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)

To compare the efficacy and cost of managing mildly or moderately dehydrated diarrhea patients with oral rehydration soulution (ORS) versus intravenous fluids (I.V.), hospitalized patients were analyzed retrospectively during 2 different time periods. In 1981, 133 of 134 patients, 110 of whom were mildly-moderately dehydrated, were managed only with I.V.; while in 1982, 126 mildly-moderately dehydrated received only ORS, 15 severely dehydrated patients were given short term I.V. followed by ORS, and 29 mildly-moderately dehydrated patients were given I.V. before ORS, due to non-acceptance of ORS and/or persistent vomiting. In 1981, all but one of the 134 patients received I.V.; in 1982, 126 of the 155 mildly dehydrated were rehydrated with ORS alone, while the remaining 29 mildly dehydrated were rehydrated with I.V. followed by ORS. 15 severely dehydrated patients were treated with I.V. plus ORS. The average hospital stay was 3.6 days in 1981 and 1.6 days in 1982. The average net expenditure per patient was Bangladeshi Rs. 323.08 in 1981 and Rs. 99.61 in 1982 (about Rs. 9 to US $1. The present study thus establishes the usefulness of ORS at the hospital level, and its statistically significant impact on reducing the duration and cost of hospitalization. Moreover, use of ORS also indirectly avoids other disadvantages of I.V., such as overhydration, electrolyte imbalances and thrombophlebitis, all of which are not uncommon.
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PMID:Comparison of oral and intravenous rehydration among hospitalized children with acute diarrhoea. 406 24

Results are presented of an evaluation of the contraceptive efficacy, cycle control, and tolerance of a low dose triphasic pill, Trigynon, used by 353 reproductive-aged women for a total of 1668 cycles. 20 physicians in different Belgian centers recruited and followed the women. Average weight of the patients was 56.8 kg, average age was 24.8 years, average parity was 1.07, and 1/3 smoked. None had any medical condition contraindicating the use of the preparation. 156 of the women had never used contraception, 163 had used combined pills, 4 had used injectables, 6 had used progestin-only minipills, 21 had used IUDs, and 22 had used other methods. 2.5% of the patients forgot to take at least 1 pill in a typical cycle. No pregnancies were imputed to forgetting, but 3 pregnancies occurred during the study: 1 already established but not recognized at the start of treatment, 1 in a woman taking antituberculosis drugs, and 1 in a patient suffering an attack of dysentery. Almost 90% of patients had regular cycles of 28 days with treatment, compared to only 57.5% before treatment. The duration and quantity of bleeding were significantly decreased. Compared to the last pretreatment cycle, the 3rd and 6th cycles with Trigynon showed a decrease in percentage of patients complaining of dysmenorrhea, nervousness, headaches, breast tenderness, nausea, vomiting, decreased libido, depression, thrombophlebitis, and edema. The percentage complaining of acne and vertigo increased slightly at 3 months and then declined to below pretreatment levels. Average weight was almost unchanged. It appears that Trigynon offers reliable protection, excellent cycle control and few side effects, and would be an appropriate contraceptive choice for most women except those with benign breast disease or hyperestrogenism.
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PMID:[Clinical evaluation of 1,668 cycles of triphasic oral contraception (Trigynon). Multicentric Belgian study]. 681 54

Thirty-four multidrug-resistant cases of Indian visceral leishmaniasis (kala-azar) were treated with amphotericin B. A complete hemogram, liver and renal function tests, determination of serum electrolyte levels, a chest radiograph, and an electrocardiogram were done before, during, and after completion of therapy. Assessment for clinical and parasitologic cure was done weekly. Thirty-one patients who completed treatment had full cure after receiving 10-15 injections at six-months follow up. One patient died of myocarditis. A febrile reaction was observed in all cases, while thrombophlebitis was found in six cases (18.75%). Anorexia, nausea, and vomiting were found in seven cases (21.88%). No significant nephrotoxicity or electrolyte disturbances were observed. It is concluded that amphotericin B is an effective second-line drug for Indian visceral leishmaniasis, but unpredictable drug-induced myocarditis remains a problem.
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PMID:Use of amphotericin B in drug-resistant cases of visceral leishmaniasis in north Bihar, India. 761 61

Infusion-related adverse events (IRAEs) such as nausea, vomiting, fever, chills, and thrombophlebitis that are associated with amphotericin B therapy often lead clinicians to prescribe a number of adjunctive pretreatment medications in an attempt to reduce the incidence and severity of these events. The purpose of this study was to determine the incidence of IRAEs during the first week of systemic amphotericin B therapy and to identify pretreatment regimens that are effective in preventing these IRAEs. Three hundred ninety-seven adult inpatients receiving amphotericin B therapy were prospectively monitored, and data regarding IRAEs and pretreatment regimens were collected. Of these patients, 282 (71%) developed at least one IRAE during the first 7 days of therapy. The IRAEs most commonly reported were fever (51% of patients) and chills (28%), followed by nausea (18%), headache (9%), and thrombophlebitis (5%). The most common regimens included diphenhydramine, a corticosteroid, acetaminophen, and heparin, administered alone or in combination with these or other drugs. Overall, common pretreatment regimens were similar in efficacy to no pretreatment in the prevention of IRAEs. Thus empirical premedication for IRAEs associated with amphotericin B cannot be routinely advocated; instead, patients should be treated when symptoms first arise and then premedicated for subsequent amphotericin B infusions.
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PMID:Pretreatment regimens for adverse events related to infusion of amphotericin B. 779 69

A prospective, randomized controlled trial was performed from January 1988 to August 1989 involving 66 (33 in each group) children over 3 months of age diagnosed with bacterial meningitis in the pediatric hospital of the All India Institute of Medical Sciences. Children were administered chloramphenicol alone intravenously at a dose of 100 mg.kg-1.day-1 in 4 divided doses. Those who received chloramphenicol + penicillin were given 100 mg.kg-1.day-1 of chloramphenicol and 300,000-400,000 IU.kg-1.day-1 of crystalline penicillin in 6-hourly doses intravenously. Chloramphenicol was given orally after 3-5-days' treatment, if there was an improvement in sensorium and no vomiting. The antibiotics were prescribed for 10-14 days. The cell count ranged from 525 to 16,000 per mcl, while the protein level varied from 53 to 1000 mg.dl. The CSF glucose level as a proportion of the blood glucose ranged from 0 to 69%. There were 3 deaths (4.5%): all in the chloramphenicol + penicillin group. 1 death occurred within 4 hours of admission from Waterhouse-Friderichsen syndrome; in 1 fatal case, the causative agent was a Klebsiella pneumoniae strain resistant to both chloramphenicol and penicillin. Treatment failure (deaths + change of treatment) was recorded for 3 patients (9%) in the chloramphenicol-alone group and for 4 patients (12%) in the chloramphenicol + penicillin group (P 0.05). Intravenous therapy was continued for 4.27 + or - 1.01 days in the chloramphenicol-alone group, while it was required for 10.3 + 1.99 days in the chloramphenicol + penicillin group )P 0.01). Significant thrombophlebitis occurred in 17 patients (58.6%) in the combination group but only in 1 patient (3.3%) in the chloramphenicol-alone group (P 0.001). Drug fever occurred in 3 patients in the combination group and in 1 patient in the chloramphenicol-alone group. After a week of therapy, none of the patients had a total leukocyte count 4000.
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PMID:Antibiotic therapy for bacterial meningitis in children in developing countries. 849 Sep 81

Twenty-two patients with supratentorial malignant gliomas were treated postoperatively with concurrent intracarotid chemotherapy and radiation therapy. There were seven women and 15 men with a median age of 56 years (range, 22-69) and median performance status (Karnofsky score) of 70 (range, 40-90). In all except two cases, histologic studies confirmed malignant glioma. All patients were irradiated with a cobalt 60 equipment. They should have received 45 Gy to the whole brain plus a 15-Gy coned-down boost to the tumor area. Chemotherapy consisted of cisplatin infusion at a dose of 60 mg/m2 on days 2, 22, and 42. Treatment was interrupted in two patients because of progressive disease and voluntary withdrawal in one patient each. In all, 63 courses of cisplatin infusion were administered, all at full dose. Two patients achieved a partial response, and nine had stable disease. Toxicities included nausea/vomiting in nine patients (41%) and transient hemiparesis, confusion, diarrhea, and thrombophlebitis in one patient each. Median time to progression was 26 weeks (range, 4-226+), and median survival was 58 weeks (range, 14-226+). In conclusion, the present study suggests that intracarotid cisplatin administered concurrently with radiation does not improve the therapeutic index in malignant gliomas.
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PMID:Concurrent radiation and intracarotid cisplatin infusion in malignant gliomas: a feasibility study. 912 86

We report herein the case of a 70-year-old woman with enteropathy accompanied by protein loss, the cause of which was found to be thrombophlebitis of the mesenteric vein. The patient was admitted to our hospital for investigations to determine the cause of hypoproteinemia. She had suffered an episode of left abdominal pain with high fever and vomiting lasting 10 days, 8 months prior to her admission. She also had a 6-year history of uncontrolled diabetes. The alpha1-antitrypsin clearance was 85.7 ml/day, suggesting protein-losing enteropathy. A scintigraphy with 99m-technetium-human serum albumin disclosed protein leakage into the intestine. X-Rays and computed tomography showed a stenotic and thickened area of small intestine 50 cm in length. Thus, a laparotomy was performed to resect this part of the intestine which was found to have undergone past thrombophlebitic changes. Following the operation, the alpha1-antitrypsin clearance decreased to within the normal range and the patient gained 5 kg in weight.
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PMID:Protein-losing enteropathy due to thrombophlebitis of the mesenteric vein: report of a case. 974 3

The safety and tolerability of quinupristin/dalfopristin were assessed in both comparative and non-comparative trials (2298 quinupristin/dalfopristin-treated patients). In comparative clinical trials, the most frequent systemic adverse events related to quinupristin/dalfopristin were nausea (4.6%), diarrhoea (2.7%), vomiting (2.7%) and skin rash (2.5%). The comparator group showed similar rates, except that nausea was significantly more common (7.2%; P = 0.01). In non-comparative trials, arthralgia and myalgia were reported most frequently but were reversible upon treatment discontinuation. The renal, inner ear, cardiovascular and central nervous systems were not implicated as significant target organs for toxicity. The most frequent local adverse events related to infusion of quinupristin/dalfopristin were inflammation, pain, oedema, infusion site reaction and thrombophlebitis. Results of laboratory tests while on therapy were comparable for quinupristin/dalfopristin and comparator groups, except that increases in conjugated bilirubin of >5 x the upper limit of normal were reported in 5.5% of quinupristin/dalfopristin recipients; increases in total bilirubin of >5 x the upper limit of normal occurred in 1.5%. Comparator recipients more frequently had increases in alanine aminotransferase and alkaline phosphatase. Quinupristin/dalfopristin inhibits the cytochrome P450 3A4-mediated metabolism of drugs including midazolam, nifedipine, terfenadine and cyclosporin. Therefore, plasma drug monitoring and/or dosage reduction of these agents is prudent. Concomitant administration of drugs that can prolong the electrocardiographic QTc interval should be avoided. Quinupristin/dalfopristin is visually and chemically compatible with commonly used drugs of various classes, but it is not compatible with sodium chloride solution and certain other drugs, including some antimicrobials. Therefore, when prescribing quinupristin/dalfopristin, clinicians should be aware of the potential for peripheral venous intolerance, arthralgias and myalgias, increases in conjugated bilirubin, interactions with drugs metabolized by the cytochrome P450 3A4 isoenzyme and certain physico-chemical incompatibilities. However, multiple studies have shown that the safety and tolerability of quinupristin/dalfopristin are generally favourable, and that it provides clear benefits to ill patients with severe gram-positive infections.
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PMID:Safety and tolerability of quinupristin/dalfopristin: administration guidelines. 1051 96

The study was conducted in 35 cases of acute tubular necrosis of varied aetiology. Cases were divided in 2 groups, Group A--17 cases treated conservatively and Group B--18 cases managed by early haemodialysis. Criteria for early haemodialysis were blood urea < 120 mg% and serum creatinine < 7 mg%. Before starting therapy both the groups had comparable biochemical and renal parameters (p > 0.05). Overall mortality was lower in Group B as compared to Group A (22.2% Vs 29.4). Complication events such as uraemic encephalopathy, pulmonary oedema, haematemesis and malena, thrombophlebitis and vomiting were significantly lower in Group B (p < 0.05). Hospital stay was also significantly lower (p < 0.05) in Group B (18 +/- 2.5 days Vs 28 +/- 3 days), this can reduce the cost of treatment also.
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PMID:Early haemodialysis in acute tubular necrosis. 1122 83

Outlined is a protocol for the administration of emergency contraceptive pills. The indication for such treatment is unprotected intercourse within the past 72 hours. Absolute contraindications include the possibility of an existing pregnancy and a family history of stroke, heart attack, thrombophlebitis, breast or endometrial cancer, or liver tumor. Possibly excluded, depending on evaluation by a physician, are women with abnormal vaginal bleeding, active hepatitis, active gallbladder disease, high blood pressure, acute focal migraine, breastfeeding women, and those unable to understand instructions. The recommended regimen consists of six tablets of Ovral (two taken immediately, two more in 12 hours) or 12 tablets of Lo/Ovral, Nordette, or Levlen (four taken immediately, repeat dosage in 12 hours). The extra pills are to be used in cases of vomiting within three hours of pill ingestion. Women with a history of oral contraceptive-related nausea and vomiting should be provided with Compazine. Women should be informed that this method is effective in only about 92% of cases. All women who receive emergency contraception should be counseled that this is strictly a back-up method and helped to formulate a long-term birth control strategy.
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PMID:Emergency contraceptive pills (ECP) protocol. 1228 80


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