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)

Thirty-four children with familial dysautonomia (FD) underwent Nissen fundoplication and gastrostomy. The indications for operation were persistent cyclic vomiting that resulted in repeated aspiration pneumonia (94% of the patients), chronic dehydration (82%), failure to thrive (97%), and frequent hospitalizations (76%). There was no operative or early postoperative mortality. Long-term follow-up for up to 12 years was available. Eight patients died during this period from 7 months to 7.5 years postoperatively. In 5 patients (15% of the operated patients), the fundoplication ceased to function 16 months to 5 years postoperatively, which was attributed mainly to repeated severe dysautonomic crises with vigorous retching. Vomiting ceased in 85% of the symptomatic patients; pulmonary deterioration was halted, and the frequency of aspiration pneumonia was reduced in 68%; nutritional improvement was seen in 44%; the hydration status improved in 88%; and the frequency of hospital admissions decreased in 74%. These long-term findings resulted in a significant improvement in the quality of life for the majority of the patients. The absence of operative mortality and the low postoperative morbidity, together with the long-term beneficial results of this surgical procedure, should encourage early surgical intervention in selected FD patients.
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PMID:Nissen fundoplication in the treatment of children with familial dysautonomia. 141 39

During a 15-year period, 146 strains of Aeromonas spp. were isolated from 32810 faecal specimens from 13,820 hospitalised patients up to 13 years of age. These isolates constituted 4% of all the pathogenic bacterial strains cultured. For the years 1978-1988, the files of children with gastro-enteritis revealed 81 whose faeces yielded Aeromonas spp. Most of them (94%) were < 3 years of age, 78% < 1 year old. The peak incidence was at 2-6 months, involving severe morbidity including dehydration and vomiting with acidaemia and azotaemia; the mean duration of illness and length of hospitalisation at this age were longer than at other ages. Bloody diarrhoea was found in 7% of the children. Almost all the strains of Aeromonas were resistant to ampicillin. We conclude that Aeromonas spp. are of aetiological significance in gastro-enteritis in small children; culture for this pathogen should be routine in the bacteriological examination of faeces.
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PMID:A 15-year study of the role of Aeromonas spp. in gastroenteritis in hospitalised children. 143 52

Cholera is a diarrheal disease that results from colonization of the small intestine by the Vibrio cholerae organism. The disease is spread primarily by means of fecal contamination of drinking water and may begin with the sudden onset of profuse, watery diarrhea. Vomiting, rapid dehydration, acidosis, muscular cramps and circulatory collapse are other prominent features of severe cholera. Diagnosis is confirmed by identification of the organism in a stool specimen. Treatment requires immediate replacement of the massive fluid loss before diagnostic studies are ordered. Clinicians should suspect cholera in any case of massive, shock-producing diarrhea, especially if the patient has traveled to a cholera-affected country. This article presents epidemiology and public-health measures, pathophysiology, diagnosis, clinical signs and symptoms, and treatment modalities for adults and children infected with the V. cholerae organism.
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PMID:The diagnosis and treatment of cholera. 146 31

3 episodes of alcoholic ketoacidosis were observed in one female patient over a period of 19 months. The clinical picture consisted of vomiting, dehydration, hyperventilation and abdominal pain. Predominant laboratory findings were acidosis (pH less than 7) and hyperglycaemia, with blood glucose values of 354, 330 and 147 mg/dl. This disorder is an important cause of metabolic acidosis, but especially in the German literature there are only rare reports on this issue. The picture of ketoacidosis in mostly chronically malnourished alcoholics reflects not only the complex abnormalities of acid-base balance caused by excessive cumulation of ketoacids, but also the related severe depletion of electrolytes and extracellular volume. Adequate acute therapy (as for diabetic ketoacidosis) and thorough follow-up treatment of any concurrent conditions result in rapid reversal of the syndrome in most cases. Since there are few reports of repeated episodes in one patient, an overview of this disorder is presented concerning management and differential diagnosis of the basis of our case report.
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PMID:[Alcoholic ketoacidosis--3 episodes in one patient]. 150 41

In a case-control study we evaluated the role of maternal behaviour, as reflected in maintenance of breast feeding and the use of oral rehydration therapy (ORT) at home during acute diarrhoea, in preventing dehydration in infants and young children. A systematic 5% sample was taken of all children aged 1-35 months attending the treatment centre of the International Centre for Diarrhoeal Disease Research, Bangladesh, with acute watery diarrhoea of six days or less between August 1988 and September 1989. There were 285 children with moderate or severe dehydration as cases and 728 with no dehydration as controls in the study. In a multivariate analysis using a logistic regression model we showed that withdrawal of breast feeding during diarrhoea was associated with a five times higher risk of dehydration compared with continuation of breast feeding during diarrhoea at home. Lack of ORT with either complete formula or a salt and sugar solution at home was associated with 57% higher risk of dehydration compared with receipt of a reasonable amount of ORT after controlling for several confounders. The confounding variables--that is, lack of maternal education, history of vomiting, high stool frequency, young age and infection with Vibrio cholerae 01--were also shown to be risk factors of dehydration. Health education programmes should promote continued breast feeding and adequate oral rehydration therapy for infants with acute diarrhoea at home.
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PMID:Breast feeding and oral rehydration at home during diarrhoea to prevent dehydration. 152 6

The ability to drink clear liquids without vomiting after anesthesia and surgery is a commonly used criteria for discharge of pediatric day surgery patients. We hypothesized that the ability to drink as a prerequisite for discharge would not affect the frequency of vomiting, delay discharge, or increase the frequency of readmission of children for dehydration after day surgical procedures. We randomized 989 patients between the ages of 1 month and 18.0 yr to one of two groups. The 464 "mandatory drinkers" were required to demonstrate the ability to drink clear liquids without vomiting prior to discharge from the hospital, whereas 525 "elective drinkers" were allowed but not required to drink. Other than the discharge criteria, the patients were managed in an identical fashion; the minimum volume of intravenous fluids received by all patients was adequate to supply a calculated 8-h fluid deficit prior to discharge from the hospital. There were no differences between the two groups in the incidence of vomiting in the operating room, the postanesthesia care unit, or after discharge from the hospital. However, in the day surgery unit, only 14% of the elective drinkers vomited compared to 23% of the mandatory drinker group (P less than 0.001). The mandatory drinkers had a more prolonged stay in the day surgical unit, averaging 101 +/- 58 min (mean +/- SD) compared to 84 +/- 40 min for elective drinkers (P less than 0.001). No patient in either group required admission to the hospital for persistent vomiting on the day of surgery, and no patient required readmission for vomiting or dehydration after discharge from the day surgery unit.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Should children drink before discharge from day surgery? 155 Feb 77

Totally-enclosed motor-propelled survival craft (TEMPSC) are used to evacuate the crews of mobile offshore drilling units in emergencies. The small size and flat bottom of the TEMPSC predispose most occupants to seasickness, even in relatively calm waters. This paper discusses efforts required to improve the well-being of occupants in terms of reducing seasickness, dehydration, hypothermia, anxiety, and the other factors that contribute to loss of comfort and the will to survive. Specific recommendations include the provision of climatic control to regulate temperature, remove odors and provide fresh air; potable water, electrolytes, and survival rations; and an ample supply of motion sickness bags. Overcrowding should be avoided. Anti-motion-sickness drug therapy to control vomiting should be administered in two ways: initial injection of intramuscular scopolamine for fast action followed by a transdermal ear patch for long-term protection. Leadership and seasickness management should be requisite survival training for all oil rig workers.
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PMID:Seasickness in totally-enclosed motor-propelled survival craft: remedial measures. 156 25

Fecal excretion of astroviruses was monitored in 321 children, 0 to 3 years old, living in the rural highlands of Guatemala. During the longitudinal study, from February 1987 to February 1989, we examined 5,000 stool specimens, including 1,805 collected during 1,369 episodes of diarrhea, 830 collected during the convalescent week, and 216 and 244 collected 2 weeks and 1 week, respectively, before the onset of diarrhea. Routine specimens were taken once a month from every child who had been free from diarrhea for at least three consecutive weeks. Of the children, 124 (38.6%) excreted astroviruses during the study. In total, we identified 184 infections by astroviruses. Of the samples collected 2 weeks and 1 week before the initiation of symptoms, 0.9 and 4.9%, respectively, were positive, while 7.3% of the diarrhea episodes were associated with astroviruses. Of the convalescent specimens, 3.4% were shown to be positive; 2.4% of the 1,905 specimens taken in diarrhea-free periods contained astroviruses. Infections by other potential enteropathogens were documented in 54 and 65% of the asymptomatic and symptomatic astrovirus infections, respectively. Diarrhea associated with astroviruses alone had a median duration of 5 days and was associated with vomiting in 8.6%, with fever in 17.1%, with dehydration in 5.7%, and with loss of appetite in 34.3% of the episodes. Diarrhea due to astroviruses was accompanied by negative changes in weight gain. Astrovirus diarrhea contributes to the high morbidity observed in young children living under poor conditions and has a deleterious effect on their nutritional status.
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PMID:Astrovirus-associated diarrhea among Guatemalan ambulatory rural children. 158 11

Shigellosis results in considerable morbidity in endemic areas, but mortality is rare in developed countries. All pediatric deaths (n = 15) in Israel following shigellosis in the past 10 years were reviewed. The patients' ages ranged from 5 months to 11 years; there were eight boys and seven girls. Three were institutionalized mentally retarded patients, 11 were healthy children. Twelve had definite clinical signs of brain death within 48 hours of onset of disease. Cause of death in all patients was consistent with toxic encephalopathy. No other systemic complication was implicated as the cause of death except for one case consistent with a "Reye-like" syndrome. Shigella species were as follows: 8 flexneri, 4 sonnei, 1 dysenteriae, and 2 were not identified. Case-control study of these patients vs surviving, hospitalized patients with shigellosis showed similar severity of fever, diarrhea, vomiting, and dehydration and similar incidence of convulsions. Headache was a prominent feature of patients who died; 5 of 7 verbal patients complained of this symptom as opposed to 2 of 20 in the control group (P less than .01). There were no significant differences in the hematological and biochemical profile (except for an increased incidence of hyponatremia in the study group), pattern of shigella species, or antibiotic sensitivity. These findings indicate that mortality from shigellosis in a developed country is due primarily to the toxic encephalopathy syndrome.
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PMID:Lethal toxic encephalopathy due to childhood shigellosis in a developed country. 159 76

A retrospective, case-control study of predictors of moderate to severe dehydration in patients seen at the Diarrhoeal Disease Control Training Centre, Addis Abeba, Ethiopia, over four years (1986-1989) is presented. A total of 1626 cases with moderate to severe dehydration and an equal number of admission year matched, randomly selected, controls with no clinical evidence of dehydration were analysed. Among the possible predictors considered watery diarrhoea, duration of illness of more than 3 days, high stooling rate, frequent vomiting, fever, early weaning and antecedent protein energy malnutrition (PEM) were found significant. An increase in severity of dehydration when diarrhoea occurred in association with systemic infections, most prominently in infancy, was documented. Use of these findings in the clinical management of patients and in health education of mothers and other care-takers is suggested. Reevaluation of these and other potential predictors by a carefully designed prospective study is proposed.
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PMID:Predictors of moderate to severe dehydration in acute diarrhoeal disease: a case-control study. 160 46


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