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

A 38-year old quintipara with an unremarkable medical history suddenly complained of nausea during delivery, became pulseless and cyanotic, and lost consciousness. The ECG showed evidence of tachycardia, ventricular extrasystoles, and right-ventricular strain. Within 30 min there were also hemorrhage and a consumption coagulopathy (Table 1). Kerato-hyaline cell material was found in central-venous blood. Following cardiopulmonary resuscitation, emergency cesarean section, hemotherapy (Table 2), and intensive care (acute renal failure, ARDS, sepsis) the patient was able to be released with no permanent sequelae. The etiology, epidemiology, and clinical aspects of amniotic fluid embolism are discussed.
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PMID:[Amniotic fluid embolism]. 264 92

This is a review of 15 cases of severe pre-eclampsia with HELLP syndrome. The patients presented with severe arterial hypertension, the main symptoms were epigastric and right hypochondrial pain that were present in 66.6% of the patients, nausea and vomit in 53.8% and edema of the lower limbs in 60%. The most frequent age was in the third decade of life, and in the third trimester of pregnancy for all the cases, the main complication was acute renal insufficiency in 80% on the patients. Three patients died (20%), the causes were ARDS, brain hemorrhage and hypovolemic shock.
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PMID:[Severe pre-eclampsia and HELLP syndrome]. 782 29

1. Seven adult cases of deliberate oral exposure to 'Savlon' liquid (chlorhexidine gluconate 0.3%, cetrimide 3%) are presented. 2. In six patients, the symptoms were relatively mild including nausea, vomiting, sore throat and abdominal pain. 3. One patient who had concomitantly taken 'Dettol' liquid was comatose and hypotensive at presentation and was complicated by aspiration pneumonia and adult respiratory distress syndrome (ARDS). She was ventilated for a total of 10 days and was hospitalised for 5 weeks. 4. The data from this study suggest that symptoms associated with Savlon poisoning are usually mild. When aspirated, Savlon together with 'Dettol' liquid can cause ARDS.
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PMID:Poisoning due to Savlon (cetrimide) liquid. 782 85

To elucidate the early clinical characteristics of hantavirus pulmonary syndrome (HPS), we compared the clinical features of 24 cases of HPS with those of cases of bacteremic pneumococcal pneumonia (n = 30), influenza (n = 33), or unexplained adult respiratory distress syndrome (ARDS, n = 21). On admission, patients with HPS were less likely than outpatients with influenza to have reported sore throat (OR = 0.02, P < .01) and cough (OR = 0.1, P = .01) and were less likely than patients with pneumococcal pneumonia to have lobar infiltrates detected by chest roentgenography (OR = 0, P < .01). Multivariate discriminant analysis revealed that three clinical characteristics at admission (dizziness, nausea or vomiting, and absence of cough) and three initial laboratory abnormalities (low platelet count, low serum bicarbonate level, and elevated hematocrit level) served to identify all patients with HPS and to exclude HPS in at least 80% of patients with unexplained ARDS. These findings warrant further study and should facilitate the early recognition of patients with HPS, who may benefit from early critical-care intervention.
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PMID:Clinical features that differentiate hantavirus pulmonary syndrome from three other acute respiratory illnesses. 852 58

Fifteen patients with stage II, IIIA, and IIIB non-small cell lung cancer (NSCLC) received subcutaneous (s.c.) recombinant, glycosylated, human interferon-beta 1a (Rebif; rHuIFN-beta 1a) on each day of conventionally fractionated radiation therapy (RT) given in 2.0 Gy fractions to 60 Gy in 6 weeks. The rHuIFN-beta 1a was generated in CHO cells by recombinant DNA technology and is identical to natural IFN-beta produced by fibroblasts in primary sequence and glycosylation. Cohorts of three patients each were treated with escalating doses of rHuIFN-beta 1a: 1.5, 3, 6, 12, and 24 MIU/m2 per treatment day. Acute toxicity was assessed according to modified WHO criteria; late toxicity was graded using RTOG late toxicity criteria. The maximum tolerated dose (MTD) of rHuIFN-beta 1a was defined as the dose level immediately below that in which dose-limiting toxicity occurred in > or = two of six patients. Immunomodulatory effects and antigenicity of rHuIFN-beta 1a were assessed by 2-5A synthetase, beta 2-microglobulin, and neopterin levels and by measurement of anti-rHuIFN-beta antibodies, respectively. Fourteen of fifteen patients experienced grades 1-3 acute (early) toxicity (< or = 90 days), which was primarily gastrointestinal: dysphagia/esophagitis (14/15), nausea/vomiting (12/15), anorexia (7/15), and liver transaminasemia (6/15). One of three patients treated with 24 MIU/m2 per treatment day (total rHuIFN-beta 1a dose 672 MIU) died of complications secondary to pneumonia, sepsis, adult respiratory distress syndrome (ARDS), and radiation pneumonitis. Twelve patients were evaluable for late toxicity (> 90 days). Maximum toxicity was grade 0 in five patients, grade 1 in four patients, and grade 5 in one patient (radiation pneumonitis). Clinical responses from the combination were 1/15 CR, 6/15 PR, 6/15 stable disease, and 1/15 progressive disease. The MTD of rHuIFN-beta 1a has been estimated at 12 MIU/m2 per treatment day when given daily during conventional RT to 60 Gy in 6 weeks. Biologic response by rHuIFN-beta 1a alone was reflected by significant and dose-related increases in 2-5A synthetase, beta 2-microglobulin, and neopterin. Radiation therapy alone had no effect on these immune response parameters and did not diminish their augmentation by rHuIFN-beta 1a. There was no association of biologic modulation with clinical response or survival.
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PMID:Recombinant human interferon-beta (rHuIFN-beta) and radiation therapy for inoperable non-small cell lung cancer. 893 64

To determine the activity and toxicity of gemcitabine in non-small cell lung cancer, three phase II studies of single agent gemcitabine have been conducted between 1990 and 1994. In an early phase II study, gemcitabine was administered of 800 mg/m2 on day 1, 8, 15 every four weeks (step I), and 1,000 mg/m2 (step II). Response was observed in 3 of 13 patients with previously untreated non-small cell lung cancer, although there was no responders in the previously treated patients. Late phase II studies were performed at 20 (group A) and 24 (group B) Japanese institutions to confirm the efficacy and safety of gemcitabine administered alone in patients with non-small cell lung cancer. Seventy-three patients (group A) and 67 patients (group B) were entered into these studies. All patients had no previous chemotherapy and had measurable disease. Gemcitabine was administered at a starting dose of 1,000 mg/m2/wk for 3 weeks followed by a week of rest. The dose was escalated to 1,250 mg/m2 if severe toxicity was not seen in the previous course. Nineteen of 73 patients (26%) had a partial response in group A. Of 67 patients, 14 (20.9%) showed a partial response in group B. Grade 3 or greater toxicities included anemia (20.5%) and leukopenia (9.6%) in group A, and in 13.4% and seven 10.4% in group B, respectively. And grade 3 thrombocytopenia was observed in 1.4%. Other toxicities including hepatic toxicity, fatigue, nausea/vomiting, and fever were mild and transient. Pulmonary toxicity was observed in five patients, two of whom died of ARDS. The median durations of response were 19.6 weeks in group A and 20 weeks in group B, and median survival times were 44 and 39 weeks, respectively. In conclusion, gemcitabine is an active agent against non-small cell lung cancer with very mild toxicities. These results suggest that gemcitabine has potential utility in advanced non-small cell lung cancer on an outpatient basis. Further trials in combination with other active agents are warranted.
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PMID:[Phase II studies of gemcitabine for non-small cell lung cancer in Japan]. 1039 14

Twenty six (7.3%) of a total of 356 patients with acute renal failure were found to have acute pancreatitis as the primary disease. Seventeen (65.4%) of them were males. Their mean age was 35.6 years. Clinically epigastric pain and tenderness were seen in all (100%); nausea vomiting (73%), low grade fever (50%), left sided pleural effusion (38.4%), haemopericardium (26.9%), shock (26.9%), pseudocyst (19.3%) and adult respiratory distress syndrome (7.6%) were the other major presenting features. Serum amnylase (100%), lipase (53.8%), triglycerides (53.8%) and blood sugar (38.5%) were raised in majority whereas serum calcium was detected to be below normal in 46.2% patients. Blood urea and serum creatinine were raised in all and hyperkalacmia was found in 50% patients. CT scan and USG abdomen showed bilateral enlarged kidneys (100%), pancreatic oedema (80.7%), necrosis of pancreas (19.3%) and pseudocyst (19.3%). Management included repeated peritoneal dialysis in all (100%) and surgical intervention in 53.8% patients with severe necrotising and haemorrhagic pancreatitis. All patients recovered from acute renal failure, but 26.9% patients expired due to complications of acute pancreatitis other than acute renal failure.
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PMID:Renal failure in acute pancreatitis. 1125 2

The patient was a 74-year-old woman with gastric cancer with multiple liver metastasis. She was treated with daily oral administration of TS-1 100 mg/day (day 1-21) and systemic administration of CDDP 90 mg (day 8) as neoadjuvant chemotherapy for 2 courses. As metastatic lesions became smaller, we performed distal gastrectomy. TS-1 was started for the residual cancer lesion. However, liver metastatic lesions increased in size, so we carried out intraarterial chemotherapy (IAC), Nausea appeared at 9 days, pancytopenia at 28 days and ARDS at 78 days after IAC. She died due to ARDS.
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PMID:[Pancytopenia and ARDS with high dose hepatic arterial infusion]. 1461 11

We present a case of acute pancreatitis during pregnancy, associated with hyperlipidemia. The patient, 23 years old in 36 g. w., was hospitalized at the Clinic of Obstetrics and Gynecology with nausea, multiple vomitting, persistent abdominal pain and febrility. Because of the clinical apperance of acute pancreatitis Ceaserean Section was performed with subsequent revision of the abdominal cavity, necrectomy of the pancreas, laparostoma, lavage, drainage, nutritional yienostoma. Intubation with artificial pulmonary ventilation and high volume continuous veno-venous haemofiltration (HV CVVH) was performed because of the development of polyorgan insufficiency and ARDS. After the procedure the patient condition became stable. After four months of hospitalisation, she was discharged from hospital with stable vital signs.
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PMID:[Hyperlipidemic pancreatitis during pregnancy--a case report]. 1667 57

HELLP syndrome is a multi-organ disorder unique to pregnancy. It is characterized by hemolysis, elevated liver enzymes, and low platelets in patients with pre-eclampsia or eclampsia. In King Abdulaziz Oncology Center, Jeddah, seven patients with HELLP syndrome were admitted over a period of four years (1991-94). Retrospective analysis of data was done to study the clinical profile of HELLP syndrome. The incidence of HELLP syndrome in our institution was 1 per 2285 deliveries. One patient was Saudi and six were non-Saudis. The age range was 23 to 44 years, with a mean of 29 years. All patients were multipara. The disorder occurred between 24 to 33 weeks of gestational age, the average being 29 weeks. The most commonly encountered clinical feature was right upper quadrant/epigastric pain. Other features included nausea/vomiting, jaundice, hepatic encephalopathy, azotemia, hypotension and grand mal convulsions. All patients had severe pre-eclampsia pr eclampsia. Indirect hyperbilirubinemia was in the range of 2 to 8 mg/dL and elevated transaminases up to 229 U/L (n<40 U/L) were noted. Various degrees of peripheral thrombocytopenia (<150x10(9)/L) were present in seven patients. Four patients had elevated prothrombin and partial thromboplastin time with postive fibrinogen degradation products. Laboratory abnormalities returned to normal within 10 days following delivery. Four patients were delivered by cesarean section and three had vaginal deliveries. We had two maternal deaths (mortality 34%). One died of multi-organ failure and the other with adult respiratory distress syndrome. There was one stillbirth and the second baby died soon after birth due to prematurity (infant perinatal mortality 34%). We conclude that HELLP syndrome is rare among pregnant women in our institution. It should always be suspected in women with pre-eclampsia or eclampsia when they present with upper abdominal pain. Multipara seem to be more afflicted. Subclinical disseminated intravascular coagulation was detected in 55% of the patients. A majority of our patients presented late to the hospital.
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PMID:HELLP syndrome: Clinical profile of seven patients. 1737 23


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