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Helminth and schistosome infections occur in the same geographical areas as does malnutrition. These parasitic infections can occur already in malnourished persons. Hookworm infections reduces food intake and/or increase nutrient wastage via vomiting, diarrhea, or blood loss. These effects exasperate protein energy malnutrition, anemia, and other nutrient deficiencies. Hookworm infection reduces the work capacity and productivity of children and adults; increases maternal and fetal morbidity, premature delivery, and low birth weight, as well as the susceptibility to other infections; and reduces the rate of cognitive development. These social and economic consequences in turn reduce the ability of people and families to raise crops or earn enough money to buy food and other essentials. As many as 90% of the children in some areas of the developed world are infected with roundworm. More than 100,000 deaths in 1987 resulted from complications of roundworm infection (e.g., intestinal obstruction). Roundworm infection reduces the body's ability to use protein and to absorb fat, which worsens protein energy malnutrition. Other nutrient effects of roundworm infection are exacerbation of vitamin A deficiency and lactose and milk intolerance. Whipworm infection can effect prolapse of the rectum and nutritional problems. Treatment of children with whipworm improves hematocrit, growth rates and anthropometry, and serum albumin, and reduces diarrhea and bacterial and protozoan infections in the bowel. Schistosomiasis causes nutritional effects similar to those of helminths. Studies in Kenya show that, in children, 1 treatment against worm, infections improves growth and fitness within 4 months. Other studies in Kenya show that treating children for worms or anemia improves weight gains per month at least as much as and usually more than school feeding programs, a more labor intensive, complicated, and expensive effort. Deworming programs should operate in areas where undernutrition exceeds 25% and worms are prevalent.
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PMID:Helminth parasites, a major factor in malnutrition. 801 83

We describe the excretion of Ascaris lumbicoides, an intestinal roundworm, in the emesis of an asymptomatic patient undergoing total body irradiation. This suggests that Ascaris is sensitive to irradiation.
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PMID:Excretion of Ascaris lumbricoides during total body irradiation. 801 76

The Philippines' Department of Health believes that up to 90% of children in the country could be prone to poor physical and mental development because the problem of intestinal worms has gone largely unchecked. A nationwide study conducted over 10 years by the Department of Education, Culture, and Sports found a prevalence of 50-90% in children aged 2-14 years. Up to 30% of the population of 22 million children may have 1 or more of the 3 most common types of soil transmitted helminths: roundworm, hookworm, and whipworm. Infection with such worms through ingestion, skin penetration, or both, often affects children's performance in school because it can stunt growth, decrease physical activity, and cause poor physical and mental development. The most common symptoms of worm infestation are pain, enlargement of the abdomen, loss of appetite and weight, vomiting, insomnia, and irregular respiration. Worms thrive in tropical climates and are endemic to many developing countries. Infestation, however, is easily dealt with; 1 dose of albendazole given once per year for 3 years is enough to eradicate worms in a child. A pilot project launched last year in 2 villages in Aurora province in northern Luzon has thus far yielded encouraging results.
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PMID:Intestinal worms impair child health in the Philippines. 991 19

Biliary ascariasis is common in certain geographical areas of the world. In India, it is common in the Kashmir valley and only stray cases have been reported from other parts of the country. Between January 1995 and May 1997, 14 patients with biliary ascariasis were seen at our centre, which is more than 1000 km from the Kashmir valley. The mean (+/- SD) age of the patients was 31.7 (+/- 6.1) years and all were females. None of them had been to a place known to be endemic for biliary ascariasis. Four patients presented with acute cholangitis, eight with acute abdominal pain and vomiting, and the remaining two were diagnosed incidentally during surgery for gallstone disease. Barring these two patients, ultrasound examination of the abdomen diagnosed the condition accurately. In 10 patients, a part of the worm was visible outside the papilla of Vater. The roundworm was caught in a Dormia basket and could be extracted in nine patients. In one patient the worm migrated inside the bile duct while it was being caught in a Dormia basket. In this and two other patients, in whom the worm had migrated completely inside the bile duct, worms were removed with the help of a Dormia basket after endoscopic sphincterotomy. There were no complications of endoscopic therapy. In the two patients in whom biliary ascariasis was detected during surgery, the worms were removed after choledocholithotomy. On a mean follow-up of 13.8 months, only one patient had a recurrence of biliary ascariasis. It is concluded that biliary ascariasis is not an uncommon disease and must be considered as a possibility in patients presenting with acute cholangitis and biliary pain even in a non-endemic area. Ultrasonography is an excellent diagnostic tool and endoscopic management is very effective and safe in the treatment of these patients.
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PMID:Clinical features and management of biliary ascariasis in a non-endemic area. 1062 77

An 11-month-old girl child presented with distension of abdomen, constipation, vomiting and fever. X-ray of the abdomen suggested intestinal obstruction. Exploration revealed the distal ileum to be kinked around a band running from the tip of a congested Meckel's diverticulum to the lateral pelvic wall. A small perforation was noticed at the tip of the diverticulum and a live roundworm was found lying free in the peritoneal cavity. The diverticulum along with a segment of adjoining bowel was resected and end-to-end anastomosis done. The diverticulum had a wide lumen and showed no heterotopic tissue on subsequent examination.
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PMID:Perforation of Meckel's diverticulum by roundworm. 1577 23

Although knowledge of intestinal parasites predates Hippocrates, the Hippocratic Corpus provides the first scientific observations about the clinical perception and treatment of helminthic diseases. These observations follow the scientific principles of Hippocrates, the father of modern medicine, who relied on knowledge and observation. This article is based on a systematic study of the Hippocratic texts, and presents observations on diseases caused by intestinal parasites with respect to regularity of appearance, patient age, symptoms, and treatment. Three types of helminths are described: "helmins strongyle" (roundworm), "helmins plateia" (flatworm), and "ascaris" (which corresponds to Enterobius vermicularis). Helminthic diseases primarily appear during childhood, well after teething. The described systemic symptoms include weakness, sickness, discomfort, tiredness, anorexia, and emotional instability; gastrointestinal symptoms include change in bowel movements, vomiting, and colic pain in the epigastrium. We identified several accounts of cases of helminthic diseases in the Hippocratic texts. Of particular interest are the descriptions of a helminth emerging from a fistula in the navel region and the surgical treatment of helminthic diseases, reinforced by being described on a dedicatory inscription at the Asclepion in Epidaurus. We finally encountered the use of powerful purgatives as antihelminthics, which have been widely used, even into the 21st century.
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PMID:From the roots of parasitology: Hippocrates' first scientific observations in helminthology. 1791 92

Strongyloides stercoralis (S. stercoralis) is a soil transmitted intestinal roundworm that has a unique ability to multiply within the human host and reinfect the human carrier by a process of autoinfection. By this property, S. stercoralis can persist as an occult infection for many decades. In situations of immunosuppression or other permissive gastrointestinal conditions, there occurs a massive increase in parasite multiplication. The parasites penetrate through the intestinal mucosa and are carried in circulation and can cause multisystem involvement. We report a case of a 76-year-old Columbian male who presented with intractable vomiting and hyponatremia who was then diagnosed to have syndrome of inappropriate antidiuretic hormone (SIADH). The patient's symptoms improved after treatment with two doses of ivermectin and his serum sodium levels returned to normal. S. stercoralis infection should be suspected in patients from endemic regions who present with gastrointestinal symptoms and unexplained hyponatremia.
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PMID:Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) in Strongyloides stercoralis Hyperinfection. 2474 Dec 27

On January 15, 2017, a hospital physician notified the Alameda County Public Health Department (ACPHD) in California of a patient with a suspected diagnosis of trichinellosis, a roundworm disease transmitted by the consumption of raw or undercooked meat containing Trichinella spp. larvae (1). A family member of the initial patient reported that at least three other friends and family members had been evaluated at area hospitals for fever, myalgia, abdominal pain, diarrhea, and vomiting. The patients had attended a celebration on December 28, 2016, at which several pork dishes were served, including larb, a traditional Laotian raw pork dish, leading the hospital physician to suspect a diagnosis of trichinellosis. Although the event hosts did not know the exact number of attendees, ACPHD identified 29 persons who attended the event and seven persons who did not attend the event, but consumed pork taken home from the event by attendees. The event hosts reported that the meat had come from a domesticated wild boar raised and slaughtered on their private family farm in northern California. ACPHD conducted a case investigation that included identification of additional cases, testing of leftover raw meat, and a retrospective cohort study to identify risk factors for infection.
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PMID:Trichinellosis Outbreak Linked to Consumption of Privately Raised Raw Boar Meat - California, 2017. 2949 70