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)

Most of the previous literature concerning otologic problems in compressed gas environments has emphasized middle ear barotrauma. With recent increases in commercial, military, and sport diving to deeper depths, inner ear disturbances during these exposures have been noted more frequently. Studies of inner ear physiology and pathology during diving indicate that the causes and treatment of these problems differ depending upon the phase and type of diving. Humans exposed to simulated depths of up to 305 meters without barotrauma or decompression sickness develop transient, conductive hearing losses with no audiometric evidence of cochlear dysfunction. Transient vertigo and nystagmus during diving have been noted with caloric stimulation, resulting from the unequal entry of cold water into the external auditory canals, and with asymmetric middle ear pressure equilibration during ascent and descent (alternobaric vertigo). Equilibrium disturbances noted with nitrogen narcosis, oxygen toxicity, hypercarbia, or hypoxia appear primarily related to the effects of these conditions upon the central nervous system and not to specific vestibular end-organ dysfunction. Compression of humans in helium-oxygen at depths greater than 152.4 meters results in transient symptoms of tremor, dizziness, and nausea plus decrements in postural equilibrium and psychomotor performance, the high pressure nervous syndrome. Vestibular function studies during these conditions indicate that these problems are due to central dysfunction and not to vestibular end-organ dysfunction. Persistent inner ear injuries have been noted during several phases of diving: 1) Such injuries during compression (inner ear barotrauma) have been related to round window ruptures occurring with straining, or a Valsalva's maneuver during inadequate middle ear pressure equilibration. Divers who develop cochlear and/or vestibular symptoms during shallow diving in which decompression sickness is unlikely or during compression in deeper diving, should be placed on bed rest with head elevation and avoidance of maneuvers which result in increased cerebrospinal fluid and intralabyrinthine pressure. With no improvement in symptoms after 48 hours, exploratory tympanotomy and repair of a possible labyrinthine window fistula should be considered. Recompression therapy is contraindicated in these cases...
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PMID:Diving injuries to the inner ear. 40 82

At a recent panel on Otology, I asked the audience for a show of hands of those using Zinc for delayed healing and granulations. It was surprising to note that not more than 4 physicians out of 100 had tried Zinc. The need to report our encouraging results was apparent. From 1971 to 1975, 544 tympanoplasties and 122 mastoidectomies were studied for delayed healing due to granulations. Forty-six patients were found to have resistant granulations. Thirty-three of these healed within two weeks of therapy, 10 more required a total of four weeks for healing, and three did not respond well. Sixteen patients had recurrence when the medication was terminated as soon as healing had occurred but responded well when the medication was continued for four weeks after healing was complete. Five patients had nausea, which subsided when the dosage was reduced from the usual 200 mg. of Zinc Sulfate, three times daily with meals to 100 mg., t.i.d. or b.i.d. One patient developed mild urticaria. Zinc therapy is apparently indicated in granulomata of the ear when healing does not occur with conventional therapy, especially in the post-operative patient; however, it will not suffice when there is massive involvement of the mastoid or middle ear, where surgical removal is indicated.
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PMID:Zinc therapy in otology. 97 93

In a recent editorial, Kapur described perioperative nausea and vomiting as "the big 'little problem' following ambulatory surgery."257 Although the actual morbidity associated with nausea is relatively low in health outpatients, it should not be considered an unavoidable part of the perioperative experience. The availability of an emesis basin for every patient in the postanesthesia recovery unit is a reflection of the limited success with the available therapeutic techniques.257 There had been little change in the incidence of postoperative emesis since the introduction of halothane into clinical practice in 1956. However, newer anesthetic drugs (e.g. propofol) appear to have contributed to a recent decline in the incidence of emesis. Factors associated with an increased risk of postoperative emesis include age, gender (menses), obesity, previous history of motion sickness or postoperative vomiting, anxiety, gastroparesis, and type and duration of the surgical procedure (e.g., laparoscopy, strabismus, middle ear procedures). Anesthesiologists have little, if any, control over these surgical factors. However, they do have control over many other factors that influence postoperative emesis (e.g., preanesthetic medication, anesthetic drugs and techniques, and postoperative pain management). Although routine antiemetic prophylaxis is clearly unjustified, patients at high risk for postoperative emesis should receive special considerations with respect to the prophylactic use of antiemetic drugs. Minimally effective doses of antiemetic drugs can be administered to reduce the incidence of sedation and other deleterious side effects. Potent nonopioid analgesics (e.g., ketorolac) can be used to control pain while avoiding some of the opioid-related side effects. Gentle handling in the immediate postoperative period is also essential. If emesis does occur, aggressive intravenous hydration and pain management are important components of the therapeutic regimen, along with antiemetic drugs. If one antiemetic does not appear to be effective, another drug with a different site of action should be considered. With the availability of new antiserotonin drugs, the incidence of recurrent (intractable) emesis could be further decreased. Research into the mechanisms of this common postoperative complication may help in improving the management of emetic sequelae in the future. As suggested in a recent editorial, improvement in antiemetic therapy could have a major impact for surgical patients, particularly after ambulatory surgery. Patients as well as those involved in their postoperative care look forward to a time when the routine offering of an emesis basin after surgery becomes a historical practice.
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PMID:Postoperative nausea and vomiting. Its etiology, treatment, and prevention. 843 45

Some patients have vertigo that is more or less constant, associated with varying degrees of nausea, and only relieved by bedrest. This disorder, named disabling positional vertigo (DPV), was found to be caused by a blood vessel or vessels compressing the eighth cranial nerve in its intracranial portion, and it can be relieved by microvascular decompression (MVD) of the nerve. Important in the differential diagnosis of DPV are a detailed history, the results of audiometry (10 to 15 dB interaural threshold difference or a small mid-frequency notch), acoustic middle ear reflex response testing (may be abnormal), and recordings of brainstem auditory evoked potentials (BAEP). BAEP in such cases show increased conduction time in the auditory nerve and/or prolonged latency of wave V recorded from the contralateral ear, possibly the result of brainstem compression. Abnormalities on vestibular testing often do not reflect the severity of the illness. Forty-one patients who underwent MVD to treat DPV in one year at the author's institution have been followed for 4.5 to 5.5 years. By self-evaluation, 20 had excellent and 10 good results of the operation. The success of this procedure is even higher today, since it was found that very small blood vessels, including veins, can cause DPV; thus all vessels touching the nerve are now managed. Complications of MVD are rare. The most frequent, hearing loss, occurred in only one patient in this series.
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PMID:Vascular compression of the eighth cranial nerve as a cause of vertigo. 175 57

Fifteen hundred randomly chosen Finnish children aged 0-15 years were studied by a questionnaire about their sauna habits and possible abnormal symptoms during or immediately after the sauna. A total of 1247 families (83%) answered. Almost all children visited the sauna (98.5%), most of them "with pleasure" (83%). Nearly half of the children were in the sauna as often as 2-3 times a week, and over 90% at least once a week. The children's sauna visits began quite early, in 70% during infancy. The time spent in a hot steam bath increased with age. Symptoms were rare and were not serious. Transient symptoms (dizziness, nausea etc.) were the most common. Of the children, 17% had some chronic or recurring disorder, most commonly atopic dermatitis or middle ear infections. In half of the cases of atopic dermatitis it became worse in the sauna. Sauna is a very common practice in Finland, also among children. It does not seem to cause any significant immediate harm to healthy children.
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PMID:Sauna habits and related symptoms in Finnish children. 261 14

The efficacy and tolerance of enoxacin were tested in 65 patients treated for ear, nose and throat infections with doses of 400 or 600 mg b.i.d. The overall clinical efficacy of enoxacin was excellent in 32, good in 17, fair in six, and poor in five out of 60 evaluable patients. Three female patients complained of stomach pressure and one man of slight nausea, two of allergic skin reactions and one of arthromyalgia. The pharmacokinetic studies showed high enoxacin concentrations in the secretions, pus, and tissues studied, especially in those of the middle ear and the sinuses.
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PMID:Clinical and pharmacokinetic studies on enoxacin in ear, nose and throat infections. 346 45

Labetalol, an alpha- and beta-adrenergic receptor-blocking agent, was studied as a hypotensive agent during halothane (mostly 0.5 vol.%)-N2O-fentanyl-d-tubocurarine anaesthesia with a head-up tilt of 5 degrees in 41 patients undergoing middle ear microsurgery. After the mean initial dose of 0.3 mg/kg, the mean need for labetalol ranged from 0.05 to 0.07 mg/kg at 30 +/- 5-min intervals. The mean duration of the hypotensive period was 102 min. During the hypotension, the average mean arterial pressure ranged from 59 to 62 mmHg (7.9-8.3 kPa) and the mean heart rate from 61 to 66 b.p.m. After labetalol the maximum cardiac output decrease was 7%. Before labetalol the mean PaO2 value was 158 mmHg (21.1 kPa) and during hypotension it ranged from 145 to 149 mmHg (19.3-19.9 kPa) when FiO2 was 40%. The only peroperative side effects were ECG changes (middle junctional rhythm and sinus bradycardia) which occurred in 10% of the patients. The mean value for the degree of haemostasis rated by the otologist on a visual analogue scale between poor (0 mm) and excellent (100 mm) was 91 mm. The patients were able to open their eyes and to give their names 8-9 min after the end of anaesthesia. After extubation the patients were normotensive and there were no clinically significant changes in the cardiovascular parameters during the 4-h recovery room period. Acid-base status showed slight metabolic acidosis. The most common postoperative side effects were nausea only and nausea + vomiting, which occurred in 39% and 20% of the patients, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Labetalol as a hypotensive agent for middle ear microsurgery. 357 41

Three hypotensive anaesthetic methods were compared in 123 patients undergoing middle ear microsurgery. Hypotension was induced with halothane (1 vol.%), nitroprusside (4.4 micrograms/kg/min) or the combination of halothane (0.5 vol.%) and nitroprusside (1.2 micrograms/kg/min). The compensatory rise in the heart rate was controlled with a beta-adrenergic receptor blocking agent, practolol, the mean need for which was 0.03 mg/kg in the halothane group and 0.1 mg/kg in the other groups. The mean duration of the hypotensive period ranged from 79 to 107 min in the groups. During the hypotension, the average mean arterial pressure ranged from 55 to 60 mmHg (7.33 to 8.00 kPa) and the mean heart rate from 67 to 79 beats/min in the groups. The PaO2 value in the nitroprusside and halothane + nitroprusside groups, but not in the halothane group, decreased statistically and in some cases clinically significantly. The only peroperative side effects were ECG changes (mostly junctional rhythm), the incidence of which ranged from 16 to 24% in the groups. The mean values for the degree of haemostasis rated by the otologist on a visual analogue scale between poor (0 mm) and excellent (100 mm) were 90, 73 and 89 mm in the halothane, nitroprusside and halothane + nitroprusside groups, respectively. Recovery in the halothane group was statistically highly significantly longer than in the other groups. No rebound hypertension occurred in any of the groups after discontinuation of the hypotension. The most common side effect was nausea + vomiting, the incidence of which ranged from 15 to 26% in the groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of three hypotensive anaesthetic methods for middle ear microsurgery. 648 41

A short review is given of the pharmacokinetic characteristics and side effects of the nitroimidazoles: metronidazole, tinidazole and ornidazole. The drugs are well absorbed from the gastrointestinal tract, maximum plasma levels generally being obtained 1 to 4 h after oral intake. Metronidazole has been shown to be absorbed after rectal administration; vaginal absorption is documented for all three drugs. The nitroimidazoles are widely distributed in the body, cross the placenta and appear in breast milk. Therapeutically effective concentrations of e.g. metronidazole have been demonstrated in e.g. the central nervous system, middle ear discharges, bile, peritoneal fluid, and fluids and tissues of the female genital tract. The binding to plasma proteins is less than 20%. Available data suggest that the elimination half-lives of these drugs differ, being 7-8 h for metronidazole, about 12 h for tinidazole and 14-15 h for ornidazole. Both metronidazole and ornidazole, but not tinidazole, seem to be extensively metabolized before elimination. The nature and frequency of adverse reactions to this drug include encephalopathy in a few patients treated with doses between 5 and 10 g daily as an adjunct to radiotherapy, and peripheral neuropathy observed in patients treated for prolonged periods with high doses. Among the common side effects of the nitroimidazoles are symptoms from the gastrointestinal tract such as nausea, anorexia, vomiting and metallic or bitter taste. Dizziness, ataxia and headache have been reported. When given together with alcohol, a disulfiram-like intolerance reaction can be obtained.
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PMID:Pharmacokinetics of nitroimidazoles. Spectrum of adverse reactions. 694 57

Total intravenous anaesthesia using propofol is indicated in the following cases: patients with a previous history of postoperative nausea or vomiting; surgery of the middle ear; gynaecological procedures involving laparotomy; ENT and squint surgery in children. Up to now, the relationship between the clinical benefit (less incidence of postoperative nausea and vomiting) and intrinsec anti-emetic properties of propofol is not included in the regulatory labelling.
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PMID:[Effects of Diprivan on nausea and vomiting]. 787 50


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