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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study seeks to assist in setting priorities for assessing medical practices and technologies when assessment resources are scarce. It develops an objective index of expected gain from technology assessment, using modified DRG-level data on hospitalizations in NY State. The index uses standard economic concepts to combine measures of resource use, the coefficient of variation in use rates across regions, and the rate at which the incremental value of a medical intervention changes as its rate of use changes, providing a dollar-valued welfare loss from variations. For the entire US in 1987, the highest index occurred for coronary artery bypass graft ($0.95 billion per year), but most of the high-index interventions were nonsurgical, including hospitalizations for psychosis ($0.74 billion per year), cardiac catheterization ($0.62 billion per year), chronic obstructive lung disease ($0.55 billion per year), angina pectoris ($0.46 billion per year), adult gastroenteritis ($0.38 billion per year), adult pneumonia ($0.32 billion per year) and medical back problems ($0.28 billion per year). The top 25 interventions create an annual welfare loss of exceeding $7 billion. The present value of convincingly assessing the correct way to use these interventions sums many years of annual gains from eliminating these welfare losses. The gains from eliminating unexplained variation in medical practices appear greatly larger than costs of necessary studies.
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PMID:Priority setting in medical technology and medical practice assessment. 164 Jul 69

An enquiry has been made into the causes of admission in 1994 of African patients to Gelukspan Hospital, North West Province, South Africa. The study concerned 3791 patients of whom 3533 (93.2%) were classifiable. Two groups were not included in this number, namely, 1584 'lodgers' (e.g. mothers of infants), and 1868 females admitted for normal pregnancy. Of the 3533 patients, 940 (26.6%) were aged 14 years and younger; 545 (58.0%) these were boys and 395 (42.0%) were girls. The main causes of their admission were pneumonia, gastroenteritis, trauma, poisoning, and infections. Of the 2593 adults, 1418 (54.7%) were males and 1175 (45.3%) females. Among males, chief causes were pulmonary tuberculosis, trauma and accidents, congestive cardiac failure, psychosis, cancer and diabetes. Of the females, chief causes were pulmonary tuberculosis, trauma and accidents, pregnancy related disorders, gastroenteritis, anaemia and pneumonia. Regarding other diseases, 4.5% of adults were admitted for cancer, and 1.8% for diabetes. The general pattern of admissions is similar to that reported in other rural hospitals. The causes of admissions are discussed, regarding; (i) public health improvements occurring, and (ii) means of promoting further improvements by community self-help, and by help from State health and other services.
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PMID:Causes of admission of African patients to Gelukspan Hospital, North West Province, South Africa. 899 67

Acute symptomatic hyponatraemia is a life-threatening emergency which must be diagnosed and treated promptly. The initial symptoms are often dramatic, with seizures and coma, and there is therefore a risk that the diagnosis and the urgent sodium correction therapy may be delayed by procedures such as computed tomography (CT) of the brain. As the most common aetiological factors are psychotic polydipsia and different iatrogenic causes, this condition usually develops in hospitalised patients. Water intoxication alone is very unlikely to cause severe hyponatraemia in a person with normal renal function, unless for some reason the antidiuretic hormone secretion is increased. We describe a case in which dehydration due to common gastroenteritis in combination with excessive intake of water caused the death of a young, previously healthy woman. Increased awareness of this potentially fatal condition is recommended.
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PMID:Fatal hyponatraemic brain oedema due to common gastroenteritis with accidental water intoxication. 947 92

Beriberi is a disease caused by thiamine (vitamin B1) deficiency. Peripheral and central nerve involvement causes psychosis and memory loss as well as cardiocirculatory effects. We report the case of a 35-year-old woman 8 weeks pregnant who came to the emergency department after bouts of nausea and vomiting over a period of 6 days, with intolerance of both solids and liquids. The initial diagnosis of gastroenteritis was later changed to hyperemesis gravidarum. Episodes of vomiting and nausea continued 48 hours after admission, accompanied by vertical nystagmus, ataxia, and diminished osteotendinous reflexes. Evaluation of the clinical picture confirmed vitamin B1 deficiency, leading to a diagnosis of Wernicke-Korsakoff syndrome. Symptoms improved with thiamine therapy but did not entirely disappear. The patient was admitted for elective cesarean section at 37 weeks' gestation. Examination revealed neurological involvement (horizontal and vertical nystagmus) and general anesthesia was therefore chosen to assure adequate hemodynamic control given the possibility of cardiocirculatory alteration.
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PMID:[Anesthetic management for elective cesarean section for a woman with beriberi]. 1739 Jun 94

Experience of acute medical, surgical conditions, and clinical procedures of undergraduate students were assessed via a questionnaire survey during the final week of the 1993/1998 programme at the School of Medical Sciences, Univestiti Sains Malaysia. Individual performances were assessed by a scoring system. One hundred and twenty four students responded, (response rate 97%). More than 90% had seen myocardial infarction, cerebrovascular accident, pneumonia, respiratory distress, gastroenteritis, coma, and snake bite. Less than 33% had witnessed acute psychosis, diabetic ketoacidosis, acute hepatic failure, status epilepticus, near drowning, hypertensive encephalopathy, acute haemolysis or child abuse.Acute surgical/obstetrics cases, seen by >90% students, included fracture of long bones, head injury, acute abdominal pain, malpresentation and foetal distress. Less than 33% had observed epistaxis, sudden loss of vision, peritonitis or burns. Among operations only herniorrhaphy, Caesarian section, internal fixation of fracture and cataract extraction were seen by >80% students. The main deficits in clinical procedures are in rectal and vaginal examinations, urine collection and microscopic examinations. The performance of individual students, assessed by a scoring system, showed 15 students had unacceptably low scores (<149/230, 50%), 37 had good scores (>181.4/230, 70%) and 5 had superior scores (197.6/230, 80%).
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PMID:Clinical experience of medical students at university sains malaysia. 2284 12

We report that two young adult patients who were initiated with clozapine for severe psychosis during a hospital-wide gastroenteritis outbreak went into severe shock. Neither patient had troponin elevation. Each required left ventricular assist device support for myocarditis. Endomyocardial biopsy revealed lymphocytic myocarditis in one patient and eosinophilic myocarditis in the other. The former patient expired. Polymerase chain reaction testing was negative for Coxsackie virus. These two patients illustrate that myocarditis can occur at usual incipient doses and that there may be an epidemiologic risk associated with gastroenteritis. Although the white blood cell (WBC) count is expected to decrease with clozapine, these patients had persistently elevated WBC counts. In conclusion, physicians should exercise caution when prescribing clozapine, especially for those with diarrhea.
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PMID:Clozapine-associated cardiac dysfunction during a gastroenteritis outbreak. 2798 78