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)

Common and uncommon diseases whose symptom picture includes signs that may lead to an incorrect diagnosis are examined. Questions of this kind are obviously important in both medicine and emergency surgery, since incorrect diagnosis may involve either delay in the commencement of suitable treatment or the taking of what may even be dangerous therapeutic measures. Instances of heart and lung disease frequetly marked by abdominal symptomatologies are presented: bronchopulmonitis of various aetiologies, myocardial infarct, rhythm disturbances. In addition to the more atypical signs, such as epigastric pain in infarct and right hypochondriac pain in right basal bronchopulmonitis, manifestations such as vomiting, diarrhoea, diffuse abdominal pains and intestinal occlusion must be borne in mnd in establishing the correct diagnosis.
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PMID:[Thoracic diseases with predominant abdominal symptomatology]. 95 Oct 41

In 70 patients (maxillo-facial-, neurosurgical-, abdominal- and gynaecological operations) the technique of "analgetic anaesthesia" using high doses of fentanyl (0.025 mg/kg body weight) and naloxone as its antagonist (0.02 mg/kg body weight) has been employed. All patients were artificially ventilated with N2O/O2 in a 3:1 ratio. Muscle relaxation was achieved with pancuronium-bromide (0.08 mg/kg). The patients had no apparent heart or lung disease. The youngest patient was 4 years of age, the oldest 82 years of age (average age 48.9). The necessity for a reinjection of fentanyl (half the initial dose) was determined by continously monitoring heart rate. This variable appeared to be the most subtle index indicating a reduction in analgesia. Sufficient analgesia was maintained once the heart rate stayed 20% below preanaesthetic levels. At the end of the operation naloxone reversed the respiratory depression. There was no evidence indicating postoperative pain, which may have required administration of additional analgesics. If deep analgesia was maintained up to the last surgical procedures no emesis appeared in the post operative period. The incidence of emesis was higher 10% compared to the classical neuroleptanalgesia with droperidol this was often noted in cases where blood accumulated in the stomach (maxillo-facial operations) (70%). In 3% of all cases psychomotor agitation with delirium appeared right after the injection of naloxone. This lasted for about 15 minutes. We suspect that due to the sudden and powerful effect of naxolone, in replacing fentanyl from its receptor site, acute withdrawal symptoms may be precipitated.
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PMID:[High doses of fentanyl as the sole anaesthetic agent and naloxone as its antagonist (author's transl)]. 113 60

Fundoplication with gastrostomy has become a frequent treatment for patients with familial dysautonomia, so we evaluated the use of both procedures in 65 patients. Although patients differed widely in presenting signs and age, from 5 weeks to 40 years, gastroesophageal reflux was documented in 95% of patients by cineradiography or pH monitoring. Panendoscopy was a useful adjunct. Preoperative symptoms of gastroesophageal reflux included vomiting, respiratory infections, and exaggerated autonomic dysfunction. Severe oropharyngeal incoordination frequently coexisted and resulted in misdirected swallows with aspiration, dependence on gavage feedings, or poor weight gain and dehydration. Follow-up after surgical correction ranged from 3 months to 11 years; 55 patients (85%) were available for a 1-year postoperative assessment. We had no instances of surgical death. The long-term mortality rate was 14%, primarily related to severe preexisting respiratory disease. Beyond the first postoperative year, 30 patients had pneumonia attributed to continued aspiration, exacerbation of preexisting lung disease, or recurrence of gastroesophageal reflux. Of 11 patients who vomited postoperatively, six had recurrence of reflux. Recurrence of gastroesophageal reflux was documented in eight patients (12%), and we revised the fundoplication in three patients. The number of patients with cyclic crises was reduced from 18 to 7; retching replaced overt vomiting in all but two of these seven patients, neither of whom had recurrence of reflux. Because oropharyngeal incoordination was prominent, concomitant use of gastrostomy and an antireflux procedure was especially effective in the treatment of younger patients with familial dysautonomia, before the development of severe respiratory disease. Despite the development of severe morning nausea in 15 patients, the combination procedure resulted in significantly improved nutritional status, decreased vomiting, and decreased respiratory problems. Appropriate use of gastrostomy feedings also contributed to success of the operation. The generally good outcome of fundoplication with gastrostomy confirms the benefit of this procedure in familial dysautonomia.
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PMID:Fundoplication and gastrostomy in familial dysautonomia. 199 77

Methylglyoxal bis-guanylhydrazone (MGBG), a potent inhibitor of polyamine synthesis, has demonstrated single agent activity against a number of tumor types including malignant lymphomas and head and neck, esophageal and non-small cell lung cancers. The growth of small cell lung cancer (SCLC) cell lines can be arrested by polyamine inhibition. Therefore a phase II trial was conducted in twenty-four patients with refractory SCLC. MGBG was administered by intravenous infusion at a dose of 500 mg/m2 per week for four cycles and then every two weeks thereafter. The dose was escalated by 100 mg/m2 every two weeks in the absence of toxicity greater than or equal to grade 2. One patient achieved a partial response of objectively measurable lung disease and supraclavicular adenopathy. Three patients had stable disease. Dose limiting toxicity consisted primarily of mild to moderate nausea, vomiting, stomatitis and/or diarrhea. Myelosuppression was uncommon and rarely dose limiting. We conclude that MGBG in the dose and schedule used does not have significant activity as a single agent in previously treated small cell lung cancer.
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PMID:Phase II trial of methylglyoxal bis-guanylhydrazone (MGBG) in refractory small cell lung cancer. 216 8

Nitulamide (ANANDRON (R] is an antiandrogen used as an adjuvant therapy in the treatment of advanced prostatic cancer. The effects of ingestion of high doses of nitulamide has not been so far reported. A 79 years old man was admitted 2 hours after the ingestion of 13 g of nitulamide (170 mg/kg or 43 times the therapeutic dose), in a suicide attempt. He was receiving nitulamide 300 mg/day for two weeks. On admission, he underwent immediately gastric lavage, followed by administration of oral activated charcoal and received an intravenous infusion of glucose in balanced salt solution. During the first 12 hours, the patient presented with moderate vomiting and diarrhoea. There was no change in the following parameters: blood cell count, plasma electrolytes, serum transaminases and serum bilirubin, arterial blood gases, plasma cortisol value, as compared to the pre-treatment values. Chest X ray was unchanged. Plasma concentrations were measured 2 hours, 3 hours, 12 hours, 24 hours, 48 hours and 72 hours after ingestion. The initial level reached 6 times the normal therapeutic range, then fell to 3.5 times at the 72th hour. The patient recovered rapidly and was discharged on the 4th day. Biologic parameters were controlled on 4th, 9th, 30th day and remained unchanged. Treatment was started again on the 30th day with nitulamide 150 mg/day. We did not notice any side effect previously described in daily administration of nitulamide: anemia, rise in serum transaminases, interstitial pneumopathy.
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PMID:[Absence of clinical and biological manifestations after massive absorption of nitulamide]. 281 Jan 41

A previously healthy 50-year old man presented with acute small bowel obstruction. No etiology was found at laparotomy. Postoperatively, the patient remained symptomatic with nausea, vomiting and severe constipation. Gastroscopy revealed retained food in the stomach. Gastric emptying of solids and liquids was dramatically decreased at scintigraphy. The colon was dilated on X-ray study. Chest X-ray revealed a pneumopathy and a small-cell lung cancer was discovered at bronchoscopy. The patient died 5 months after onset. Histologic study of the gut showed widespread degeneration of the myenteric plexus with plasma cell infiltration, Schwann cell proliferation and a reduced number of neurons of which many were abnormal. Intestinal pseudo-obstruction can reveal a small-cell lung cancer; the mechanism of neuronal impairment leading to pseudo-obstruction remains unknown, but could be related to the pathophysiology of paraneoplastic syndromes.
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PMID:Paraneoplastic intestinal pseudo-obstruction as the presenting feature of small-cell lung cancer. 283 68

To exploit possible different non-cross-resistant mechanisms of cytotoxicity, 25 patients with advanced breast cancer were given combination chemotherapy consisting of iv mitoxantrone (7 mg/m2) and doxorubicin (30 mg/m2) every 3-4 weeks. The patients had predominantly visceral disease and received a median of six (range, one to 12) cycles of therapy. There were no complete responders, but 13 patients (52%) achieved partial remission lasting a median of 8 months (range, 4-21+). Three patients (12%) had disease stabilization and nine (36%) had disease progression. Hematologic toxicity was generally mild, with median wbc count and platelet count nadirs of 1900/mm3 (range, 700-3100) and 160,000/mm3 (range, 49,000-406,000), respectively. One patient may have died from treatment-related sepsis (pneumonia), but lymphangitic lung disease was not excluded. Hair loss progressing to severe alopecia over several treatment cycles was relatively common, affecting seven of 16 evaluable patients (44%). Vomiting was mild or absent in 17 (71%) of 24 evaluable patients. Three of 15 patients in whom serial measurements of left ventricular ejection fraction were performed developed significant reductions compatible with anthracycline-induced cardiotoxicity. Two of these patients also had pericardial effusions and one developed congestive heart failure. In conclusion, mitoxantrone and doxorubicin is an active, well-tolerated drug combination for the treatment of advanced breast cancer but may have appreciable cardiotoxicity.
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PMID:Phase II trial of a combination of doxorubicin and mitoxantrone in metastatic breast cancer. 330 79

Gastric emphysema is a rare condition in which gas from a nonbacterial source accumulates within the wall of the stomach. Gastric distension and vomiting frequently precede the formation of the intramural air. Pulmonary disease, instrumentation of the stomach, and obstructing lesions of the antrum and pylorus are also common contributing factors. A case report and an extensive review of the literature are presented.
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PMID:Gastric emphysema. 650 13

We treated 13 elderly patients with chronic mycobacterial lung disease with clarithromycin using 1000 mg b.i.d. as monotherapy. Patients had a mean age of 70 years, and 12 of 13 had creatinine clearances of 31-71 ml/min. Adverse events were seen in 100% of patients, with the most common being bitter taste (92%), nausea (92%), vomiting (54%) and central nervous system symptoms (54%). Elevated liver enzymes developed in five (38%) of 13 patients at weeks 1-6 of therapy. Mean serum levels of clarithromycin plus its 14-OH metabolite were 12.9 +/- 3.6 micrograms/ml (SD). There were 11 patients (85%) who discontinued the high dose within 3 months because of side effects. Serum drug levels of clarithromycin plus its 14-OH metabolite consistently exceeded 12 micrograms/ml in six of six patients who discontinued drug (10 of 10 values) compared with neither of two patients who tolerated the high dose (0 of 6 values). A dose reduction to 500 mg b.i.d. was well tolerated (nine of 10 patients). Future trials with clarithromycin in this population should use lower doses with attention to body mass and renal function to minimize side effects.
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PMID:Drug intolerance to high-dose clarithromycin among elderly patients. 847 75

The role of rapidly growing mycobacteria (RGM) as pulmonary pathogens has been unclear. We identified 154 cases of lung disease caused by RGM using the microbiologic and radiographic criteria of the American Thoracic Society (ATS) and availability of the causative organism for study. More than one third of patients had positive lung biopsy cultures. Patients were predominantly white (83%), female (65%) nonsmokers (66%), and they had prolonged periods from onset of symptoms to diagnosis of their disease. Cough was an almost universal presenting symptom, whereas constitutional symptoms became more important with progression of disease. Upper lobe infiltrates were most common (88%), with 77% of patients developing bilateral disease. Cavitation was present in only 16% of the patients. Specific underlying diseases were infrequent, but they included previously treated mycobacterial disease (18%), coexistent Mycobacterium avium complex (8%), cystic fibrosis (6%), and gastroesophageal disorders with chronic vomiting (6%). The majority of isolates (82%) were M. abscessus (formerly M. chelonae subsp. abscessus). Effective treatment for M. fortuitum long disease was accomplished with drug therapy, whereas surgical resection of localized disease was the only effective long-term therapy for M. abscessus. Although the disease was generally slowly progressive, 21 of 154 (14%) patients died as a consequence of progressive RGM lung disease and respiratory failure. RGM should be recognized as a cause of chronic mycobacterial lung disease, and respiratory isolates should be assessed carefully.
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PMID:Clinical features of pulmonary disease caused by rapidly growing mycobacteria. An analysis of 154 patients. 848 42


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