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)

Forty-five patients undergoing total abdominal hysterectomy were randomly divided into three groups. An epidural tube was inserted into one of the following three sites, Th11-12, L2-3, and caudal region. General anesthesia was then maintained with nitrous oxide-oxygen-enflurane, and pancuronium bromide. Morphine hydrochloride 2 mg in 8 ml of normal saline was administered into one of the designated epidural spaces one to two hours before the assumed end of surgery. Postoperative pain was assessed every four hours after the end of the operation until the next morning. Morphine exerted a relatively profound and prolonged analgesic effect in 40% of the Th11-12 group of patients, as well as in 6.7% of the L2-3 and caudal groups. But, supplementary analgesics were necessary in the other patients. No significant differences were found in the degree and extension of postoperative pain, as well as the doses of supplementary analgesics among the three groups. Adverse effects, such as nausea, vomiting and itching, occurred in 30 to 40% of each of the morphine administered groups. Though morphine was applied into different spinal levels, this clinical study did not show any difference in extension of analgesia. The epidurally applied morphine may be distributed widely in the spinal arachnoid space after some time, and may exert an effect on the brain as well as on the spinal nerves. When morphine is administered epidurally one to two hours before the end of a surgical operation, selection of an injection site according to the dermatome level of the skin incision may be unnecessary.
 ...
PMID:[Degree and extension of analgesic effect of morphine applied at three different spinal levels of epidural space]. 227 45

The management of postoperative pain with continuous epidural fentanyl infusion was compared with continuous intravenous fentanyl infusion. In a randomized, doubleblind protocol we prospectively studied 20 patients undergoing repair of the anterior cruciate ligament of the knee. The quality of analgesia and the incidence of side effects were documented. Compared with patients receiving continuous intravenous fentanyl infusion, at 18 h postoperatively patients given continuous epidural fentanyl infusion reported similar pain scores both at rest (22 +/- 25 vs 27 +/- 21, P = 0.52) and with ambulation (59 +/- 18 vs 56 +/- 22, P = 0.82). Plasma fentanyl levels were 1.8 +/- 0.4 and 1.7 +/- 0.4 ng/mL (P = 0.91) for the intravenous and epidural groups, respectively. There were no significant differences in the incidence of nausea, pruritus, or urinary retention. There was no respiratory depression in either group. We conclude that when compared with continuous intravenous fentanyl infusion, continuous epidural fentanyl infusion offers no clinical advantages for the management of postoperative pain after knee surgery.
 ...
PMID:Epidural and intravenous fentanyl infusions are clinically equivalent after knee surgery. 197 97

Six patients were studied to evaluate the efficacy and safety of plasma exchange (PE) in the treatment of primary biliary cirrhosis (PBC). All patients were affected by PBC at stage III-IV and presented symptoms refractory to pharmacologic therapy. Patients underwent PE for a mean period of 40 weeks (range 10-88). A mean of 33 liters (range 17-64) of plasma per patients was removed. Patients reported less fatigue (4/6), pruritus (5/5), nausea (3/3), Sjogren's syndrome (2/6), and painful neuropathy (2/3). A reduction of xanthomata was noted in one of the three affected patients. Definitive improvement was seen in the patient with Raynaud's phenomenon. A significant reduction was noted for serum cholesterol and gammaglobulins. ALT, AST, gamma-GT, alkaline phosphatase, bilirubin, prothrombin activity, AMA titers were not affected by PE. All patients suffered some mild adverse effects during PE. Two patients (IV stage) developed late edema and ascites after 34 and 44 weeks of treatment. We conclude that PE can be considered effective chronic treatment for advanced symptomatic PBC refractory to pharmacological therapy.
 ...
PMID:Effects of plasma exchange (PE) in primary biliary cirrhosis (PBC). A pilot study. 231 37

The authors report a case of toxic hepatitis in a woman of 22 years of age in the third trimester of her first pregnancy treated by methyldopa for hypertension of pregnancy which was diagnosed at 33 weeks of amenorrhoea. The prodromal symptoms were mild and consisted of nausea, vomiting and rise in temperature and this phase was associated with febrile jaundice without pruritus and it was only associated with coagulation disorders in the third stage of labour. This was a case of mixed cytolytic hepatitis (ASAT x 3N) and cholestasis (x 1.5N). The outcome was fatal. The patient died three days after delivery following haematemesis and renal failure as well as hepatic encephalopathy. The main diagnostic feature was acute hepatic stasis in spite of the absence of pruritus and the presence of a raised temperature after hematolytic, viral and obstructive causes had been eliminated. Histology confirmed that there was toxic hepatitis. This aetiology was suggested by the timing of the symptoms after MD (methyldopa) had been taken. Elkington described methyldopa hepato-toxicity in 1969. Fatal cases in the literature were in patients who were over 40 years of age. Methyldopa is used in pregnant women because of its safety as far as the fetus is concerned. Mechanism by which it causes toxic hepatitis is a combination of abnormal metabolism (the cytochrome P450 chain produces an antigen) and an immune reaction in response to this antigen and these explain why such severe and potentially fatal forms of the condition exist.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Fatal toxic hepatitis in pregnancy. A discussion of the role of methyldopa]. 232 42

Epidural narcotics has been shown to produce profound and long-lasting analgesia. It has been suggested that lipid-soluble narcotics such as fentanyl, because of their short transit time in the CSF, are less likely to be associated with delayed respiratory depression and side effects. We tried to combine low concentrations of fentanyl with bupivacaine to minimize side effects and to see if synergistic effect existed. Forty ASA physical status I or II patients who present for cholecystectomy were included in the trial. Before surgery a thoracic epidural catheter was inserted and pain control began when patients became fully awake and complained of pain in the recovery room after surgery. Patients were randomized in a double-blind fashion to one of four groups. Patients in group I were given epidural infusions of fentanyl 0.001%; patients in group 2 received fentanyl 0.001% mixed with bupivacaine 0.1%; patients in group 3 received fentanyl 0.0005%; patients in group 4 received fentanyl 0.0005% mixed with bupivacaine 0.1%. A continuous epidural infusion of these drugs began at a rate of 10 mL/h after a 5-mL bolus of the solution. Pain relief was assessed with visual analogue pain scale. Respiratory rates, vital signs, and mental status were assessed hourly. Except the group 3, the degree of analgesia achieved was similarly satisfactory in all other groups. There was no respiratory depression developed in either group. Motor block was minimal or absent in all groups. The incidence of nausea and pruritus was significant less in group 3 and group 4. In conclusion, the continuous infusion of dilute bupivacaine with fentanyl provides synergistic analgesia with minimal side effects.
 ...
PMID:Comparison of continuous epidural infusion of fentanyl and fentanyl-bupivacaine for post cholecystectomy pain control. 235 68

Somatic symptoms are common in patients on dialysis. Their causes are largely unknown and their therapy is unsatisfactory. To examine the relationship of psychological and clinical factors to these symptoms, 191 interviews were done in patients on hemo- and peritoneal dialysis. The severity of 8 somatic symptoms (tiredness, sleep disturbance, cramps, pruritus, headache, nausea, dyspnea, joint pain) of importance in dialysis patients was measured using previously validated scales. Indices of affect and quality of life were obtained, as was demographic, clinical and laboratory information. The severity of each symptom was significantly related to the indices of affect and quality of life. Using multiple logistic regression, poor affect score was the strongest correlate of each of the following somatic symptoms, tiredness, pruritus, sleep disturbance and cramps. It was ahead of any clinical or demographic variable and was also significantly correlated with the severity of the other symptoms. Indices of hyperparathyroidism were significantly associated with headache, joint pain, dyspnea and nausea. We conclude that the strongest correlate of common somatic symptoms in dialysis patients is affect disturbance, and that therapy aimed at improving the affect may improve the symptoms.
 ...
PMID:Clinical and psychological correlates of somatic symptoms in patients on dialysis. 235 74

This study aimed to compare the efficacy and side-effects of sublingual buprenorphine, a synthetic opioid agonist antagonist, with those of subcutaneous morphine. Fifty ASA class 1 patients were included in the study after having given their informed consent. Caesarean section was carried out under epidural block with 0.5% bupivacaine; no opioids were used during the procedure. The first dose of opioid was given 2 h after the first dose of bupivacaine. Patients were randomly given either 10 mg morphine (n = 25) or 0.4 mg buprenorphine (n = 25), followed by the same dose every 6 h for 36 h. When analgesia was insufficient, tablets containing dextropropoxyphene and paracetamol were given. No attempt was made to blind the study to the patient, but the investigator assessing pain was unaware of the drug given to the patient. Pain intensity was assessed before, and 2 h after each dose of opioid with a 100 mm visual scale, as well as systolic, diastolic and mean arterial blood pressures, heart and breathing rates, and SpO2. Side-effects (pruritus, nausea, vomiting, drowsiness) were also noted. In 2 patients in each group, the protocol was stopped before the 36th h, but after the fourth dose, either because of side-effects, or at the patient's request. Results were similar in both groups of patients, whether for degree of pain relief, or physiological effects. There was no clinically detectable respiratory depression. Duration and intensity of episodes of arterial oxygen desaturation, and the incidence of nausea, were similar in the 2 groups; pruritus was more common in the morphine group.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Postoperative analgesia after cesarean section: sublingual buprenorphine versus subcutaneous morphine]. 237 54

This randomized, double-blind study compared epidural (EP) and intramuscular (IM) morphine in 24 healthy parturients for 24 h after cesarean section. The 11 EP subjects received 5 mg of EP morphine and normal saline intramuscularly, and the 13 IM patients received 5 mg of IM morphine and normal saline epidurally. Both injections were given simultaneously just after delivery and then upon request with at least 30 min between each pair of injections. Blood pressure, visual analogue scale pain score, somnolence score, and presence of nausea, vomiting, or pruritus were assessed every 30 min for 1 h after each dose and then hourly. Oxyhemoglobin saturation (Spo2) and respiratory rate (RR) and pattern were monitored continuously with pulse oximetry and respiratory inductive plethysmography. The EP group had significantly lower pain scores (less pain) than the IM (0.9 +/- 0.3 vs. 3.3 +/- 1.3; mean +/- SD; P less than 0.001) with less morphine (0.3 +/- 0.2 vs. 2.2 +/- 0.6 mg patient-1 h-1; P less than 0.001). There was no difference between groups for RR, Spo2, incidence or frequency of slow respiratory rate (SRR, 5-min mean RR less than 10) and apneas (AP, greater than or equal to 15 s of less than 100 ml tidal volume), incidence of nausea and/or vomiting, pruritus, or hypotension, and hours asleep or drowsy. There were no major respiratory abnormalities. During control monitoring of nine EP and 11 IM subjects while asleep postoperatively, the RR, Spo2, and incidence and frequency of SRR and AP were similar to the study period in both groups. In conclusion, EP morphine was a more effective analgesic than IM morphine, but the side effects of both were similar.
 ...
PMID:A comparison of epidural and intramuscular morphine in patients following cesarean section. 240 43

Personal samples of nitrogen dioxide (NO2) and respirable particulate (RP) were collected over the shift on 232 workers in four diesel bus garages. Response was assessed by an acute respiratory questionnaire and before and after shift spirometry. Measures of exposure to NO2 and RP were associated with work-related symptoms of cough; itching, burning, or watering eyes; difficult or labored breathing; chest tightness; and wheeze. The prevalence of burning eyes, headaches, difficult or labored breathing, nausea, and wheeze experienced at work were higher in the diesel bus garage workers than in a comparison population of battery workers, while the prevalence of headaches was reduced. Mean reductions in forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), peak flow, and flows at 50 and 75% of FVC were not obviously different from zero. There was no detectable association of exposure to NO2 or respirable particulate and acute reductions in pulmonary function. Workers who often had respiratory work-related symptoms generally had a slightly greater mean acute reduction in FEV1 and FEF50 than did those who did not have these symptoms, but these differences were not statistically significant.
 ...
PMID:Epidemiological-environmental study of diesel bus garage workers: acute effects of NO2 and respirable particulate on the respiratory system. 243 31

In order to investigate the efficacy and safety of long-term treatment with flupirtine in patients with chronic pain, in particular arthrosis and arthritis, a study was planned which, when completed, will encompass the treatment of 200 patients over a 12-month period. The present paper is a preliminary report of this ongoing study. The report deals with 104 patients: 55 of whom completed the 12-month treatment period and a 2-week follow-up phase, during which flupirtine was replaced by placebo in order to be able to detect drug-withdrawal effects. Forty nine patients withdrew from the study. Most of the patients were suffering from degenerative rheumatic arthrosis or inflammatory rheumatic arthritis. The average daily dosage was 300 mg. The incidence of drop-outs was highest in the first months with hardly any patients withdrawing in the last six months. Fifteen patients dropped out because of side effects (dizziness, nausea, sleep disturbances, and headache). Ten patients dropped out because of ineffectiveness, seven because of side effects plus ineffectiveness, and three because of side effects and other reasons. The remaining 14 patients dropped out because of other or non-medical reasons. For the 55 patients who completed the study, the analgesic took effect within 45 minutes to 2 hours, the duration of effect was 4-6 hours. Three-quarters of the patients responded to the drug, one-quarter did not. The analgesic effect remained constant during the 12-month treatment, as did the average number of capsules taken per month. There was no evidence that tolerance developed. The most frequent side effects were drowsiness (9% of patients), dizziness (11%), dry mouth (5%) and pruritus (9%). The withdrawal symptom scale completed every month during treatment (to determine baseline values) and every day throughout the 2-week placebo post-treatment phase showed no changes in the median. The mean value increased during the withdrawal phase, however, indicating that the symptomatology was more pronounced in some subjects. After withdrawal, the non-specific symptoms increased to a greater extent than symptoms from the opiate scale. The symptoms were present throughout the withdrawal phase. If the withdrawal phenomena had corresponded to the flupirtine's terminal half-life, then the symptoms ought to have been present mainly in the first few days. There was a slight trend for lowering systolic blood pressure but no changes in diastolic blood pressure or heart rate, nor changes in the ECG or laboratory analysis that could be related to flupirtine. These preliminary data suggest that flupirtine is safe when given for a period of one year.
 ...
PMID:On the adverse reactions and efficacy of long-term treatment with flupirtine: preliminary results of an ongoing twelve-month study with 200 patients suffering from chronic pain states in arthrosis or arthritis. 245 18


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