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

The urgent admission to hospital of diabetic patients is often precipitated by hypoglycaemia, by vomiting or by ketoacidosis following cessation insulin therapy. By the use of simple agents, such as glucagon, lemonade and quick-acting insulin, such episodes can usually be averted in the early stages by the diabetic, his family and his doctor. These preventive measures keep the diabetic at work or at school and out of hospital, but require the provision of a simple emergency kit.
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PMID:The emergency management of the diabetic at home. 81 86

Thirty infants scheduled for a variety of gastrointestinal, genitourinary and thoracic surgical procedures were selected for insertion of lumbar or thoracic epidural catheters via the caudal approach using either an Intracath or a Burron continuous brachial plexus kit. The catheters were inserted with ease by residents in training and no catheter-related complications were encountered. Lidocaine 0.5 per cent with 1:200,000 epinephrine was then injected to assure proper placement of the catheter before narcotics were administered. Postoperative analgesia was adequate in all patients using preservative-free morphine 0.05 mg.kg-1. The mean dosing interval was 15 hr and no episodes of nausea, vomiting, hypotension or histamine release were noted. Urinary retention occurred in two infants and one infant became apnoeic three hours after epidural morphine administration but responded to naloxone and pulmonary ventilation with bag and mask. In conclusion, epidural catheters placed via the caudal approach are a safe and effective means of providing postoperative pain control in infants using preservative-free morphine. However, the use of epidural narcotics in infants less than two years of age is restricted to those who will receive intensive care unit monitoring postoperatively so that if apnoea occurs, rapid intervention can be taken by skilled nursing personnel.
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PMID:Lumbar and thoracic epidural analgesia via the caudal approach for postoperative pain relief in infants and children. 232 73

A 48-year-old man was admitted for treatment of Cushing's syndrome due to right adrenal adenoma, associated with chronic renal failure (CRF) with a blood urea nitrogen level of 64.2 and serum creatinine level of 3.9 mg/dl. After removal of the adrenal adenoma, the CRF deteriorated with progressive symptoms of anorexia, vomiting and hypertension, and the patient was placed on hemodialysis. Prior to adrenalectomy, the 17 OHCS and 17 KGS in the urine were not so high. However, the urinary 17 KS was high with an elevated 11-oxy fraction. In comparison with 2 patients suffering from adrenal Cushing's syndrome with normal renal function, there were no large accumulated quantities of glucuronic conjugated and unconjugated metabolites in the plasma of the CRF Cushing's syndrome, with confirmation ascribable to the radioimmunoassayable cross-reactivity of the cortisol antiserum used in the radioimmunoassay kit. In the Cushing's syndrome with CRF, almost all the cortisol, which was hypersecreted from the adenoma, was presumed to be converted to the 11-oxy fraction of 17 KS, possibly by activation of hepatic enzymes.
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PMID:Cortisol and its metabolites in the plasma and urine in Cushing's syndrome with chronic renal failure (CRF), compared to Cushing's syndrome without CRF. 279 94

This study was undertaken to compare countercurrent immunoelectrophoresis (CIE) and enzyme-linked immunosorbent assay (ELISA) using Rotazyme kit to detect rotavirus antigen in the stools of children with gastroenteritis and to compare and contrast the signs and symptoms of rotavirus antigen-positive with antigen-negative children. Over 2 years, 171 infant and children admitted to the pediatric in-patient unit at St. Luke's Hospital, Cleveland, Ohio, with gastroenteritis were evaluated. Stools from 108 (63%) had rotavirus antigen. In most patients, antigen was detected by both CIE and ELISA. 100 (94%) of the 108 patients were under age 2; 72 (66%) rotavirus-positive patients were seen during the colder months. Frequency and duration of diarrhea, presence and duration of vomiting, presence and duration of fever, and lack of examination findings distinguished the rotavirus antigen-positive from the rotavirus antigen-negative patients. CIE and ELISA are reliable, simple laboratory methods for identifying this etiologial agent in stool. Rotavirus antigen was detected by both CIE and Rotazyme technique in most patients. In a few patients only 1 test was positive for the antigen. In 16 (14.8%) positive specimens antigen only could be detected by CIE, while in 11 (10.2%) positive specimens the antigen was demonstrable only by the Rotazyme method. This discrepancy is hard to explain since both methods are sensitive and compare well with immune electron microscopy. CIE is an inexpensive, simple test which can be done easily in any microbiology or clinical laboratory, with the results ready in 3 hours. Rotazyme is very sensitive but it is also more complicated than CIE.
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PMID:Clinical features and laboratory diagnosis of rotavirus-associated gastroenteritis in infants and children. 609 39

In the year ending March 1994, British Airways (BA) carried in excess of 30 million passengers worldwide. There was a total of 2078 reported in-flight medical incidents, with 18 unscheduled diversions for medical reasons. The commonest reported conditions were faints, diarrhoea and vomiting. The BA aircraft medical kit content exceeds the statutory minimum requirement and all cabin crew undergo training in first aid and life support. There is a BA doctor on 24 h call with whom an aircraft captain may communicate via a high-frequency radio link. This link has limitations and immediate contact is not always possible. BA is installing satellite communication facilities in new aircraft and the application of telemedicine utilizing this facility is being explored.
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PMID:Telemedicine in British Airways. 937 86

In order for women to benefit from adequate community-based care during pregnancy, delivery, and the postpartum, health authorities must provide adequate local services with a sufficient number of trained agents to supervise all deliveries, and the communities themselves must strive to prevent maternal deaths. The community should monitor the health of women, assure access to family planning and prenatal care for all women, and make its members aware of warning signs during pregnancy and delivery. Communities need the assistance of a maternity center or hospital for high-risk pregnancies and difficult deliveries if morbidity and mortality are to be avoided. Each delivery should be attended by a trained person who knows when the delivery is excessively protracted and hospitalization is necessary, what to do in case of hemorrhage or poor presentation of the infant, what rules of hygiene to follow, and how to handle other situations that arise during delivery. Women who are healthy and well-nourished before pregnancy have fewer problems during pregnancy and delivery, and family planning allows high-risk pregnancies to be avoided. Regular prenatal care allows high-risk pregnancies to be identified so that the women can be sent to a hospital for delivery. The expectant mother can be given iron supplements, the 2 injections that will protect mother and infant against tetanus, and antimalarial drugs if necessary. Hypertensive women can be identified, and women can be given advice on child care and family planning. Warning signs before pregnancy include pregnancy within the past 2 years, being under 18 or over 35 years old, family size of 4 or more children, birth of a previous infant weighing under 2500 gm at birth, history of difficult delivery or cesarean, previous premature delivery or stillbirth, maternal weight under 38 kg or height under 145 cm, or chronic illness. Warning signs during pregnancy include failure to gain weight, pallor in the interior of the eyelids, and swelling of the legs, arms, or face. 6 signs requiring immediate attention are vaginal bleeding during pregnancy, intense headaches which may signal high blood pressure, significant vomiting, fever, convulsions, and labor of more than 24 hours. The community should try to ensure that each pregnant woman has a delivery kit in her home ready for use so that the delivery can be safely attended at home if necessary. Women and families should know where to seek further assistance if complications or warning signs occur. Communities can organize 2-way communications by telephone or radio with the referral hospital and can ensure that transportation is always available. Communities can also organize their own forms of insurance so that women can pay for emergency medical care.
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PMID:[Maternal care: what must it provide in the community for maternity without risks?]. 1228 31

The purpose of the investigation was to evaluate the efficacy of a slow bupivacaine infusion at postoperative surgical sites in immediate breast reconstruction patients. This prospective study included 16 patients who underwent autologous breast reconstruction with a latissimus dorsi pedicled flap immediately after mastectomy. A two-site infusion kit with dual split-flow catheters was secured at the operative sites before skin closure. A spring-loaded disposable pump then infused 0.25% bupivacaine at a rate of 2.08 cc per catheter per hour for 48 continuous hours. Patient pain levels, nausea/emesis, and oral and intravenous narcotic use were then recorded at 12-hour intervals. Medication use was converted to pain units for results comparison (one pain unit was defined as the equivalent of 10 mg of intravenous morphine). A retrospective control group comprised 16 consecutive patients from December of 1999 to October of 2002 who underwent the same surgery by the same surgeon using oral and intravenous pain medications. The experimental group demonstrated a more than fivefold decrease in the use of oral and intravenous pain medications compared with the historical controls (6.7 versus 1.7 pain units) (p < 0.001). The overall pain experienced by the catheter patients was nearly twofold less than the pain experienced by those without the catheter (1.8 versus 3.4 on the visual analog pain scale) (p < 0.017). Twenty-eight percent of the experimental group experienced nausea/emesis compared with 61 percent in the control group. No complications occurred with the use of the pain pump catheter. A 48-hour infusion of 0.25% bupivacaine significantly decreases the need for postoperative narcotics and the over-all pain experience in immediate breast reconstruction patients. This effective form of pain control may alleviate patient concerns of postoperative pain and may safely downstage many plastic surgery procedures, such as immediate breast reconstruction, and many cosmetic procedures to same-day status when the primary indication for admission is pain management.
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PMID:Efficacy of the pain pump catheter in immediate autologous breast reconstruction. 1546 95

The highest body temperature and clinical symptoms during the influenza infection were analyzed on 2,145 patients with influenza, (type A: 1,408cases, type B: 737cases: confirmed by a rapid diagnosis kit, Capilia FluA, B), and for 670 patients with a negative response to the rapid diagnosis kit (controls). The study was a multi-center study of the 2002-2003 influenza season. The percentages of patients with fever over 38 degrees C, 38.5 degrees C and 39 degrees C were significantly higher in influenza A than in influenza B or controls (16-64 yrs). Over 80% of the patients in all age groups of 0-6 yrs, 7-15 yrs, 16-64 yrs or over 64 yrs with influenza A or B had a cough. The percentage of patients with cough was significantly higher for patients with influenza A or B than for controls under 65 yrs. The percentages of influenza A or B patients with rhinorrhea or loss of appetite were significantly higher than in controls under 65 yrs. The percentage of patients reporting fatigue, headache or myalgia was significantly higher for influenza A than for controls of 16-64 yrs. Differences in symptoms, including fever, were minimal between influenza A and B patients under 16 yrs, and also among influenza A, B and controls in patients over 64 yrs. The percentage of patients with cough was not different among the three age groups by influenza A or B. However, the percentage of patients with rhinorrhea, loss of appetite, vomiting or diarrhea was higher in children under 16 yrs than in adults aged 16-64 yrs in influenza A or B. In conclusion, consideration must be given to the patient's age and the type of influenza when doing a symptomatic diagnosis of influenza. In addition, the use of a rapid diagnosis kit seems necessary for the diagnosis of influenza in elderly patients, who may have no specific symptoms of influenza.
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PMID:[Clinical symptoms of influenza infection in the 2002-2003 season]. 1547 43

We have reported previously the efficacy of antiprotozoal drugs against canine giardiasis (In press, Journal of Veterinary Clinic, the Korean Society of Veterinary Clinics). Fenbendazole was found to be the most efficacious for the treatment of canine giardiasis. There were no significant differences between the efficacy of albendazole and fenbendazole against canine giardiasis. On the other hand, the efficacy of metronidazole for the treatment of canine giardiasis, the efficacy was lower when compared to that of albendazole and fenbendazole. On the basis of these results, to evaluate clinical effect of silymarin, we evaluated the therapeutic efficacy of metronidazole alone, or combined with silymarin for 2 weeks for canine giardiasis. In addition, to observe effects on nutrition, we investigated the changes of body weight, the serum biochemical indicators for liver inflammation (GOT, GPT, NH3), the liver cell regeneration indicators (total protein, albumin) and the hematological changes during treatment (WBC, RBC, MCV, MCH and MCHC). The dogs were allocated to four groups; one group was treated with silymarin (3.5 mg/kg once a day, oral), another with metronidazole (50 mg/kg once a day, oral), and the other group with silymarin (3.5 mg/kg once a day, oral) plus metronidazole (50 mg/kg once a day, oral), while control group remained nontreated. The fecal samples from all the dogs were examined, using the ZSCT and giardia antigen test kit (SNAP(*) Giardia, IDEXX Laboratories), from each dog of each group for three times a week for 2 weeks. Dogs were considered to have giardiasis when one or more of the fecal samples had positive results for Giardia cysts. Seven days after treatment, the efficacy of silymarin plus metronidazole was found 79%, whereas that of metronidazole was 72%. Ten days post-treatment the efficacy of metronidazole plus silymarin (91%) was significantly different in comparison with that of metronidazole (75%). Two weeks post-treatment no cysts were detected in the fecal samples in the dogs of metronidazole or silymarin plus metronidazole-treated groups. Whereas, the fecal samples of all the dogs of the control and only silymarin-treated groups were giardia positive. Signs of side effects were not observed in silymarin plus metronidazole-treated dogs. But poor appetite and intermittent vomiting signs were observed in two dogs of the metronidazole-treated group that resolved when metronidazole administration was discontinued. The body weight of those treated with metronidazole was significantly decreased in comparison with those treated with silymarin and metronidazole plus silymarin. There were significant differences of body weight between the dogs treated with silymarin and metronidazole. Two weeks after metronidazole treatment, serum concentration of GOT, GPT and NH3 were significantly increased in comparison with those treated with silymarin. On the other hand, the serum concentration of GOT, GPT and NH3 were not significantly increased when treated with silymarin plus metronidazole compared to those treated with metronidazole. Serum total protein and albumin concentrations were decreased after metronidazole treatment as compared to those treated with silymarin and silymarin plus metronidazole. The concentrations of serum total protein and albumin decreased significantly in metronidazole-treated group as compared to that of treated with silymarin. The numbers of WBC and RBC did show significant differences in the dogs treated with metronidazole, while MCV, MCH were significant by different between silymarin and metronidazole-treated dogs. On the other hand, there were no significant differences in MCHC in any groups. These data suggest that silymarin, in supplement with antiprotozoal drugs, can influence the therapy of canine giardiasis.
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PMID:Evaluation of silymarin in the treatment on asymptomatic Giardia infections in dogs. 1615 41

National prevalence of Giardia infection in dogs and cats presenting to clinics with vomiting and/or diarrhea was examined using the IDEXX SNAP Giardia test kit. Veterinary practices across the United States were sent an invitation to participate in the survey and asked to use the test on fecal samples from the target population. The survey requested that the clinics report the results of 20 or more tests. A total of 21,092 results were reported, comprised of 16,114 dogs and 4,978 cats. Analysis of the data (excluding the handful of results reported from Puerto Rico) showed a Giardia prevalence of 15.6% among dogs tested, and 10.8% among cats. This difference was statistically significant (p < 0.001). Regional categorization into Northeast, Southeast, West, and Midwest drew out significant (p < 0.001) differences in prevalence in most cases for dogs; the differences were not significant for cats. These differences and other variables are currently being examined with this and additional data sets. We conclude on the basis of the SNAP test diagnostic that Giardia is a common enteric agent among dogs and cats with gastrointestinal signs.
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PMID:Prevalence of Giardia in symptomatic dogs and cats throughout the United States as determined by the IDEXX SNAP Giardia test. 1703 42


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