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)

The isolation of substance P (SP) in 1931, and the later discovery of its preferred neurokinin (NK)1 receptor, led to an intense research effort aimed at elucidating the biological role of SP, particularly within the central nervous system. There is now a large body of evidence to support the hypothesis that SP is one of the most important neurotransmitters and neuromodulators present in the brain. Its pharmacology has been intimately linked to the pathophysiology of several relevant neurological and psychiatric disorders, namely nociception, migraine, asthma, nausea, inflammatory bowel syndrome, urinary incontinence, anxiety and depression. This wide therapeutic potential triggered an unprecedented research effort, both preclinically and clinically, to identify appropriate NK1 receptor antagonists and transform them into effective drugs. To date, despite huge investments made by some of the largest pharmaceutical groups worldwide, aprepitant (MK-869, an anti-emetic agent) remains the only NK1 receptor antagonist on the market. Nevertheless, the 'NK1 receptor antagonist race' is not over, as witnessed by the significant number of patents and scientific publications claiming the discovery of new NK1 receptor antagonists issued in recent years. This review describes the most relevant results obtained in this field in the period 2005 to 2006.
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PMID:Neurokinin 1 receptor antagonists--current prospects. 1778 60

Gosha-jinki-gan (GJG), a traditional Chinese medicine, is known to be potentially effective for urinary disturbance. For the clinical evaluation of Gosha-jinki-gan, we administered GJG for 6 weeks to elderly male patients with overactive bladder (OAB) and assessed its efficacy and tolerability. In this study, 30 male patients with over 6 months of OAB symptoms had received 2.5 g GJG mixture x 3/day. After 6 weeks of treatment, the efficacy, safety, and tolerability were assessed. We evaluated International Prostate Symptom Score (I-PSS), Overactive Bladder Symptom Score (OABSS), quality of life (QOL), maximal urinary flow rate (Qmax), average urinary flow rate (Qave), incidence of urinary incontinence, and post-void residual before and after treatment. We observed significant improvements in I-PSS (15.2 +/- 1.0 vs. 12.0 +/- 0.9, p < 0.0001), OABSS (7.5 +/- 0.6 vs. 4.9 +/- 0.5, p < 0.0001), and QOL score (4.4 +/- 1.0 vs. 3.3 +/- 1.1, p < 0.0001, Wilcoxon rank sum test). GJG was significantly effective in improving urgency, micturition frequency, nocturia, and urinary incontinence (p < 0.05). However, Qmax, Qave, and post void residual did not significantly change. Mild adverse effects were observed in 3 cases. The symptoms were diarrhea, nausea, and urinary frequency. These data suggest that Gosha-jinki-gan may be a new potential therapeutic agent for OAB without deterioration of voiding function in men with benign prostatic obstruction (BPO).
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PMID:Effect of Chinese herbal medicine on overactive bladder. 1820 22

Stress urinary incontinence (SUI) is the most common form of urinary incontinence and occurs more frequently in women than in men. Duloxetine is a balanced dual serotonin (5-HT) and norepinephrine (NE) reuptake inhibitor and shows no relevant binding affinity for histaminergic, dopaminergic, cholinergic, and adrenergic receptors. The efficacy of duloxetine in SUI is based on the inhibition of the presynaptic reuptake of 5-HT and NE in Onuf's nucleus of the sacral spinal cord, whereby it may increase the concentration of 5-HT and NE in the synaptic cleft. The effectiveness of duloxetine was studied in a cat model of acetic acid-induced bladder irritation. The results showed that in cats with previous irritated bladder function, there was a dosage-dependent improvement of bladder capacity and periurethral electromyography (EMG) activity. In women with SUI, it is assumed that the clinical efficacy of duloxetine is based on stronger urethral contraction and persistent sphincter tone during the storage phase. In clinical trials in women with SUI, duloxetine has demonstrated efficacy in reducing incontinence episodes and increasing quality of life. Nausea was the most common adverse event and the main cause for discontinuation. In summary, duloxetine appears to be a promising new option for the treatment of SUI.
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PMID:Duloxetine in the treatment of stress urinary incontinence. 1836 May 68

We report a rare case of urinary retention secondary to Listeria meningitis. A 90-year-old woman presented with high fever, nausea, diarrhea, and incontinence of urination and feces. Lumbar puncture was performed. The total cell number of the cerebrospinal fluid (CSF) was elevated indicating that the glucose level was decreased. A CSF culture and a blood culture revealed Listeria monocytogenes (L. monocytogenes). We treated this bacterial meningitis with antibiotic medicine. One month after onset, stiff neck and laboratory data greatly improved and only urinary retention continued. Lumbar magnetic resonance imaging (MRI) showed no responsible lesions for the urinary retention. She received urological examination for urinary retention and was diagnosed with a neurogenic bladder. Two months later, she was able to walk after rehabilitation. However, the urinary retention continued despite urological therapy. We are not aware of descriptions on urinary retention resulting from bacterial meningitis in the recent literature. This is a rare case of prolonged urinary retention caused by bacterial meningitis.
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PMID:Urinary retention secondary to Listeria meningitis. 1855 72

Oral sodium picosulfate/magnesium citrate (CitraFleet; Picolax), consisting of sodium picosulfate (a stimulant laxative) and magnesium citrate (an osmotic laxative), is approved for use in adults (CitraFleet; Picolax) and/or adolescents and children (Picolax) as a colorectal cleansing agent prior to any diagnostic procedure (e.g. colonoscopy or x-ray examination) requiring a clean bowel and/or surgery. It is dispensed in powder form (sodium picosulfate 0.01 g, magnesium oxide 3.5 g, citric acid 12.0 g per sachet), with the magnesium oxide and citric acid components forming magnesium citrate when the powder is dissolved in water. In adult patients, two sachets of sodium picosulfate/magnesium citrate was at least as effective and well tolerated as oral magnesium citrate 17.7 or 35.4 g, or oral polyethylene glycol 236 g in adult patients undergoing a double-contrast barium enema procedure in three large, randomized, comparative clinical studies. In contrast, sodium picosulfate/magnesium citrate was less effective than a sodium phosphate enema preparation in two studies in patients undergoing flexible sigmoidoscopy. A similar number of patients receiving two sachets of sodium picosulfate/magnesium citrate or two 45 mL doses of oral sodium phosphate the day before a double-contrast barium enema procedure achieved satisfactory barium coating and none/minimal faecal residue in one study. However, the data from three of these studies should be interpreted with caution because the administrative regimens used differed from that recommended. Sodium picosulfate/magnesium citrate is also an effective and generally well tolerated colorectal cleansing agent in children and adolescents; the preparation was more effective than oral bisacodyl 0.01 or 0.02 g plus a sodium phosphate enema preparation in this population. Further research is thus required to accurately position sodium picosulfate/magnesium citrate and fully establish its efficacy and tolerability prior to various exploratory or surgical procedures. Nevertheless, oral sodium picosulfate/magnesium citrate provides a useful option in the preparation of the colon and rectum in adults, adolescents and children undergoing any diagnostic procedure (e.g. colonoscopy or x-ray examination) requiring a clean bowel and/or surgery. Oral sodium picosulfate/magnesium citrate acts locally in the colon as both a stimulant laxative, by increasing the frequency and the force of peristalsis (sodium picosulfate component), and an osmotic laxative, by retaining fluids in the colon (magnesium citrate component), to clear the colon and rectum of faecal contents. It is not absorbed in any detectable quantities. Sodium picosulfate is a prodrug: it is hydrolyzed by bacteria in the colon to the active metabolite 4,4'-dihydroxydiphenyl-(2-pyridyl)methane. Sodium picosulfate/magnesium citrate may be associated with a dehydrating effect, as evidenced by a reduction in bodyweight and increased haemoglobin levels; some at-risk patients may experience postural hypotension and older patients may require additional electrolytes. In three large (n >100), randomized, single-blind clinical studies, two sachets of oral sodium picosulfate/magnesium citrate was at least as effective as oral magnesium citrate 17.7 or 35.4 g, or oral polyethylene glycol 236 g as a colorectal cleansing agent in adult patients undergoing a double-contrast barium enema procedure. In contrast, sodium picosulfate/magnesium citrate was less effective than a sodium phosphate enema preparation in two studies in patients undergoing flexible sigmoidoscopy. A similar number of patients receiving two sachets of sodium picosulfate/magnesium citrate or two 45 mL doses of oral sodium phosphate the day before a double-contrast barium enema procedure achieved satisfactory barium coating and none/minimal faecal residue in one study. However, the data from three of these studies should be interpreted with caution because the administrative regimens used differed from that recommended. In children and adolescents, sodium picosulfate/magnesium citrate was significantly more effective as a colorectal cleansing agent than oral bisacodyl 0.01 or 0.02 g plus a sodium phosphate enema preparation in a randomized, single-blind study; dosages were adjusted for age in this study. Oral sodium picosulfate/magnesium citrate is generally well tolerated in adult patients undergoing various investigational colorectal procedures. Adverse events were generally mild to moderate in intensity and mainly gastrointestinal in nature (e.g. abdominal cramps/pain, nausea); other common treatment-emergent adverse events included disturbance of daily activity, headache and sleep disturbance. This combination is at least as well tolerated as oral sodium phosphate or oral polyethylene glycol, with moderate/severe nausea and vomiting occurring less frequently in sodium picosulfate/magnesium citrate recipients than in those receiving oral sodium phosphate, and abdominal bloating/pain and nausea developing less often with sodium picosulfate/magnesium citrate than polyethylene glycol therapy. The incidence of abdominal pain and sleep disturbance in sodium picosulfate/magnesium citrate versus oral magnesium citrate recipients was similar in one study, but significantly lower with sodium picosulfate/magnesium citrate in another. While the incidence of most adverse events was similar in recipients of sodium picosulfate/magnesium citrate and a sodium phosphate enema preparation, more patients receiving sodium picosulfate/magnesium citrate reported moderate/severe flatulence, incontinence and sleep disturbance, and more patients receiving the enema preparation reported rectal soreness. The tolerability profile of sodium picosulfate/magnesium citrate in patients aged >70 years is reportedly similar to that in patients aged <70 years. Abdominal pain also occurred less frequently with sodium picosulfate/magnesium citrate than with oral bisacodyl plus a sodium phosphate enema preparation in children and adolescents.
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PMID:Sodium picosulfate/magnesium citrate: a review of its use as a colorectal cleanser. 1919 41

Functional bowel disorders encompass a number of symptoms including abdominal, pelvic and/or anal pain, bloating, nausea, disturbed bowel function, faecal urgency or incontinence, straining to evacuate bowels, incomplete emptying and constipation. This article examines the causes and effects of functional bowel problems on patients' quality of life. It provides an overview of the treatment options and clinical management of these conditions, focusing on biofeedback and rectal irrigation. The author reports results from a small scale audit at her hospital and concludes that rectal irrigation is a valuable treatment option for patients with functional bowel disorders.
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PMID:Rectal irrigation for patients with functional bowel disorders. 2037 12

A wide variety of symptoms have been attributed to menopause, negatively influencing women's physical and psychological health. In addition to lifestyle parameters and personal history, genetic factors are considered to be the main source of this variation. This study aims to investigate the incidence of menopausal symptoms among midlife women according to their menopausal status, and to evaluate the contribution to their manifestation from CYP1B1 Leu432Val polymorphism as a predisposing factor for menopausal symptoms. The studied cohort consisted of 299 women ranging from 39 to 59 years of age. Women were recruited from the western and middle parts of Slovakia, and all participants completed a menopause-specific questionnaire and provided blood or saliva samples for genotyping. Our results indicated that all women are at risk of typical menopausal symptoms, but there is a higher number of postmenopausal women affected than premenopausal ones. Regression analysis showed that the CYP1B1 Leu/Leu genotype can increase the experience of bloated stomach and facial hair increase in all the sampled women, while the Leu/Leu genotype may increase experience of palpitations and involuntary urination in the premenopausal women. The Leu/Leu genotype may increase the experience of nausea, bloated stomach, and vaginal dryness in peri- and postmenopausal women. We determined that women with the Leu/Leu, or Leu/Val genotypes were approximately five times more likely to suffer from vaginal dryness than the Val/Val women (OR = 4.948; 95% CI, 1.259-19.447). We therefore suggest that CYP1B1 Leu432Val polymorphism could be involved in individual susceptibility to menopausal symptoms in Slovak midlife women.
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PMID:Menopausal complaints in Slovak midlife women and the impact of CYP1B1 polymorphism on their incidence. 2335 Jan 53

To achieve a 'good' death, management of urinary incontinence at the end of life arguably should be as much a priority for nursing attention as managing symptoms such as pain and nausea. To understand how contemporary best practice is described and the nature of interventions prescribed for managing this issue, this article reviews the content of 16 seminal palliative care textbooks and 10 journal articles (retrieved through systematic search techniques) that discuss the management of urinary incontinence for patients at the end of life. The findings depict an area of nursing that has been governed by 'common sense' and precedent rather than evidence-based research, particularly regarding the use of indwelling urinary catheters. There is very little robust research evidence on this topic. Further research is required to ascertain the current state of practice in settings where patients who are approaching the end of life are cared for and the needs and preferences of patients and families.
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PMID:Managing urinary incontinence at the end of life: an examination of the evidence that informs practice. 2447 7

Topiramate is an anticonvulsant that has been widely used in psychiatric conditions. The most common treatment-related adverse effects of topiramate were diarrhea, nausea, loss of appetite, fatigue, paresthesia, cognitive impairment, and metabolic acidosis. The following is a case report intended to draw attention to a rarely reported adverse effect of topiramate. A male patient treated with topiramate developed urinary incontinence that was considered drug associated because of the temporal relationship between its appearance and the commencement of topiramate, its resolution upon topiramate discontinuation, and its recurrence with topiramate rechallenge. Urinary incontinence, although not life threatening, can be a distressing problem with a profound impact on quality of life. This case reminds that physicians prescribing topiramate should be aware of this possible adverse effect and communicate it to patients and their caregivers.
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PMID:Topiramate-associated urinary incontinence: a case verified by rechallenge. 2522 72

Prion diseases are typically recognized as rapidly progressive dementing illnesses that also feature myoclonus and cerebellar ataxia. Several families have now been described with a late-onset hereditary sensory and autonomic neuropathy caused by truncation of prion protein (PrP), and associated with systemic amyloidosis, which was a profoundly unexpected phenotype. The chronic symptoms of this disorder, termed PrP systemic amyloidosis, can be very disabling, and are comparable to familial amyloid polyneuropathy (FAP) caused by transthyretin mutations. Patients require symptomatic therapies directed towards control of nausea, diarrhoea, incontinence, neuropathic pain and postural hypotension. Although the potential transmissibility of this new prion disease is probably extremely low, we advocate PrP gene analysis before biopsy in the investigation of peripheral and autonomic neuropathies, or for patients with unexplained diarrhoea and neuropathy. Prion diseases and the FAPs both display prominent effects of mutation type on clinical presentation and patterns of pathology-a fascinating but unexplained observation. Several neurodegenerative diseases associated with central protein misfolding, such as Huntington and Parkinson diseases, also have under-recognized peripheral components. Most of the familial amyloidoses can be explained by known gene mutations, but amino acid variants in proteins involved in other central neurodegenerative diseases might direct the initial pathology to the periphery.
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PMID:A new prion disease: relationship with central and peripheral amyloidoses. 2562 92


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