-
Pediatrics in Review Jun 2017
Review
Topics: Asphyxia; Diagnosis, Differential; Humans; Infant, Newborn; Intensive Care, Neonatal; Lethargy; Seizures
PubMed: 28572143
DOI: 10.1542/pir.2016-0004 -
Medicina (Kaunas, Lithuania) 2008Coma is the disorder of consciousness because of the damage to diffused bilateral cerebral hemisphere cortex or reticular activating system. Coma can be caused by... (Review)
Review
Coma is the disorder of consciousness because of the damage to diffused bilateral cerebral hemisphere cortex or reticular activating system. Coma can be caused by neurogenic (head brain injury), metabolic (endogenic), and toxic (exogenic) factors. To determine the cause of metabolic and toxic coma, laboratory tests are performed; in case of neurogenic coma, the neurologic examination is essential, when five systems are evaluated: the level of consciousness (according to Glasgow Coma Scale or Full Outline of Unresponsiveness Scale), photoreaction of pupils and ophthalmoscopic examination, oculomotoric, motoric, and cardiopulmonary systems. For the treatment of coma, adequate oxygenation and correction of blood circulation disorders are important. The treatment of metabolic coma is guided by special schemes; antidotes often are needed in the treatment of toxic coma, and surgery helps if traumatic brain injury is present. The prognosis and outcomes of the comatose patient depend on the age and comorbid diseases of the patient, the underlying cause of coma, timely medical help and its quality, and intensive treatment and care of the patient in coma.
Topics: Aged; Brain Death; Coma; Confusion; Critical Care; Diagnosis, Differential; Electroencephalography; Glasgow Coma Scale; Humans; Lethargy; Magnetic Resonance Imaging; Prognosis; Sepsis; Stupor; Time Factors
PubMed: 19001840
DOI: No ID Found -
NeoReviews Nov 2023
Topics: Infant, Newborn; Humans; Muscle Hypotonia; Lethargy
PubMed: 37907399
DOI: 10.1542/neo.24-11-e733 -
Pediatrics in Review Feb 2022Laboratory results include the following: white blood cell count, 21,600/μL (21.6 × 109/L; reference range, 9,000-30,000/μL [9-30 × 109/L]); hemoglobin, 18.2...
Laboratory results include the following: white blood cell count, 21,600/μL (21.6 × 109/L; reference range, 9,000-30,000/μL [9-30 × 109/L]); hemoglobin, 18.2 g/dL (182 g/L; reference range, 14.0-24.0 g/dL [140-240 g/L]); platelet count, 111 × 103/μL (111 × 109/L; reference range, 150-450 × 103/μL [150-450 × 109/L]); blood type, B+; direct antiglobulin test, negative; and reticulocyte count, 4% (reference range, 3%-7%). Comprehensive metabolic panel is significant for hyponatremia, with a sodium level of 132 mEq/L (132 mmol/L; reference range, 135-145 mEq/L [135-145 mmol/L]). Liver enzyme levels are normal (alanine aminotransferase, 41 U/L [0.68 μkat/L]; aspartate aminotransferase, 86 U/L [1.44 μkat/L]), as are total protein (5.4 g/dL [54 g/L]) and albumin (3.0 g/dL [30 g/L]) levels. Repeated bilirubin level is 12.4 mg/dL (212 µmol/L) at 14 hours after birth, with an elevated direct bilirubin level of 2.9 mg/dL (49.6 µmol/L). Direct or conjugated hyperbilirubinemia is defined as a direct bilirubin level greater than 2 mg/dL (34.2 mmol/L) or more than 20% of total bilirubin. γ-Glutamyl transferase level is normal. Coagulation studies show an elevated prothrombin time of 23.4 seconds (reference range, 11-17 seconds), with an international normalized ratio of 2.1 (reference range, 0.9-1.3); activated partial thromboplastin level is 49.5 seconds (reference range, 30-60 seconds). Fibrinogen level is decreased at 70 mg/dL (0.70 g/L) (reference range, 230-450 mg/dL [230-450 g/L]). Lactate level is 24.3 mg/dL (2.7 mmol/L; reference range, 2.0-26.9 mg/dL [0.22-2.98 mmol/L]). Ammonia level is 96.6 µg/dL (69 μmol/L; reference range, 89.6-149.9 µg/dL [64-107 μmol/L]). Cerebrospinal fluid studies are unremarkable. Magnetic resonance imaging (MRI) of the brain and echocardiography are normal. Ultrasonography of the abdomen shows diffuse hepatic echogenicity. Blood and cerebrospinal fluid cultures are negative. Further testing reveals the diagnosis.
Topics: Blood Coagulation Disorders; Humans; Jaundice; Lethargy; Liver; Reference Values
PubMed: 35102400
DOI: 10.1542/pir.2020-003046 -
Current Biology : CB Feb 2021Fatigue and sleepiness are widely observed but ill-understood responses to tissue injury. A new study in Caenorhabditis elegans illuminates how the innate immune system...
Fatigue and sleepiness are widely observed but ill-understood responses to tissue injury. A new study in Caenorhabditis elegans illuminates how the innate immune system mediates injury-induced sleep, which may help in surviving the injury.
Topics: Animals; Caenorhabditis elegans; Caenorhabditis elegans Proteins; Humans; Lethargy; Sleep; Wakefulness
PubMed: 33561412
DOI: 10.1016/j.cub.2020.11.048 -
Journal of the American Veterinary... Dec 2022
Topics: Female; Animals; Lethargy; Anorexia; Chickens; Fever
PubMed: 36563065
DOI: 10.2460/javma.22.10.0475 -
JAAPA : Official Journal of the... Oct 2022
Topics: Female; Fever; Humans; Infant; Lethargy; Maternal Behavior; Mothers
PubMed: 36165552
DOI: 10.1097/01.JAA.0000873800.89651.3a -
American Journal of Kidney Diseases :... May 2019
Topics: Alkalosis; Carbamates; Humans; Hypercalcemia; Lethargy; Male; Middle Aged; Tomography, X-Ray Computed
PubMed: 31010485
DOI: 10.1053/j.ajkd.2018.06.035 -
Australian Journal of General Practice 2020
Topics: Acidosis; Diabetes Complications; Humans; Insulin; Lethargy; Male; Middle Aged; Sodium-Glucose Transporter 2 Inhibitors
PubMed: 32008264
DOI: 10.31128/AJGP-06-19-4970 -
Current Oncology Reports Apr 2014There is an interdependent relationship between insomnia and fatigue in the medical literature, but both remain distinct entities. Insomnia entails problematic sleep... (Review)
Review
There is an interdependent relationship between insomnia and fatigue in the medical literature, but both remain distinct entities. Insomnia entails problematic sleep initiation, maintenance, or restoration with an accompanying decrease in perceived daytime function. Lethargy is a symptom that has a wide differential diagnosis that heavily overlaps with cancer-related fatigue; however, insomnia may contribute to worsened fatigue and lethargy in cancer patients. Insomnia is a major risk factor for mood disturbances such as depression, which may also contribute to lethargy in this at-risk population. The pathophysiology of fatigue and insomnia is discussed in this review, including their differential diagnoses as well as the emerging understanding of the roles of neurotransmitters, branched-chain amino acids, and inflammatory cytokines. Treatment approaches for insomnia and fatigue are also discussed and reviewed, including the role of hypnotics, psychotropics, hormonal agents, and alternative therapies.
Topics: Comorbidity; Diagnosis, Differential; Fatigue; Humans; Lethargy; Metaphor; Neoplasms; Palliative Care; Sleep Initiation and Maintenance Disorders; Yin-Yang
PubMed: 24535303
DOI: 10.1007/s11912-014-0377-1