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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of peripartum cardiac failure is reported in a 20-year-old gravida 3, para 3 black female. The patient was 6 weeks postpartum. Graves' disease had been diagnosed in the first trimester of her pregnancy. The patient presented to the emergency department with complaints of fever, abdominal pain, shortness of breath, and chest pain. Physical examination revealed signs of congestive heart failure and anasarca. Chest x-ray revealed bilateral pleural effusions, and an abdominal series was consistent with ascites. Bedside electrocardiogram revealed pan-hypokinesis of all four cardiac chambers. The authors believe that this is the first case reported in the literature of peripartum cardiac failure occurring in a patient with Graves' disease.
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PMID:Peripartum cardiac failure in a woman with Graves' disease. 173 15

To determine the pattern of emergency department (ED) utilization by renal dialysis (RD) patients, a prospective study was conducted of dialysis patients presenting to the ED of a regional dialysis center. The most common presenting complaints were shortness of breath (SOB), chest pain, abdominal pain, and vomiting; the most common diagnoses were congestive heart failure, chest wall pain, and electrolyte abnormalities. Interventional dialysis (ID), defined as emergent dialysis required to treat the patient's presenting complaint, was required for 30 patients, with the most common presenting complaints of these patients being shortness of breath, weakness, and chest pain. Only SOB was statistically significant in predicting the need for ID (P less than 0.001), with a positive predictive value of 0.63 and a negative predictive value of 0.85. Prehospital implications of these data suggest that RD patients with a chief complaint of SOB should be transported directly to a facility capable of dialysis on an emergent basis.
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PMID:Emergency department presentation of renal dialysis patients: indications for EMS transport directly to dialysis centers. 205 Sep 72

The clinical features of an inner-city population of 304 patients presenting with acute myocardial infarction (MI) with and without typical chest pain, were studied retrospectively. This population consisted of 172 men and 132 women; 155 (51%) were black, 88 (29%) hispanic, and 61 (20%) white, by self-identification. Typical ischemic chest pain was the presenting symptom in 85% (258); 15% (46) presented with nonchest symptoms, most frequently shortness of breath, abdominal pain, and dizziness. But the frequency of such nonchest symptoms was similar in both groups. When patients were grouped by the presence or absence of chest pain, the proportions of those without chest pain were significantly higher for blacks (22.7%) than hispanics (9.1%, P = 0.001) or whites (4.9%, P less than 0.01). Patients without chest pain also had higher admission systolic (P less than 0.01) and diastolic (P less than 0.01) blood pressures and more frequent histories of congestive heart failure (P less than 0.05), and more often presented with pulmonary edema (P = 0.001) than those with chest pain. Both groups were similar in age, sex, history of hypertension, and presence of hypertension on admission, defined as greater than or equal to 160/95 mmHg, prevalence of diabetes, history of smoking, previous MI, type of MI, history of angina, and mortality rates. Patients without chest pain were characterized by black race, history of congestive heart failure, elevated blood pressure and pulmonary edema than those with typical ischemic chest pain. Thus significant delays in the diagnosis and treatment of this important clinical entity may be reduced by alerting clinicians to these features and by educating selected patient groups.
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PMID:Clinical features of patients with acute myocardial infarction presenting with and without typical chest pain: an inner city experience. 252 Aug 50

We performed a one-year prospective survey of emergency medical responses to travelers at an international airport to observe the frequency and type of emergencies experienced in flight and before and after travel. Emergency personnel evaluated a total of 1107 people; 754 (68%) were travelers, 232 (21%) were employees of the airport or airlines, and 118 (11%) were area residents. Of the 754 travelers, 190 (25%) experienced their problem during flight; the aircraft made an unscheduled landing for seven of these travelers. The frequency of in-flight emergencies was 1 per 753 inbound flights, or 1 per 39,600 inbound passengers. The most common emergency problems among all travelers were abdominal pain, chest pain, shortness of breath, syncope, and seizures; 25% of the emergencies were caused by minor trauma. The majority of emergencies among air travelers (75% [564/754]) happened on the ground within the air terminal. Most problems (84% [633/754]) were effectively handled by personnel trained as emergency medical technicians. The types of problems encountered suggest that the "doctors only" medical kit now required aboard US air carriers contains clinically useful items and should continue to be required on board.
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PMID:Frequency and types of medical emergencies among commercial air travelers. 229 87

A 48-year-old white man with a multiprogrammable Intramedics 259-01 pacemaker was treated for inoperable lung cancer with a course of cobalt-60 radiotherapy (total 3,500 rad). Several weeks subsequent to his last radiation treatment, the patient presented to the emergency department with chest and abdominal pain, shortness of breath, hypotension, and tachycardia. A paced tachycardia was noted, and application of a magnet over the pacemaker completely inhibited its function, allowing a normal sinus rhythm to ensue and the patient's symptoms to be relieved. Pacemaker failure probably was a complication of radiotherapy.
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PMID:Pacemaker failure associated with therapeutic radiation. 317 52

Alcoholic ketoacidosis is a frequently encountered metabolic disturbance that follows a prolonged intake of ethanol. Following a brief duration of abstinence, patients typically present with vomiting, abdominal pain, and shortness of breath. Examination reveals Kussmaul breathing, variable volume loss, and coincident manifestations of chronic alcohol usage. Characteristic laboratory findings include anion-gap metabolic ketoacidosis, normal serum glucose, and zero ethanol levels. Phosphate measurements may be depressed, particularly after institution of therapy. Intravascular volume restitution, delivery of dextrose, attention to electrolytes, and discovery of alcohol-related illnesses are the mainstays of therapy.
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PMID:Alcoholic ketoacidosis--a review. 331 91

Malignant mesothelioma has been rare in the general population. In recent decades its incidence has risen dramatically, parallel to the increasing use of asbestos in industry since 1930. Altogether 17,800 asbestos insulation workers, members of the International Association of Heat and Frost Insulators and Asbestos Workers (AFL-CIO-CLC) in the United States and Canada, were enrolled for prospective study on 1 January 1967 and followed up to the present. Every death that occurs is investigated by our laboratory. One hundred and seventy five deaths from mesothelioma occurred among the 2221 men who died in 1967-76 and 181 more such deaths in the next eight years. Altogether, 356 workers had died of malignant mesothelioma (pleural or peritoneal) by 1984. Diagnosis of mesothelioma was accepted only after all available clinical, radiological, and pathological material was reviewed by our laboratory and histopathological confirmation by the pathology unit made in each case. One hundred and thirty four workers died of pleural and 222 of peritoneal mesothelioma. Age at onset of exposure, age at onset of the disease, and age at death were similar in both groups of patients. Significant difference was noted only in the time elapsed from onset of exposure to the development of first symptoms, which was longer in the group with peritoneal mesothelioma. Shortness of breath, either new or recently increased, and chest pain were the most frequent presenting symptoms in the group with pleural mesothelioma; abdominal pain and distension were frequent in the patients with peritoneal mesothelioma. Pleural effusion or ascites were found in most patients. The most effective approach to the diagnosis of malignant pleural mesothelioma in these cases was by open lung biopsy; exploratory laparotomy was best for diagnosing peritoneal mesothelioma. Patients with pleural mesothelioma died principally from pulmonary insufficiency whereas those with peritoneal mesothelioma succumbed after a period of pronounced wasting.
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PMID:Malignant mesothelioma in a cohort of asbestos insulation workers: clinical presentation, diagnosis, and causes of death. 334 94

Five weeks after developing spells of shortness of breath, headache, weakness and abdominal pain, a 29-year-old woman, who was in the 36th week of her third pregnancy developed adult respiratory distress syndrome (ARDS). Although the ARDS resolved after a cesarean section, her infant died at birth. Her "spells" continued until a left pheochromocytoma was diagnosed and resected 2 years later. If there are no other known inciting causes of ARDS in a pregnant patient, a pheochromocytoma should be ruled out with appropriate catecholamine determinations.
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PMID:Adult respiratory distress syndrome in a pregnant patient with a pheochromocytoma. 403 96

A brief report on the clinical studies of schistosomiasis japonica at Langko village in the Lindu lake area was given. The studies consisted of stool surveys, COPT, evaluation of the signs and symptoms of schistosomiasis, determination of the liver and spleen enlargement as well as the disease index and the clinical gradient. It seemed that the stool examinations as well as the COPT were considered sufficient, accurate and practical for mass surveys. The result of evaluation of the signs and symptoms of schistosomiasis at Lindu lake area showed that dermatitis, dysentry, abdominal pain, nausea and vomiting, loss of appetite, weakness, shortness of breath, distension of the abdomen, melena, icterus, and hepatomegaly were found to be significantly different between the schistosomiasis group and the control group. This finding was almost similar to the findings reported by Billings et al. (1946) and Pesigan et al. (1958), only the frequencies of occurrence were different. The clinical gradient of schistosomiasis at Lindu lake area was mostly of the mild type of the disease.
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PMID:Clinical study of Indonesian schistosomiasis at Lindu lake area, Central Sulawesi. 653 66

Praziquantel (2-cyclohexylcarbonyl-1,2,3,6,7,11b-hexahydro-4H-pyrazino[2,1-a]++ +isoquinolin- 4-one, EMBAY 8440, Biltricide) has been used in 4853 patients with Opisthorchis viverrini infection. 786 patients were treated as inpatients with extensive clinical evaluation and the rest were out-patients. A cure rate (evaluated with 5 faecal samples) of 100% was obtained in groups given 6 X 25 mg/kg on 2 days and 3 X 25 mg/kg on 1 day, while in groups given 2 X 25 mg/kg, 1 X 25 mg/kg and 1 X 40 mg/kg all on 1 day the cure rates were 88, 44 and 91%, respectively. With one sample evaluation the parasitological cure rate was 96% in further 96 patients excreting the geometric mean (GM) of 5394 eggs per gram (EPG) and receiving 1 X 40 mg/kg. Another 68 patients with an egg output of 26044 (GM/EPG) and treated with 1 X 50 mg/kg showed a cure rate of 97% by similar evaluation. Side effects were mild and transient and were more frequent in higher dosage groups. They included anorexia, nausea, vomiting, abdominal pain, epigastric pain, rumbling in the abdomen, diarrhoea, lassitude, myalgia, headache, dizziness, sleeplessness, sleepiness, "hot sensation", shortness of breath, and skin rash in a few cases. Headache (30.7%) was most common in the 6 X 25 mg/kg group. In 53 patients with severe jaundice the side effects were similar. There was no evidence of toxicity. Remarkable was one patient treated with 1 X 50 mg/kg who expelled 5636 O. viverrini worms, most of which were elongated and damaged. When a single dose is prescribed it should be given at bed time to reduce the side effect of sedation.
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PMID:Opisthorchis viverrini: clinical experience with praziquantel in Hospital for Tropical Diseases. 654 86


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