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)

At present, no universally-accepted effective treatment for cutaneous gnathostomiasis is available. At the Hospital for Tropical Diseases, Mahidol University, albendazole 400 mg twice a day for 14 days is commonly prescribed for patients diagnosed with cutaneous gnathostomiasis. The efficacy of albendazole to induce outward migration of the parasite was less than or around 20% in 2 studies. Research for alternative, more efficacious treatment, is needed. In this prospective open-labeled study, we assessed the safety of ivermectin in 20 Thai patients diagnosed with cutaneous gnathostomiasis. Ivermectin, one time only, at dosages of 50, 100, 150, or 200 microg/kg bodyweight, was given orally to 4 groups of patients, 5 patients each group. Adverse events were recorded and laboratory tests were obtained before and after treatment. No serious adverse events occurred in this study. Forty adverse events were possibly related to ivermectin. The adverse events were malaise (35%), myalgia (30%), drowsiness (30%), pruritus (20%), nausea/vomiting (20%), dizziness (15%), diarrhea (15%), feeling of shortness of breath (10%), feeling of palpitations (10%), constipation (5%), anorexia (5%), and headache (5%). These adverse events were self-limited and not dose-related. Laboratory abnormalities were found in 3 patients (15%). Transient microscopic hematuria, pyuria, and mildly elevated liver enzymes were found in 1 patient each. Ivermectin single dose, of 50,100, 150, and 200 microg/kg bodyweight, is considered safe in Thai patients. Future trials of ivermectin on human gnathostomiasis may be performed using dosages up to 200 microg/kg bodyweight.
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PMID:Tolerability of ivermectin in gnathostomiasis. 1612 31

Noncardiogenic pulmonary edema is a rare but potentially life-threatening complication of hydrochlorothiazide therapy. We describe three patients who developed this serious adverse reaction. A 64-year-old woman developed dypsnea and hypotension within 60 minutes of taking a single dose of hydrochlorothiazide 25 mg. She was admitted to the critical care unit with acute respiratory failure and subsequent multiple-organ dysfunction. The second patient was a 56-year-old woman who experienced sudden onset of shortness of breath that developed 10 minutes after taking a single dose of hydrochlorothiazide 25 mg. The third was a 59-year-old woman who developed sudden onset of shortness of breath, nausea, vomiting, and diarrhea after her first dose of hydrochlorothiazide-triamterene. All three women had a history of a similar, albeit minor, reaction to a thiazide diuretic. Review of the literature identified 36 additional cases of noncardiogenic pulmonary edema after thiazide use. The patients developed symptoms 10-150 minutes after ingestion of hydrochlorothiazide or another thiazide. Symptoms can occur on first exposure to the drug or in patients taking the drug intermittently. Of interest, 90% of documented cases occurred in women. With the increasing use of thiazide diuretics in the treatment of hypertension, clinicians need to be aware of the possible association of these drugs with the development of noncardiogenic pulmonary edema.
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PMID:Hydrochlorothiazide-induced noncardiogenic pulmonary edema: an underrecognized yet serious adverse drug reaction. 1616 99

The results of a multicenter phase II study investigating carboplatin and pegylated liposomal doxorubicin (PLD) in patients with recurrent/metastatic uterine and cervical malignancies (UCM) are presented here. Fifty-three subjects with measurable, untreated, advanced UCM were enrolled. Fifty-one were evaluable for response. Prior combined-modality treatment was permitted if a component of primary therapy. Patients received carboplatin AUC = 5 with PLD 35 mg/m(2) intravenously once every 4 weeks. Overall response rate was 33% (35% stable disease). Overall survival (OS) at six months was 86% (95% CI 76%-96%). Six-month progression-free survival (PFS) was 43% (95% CI 30%-57%). Median PFS was 22.9 weeks (range 16.0-35.3) and median OS was 49.1 weeks (range 41.4-75.1). The most frequent grade 3-4 nonhematological adverse events were: abdominal pain (n = 7), fatigue (4), vomiting (4), nausea (3), and shortness of breath (3). There was 1 report of grade 3 hand-foot syndrome and none of grade 4. Twelve patients had first infusion reactions with only 1 discontinuing treatment. Grade 3-4 neutropenia occurred in 26/230 cycles (11.3%). There were no treatment-related deaths. The combination of carboplatin and PLD is well tolerated with sufficient activity to justify additional evaluation in clinical trials and might be suited to the addition of a taxane.
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PMID:Phase II multicenter open-label study of carboplatin and pegylated liposomal doxorubicin in uterine and cervical malignancies. 1617 27

Subtyping panic disorder by predominant symptom constellations, such as cognitive or respiratory, has been done for some time, but criteria have varied considerably between studies. We sought to identify statistically symptom dimensions from intensity ratings of 13 DSM-IV panic symptoms in 343 panic patients interviewed with the Anxiety Disorders Interview Schedule for DSM-IV Lifetime Version. We then explored the relation of symptom dimensions to selected illness characteristics. Ratings were submitted to exploratory maximum likelihood factor analysis with a Promax rotation. A three-factor solution was found to account best for the variance. Symptoms loading highest on the first factor were palpitations, shortness of breath, choking, chest pain, and numbness, which define a cardio-respiratory type (with fear of dying). Symptoms loading highest on the second factor were sweating, trembling, nausea, chills/hot flashes, and dizziness, which defines a mixed somatic subtype. Symptoms loading highest on the third factor were feeling of unreality, fear of going crazy, and fear of losing control, which defines a cognitive subtype. Subscales based on these factors showed moderate intercorrelations. In a series of hierarchical multiple regression analyses, the cardio-respiratory subscale was a strong predictor of panic severity, frequency of panic attacks, and agoraphobic avoidance, while the cognitive subscale mostly predicted worry due to panic. In addition, patients with comorbid asthma had higher scores on the cardio-respiratory subscale. We conclude that partly independent panic symptom dimensions can be identified that have different implications for severity and control of panic disorder.
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PMID:Panic attack symptom dimensions and their relationship to illness characteristics in panic disorder. 1629 63

Patients with an untreated myocardial infarction may present with serious late complications. 3 patients are described. A 63-year-old woman became progressively more short of breath 4 days after an acute episode of chest pain accompanied by nausea and sweating. It proved to be a cardiogenic shock following a rupture of a papillary muscle. A man aged 65 collapsed 5 days after an episode of back pain and nausea. This was a cardiac tamponade due to rupture of the left ventricle. A woman aged 74 had transient aphasia and during investigations for this was seen to have anomalies on ECG. She had cerebral emboli and a cardiac aneurysm with associated thrombus. All 3 patients recovered following mitral-valve replacement, repair of the rupture and medicinal treatment for the clot, respectively. Around one-third of patients who have a myocardial infarction do not have chest pain but experience shortness of breath, autonomic nervous symptoms (sweating, nausea, vomiting), extreme and inexplicable tiredness and fainting. These atypical symptoms should suggest myocardial infarction. In order to avoid high morbidity and death from complications such as arrhythmias, heart failure, rupture and aneurysm formation it is important that a patient who has had a myocardial infarction should be treated as soon as possible, preferably by reperfusion therapy.
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PMID:[Complications of an unrecognized myocardial infarction]. 1635 69

A 61-year-old man presented to the emergency department of a community hospital with a 2-week history of fever, chills, and sudden extreme weakness of his right arm and lower extremities. He also had a cough, shortness of breath, nausea, abdominal pain, diarrhea, and myalgia. Though initially alert and cooperative, he quickly became unresponsive. In addition, he had hyponatremia, renal insufficiency, and compromised cardiopulmonary function. He was admitted to the intensive care unit for suspected bacterial infection and was started on broad-spectrum antibiotics. Chest radiograph revealed miliary infiltrates consistent with infectious emboli or metastatic carcinoma. Despite intensive resuscitation, the patient died 36 hours after admission. At autopsy multiple nodular lesions were observed on gross examination of the lungs, perihilar and paratracheal lymph nodes, and liver. Microscopic sections of the lung (Figure 1) and brain (Figures 2 and 3) are shown.
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PMID:Fever, chills, and weakness in a 61-year-old man. 1637 68

This randomized controlled trial investigated the effect of reporting physical symptoms by using a systematic symptom monitoring instrument, the Symptom Monitor, on symptom prevalence and severity among patients with cancer in the palliative phase. The overall objective was to achieve symptom relief through systematic and regular symptom reporting by patients themselves. One hundred forty-six patients with cancer in the palliative phase were randomized to either the intervention group (n = 69 with Symptom Monitor) or the control group (n = 77 without Symptom Monitor). Ten physical symptoms with regard to prevalence and severity were monitored. After 2 months, the prevalence of symptoms was lower in the intervention group compared to the control group (prevalent differences 2.1-24.3%) for 9 out of 10 symptoms (except coughing). The intervention group scored a statistically significantly lower prevalence in constipation and vomiting (prevalence differences 24.3% and 18.0%, respectively). In four symptoms (fatigue, lack of appetite, shortness of breath, and nausea), the intervention group had a lower, although not statistically significant, severity score (median differences 0.5-1). In four symptoms (pain, coughing, sleeplessness, and diarrhea), the severity score was the same in both groups (medians 2-4). In two symptoms (constipation and vomiting), the severity score was lower in the control group (median differences -1 and -2). A comparison between the study groups on improved, deteriorated, or steady-state cases showed that the severity score had deteriorated less for 8 out of 10 symptoms in a larger proportion of patients in the intervention group. Although statistical significance was not reached, the prevalence as well as severity of symptoms in the palliative phase of cancer can be influenced by using the Symptom Monitor.
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PMID:Using the symptom monitor in a randomized controlled trial: the effect on symptom prevalence and severity. 1644 79

This study determines the prevalence of types of sicknesses and diseases affecting patients visiting health service facilities and the available health services within the Selebi Phikwe Ni-Cu mine area, Botswana. Through the administration of questionnaires and structured questions, attempts were made to establish and verify the existing human health problems at the study area by focusing on respiratory tract related symptoms of sicknesses and diseases. With the aid of statistical package for social sciences (SPSS), interpreted results from respondents indicated that all the health service providers served patients suffering from headaches, persistent coughing, chest pains, lower abdominal pains, pain when passing out urine, genital discharge and diarrhea. Seventy one percent of the health service providers indicated that their patients suffered from body weakness, 86 % indicated that they had patients who suffered from recent loss of body weight, and another 86 % pointed out that their patients had influenza/common cold. Other health complaints reported included unusual spitting, shortness of breath, palpitations, nausea/vomiting, diarrhoea, and constipation. Moreover the health service providers indicated that they had patients who suffered from significant illnesses of which some passed away. However if there are lacking facilities, patients are referred to bigger health service providers in the country. The findings of the study do not in general depict demarcating differences of health status of residents of the study area to those of the control site. A need therefore for further investigations to be conducted to establish relations of mining activities to human health at Selebi Phikwe is called for.
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PMID:Health Worker Opinion/perception of health services provided to patients in the Selebi Phikwe Ni-Cu Mine Area, Botswana. 1734 49

2,4,6-Trinitrotoluene (TNT) is an important occupational and environmental pollutant. In TNT-exposed humans, notable toxic manifestations have included aplastic anaemia, toxic hepatitis, cataracts, hepatomegaly and liver cancer. Therefore, it is important to develop protection measures and to monitor workers involved in the clean-up of ammunition sites. Haemoglobin (Hb) adducts of TNT, 4-amino-2,6-dinitrotoluene (4ADNT) and 2-amino-4,6-dinitrotoluene (2ADNT), and the urine metabolites of TNT, 4ADNT and 2ADNT were found in 22-50% of the exposed workers, but not in the control group. The exposed workers were wearing protective equipment. The levels of erythrocytes, haemoglobin, creatinine, serum glutamic pyruvic transaminase and lymphocyte levels were significantly lower in the exposed workers than in the non-exposed workers. The levels of blood urea and reticulocytes were significantly higher in the exposed workers than in the non-exposed workers. Headache (26%), mucous membrane irritation (16%), sick leave (18%), lassitude (8%), anxiety (6%), shortness of breath (3%), nausea (5%) and allergic reactions (8%) were reported by the exposed workers. In a further analysis the U-4ADNT levels and the Hb-adduct levels were compared to the blood parameter and the health effects. The blood parameters were not significantly different between the U-4ADNT positive and U-4ADNT-negative group. Headache, mucous membrane irritation, sick leave, lassitude, anxiety, shortness of breath and allergic reactions were statistically not different between the two groups. Also in the workers with Hb-4ADNT adducts no significant negative changes were seen in regards to the changes of the blood parameters or the health effects. According to the results of the present study, it appears that the blood parameter changes and the health effects are more influenced by other factors than by the internal exposure to TNT.
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PMID:Biomonitoring of workers cleaning up ammunition waste sites. 1785 74

Palliative medicine, in the sense of a special, primarily symptomatic treatment of incurable and terminally ill patients has so far been described as an invention of the 20th or, at most, the late 19th centuries. As this paper seeks to show, the "cura palliativa" was the subject of a lively debate already from the late 16th century onwards, however. Medical case histories presented it as a sometimes indispensable alternative to radical, curative treatment. Therapeutic handbooks and, from 1692, books specifically devoted to the topic, gave detailed recommendations on the medicines and other therapeutic measures which could be used to alleviate pain, nausea, shortness of breath and other tormenting symptoms and to assure as mild a death as possible. They also warned against futile last-resort measures which only threatened to cause "dysthanasia" by aggravating the patients' suffering. More than today, the term "palliare" was understood in its original literal sense of "cloaking", however, and was also used for treatment which only covered up external defects or, even worse, the healer's incompetence. Here, the debate on the "palliative cure" also served as a vehicle for the physicians' polemical attacks against their less learned competitors whom they declared unable to discern and remove the true causes of diseases.
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PMID:["Cura palliativa". The concept of palliative care in pre-modern medicine (c. 1500-1850)]. 1787 50


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