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)

89 preschool children, 2-4 years old, treated under the diagnosis of appendicitis were analyzed. 46 of them were operated. In 39% of those children the diagnosis of an acute nonperforated appendicitis could have been ensured, in 39% the diagnosis of a perforated appendicitis was found, in 22% the was found, in 22% the laparotomy was negative. In cases of an acute perforated appendicitis typical symptoms were vomiting (100%), general stomach-ache (89%) and fever (61%). In most cases of an perforated appendicitis the state of patients was reduced drastically (80%), in 50% an ileus could be observed. Half a children with an acute nonperforated appendicitis as well as an perforated appendicitis had got a respiratory disease additionally. This fact was the main reason for the to late diagnosis particularly in the age up to 3. In all cases being not sure a consequent control at a ward is necessary; an important fact for this recommendation is the shortness of the acute perforated appendicitis in early childhood.
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PMID:[The diagnosis of appendicitis in childhood]. 175 6

Alkaline gastroesophageal reflux is a rare disorder, although it has been suggested as a cause of esophagitis. However, up to now, there exists no unequivocally accepted diagnostic method for alkaline reflux that can be routinely applied. "Normal ranges" of episodes of pH greater than 7.0-7.5 in asymptomatic as well as in symptomatic infants are proposed. In the asymptomatic infants (n = 83), the mean percentage of time the pH was greater than 7.0 was 1.3 +/- 2.6, and the number of episodes in 24 h with a pH greater than 7.0 was 10.4 +/- 16.4. In the symptomatic group (n = 60), including infants with chronic vomiting, the mean percentage of time the pH was greater than 7.0 was 0.15 +/- 0.5, and the number of episodes with a pH greater than 7.0 was 2.8 +/- 5.5. In all but six infants the percentage of time the pH was greater than 7.5 was less than 0.1. In three of four of these infants (endoscopy was refused by two parents) whose conditions exceeded the cut-off limits, there was a histologically proven esophagitis. To evaluate the proposed "normal" ranges for episodes of pH greater than 7.0 and 7.5, 200 symptomatic children were included in a prospective study. Symptoms were repetitive vomiting (n = 110), excessive crying (n = 53), and chronic respiratory disease (n = 37). Esophagoscopy was performed in 18 babies (9%) because pH monitoring data exceeded the proposed limits for the percentage of time the pH was greater than 7.0.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Alkaline gastroesophageal reflux in infancy. 186 77

Sixty-three infants, aged from 1 to 4 months, were examined for gastroesophageal reflux (GER) using esophageal pH monitoring. Thirty were examined because of chronic vomiting, 21 were healthy controls examined for GER as part of a screening program for sudden infant death syndrome, and 12 had an acute respiratory disease (RD). The 24-h pH monitoring data were within normal ranges in 26 infants (20 controls, 2 babies with emesis, and 4 with RD). Data were abnormal in 37 infants (1 control, 28 infants with emesis, and 8 with RD). All babies were submitted during a fasting awake period to a 30-min chest physiotherapy session. In the three groups studied, the incidence of GER episodes detected by the pH probe was significantly higher during physiotherapy if compared (a) to the calculated mean incidence during a 30-min period of the 24-h investigation or (b) to the incidence during a fasting awake period such as that during which the physiotherapy was given (p less than 0.001; Wilcoxon rank-sum test). We conclude that chest physiotherapy significantly increases GER incidence. We therefore propose restricting chest physiotherapy to fasting periods. These data add to the confusion that already exists regarding the possible causal relationship between (acid) GER and respiratory disease.
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PMID:Esophageal pH monitoring data during chest physiotherapy. 191 48

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

A questionnaire study was conducted to assess the prevalence and severity of symptoms suggestive of esophageal disorders in a general population. The study included 407 randomly selected subjects, evenly distributed in terms of sex and age, within the age span of 20-79 years. A total of 337 subjects replied (85%). Symptoms suggestive of gastroesophageal reflux were found among 25% of the participants. Cough on swallowing was common (27%), as was globus (16%) and chest pain (13%). In addition, dysphagia was reported by 10% and vomiting by 9%. The symptoms were usually mild, and moderate to severe symptoms were reported only occasionally (1-4%). No statistical correlation was found between esophageal symptoms and age, sex, or the reported consumption of tobacco, alcohol, or non-steroidal anti-inflammatory drugs. The frequency of heartburn and/or acid regurgitation was twice as common among those with symptoms of respiratory disease as among those with no respiratory complaints. A stepwise logistic regression analysis showed that a chronic cough and/or breathing difficulties were significantly related to the presence of symptoms suggestive of gastroesophageal reflux.
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PMID:The prevalence of symptoms suggestive of esophageal disorders. 200 1

Esophageal pH monitoring is recognized as the best diagnostic procedure for gastroesophageal reflux (GER) and operation is seldom recommended in the absence of abnormal pH data. To emphasize that operation should not be ruled out for children who may have false-negative pH studies, we report 14 patients operated on for GER in spite of normal pH-monitoring. The mean age was 54 months (range, 18 to 90). Clinical features included vomiting, dysphagia, respiratory disease, anemia, and torticollis. All had radiologic evidence of GER, and 10 had endoscopic and histological esophagitis. Conventional pH-monitoring values were normal but lower esophageal sphincter pressure and propulsive peristalsis were significantly decreased whereas nonpropulsive contractions were predominant. Operation was recommended after an average of 24 months of unsuccessful medical treatment. Independent postoperative assessment showed that 13 of the 14 patients were relieved of their symptoms and dysphagia persists in one. We suggest that the diagnosis of GER should be accepted on the basis of sound clinical judgement plus more than one abnormal test even when pH results are normal. Operation should not be withheld when clinically indicated. There are several explanations for false-negative pH studies, of which alkaline reflux is probably the most important and warrants further investigation in children.
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PMID:Surgery for gastroesophageal reflux in children with normal pH studies. 206 6

Extended esophageal pH-metering is the best method for GER diagnosis, but it has a certain number of false negatives. In a attempt to judge in which extent we can indicate surgery with a "normal" pH-metering study, we have reviewed our 110 operated children since 1982, and selected 12 in whom pH studies were normal. There where five females and seven males with ages ranging between 18 and 90 months. The clinical course until the diagnosis was accepted was long. Nine patients had vomiting, five respiratory disease, six dysphagia, four anemia and three torticollis. Only two were malnourished. There was radiologic GER in all children (with only one hiatal hernia). In spite of "normal" pH-metering, eight had decreased lower esophageal sphincter, and 11 disturbed motility. Nine had endoscopic esophagitis and eight histologic esophagitis. After operation, indicated only after long periods of medical treatment, vomiting disappeared in all, and so did respiratory disease and torticollis. Five families were very satisfied, six rather satisfied (gas bloat syndrome) and one frankly dissatisfied (dysphagia with severe immotility). Based on this evidence, we believe that some limited indications for surgery in GER are acceptable even in the presence of "normal" pH-studies.
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PMID:[False negatives in pH measurement. A retrospective study of 12 surgical cases]. 207 69

This is a report on 912 patients treated during 1973 to 1979 for pulmonary tuberculosis and/or extrapulmonary organ involvement. These patients had been treated with a fixed tablet combination of isoniacide, prothionamide and diaphenyl sulfone in association with rifampicin and partly other substances. It was the aim of our study to examine this form of therapy in respect of side effects and effectivity. 535 of these 912 patients were followed up for as long as 13 years (maximum follow-up period). According to the criteria of the American Tuberculosis and Respiratory Diseases Association the patients were suffering from 182 cases of pulmonary tuberculosis of only slight extension, 490 of moderate extension and 130 of large extension, as well as 55 cases of pleuritis, 67 extrapulmonary organ tuberculoses and 1 tuberculosis of the bronchial mucosa. Allergic skin reactions occurred in 0.7% of the cases, and in 0.9% there were neurological disturbances such as vertigo, paroxysms and polyneuropathies. In 7.4% of the patients there was an increase in serum enzyme activities of SGOT, SGPT, Y-GT as a sign of hepatotoxicity. In 5.5% of the patients there were several gastrointestinal concomitant phenomena such as sensation of fullness, nausea, and vomiting. Under IPD therapy the hemoglobin valuedropped on the average by 12% up to the 5th or 6th week of treatment and rose subsequently to almost normal levels. No permanent damage was seen in any of the patients under observation. In the moderately extended tuberculosis cases disinfection occurred on the average between the 6th and 8th week of treatment, in the greatly extended cases on the average in the 9th to 13th week.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Short- and long-term results of tuberculosis therapy with a fixed combination of isoniazide, prothionamide and diaminodiphenylsulfone combined with rifampicin]. 211 30

Vitamin A deficiency is a serious problem throughout the developing world. An estimated 25-50 million children may well suffer the physiologic consequences of vitamin A deficiency; 5 million develop xerophthalmia, of whom 250,000 to 500,000 go blind every year; and untold numbers are at increased risk of diarrhea, respiratory disease, and death. Even mild vitamin A deficiency has been associated with a 14- to 10-fold increase in mortality, and controlled field trials have demonstrated vitamin A supplementation can reduce childhood death rates by 30%-70%. Three general intervention strategies exist for improving vitamin A status of high-risk, rural, economically deprived populations. These include nutrition education leading to increased dietary intake; vitamin A fortification of centrally processed, widely consumed dietary items; and periodic administration of large doses of vitamin A. At present, the latter is far and away the most widely employed intervention activity, because of its immediate impact, and because it can be implemented through the existing (and specialized) health care infrastructure. Vitamin A is a fat-soluble vitamin stored in the liver, so that a large dose of 200,000 IU (100,000 IU for children under 1 year of age) every 6 months reduces mortality, stimulates growth, and prevents xerophthalmia and nutritional blindness. Recent data suggest more frequent administration, every 3 to 4 months, may be desirable. Side effects have been minimal, with mild nausea, vomiting, and headaches in less than 1% to 4% of recipients. Care should be taken, however, that doses above 10,000 IU not be administered to women during the first trimester of pregnancy because of potential teratogenic effects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Large dose vitamin A to control vitamin A deficiency. 250 5

Long-term oesophageal pH monitoring has become the preferred technique for detection and quantification of gastro-oesophageal reflux (GOR). The most obvious advantages of pH monitoring are the duration of the investigation, the possibility of being able to relate "events" (emesis, heartburn, apnoea) to pH changes (and to study "occult GOR"), the physiological conditions in which the data are recorded (sleep, work), and the possibility of repeating the investigation in treatment conditions. However, it has been reported that the accuracy of pH monitoring is no higher than 90%, because the intermittent presence of acid in the oesophagus is only one of the various abnormalities in the syndrome of GOR. A tremendous number of technique- (pH monitoring system, type of electrode, location of the electrode) and patient-related factors influence pH data. Age, position (both for adults and for infants), duration of the investigation (day/night), feeding and drugs are patient-related factors. Finally, the question arises (which is still unanswered) whether the indication for pH monitoring should be considered in the interpretation of the data: are the same criteria valid for GOR in children presenting with emesis and oesophagitis as for children with GOR resulting in chronic respiratory disease or "near-miss sudden infant death syndrome".
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PMID:PH monitoring in children. 272 3


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