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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The syndrome of abdominal fullness and nausea, diaphoresis, chest pain, and ECG changes long has been associated with impending myocardial infarction. For a few patients, however, a working diagnosis of coronary ischemia is seen to be inaccurate on further testing, including stress testing and cardiac catheterization. Acute cholecystitis may cause a clinical picture similar to that of cardiac ischemia. The ECG changes that may occur in acute cholecystitis, the possible basis for these changes, and their clinical implications are discussed in this article.
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PMID:Electrocardiographic changes in acute cholecystitis. 274 79

High-dose interleukin-2 (IL-2) with or without lymphokine-activated killer (LAK) cells has been reported to have activity in certain solid tumors, but toxicity has usually required hospitalization for administration. The purpose of this trial was to determine the antineoplastic effect and toxicity of IL-2 administered at a lower dose in an outpatient setting. Eligibility criteria included measurable disease, Karnofsky performance greater than or equal to 70%, age greater than 18 years, and adequate bone marrow, renal, and hepatic function. The median age of 35 patients was 56 years (range, 20 to 75). Diagnoses included malignant lymphoma (ML), (nine patients), chronic lymphocytic leukemia (CLL) (eight), melanoma (eight), colorectal cancer (six), renal cancer (two), and breast cancer (two). The initial 18 patients were treated with 1 mg/m2 (3 x 10(6) U/m2 intravenous [IV] bolus) for five days every other week for a total of 4 treatment weeks (8 weeks total). The subsequent 17 patients were treated with 0.5 mg/m2 (1.5 x 10(6) U/m2). All patients were evaluable for toxicity, and 26 for tumor response. Toxicities included fatigue (71%), nausea (69%), hypotension (54%), fever (51%), chills (40%), weight gain (37%), pruritus or rash (31%), dyspnea (14%), azotemia (6%), confusion (6%), thrombocytopenia (6%), and myocardial infarction (3%). Four patients died from apparently unrelated causes within the first 2 weeks of treatment. Treatment was discontinued before the completion of 8 weeks of treatment because of progressive disease (12 patients), severe hypotension (three), azotemia (one), myocardial infarction (one), early death (four), and miscellaneous causes (two). IL-2 at 1 mg/m2 IV for five days is associated with moderate toxicity, but a dose of 0.5 mg/m2 is tolerable for outpatient administration. Three partial responses (PR) and one minor response (MR) lasting 1 to 17+ months have been observed in 12 patients with ML and CLL evaluable for response. One additional MR was observed in a patient with melanoma. IL-2 deserves further study in patients with ML and CLL.
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PMID:Phase II trial of outpatient interleukin-2 in malignant lymphoma, chronic lymphocytic leukemia, and selected solid tumors. 278 39

Adverse reactions to ophthalmic patients during 9909 fluorescein angiographies during 9 years were registered. Nausea (4.6%) and vomiting (1.3%) were the most common untoward reactions. Allergic skin manifestations occurred in 48 patients, and 5 patients complained of shortness of breath. 56 patients (0.6%) felt dizzy during or immediately after the investigation. Nine patients complained of chest pain, three of whom developed myocardial infarction. Sixteen patients collapsed during the procedure. One healthy male, 42-year-old, collapsed after the injection of fluorescein during angiography, and electrocardiogram showed an asystole of 24 seconds. Otherwise, the electrocardiograms registered on 100 consecutive patients did not reveal any systematic changes in heart rate or rhythm during fluorescein angiography.
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PMID:Adverse reactions to fluorescein angiography. 294 49

Mechanism of action, indications, side effects and contraindications of oral contraceptive agents (OCA) are reviewed. OCA can be divided into two groups: consecutive and combined agents. Combined OCA contain both estrogens and gestagens and are taken for 3 weeks, while consecutive OCA contain only estrogens and are taken for 2 weeks followed by 1 week of combined OCA until the onset of menstruation. Biological activity of synthetic gestagens is estimated by a dosage which results in a delay of menstruation by 2 weeks. Gestagens norethindrone and norethynodrel were shown to be equally effective, while ethinodiol diacetate and norgestrel were 15-30 times more effective. Estrogen component of OCA is represented by ethinyl estradiol or mestranol. Combined OCA are more effective than consecutive OCA; probability of undesirable pregnancy during administration of combined OCA does not exceed 0.2%. The most frequent side-effects of OCA include nausea, headache, uterine hemorrhage, and changes in libido. OCA can affect the endocrine and reproductive systems. Major endocrine effects of OCA include changes in the cortisol metabolism in the adrenal glands, increase in the level of thyroid-binding globulin in the thyroid gland, changes in the glucose metabolism in the pancreas, inhibition of the luteinizing hormone releasing hormone in the hypothalamus with simultaneous decrease in the production of pituitary gonadotropins and inhibition of the ovulation. The most serious side-effects of OCA include cholelithiasis, thrombophlebitis, thromboembolism, liver adenoma, and myocardial infarction. Absolute contraindications to the use of OCA include hypertension, hyperlipidemia, breast or endometrial cancer, pregnancy, cardio-vascular diseases, liver diseases, and kidney insufficiency.
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PMID:[Principles of the use of oral contraceptive preparations]. 307 80

Forty patients with relapsed (26) or refractory (14) myeloma were treated with epirubicin of doses of 75, 90, 105, and 120 mg/m2 in groups of 6 or more patients to test for response, maximum tolerated dose, and toxicity. Thirteen patients had received prior doxorubicin and were included in the dose findings part of the study only. Staging was I (1), II (5), and III (34). Partial responses were seen in 5 patients (18.5%) (duration 1.5, 2, 2.5, 10, and 18 months) not previously treated with doxorubicin. No responses were seen in patients treated with prior anthracycline. Responses were not dependent upon dose level of epirubicin. Median nadir white blood cell count at the four-dose levels were 2,300, 1,000, 1,600, and 1,700/mm3 with median nadir granulocyte counts of 897, 720, 688, and 192/mm3. Fever/neutropenia was infrequently observed at the three lower dose levels but occurred in 6 of 10 patients at 120 mg/m2. Platelet nadirs were 110,000, 83,000, 169,000, and 42,000/mm3. Nonhematological toxicity was not dose dependent and included alopecia (100%), nausea/vomiting (40%), and stomatitis (25%). Six patients had greater than or equal to 0.10 changes in the resting ejection fraction with one patient developing congestive heart failure that responded to medical management. This patient had received prior doxorubicin and had a history of myocardial infarction. Epirubicin can produce remissions in patients with previously treated myeloma who have not received prior doxorubicin. Since the response rate was not enhanced at 120/m2 and since fever/neutropenia was seen regularly at this dose level, the recommended dose for further study is 105 mg/m2.
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PMID:Phase I-II study of epirubicin in multiple myeloma. 316 70

Symptoms experienced by 227 consecutive patients before their admission to the coronary care unit were identified by questionnaire and those associated with myocardial infarction (98) compared with those occurring with ischaemia (53) and chest pain or discomfort of unknown cause (29). The diagnosis of myocardial infarction by the nature of the resultant pain or discomfort was unreliable in contrast to the associated symptoms sweating, nausea, belching and vomiting. The predictive value of the latter was 91%. Nausea was associated with inferior site of infarction and development of Q waves on the electrocardiogram. Morphine administration was not followed by an increased incidence of vomiting. Back pain or discomfort during infarction was experienced twice as often by women.
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PMID:Symptoms associated with myocardial infarction: are they of diagnostic value? 345 80

Problems related to general anaesthesia of 109 consecutive vitrectomies performed on diabetic patients were retrospectively reviewed. On the morning of surgery a normal or a slightly reduced dose of the patient's regular insulin was administered subcutaneously. The amount of intravenous infusion, mostly 5% glucose, was calculated according to the pre-operative urine volume. After surgery, hypoglycaemic (less than 3 mmol/l) values were seen in less than 11% of the patients, and high glucose in less than 30%; 20% had a mild ketoacidosis post-operatively. Difficulties in tracheal incubation was encountered in 10%. Three patients complained of chest pain after surgery, and in one of them a myocardial infarction was diagnosed. Forty-one per cent of the patients complained of nausea or vomited in the afternoon after surgery, and 21% had difficulties in urination the night after surgery. Two of four patients with peritoneal dialysis complained of stomach pain post-operatively. There was no significant association between recurrent vitreous haemorrhage and blood glucose concentration or arterial blood pressure in the early post-operative period.
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PMID:Concomitant problems to the anaesthesia of diabetic vitrectomy patients. 360 9

Nausea and vomiting occurring during myocardial ischemia is believed to be associated with inferior wall infarction. However, data supporting such an association are limited, and an alternative hypothesis that cardiac vomiting is related to infarct size has also been advanced. The 2 hypotheses were tested in a cross-sectional study of 265 patients consecutively admitted to the coronary care unit. Nausea or vomiting was a good predictor of myocardial infarction (p less than 0.0001). The odds of having an infarction was 3.14 times greater for patients with nausea or vomiting than for those without these symptoms. Nausea was not a good predictor for inferior wall infarction (p = 0.14): 51% of patients with inferior infarcts had nausea or vomiting and 66% with anterior infarcts had these symptoms. Using peak serum creatine kinase level as an index of infarct size, nausea or vomiting was a good predictor of larger infarction. While 55% of all patients with infarction had nausea or vomiting, for patients with infarctions that produced a peak creatine kinase level of more 1,000 IU/liters, 78% had nausea or vomiting. Sex was a marginally important variable. After adjusting for sex, the presence of nausea or vomiting still predicted infarct size (p less than 0.001). Thus, cardiogenic nausea and vomiting are associated with larger myocardial infarctions but do not suggest infarcts in a particular location.
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PMID:Nausea and vomiting during acute myocardial infarction and its relation to infarct size and location. 360 39

Studies have attempted to define predictive indicators of diagnosis and/or prognosis for acute myocardial infarction (AMI) in the emergency department and to identify the need for hospital admission in patients with chest pain. Because prehospital predictors have not been defined, dispatchers, paramedics, and base station physicians continue to triage based on patient history. We reviewed 401 patients presenting in one year to an urban paramedic system with chest pain, normal vital signs, and stable rhythms to identify predictors of AMI and unstable angina. Thirty-one percent (123) had a diagnosis of AMI, 26% (105) unstable angina, and 43% (173) "other" diagnoses. Two-hundred seventy-eight patients required nitroglycerin administration, 182 required IV morphine, 14 developed arrhythmias requiring lidocaine, and two suffered cardiac arrest in the field. Nine other patients had a cardiac arrest after arrival in the ED. When comparing AMI and unstable angina patients to the "others," 64% (132) versus 36% (74) had radiation of pain (P less than .003), 72% (95) versus 28% (37) had diaphoresis (P less than .0001). Neither difficulty breathing, nausea/vomiting, vital signs, initial rhythm, nor past history of myocardial infarction were helpful in discriminating AMI and unstable angina from others. Comparing AMI alone versus others, the presence of ST segment elevation on lead II was present in 15% (18) AMIs, 3% (3) unstable angina, and 8% (14) others (P = .005). Diaphoresis also was a predictor of diagnosis with 51% (63) of the AMIs and 25% (69) of others exhibiting this sign (P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Limitations of prehospital predictors of acute myocardial infarction and unstable angina. 368 92

The effect of a new dopamine agonist, CU 32-085 (8 alpha-amino-ergoline), on pituitary function in acromegaly was evaluated by a controlled, single blind study of 12 acromegalics. The study included a single dose placebo/drug (0.5 mg CU 32-085) trial and a long-term crossover trial with 3 month periods (placebo/CU 32-085 8 mg daily). The patients were evaluated clinically and biochemically (oral glucose tolerance (OGTT), TRH- and LHRH-tests) before and after each 3 month period. Nine patients completed this long-term trial; one died from myocardial infarction during the placebo period, and two dropped out because of side effects. The release of GH, judged from more than 9 h suppression of serum GH following the single dose, and from the response to OGTT after the long-term treatment, was significantly inhibited by CU 32-085. Serum GH reached normal values in 4 of 9 patients. Serum PRL was also markedly suppressed, to subnormal values after the 3 months in all but one hyperprolactinemic patient. Serum TSH, cortisol, FSH and LH were generally unaffected. Glucose tolerance was not significantly altered, although an improvement was found in six of nine patients. A semiquantitative evaluation of subjective symptoms showed a significant improvement following the long-term treatment, while objective signs of acromegaly were unaffected. The blood pressure was slightly lowered, both after a single dose and after 3 months' treatment. Seven patients experienced nausea and dizziness, two of them with vomiting, after a single dose of the drug. Four of these had similar symptoms initially during the long-term treatment, which forced two to interrupt the trial. We conclude that CU 32-085 caused a marked suppression of the release of GH and PRL and an improvement of the major symptoms of acromegaly, a therapeutic effect that is comparable to the previous experience with bromocriptine.
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PMID:The effect of a new ergoline derivative, CU 32-085, in the treatment of acromegaly. A controlled study. 388 7


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