Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1762617 (weakness)
 37,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case of a 36-year-old women found to have a hepatic tumor is reported. The patient complained a malaise, weakness, dyspnea, and ankle edema and had been aware of a slowly growing abdominal swelling for 3 years. She had been taking Gynovlar 21 (3 mg norethinsterone acetate with 50 mcg ethinyl estradiol) for 6 years. Laparotomy revealed a solid, vascularized tumor arising from the left lobe of the liver and from part of the right lobe. A 2800 gm mass was excised along with a 40 gm mass from the celiac axis that involved lymphatic tissue. This is the 1st case report of a hepatic malignancy associated with an oral contraceptive that showed histological evidence of secondary spread.
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PMID:Hepatocellular carcinoma associated with oral contraceptives. 20 11

Thirty-four women with first recurrence of breast cancer were randomized into two groups, and received either Diethylstilbestrol (DES) 5 mg orally (PO) t.i.d. alone, or in combination with Chlorambucil (CB) 0.1--0.2 mg/kg/day PO. All patients randomized were greater than 5 years postmenopausal at the time of the study and had no prior chemical or hormonal therapy. Estrogen receptors were not available. There was no significant difference between Groups A and B with respect to frequency of objective response or mean duration of that response, with the values for Group A being 46.2% and 4.8 months, respectively, and for Group B, 46.7% and 4.8 months (P greater than 0.05). The most common toxicities noted for both groups were nausea and vomiting, edema, weakness, and thrombophlebitis. The risk of major toxicity necessitating withdrawal from the study was greater in Group B due to the added danger of thrombocytopenia/pancytopenia. The addition of CB to DES does not appear to offer any significant advantage over DES alone in women with first recurrence of breast cancer.
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PMID:Comparison of DES vs DES + chlorambucil in women with first recurrence of breast cancer. 48 Sep 49

In 1983, a previously healthy 21-year old mother came to University Hospital in Dijon, France feeling weak and had a severe frontal headache with vomiting. Clinical and biochemical tests were normal. She smoked 20 cigarettes/day and used a high dosed combined oral contraceptive (OC) (ethinyl estradiol and cyproterone acetate). 15 days later, the headache returned and she could not understand spoken words and the bilateral section of the brain had slowed. Yet her mental status was normal as were cerebrospinal fluid and cerebral computerized tomography tests. The antiherpes virus drug, vidabarine, did not alleviate symptoms. At least 1 month later, a severe left pulmonary embolism caused acute right heart failure. She also had a prethrombotic left iliac vein, so physicians began heparin therapy, adding nifedipine and buflomedil to control the spasms in the right internal iliac artery and both external iliac arteries. Acute ischemia of the lower limbs eased within a week but sensory disorders remained for 2 months. Satisfactory collaterality transpired due to a blocked left external iliac artery and left iliac vein. The following signs and symptoms indicated her condition to be homocystinuria: blond hair with deep blue eyes, macrocytic anemia, factor VII deficit (51%), strong positive Brandt's reaction, cystine homocystine in the plasma, and presence of homocystine, cystathionine, and methionine in the urine. Physicians took her off the OC and discharged her on vitamin B6/day, folic acid/day, betaine citrate/day, and the anticoagulant Coumadin. A subsequent check of her 19-year old sister found she had it too. They assessed the patient's condition yearly. In 1988, her left leg developed edema and she limped when not using elastic stockings. Effects of iliac vein phlebitis were evident. She no longer suffered from headaches. Since plasma methionine was within the normal range and homocystine no longer was present in plasma and urine, the physicians halted the anticoagulant therapy. In conclusion, the OC precipitated this partial form of homocystinuria.
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PMID:Vascular manifestations in homocystinuria. 161 Jun 63

Psychotropic effects have been imputed to oral contraceptives (OCs); however, studies with large populations found no depressive episodes caused by OCs. Affective disorders of women such as premenstrual syndrome and postpartum and menopausal depression are well-known. The estrogen and progesterone levels are high during pregnancy, when the risk of emotional disease declines. A study on Marvelon (containing .15 mg of desogestrel and .03 mg of ethinyl estradiol) involving 27,000 women found a history of depression in 3%, but in 90% the symptoms disappeared after OC use. Other studies corroborated the finding that OCs exerted a stabilizing effect on emotional disorders. The overwhelming majority of women without psychiatric anamnesis did not suffer any mood fluctuations under OC use. In a study, 4327 women were interviewed at 3 and 6 months of OC use, and in 45.7% their sense of well-being improved, 30.3% were in a good frame of mind, and 21.2% had a slight deterioration of their sense of well-being. Neurotic and introverted persons tended to attribute affective disorders, weakness of concentration, sleep disturbances, and the avoidance of sex to OCs. With such individuals, OC indication requires particularly strict adherence to rules. The ability of Ocs to improve acne was analyzed when 1785 questionnaires were examined from 1958 women who had used Marvelon. 60% reported improvement of their acne, and 50% of the more severe cases improved. Dysmenorrhea and menstrual cycle disorders improved similarly. Body weight increase in insignificant with modern OCs. OCs exert a positive psychotropic effect through their ability to influence these conditions.
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PMID:[Does the pill have a psychotropic effect?]. 215 6

Platelet aggregation during steroidal treatment of dysfunctional uterine hemorrhages in the climacteric was studied. Non-ovlon, containing .05 mg of ethinyl estradiol and 1 mg of norethisterone acetate, and Norcolut, containing 5 mg of norethisterone, were used as sex steroids. The study included 60 women, aged 40-53 years, with dysfunctional hemorrhages. The control group consisted of 20 healthy women in the same age group. Upon admission, all patients were complaining of uterine hemorrhages and general weakness. In most cases, the hemorrhages were of an acyclical nature. In 3 months, 5 of the 20 women taking Non-ovlon developed the clinical symptoms of thrombophilia. In 3 of the 5 patients, symptoms of thrombophlebitis were observed. Hormonal therapy for these patients was terminated and they were treated with anticoagulants and antiaggregants. Norcolut caused no clinical symptons of thrombophilia. Results were confirmed by platelet determinations and aggregatograms. Comparison of clinical and laboratory data suggests a direct correlation between platelet hyperactivity and the genesis of the aforementioned complications of combined estrogen/gestagen preparations. Results contribute to a better understanding of the disorders occurring during the intake of sex steroids in the climacteric.
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PMID:[Platelet aggregation during the intake of sex steroids in patients with dysfunctional uterine hemorrhages in the climacteric]. 240 8

Most antiandrogens appear to act by binding to the androgen receptor and competitively inhibiting the binding of testosterone and cihydrotestosterone to the receptor. Focusing on those compounds which appear to inhibit androgen receptor mediated responses, this review discusses the chemistry of those antiandrogens which have been studied to the extent that their mechanism of action is at least partially understood, outlines the mechanism of androgen action as it is currently understood and suggests how antiandrogens might fit in with this mechanism, indicates the major metabolites of several important antiandrogens, and discusses the clinical applications of several antiandrogens. Cyproterone acetate has been studied extensively as a potential male contraceptive. Although it was recognized that 100 mg of cyproterone acetate per day inhibited spermatogenesis, that dose also reduced libido and potency. Following the administration of 10 or 20 mg of cyproterone acetate per day to 15 males for 26 weeks, the following observations were made: the number of motile sperm was reduced; the quality of their motion was impaired; and the ability of the sperm to penetrate cervical mucus was decreased. Sperm density was also suppressed, but neither it nor sperm motility were inhibited to the extent necessary for contraception. Antiandrogens have been demonstrated to be beneficial in treating 5 clinical syndromes or diseases: acne, seborrhea, hirsutism with or without menstrual abnormalities; precocious puberty; benign prostatic hypertrophy; cancer of the prostate; and sexual deviates. Since 3 of these conditions are very common, effective and safe treatment would have a large market. At this time, antiandrogens are widely used in Europe for treatment of seborrhea, acne, and hirsutism and a large Veterans Administration Cooperative Study in the US was approved but has not yet been funded to compare antiandrogens with other treatments for cancer of the prostate. Studies to assess antiandrogen interaction with other hormones or drugs have been limited. Side effects in the female have been best evaluated when cyproterone acetate was administered in combination with ethinyl estradiol. In 46 women followed over 317 cycles, side effects were similar to those reported with estrogen-progestin contraceptives. Administration of 10-20 mg of cyrproterone acetate per day to males caused no significant side effects, but 100 mg or more/day has caused loss of libido, impotence, gynecomastia, tiredness, weakness, decreased efficiency, weight gain, drying and desquamation of skin over the legs, and loss of hair on the trunk and pubic area.
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PMID:Androgen antagonists in androgen target tissues. 620 9

This case study reports on an obstetric rarity -- an intrauterine and an extrauterine pregnancy of a patient with an IUD in place. The 26-year-old primigravid patient had a previous history of cesarean section for cephalopelvic disproportion. 10 months after the cesarean section a Lippes Loop D was inserted. 2 months after the insertion she was hospitalized for heavy vaginal bleeding following a menstrual delay of 3 weeks. The IUD was shown to be correctly inserted. The uterine cervix was soft and half open. Upon palpation the uterus was found to be enlarged. The probable diagnosis was incomplete spontaneous abortion. IUD removal was followed by curettage. The pathologist's report confirmed the diagnosis of spontaneous abortion. A week after the curettage the patient again complained of scant vaginal bleeding and cramping pain localized in the lower abdomen. She was given ethinyl nortestosterone acetate and ethinyl estradiol for 10 days. After 48 hours of treatment the bleeding stopped. A month later the patient reported copious vaginal bleeding. Another curettage was performed in which several clots were removed. A puncture of the posterior fornix was performed with negative results. Examination of the patient under anesthesia revealed a small mass in the right lower quadrant. The 2nd pathology report on the clots referred to "endometrial tissue with signs of progesterone treatment" without an Arias-Stella image. 5 days after the last curettage the patient was admitted with abdominal pains, vaginal bleeding, weakness, and dizziness. An extrauterine pregnancy was suspected and a laparoscopy was performed. A ruptured right tubal pregnancy was found. A salpingectomy was then performed. Because of the reliability of the patient, it is certain that she did not have intercourse after the 1st curettage. This fact invalidates the possibility of an ectopic pregnancy occurring after her normal pregnancy.
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PMID:Double (uterine and ectopic) pregnancy of a patient using an intrauterine contraceptive device. 646 63

Up to 40 percent of postmenopausal women have symptoms of atrophic vaginitis. Because the condition is attributable to estrogen deficiency, it may occur in premenopausal women who take antiestrogenic medications or who have medical or surgical conditions that result in decreased levels of estrogen. The thinned endometrium and increased vaginal pH level induced by estrogen deficiency predispose the vagina and urinary tract to infection and mechanical weakness. The earliest symptoms are decreased vaginal lubrication, followed by other vaginal and urinary symptoms that may be exacerbated by superimposed infection. Once other causes of symptoms have been eliminated, treatment usually depends on estrogen replacement. Estrogen replacement therapy may be provided systemically or locally, but the dosage and delivery method must be individualized. Vaginal moisturizers and lubricants, and participation in coitus may also be beneficial in the treatment of women with atrophic vaginitis.
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PMID:Diagnosis and treatment of atrophic vaginitis. 1083 58

The sequential method of contraception with megestrol acetate with ethinyl estradiol was offered to 61 women for 549 cycles in this study. No pregnancies occurred. Flow was less in 7 women and greater in 3; duration of flow was longer in 5 women and shorter in 3. There were 2 instances of breakthrough bleeding. Persistant postnatal amenorrhea occurred in 1 woman and menorrhagia in another. Random endometrial biopsies showed proliferative activity in the majority of cases. Side effects observed were: nausea, vomiting, giddiness, leucorrhea, headache, weakness and abdominal pain. Most of these symptoms occurred in the first 2 cycles. 29 women dropped out after the first year, and 8 of these women conceived. Ethinyl estradiol was used in .1mg dose, megestrol acetate in 1 mg.
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PMID:Evaluation of sequential method of contraception with megestrol acetate and ethinyl oestradiol. 1215 52

Regardless of their origin, neuroactive steroids are capable of modifying neural activities by modulating different types of membrane receptors. Neurosteroids are synthesized de novo in neurones and glia. Steroidogenic enzymes are found in the central nervous system. Classical steroid receptors are localized in the cytoplasm, they exert regulatory actions on the genome, and their activation causes medium- and long-term effects. Non-classical receptors are located within the membrane and act as mediators of short-term effects. Other important players are co-repressors and co-activators that can interfere with or enhance the activity of steroid receptors. Beyond their function in stress, corticosteroids play a very important role in fear, anxiety, and memory functions. Patients with Cushing's syndrome frequently develop mood disorder, reversible brain atrophy with transient memory loss, rarely delirium or psychosis. Well-known peripheral symptom is steroidal myopathy. In patients with Addison's disease the main signs are weakness of muscles, lack of energy, decreased mental functions and reduced quality of life. Estrogen and progesterone have their own respective hormone receptors, whereas allopregnanolone acts via the GABA receptors. These hormones have significant role in the development of brain, the architecture of neural circuits and dendrites, density of axonal connections, and the number of neurons. They influence maturation, neuroprotection, seizures, cognitive functions, mood, anxiety, pain, and restitution of peripheral nerves. Androgens also affect cognitive functions, pain, anxiety, mood, and additionally aggression.
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PMID:[Neurological and psychiatric aspects of some endocrine diseases. The role of neurosteroids and neuroactive steroids]. 1792 Nov 20


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