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Query: UMLS:C0027497 (nausea)
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To elucidate the early clinical characteristics of hantavirus pulmonary syndrome (HPS), we compared the clinical features of 24 cases of HPS with those of cases of bacteremic pneumococcal pneumonia (n = 30), influenza (n = 33), or unexplained adult respiratory distress syndrome (ARDS, n = 21). On admission, patients with HPS were less likely than outpatients with influenza to have reported sore throat (OR = 0.02, P < .01) and cough (OR = 0.1, P = .01) and were less likely than patients with pneumococcal pneumonia to have lobar infiltrates detected by chest roentgenography (OR = 0, P < .01). Multivariate discriminant analysis revealed that three clinical characteristics at admission (dizziness, nausea or vomiting, and absence of cough) and three initial laboratory abnormalities (low platelet count, low serum bicarbonate level, and elevated hematocrit level) served to identify all patients with HPS and to exclude HPS in at least 80% of patients with unexplained ARDS. These findings warrant further study and should facilitate the early recognition of patients with HPS, who may benefit from early critical-care intervention.
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PMID:Clinical features that differentiate hantavirus pulmonary syndrome from three other acute respiratory illnesses. 852 58

Two hundred and thirty-one patients were questioned the day following their cataract surgery to ascertain the incidence of postoperative morbidity. One hundred and nineteen patients received local anaesthesia (LA) and 112 received general anaesthesia (GA). There was a significant difference in the incidence of nausea (21% in GA group, 3% in LA group, p < 0.01), sore throat (41% GA group, 3% LA group, p < 0.01), and bruising of the eye (15% GA group, 39% LA group, p < 0.01). There was no significant difference in the incidence of vomiting, headache, double vision, the severity of postoperative pain, or the need for analgesia. The time before the patients drank and ate postoperatively was significantly shorter in the local anaesthetic group (1.3 h and 1.8 h LA group, 4.1 h and 6.7 h GA group respectively, p < 0.01).
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PMID:Postoperative morbidity following cataract surgery. A comparison of local and general anaesthesia. 903 83

A survey was performed to estimate the incidence of the minor sequelae of anaesthesia in children. During an eight-month period 266 children, aged five years and over, were personally interviewed by an anaesthetist following recovery from anaesthesia. At interview the child was questioned to ascertain any morbidity suffered and record was made of the operation performed and the anaesthetic administered. Data were then evaluated, using multivariate analysis, to identify risk factors for the more common sequelae. This study revealed a higher incidence of the minor sequelae of anaesthesia in children than had previously been reported. The three most common sequelae recorded were nausea (48.1%), vomiting (35.0%), and sore throat (31.4%).
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PMID:The incidence of minor sequelae following anaesthesia in children. 882 45

The federal country of Carinthia is known for its lakes and ponds, which are extensively used for bathing. The water quality is monitored regularly in accordance to the EC-Directive 76/160/EC and especially to the more rigorous Austrian Standard M6230. Since redevelopment measures of the lakes have been nearly finished the water quality found has improved essentially. In spite of these monitored data no effective correlation to data from the concerning ambulant sector of medical care could be established. The Carinthian Sentinel Practice Network started in summer 1994 to retrieve informations about occurrence and frequency of bathing related illness of children up to 16 years old. The 26 participating primary health care and pediatric physicians, having their own independent practices spread all over the country, reported the specific doctor-patient-contracts to the coordinating base. Criteria for inclusion in the medical report were headache, sore throat, otalgia, stomach-ache, nausea, emesis, diarrhoea, fever, rhinitis, cough, cold, moreover conjunctivitis, skin rash and specific dermatitis. In addition physicians reported where, how long and how often the children had been bathing and how long they had been free of symptoms afterwards. Each case was reported to the coordinating base including a presumed diagnosis. Statistic evaluation showed that bathing related illness may be divided into three main groups according to symptom frequency. The frequency of otalgia (32.4%) was significantly higher than any other symptom asked for. Two groups of symptoms correlate with each other: on one hand rhinitis, conjunctivitis, cough and sore throat (36.5%) and on the other hand nausea, emesis, diarrhoea and fever (41.9%). These data underline conclusions drawn by other authors but are not representative enough to correlate to data from water monitoring. First results suggest that conclusions for public health authorities can be drawn from this additional information about the state of the lakes and ponds-providing a sufficient number of data is reported.
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PMID:[Bathing water related diseases: the Carinthian Sentinel Project as the source of epidemiological data]. 937 46

The herbicide pendimethalin (STOMP) shares a similar chemical structure with nitro compounds such as dinitrobenzene, which was previously demonstrated to cause methemoglobinemia in mammals. However, reports on STOMP poisoning in humans are rare. We reviewed 71 STOMP poisoning cases (42 men and 29 women of mean age 43.9 +/- 2.5 y) reported to the Poison Control Center--Taiwan from September 1986 to September 1997 and summarized their clinical manifestations. Two incidences resulted from skin and eye contact. The rest were due to oral ingestion intentionally or accidentally. The average ingestion was 106.1 +/- 13.4 ml. Among them, 20 cases had no symptoms or signs, 38 had mild effects such as nausea, vomiting and sore throat, 7 had effects such as severe retching, hematemesis and seizures. Four patients expired due to also taking other herbicides (mainly organophosphates) and because of inadequate airway management. Adequate ventilation support was the major therapy in salvaging the poisoning cases.
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PMID:Clinical experience with pendimethalin (STOMP) poisoning in Taiwan. 961 Apr 93

Acute autonomic and sensory neuropathy (AASN) is a rare neuropathy characterized by acute autonomic dysfunction and objective sensory disturbances. A 26-year-old pregnant woman with severe autonomic and sensory dysfunction is reported. This patient suddenly developed marked nausea and vomitting in about 2 days after having a sore throat. She then developed signs of autonomic dysfunction including dilated non-reactive pupils, dryness of the eyes and oral mucous membranes, generalized anhidrosis, paralytic ileus, orthostatic hypotension, and continuous tachycardia. She also had severe generalized sensory impairments of all modalities, and all deep tendon reflexes were absent. Sensation was almost totally lost for all modalities below the neck. There was marked pseudoathetosis and sensory ataxia in all extremities. Motor examination was normal. She had inability to urinate. At this time she was 38 weeks pregnant, and when she showed signs of fetal distress, a Caesarean section was performed. Albumino-cytological dissociation was seen in the CSF. Serum noradrenaline was reduced, no sensory nerve action potentials could be elicited, and reduced coefficient of variation of the R-R interval on electrocardiography was observed. Plasma exchange was performed every other day for 3 days for about 3 weeks after the onset of the illness, but no favorable effects. Seven months after the onset, her autonomic dysfunction slightly improved, but there was no recovery from the sensory disturbances. Many symptoms and signs that characterize AASN occurred in this patient, and each was severe. The patient developed SIADH, sleep apnea, personality change, and amenorrhea in the course of the disease. We suggest that AASN patients might have both peripheral and central nervous system manifestations including seizures and personality changes.
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PMID:[A severe case of acute autonomic and sensory neuropathy]. 986 13

There are three clinical presentations of anthrax in humans: cutaneous (>95% of cases), orogastric and inhalational. The infectious form, the spore, enters the body and is thought to germinate within macrophages either at the site of inoculation (cutaneous or orogastric) or in the regional lymph node (inhalational). The bacillus then synthesizes its antiphagocytic capsule and the lethal and oedema toxins which interfere with the non-specific host defences leading to the characteristic locally destructive lesion and spread by lymphatics to the systemic circulation and other organs. The cutaneous form begins as a papule which progresses over several days to a vesicle and then ulcerates. There is often oedema, sometimes massive, probably due to the oedema toxin that surrounds the lesions which then develop a characteristic black eschar. The patient may be febrile with mild to severe systemic symptoms of malaise, headache and toxicity. Oropharyngeal anthrax presents with severe sore throat or an ulcer in the oropharyngeal cavity associated with neck swelling, fever, toxicity and dysphagia. Gastrointestinal anthrax begins with anorexia, nausea, vomiting and abdominal pain which may be similar to an acute abdomen. There may be diarrhoea and ascites, both of which may be haemorrhagic. Inhalational anthrax begins with non-specific symptoms of malaise, fever, myalgia and non-productive cough. After a period of 2-3 days, this is followed by a sudden onset of severe respiratory distress associated with diaphoresis, cyanosis and increased chest pain. There may be a widened mediastinum and pleural effusions on chest X-ray. Death follows in 24-36 h from respiratory failure, sepsis and shock. The diagnosis of anthrax is easy if it is considered. The organism is readily observed by Gram or Wright stain in local lesions or blood smear and can be easily cultured from the blood and other body fluids. However, because of its rarity, it is not often included in the differential diagnosis and in inhalational disease the diagnosis is rarely made until the patient is moribund. More rapid diagnostic tests are under development. Penicillin, combined with supportive care, remains the mainstay of treatment, although the organism is susceptible in vitro to many antibiotics. In recent years, there have been significant advances in our knowledge of the organism and its toxins and it is anticipated that similar progress will be made in the future in developing more rapid diagnostic tests and new modalities of treatment.
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PMID:Clinical aspects, diagnosis and treatment of anthrax 1047 74

A 47-year-old man who smelled of alcohol presented with a three-day history of sore throat. He had not had fever, nausea, vomiting, diarrhea, rhinorrhea, cough, chest pain, or palpitations. On evaluation in the emergency department, he was found to have tachycardia and an irregular pulse.
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PMID:An alcoholic man with an abnormal pulse. 1061 94

The authors studied 5,034 consecutive patients undergoing elective surgery. Preoperative, intraoperative, and postoperative variables were gathered and patient satisfaction was assessed using direct interviews at pre- and post-anesthesia clinic. Fifty-nine percent of the 4,717 responders showed satisfaction and 4% showed dissatisfaction with anesthesia. The most undesirable perioperative outcome was vomiting/nausea. Other undesirable outcomes include discomfort of urine catheter, sore throat, memory of extubation, postoperative pain and so on. Anesthesiologist can improve the quality of anesthesia by preoperative explanation and preventative management for undesirable perioperative outcomes.
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PMID:[Assessment of anesthesia satisfaction using direct interviews at post-anesthesia clinic]. 1129 32

An outbreak of illness with flulike symptoms among state workers responding to a Pfiesteria bloom that resulted in fish death and distress on the Chicamacomico River on Maryland's Eastern Shore was investigated. Using case-control methodology, seven workers present at the Chicamacomico were compared to seven occupationally matched controls not present. Participants completed questionnaires assessing their exposures to water and their symptom histories and were assessed with a standard neuropsychological test battery. Three months later, the same questionnaires and neuropsychological tests were repeated. Three of the seven exposed workers cited minimal direct contact with water and four cited none. During the event, four developed burning eyes or nares and six developed a headache or sore throat. Six developed crampy abdominal pain, nausea, or diarrhea within 4 h of their exposure. In contrast, the only aforementioned symptom reported by controls was headache in two individuals. Acute and follow-up neuropsychological tests showed no consistent pattern of deficiency among the exposed. In conclusion, a flulike clinical illness was observed following exposure to a Pfiesteria-related fish kill, possibly as a result of inhalation of toxic aerosols.
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PMID:Gastrointestinal and respiratory tract symptoms following brief environmental exposure to aerosols during a pfiesteria-related fish kill. 1154 15


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