIL-2 injection. When computed tomographic (CT) scans were obtained soon after treatment, areas of low density suggested a greater-than-normal extent of edema around the operative site. At the present time, CT scans indicate that the tumors of seven patients have recurred with an average disease-free interval of 25 +/- 6 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
Neurosurgery 1988 Dec
PMID:Intralesional infusion of lymphokine-activated killer (LAK) cells and recombinant interleukin-2 (rIL-2) for the treatment of patients with malignant brain tumor. 285 Nov 16


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