Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Persistent idiopathic facial pain (PIFP) is a poorly understood chronic disorder that rarely occurs in children. An 11-year-old boy initially presented with right cheek pain and a streptococcal infection 6 weeks previously. Facial cellulitis was suspected, which was resolved by antibiotic treatment. The right cheek pain recurred within 4 weeks of this initial visit. Because the antibiotic treatment did not relieve the pain, the patient visited our outpatient clinic. Physical examination revealed facial tenderness in an area that corresponded with the region supplied by the second branch of the trigeminal nerve (maxillary nerve), suggesting trigeminal neuralgia (TN). However, brain magnetic resonance imaging revealed no vascular compression. Furthermore, the continuous nagging and dull nature of the pain experienced by the patient differed from the sudden and severe nature of pain associated with TN. Subsequently, PIFP was diagnosed. The patient was unable to attend school because of prolonged lassitude, nausea, headache, and anorexia. Psychological counseling revealed psychological stress related to his out-of-school life. Upon learning stress management through psychotherapy, his general malaise gradually improved, and he was able to attend school with more facial expressions. This case indicates the psychogenic aspect of PIFP as well as the value of psychological counseling.
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PMID:Persistent Idiopathic Facial Pain Associated with Somatoform Disorder in an 11-Year-Old Boy. 3088 20

Background: Cannabis is increasingly used by persons at end of life to ameliorate symptoms such as pain, spasticity, anorexia, or anxiety. Cannabis hyperemesis is a distressing adverse effect of chronic use and may cause significant morbidity. Unfortunately, the clinical presentation of this syndrome may be subtle in a person with complex medical issues or disability. Providers must remain vigilant for possible variations in presentation in these populations. Aim: To assess literature on cannabis hyperemesis and present unique considerations for clinical assessment and treatment for patients at end of life. Design: Initial literature scoping yielded limited evidence on the subject in the setting of chronic disease and disability. A case of cannabis hyperemesis in a person with advanced amyotrophic lateral sclerosis is presented to illustrate challenges in diagnosis and management in this setting. A narrative synthesis of current literature on assessment and management and special considerations for evaluation and treatment for patients under palliative care was performed. Results: Several unique considerations for the diagnosis and management of cannabis hyperemesis in palliative care patients are highlighted in the case presented, including: (1) Symptoms may possibly be abolished through decrease rather than complete abstinence from cannabis, (2) Frequent hot baths may not be present in patients with physical impairments in activities of daily living, and (3) Management of primary symptoms (pain, spasticity, nausea, and anxiety) in the end-of-life care patient must be considered to maximize comfort. Conclusion: The presentation of cannabis hyperemesis may be atypical in palliative care patients due to disability. More work is needed to improve risk stratification for patients using cannabis for palliative care.
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PMID:Cannabis Hyperemesis Syndrome in Palliative Care: A Case Study and Narrative Review. 3108 61


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