Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metoclopramide, 4-amino-5-chloro-2-methoxy-N-(2-diethyl-aminoethyl) benzamide, is advocated for use in gastro-intestinal diagnostics, and in treating various types of vomiting and a variety of functional and organic gastro-intestinal disorders. Published data have indicated that metoclopramide assists radiological identification of lesions in the small intestine, facilitates duodenal intubation and small intestine biopsy, and eases emergency endoscopy in upper gastro-intestinal haemorrhage. Metoclopramide reduces post-operative vomiting and radiation sickness, and ameliorates some types of drug-induced vomiting. It may provide symptomatic relief in dyspepsia and possibly in vertigo, reflux oesophagitis and hiccups, but further controlled trials are needed to confirm the efficacy of metoclopramide in these proposed areas of use. It promotes gastric emptying prior to anaesthesia. Its effects in healing gastric ulcer and preventing relapse of duodenal ulcer remain unproven. Side-effects are few and transient, though alarming extrapyramidal reactions can occur in a small proportion of patients receiving therapeutic doses but more usually following excessive doses in young subjects. They respond rapidly to withdrawal of the drug.
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PMID:Metoclopramide: a review of its pharmacological properties and clinical use. 78 7

Levo-sulpiride is a substituted benzamide with antiemetic activity 3-8 times more potent than the racemic form and the d-isomer. Its mode of action is partially central (inhibition of dopaminergic receptors at the trigger zone for vomiting) and partially peripheral (normalization of motor activity of stomach and gall-bladder). The drug was found effective in the prevention of chemotherapy-induced and post-operative vomiting as well as in the treatment of nausea and vomiting during hepatic, biliary and gastroduodenal disorders, organic and functional dyspepsia, motion sickness and vertigo. Levo-sulpiride is at least as effective as domperidone, antihistamines and neuroleptic agents. Compared with the latter drugs and with d-sulpiride and the racemus, l-sulpiride is much better tolerated. Drowsiness is reported only at high doses, and no clinical signs of hyperprolactinaemia are observed, even after prolonged treatment.
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PMID:[Antiemetic properties of levo-sulpiride]. 228 Aug 76

A large number of Ethiopians reside abroad as refugees, immigrants, or students. To provide adequate care, physicians must understand their beliefs about health and medicine. To Ethiopians, health is an equilibrium between the body and the outside. Excess sun is believed to cause mitch ("sunstroke"), leading to skin disease. Blowing winds are thought to cause pain wherever they hit. Sexually transmitted disease is attributed to urinating under a full moon. People with buda, "evil eye," are said to be able to harm others by looking at them. Ethiopians often complain of rasehn, "my head" (often saying it burns); yazorehnyal, "spinning" (not a true vertigo); and libehn, "my heart" (usually indicating dyspepsia rather than a cardiac problem). Most Ethiopians have faith in traditional healers and procedures. In children, uvulectomy (to prevent presumed suffocation during pharyngitis in babies), the extraction of lower incisors (to prevent diarrhea), and the incision of eyelids (to prevent or cure conjunctivitis) are common. Circumcision is performed on almost all men and 90% of women. Ethiopians do bloodletting for moygnbagegn, a neurologic disease that includes fever and syncope. Chest pain is treated by cupping. Ethiopians often prefer injections to tablets. Bad news is usually given to families of patients and not the patients themselves. Zar is a form of spirit possession treated by a traditional healer negotiating with the alien spirit and giving gifts to the possessed patient. Health education must address Ethiopian concerns and customs.
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PMID:Cross-cultural medicine and diverse health beliefs. Ethiopians abroad. 907 36

Most patients with advanced cancer develop diverse symptoms that can limit the efficacy of pain treatment and undermine their quality of life. The present study surveys symptom prevalence, etiology and severity in 593 cancer patients treated by a pain service. Non-opioid analgesics, opioids and adjuvants were administered following the WHO-guidelines for cancer pain relief. Other symptoms were systematically treated by appropriate adjuvant drugs. Pain and symptom severity was measured daily by patient self-assessment; the physicians of the pain service assessed symptom etiology and the severity of confusion, coma and gastrointestinal obstruction at each visit. The patients were treated for an average period of 51 days. Efficacy of pain treatment was good in 70%, satisfactory in 16% and inadequate in 14% of patients. The initial treatment caused a significant reduction in the average number of symptoms from four to three. Prevalence and severity of anorexia, impaired activity, confusion, mood changes, insomnia, constipation, dyspepsia, dyspnoea, coughing, dysphagia and urinary symptoms were significantly reduced, those of sedation, other neuropsychiatric symptoms and dry mouth were significantly increased and those of coma, vertigo, diarrhea, nausea, vomiting, intestinal obstruction, erythema, pruritus and sweating remained unchanged. The most frequent symptoms were impaired activity (74% of days), mood changes (22%), constipation (23%), nausea (23%) and dry mouth (20%). The highest severity scores were associated with impaired activity, sedation, coma, intestinal obstruction, dysphagia and urinary symptoms. Of all 23 symptoms, only constipation, erythema and dry mouth were assessed as being most frequently caused by the analgesic regimen. In conclusion, the high prevalence and severity of many symptoms in far advanced cancer can be reduced, if pain treatment is combined with systematic symptom control. Nevertheless, general, neuropsychiatric and gastrointestinal symptoms are experienced during a major part of treatment time and pain relief was inadequate in 14% of patients. Cancer pain management has to be embedded in a frame of palliative care, taking all the possibilities of symptom management into consideration.
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PMID:Symptoms during cancer pain treatment following WHO-guidelines: a longitudinal follow-up study of symptom prevalence, severity and etiology. 1151 84

The studied population (1000 children and young workers and 250 controls) were interviewed for health complaints and subjected to extensive medical investigations. Health problems are more encountered among the workers than in the controls, which has been attributed to the impact of work on health and to the low socioeconomic background that compels the children to work, which may constitute a potential health problem from the start. The significant health problems include: a) Respiratory system complaints, attacks of cough, chronic bronchitis, bronchial asthma and reduction in FEV1.0/FVC; b) cardiovascular abnormalities including palpitations, sinus tachycardia, anemia, vertigo and syncope; c) gastrointestinal abnormalities including dyspepsia and parasitic infestations; d) neuropsychiatric complaints; and e) other health problems including urinary tract infections, backache, visual impairment, repair of hernia and nocturnal enuresis. The study has been concluded by recommending the use of primary health care approach to child labour, emphasizing the importance of pre-employment and periodical medical examinations for protecting this vulnerable group from work hazards, and expanding the efforts of family planning to reduce family size.
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PMID:Child labour in Egypt. II. Impact of work environment on health. 1726 56

Louisa May Alcott (1832-1888), famous in her own time and immortalized in ours as a major figure of the "American Renaissance," died at the age of 55 after intermittent suffering over 20 years. Her illnesses evoked intense interest in her time and in ours. Alcott tracked her signs and symptoms (in letters and journal entries), which included headaches and vertigo, rheumatism, musculo-skeletal pain, and skin rashes; in her final years she recorded severe dyspepsia with symptoms of obstruction, and headaches compatible with severe hypertension. Her death came suddenly with a stroke. Standard biographies propose that her illnesses were due to acute mercury poisoning from inorganic mercury medication she received for a bout of typhoid in 1863, a cause she herself believed. We have reviewed Alcott's observations, as well as those of others, and have determined that acute mercury poisoning could not have caused her long-term complaints. We propose instead that Alcott suffered a multi-system disease, possibly originating from effects of mercury on the immune system. A portrait of Alcott raises the possibility that she had systemic lupus erythematosus (SLE).
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PMID:Louisa May Alcott: her mysterious illness. 1746 41

Narcolepsy is a disease in which there is diurnal excessive sleepiness with sleep attacks and a prevalence in the general population of 1/4000 individuals. Classically, it is characterized by cataplexy, sleep paralysis, hypnagogic hallucinations and fragmented sleep. The use of modafinil in the treatment of narcolepsy is the first option of treatment for diurnal excessive sleepiness. Although considered a safe drug for use in patients with narcolepsy, being utilized for more than 20 years, modafinil possesses a series of side effects, some of them still not fully researched or described. Side effects such as headache, nausea, anxiety, insomnia, lumbago, diarrhea, dyspepsia, rhinitis and vertigo are the most frequent. However, the clinical follow-up of patients under treatment with modafinil must be intensive and the side effects ought to be noted and evaluated. The under-response to treatment or the unexpected side effects must always be directed to differential diagnostics. The objective of this article is to describe an unexpected side effect of the use of modafinil in a patient with incorrect diagnosis of narcolepsy.
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PMID:Cataplexy as a side effect of modafinil in a patient without narcolepsy. 2648

Introduction: "Medically Unexplained Physical Symptoms" (MUPS) defines a subgroup of patients presenting physical symptoms of unclear origin. The study aims to profile clinical and socio-demographic characteristics of patients with MUPS. Materials and Methods: This 9-years observational retrospective study assesses all patients admitted between 2008 and 2016 in the divisions of neurology and gastroenterology. Socio-demographic and clinical variables were evaluated: gender, age, diagnosis or diagnostic hypothesis, presence of psychiatric comorbidities, psychiatric evaluation, pharmacological treatment, number of admissions/visits. Results: Among 2,479 neurological patients 10.1% presented MUPS. Patients were more frequently women (63.5%), with a mean age of about 50 years. Reported symptoms were headache (22.6%), seizures (8.7%), vertigo (5.9%), fibromyalgia (5.5%), paresthesia (5.1%), visual disturbances (5.1%), amnesia (3.9%). The diagnosis was somatoform disorder in 6.3% of cases, conversion disorder in 2.7%, and somatic symptom disorder in 1.5% only. 2,560 outpatients were evaluated in gastroenterology division. 9.6% (n = 248) of patients had MUPS; 62.1% of them were women. The most affected age group ranged between 15 and 45 years. The most frequent diagnoses were functional abdominal pain (50%), dysmotility-like dyspepsia (26.6%), irritable bowel syndrome (10.4%), meteorism of unknown cause (2.4%), hiccup (1.6%), burning mouth syndrome (1.2%). No patients received a diagnosis of somatic symptom disorder. Discussion: Patients with MUPS are more often women, of middle age, with self-referred specific symptomatology. While neurological patients received a diagnostic-therapeutic approach in line with the literature, gastroenterological patients mainly received antipsychotics. A more comprehensive assessment and a development of psychoeducational interventions are needed to improve patients' quality and quantity of life.
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PMID:Medically Unexplained Physical Symptoms in Hospitalized Patients: A 9-Year Retrospective Observational Study. 3053 14