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)

Chest pain is a hallmark symptom in patients with unstable angina pectoris (UAP). However, little is known regarding the prevalence of an atypical presentation among these patients and its relation to subsequent care. We examined the medical records of 4,167 randomly sampled Medicare patients hospitalized with unstable angina at 22 Alabama hospitals between 1993 and 1999. We defined typical presentation as (1) chest pain located substernally in the left or right chest, or (2) chest pain characterized as squeezing, tightness, aching, crushing, arm discomfort, dullness, fullness, heaviness, pressure, or pain aggravated by exercise or relieved with rest or nitroglycerin. Atypical presentation was defined as confirmed UAP without typical presentation. Among patients with confirmed UAP, 51.7% had atypical presentations. The most frequent symptoms associated with atypical presentation were dyspnea (69.4%), nausea (37.7%), diaphoresis (25.2%), syncope (10.6%), or pain in the arms (11.5%), epigastrium (8.1%), shoulder (7.4%), or neck (5.9%). Independent predictors of atypical presentation for patients with UAP were older age (odds ratio 1.09, 95% confidence interval 1.01 to 1.17/decade), history of dementia (odds ratio 1.49, 95% confidence interval 1.10 to 2.03), and absence of prior myocardial infarction, hypercholesterolemia, or family history of heart disease. Patients with atypical presentation received aspirin, heparin, and beta-blocker therapy less aggressively, but there was no difference in mortality. Thus, over half of Medicare patients with confirmed UAP had "atypical" presentations. National educational initiatives may need to redefine the classic presentation of UAP to include atypical presentations to ensure appropriate quality of care.
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PMID:Atypical presentations among Medicare beneficiaries with unstable angina pectoris. 1250 91

Eight adults ingested foothill camas (Zigadenus paniculatus) bulbs in Juab County, Utah, believing them to be nontoxic wild bulbs. All who ingested the bulbs became ill, and three of them required admission for supportive care. All patients had nausea; other findings included vomiting, abdominal pain, dizziness, near syncope, hypotension, and bradycardia. No specific antidote is available for intoxication with Zigadenus species. Supportive care is indicated and atropine may benefit those with sympytomatic bradycardia and hypotension.
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PMID:Intoxication with foothill camas (Zigadenus paniculatus). 1264 69

Paroxysmal atrial fibrillation (PAF) significantly impairs patients' quality-of-life (QOL). The effect on QOL of recently developed ablation techniques with curative intention has not been studied. Thirty patients (21 men, age 54.1 +/- 9.5 years) with PAF (duration 5.6 +/- 5.2 years) who failed antiarrhythmic (3.8 +/- 1.2 trials) drug therapy underwent catheter ablation. The follow-up time was 33.9 +/- 11 months. QOL was assessed preablation, 3, 6, 9, 12, 24, and 36 months after catheter ablation. The Medical Outcomes Survey Short-Form (SF-36), scored on a 0-100 scale for each of eight domains: bodily pain, general health, mental health, physical functioning, role-emotional, role-physical, social functioning, and vitality, was used. Simultaneously, patients filled out a symptom-specific checklist (SSC) with seven clinical items scored 1-4 (1 best): dyspnea, nausea, palpitations, anxiety, syncope, presyncope, and NYHA classification. Patients with successful catheter ablation had a significant benefit in seven of eight subscales while patients with recurrence had an impact on QOL in two of eight subscales. Using SSC, a successful ablation influenced scores in all seven items while patients with recurrence had a significant change of clinical symptoms in only one item, anxiety. The subscales of the study group compared to a healthy population show higher scores after 24 months of follow-up. Patients with PAF experience a significant improvement in QOL after a successful catheter ablation. In contrast, in patients with recurrence of PAF the QOL showed improvement to a lesser extent and patients experienced ongoing symptoms.
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PMID:Quality-of-life in patients with paroxysmal atrial fibrillation after catheter ablation: results of long-term follow-up. 1269 67

Antiretroviral agents may participate in drug interactions that influence the efficacy and toxicity of other antiretrovirals, as well as pharmacologic treatments of coincident or complicating diseases. The viral protease inhibitor, ritonavir, may cause drug interactions by inhibiting the activity of cytochrome P450-3A (CYP3A) isoforms. In a single-dose, blinded, four-way crossover study, 10 healthy volunteer subjects received 50 mg of trazodone hydrochloride or matching placebo concurrent with low-dose ritonavir (four doses of 200 mg each) or with placebo. Compared to the control condition, ritonavir significantly reduced apparent oral clearance of trazodone (155 +/- 23 vs. 75 +/- 12 ml/min, p < 0.001), prolonged elimination half-life (6.7 +/- 0.7 vs. 14.9 +/- 3.9 h, p < 0.05), and increased peak plasma concentrations (842 +/- 64 vs. 1125 +/- 111 ng/ml, p < 0.05) (mean +/- SE). Coadministration of trazodone with ritonavir increased sedation, fatigue, and performance impairment compared to trazodone plus placebo; differences reached significance only for the digitsymbol substitution test. Three subjects experienced nausea, dizziness, or hypotension when trazodone was given with ritonavir; 1 of these subjects also experienced syncope. Thus short-term low-dose administration of ritonavir impairs oral clearance of trazodone and increases the occurrence of adverse reactions. The findings are consistent with impairment of CYP3A-mediated trazodone metabolism by ritonavir.
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PMID:Short-term exposure to low-dose ritonavir impairs clearance and enhances adverse effects of trazodone. 1272 62

One hundred and forty-two patients with second and third degree internal haemorrhoids were randomised to rubber band ligation only (n = 72) or rubber band ligation + local anaesthetic injection (n = 70). Pain was assessed by the patients at intervals of 6 hours and 1, 2, 3 and 4 days after banding. Other symptoms, complications, analgesic requirements and patient satisfaction were also recorded for 10 days following the treatment. There was a significant reduction in pain at 60 minutes and 6 hours after the procedure in the rubber band ligation plus local anaesthetic injection patients compared with the rubber band ligation only group (P < 0.05), but there was no reduction in pain when local anaesthetic was used compared with rubber band ligation only on days 1, 2, 3 and 4 days after ligation. On day 10 after banding, there was no difference between the two groups with respect to symptoms such as nausea, feeling of heaviness and/or tenesmus, fainting; complications, analgesic consumption or overall patient satisfaction. Bupivacaine injection after multiple rubber band ligation may be useful in reducing pain during the first 6 hours of the postbanding period.
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PMID:A prospective randomised study of local anaesthetic injection after multiple rubber band ligation of haemorrhoids. 1274 96

The purpose of this study was to compare the hemodynamic and sympathetic nerve activity (SNA) responses to graded lower body negative pressure (LBNP) in healthy subjects with either a positive (n = 24, SNA in 8) or a negative (n = 18, SNA in 6) LBNP response. A positive LBNP response was defined as an abrupt drop in systolic blood pressure associated with a decrease in heart rate and/or a decrease in SNA. All positive responses were accompanied by symptoms common to pre-syncope, defined as lightheadedness, diaphoresis, tunnel vision and/or nausea. If subjects tolerated 30 minutes of LBNP, this was considered a negative response. Comparisons were made between baseline, -10 mmHg (low-level LBNP) and -60 mmHg (high-level LBNP). Baseline SNA and arterial baroreflex sensitivity were not different between the 2 groups. However, subjects with pre-syncope had a significantly attenuated SNA response during low-level LBNP (p < 0.05) compared to subjects who did not experience pre-syncope. The hemodynamic data during high-level LBNP were similar until the occurrence of pre-syncope. Pre-syncope was preceded by a significant decrease in heart rate and SNA. Our findings suggest that subjects with LBNP induced pre-syncope might have an impairment in the cardiopulmonary baroreflex gain function in the setting of a preserved arterial baroreflex gain.
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PMID:Sympathoexcitation is attenuated during low level lower body negative pressure in subjects who develop pre-syncope. 1291 31

This article reviews the piperidine derivative, donepezil hydrochloride (E2020, Aricept), a reversible central acetylcholinesterase inhibitor currently approved for treatment of mild-to-moderate Alzheimer's disease. Donepezil is well absorbed orally, unaffected by food or by time of administration; it reaches therapeutic levels in doses of 5-10 mg/day and peak plasma concentrations are obtained 3-4 h after oral administration. A single bedtime dose is recommended due to the long elimination half-life of the drug (70 h). Donepezil does not cause liver toxicity or significant drug interactions and is relatively well-tolerated. Initial side effects include nausea, vomiting, diarrhoea, insomnia, muscle cramps, fatigue, anorexia and syncope. Caution is advised in patients with bradycardia. Long-term use of donepezil in AD has been found to delay nursing-home placement and to result in caregiver respite. Donepezil also slows deterioration of cognition and global function in patients with moderate-to-severe AD, with improvement of abnormal behaviours. In addition to AD, donepezil demonstrates significant improvement in cognition, global function and activities of daily living in comparison with placebo-treated patients with vascular dementia and has potential therapeutic benefit for other neurological conditions.
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PMID:Donepezil: a clinical review of current and emerging indications. 1468 Apr 45

The aim of this study was to clarify the association of clinical characteristics of unexplained syncope with the outcome of the head-up tilt test (HUT) in children. A total of 47 patients with unexplained syncope were classified into two groups according to their outcomes of HUT: the positive response group and the negative response group. We reviewed their clinical data as well as the results of HUT and analyzed them with logistic regression method. The results showed that the incidence of positive responses to HUT was higher in girls than in boys (8/22 vs 10/7, p < 0.05). Compared with fainted children younger than 12 years of age, 12- to 16-year-old adolescents with unexplained syncope had a high positive outcome of HUT (30 vs 72.9%, p < 0.05). Compared with fainted children with negative response of HUT, children with positive response to HUT often had syncope in special circumstances (e.g., prolonged standing, anxiety and fright, and morning exercise), and they often had prodrome, such as pallor, lightheadedness, and nausea (28/30 vs 8/17, p < 0.05). However, the number and duration of syncopal spells did not relate to the positive responses to HUT. The logistic regression analysis showed that three factors significantly influenced the outcome of HUT: predisposing factors of syncope, prodrome of syncope, and age (p < 0.05; OR = 32.9434, 17.7281, and 2.7842, respectively). Hence, if pubertal girls with unexplained syncope had clear predisposing factors and prodromes, they were likely to have positive responses to HUT, and they were likely to be clinically considered as having vasovagal syncope.
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PMID:Association of clinical characteristics of unexplained syncope with the outcome of head-up tilt tests in children. 1472

Ferric gluconate complex in sucrose (Ferrlecit) has been associated with less side-effects than iron dextran; however, the recommended dose of 62.5-125 mg per treatment is only suitable for haemodialysis (HD) patients. We retrospectively analysed the incidence of the side-effects associated with a high dose of Ferrlecit infusion (20 treatments in 13 patients; 10 treatments of 250 mg/3-4 h, and 10 treatments of 500 mg/5 h infusion). The patients were in the age range of 32-75 years old, seven with chronic renal failure (CRF), and six on dialysis treatment. One (10%) of the 10 treatments using a 250 mg dose was complicated with severe nausea/vomiting, diarrhoea and a burning sensation in the feet. Three (30%) of the 10 treatments using a 500 mg dose were complicated with: chills, severe nausea/vomiting, hypotension and syncope in one; severe nausea/vomiting, diarrhoea and hypotension in one; and an episode of vomiting in one patient. A single treatment with a 250 mg dose resulted in no significant change in haematological parameters. A single treatment with a 500 mg dose resulted in a significant increase in haemoglobin (Hgb) and haematocrit (Hct), but only a rising trend in serum iron,% transferrin saturation and ferritin pre versus 1-2 months postinfusion. In conclusion, Ferrlecit doses of 250 or 500 mg are complicated with significant untoward reactions in 10-30% of patients, in a dose-dependent fashion.
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PMID:Incidence of side-effects associated with high-dose ferric gluconate in patients with severe chronic renal failure. 1499 10

The purpose of this study was to examine whether the symptoms experienced by patients with unstable angina (UA) differed from the symptoms experienced by patients with myocardial infarction (MI). Data were obtained from two studies: one examining the symptoms of MI (n=238) and one examining the symptoms of UA (n=100). Interviews were conducted after hospital admission at three medical centers in the Midwest. There were no differences between patients with MI or UA in age, gender, or race. The patients experiencing MI reported significantly more nausea (46% vs. 32%), vomiting (19% vs. 2%), indigestion (42% vs. 16%), and fainting (9% vs. 2%). The patients experiencing UA reported significantly more chest discomfort (97% vs. 87%), lightheadedness (52% vs. 39%), numbness in the hands (43% vs. 28%), and neck discomfort (31% vs. 13%). Patients with MI rated the peak intensity of the chest discomfort higher than patients with UA (mean 8.4 vs. mean 7.7).
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PMID:Differences in the symptoms associated with unstable angina and myocardial infarction. 1501 50


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