Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mepyramine-theophylline-acetate (MTA), a theophylline derivative combined with an antihistamine, is used to treat patients with asthma. A double-blind, randomized, prospective, parallel-group study was conducted to evaluate the efficacy and safety of MTA in the treatment of asthmatic crisis in children 2 to 6 years of age. Forty patients with mild-to-moderate asthma were admitted to the study. The MTA group received 8 mg/kg per day of MTA by mouth in three divided doses for 7 days. The other group received 50 microL/kg per day of placebo in three divided doses for 7 days. Salbutamol (albuterol) syrup was used as the rescue drug if manifestations of asthma persisted. Both the MTA group and the placebo group had similar demographic characteristics at baseline. Both groups showed improvement of the asthma symptoms (cough, dyspnea, hypoventilation, and wheezing), as evaluated by the investigators at days 3 and 7. Patient diary scores showed earlier improvements in the MTA group than in the placebo group. Both groups showed improvement in peak flow at days 3 and 7 (P = 0.005). The control group used more doses of salbutamol than the MTA group on days 2 through 6 and globally (mean +/- SD, 6.79 +/- 9.11 doses vs 1.29 +/- 2.23 doses). The improvements in the placebo group were thought to be due to salbutamol. Three MTA patients dropped out of the trial, one because the parents felt that the treatment was not effective and two because of gastrointestinal manifestations (epigastric discomfort and vomiting). In the placebo group, two patients dropped out. One patient had epigastric discomfort and the other had to be treated in the emergency department for an exacerbation of the asthma. We conclude that MTA may be a good therapeutic option for the treatment of asthmatic crisis in children 2 to 6 years of age.
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PMID:Efficacy and safety of mepyramine-theophylline-acetate in the treatment of asthmatic crisis in children. 856 34

Cam-2445 is a selective, high-affinity NK1 receptor antagonist that is a potentially useful treatment for arthritis, asthma, migraine, anxiety, psychosis, and emesis. Cam-2445 exhibits low aqueous solubility and high lipophilicity and has a molecular weight of 470. Cam-2445 has poor oral bioavailability and the purpose of this research was to examine the potential barriers to the oral bioavailability of Cam-2445. Cam-2445 was relatively stable at 37 degrees C in 0.1 N HCl, 5 microM alpha-chymotrypsin, rat intestinal perfusate, and in rat jejunal brush border membrane suspension. High permeability was observed from CACO-2 cells and from rat single-pass intestinal perfusions. Cam-2445 was administered as a solution to rats by intravenous (i.v.), oral (p.o.), intraduodenal (i.d.), and intraportal (i.p.v.) routes. The total oral bioavailability was poor at 1.4%. Absorption appeared to be rapid after i.d. dosing; bioavailability was 26%, and 54% of the dose was absorbed intact into the portal system. After i.p.v. dosing, 48% of the dose was available to the systemic circulation. The elimination t1/2 after i.d. dosing (2.91 h) was comparable to that i.v. dosing (2.93 h), whereas it was significantly longer after p.o. dosing (12.4 h). The p.o. dose apparently precipitated in the gastrointestinal (GI) tract, resulting in low oral bioavailability. These results indicated that neither stability in the GI tract nor membrane transport were major obstacles to the absorption of Cam-2445. While hepatic extraction of 52% was significant, the low aqueous solubility of Cam-2445, as well as the differences noted between p.o. and i.d. studies, strongly support GI dissolution and/or precipitation as the limiting factor for the oral bioavailability of the compound.
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PMID:Absorption of Cam-2445, and NK1 neurokinin receptor antagonist: in vivo, in situ, and in vitro evaluations. 869 23

Methotrexate has been used as an anti-inflammatory agent in chronic asthma. We evaluated the action of methotrexate in eight corticodependent severely asthmatic children (more than 10 mg of prednisone per day for at least one year). The patients (3 males and 5 females; aged 8 to 14 years) received a single weekly dose of 0.6 mg/kg methotrexate (maximum 25 mg) and folic acid (15 mg/day for 5 days in the week). The children were examined and had their pulmonary function test evaluated weekly. As the study progressed, the dose of prednisone was reduced and maintained till the next evaluation if the patient's symptoms were under control. After the 3rd month of treatment, we observed a significant reduction in the dose of prednisone and maintenance of the spirometric parameters. At the end of the trial, in 4 patients it was possible to reduce the basal prednisone dose 56% or more. In the remaining 4, one did not show any benefit and in the other 3, it was possible to obtain an average reduction of 40% of the basal prednisone dose. The total mean reduction was 55.9%. This oral corticoid reduction was not associated with clinical or pulmonary function deterioration, except in one patient. The patients were submitted to white blood cell count, hepatic transaminases, urine tests and other determinations at least once a month. There were no changes in biochemical tests. The side-effects were nausea, vomiting and abdominal pain. In conclusion, methotrexate given to severely corticodependent asthmatic children permitted a reduction in the daily intake of prednisone, reducing the severe side-effects of chronic corticotherapy.
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PMID:Methotrexate in the treatment of corticodependent asthmatic children. 872 71

1. After ingestion, Dettol liquid (4.8% chloroxylenol, pine oil, isopropyl, alcohol), a common household disinfectant, can cause central nervous system depression and corrosion of the oral mucosa, larynx and the gastrointestinal tract. The main risk from Dettol poisoning is pulmonary aspiration, leading to pneumonia, adult respiratory distress syndrome (ARDS) and/or sudden cardiorespiratory arrest. 2. To determine to what extent pulmonary aspiration in Dettol poisoning could be prevented, 13 patients treated in a general teaching hospital in Hong Kong were studied. Their clinical details were compared with those of control Dettol poisoning cases without pulmonary aspiration in order to identify possible risk factors for this complication. 3. At presentation, evidence of pulmonary aspiration was present in eight of the 13 patients prior to gastric emptying, but the use of gastric lavage without adequate protection of the airways could have aggravated the problem in three. In two other patients, evidence of aspiration was only present after gastric lavage was performed. The consequences of pulmonary aspiration were pneumonia (n = 10), ARDS (n = 2), acute exacerbation of asthma or chronic obstructive airway disease (n = 2) and sudden cardiorespiratory arrest (n = 1). Three patients with aspiration pneumonia (n = 2), ARDS (n = 1) and/or sudden cardiorespiratory arrest (n = 1) died. 4. Compared with the controls, the median amount of Dettol ingested was considerably larger (400 vs 150 ml), vomiting (100% vs 72.6%) and drowsiness/ confusion (60.2% vs 19.4%) occurred more often. 5. Amongst the 13 patients with Dettol poisoning and pulmonary aspiration, gastric lavage using the nasogastric tube technique without adequate production of the airways had been responsible for the occurrence or worsening of aspiration in two and three patients, respectively. Thus, gastric lavage particularly when using a nasogastric tube appeared to carry more harm than benefits in patients with Dettol poisoning. If the procedure is considered necessary, say because of the concomitant ingestion of the other poisons, the airways must first be well protected and the oropharyngeal aspiration and lavage technique using a wide bore Jacques tube is recommended. 6. Comparison with a control group has identified other risk factors for pulmonary aspiration: the amount of Dettol ingested, the occurrence of vomiting, drowsiness or confusion.
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PMID:Pulmonary aspiration following Dettol poisoning: the scope for prevention. 890 35

Numerous undesirable reactions to alcoholic beverages, foods, drugs and other substances are characterized by allergy-like signs and symptoms and yet show unambiguously negative allergy test results. Such persons should be assessed for evidence of histamine intolerance caused by histamine overload and/or diamine oxidase deficiency. Diamine oxidase is the main histamine degrading enzyme with a predominantly gut activity. This would explain why nutritional allergies are often primarily suspected. The clinical evidence for histamine intolerance is based on chronic headache, diarrhoea, vomiting, flush, urticaria, asthma-like symptoms, rhinitis and others. Histamine restricted food, supported if necessary by H1 antihistamine blockade are simple but highly efficacious measures as shown by us in large patient groups. Intolerance to red wine probably is the most outstanding clinical characteristic and a directed question must be included into any allergy history in order to avoid missing a very major diagnostic spectrum with good therapeutic maneuverability.
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PMID:[Pseudo-allergies are due to histamine intolerance]. 901 5

From 1974 to 1995, 19 children with achalasia of the esophagus have been treated at our institution. Presenting symptoms included vomiting (n = 14), dysphagia (n = 13), failure to thrive (n = 6), and odynophagia (n = 1). Diagnosis was established by a barium swallow in 19, with eight also undergoing esophageal manometry. Six boys and 13 girls with an average age of 10 years (range, 1.3 to 17.6) underwent a transthoracic, modified anterior Heller esophagomyotomy (HM). Five underwent a concomitant, modified, Belsey fundoplication (BF). Follow-up ranging from 6 months to 21 years (mean, 9 years) was accomplished in all 19 patients by both office visits and telephone interviews. Early postoperative follow-up showed initial swallowing difficulty in two (14%) patients with a HM alone and in four out of five (80%) patients treated with a HM and BF. All patients (n = 5) with a HM and BF and one with a HM alone required one esophageal dilation during the first postoperative year. These initial swallowing difficulties resolved in all six patients during this first postoperative year. Late postoperative follow-up, however, indicates occasional, mild dysphagia in two out of five with an HM and BF resulting in complete relief of presenting symptoms in 17 of the 19 patients (90%). All patients rated their overall result as either excellent (68%) or good (32%) with none rating it as fair or poor. None of the 19 patients had clinical evidence of gastroesophageal reflux, although five patients had evidence of nonpathologic reflux noted during upper gastrointestinal x-ray. Recurrent vomiting, asthma, wheezing, or esophagitis symptoms have not been reported by any patients. No patients required reoperation, and there were no deaths or postoperative complications. Modified Heller esophagomyotomy is safe (0% mortality) and effective (90% relief of symptoms) in children with achalasia. A concurrent modified Belsey fundoplication results in early and late mild postoperative dysphagia that was responsive to esophageal dilation. The transthoracic, modified Heller esophagomyotomy without a fundoplication is currently our treatment of choice for achalasia in children.
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PMID:Efficacy of the transthoracic modified Heller myotomy in children with achalasia--a 21-year experience. 904 49

Eosinophilic gastroenteritis is an uncommon disorder, characterised by eosinophilic infiltration of gut wall, with variable clinical features, depending affected layer of the wall and digestive area, but usually consisting in abdominal pain, diarrhoea, and vomiting. Etiopathogenesis is unknown, with a frequent allergic condition and good response to corticosteroids therapy. Although the existence of eosinophilic gastroenteritis may be suggested by abdominal manifestations, an allergic history with laboratory date and ESR normal, only the antral or intestinal biopsy might to confirm the diagnostic. We report a case of a patient with eosinophilic gastroenteritis and history of bronchial asthma, without evidence of intestinal parasitosis, and a spectacular response to corticosteroids therapy.
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PMID:[Eosinophilic gastroenteritis, apropos a new case]. 918 15

This study describes the medical practice among a sample of indigenous healers from Thaba Nchu, Ganyesa, Kurumane, Mankwe, and Molopo regions of the North West province of South Africa. Data were obtained from interviews conducted among 35 indigenous healers recommended by heads from a sample of 40 villages. Findings indicate that 60% were Botswanan. 51% were female. 85.7% were aged 30-59 years. 77% were married, and 5.7% were divorced. 31% had a lower primary education, and 25.7% finished high primary schooling. 22.4% had no formal schooling. 60% were bone throwers, and 34.2% were bone throwers and sangomas. 54% received their training "by their ancestors through dreams." 31% received formal training in indigenous healing. 14% served an apprenticeship with an experienced healer. 94% had a period of training from 2-5 years. 57% were registered with an association for indigenous healers. 77% relied on bone throwing for diagnosis of health problems. Other treatment methods included scarification, enema, induced vomiting, ritual performance, and prevention of witchcraft. Healers treated infertility, septic sores, impotence, sexually transmitted diseases, deliveries, makgome or boswagade, asthma, mental illness, high blood pressure, palpitations, tuberculosis, alcoholism, diabetes, and cancer. Pediatric diseases that were treated included tlhogwana, ditantanyane, measles, Kwashiorkor, and whooping cough. Healers relied on the following methods for disease prevention and health promotion: home fortifying, home cleansing, personal cleansing, scarification, and cultural education in taboos. 74% made referrals to either a western trained physician (17 out of 26) or other healers. All were generalists. Clients included professionals, such as nurses, teachers, and religious ministers. Although there is potential danger in some treatment methods, healers serve an important role in health prevention and treatment.
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PMID:Indigenous healers in the North West Province: a survey of their clinical activities in health care in the rural areas. 928 40

This review illustrates the changing paradigms in the understanding of the pathogenesis of pneumatosis intestinalis. Although many theories have been evoked, pragmatically there appear to be four major clinical and diagnostic imaging considerations. The most common and most emergent life-threatening cause of intramural bowel gas is the result of bowel necrosis due to bowel ischemia, infarction, necrotizing enterocolitis, neutropenic colitis, volvulus, and sepsis. In the stomach, intramural gas can be caused by emphysematous gastritis or ingestion of caustic agents. These situations represent surgical emergencies. Pneumatosis is found secondary to mucosal disruption presumably due to over-distention from peptic ulcer, pyloric stenosis, annular pancreas, and even to more distal obstruction. Disruption can also be caused by ulceration, erosions, or trauma, including the trauma of child abuse. Disruption can also be iatrogenic from intracatheter jejunal feeding tubes, stent perforation, sclerotherapy, or surgical or endoscopic trauma. In these cases, the gas may be focal or linear. Treatment depends on the extent of the disruption and the underlying cause. A more subtle form of mucosal disruption may occur due to mucosal erosions and also to defects in intestinal crypts secondary to acute and subclinical enteritides that allow intraluminal bacterial gas under pressure to percolate into the bowel wall layers, particularly the submucosa (29). Pneumatosis, often linear or cystic in appearance, is seen with increased frequency in patients who are immunocompromised because of steroids, chemotherapy, radiation therapy, or AIDS. In these cases, the pneumatosis may result from intraluminal bacterial gas entering the bowel wall due to increased mucosal permeability caused by defects in bowel wall lymphoid tissue. Clinical and imaging findings are important in the differentiation of this transient pneumatosis from fulminant life-threatening causes in this subset of patients. A pulmonary cause must still be considered in cases of chronic obstructive pulmonary disease, asthma, and cystic fibrosis. It can occur with barotrauma and after chest tube placement. It may relate to increased intrathoracic pressure associated with retching and vomiting. The possibility remains that occasionally the origin of pneumatosis intestinalis will remain cryptogenic--caused but unexplained.
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PMID:Pneumatosis intestinalis: a review. 953 Feb 94

Theophylline has been used for over a century in the treatment of asthma and while it is used principally as a bronchodilator, a number of recent studies have demonstrated potential anti-inflammatory and immunomodulatory activity. Indeed, regular treatment with low-dose theophylline, affords significant clinical benefit at the expense of unwanted side-effects associated with this drug, including headache and vomiting. The mechanism of action of theophylline is unclear, although a significant body of evidence points to an involvement of phosphodiesterase enzyme inhibition. Phosphodiesterases are a diverse group of enzymes that belong to at least seven families and of particular interest is the role of phosphodiesterase 4 isoenzyme as it is distributed in a number of inflammatory and immune cells and whose inhibition results in the downregulation of inflammatory and immune cell function. The discovery of pharmacological drugs selective for this isoenzyme has been viewed with interest in light of the positive results from preclinical and early clinical studies. Whether orally active safe phosphodiesterase 4 isoenzyme inhibitors will be useful in the treatment of asthma remains to be established.
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PMID:The role of theophylline and phosphodiesterase4 isoenzyme inhibitors as anti-inflammatory drugs. 975 83


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