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

The diagnosis of traumatic injury of the gallbladder may only be discovered at the time of celiotomy. The patient initially may be asymptomatic; later, he may develop nausea, vomiting, or paralytic ileus. Hemoconcentration, leukocytosis, and biliurea all have been observed, but are inconstant findings. However, increasing abdominal distention without a change in hematocrit value, jaundice, dark urine, or acholic stools accompanied by a rising bilirubin level should aid in diagnosis. Although the treatment of traumatic rupture of the gallbladder may be altered to fit the clinical situation and degree of anatomic disruption, most authors agree that cholecystectomy is the method of choice.
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PMID:Rupture of the gallbladder after blunt abdominal trauma. 112 32

The clinical presentation, complications and sensitivity pattern was studied in 30 cases of enteric fever. Fever was the main presenting feature in all. Other associated predominant presenting feature were vomiting in 15 (50%), Loose motion 9 (30%), Cough 6 (20%), headache 4 (13.33%) and altered sensorium in 2 (6.66%). The various complications observed during hospital stay were myocarditis 5 (6.16%), Paralytic ileus 2 (6.66%), Pneumonia 1 (3.33%) and Joint effusion in 2 (6.66%) cases respectively. In laboratory parameters-mild elevation of blood urea and SGOT/SGPT were detected in 1st week, which returned to normal in 2-3 weeks time. In vitro sensitivity of organism isolated (24 cases) were as follow--Chloramphenicol 7 (29.16%), Ampicillin 8 (33.33%), Gentamicin 22 (91.66%), Amikacin 24 (100%), Cefotaxime 22 (91.66%), Ciprofloxacin 24 (100%), and Ofloxacin 24 (100%). Clinical response to Ofloxacin and Ciprofloxacin was 100%, and fever subsided in 3-5 days.
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PMID:Changing profile of enteric fever--in summer-91. 130 27

Fifty patients of grade III & IV malnutrition with diarrhoeal dehydration were rehydrated using the WHO recommended ORS. Serum sodium and potassium levels were estimated at admission and 24 hours later. Forty seven patients were successfully rehydrated orally. In 7 patients the level of dehydration at initial assessment was overestimated. Periorbital edema developed in 25.5% of the patients rehydrated. No patient had cardiac failure or convulsions during therapy. Though persistent hyponatremia and hypokalemia were found in 10.6% and 19.15% cases respectively after rehydration, the incidence decreased as compared to the pre-hydration levels and was comparable to that found in malnourished children without diarrhea who served as controls in the present study. Oral rehydration was discontinued in three patients due to development of excessive vomiting in one case and paralytic ileus in two. Thus WHO ORS can be used safely in children with severe malnutrition but constant monitoring is required.
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PMID:Oral rehydration therapy in severely malnourished children with diarrheal dehydration. 139 64

Hereditary tyrosinemia results from an inborn error in the final step of tyrosine metabolism. The disease is known to cause acute and chronic liver failure, renal Fanconi's syndrome, and hepatocellular carcinoma. Neurologic manifestations have been reported but not emphasized as a common problem. In this paper, we describe neurologic crises that occurred among children identified as having tyrosinemia on neonatal screening since 1970. Of the 48 children with tyrosinemia, 20 (42 percent) had neurologic crises that began at a mean age of one year and led to 104 hospital admissions. These abrupt episodes of peripheral neuropathy were characterized by severe pain with extensor hypertonia (in 75 percent), vomiting or paralytic ileus (69 percent), muscle weakness (29 percent), and self-mutilation (8 percent). Eight children required mechanical ventilation because of paralysis, and 14 of the 20 children have died. Between crises, most survivors regained normal function. We found no reliable biochemical marker for the crises (those we evaluated included blood levels of tyrosine, succinylacetone, and hepatic aminotransferases). Urinary excretion of delta-aminolevulinic acid, a neurotoxic intermediate of porphyrin biosynthesis, was elevated during crises but also during the asymptomatic periods. Electrophysiologic studies in seven patients and neuromuscular biopsies in three patients showed axonal degeneration and secondary demyelination. We conclude that episodes of acute, severe peripheral neuropathy are common in hereditary tyrosinemia and resemble the crises of the neuropathic porphyrias.
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PMID:Neurologic crises in hereditary tyrosinemia. 215 31

Elimination for the spinal cord-injured patient presents a challenge to nurses in both the acute and rehabilitation phases. The most frequent GI and urinary complications associated with spinal shock are gastric dilatation and paralytic ileus, stress ulcers, metabolic disturbances, and neurogenic bowel and bladder. Associated clinical findings are often altered or absent from the lack of sensory, motor, and reflex functions. Nonspecific signs and symptoms such as anorexia, nausea, and vomiting, create the need for complex differential diagnosis. Critical care nurses have a vital role in this diagnostic process by monitoring and reporting significant changes in assessment and laboratory findings. In addition, care measures are directed at preventing complications or supporting the patient's current condition. These interventions include gastric decompression, gastric pH monitoring, administration of antacids, nutritional support, and early bowel and bladder management.
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PMID:Elimination concerns with acute spinal cord trauma. Assessment and nursing interventions. 226 61

A total of 186 infants, suffering from acute diarrhea were studied and divided into two groups: 84 children were placed in group A and given the ORS recommended by the World Health Organization which contains sodium and glucose at concentrations of 60 and 90 mmol/L respectively and an osmolality of 311 mOsm/kg (mmol/kg) (ORS-90). Group B included 82 children who received an ORS containing sodium and glucose at concentrations of 60 and 90 mmol/L respectively and with an osmolality of 240 mOsm/kg (mmol/kg) (ORS-60). Seven belonging to group A (8.3%) required intravenous rehydration due to the severity of the diarrhea (three cases), persistent vomiting (three cases) and paralytic ileus (one case), while only two cases belonging to group B (2.5%) required intravenous rehydration due to severe losses through feces (one case) and another due to paralytic ileus (one case). No differences were observed due to the variations in sodium concentrations among either of the groups of patients, whether that be in the natremias when admitted or once rehydrated, with a general tendency towards the correction of the hypernatremia or hyponatremia seen during admittance with both types of ORS. A similar situation was observed with the variations in serum potassium. The results obtained from this study show the different advantages of using an ORS with lesser sodium and glucose concentrations as well as minor osmolality with those from using the solution recommended by the World Health Organization, when a lesser index of failures is observed in the treatment of children with acute diarrhea with oral rehydration therapy. Yet before widely recommending its' use, it should be demonstrated that the new ORS induces lesser losses through feces during the rehydrating period in children dehydrated due to acute diarrhea.
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PMID:[Comparative study of 2 oral rehydration solutions containing 60 or 90 mmol/L of sodium and with different osmolalities]. 227 Nov 25

Fifty-one patients with metastatic melanoma were treated with cisplatin, vinblastine, and bleomycin. Of the 50 evaluable patients, 11 (22%) achieved an objective response, including three complete (6%) and eight partial (16%) responses. Four of the 11 responding patients had previously received dacarbazine; the remaining patients had received no prior chemotherapy. Responses were noted in cutaneous and lymph node sites as well as visceral metastases. However, with one exception, all responding patients with visceral involvement had lung metastases. Response durations were brief and toxicity was substantial. Nadir leukocyte counts less than 0.5 X 10(9)/L occurred in 28% of the patients. Debilitating neurotoxicity, primarily paralytic ileus, and severe nausea and emesis were experienced by 24% of the patients. The combination of cisplatin, vinblastine, and bleomycin is not sufficiently beneficial to warrant its use in metastatic melanoma.
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PMID:Cisplatin, vinblastine, and bleomycin in the treatment of metastatic melanoma: a phase II study of the Southeastern Cancer Study Group. 241 Jan 20

A 12-year-old girl was admitted to our hospital with signs of an acute abdomen with paralytic ileus. The previous and family history were without abnormalities. Abdominal pain and vomiting had started two days earlier. On palpation the swollen abdomen was painful and there was an increased tension in the left upper part. The clinical diagnosis of acute pancreatitis was confirmed by an increased serum level of lipase (4480 U/l). Clinical chemical investigations further revealed a permanent hypercalcemia in the range of 6.4 to 8.3 mval/l. This, together with concomitantly reduced levels of serum phosphate and a threefold increased level of parathyroid hormone (343 pg/ml, upper limit of reference = 100 pg/ml) were consistent with a hyperparathyroidism. In fact, sonography of the cervical organs revealed a solitary adenoma of the parathyroid glands. After surgery serum levels of calcium returned to normal. Hypercalcemia as a consequence of primary hyperparathyroidism has to be included in the differential diagnosis of acute pancreatitis in childhood.
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PMID:[Acute pancreatitis as an initial manifestation of hypercalcemia in primary hyperparathyroidism in childhood]. 265 77

We describe a patient with systemic lupus erythematosus (SLE) and overlapping syndrome who had repeated gastrointestinal (GI) symptoms such as nausea, vomiting and malabsorption. With a subacute process, she developed paralytic ileus and contracted bladder, and died of perforation of the ileum. When 13 reported cases with lupus cystitis were reviewed, an extremely strong correlation between GI and urinary tract symptoms was observed, indicating the presence of a unique subgroup of SLE.
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PMID:Lupus cystitis and performation of the small bowel in a patient with systemic lupus erythematosus and overlapping syndrome. 268 79

Potassium is one of the most abundant ions in the human body and yet it is difficult to assess potassium balance. Potassium chloride is extensively used as a potassium supplement, both by physicians as a therapeutic modality and by the general public, mostly in the form of salt substitute. Therapeutically, both the oral and intravenous forms of potassium are utilised. Overdose of potassium is not as frequently encountered in clinical practice as hyperkalaemia (excess potassium in the body) due to acute or chronic renal disease. Potassium homeostasis is maintained very delicately and is governed by the daily consumption of potassium and the renal excretion mechanisms. Any change in these or related factors can present as hyperkalaemia. However, potassium overdoses leading to serious consequences do occur. Orally, the dose of potassium has to be large enough so that the normal excretory mechanisms for potassium are overcome and clinical toxicity occurs. It takes a much bigger dose of ingested potassium to produce toxicity in a person with normal renal function than in patients with compromised renal function. Potassium toxicity manifests in significant, characteristic, acute cardiovascular changes with ECG abnormalities. Besides cardiovascular effects, neuromuscular manifestations in the form of general muscular weakness and ascending paralysis occur. Gastrointestinal symptoms manifest as nausea, vomiting, paralytic ileus, and local mucosal necrosis which may lead to perforation. It is imperative when treating hyperkalaemia that the whole clinical picture is taken into account rather than the numerical potassium values. Only the extracellular potassium can be measured in the laboratory, yet 98% of the body potassium is intracellular and cannot be measured. In acute overdose situations due to ingestion of potassium salt, the general principles of treatment for overdoses should be followed. Calcium chloride infusion, dextrose and insulin in water, and correction of acidosis with sodium bicarbonate are helpful in controlling the acute, life-threatening cardiac arrhythmias. These modalities do not remove the excess potassium from the body. That is achieved either by utilising ion-exchange resins or by mechanically removing potassium via haemodialysis. To curtail inadvertent or accidental potassium overdoses, physicians should prescribe any potassium supplements very carefully to their patients and monitor the plasma potassium periodically.
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PMID:Clinical features and management of poisoning due to potassium chloride. 268 36


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