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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A point source outbreak of Vibrio cholerae O1 El Tor Inaba infections occurred aboard an oil rig south of Port Arthur, Texas, in September 1981. Sixteen crew members had V. cholerae O1 infections as determined by serology or stool specimens; 15 were symptomatic. The high percentage of symptomatic infections was attributed in part to the ingestion of a large number of V. cholerae O1 organisms by susceptible individuals. Symptoms included diarrheal stools (100%), weakness (60%), abdominal cramps (53%), nausea (40%), and vomiting (27%). Only one of the three patients who sought medical attention was diagnosed by his physician as having cholera. Physicians who treat patients who live near or travel to the Gulf Coast should consider cholera in patients with watery stools. If cholera is suspected, laboratories should use thiosulfate-citrate-bile salts-sucrose (TCBS) agar in addition to routine enteric media for processing stool specimens.
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PMID:Clinical and laboratory features of an outbreak of Vibrio cholerae O1 infections in the United States. 397 22

Two regimens of fluid and electrolyte therapy were studied in children with severe cholera and noncholera diarrhoea. In one, lactated Ringer's solution was the sole intravenous fluid, additional water, glucose, and potassium being given by mouth. In the other, three different intravenous solutions were employed to meet all fluid and electrolyte requirements. The response to therapy was satisfactory with each regimen. Because of prolonged stupor or vomiting about 15% of children treated by the first regimen were unable to ingest a sufficient quantity of glucose solution by mouth, and intravenous supplementation with a hypotonic glucose-saline solution was necessary. It is concluded that lactated Ringer's solution is suitable as the sole intravenous solution for children with acute cholera and noncholera diarrhoea provided oral supplementation, as described, is possible. The study also provides useful observations on the means of evaluating fluid requirements in such children and specific guidelines for such therapy.
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PMID:The use of Ringer's lactate in the treatment of children with cholera and acute noncholera diarrhoea. 453 50

Cholera is a disease state caused by the Vibrio cholerae. The vibrios remain in the gut lumen, and the disease is atypically afebrile. The main symptom is a profuse isotonic diarrhea of rice-water character with an output rate of as much as 1 liter/hour. Early signs in the untreated patient are skeletal muscle cramps (presumably due to electrolyte loss) and vomiting. Mortality rate in untreated cases may be as high as 80%, and in treated cases, 20%. The U.S. Navy method of treating chlera has reduced the mortality rate to zero in the uncomplicated cases. U.S. Navy scientists have demonstrated that the cholera stool is remarkably constant from patient to patient and throughout the course of the disease. The simplicity of the Navy method for treating cholera makes it well suited for use in epidemics in populations with no experience in cholera. The method measures plasma specific gravity by the copper sulfate method. The Navy scientists found that there is a sodium transport inhibitor in cholera stools, and that there is decreased sodium transport from the gut lumen to plasma in the acute phase of cholera. Unlike other forms of shock, the mesenteric circulation in cholera must continue as there is a danger of loss of protein-free plasma, eventually leading to death. Tetracycline and other antibiotics have been shown to halve the course of the disease and fluid requirements for its therapy.
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PMID:Cholera in the perspective of 1966. 592 97

The case of a 25-year-old patient is reported who suffered from a syndrome similar to immune complex disease following cholera revaccination. The clinical picture included fever, muscle, joint and abdominal pain, vomiting, serositis, hepatitis, suspected myocarditis, anaemia and thrombocytopenia. Clinical symptoms subsided spontaneously within two weeks. This case illustrates a hazard of cholera vaccination so far not reported in the literature.
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PMID:Episode resembling immune complex disease after cholera vaccination. 623 47

After having eaten dinner many customers of a restaurant in Dolo (Venice) developed gastroenteritis with diarrhoea and vomiting. Strains of non O group 1 Vibrio cholerae were isolated from rectal swabs of four customers. Epidemiological investigations revealed an association between the illness and raw oyster consumption (p = 0.008). Also, an association was found between age and illness among males (p = 0.034). As a consequence of this outbreak, a gastroenteritis surveillance programme was run for three months by health authorities in the Regione Veneto. The results indicate that, although non 0-1 V. cholerae does not account for severe pathology, it causes mild gastroenteritis and asymptomatic infections in developed countries.
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PMID:Transmission of non O group 1 Vibrio cholerae by raw oyster consumption. 649 Mar 4

A randomised controlled trial was conducted to investigate the ability of chlorpromazine to reduce intestinal secretion in cholera. Chlorpromazine had reduced loss of intestinal fluid in animals with diarrhoea induced by cholera toxin, and in a preliminary study the drug had reduced purging in patients with cholera. Forty-six adults with cholera were included in the randomised trial. Of these, 34 were treated with chlorpromazine (1 mg/kg or 4 mg/kg either by mouth or intramuscularly) and 12 served as controls. After treatment with the drug there was a significantly greater reduction in the rate of fluid loss in the treated patients than in the controls during the first (p less than 0.005), second (p less than 0.05), and fourth (p less than 0.01) eight-hour periods, but not during the third eight-hour period; the dose of 4 mg/kg was only marginally more effective than 1 mg/kg. The effect of chlorpromazine was strikingly biphasic, with one peak during the first eight hours and another 24-32 hours after administration. Chlorpromazine also significantly reduced the duration of diarrhoea, frequency of vomiting, and amount of intravenous fluid required. The drug induced mild sedation and no hypotension in these well-hydrated patients. These findings confirm the effectiveness of chlorpromazine in reducing fluid loss in cholera. A sedative effect, however, especially in children, may limit its usefulness and requires further study.
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PMID:Controlled trial of chlorpromazine as antisecretory agent in patients with cholera hydrated intravenously. 680 77

In the US oral glucose electrolyte solutions have been marketed for over 30 years for the treatment of infantile diarrhea. Recently, oral solutions have been widely used instead of intravenous fluids for treatment of dehydration from diarrhea, especially in developing countries, where diarrhea is a major cause of death in infants and young children and facilities for intravenous fluid replacement are limited or unavailable. The high concentrations of glucose and other carbohydrates in older preparations may make the diarrhea worse. The use of 2-2 1/2% glucose, as in "Infalyte, Pedialyte R.S." and the World Health Organization (WHO) solution avoids the osmotic effect of unabsorbed glucose, makes the taste tolerable, and promotes coupled absorption of sodium from the intestine. Replacement solutions for fluid loss due to diarrhea should also contain about 20 mEq/L of potassium because diarrhea invariably results in a substantial loss of potassium. Although homemade mixtures of glucose electrolyte solutions and commercial powders that require dilution are less costly than ready to use commercial solutions, errors in mixing or diluting occur often and can have serious consequences. For rehydration after volume depletion, the sodium concentration of the replacement fluid should be between 50-90 mEq/L, regardless of the cause of the diarrhea, patient's age, or the serum sodium concentration. For early treatment of diarrhea to prevent dehydration or for maintenance of hydration after parenteral fluid replacement, 90 mEq/L of sodium is acceptable for adults and children, but may not be appropriate for infants who have a higher insensible water loss. When diarrhea in infants is not caused by cholera, some consultants prefer to use more dilute fluids that contain 50-60 mEq/L of sodium. When circulatory insufficiency (10-15% weight loss), severe vomiting, inability to drink, or severe gastric distention is present, parenteral fluid replacement is indicated. With 5-8% acute weight loss, oral rehydration alone is often successful. Infants should be offered frequent small amounts of rehydration solution, aiming for an intake of about 150 ml/kg in the 1st 24 hours, 1/2 in the 1st 8 hours, if possible.
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PMID:Oral rehydration solutions. 682 25

Texas Star-SR, a laboratory-derived mutant of Vibrio cholerae El Tor Ogawa 3083, which produces B but not A subunit of cholera toxin was given to 68 healthy adult volunteers in doses of 10(5) to 5 X 10(10) organisms. 16 of 68 exhibited loose stools but in only one individual was stool volume notable. Vomiting occurred in 1 and abdominal cramps in 3 vaccines; malaise and fever were not seen. Texas star was recovered from stools of 22% who received low doses (10(5) or 10(6) organisms) and from 63% who received high doses (10(8), 10(10), 2 X 10(10) or 5 X 10(10)). The attenuated strain was also recovered from jejunal fluid of 76% in the high dose group; cultures revealed 10(2)-10(5) organisms/ml. Seroconversions of vibriocidal antibody occurred in 93% and peak organisms/ml. Seroconversions of vibriocidal antibody occurred in 93% and peak titers were resembling those seen following clinical cholera. In contrast, serum IgG ELISA antitoxin rose significantly in only 29% and levels were below those encountered after clinical cholera. Only 5 of 18 vaccinees tested so far had significant rises in intestinal SIgA antitoxin; these also manifested rises in serum antitoxin. The occurrence of loose stools did not correlate with dose ingested, excretion of vibrios or rise in serum antitoxin. 503 clones recovered from coprocultures and jejunal fluids were negative when tested for enterotoxin. One month following a single 5 X 10(10) organism dose of Texas Star, 7 vaccinees and 6 controls were challenged with 10(6) pathogenic El Tor Ogawa vibrios. Diarrhea occurred in 7 of 10 controls but in only 1 of 7 vaccinees (p = 0.05). Despite clinical protection, excretion of pathogenic V. cholerae was similar in vaccinated and control groups. Twelve vaccinees who received two 10(9) or two 2 X 10(10) organisms doses of Texas Star 1 week apart were challenged with 10(6) pathogenic V. cholerae El Tor of the heterologous serotype. Diarrhea occurred in 11 of 15 controls but in only 3 of 12 vaccinees (p. 0.01). The 3 vaccinees with diarrhea all had mild illness. Texas Star-SR is a prototype that commonly causes mild diarrheal responses but is genetically stable in vivo and stimulates protective immunity against challenge with either the homologous or heterologous serotype.
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PMID:Texas Star-SR: attenuated "Vibrio cholerae" oral vaccine candidate. 687 77

Four hundred and ten patients with severe watery diarrhea; including 316 patients with cholera, were studied in a double-blind, randomized, placebo controlled trial to determine if chlorpromazine (1 mg/kg) would be useful in the management of such patients. All patients were at least 7.5% dehydrated on admission into the study; all received intravenous fluids followed by oral rehydration solution and all received tetracycline. In addition, one-half of the patients received chlorpromazine, 1 mg/kg, orally as a single dose 2 h after admission. Effectiveness of the chlorpromazine was determined by comparing oral therapy failure rates, purging rates, vomiting rates, i.v. fluid requirements and hospitalization time in groups of the patients receiving and not receiving the drug. In children with severe cholera, e.g., with shock on admission or with very high purging rates, chlorpromazine lowered the oral therapy failure rate by about 50%. However, children with less severe cholera, adults with cholera, and patients of all ages with noncholera diarrhea could not be demonstrated to benefit significantly from the drug. In these groups of patients, oral therapy failures were rare irrespective of whether or not chlorpromazine had been given. We, therefore, do not recommend chlorpromazine in the routine management of patients with watery diarrhea, however, it may be useful in treatment of children with severe cholera when added to standard treatment of hydration and tetracycline.
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PMID:The use of chlorpromazine in the treatment of cholera and other severe acute watery diarrheal diseases. 704 Jan 57

The authors studied the frequency of diarrheal illness associated with non-typhi Salmonella at two clinics in Bangladesh for the years 1977-1979. Non-typhi salmonellae were isolated from 0.29% of fecal specimens or rectal swabs in an urban area and 0.26% of similar specimens in a rural area; the frequency of isolations peaked in the summer months. Isolations of Shigella and Vibrio cholerae were much more common than Salmonella. Only two of 50 Salmonella isolates were resistant to more than one antibiotic. None of 13 isolates tested produced an enterotoxin. S. java and S. virchow accounted for 64% of all the isolates. Patients with diarrheal illness associated with isolation of Salmonella frequency had vomiting (88%), watery diarrhea (78%), abdominal pain (61%), and fever (39%), but the clinical features of the illnesses and the socioeconomic backgrounds of the patients could not be distinguished from those of matched controls who were attending the same clinic. The infrequency of Salmonella infection in an area where several other bacterial and viral enteric diseases are hyperendemic requires further investigation.
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PMID:Salmonellosis at rural and urban clinics in Bangladesh: epidemiologic and clinical characteristics. 711 37


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