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)

Since February 1987, we have been using extracorporeal lithotripsy for certain cases of chronic biliary lithiasis, using an EDAP lithotripter. The technique is reserved for patients with less than four radiotransparent, or partially calcified calculi, less than 25 mm in size, within the context of a functioning gall bladder with no evidence of lithiasis in the C.B.D. Dissolution of the fragments after lithotripsy is ensured by bile salts, this treatment being continued for at least 3 months after the gall bladder has been completely cleared. 160 patients were treated using a total of 181 treatment sessions. Hospitalisation lasted on average 3 days, 1/5th of the patients suffered right hypochondrial pain and nausea for 24 hours. 17% of patients showed a transient elevation in alkaline phosphatase and 12% an elevation in amylase after the procedure. The rate of gall bladder clearance was 24% at 1 month, 40.7% at 3 months ans 50% at 1 year. 11 cholecystectomies were carried out (6.8%), 8 of which were essential. Bile duct migration occurred in 2 cases and produced oedematous pancreatitis in one case. Recurrent lithiasis was noted in 4 cases between 6 and 18 months after gall bladder clearance. 75% of cured patients had a single, radiotransparent stone less than 20 mm in diameter.
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PMID:[Extracorporeal lithotripsy of biliary lithiasis. 160 patients treated with an EDAP apparatus]. 261 78

Nasogastric (NG) decompression after colorectal surgery is practiced commonly. Our aim was to determine whether routine NG decompression benefitted patients undergoing this type of surgery. Five hundred thirty-five patients were randomized prospectively to either NG decompression or no decompression. Stratification was by type of operation and patient age. Excluded were patients who had emergency surgery with peritonitis, extensive fibrous adhesions, enterotomies, previous pelvic irradiation, intra-abdominal infection, pancreatitis, chronic obstruction. prolonged operating times, or difficult endotracheal intubation. Two hundred seventy-four patients received NG decompression (Salem sump, Argyle Co., Division of Sherwood Medical, St. Louis, MO) and two hundred sixty-one did not. There were 33 protocol violations included in the 535 patients. Patients who were not decompressed experienced significantly more abdominal distention, nausea, and vomiting than did those patients who were. Moreover, 13% required subsequent NG decompression as opposed to a reinsertion rate of 5% for patients routinely decompressed. The mean length of hospitalization for both groups was 11 days. There were no significant differences in nasopharyngeal or gastric bleeding, inability to cough effectively, respiratory infections, wound disruptions, reoperation, and wound infection rates (5%) between the two groups. We conclude that even though there is an increase in the rate of minor symptoms of nausea, vomiting, and abdominal distention, routine nasgastric decompression is not warranted after elective colon and rectal surgery.
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PMID:Elective colon and rectal surgery without nasogastric decompression. A prospective, randomized trial. 265 80

Octreotide is an analogue of somatostatin. Like endogenous somatostatin, it exerts a potent inhibitory effect on the release of anterior pituitary growth hormone and thyroid-stimulating hormone, and peptides of the gastroenteropancreatic endocrine system, while overcoming some of the shortcomings of exogenously administered somatostatin, namely a short duration of action, a need for intravenous administration and postinfusion rebound hypersecretion of hormone. Clinical studies have shown that octreotide is effective in the treatment of acromegaly and thyrotrophinomas. In comparative trials octreotide was significantly superior to bromocriptine in patients with acromegaly. Octreotide also appears to provide a significant advantage over existing therapies in the management of the carcinoid syndrome and offers considerable therapeutic potential in reversing carcinoid crises which may be life-threatening. Trials in patients with tumours producing vasoactive intestinal peptide demonstrated that octreotide may be an effective first-line choice for this condition, which has usually metastasised and become refractory to traditional symptomatic therapy. In limited studies in patients with high-output secretory diarrhoea, including cryptosporidium-related diarrhoea associated with AIDS and in patients with small bowel fistulas, octreotide has been shown to be effective in reducing stool/fistula output. However, well-designed clinical trials are still required to confirm its long term usefulness in these disorders. Similarly, although the use of octreotide in other conditions such as neonatal hypoglycaemia caused by nesidioblastosis, reactive pancreatitis, insulin-dependent diabetes mellitus, postprandial hypotension and the dumping syndrome has provided encouraging preliminary results, more studies are needed to clarify the place of octreotide in their treatment. Overall, octreotide appears to be well tolerated with the most frequently reported reactions being pain at the site of injection and gastrointestinal symptoms such as abdominal cramps, nausea, bloating, flatulence, diarrhoea and steatorrhoea. These adverse effects usually abate with time. Additionally, octreotide, like endogenous somatostatin, may also result in cholelithiasis, presumably by altering fat absorption and possibly by decreasing motility of the gallbladder. Thus, octreotide represents a new departure from traditional therapies in the treatment of various pathophysiological states associated with excessive peptide production and secretion. It offers a significant advantage over existing therapies in the medical management of patients with acromegaly, thyrotrophinomas, the carcinoid syndrome, tumours producing vasoactive intestinal peptide and severe secretory diarrhoea in whom conventional management options have either become exhausted or have provided suboptimal symptomatic relief.
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PMID:Octreotide. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in conditions associated with excessive peptide secretion. 268 36

Chronic pancreatitis is a rare childhood illness, most often presenting with nausea, vomiting, and recurrent abdominal pain. Obstructive jaundice secondary to biliary stricture is an uncommon manifestation of childhood pancreatitis, with only 11 patients previously described in the surgical literature. We report our experience with two additional children with jaundice secondary to pancreatitis and review the literature on this problem. Laboratory tests are often of little diagnostic value, and a high index of suspicion is essential for correct diagnosis. Endoscopic retrograde cholangiopancreatography is emerging as an extremely useful diagnostic study in these patients. The surgical management of this uncommon pediatric illness remains controversial.
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PMID:Obstructive jaundice secondary to chronic pancreatitis in children: report of two cases and review of the literature. 305 95

174 patients with chronic pancreatic diseases, 30 patients with pancreatic carcinoma and 144 with chronic relapsing pancreatitis, 50 of them with calcifications, were observed in the Department of Internal Medicine of the University of Marburg/FRG between 1972 and 1982. In order to differentiate between carcinoma and relapsing pancreatitis the data of these patients were analysed retrospectively with regard to patient history, actual complaints, findings of laboratory, sonography, ERCP and X-ray investigations. The following results were obtained: Of discriminating value are steatorrhoe, local palpatory pain, alcohol ingestion, a history of earlier attacks and relapsing pain situations; however, general abdominal pain, nausea, vomiting and weight loss (if not exactly specified) are not. Within the laboratory findings bilirubin, GOT, alkaline phosphatase, gamma-GT, serum potassium, blood sugar and chymotrypsin content of the stool were significant while serum and urine amylase were similarly distributed within the groups of patients. Carcinoma and chronic relapsing pancreatitis can be identified by sonography in the majority of patients, but calcifications of the pancreas were rarely demonstrated during this observation period. The obstruction of the extrahepatic bile ducts--mostly due to a carcinoma of the pancreas head--was usually well documented by sonography. Intraabdominal air proofed to be the most disturbing factor. In carcinoma patients, the ERCP is important in demonstrating a complete obstruction of the pancreatic duct and stenosis and dilatation of the extrahepatic bile ducts. In patients with chronic relapsing pancreatitis the pancreatic duct alterations such as dilatations and partial stenosis are well documented by ERCP especially if calcifications occur. In patients without calcifications, dilatation of the branches of the main duct are less relevant in the diagnosis of pancreatic diseases. Radiological demonstration of calcification of the pancreatic area is important for the differential diagnosis. Longstanding characteristical complaints, symptoms and calcifications within the pancreatic area are the most relevant factors in discriminating carcinoma and chronic relapsing pancreatitis.
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PMID:[Differential diagnostic evaluation of chronic pancreatitis in relation to pancreatic cancer based on clinical, laboratory chemical and diagnostic parameters. Studies of 174 patients in 10 years]. 353 95

In a retrospective study of patients 18 years of age and younger over a 28-year period, 48 children had pancreatitis. Epigastric pain, nausea, and emesis were present in 90%. Hyperamylasemia was present in 34 children; elevated amylase/creatinine clearance ratio was helpful in diagnosing ten others. In four children, pancreatitis was diagnosed at laparotomy. Etiology of the pancreatitis was idiopathic in 16, drug-induced in 12, all of whom had received corticosteroids. Nine developed pancreatitis after blunt trauma; seven had obstruction of the pancreaticobiliary drainage system. Two children developed pancreatitis in association with sepsis, and two had recurrent hereditary pancreatitis. Thirty of the 48 patients were managed nonoperatively while operations were required in 18. Seven had drainage of pancreatic pseudocysts, four had a pancreatectomy, and four underwent laparotomy with debridement and drainage of necrotic pancreas. Bilioenteric bypass procedures were performed to prevent recurrent pancreatitis in three patients; while duodenojenjunostomy sphincteroplasty and cholecystectomy were performed in one child each. Cure was achieved in 38 of 48 children treated for pancreatitis and its complications; each subsequently grew and developed normally. Hemorrhagic pancreatitis occurred in seven children, six of whom died. Seven deaths occurred, all in the medically treated group. Fifteen of the 18 children treated operatively did well in long-term follow-up. Although rare, pancreatitis is a serious cause of abdominal pain in childhood; almost half of the children will benefit from operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical management of pancreatitis in childhood. 361 58

A 68-year-old man without previous hepatobiliary or pancreatic disease was admitted after five attacks of nausea, vomiting, abdominal pain and high fever. Laboratory investigations indicated cholestatic liver disease and pancreatitis. For 1.5 years the patient had occasionally been taking a non-steroidal anti-inflammatory drug, sulindac (clinoril, MSD, New York), for osteoarthritis. On suspicion of a drug-associated disease, a rechallenge experiment was performed with sulindac. Five hours after drug administration symptoms recurred. There was a pronounced increase in serum alkaline phosphatase and amylase. A liver biopsy 3 d later showed portal tract inflammatory infiltration and abnormal interlobular bile ducts with degeneration and necrosis of the epithelium and neutrophilic infiltration of the ducts. Sulindac-induced cholangitis has not been described previously. The pathogenetic mechanism is considered to be an immunoallergic idiosyncratic reaction to the active metabolite of sulindac absorbed by the bile duct epithelium. The lesion is apparently reversible.
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PMID:Acute cholangitis and pancreatitis associated with sulindac (clinoril). 362 32

Pancreas divisum is a variant of pancreatic ductal drainage. Its existence is being observed more frequently with the widespread use of endoscopic retrograde cholangiopancreatography (ERCP). On occasion, a relative stenosis of the accessory sphincter will cause a symptom complex which includes nausea, vomiting, upper abdominal pain, and intermittent pancreatitis. In 20 patients seen over the past 4 years, symptoms have been severe enough to consider the patient for transduodenal sphincteroplasty. The use of morphine prostigmine stimulation as a screening tool, has been helpful in 79 per cent of the patients in the series. Intravenous secretin has been a valuable adjunct to both ERCP identification and cannulation of the duct, as well as in two patients in whom the diagnosis was only suspected, and confirmed at the operating table. Operative common duct manometry has shown 40 per cent of the patients to have abnormal flow dynamics, suggesting possible disturbance in the biliary sphincter, as well as the accessory pancreatic sphincter. Pathologic examination has demonstrated abnormal gallbladders in nine of nine patients without previous cholecystectomy. The suggested procedure of dual sphincteroplasty has resulted in no mortalities, but a 50 per cent complication rate. Follow-up shows 70 per cent of the patients to be currently asymptomatic, two patients have had recurrent pancreatitis, and four patients have other problems causing continued post-operative pain. This study suggests dual sphincteroplasty is an acceptable form of therapy for patients with pancreatic divisum and no other source for their pain. Further follow-up will be necessary to insure that therapy is truly curative.
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PMID:Pancreas divisum. Detection and management. 399 78

At least 25 different drugs have been implicated in drug-induced pancreatitis. For some drugs the evidence is strong, but for many a contradictory or incomplete association exists between their administration and the occurrence of pancreatitis. To our knowledge, carbamazepine has not been associated with pancreatitis. We report a case of a 73-year-old female on carbamazepine 200 mg bid for partial complex seizures who developed nausea, fatigue, anorexia, malaise, headache, and increased thirst. After carbamazepine discontinuation, the patient noted an almost immediate decrease in all symptoms. Her seizures are now treated successfully with phenytoin.
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PMID:A possible case of carbamazepine-induced pancreatitis. 408 52

Acute pancreatitis in a patient on oral contraceptive therapy is reported, and the relationship of estrogen administration to hyperlipemia and pancreatitis is discussed. A 23-year-old white woman was admitted to a hospital with epigastric pain, nausea, and vomiting. Three previous episodes of abdominal pain had been diagnosed as acute pancreatitis. On the present and previous admissions, she had just completed a cycle on her combination norethindrone 1 mg, mestranol 8 micrograms contraceptive. Laboratory results showed mild leukocytosis and elevated concentrations of blood glucose, alkaline phosphatase, serum amylase, and urine amylase. Serum cholesterol and triglycerides were elevated, and lipoprotein electrophoresis showed a type IV pattern. Abdominal sonogram revealed a normal pancreas, and all other test results were normal. The patient was treated with i.v. fluid replacement, dimenhydrinate, and meperidine hydrochloride. Within 72 hours she was asymptomatic, and serum amylase, triglyceride, and cholesterol concentrations had decreased. She was discharged with a diagnosis of acute pancreatitis secondary to oral-contraceptive-induced hyperlipidemia. Oral contraceptive therapy was not resumed. Predisposing factors, symptoms, and laboratory findings associated with estrogen-induced acute pancreatitis are presented, and the mechanisms through which serum lipid elevations and subsequent pancreatitis occur are discussed. Monitoring serum lipid concentrations before and during estrogen therapy is recommended. Research suggests that patients who are over 40 years old or have family histories of hyperlipemia are at particular risk, and that estrogen therapy should be discontinued if pancreatitis occurs.
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PMID:Estrogen-induced pancreatitis. 688 34


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