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

Two case reports on carcinoma of the stomach associated with pregnancy are presented. In both cases, the main symptoms were persisting hyperemesis, nausea and weight loss. Both mothers succumbed within a year after their pregnancy, but the infants born by Cesarean section are doing well. The diagnostic and therapeutic difficulties which are encountered when a carcinoma complicates a pregnancy are discussed.
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PMID:Carcinoma of the stomach associated with the pregnancy: two case reports. 224 98

A 35-year-old, previously healthy woman, known to be thyrotoxic, was transferred from a community hospital for "acute abdomen." Abdominal pain, distention, and hyperemesis resolved with placement of nasogastric tube (NGT) and return of 2,600 mL of bilious fluid. Continued high NGT output made oral or NGT administration of antithyroid drugs impossible. We gave propylthiouracil (PTU) by retention enemas with therapeutic serum levels and sublingual saturated solution of potassium iodide (SSKI) with 70% absorption based on 24-hour free iodine urinary excretion. The patient's thyroxine (T4) and triiodothyronine (T3) radioimmunoassays were normal on hospital days 10 and 12, respectively. However, free T4 and T3 resin uptake did not normalize until hospital day 31. On hospital day 32, she tolerated removal of NGT without nausea and 4 days later was taking a regular diet. We conclude that our patient's gastrointestinal symptoms were a prominent feature of her thyrotoxicosis and that rectal PTU and sublingual SSKI are effective in administration of antithyroid drugs.
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PMID:Duodenal obstruction in thyroid storm. 938 60

Nausea and vomiting are both common in early pregnancy. Most cases are mild and do not require treatment. However, persistent vomiting and severe nausea can progress to hyperemesis if the woman is unable to maintain adequate hydration, and fluid and electrolyte as well as nutritional status are jeopardised. Hyperemesis gravidarum is a diagnosis of exclusion, characterised by prolonged and severe nausea and vomiting, dehydration, ketosis and bodyweight loss. Investigation may show hyponatraemia, hypokalaemia, a low serum urea level, metabolic hypochloraemic alkalosis and ketonuria. The haematocrit is raised and the specific gravity of the urine is increased. There may be associated liver function test abnormalities and abnormal thyroid function tests, with biochemical thyrotoxicosis with raised free thyroxine levels and/or suppressed thyroid-stimulating hormone levels. The pathophysiology of hyperemesis is poorly understood. Various hormonal, mechanical and psychological factors have been implicated. Studies have demonstrated a direct relationship between the severity of hyperemesis, the degree of biochemical hyperthyroidism and the levels of human chorionic gonadotrophin (hCG). Management of hyperemesis should include hospitalisation, intravenous fluid and electrolyte replacement, thiamine (vitamin B1) supplementation, use of conventional antiemetics and psychological support. Most patients improve spontaneously with the help of the above measures without long term sequelae. Conventionally, antiemetics are not usually prescribed, especially before 12 weeks gestation, except for women with hyperemesis. This reluctance relates to fears which are often unfounded concerning the teratogenic effects of antiemetics. Severe hyperemesis, refractory to conventional management with intravenous fluids and antiemetics is a rare, miserable and disabling condition, associated with multiple hospital admissions, time away from work and the family, and psychological morbidity. If inadequately or inappropriately treated, it may cause Wernicke's encephalopathy, central pontine myelinolysis and death. In extreme cases, women may request, or their obstetricians recommend, termination of the pregnancy. There are uncontrolled data supporting a beneficial effect of corticosteroids in these women, and a randomised placebo-controlled trial is currently in progress.
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PMID:Treatment of nausea and vomiting in pregnancy. When should it be treated and what can be safely taken? 970 51

The basic concepts of homeopathy are presented, including the vital force, the Law of Similars, the Law of Proving, and the Law of Potentization. The method by which the practitioner applies these laws in a clinical setting in order to choose a homeopathic remedy is described. Careful history taking and observation of the client to ascertain the etiology and location of a complaint, associated sensations, factors that aggravate or ameliorate symptoms, the emotional and mental state, general observations, and strange, rare, and peculiar symptoms are stressed. Specific remedy recommendations for the treatment of leg cramps and other pregnancy-induced discomforts, such as anemia, herpes, nausea and hyperemesis, ptyalism, and pica are included. The use of remedies to turn breech and other malpositioned babies prior to term is presented, as well as discussions on the induction of labor and homeopathic intervention for premature labors. A description of how remedies are administered, handled, and stored is included. Finally, qualifications to practice homeopathy and legal issues for midwives are discussed.
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PMID:Homeopathic remedies in prenatal care. 1038 Apr 47

Of 504 biliopancreatic diversions, 37 patients (7%) had to be reversed. There were many underlying causes for the nutritional compromise that preceded each reversal, but nearly two-thirds were due to either the nausea/ hyperemesis syndrome or to protein malnutrition and anemia. Poor patient compliance with respect to supplements was a major contributory factor. The procedure can be reversed by either a proximal enteroenterostomy or restoration of anatomical continuity. The simpler enteroenterostomy, the method of choice, was done in 70% of the cases. There are specific indications for the more complex anatomical restoration. Reversals have proved to be successful in correcting the nutritional defects.
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PMID:An Analysis of 37 Reversals on 504 Biliopancreatic Surgeries over 12 Years. 1075 15

Hyperemesis gravidarum, severe vomiting, develops in about 1-2% of all pregnancies. Acupuncture on the point PC6 above the wrist on the palmar side has been found to prevent some types of nausea and vomiting. The purpose of the present study was to see if acupuncture, in addition to standard treatment, could hasten the improvement of hyperemesis gravidarum. Thirty-three women with hyperemesis were evaluated in a randomized, single-blind, crossover comparison of two methods of acupuncture, active (deep) PC6 acupuncture or placebo (superficial) acupuncture. The women estimated their degree of nausea on a visual analogue scale (VAS). The daily number of emesis episodes were documented. Crossover analyses showed that there was a significantly faster reduction of nausea VAS and more women who stopped vomiting after active acupuncture than after placebo acupuncture. This study suggests that active PC6 acupuncture, in combination with standard treatment, could make women with hyperemesis gravidarum better faster than placebo acupuncture.
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PMID:Manual acupuncture reduces hyperemesis gravidarum: a placebo-controlled, randomized, single-blind, crossover study. 1102 9

Both parity and a young age at first pregnancy are associated with a reduction in breast cancer risk. The hormones involved in this process are not fully investigated. Human chorionic gonadotropin is a placental hormone, which in rats and in human breast cells in vitro has been shown to prevent against breast cancer. Hyperemesis, a severe nausea combined with vomiting during pregnancy, is associated with increased levels of human chorionic gonadotropin. We investigated the possible relationship between hyperemesis and subsequent breast cancer risk in a case-control study based on registry data. Among 13 079 breast cancer cases and 34 348 individually matched controls we found 148 cases and 405 controls who had been hospitalised for hyperemesis. Hyperemesis was not associated with breast cancer risk (adjusted odds ratio 1.05, 95% confidence interval 0.86-1.27), and similar risks were observed regardless of age at diagnosis, number of hospitalisations for hyperemesis or time of follow-up. Our results do not support the hypothesis that human chorionic gonadotropin is responsible for the protective effect of pregnancies upon breast cancer risk.
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PMID:Hyperemesis gravidarum and subsequent breast cancer risk. 1243 87

Chemotherapy and radiation therapy for cancer often have severe side effects that limit their efficacy. Glucocorticoids (GCs) are frequently used as cotreatment because they may have potent proapoptotic properties and reduce nausea, hyperemesis, and acute toxicity on normal tissue. In contrast to the proapoptotic effect of GCs in lymphoid cells, resistance toward cancer therapy-mediated apoptosis was induced in solid tumors of human cervix and lung carcinomas. Filter hybridization, expression data, as well as functional assays identified multiple core apoptosis molecules, which are regulated by GCs in a pro- or antiapoptotic manner. Both antiapoptotic genes such as FLIP and members of the Bcl-2 and IAP family as well as proapoptotic elements of the death receptor and mitochondrial apoptosis pathways were down-regulated in carcinomas resulting in a decreased activity of caspase-8, caspase-9, and caspase-3. In contrast, death receptor and mitochondrial apoptosis signaling as well as caspase activity was enhanced by dexamethasone in lymphoid cells. To restore apoptosis sensitivity in dexamethasone-treated carcinomas, caspase-8 and caspase-9 were transfected. This resensitized tumor cells in vitro and xenografts in vivo to cisplatin induced cell death. These data therefore raise concern about the widespread combined use of GCs with antineoplastic drugs or agents in the clinical management of cancer patients.
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PMID:Glucocorticoid cotreatment induces apoptosis resistance toward cancer therapy in carcinomas. 1281 Jun 37

Examination of a 36-year-old man revealed no physical or psychological disorders that could explain his chronic, intermittent severe vomiting that did not respond to a wide range of antiemetics. After a recent publication on cannabinoid hyperemesis, the patient was questioned further, and it was found that he was a chronic cannabis smoker since the age of 14 years. This is the first Dutch patient with cannabinoid hyperemesis. The syndrome is characterised by a prodromal phase, during which the patient suffers from nausea several days a week, particularly in the morning. Thereafter, the severity of symptoms increases and the patient can present with recurring episodes of treatment-resistant nausea, continuous vomiting, and colicky abdominal pain. Due to the severity of the vomiting, patients are frequently hospitalised for the treatment of dehydration. A typical sign ofcannabinoid hyperemesis is compulsive bathing in warm water, which is the only way to suppress the symptoms. The mechanism underlying the syndrome has not been clarified, but it is clear that chronic cannabis use is a key factor: discontinuation causes the symptoms to disappear immediately, whereas recommencing the use of cannabis can lead to the recurrence of cyclic vomiting and nausea within a few weeks or months.
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PMID:[Cannabinoid hyperemesis with the unusual symptom of compulsive bathing]. 1626 21

A 34-year-old woman presented at 19 weeks in her third pregnancy with abdominal pain and hyperemesis. This was her third admission during the pregnancy for similar complaints. A few days after admission an exacerbation in her pain was noted, in particular on eating or lying down, and a firm and mobile epigastric mass could be palpated separate from her uterus. The differential diagnosis was a hernia or a degenerating pedunculated fibroid. Sonography revealed a mass separate from the uterus with an appearance consistent with intussusception. Magnetic resonance imaging confirmed the diagnosis. A limited right hemicolectomy was performed. The final diagnosis was adenocarcinoma of the colon. It is difficult to diagnose intussusception during pregnancy. The presenting symptoms of nausea, vomiting, abdominal pain and constipation are common in pregnancy and the displacement of the bowel by the gravid uterus hampers examination. Intussusception is very rare in adults and generally it is associated with tumors. Preoperative diagnosis is difficult but possible with accurate imaging.
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PMID:Intussusception: a rare cause of abdominal pain in pregnancy. 1695 24


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