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)

Ten to 28 days after hospital admission cell count and/or total protein concentration showed no decrease or further increase in 33 children (25 boys, 8 girls) between 2 to 15-years of age who suffered from acute aseptic meningitis (causative agents: mumps virus in 9 children, enterovirus in 5 children). Three of these children had cerebral palsy as a possible predisposing factor. The onset of prolonged aseptic meningitis was protracted in some children. At hospital admission the clinical features of this disorder differed not from those in uncomplicated acute aseptic meningitis. In 4 children a one-sided and in 4 patients a doublesided peripheral facial paralysis occurred as a transitory complication. One child showed transient arterial hypertension. EEG was normal in most of the children or revealed a slight general slowing only. Apart from a slight enlargement of the ventricles in 3 children cerebral CT showed no abnormality. Complaints like vertigo, headache, and vomiting persisted for weeks or months in part of the children. During the course of the disease CSF reflected two different reactions: 1. further increase of total protein in combination with a minimal cellular response, affecting 2-10 years old boys and girls equally; protein electrophoresis revealing the pattern of severe blood-CSF barrier disturbance, 2. persistant elevation or further increase of both cell count and total protein occurring nearly exclusively in 6-15 years old boys, associated with the CSF-protein pattern of severe blood-CSF barrier disturbance and of oligoclonal gamma-fractions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prolonged nonbacterial meningitis: clinical aspects and cerebrospinal fluid findings]. 651 22

1. Gastro-oesophageal reflux of infancy and childhood leads to vomiting and frequently to aspiration pneumonia and failure to thrive. 2. Two thirds of all cases can be cured conservatively. One third has to undergo surgery. 3. According to our present knowledge, the mechanism of the cardia seems to be competent at birth, however, peristaltism and reflex activity undergoes a maturation process. 4. The aetiology of gastro-oesophageal reflux in childhood is variable. There is a distinct difference between primary and secondary reflux. The latter occurs in children with cerebral palsy as well as following operations of the oesophagus or the hiatus. 5. The indication for an operative intervention is not as much depending upon the radiographic findings as upon the existence of oesophagitis, stenosis, anemia and aspiration pneumonia. 6. Nissen's fundoplication is not the operation of choice in childhood since this intervention is followed by a high morbidity. For uncomplicated cases, reconstruction of the angle of His and repositioning of the abdominal oesophagus into the abdominal cavity in combination with a semiplication of the fundus is preferable.
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PMID:[Gastroesophageal reflux in childhood]. 722 23

Hormonal imbalances in utero may render males more vulnerable to neurodevelopmental disorder (ND) than females. Since hormonal activity can be influenced by photoperiod, the relationship between season of conception and incidence of ND in offspring was examined within 11,578 mother/child pairs. Fall conception significantly elevated the odds for mental retardation, reading, arithmetic disability, or performance aptitude deficits (but not seizures, articulation disorder, cerebral palsy, or verbal aptitude deficits), and decreased the odds for reading talent (even when socioeconomic class, prenatal visits, infections, fever, vomiting, edema, anemia, and weight loss were covaried). Since the seasonality effect was not stronger in males, and was not specific to those NDs caused by left hemisphere dysfunction, the predictions of Geschwind and Galaburda (1985a, 1985b, 1985c) were not confirmed.
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PMID:Fall conception increases the risk of neurodevelopmental disorder in offspring. 783 99

In a retrospective study of hospital records over a 50-year period, data on 32 patients who died as a result of intestinal obstruction are presented and compared with comparison groups and national mortality statistics. There was a higher incidence and lower mean age at death of fatal intestinal obstruction compared with the total national population. The mean age at death significantly increased over the study period. Intestinal volvulus was a common cause of obstruction particularly in those with cerebral palsy. There was a high prevalence of chronic constipation and megacolon. Foreign-body obstruction was de facto related to pica, but overall, there was a low prevalence of pica. Overall, mean IQ was low, but only significantly so in the male subjects. The length of acute illness was short; in 22 patients it was less than 24 h. Vomiting and abdominal distension were often absent and abdominal signs were recorded only in five patients. Pain or distress was recorded in only nine patients. Only eight patients were correctly diagnosed before death and only two had surgery. The results suggest that fatal intestinal obstruction is more common in mentally handicapped people and chronic constipation and megacolon are risk factors. Intestinal obstruction in mentally handicapped people can present late and with deceptively minimal signs and symptoms.
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PMID:Fatal intestinal obstruction in the mentally handicapped. 794 92

Ornithine transcarbamylase deficiency (OTCD) is caused by an alteration of urea synthesis, linked with partial modification of the X-chromosome, whose clinical manifestations are: lethargy, nausea, vomiting and cerebral edema. While in newborn males OTCD presents with hyperammoniemia leading to cerebral palsy with profound neurological impairment and eventually death, in women who are healthy carriers, it is possible to detect the disorder only through specific tests, since heterozygote women are rarely symptomatic. We describe the case of a young woman admitted to the hospital after an episode of mental confusion with vomiting and psychomotor restlessness, which had previously occurred several times during the premenstruum and lasted a few hours. A 2 day history of stupor made admission mandatory. Tests carried out during the hospital stay showed marked hyperammoniemia and unconjugated hyperbilirubinemia, marked cerebral edema documented by a CT scan. Liver biopsy and CSF test were normal. Screening of plasma and urinary aminoacids, level of orotic acid in the urine and OTC activity in the liver, confirmed the diagnosis of OTCD. The possibility of early diagnosis and therapy of a disease which otherwise leads to death, emphasizes the importance of precise evaluation of a possible organic cause of anorexia and behaviour disorders in young women.
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PMID:Hyperammoniemic coma in an adolescent girl: an unusual case of ornithine transcarbamylase deficiency. 828 23

Feeding difficulties, vomiting and recurrent chest infections associated with poor growth and nutrition are common in children with cerebral palsy (CP). However, the role of gastrooesophageal reflux as a possible cause has been little studied. We therefore investigated 23 children with cerebral palsy (median age 2.3 years, range 0.6-11.8) whose symptoms were consistent with gastrooesophageal reflux (severe feeding difficulties 70%, failure to thrive 52%, anaemia 31% and recurrent chest infections 31%). Using 24-hour ambulatory oesophageal pH monitoring, we determined the relationship between gastrooesophageal reflux and: (a) developmental age (Griffith's scales); (b) feeding behaviour skills score; (c) nutritional status and (d) clinical assessment of cerebral palsy (type and severity). Abnormal gastrooesophageal reflux (i.e. reflux index > 5%) was detected in 16 (70%) patients (median reflux index 11.4%; range 5.4-59%). Reflux was unrelated to chronological or developmental age, but there was a significant, unexplained association with male gender (P < 0.01). No correlation was found with feeding behaviour skills score, malnutrition (which was commonly severe) and type and severity of cerebral palsy. We conclude that gastrooesophageal reflux is common and should be sought in symptomatic, neurologically handicapped children as effective treatment is likely to improve quality of life.
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PMID:Gastrooesophageal reflux in children with cerebral palsy. 846 29

The safety and efficacy of epidural opioids as postoperative analgesics for children with cerebral palsy were studied in 85 pediatric patients with cerebral palsy. The patients were 5 to 15 years of age and were undergoing elective orthopedic operations on the lower extremities. These patients were divided into four groups. All the patients received inhalational anesthesia combined with caudal anesthesia, while the patients in groups 2, 3, and 4 were given epidural morphine (40 micrograms.kg-1), buprenorphine (3 micrograms.kg-1), or butorphanol (30 micrograms.kg-1) at the end of operation, respectively. Number of patients who received analgesics more than 2 times within 24 hours after operation was larger in group 1 than in groups 2-4. Although groups 2-4 compared with group 1 were still sedated at 24 hours after the operation, there was no difference in degree of sedation among the groups 2-4. The epidural opioids did not increase the frequency of side effects such as nausea, vomiting etc. The authors conclude that epidural opioids achieve safe and useful postoperative pain control in children with cerebral palsy.
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PMID:[Epidural opioids for post-operative pain control in pediatric patients with cerebral palsy]. 851 41

Selective dorsal root rhizotomy is performed for relief of spasticity in children with cerebral palsy. Postoperative pain relief can be provided by intrathecal morphine administered at the time of the procedure. We sought to define an optimal dose of intrathecal morphine in children undergoing selective rhizotomy, through a randomized, double-blinded prospective trial. After institutional approval and parental written informed consent, 27 patients, ages 3-10 years, were randomized to receive 10, 20, or 30 micrograms.kg-1 (Groups A, B, and C, respectively) of preservative-free morphine administered intrathecally by the surgeon after dural closure. Postoperatively, vital signs, pulse oximetry, and pain intensity scores were recorded hourly for 24 hr. Supplemental intravenous morphine was administered postoperatively according to a predetermined schedule based on pain scores. There was considerable individual variability in the time to initial morphine dosing and cumulative supplemental morphine dose. Time to first supplemental morphine dose was not different between groups. When compared to Groups A and B, cumulative 6-hr supplemental morphine dose was significantly lower in Group C (38.6 +/- 47 micrograms versus 79.1 +/- 74 and 189.6 +/- 126 for Groups A and B, respectively). By 12 hr, cumulative supplemental morphine dose was similar in Groups A and C. Group B consistently had a higher supplemental dose requirement than Groups A and C at 6, 12, and 18 hr. By 24 hr, there was no difference in cumulative dose among groups. Postoperative pain scores and the incidence of respiratory events, nausea, vomiting and pruritus were comparable among groups. These data suggest that intrathecal morphine at 30 micrograms.kg-1 provides the most intense analgesia at 6 hr following selective dorsal root rhizotomy, but was otherwise comparable to the 10 micrograms.kg-1 dose.
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PMID:Intrathecal morphine for analgesia in children undergoing selective dorsal rhizotomy. 885 77

Idiopathic localization-related epilepsies are summarized according to the current classification of the International League Against Epilepsy. The recognition of a distinctive idiopathic epileptic syndrome occurring in children and featuring ictal vomiting, partial motor seizures, and occipital spikes is emphasized. Atypical evolutions of benign partial epilepsy of childhood and status of BPECS. Acquired epileptic aphasia has also been correlated to BPECS, and all these syndrome (CSWS). Childhood epilepsy with occipital paroxysms may also evolve into CSWS and into clinical and EEG status. Differential diagnosis of BPECS includes children with fortuitous associations of BPECS with cerebral palsy and the occurrence of a clinicoelectroencephalographic phenotype of BPECS in children with progressive and nonprogressive structural brain pathologies. Childhood epilepsy with occipital paroxysms should be differentiated from cerebrovascular abnormalities mitochondrial myophathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS), and the syndrome of posterior cerebral calcifications, epilepsy, and celiac disease.
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PMID:[Atypical evolution of benign partial epilepsy in children]. 897 48

We describe the prevalence and nature of gastrointestinal (GI) symptoms in 58 children affected by cerebral palsy (range: from 6 months to 12 years of age) referred to a pediatric neurology outpatient clinic. In each patient we assessed (GI) symptoms and defined the associated GI functional or structural abnormalities. Furthermore, we tried to correlate the type of GI dysfunction with findings on computed tomography (CT) or magnetic resonance imaging (MRI) of the brain. Our results showed that 92% of children with cerebral palsy had clinically significant gastrointestinal symptoms. Swallowing disorders were present in 60% of patients, regurgitation and/or vomiting in 32%, abdominal pain in 32%, episodes of chronic pulmonary aspiration in 41% and chronic constipation in 74%. Dysfunction of the oral and/or pharyngeal phase of swallowing was found in 28 of 30 (93%) patients with swallowing disorders. Of the 45 patients with symptoms suggesting gastroesophageal reflux, 41 (91%) had an abnormal pH-monitoring and/or esophagitis. Furthermore, a significant delay in the scintigraphic gastric emptying of liquids was found in 12 of 18 patients (67%) and an abnormal esophageal motility in 11 of the 18 (61%) investigated patients. In 25 patients with chronic constipation evaluation of colonic transit showed a delay at level of the proximal segments of the colon in 13 (52%), at level of the left colon and rectum in 9 (36%) and in 3 (12%) at level of the rectum only. Computed tomography and/or magnetic resonance imaging were normal in 5 (9%) and abnormal in 53 (91%) of the 58 children with cerebral palsy. No GI symptom was significantly associated with any kind of abnormal neuroimaging. In conclusion, children with cerebral palsy exhibited diffuse GI clinical manifestations, mostly due to disorders of GI motility. The GI symptoms seemed not to be related to any specific finding on CT or MRI of the brain.
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PMID:Gastrointestinal manifestations in children with cerebral palsy. 1041 17


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