Lassitude Health Dictionary

Acidosis is a condition in which there is either a production in the body of two abnormal acids – beta-hydroxybutyric and acetoacetic acids; or a diminution in the alkali reserve of the blood.

Causes The condition is usually due to faulty metabolism of fat, resulting in the production of beta-hydroxybutyric and acetoacetic acids. It occurs in DIABETES MELLITUS when this is either untreated or inadequately treated, as well as in starvation, persistent vomiting, and delayed anaesthetic vomiting. It also occurs in the terminal stages of glomerulonephritis (see KIDNEYS, DISEASES OF), when it is due to failure of the kidneys. A milder form of it may occur in severe fevers, particularly in children. (See also ACETONE.)

Symptoms General lassitude, vomiting, thirst, restlessness, and the presence of acetone in the urine form the earliest manifestations of the condition. In diabetes a state of COMA may ensue and the disease end fatally.

Treatment The underlying condition must always be treated: for example, if the acidosis is due to diabetes mellitus then insulin must be given. Sodium bicarbonate (see SODIUM) is rarely necessary for diabetic ketoacidosis; if it is used, it is invariably now given intravenously. Acidosis might be treated with oral sodium bicarbonate in cases of chronic renal failure. Anaesthetists dislike the administration of bicarbonate to acidotic patients, since there is some evidence that it can make intracellular acidosis worse. They almost always use HYPERVENTILATION of the arti?cially ventilated patient to correct acidosis.... acidosis

One of the dozen or so vitamins included in the vitamin B complex. It is found in liver, eggs and meat, and also synthesised by bacteria in the gut. Absorption from the gut is prevented by avidin, a constituent of egg-white. The daily requirement is small: a fraction of a milligram daily. Gross de?ciency results in disturbances of the skin, a smooth tongue and lassitude. (See APPENDIX 5: VITAMINS.)... biotin

Tropical fish poisoning occurring some 1-24hrs after ingestion of fish containing ciguatoxin. Symptoms are diverse and include (in approximate frequency): lassitude, muscle pains, burning of skin when cold objects are touched, itching, joint pains, paraesthesiae (especially hands, feet and lips), headache and diarrhoea, as well as manyother less common symptoms. Ciguatera is a major world health problem in Countries relying on reef fish as the main source of protein and has caused many deaths. Neurological signs and symptoms may last for months, even years.... ciguatera

Lethargy, or lassitude, means a loss of energy. It is a common presenting complaint both to general practitioners and to hospital consultants. It may have a physical cause or a psychological cause; it may be the result of inadequate rest, environmental noise, boredom, insomnia or recent illness. Certain medicinal drugs can cause lethargy, the most common being beta blockers (see BETA-ADRENOCEPTOR-BLOCKING DRUGS) and DIURETICS, and drugs of abuse may also be a cause (see DEPENDENCE). The common psychosocial problems producing lethargy are DEPRESSION and anxiety.

If the patient with lethargy runs a fever, the di?erential diagnosis is that of a PUO (pyrexia of unknown origin). Many patients with fatigue can establish the onset of the symptom to a febrile illness even though they no longer run a fever. The lethargy that follows some viral infecions, such as HEPATITIS A and glandular fever (see MONONUCLEOSIS) is well recognised; MYALGIC ENCEPHALOMYELITIS (ME) or chronic fatigue syndrome is another disorder associated with lethargy and tiredness. Organic causes of lethargy include ANAEMIA, malnutrition and hypothyroidism (see THYROID GLAND, DISEASES OF). Some of these patients have a true depressive illness and their presentation and response to treatment is little di?erent from that of sufferers of any other depressive illness, URAEMIA, alcoholism and DIABETES MELLITUS.... lethargy

This infection – also known as bubonic plague

– is caused by the bacterium Yersinis pestis. Plague remains a major infection in many tropical countries.

The reservoir for the bacillus in urban infection lies in the black rat (Rattus rattus), and less importantly the brown (sewer) rat (Rattus norvegicus). It is conveyed to humans by the rat ?ea, usually Xenopsylla cheopis: Y. pestis multiplies in the gastrointestinal tract of the ?ea, which may remain infectious for up to six weeks. In the pneumonic form (see below), human-to-human transmission can occur by droplet infection. Many lower mammals (apart from the rat) can also act as a reservoir in sylvatic transmission which remains a major problem in the US (mostly in the south-western States); ground-squirrels, rock-squirrels, prairie dogs, bobcats, chipmunks, etc. can be affected.

Clinically, symptoms usually begin 2–8 days after infection; disease begins with fever, headache, lassitude, and aching limbs. In over two-thirds of patients, enlarged glands (buboes) appear – usually in the groin, but also in the axillae and cervical neck; this constitutes bubonic plague. Haemorrhages may be present beneath the skin causing gangrenous patches and occasionally ulcers; these lesions led to the epithet ‘Black Death’. In a favourable case, fever abates after about a week, and the buboes discharge foul-smelling pus. In a rapidly fatal form (septicaemic plague), haematogenous transmission produces mortality in a high percentage of cases. Pneumonic plague is associated with pneumonic consolidation (person-to-person transmission) and death often ensues on the fourth or ?fth day. (The nursery rhyme ‘Ringo-ring o’ roses, a pocketful o’ posies, atishoo! atishoo!, we all fall down’ is considered to have originated in the 17th century and refers to this form of the disease.) In addition, meningitic and pharyngeal forms of the disease can occur; these are unusual. Diagnosis consists of demonstration of the causative organism.

Treatment is with tetracycline or doxycycline; a range of other antibiotics is also e?ective. Plague remains (together with CHOLERA and YELLOW FEVER) a quarantinable disease. Contacts should be disinfected with insecticide powder; clothes, skins, soft merchandise, etc. which have been in contact with the infection can remain infectious for several months; suspect items should be destroyed or disinfected with an insecticide. Ships must be carefully checked for presence of rats; the rationale of anchoring a distance from the quay prevents access of vermin. (See also EPIDEMIC; PANDEMIC; NOTIFIABLE DISEASES.)... plague

n. a benign gelatinous tumour of connective tissue. Atrial myxoma is a tumour of the heart, usually of the left side, arising from the septum dividing the two upper chambers. Symptoms may include fever, lassitude, joint pains, and sudden loss of consciousness due to obstruction of the bloodflow. The tumour may be wrongly diagnosed as stenosis of the mitral valve as it can produce a similar murmur. Treatment requires surgical removal. —myxomatous adj.... myxoma

A serious infectious disease of tropical Africa caused by the protozoan parasite TRYPANOSOMA BRUCEI, which is transmitted to humans by the bites of tsetse flies.

One form of the disease, which occurs in West and Central Africa, takes a slow course, with bouts of fever and lymph node enlargement. After months or years, spread to the brain occurs, causing headaches, confusion, and, eventually, severe lassitude. Without treatment, coma and death follow. The other, East African, form runs a faster course. Fever develops after a few weeks of infection, and effects on the heart may be fatal before the disease has spread to the brain.

Drugs can effect a cure, but there may be residual brain damage if the infection has already spread to the brain.... sleeping sickness

n. a drug (see beta blocker) used to treat abnormal heart rhythm, angina, and high blood pressure; it is also taken to relieve the symptoms of thyrotoxicosis and anxiety associated with palpitation or tremor and to prevent migraine headaches. Common side-effects include digestive upsets, sleep disturbances, lassitude, and coldness of extremities.... propranolol