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

This study reports the reliability and validity of the distress subscale of the GERD Symptom Assessment Scale (GSAS) and the acute SF-36 Health Survey in a clinical trial setting. Patients with moderately severe GERD completed the GSAS and SF-36 at baseline and four weeks following treatment. The age (mean +/- SD) of the 187 patients was 45.5 +/- 11.1 years and most were female (63%) and Caucasian (78%). All scales met the 0.70 reliability criterion except for the SF-36 bodily pain scale. Mean baseline GSAS scores were significantly (P < 0.001) poorer by 10-17% among patients reporting more severe levels of all symptoms. Mean baseline SF-36 physical component summary scores were significantly (P < 0.02) poorer among patients reporting more severe levels of regurgitation, early satiety, bloating, and nausea. Patients reporting complete and satisfactory heartburn relief reported improvements in GSAS scores that were 13% and 10% greater, respectively, than patients who did not experience these levels of relief (P < 0.001). In conclusion, the GSAS and SF-36 scales were reliable and valid measures in this clinical trial. Differences of 10% in GSAS distress scores correspond to differences in symptom severity at a point in time and to changes in symptom severity over time. The SF-36 was not as useful in detecting differences in symptom severity over time.
 ...
PMID:Measuring symptom distress and health-related quality of life in clinical trials of gastroesophageal reflux disease treatment: further validation of the Gastroesophageal Reflux Disease Symptom Assessment Scale (GSAS). 1214 13

Vagal afferents are extensively distributed in the digestive tract from the oesophagus to the colon. They are involved in the reflex control of normal gastrointestinal (GI) tract function (e.g. secretion and motility) as well as reflexes more characteristic of diseases such as functional dyspepsia and gastroesophageal reflux disease (e.g. vomiting, disordered lower esophageal sphincter relaxation and gastric accommodation). They are also implicated in signalling non-painful sensations (e.g. nausea and early satiety) associated with disease. A variety of receptors has been identified on vagal afferents, which can either enhance (e.g. 5-HT3, CCK1, VR1 and NK1 receptors) or reduce (e.g. ghrelin, leptin, k-opioid and GABAB receptors) activity, offering a range of potential therapeutic targets. Commonly used laboratory species (e.g. rat and mouse) lack an emetic reflex, and the implications of this for models of upper GI disorders have been explored in the light of expanding knowledge of the neuropharmacology of the emetic reflex implicating glutamate, prostanoids, cannabinoids and substance P. Additional pathophysiological roles for vagal afferents (e.g. in thermoregulation, arousal and fatigue) are being investigated, raising the intriguing possibility of the vagus as a target in non-GI disorders.
 ...
PMID:Abdominal vagal afferent neurones: an important target for the treatment of gastrointestinal dysfunction. 1248 26

Eosinophilic esophagitis is a disease that has moved from relative obscurity, known to a few pediatricians, to one of emerging interest and attention in both the pediatric and adult literature. In part, this is due to the underrecognition of the disease, its increasing description in adults, and the fact that it may be a great imitator of gastroesophageal reflux disease. Symptoms may be protean including heartburn, dysphagia, nausea, vomiting, and abdominal pain accompanied by a history of atopic illnesses. Similarly, endoscopic and radiographic appearances may vary, ranging from stricture and "ring" formation to a completely normal-appearing esophagus, with diagnosis made only on biopsy sampling throughout the entire esophagus. Because this disease is thought to be allergic in origin, primary therapy is an attempt to identify and exclude possible food allergens through skin testing. Owing to the inability to identify an allergen or, conversely, poor compliance with a diet avoiding multiple food allergens, steroids may be useful in this disease. Strictures often require dilation as well owing to the chronic and fibrotic nature of these lesions.
 ...
PMID:Eosinophilic Esophagitis. 1252 72

Gastroesophageal reflux disease (GERD) is associated with several symptoms, such as heartburn, belching, and regurgitation, which arise from esophageal exposure to gastric acid. Symptoms may occur in the absence of endoscopically observed esophageal mucosal damage and inflammation. These patients represent the majority of those who present with GERD symptoms. Although acid suppression therapy is a logical approach to relieving GERD symptoms, it has been thought to relieve symptoms less reliably in patients with endoscopically negative, or symptomatic GERD than in those with erosive GERD. Two multicenter, randomized, double-blind, placebo-controlled clinical trials were conducted in the United States to evaluate the efficacy of rabeprazole sodium 10 mg and 20 mg compared with placebo for the relief of heartburn and other symptoms associated with symptomatic GERD. Results from these studies indicated that rabeprazole 10 or 20 mg once daily relieved heartburn within the first 1 or 2 days of treatment and also had significant positive effects on other GERD symptoms, including regurgitation, belching, bloating, satiety, and nausea. Overall, these results suggest that rabeprazole may hold a significant therapeutic advantage in the treatment of heartburn and other symptoms associated with endoscopically negative GERD, particularly in the majority of patients who often are treated empirically without, or before, endoscopic evaluation.
 ...
PMID:Rabeprazole-based therapy in the management of symptomatic gastroesophageal reflux disease. 1264 31

Alendronate sodium is an aminobiphosphonate, an analog of inorganic pyrophosphate, indicated for the treatment of osteoporosis in post-menopausal women. We analyzed events reported in patients prescribed alendronate by general practitioners (GPs) in England. A non-interventional observational cohort study was conducted using the technique of prescription event monitoring (PEM). Exposure data were obtained from dispensed prescriptions issued between October 1995 and January 1997. Outcome data were obtained by sending questionnaires to prescribing GPs. The cohort comprised 11,916 patients. Events most frequently reported as suspected adverse drug reactions and reason for stopping alendronate were recognized gastrointestinal events listed in the Summary of Product Characteristics. These included nausea/vomiting, abdominal pain, dyspepsia, esophagitis and esophageal reflux. Events with the highest incidence density (ID(1) per 1000 patient months treatment) were dyspeptic conditions (32.2), nausea/vomiting (20.8) and abdominal pain (13.8). The term dyspeptic conditions included dyspepsia, esophagitis, esophageal reflux, duodenitis, gastritis and heartburn. Serious suspected adverse reactions possibly related to alendronate were single reports of angioedema, erythema multiforme, hypercalcemia and hypocalcemia. There were 540 deaths in this elderly cohort. This study suggests that alendronate appears to be well tolerated, though there may be risk of developing gastrointestinal side effects including esophagitis and esophageal ulcers.
 ...
PMID:Pharmacovigilance study of alendronate in England. 1273 Jul 57

Cough is an important defensive reflex of the airway and a common symptom of respiratory disease. After an upper respiratory tract virus infection, cough is transient, but is more persistent with conditions such as asthma, rhinosinusitis, gastroesophageal reflux, chronic obstructive pulmonary disease (COPD) and lung cancer. Treatment directed at these conditions may improve cough, but there remains a need to control cough directly. The most effective antitussives are opioids, such as morphine, codeine or pholcodeine, but they produce side effects including drowsiness, nausea, constipation and physical dependence. Opioids such as k- and d-opioid receptor agonists, non-opioids such as nociceptin, neurokinin and bradykinin receptor antagonists, vanilloid receptor VR(1) antagonists, blockers of sodium-dependent channels, and maxi-K calcium-dependent channel activators of afferent nerves may all represent novel antitussives and this needs to be confirmed in clinical trials.
 ...
PMID:Current and future prospects for drugs to suppress cough. 1291 74

The symptom spectrum of gastroesophageal reflux disease (GERD) is much wider than is commonly believed, and in about half the patients endoscopic examination is negative. The role of endoscopy to assess response to treatment is therefore much reduced in GERD. Assessment of symptoms is becoming increasingly important, so different outcome measures are required. The Reflux Questionnaire ReQuest was thus designed as a brief, effective and robust method of tracking and quantifying GERD symptoms during treatment. It comprises seven dimensions: general well-being, acid complaints, upper abdominal/stomach complaints, lower abdominal/digestive complaints, nausea, sleep disturbances and other complaints. In the short version of ReQuest the symptom burden of each dimension is measured by its frequency and intensity (except general well-being, for which only the intensity was determined). The long version also includes 67 symptom descriptions that constitute the dimensions (except general well-being). The rigorous validation process included clinical trial evaluation and statistical assessment of the findings. Important measures of the instrument, such as internal consistency, test/ retest reliability, construct validity and the responsiveness to changes during treatment, among others, all fulfilled or exceeded requirements, thereby demonstrating the accuracy of the instrument. ReQuest meets the criteria set by regulatory authorities and serves as the primary outcome measure for symptom assessment in future clinical trials of current and new treatments.
 ...
PMID:Look--but also listen! ReQuest: A new dimension-oriented GERD symptom scale. 1519 Mar 83

Over a 2-year period, 34 children were referred to the division of pediatric gastroenterology at the University of Virginia with chronic upper gastrointestinal symptoms whose symptoms rapidly and completely resolved when their unrecognized constipation was treated. The average age at presentation was 8.24 (SD 0.78) years and average duration of upper intestinal symptoms was 15.6 (SD 3.5) months. Twenty-six of 34 had experienced recurrent vomiting, 6 complained of chronic nausea, 17 had chronic symptoms of gastroesophageal reflux, and 20 complained of chronic or recurrent abdominal pain, most often in the epigastric region. Smaller numbers had experienced early satiety, choking, gagging, dysphagia, or intermittent diarrhea. Given the prevalence of constipation in childhood, it seems likely that many children who experience chronic upper intestinal symptoms may be suffering from chronic unrecognized constipation as the cause of their upper intestinal symptoms.
 ...
PMID:Recurrent vomiting and persistent gastroesophageal reflux caused by unrecognized constipation. 1520 51

When no organic cause for dyspepsia is found, the condition generally is considered to be functional, or idiopathic. Nonulcer dyspepsia can cause a variety of symptoms, including abdominal pain, bloating, nausea, and vomiting. Many patients with nonulcer dyspepsia have multiple somatic complaints, as well as symptoms of anxiety and depression. Extensive diagnostic testing is not recommended, except in patients with serious risk factors such as dysphagia, protracted vomiting, anorexia, melena, anemia, or a palpable mass. In these patients, endoscopy should be considered to exclude gastroesophageal reflux disease, peptic or duodenal ulcer, and gastric cancer. In patients without risk factors, consideration should be given to empiric therapy with a prokinetic agent (e.g., metoclopramide), an acid suppressant (histamine-H2 receptor antagonist), or an antimicrobial agent with activity against Helicobacter pylori. Treatment of patients with H. pylori infection and nonulcer dyspepsia (rather than peptic ulcer) is controversial and should be undertaken only when the pathogen has been identified. Psychotropic agents should be used in patients with comorbid anxiety or depression. Treatment of nonulcer dyspepsia can be challenging because of the need to balance medical management strategies with treatments for psychologic or functional disease.
 ...
PMID:Evaluation and management of nonulcer dyspepsia. 1525 26

Ambulatory esophageal 24-hr pH monitoring is used to diagnose GERD by determining the total acid contact time and/or symptom index (SI). The aim of this study was to compare the relationship between total acid contact times and SI in two groups: patients with very low vs. very high total acid contact times. We reviewed 973 consecutive 24-hr pH studies and compared patients with the lowest and highest 5% of total acid contact times. The low reflux group was significantly younger (median 50 vs. 54 years) and more predominantly female (78 vs. 47%) than the high reflux group. Median total acid contact time was 0.6 and 26.4% in the low and high reflux groups, respectively. The median SI was significantly lower in the low vs. high reflux groups for all symptoms (heartburn, 0 vs. 100%; regurgitation, 20 vs. 100%; cough, 0 vs. 55%; chest pain, 0 vs. 75%; nausea, 0 vs. 100%; and total SI, 12 vs. 86%). In patients with very low total acid contact times, only 12% of symptoms (typical or atypical) are associated with acid reflux, compared to 86% in patients with very high acid contact times. Younger females are overrepresented in the very low reflux, low SI group.
 ...
PMID:Most GERD symptoms are not due to acid reflux in patients with very low 24-hour acid contact times. 1538 25


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>