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

Classic renal tubular acidosis is characterized by a primary defect in establishment of a large hydrogen ion gradient across the distal renal tubule. Thus the development of hyperchlorenic metabolic acidosis follows. In addition, hypokalemia results from renal potassium wasting secondary hyperaldosteronism from sodium wasting and contraction of the extracellular fluid. The presenting signs and symptoms are growth retardation, fatigue, periodic paralysis, polyuria, polydipsia, vomiting and constipation as well as nephrocalcinosis and nephrolithiasis. It is suggested that effective treatment with alkali therapy requires markedly higher doses than formerly recommended, and may related to a higher rate of endogenous acid production from (1) intermediary metabolism of sulfur amino acids and organic acids, (2) impaired tubular reabsorption of bicarbonate and (3) hydrogen ion release from hydroxyapatite formation. It is also suggested that acidosis may interfere with vitamin D metabolism and thus play an important role in the pathoetiology of the growth failure in children with this disorder.
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PMID:Acid-base, calcium, potassium and aldosterone metabolism in renal tubular acidosis. 3 60

The importance of maintaining the cancer patient's nutritional status is now recognized as a major part of the medical care. It is necessary for the oncology team to be aware of the psychological and physiological factors that interfere with food acceptance so that the correct food can be offered at the right time in the most palatable form. The oral route is the preferred method of feeding, and nutritional supplements, chosen according to the individual patient's needs, are of great value in assuring an adequate oral intake. Diagnostic tests and therapy are frequent causes of disruption of the meal schedule and the dietary service must be flexible in providing the patient an opportunity to make up for missed meals. Taste disturbance, nausea, vomiting and mucositis caused by therapy may necessitate periods of intravenous hyperalimentation. Food aversions due to therapy can frequently be prevented by avoiding new or unusual foods in the hours before chemotherapy or irradiation. Regular nutrition counseling during clinic visits and/or hospitalization permits diet modification for specific therapeutic needs. The ultimate goal is the prevention of wasting and debilitation due to malnutrition in the cancer patient.
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PMID:Oral feedings in the cancer patient. 10 86

The four alternatives discussed in the previous paper (5), are applied to a number of virus infections which are common in pigs. The enzootic state of SMEDI enteroviruses, vomiting and wasting virus and parvovirus should be promoted by bringing the young gilts into close contact with the older sow population at a sufficiently early stage. There should preferably not be a change of herd for primiparous sows during pregnancy. In parvovirus infection, maternal immunity may be so prolonged that gilts will only be infected after the time of breeding. Therefore, mating should preferably be postponed until they are nine months of age, unless previous serological tests have shown that they are in a state of active immunity. Considering the present disease situation of swine fever in several continental West European countries and consequently they high number of existing virus sources, compulsory vaccination of sows and fattening piglets is recommended against this virus on an international scale for at least three years. This vaccination can be omitted only after the number of outbreaks has been reduced to a very low level. Vaccination is the only possible alternative left in the combat against Aujezky's disease. Caution is undoubtedly indicated in using live vaccines in these cases. So far, methods have not become available for the effective control of transmissible gastroenteritis and prospects are not encouraging. The possibility of eradication of transmissible gastroenteritis is discussed.
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PMID:[Possible methods of control of virus disease in swine today and in the future. II. Specific applications (author's transl)]. 65 95

A newborn boy (birth weight 2550 g) presented from the first days of life with poor drinking, moderate vomiting and persistent weight loss. On hospital admission at age 4 weeks, there were severe dehydration, dystrophy and electrolyte disturbances (Na 107, Cl 80, K 5,4 mval/l). The usual causes of salt wasting were excluded, but plasma renin activity, plasma aldosterone and urinary aldosterone-18-glucuronide were markedly increased. DOCA had no salt-retaining effect, but a sodium chloride supplement of 3 g per day improved the clinical condition dramatically and normalized the electrolyte values. With this treatment, plasma renin activity and aldosterone were normal or almost normal beyond the age of 6.5 months, but urinary aldosterone-18-glucuronide remained slightly increased. Considerable augmentation of the plasma renin activity and of urinary aldosterone-18-glucuronide, but no clear salt loss were induced by spironolactone. With salt restriction, there was evidence for marked salt loss. Its progress could be inhibited by administration of indomethacin. Since indomethacin inhibits the synthesis of prostaglandins with saluretic activity, it is probable that the prostaglandins participate in the pathogenesis of the salt wasting in pseudohypoaldosteronism.
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PMID:Congenital pseudohypoaldosteronism: case report and review. Effect of indomethacin during sodium chloride depletion. 65 59

An attempt was made to search the medical records of the University Hospital and five affiliated hospitals at Rochester, NY for the last 10 years. Seventeen patients with superior mesenteric artery compression syndrome were found. The prevalence of this disease in a chronic-care hospital (0.965/1,000 admisssions) is significantly higher than that in acute general hospitals (0.0108-0.0520/1,000 admissions) by Chi square statistic (P less than 0.001). This syndrome should be suspected in patients with chronic wasting diseases who are bedridden and have lost weight after which they develop frequent vomiting or aspirations. On reviewing 146 cases from the literature after 1963, duodenojejunostomy was considered to be the best procedure for severe cases. The same good results were not achieved after gastrojejunostomy and lysis of the ligament of Treitz. Gastrojejunostomy provided adequate decompression of the stomach but was inadequate for releasing duodenal obstruction. Some patients after division of the ligament of Treitz had difficulty in downward displacement of the duodenum and the symptoms of obstruction persisted necessitating duodenojejunostomy. This paper demonstrates that in two patients gastrojejunostomy failed to relieve the obstruction. One of them had to be reoperated on and a duodenojejunostomy was performed with relief of obstructive symptoms.
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PMID:Superior mesenteric artery compression syndrome. 71 65

Cisplatin has many toxic effects; emesis, impairment of renal function, myelosuppression, peripheral neuropathy, ototoxicity and renal tubular wasting. We used MVP regimen (Mitomycin C, Vp-16, and Cisplatin) in advanced Non-Small Cell Lung Cancer (NSCLC). Using hydration and prophylactic supplementation of sodium and potassium before and during chemotherapy, we have observed the development of hyponatremia in 48 courses (43%), hypokalemia in 23 courses and hypomagnesemia in 11 courses. Some patients showed abnormalities of renal function in 16 courses. All the electrolyte depletion and renal problem was corrected before next courses by hydration and replacement of the wasting. Frequent measurement of serum cation and appropriate replacement are recommended when high dose Cisplatin containing regimen is used in chemotherapy of neoplasms.
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PMID:Renal salt wasting in patients treated with high-dose cisplatin, etoposide, and mitomycin in patients with advanced non-small cell lung cancer. 133 77

The gross and histological lesions of a protozoan infection, possibly caused by Leucocytozoon, in parakeets (genera Neophema and Cyanoramphus), budgerigars (Melopsittacus undulatus) and a wild buzzard (Buteo buteo) are described. The infection appears not to have been identified before in budgerigars in Great Britain, and in its chronic form resulted in vomiting and wasting. The possible identity of the parasite and the epidemiological factors are considered.
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PMID:Leucocytozoon-like infection in parakeets, budgerigars and a common buzzard. 192 86

Type I pseudohypoaldosteronism (PHA) is a hereditary disease characterized by salt wasting resulting from target organ unresponsiveness to mineralocorticoids. We have studied two kindreds including a total of nine patients with PHA. In kindred I, the propositus presented with renal salt wasting in infancy (vomiting, failure to thrive, short stature, hyponatremia, hyperkalemia) and responded dramatically to a high salt diet (2.5 g/day). Sodium supplementation was discontinued at the age of two. In seven additional family members from three generations, clinical expression of PHA varied from asymptomatic to moderate. In affected members (propositus, mother, and two brothers), hyperaldosteronism persisted over 13 yr; however, the PRA decreased gradually to near normal values. Persistent hyperaldosteronism in the face of a decrease in PRA indicated the development of tertiary hyperaldosteronism due to autonomously functioning zona glomerulosa. The pedigree was consistent with an autosomal dominant mode of transmission with variable expression. In kindred II, the propositus, who was the product of a consanguineous marriage, developed severe renal salt losing at age 9 days. She had also increased salivary and sweat electrolytes consistent with PHA resulting from multiple organ unresponsiveness to mineralocorticoids. Life threatening episodes of salt wasting recurred beyond the age of 2 yr. At 5 yr of age she still requires high amounts of salt supplements (14 g/day). A sister died at 9 days of age with PHA symptoms. Six close relatives (parents, three siblings, maternal uncle) showed no biochemical abnormalities. This pedigree was consistent with an autosomal recessive mode of inheritance. In view of the findings on these two kindreds and the analysis of those in the literature, we conclude that type I PHA includes two clinically and genetically distinct entities with either renal or multiple target organ defects.
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PMID:Type I pseudohypoaldosteronism includes two clinically and genetically distinct entities with either renal or multiple target organ defects. 193 32

Nine black children aged between 3 months and 30 months of age, with human immunodeficiency virus type I (HIV-I) infection are described to draw the attention of health professionals in southern Africa to special clinical characteristics useful for recognising this problem, which has many shared features with common diseases of infancy and childhood in the Third World. The main presenting complaints were chronic cough and persistent diarrhoea and vomiting. These children frequently had diarrhoea (8 of 9 patients), mucocutaneous candidiasis (8), pneumonia (7), hepatosplenomegaly (9), significant lymphadenopathy (5) and wasting (5). All were infected by common bacteria, such as Gram-negative organisms, Mycobacterium tuberculosis and Campylobacter jejuni, or by opportunistic infections such as Candida or cytomegalovirus (CMV), or by both bacterial and opportunistic organisms. A raised total serum globulin level, anaemia, lymphopenia and a cerebrospinal fluid (CSF) pleocytosis were frequent findings. Incomplete data on parental HIV status suggest perinatal transmission. Three of the children were HIV-antigen positive. The diagnosis of full-blown acquired immunodeficiency syndrome (AIDS), using the stringent Centers for Disease Control criteria, is difficult in our situation because of limited diagnostic resources; however, using these criteria, and the clinical case definition for AIDS recommended by World Health Organisation, it is thought that probably 4 of these children could be considered as having AIDS.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Some early observations on HIV infection in children at King Edward VIII Hospital, Durban. 223 85

Nineteen children with clinical diagnoses of renal tubular acidosis were followed for periods ranging from 3 months to 20 years. Twelve patients had Type 1 renal tubular acidosis, five had Type 2, and two had Type 4. No sex predilection was found for any one of the types. Most patients had been diagnosed before 18 months of age, with failure to thrive the most common presentation. Tachypnea, polydipsia, polyuria, and vomiting were frequent symptoms. Some of these children had associated renal hypoplasia, vesicoureteral reflux, unilateral renal agenesis, glomerulocystic disease, adult polycystic kidney disease, and cyanotic congenital heart disease. Urinary anion gap may be useful for differential diagnosis of altered distal urinary acidification from other hyperchloremic metabolic acidosis. Furosemide test may need further investigation. Inability to raise urine to blood pCO2 gradient is helpful for diagnosis of Type 1 renal tubular acidosis. Hypokalemia, hypocalcemia, hypophosphatemia, decreased tubular reabsorption of phosphate, and hypercalciuria occurred in some patients. Complications included rickets in two, nephrocalcinosis in one, and episodic hematuria in one. There was relative bicarbonate wasting in children with Type 1 renal tubular acidosis, with a mean therapeutic bicarbonate requirement of 4.4 +/- 2.6 meq/kg/day. The mean bicarbonate dose for patients with Type 2 renal tubular acidosis was 8.3 +/- 2.6 meq/kg/day. Most children had good response to treatment with complete catch-up linear growth in 13, improved growth in 4, and continuing poor growth in 2. Two patients died during follow-up. Two other patients maintained normal growth without medication.
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PMID:Renal tubular acidosis in childhood. 226 80


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