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

Late cardiac tamponade is a rare but serious complication following open-heart surgery. It occurred in 9 (0.8%) of 1 094 consecutive patients 6 to 13 (median 8) days after operation. Six patients had undergone valve replacement and three coronary bypass surgery. All were on anticoagulant medication postoperatively (median TT index 7%). Early symptoms of cardiac tamponade were nausea and general malaise (present in all 9 cases), whereas classical signs of tamponade such as arterial hypotension and distended neck veins appeared late. The cardiac silhouette was radiographically enlarged in all cases, but this finding was seldom diagnostic. Computed tomography gave the surest diagnosis and permitted quantitative assessment of the fluid in the pericardium. Pericardial needle puncture was effective in temporarily relieving the tamponade, but insertion of a tube by the subxiphoid approach gave definitive drainage.
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PMID:Late cardiac tamponade following open-heart surgery. Diagnosis and treatment. 348 86

A previously healthy 27 year-old male plumber presented with six days of fever, nausea, vomiting, malaise and headache. The subsequent development of cough, dyspnoea and pleuritic pain coincided with the simultaneous development of progressive bilateral cavitary pneumonia with pleural effusion. Leucocytosis, thrombocytopenia, hyponatraemia, hypoalbuminaemia, hypophosphataemia and hypoxaemia were the main laboratory abnormalities. Clinical suspicion of Legionnaires' disease was confirmed by the presence of serum antibody to Legionella pneumophila (titre 1:512) by an indirect fluorescent antibody test. Treatment with erythromycin and rifampicin resulted in clinical recovery with minimal residual bilateral pleural effusion six months after presentation. This patient is the first to acquire Legionnaires' disease in Singapore.
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PMID:Legionnaires' disease--report of Singapore's first local case. 355 84

Subacute carbon monoxide poisoning is commonly misdiagnosed as an influenza-like viral illness. All patients presenting to the triage nurse at University Hospital with flu-like symptoms during February 1985 were asked to give blood samples for carboxyhemoglobin determination. Fifty-five patients (10% of those eligible) with headache, dizziness, nausea, vomiting, diarrhea, weakness, general malaise, or shortness of breath were enrolled in the study. Carboxyhemoglobin levels ranged from 0 to 21%. Thirteen patients (23.6%) of this self-selected subgroup had carboxyhemoglobin levels greater than or equal to 10%. There was no statistically significant difference in carboxyhemoglobin levels between smokers and nonsmokers. More patients using wood heat had elevated carboxyhemoglobin levels than patients using any other form of heating (P less than .05). No patient with a carboxyhemoglobin level greater than or equal to 10% was diagnosed as having subacute CO poisoning by emergency physicians. Physicians must seek out the possibility of CO toxicity in patients with flu-like illness, particularly in inner-city populations during the heating months. Fundoscopy and COHb levels may be useful in selected cases to correctly diagnose patients and avoid a return to a hazardous environment with potentially fatal consequences.
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PMID:Carboxyhemoglobin levels in patients with flu-like symptoms. 359 33

A study was carried out in 127 patients (94 males and 33 females) presenting with arteriosclerosis (88 patients) or diabetic vasculopathy (39 patients) in different stages of severity (Fontaine) to assess the effectiveness and tolerance of treatment with high doses of pentoxifylline. Patients received a daily dosage of 2200 mg, given as 800 mg orally and 300 mg by intravenous infusion in saline twice daily, for a mean period of 15.8 days. Relevant clinical parameters were assessed and measurements made of biological and laboratory indices before and after treatment. The results showed that intermittent claudication was improved in 52.4% of the arteriosclerotic and 50% of the diabetic patients Stage II disease, pain at rest disappeared in 64% and 78% of patients in Stage III, respectively, and trophic lesions in Stage IV patients were reduced or became less clearly marked in 47% and 44%, respectively. Arterial blood pressure, recorded on the tibial arteries using Doppler ultrasound, showed a mean increase of 18%, but no significant changes in blood flow were evident from rheographic examination. Whole blood erythrocyte filtration time was reduced by a mean of 8%. The main changes in the biological indices after treatment were decreases in haematocrit, mean corpuscular volume and blood fibrinogen values, but these were not statistically significant. The other variables showed little if any change. Side-effects initially reported by the patients consisted of headache, nausea, sweating, pruritus and general malaise, and were mainly associated with the infusion time and regressed in most cases when this was extended.
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PMID:Results of clinical, laboratory and haemorheological investigations of the use of pentoxifylline in high doses. 360 22

We have reported a case of diarrhea caused by Blastocystis hominis, an intestinal protozoan parasite of man. The organism is present in small numbers in up to one fifth of stool samples in hospitalized patients, but is associated with diarrhea in only heavily infested patients. Typical symptoms include diarrhea, crampy abdominal pain, nausea, vomiting, low-grade fever, gas, malaise, and chills. Fecal leukocytes are occasionally seen. The pathophysiologic mechanism of the diarrhea is not clear. Not all patients having large parasite burdens are symptomatic. Metronidazole, 1 to 2 gm/day orally in divided doses, is the treatment of choice.
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PMID:Diarrhea due to Blastocystis hominis: an old organism revisited. 360 19

A 31-year-old male patient with lepromatous leprosy developed fever, malaise, nausea, anorexia, lymphadenopathy, hepatitis, exfoliative dermatitis and ainhum like lesions while on multidrug therapy comprised of dapsone, clofazimine and rifampicin. The provocation tests confirmed the dapsone to be cause of this event.
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PMID:Dapsone syndrome--a case report. 361 56

To determine whether exogenous cholecystokinin (CCK) and endogenous CCK evoke different gastrointestinal motor responses, we investigated the motility induced by CCK by use of standard manometric methods. Injection (ip) of 500 ng/kg CCK caused immediate profound gastric inhibition and duodenal phasic excitation that did not resemble the postprandial pattern. Similar profound gastric inhibition has been associated with nausea. The contribution of endogenous CCK to the fed pattern of motility was investigated using proglumide; intraperitoneal injection of the antagonist before feeding caused no change, but injection before a second meal induced a decrease (P less than 0.025, n = 6) in gastric pressure with no accompanying duodenal change. This suggests that CCK causes an increase in gastric pressure that could result from a delay in gastric emptying. In support of this hypothesis, we have previously demonstrated, by use of proglumide, that endogenous CCK delays gastric emptying. Therefore exogenous CCK may reduce food intake by evoking an abnormal gastrointestinal motor pattern that may induce malaise, whereas endogenous CCK may decrease food intake by delaying gastric emptying, thus prolonging gastric satiety signals.
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PMID:Endogenous and exogenous cholecystokinin may reduce food intake by different mechanisms. 361 36

Suramin sodium is a reverse transcriptase inhibitor with in vitro activity against the human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS). Ninety-eight patients with AIDS manifest as opportunistic infections (n = 38), AIDS with Kaposi's sarcoma (n = 38), AIDS-related complex (n = 20), or AIDS-associated non-Hodgkin's lymphoma (NHL) (n = 2) were treated with suramin sodium at 0.5, 1.0, or 1.5 g/wk for six weeks followed by maintenance therapy with 0.5 or 1.0 g/wk. Of 72 patients who were HIV culture positive before therapy and were assessable for subsequent HIV culture 40% became culture negative during treatment, with no apparent correlation between virus recovery and serum suramin concentration. No immunologic improvement was noted. One complete clinical remission was noted in a patient with Kaposi's sarcoma and stage IV NHL. Seven minor clinical responses were also noted. Toxic reactions were generally reversible, and included fever (78%), rash (48%), malaise (43%), nausea (34%), neurologic symptoms (33%), and vomiting (20%). Suramin-induced neutropenia was noted in 26%, thrombocytopenia in 12%, a serum creatinine level of 180 mumol/L or higher (greater than or equal to 2.1 mg/dL) in 12%, liver dysfunction in 14%, and clinical and/or laboratory evidence of adrenal insufficiency in 23%. Sixteen patients died while receiving suramin or within three weeks of discontinuation of drug therapy due to infection (n = 6), hepatic failure (n = 3), pulmonary Kaposi's sarcoma (n = 2), AIDS encephalitis (n = 2), AIDS-associated NHL (n = 1), iatrogenic hemo-pneumothorax (n = 1), or pulmonary disease of uncertain etiology. Suramin as currently administered cannot be recommended as effective therapy for AIDS.
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PMID:Suramin therapy in AIDS and related disorders. Report of the US Suramin Working Group. 365 Mar 39

A 29-year-old nullipara was admitted at 31 weeks' gestation because of toxemia. She noted gradually polyuria, severe thirst, malaise, nausea and anorexia. A water-deprivation test and administration of aqueous vasopressin confirmed the diagnosis of nephrogenic diabetes insipidus. At 33 weeks' gestation, blood chemistry studies revealed moderately elevated transaminase levels and hyperuricemia. Male twins were delivered by vacuum extraction at 35 weeks' gestation. After delivery, she became drousy and icterus appeared. Acute hepatic failure with marked hyperuricemia was diagnosed. She was treated with glucose solution with glucagon and soluble insulin, branched chain amino acids, gabexate mesilate, lactulose and famotidine. Her consciousness cleared rapidly and all laboratory data became normal by 15 days postpartum. The urine volume was about 5 liters per day from the first to sixth postpartum day. The diuresis decreased after the eighth postpartum day. Rare pregnancy complicated by transient nephrogenic diabetes insipidus and acute hepatic failure is discussed.
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PMID:Transient nephrogenic diabetes insipidus associated with acute hepatic failure in pregnancy. 365 42

The combination chemotherapy including cis-diamminedichloroplatinum (CDDP), adriamycin (ADM) and 5-fluorouracil (5-FU) is reported as one of the most effective regimens of urothelial cancer. We experienced one patient who had multiple metastatic urothelial cancer in the lung, liver and brain and who showed complete response, even in short duration, by this regimen. Since then, we have been using this regimen as the adjuvant chemotherapy of the invasive urothelial cancer. This regimen consists of 15 mg/m2 CDDP on days 1 to 5, 30 mg/m2 ADM on day 1 and 300 mg/m2 5-FU on days 1 to 5, and is repeated 3 times for 3 to 4 weeks. If toxicity is intolerable, the dosage of CDDP and ADM was decreased in thirty percent. As the maintenance, tegaful was administrated oral or suppository for 1 to 2 years. Seven cases which were followed for at least 12 months were evaluated. In one patient, local recurrence appeared after 16 months, but the other patients were disease free. General malaise, nausea, vomiting and alopecia were recognized in all patients in various degrees, but severe myelosuppression did not appear. Because of the toxicity, three patients had to have reduced dosage. In the adjuvant chemotherapy the most effective regimen should be used in the first therapy to eradicate the micrometastasis. At present, the combination chemotherapy of CDDP and ADM is the most effective for urothelial cancer as reported by many authors. Although the number of patients and the duration of follow up are inadequate to evaluate this adjuvant chemotherapy, we believe that this regimen is effective since invasive urothelial cancer usually recurs within 2 years.
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PMID:[Therapeutic experiences of cis-diamminedichloroplatinum, adriamycin and 5-fluorouracil combination chemotherapy in advanced urothelial cancer, with special reference to adjuvant chemotherapy in invasive urothelial cancer]. 376 38


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