Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
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Prostaglandin (PG) gels were used to induce second-trimester abortion in 141 women aged 16-44 years, 1973-1976. PGE2 gel was used alone for 65 women, and in combination with oxytocin for 25 women; PGF2-alpha was used alone for 15, and combined with oxytocin for 36. Indications were: medical (5 cases), psychosocial (97 cases), and missed abortion or fetal death in utero (39 cases). The gel was administered extra-amniotically via catheter; abortion occurred within 36 hours in 136 cases. Mean administration abortion interval varied from 9 hours 52 minutes to 16 hours 17 minutes. A dose-response relationship was noted between the prostaglandin dose and the interval to abortion. Side effects included vomiting (29 cases), diarrhea (2 cases), fever (9 cases), hemorrhage (14 cases), endometritis (2 cases), and circulatory symptoms (2 cases) and torn cervix (1 case). No signficant differences between primigravidae and others were observed.
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PMID:[Therapeutic abortions in the second trimestre of pregnancy with prostaglandine gel (author's transl)]. 64 Mar 66

The authors have studied the influence of mechanical and hormonal contraceptives on the organism of women, more specifically on their menstrual and child-bearing function. The studied women were divided into 2 groups: in the 1st group were 1532 women wearing intrauterine devices and 200 women examined in the remote period. The 2nd group consisted of 218 women using Infecundin for contraceptive purposes. The length of the observation period varied from 1 to 7 years. All women observed were healthy and of reproductive age. They were between 20 and 45 years of age. They all had a 2-phase menstrual cycle until they started to use a contraceptive. The women wearing IUD's had been using them for 6 months to 5 years. 93.4% did not show any sign of complication; 7.9% were experiencing various complications such as menstrual disorders, acute inflammations of the sexual organs; 38 women became pregnant; there was one case of spontaneous abortion; and 2 cases of extra-uterine pregnancy. 23 pregnancies went to term normally and 12 cases necessitated an induced abortion. The women from the 2nd group had been taking Infecundin for 3 months, 6 months, 12 months and over 1 year. 17 of these women were complaining of side effects such as nausea, vomiting, cardiac pain, swelling of the mammary glands, weight gain, headaches and hepatic disorders. Some histological examinations of the endometrium showed signs of endometritis. 10 women discontinued the use of Infecundin. On the whole, hormonal and mechanical contraceptives are of satisfying efficiency. They do not appear to provoke any significant complications in the menstrual and child-bearing functions of the woman. However the use of oral contraceptives tends to provoke a pronounced atrophy of the mucous membrane in the uterus. Therefore it is advisable to prescribe oral contraceptives in cycles separated by 2 to 3 month interruptions.
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PMID:[Menstrual and child-bearing functions of women using mechanical and hormonal contraceptives]. 99 12

Clinical trials in Europe have found that a single oral dose of RU-486, followed by prostaglandin administration, effectively and safely terminates early pregnancy in about 95% of women. In a multicenter study carried out in France, 1 600-mg dose of RU-486, followed 36-48 hours later by intramuscular sulprostone or intravaginal gemeprost, induced complete abortion in 96% of 2000 women with up to 49 days of amenorrhea. In a British multicenter study, the combination of RU-486 and intravaginal gemeprost induced abortion in 95% of 600 women with up to 63 days of amenorrhea. RU-486 is not effective in aborting ectopic pregnancies. Bleeding usually starts 1-2 days after treatment and lasts for 1-2 weeks. About 1% of patients have required curettage since the amount of blood loss exceeds that in a normal menstrual period. The other side effects recorded with any frequency--abdominal cramping, nausea, vomiting, diarrhea, and headache--are all transitory and mild. Only 1 case of myocardial infarction has been reported in the more than 20,000 RU-486 acceptors studied. Endometritis and salpingitis are extremely rare complications. There have been no maternal deaths, and no fetal abnormalities have been observed in women who took RU-486 alone early in pregnancy and failed to abort.
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PMID:Mifepristone (RU 486). 224 20

The term "pregnancy interception" covers all fertility control methods that interfere with implantation of the fertilized egg, either by inhibiting its transport or implantation or by eliminating the already implanted blastocyst. A few researchers beginning in 1960 used high doses of estrogen in the immediate postovulatory period to prevent implantation. It was discovered that administration had to occur soon after coitus to be effective. Estrogens were administered orally for 5 days beginning in the 72 hours following unprotected intercourse in the ovulatory phase. Secondary effects were common: vomiting in 40% of cases, menometrorrhagia in 30%, and almost constant breast discomfort. About 10% of pregnancies in case of failure of the method were ectopic. The mechanism of action is still not understood. A combined treatment of 50 mcg ethinyl estradiol and a 19-norsteroid progestin has been used since 1975. It must be administered in the 48 hours following coitus and repeated 12 hours later. The duration of treatment and quantity of hormones are significantly reduced, but the secondary effects are similar to those of estrogens used alone, and the failure rate is 2%. Some progestins can also be used alone. IUD insertion up to 7 days after the unprotected intercourse has a contragestive effect, but the risk of infection is considerable and 3% of patients develop endometritis. The risk of secondary sterility discourages use of the method, especially in nulliparas. The prostaglandins E and F are effective in early pregnancy termination, but their side effects considerably limit their use. The average duration of bleeding is acceptable, but prostaglandins cause very painful uterine contractions in 30-40% of cases. Gastrointestinal secondary effects often require termination of treatment. The recent synthesis and use of the antiprogesterone compound RU-486 offers real promise for a widely usable contragestive method. Progesterone is indispensable for the continuation of pregnancy, and inhibiting its action on the endometrium interrupts pregnancy. An antiprogesterone acts by competing directly with progesterone at the target cells. The antiprogesterone RU-486 also has dose-dependent luteolytic and antigonadotropic effects whose mechanisms are not completely understood. Clinical trials have proven the innocuity of RU-486, and its efficacy of about 90% will undoubtedly be improved. Interruption of early pregnancy is a major indication for RU-486. The duration of the pregnancy appears to be the determining factor in the percentage of success, but most researchers have had failure rates of 15% even in pregnancies of less than 5 weeks. Possible heavy bleeding or failure in case of ectopic pregnancy indicate the need for medical surveillance. A different route of administration and combination with a small dose of prostaglandin would undoubtedly raise the success rate. RU-486 may have more promise as a post-coital agent, and may potentially be the basis for development of a once-a-month pill.
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PMID:[Contragestion]. 365 95

Characteristic features of expert evaluation of temporary disability during pregnancy and after abortion and labor adopted in the USSR are outlined. At the earliest stages of pregnancy, women should be assigned to the work not associated with potential exposure to hazardous factors. Women with pregnancy complications should undergo comprehensive examination, preferably in a hospital setting: average length of stay is 20 days for threatened abortion, 21 days for premature labor (28-37-week pregnancy), 16 days for hypertension, 14 days for vomiting or nephropathy, 17 days for anemia, and 14 days for Rhesus-incompatibility. After abortion on demand or abortion for medical indications, a woman should be given a sick leave. The length of sick leave depends upon the pregnancy term (56 days for pregnancy longer than 28 weeks). Women with normal pregnancy and labor can receive a leave for 112 calendar days (56 days during the prelabor period and 56 days for the postpartum period). In the case of labor complications or multiple pregnancy, duration of the postpartum leave should be increased to 70 days. Indications for a 70-day postpartum leave include preeclampsia or eclampsia; cesarean section or vacuum-extraction; profuse hemorrhage during labor requiring blood transfusions; tears of the cervix uteri; postpartum endometritis, thrombophlebitis, septicemia, and suppurative mastitis; history of heart valve disease or congenital heart defects; and premature labor.
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PMID:[Expert evaluation of temporary disability with regard to pregnancy, abortion and labor]. 368 64

The use of intraamniotic injection of hypertonic solutions for termination of pregnancy during the second trimester has been generally adopted. Because of side effects in such treatment with other agents, it was decided to use intraamniotic instillation of urea solution (Urevert) to induce midtrimester therapeutic abortion in 38 patients. The method was successful in 35 patients (92%) with a mean injection/abortion interval of 26.1 hours, shorter than that with the use of hypertonic saline or hypertonic glucose solutions. The side effects of headache, nausea, and vomiting were mild, and an endometritis in 1 patient responded well to antibiotic treatment. Intravenous oxytocin drip was necessary in patients with hypotonic contractions or in those who failed to react within 36 hours after injection. In 3 cases of missed labor, the urea solution injected induced labor within 5-8 hours, with no side effects. The mean in-patient hospital time was 4.3 days.
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PMID:Termination of midtrimester pregnancy by intramniotic injection of urea. 482 62

In the early 1970s the effort was begun to examine the clinical benefits of "menstrual induction" (MI) at 6 weeks pregnancy (last menstrual period), in the belief that if pregnancy is to be terminated there was no sound medical nor psychological reason to delay the procedure. It was found that the transcervical, intrauterine delivery of a "PG-impact" compromised the conceptus and terminated pregnancy in 95% of the cases, with clinical symptoms of menstruation rather than abortion. The side-effects were acceptable; the prematurity rate did not increase in subsequent pregnancies. Yet, the need for strict asepsis limited the use of this otherwise simple and effective procedure. Recently, this limitation has been overcome by the development of the PGE2 analogue 16-phenoxy-w17,18,19,20 tetranor-PGE2-methyl sulfanylamide ('Sulproston'). Clinical trials have been done in terms of dealing with the questions of efficacy, acceptability, and preference. 90 volunteers have been studied. At 14 days follow-up the success rate (negative pregnancy test) was 96%. The side effects were acceptable -- vomiting 26%, diarrhea 10%, and endometritis 2%. Of the 42 patients interviewed, 90% were satisfied with the procedure. Of those who had previously experienced surgical interruption, 89% preferred this pharmacological method.
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PMID:Menstrual induction in preference to abortion. 610 32

Vaginal suppositories containing (15S)-15-methyl prostaglandin F2 alpha methyl ester were administered to 40 subjects, in an attempt to induce an early abortion. All subjects were 49 days or less from their last menstrual period. Ten subjects received a 3-mg suppository followed in 3 hours by a 1 mg suppository, ten subjects received the 1-mg suppository followed in 3 hours by a 3-mg suppository, and twenty subjects received the 3-mg suppository followed in 1 hour by the 1-mg suppository. Twenty-four subjects (60%) had a successful termination of their pregnancy using the two vaginal prostaglandin suppository regimen. All subjects who aborted had 10 percent or less of their pretreatment levels of beta-hCG 7 to 22 days after therapy. Sixteen subjects (40%) did not abort. One of the subjects who failed treatment refused the second suppository due to gastrointestinal side effects and uterine cramping following the insertion of the 1-mg suppository. A second subject had an incomplete abortion and developed mild endometritis. Sixteen subjects reported side effects which included nausea, emesis, diarrhea, uterine cramping requiring analgesia, restlessness, shakiness, and dizziness. The addition of the second vaginal suppository containing this particular prostaglandin analogue did not significantly increase the overall abortifacient activity of this method.
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PMID:Termination of early gestation with (15S)-15-methyl prostaglandin F2 alpha methyl ester vaginal suppositories. 617 57

Abdominal pain and fever after an uncomplicated elective abortion usually point to incomplete abortion and endometritis. We treated a woman for acute suppurative appendicitis one week after such an abortion. When fever, nausea, vomiting and pain are not relieved by the standard doses of medication, acute appendicitis must be added to the usual gynecologic differential diagnoses.
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PMID:Ruptured appendix after elective abortion. A case report. 622 52

Antibiotic use was evaluated retrospectively in 1229 patients of a university hospital (Basle, Switzerland). The frequency with which antibiotics were prescribed, the indication, duration of treatment, side-effects and clinical results were compared in relation to various subspecialities. 38.1% of medical, 36.4% of surgical and 24.4% of gynecological patients received one or more antibiotic during hospitalization. The main indications for antibiotic treatment were respiratory infection (57.8%) and urinary tract infections (21%) in medical patients, prophylaxis (38%) and urinary tract infections (23%) in surgery, and urinary tract infections (43%) and adnexitis or endometritis (23%) in gynecology. Amoxycillin or penicillin G were the first-line drugs for respiratory infection, cotrimoxazole for urinary tract infection and cefalothin or cefacetrile for surgical prophylaxis. Patients with endometritis or adnexitis usually received clindamycin in combination with an aminopenicillin. Aminoglycosides were employed in only 9.5% of antibiotic courses. Information on adverse reactions in the records was scanty, only generalized exanthem (13 cases) and nausea/vomiting (2 cases) being specifically mentioned. The therapeutic result was classified by the responsible physician as cure in 50.8% or definite improvement in 16.4% of patients. However, in 118 cases (29.7%) the contribution of antibiotics to the clinical outcome could not be evaluated retrospectively.
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PMID:[Use of antibiotics in hospitalized patients. Comparison of medical, surgical and gynecological units]. 720 74


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