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)

Of 66 babies under the age of 3 months, who were examined during a 6-month period for excessive or unusual crying, and who showed no signs of fever, diarrhoea, vomiting, blocked nose, skin eruptions, and difficulties with breast- or bottle-feeding, 9 had pus or mucus in the middle ear. All who care for young children should be skilled in examining them for otitis media.
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PMID:Infants with earache. 116 34

Tuberculosis of the middle ear is rare; associated meningitis is even more unusual. This report contains our experience with a one and a half year old psychomotor retarded boy. He had a poor healing left postauricular abscess four months prior to admission. Also noted was postprandial vomiting and left sided involuntary movement. On admission spinal tapping was done. Results showed leukocytosis, with lymphocytes being predominant, as well as high protein and low glucose levels. A cranial CT revealed left mastoiditis, hydrocephalus, basal cistern abnormal enhancement and a prominent posterior fossa postcerebellar CSF space. Left radical mastoidectomy was performed. A biopsy showed caseous necrosis surrounded by epitheloid and Langhan's giant cells. He also received a ventriculoperitoneal shunt. The gastric and CSF were both positive for tuberculous culture.
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PMID:[Tuberculous otitis media, mastoiditis associated with meningitis: report of one case]. 131 95

In a recent editorial, Kapur described perioperative nausea and vomiting as "the big 'little problem' following ambulatory surgery."257 Although the actual morbidity associated with nausea is relatively low in health outpatients, it should not be considered an unavoidable part of the perioperative experience. The availability of an emesis basin for every patient in the postanesthesia recovery unit is a reflection of the limited success with the available therapeutic techniques.257 There had been little change in the incidence of postoperative emesis since the introduction of halothane into clinical practice in 1956. However, newer anesthetic drugs (e.g. propofol) appear to have contributed to a recent decline in the incidence of emesis. Factors associated with an increased risk of postoperative emesis include age, gender (menses), obesity, previous history of motion sickness or postoperative vomiting, anxiety, gastroparesis, and type and duration of the surgical procedure (e.g., laparoscopy, strabismus, middle ear procedures). Anesthesiologists have little, if any, control over these surgical factors. However, they do have control over many other factors that influence postoperative emesis (e.g., preanesthetic medication, anesthetic drugs and techniques, and postoperative pain management). Although routine antiemetic prophylaxis is clearly unjustified, patients at high risk for postoperative emesis should receive special considerations with respect to the prophylactic use of antiemetic drugs. Minimally effective doses of antiemetic drugs can be administered to reduce the incidence of sedation and other deleterious side effects. Potent nonopioid analgesics (e.g., ketorolac) can be used to control pain while avoiding some of the opioid-related side effects. Gentle handling in the immediate postoperative period is also essential. If emesis does occur, aggressive intravenous hydration and pain management are important components of the therapeutic regimen, along with antiemetic drugs. If one antiemetic does not appear to be effective, another drug with a different site of action should be considered. With the availability of new antiserotonin drugs, the incidence of recurrent (intractable) emesis could be further decreased. Research into the mechanisms of this common postoperative complication may help in improving the management of emetic sequelae in the future. As suggested in a recent editorial, improvement in antiemetic therapy could have a major impact for surgical patients, particularly after ambulatory surgery. Patients as well as those involved in their postoperative care look forward to a time when the routine offering of an emesis basin after surgery becomes a historical practice.
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PMID:Postoperative nausea and vomiting. Its etiology, treatment, and prevention. 843 45

Cefixime was compared with amoxicillin for treatment of acute otitis media in a randomized trial. Results of tympanocentesis on day 3 to 5 of therapy were used as the major outcome. Total daily doses were 8 mg/kg of cefixime and 40 mg/kg of amoxicillin. One hundred twenty-six patients were randomly assigned to receive treatment; 64 cultures grew pathogens. Pathogens were eradicated from the middle ear after 3 to 5 days of therapy in 27 (79.4%) of 34 children given amoxicillin and 26 (86.7%) of 30 children given cefixime (p = 0.47). When Streptococcus pneumoniae cases were analyzed, bacteriologic cure occurred in 14 (93.3%) of 15 children given amoxicillin and 12 (75%) of 16 given cefixime (p = 0.333). When cases of Haemophilus influenzae infection were analyzed, significantly more cures occurred with cefixime (10/10, 100%) than amoxicillin (8/13, 62%) (p = 0.046). Pathogens associated with failure of amoxicillin therapy were H. influenzae (five cases, two beta-lactamase-positive), S. pneumoniae (one case), and Moraxella catarrhalis (one case, beta-lactamase-positive). The four failures with cefixime therapy were all in patients infected with S. pneumoniae. Rates of rash, diarrhea, and vomiting were the same in both groups and did not necessitate stopping therapy. We conclude the following: (1) Cefixime and amoxicillin were equivalent in overall clinical and bacteriologic efficacy for otitis media. (2) Cefixime was more efficacious than amoxicillin in treating H. influenzae otitis media and should be preferred when H. influenzae is the suspected etiologic agent. (3) Side effects of both drugs were mild and equivalent.
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PMID:Cefixime compared with amoxicillin for treatment of acute otitis media. 190 97

Sultamicillin, a dimer of ampicillin and a beta-lactamase-inhibiting agent, sulbactam, was given in oral form to 50 infants and children with acute otitis media. Tympanocentesis was performed on entry into the trial. Beta-lactamase-positive Haemophilus influenzae or Branhamella catarrhalis was isolated from 14 of 73 (19.2%) middle ear effusions in 9 children. Relief of symptoms (fever/otalgia) occurred in all children who completed therapy. However, in 8 children (16%), the antimicrobial agent was discontinued due to presumed adverse side effects (primarily gastrointestinal); vomiting which began prior to entry was noted in another subject who was withdrawn. An additional 14 children completed the course of treatment despite having diarrhea. Of the 41 children who completed drug therapy, 11 (26.8%) were effusion-free after 10 days, and 22 of 33 (66.7%) evaluable children were effusion-free after 6 weeks. Sultamicillin is a novel therapeutic approach to beta-lactamase-producing bacteria. In its oral form, however, diarrhea is a troublesome side effect.
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PMID:Sultamicillin (ampicillin-sulbactam) in the treatment of acute otitis media in children. 300 16

Labetalol, an alpha- and beta-adrenergic receptor-blocking agent, was studied as a hypotensive agent during halothane (mostly 0.5 vol.%)-N2O-fentanyl-d-tubocurarine anaesthesia with a head-up tilt of 5 degrees in 41 patients undergoing middle ear microsurgery. After the mean initial dose of 0.3 mg/kg, the mean need for labetalol ranged from 0.05 to 0.07 mg/kg at 30 +/- 5-min intervals. The mean duration of the hypotensive period was 102 min. During the hypotension, the average mean arterial pressure ranged from 59 to 62 mmHg (7.9-8.3 kPa) and the mean heart rate from 61 to 66 b.p.m. After labetalol the maximum cardiac output decrease was 7%. Before labetalol the mean PaO2 value was 158 mmHg (21.1 kPa) and during hypotension it ranged from 145 to 149 mmHg (19.3-19.9 kPa) when FiO2 was 40%. The only peroperative side effects were ECG changes (middle junctional rhythm and sinus bradycardia) which occurred in 10% of the patients. The mean value for the degree of haemostasis rated by the otologist on a visual analogue scale between poor (0 mm) and excellent (100 mm) was 91 mm. The patients were able to open their eyes and to give their names 8-9 min after the end of anaesthesia. After extubation the patients were normotensive and there were no clinically significant changes in the cardiovascular parameters during the 4-h recovery room period. Acid-base status showed slight metabolic acidosis. The most common postoperative side effects were nausea only and nausea + vomiting, which occurred in 39% and 20% of the patients, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Labetalol as a hypotensive agent for middle ear microsurgery. 357 41

Three hypotensive anaesthetic methods were compared in 123 patients undergoing middle ear microsurgery. Hypotension was induced with halothane (1 vol.%), nitroprusside (4.4 micrograms/kg/min) or the combination of halothane (0.5 vol.%) and nitroprusside (1.2 micrograms/kg/min). The compensatory rise in the heart rate was controlled with a beta-adrenergic receptor blocking agent, practolol, the mean need for which was 0.03 mg/kg in the halothane group and 0.1 mg/kg in the other groups. The mean duration of the hypotensive period ranged from 79 to 107 min in the groups. During the hypotension, the average mean arterial pressure ranged from 55 to 60 mmHg (7.33 to 8.00 kPa) and the mean heart rate from 67 to 79 beats/min in the groups. The PaO2 value in the nitroprusside and halothane + nitroprusside groups, but not in the halothane group, decreased statistically and in some cases clinically significantly. The only peroperative side effects were ECG changes (mostly junctional rhythm), the incidence of which ranged from 16 to 24% in the groups. The mean values for the degree of haemostasis rated by the otologist on a visual analogue scale between poor (0 mm) and excellent (100 mm) were 90, 73 and 89 mm in the halothane, nitroprusside and halothane + nitroprusside groups, respectively. Recovery in the halothane group was statistically highly significantly longer than in the other groups. No rebound hypertension occurred in any of the groups after discontinuation of the hypotension. The most common side effect was nausea + vomiting, the incidence of which ranged from 15 to 26% in the groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of three hypotensive anaesthetic methods for middle ear microsurgery. 648 41

A short review is given of the pharmacokinetic characteristics and side effects of the nitroimidazoles: metronidazole, tinidazole and ornidazole. The drugs are well absorbed from the gastrointestinal tract, maximum plasma levels generally being obtained 1 to 4 h after oral intake. Metronidazole has been shown to be absorbed after rectal administration; vaginal absorption is documented for all three drugs. The nitroimidazoles are widely distributed in the body, cross the placenta and appear in breast milk. Therapeutically effective concentrations of e.g. metronidazole have been demonstrated in e.g. the central nervous system, middle ear discharges, bile, peritoneal fluid, and fluids and tissues of the female genital tract. The binding to plasma proteins is less than 20%. Available data suggest that the elimination half-lives of these drugs differ, being 7-8 h for metronidazole, about 12 h for tinidazole and 14-15 h for ornidazole. Both metronidazole and ornidazole, but not tinidazole, seem to be extensively metabolized before elimination. The nature and frequency of adverse reactions to this drug include encephalopathy in a few patients treated with doses between 5 and 10 g daily as an adjunct to radiotherapy, and peripheral neuropathy observed in patients treated for prolonged periods with high doses. Among the common side effects of the nitroimidazoles are symptoms from the gastrointestinal tract such as nausea, anorexia, vomiting and metallic or bitter taste. Dizziness, ataxia and headache have been reported. When given together with alcohol, a disulfiram-like intolerance reaction can be obtained.
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PMID:Pharmacokinetics of nitroimidazoles. Spectrum of adverse reactions. 694 57

Total intravenous anaesthesia using propofol is indicated in the following cases: patients with a previous history of postoperative nausea or vomiting; surgery of the middle ear; gynaecological procedures involving laparotomy; ENT and squint surgery in children. Up to now, the relationship between the clinical benefit (less incidence of postoperative nausea and vomiting) and intrinsec anti-emetic properties of propofol is not included in the regulatory labelling.
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PMID:[Effects of Diprivan on nausea and vomiting]. 787 50

We examined the effects of caloric stimulation on the neuronal activity of the locus coeruleus (LC) and of the vestibular nucleus complex (VNC) in urethan-anesthetized rats. The single unit activity of neurons in the LC and VNC was extracellularly recorded. A polyethylene tube for caloric stimulation was inserted into the middle ear cavity on the ipsilateral side. Through the tube, the middle ear was irrigated by hot (44 degrees C), cold (30 degrees C), and ice (4 degrees C) water. The majority of neurons in the VNC showed excitation by middle ear irrigation with hot water and inhibition by ice-water irrigation. The responses occurred during caloric stimulation and disappeared immediately after the cessation of the stimulation. The results suggest that the responses of VNC neurons to caloric stimulation directly reflect changes in primary vestibular afferent activity. On the other hand, the predominant effect of caloric stimulation with hot and cold water on LC neuronal activity was inhibitory. The suppression of LC neuronal activity occurred approximately 1 min after the cessation of the caloric stimulation and persisted for 3-5 min. The results suggest that LC neurons receive processed vestibular signals. Motion sickness and vestibular dysfunction induced by caloric stimulation cause emesis, which is known as vestibulo-autonomic response. The vestibulo-autonomic syndrome can be prevented by amphetamine, a noradrenaline releaser. Therefore, the inhibitory response of noradrenergic LC neurons to vestibular stimulation may be involved in the vestibulo-autonomic response.
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PMID:Responses of locus coeruleus neurons to caloric stimulation in rats. 874 93


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