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

A 40-yr-old Caucasian woman who had been suffering from systemic lupus erythematosus (SLE) since five years developed vague abdominal complaints whilst under treatment with a low dose of steroids. She had been admitted because of vomiting and abdominal tenderness. The ESR and CRP levels were rising and the C4 level had been persistently low in the preceding months. Normal non-invasive procedures did not allow a diagnosis to be made. Therefore exploratory laparotomy was performed and revealed a non-bacterial peritonitis and an oedematous jejunum. She responded well to a high dose of prednisone. Serositis of the peritoneum as well as bowel vasculitis may be a rare manifestation of SLE despite apparent control of other lupus manifestations. In this patient serositis flares were associated with a rise in CRP level.
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PMID:Lupus peritonitis presented as vague abdominal complaints in a SLE patient. 143 59

An open, randomized study of treatment of radiologically verified community-acquired pneumonia is described. 33 patients were treated with phenoxymethylpenicillin orally in an average dose of 2 g every 8 h, and 36 patients were treated intravenously with benzylpenicillin 3 g every 8 h. When temperature was normalized the antibiotic dose was reduced in both groups to oral phenoxymethylpenicillin in an average dose of 1 g every 8 h. 24 and 26 patients in respective groups completed 10 days of therapy. No statistically significant differences between the two groups were found when compared for duration of fever, hospital stay, CRP, ESR, leukocyte counts and X-ray normalization. In spite of the low number of patients included in this study it gives a clear indication that treatment of pneumonia with penicillin by the oral route results in the same outcome as parenteral treatment when patients suffering from vomiting, diarrhoea and severe illness with respiratory distress are excluded. In addition, oral treatment is cheaper than parenteral and more simple to manage.
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PMID:Antibiotic therapy in pneumonia: a comparative study of parenteral and oral administration of penicillin. 311 53

Recent studies evaluating interposed abdominal compression cardiopulmonary resuscitation (IAC-CPR) have demonstrated a significant increase in cardiac output, mean arterial pressure, and cerebral perfusion, as compared with standard CPR. A clinical evaluation of IAC-CPR effectiveness on resuscitation outcome has not been reported. A prospective randomized study comparing IAC-CRP with standard CPR for resuscitation of prehospital cardiopulmonary arrest was undertaken using the Milwaukee County Paramedic System. The patients were randomized following endotracheal intubation into IAC-CPR and standard CPR groups. Since October 1983, 291 patients have qualified for the study group. Of these, 146 patients had standard CPR, and 45 (31%) were successfully resuscitated. Of the 145 patients treated with IAC-CPR, 40 (28%) were successfully resuscitated. Chi-square analysis reveals no significant difference between these groups. To determine whether abdominal compression increases regurgitation, the frequency of emesis before and after intubation was analyzed. No significant difference was found between the IAC-CPR and standard CPR groups. Thus, IAC-CPR applied by paramedics in the field to patients following intubation does not improve cardiac resuscitation rates.
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PMID:Pre-hospital IAC-CPR versus standard CPR: paramedic resuscitation of cardiac arrests. 397 Jul 69

The clinical picture of nephropathia epidemica (NE) among children is poorly understood. We made a retrospective analysis of 32 patients aged 4-15 years treated in hospital for serologically verified recent NE. The most common clinical findings were high fever (100%), nausea (81%), vomiting (72%), tenderness in the kidney area (63%), abdominal pains (59%) and headache (59%). A peculiar symptom of NE, transient visual abnormalities, was found in 25% of patients. Four children had clinical bleeding and 1 had encephalitis. 44% were transiently hypertensive. Renal function was impaired in 84%, proteinuria was present in 97%, hematuria in 73% and leukocyturia in 44%. Other common laboratory findings were thrombocytopenia (87%), leukocytosis (41%), elevated ERS (74%, up to 76 mm/h) and CRP level (89%, up to 97 mg/l), elevated liver enzymes (53%) and hypoalbuminemia (50%). No child needed dialysis therapy and all recovered. NE seems to be less severe in children than in adults.
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PMID:Clinical picture of nephropathia epidemica in children. 791 22

A case of actinomycotic granuloma of the optic chiasma and the optic nerve is reported. A 53-year-old man was admitted to our hospital with headache and vomiting on September 25, 1989. General physical and neurological examination on admission revealed no remarkable findings. CT-scan demonstrated almost normal pictures. On the 17th hospital day, his temperature was 38 degrees C and white blood cell (WBC) count was 12000 cumm. And he presented right abducens palsy. MRI demonstrated no abnormal findings then. After antibiotic therapy of penicillin intravenously for 4 days, his temperature returned to normal and abducens palsy disappeared for two weeks. He was discharged 43 days after admission. But one year after discharge he developed progressive impairment of right visual acuity. He was admitted to our hospital again on January 19, 1991. His neurological examination revealed severe impairment of right visual acuity and bitemporal hemianopsia. WBC count was 5400 and CRP was negative and temperature was 36.2 degrees C. CT-scan and MRI demonstrated a suprasellar enhancing mass lesion. Serum prolactin was 38 ng/ml. A diagnosis of pituitary adenoma was considered and a right frontotemporal craniotomy was performed. At operation, abnormally swelled right optic nerve and chiasma were found and the swelled chiasma only was resected. Histological examination showed an abscess containing necrotic tissues and actinomycotic granules with radiating filaments. The patient was given penicillin intravenously for 37 days and orally for two months. At that time, MRI revealed no abnormal enhancing lesion, and his visual acuity improved gradually. Actinomycosis of the optic nerve and chiasma is very rare.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Actinomycotic granuloma of the optic chiasma: a case report]. 832 54

A 46-year old man suffered from fever, sweating, vomiting, abdominal pains, and watery diarrhea during two weeks. The abdomen was tender on pressure. Laboratory findings revealed increased leucocytes to 18,500/microliters, increased thrombocytes to 513,000/microliters, an increased sedimentation rate of 105/129 mm, CRP of 18.2 mg/dl and slightly elevated activities of the amino-transferases. Ultrasonography showed a tumor of the liver with a diameter of 10 cm and a echocomplex wheel-spoke structure. The tumor was confirmed by computed tomography, nuclear resonance tomography, angiography, and scintigraphy without signs of malignity. Fine needle biopsy was negative. Bisegment resection of the liver revealed a tumor of the liver with focal necrosis, with the histological aspect of fibrous tissue with lymphoid infiltration and multiple abscesses. The diagnosis was "inflammatory pseudotumor of the liver" (IPT). Postoperatively the follow-up half a year later was normal. The IPT ist an important differential diagnosis of the hepatocellular carcinoma. The review of 80 cases shows that operative resection of the tumor is the treatment of choice, because the benign diagnosis cannot maintained without doubts. But the pathognomonic trias of symptoms 1. Inflammatory signs, 2. solid tumor of the liver, 3. normal liver tissue allows to make this exceptional diagnosis. The question is whether the operation of the tumor can be avoided by conservative medical therapy.
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PMID:[Inflammatory pseudotumor of the liver. Case report of a rare differential diagnosis of hepatocellular carcinoma]. 865 89

Clinically acute pancreatitis is characterized by severe abdominal pain and systemic symptoms, such as nausea, vomiting and circulatory shock. In most cases the diagnosis is verified, and differential diagnoses are excluded, by elevated serum enzyme activities as well as characteristic findings in imaging procedures. The mild form of acute pancreatitis (about 80%) is characterized by an uncomplicated course and recovery within 72 hours in response to adequate therapy. By contrast, severe pancreatitis (about 20%) shows formation of necroses and a protracted course which frequently is dominated by development of systemic complications with subsequent failure of individual or several organ systems. On this background, early discrimination between mild and severe pancreatitis is important for therapeutic management and assessment of prognosis. Several classifications have been suggested in recent years but their use has been limited because they partly depend on complicated multiscoring systems. On the other hand, it has been possible to establish simple severity markers such as serum CRP and PMN-elastase that correlate well with further clinical course and outcome.
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PMID:[Clinical aspects and classification of acute pancreatitis]. 917 95

This report describes a 12-year-old girl who developed vaccine-type pneumococcal septicemia (type 4, Danish nomenclature) 2 years after splenectomy for recurrent idiopathic thrombocytopenia despite vaccination with the 23-valent vaccine 4 weeks before surgery and antibiotic prophylaxis with penicillin V. The disease presented as high fever with shivering and vomiting followed by disseminated petechiae and a deteriorated general condition. Initial laboratory studies showed severe sepsis with leucocytopenia and thrombocytopenia, a markedly elevated CRP, and disseminated intravascular coagulation. Despite antibiotic treatment, which was initiated with clindamycin, cefotaxime and trimethoprim/sulfamethoxazole and was switched to cefotaxime and penicillin after the result of the blood culture had been obtained, the patient had to be ventilated, and hemofiltration became necessary because of acute renal insufficiency. Furthermore, she required amputation of all her toes because of severe necrosis. No type-specific pneumococcal antibody titers were detected during and after infection. It remains unclear whether the susceptibility to Streptococcus pneumoniae was due to primary failure of antibody production or a decline in antibody levels after vaccination. Patients and/or their relatives should be informed that neither vaccination nor continuous antibiotic prophylaxis can guarantee full protection against infection with S. pneumoniae in patients after splenectomy.
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PMID:Overwhelming postsplenectomy infection with vaccine-type Streptococcus pneumoniae in a 12-year-old girl despite vaccination and antibiotic prophylaxis. 942 57

Predictive factors for the development of hemolytic uremic syndrome (HUS) were evaluated in 88 inpatients who suffered from enterohemorrhagic E. coli infections in the outbreak in Sakai, 1996. All in- and outpatients received oral or intravenous fosfomycin within acute phase of hemorrhagic colitis, and HUS complicated 1.4% of them. Persistence of bloody stools and diarrhea were longer in HUS patients than in non-HUS patients, but persistence of abdominal pain was not different in either group. Leukocytosis with leukocyte counts over 15,000/microliters and/or elevated CRP level over 2.0 mg/dl at admission, and fever and/or vomiting in the course of hemorrhagic colitis were more frequent in HUS patients than in non-HUS patients. Early intensive treatments including gammaglobulin, urinastatin, aspirin, and dipyridamole were employed in 34 high risk patients for prevention of HUS. These patients were estimated to be at risk of developing HUS because of incomplete HUS, nephropathy, elevated LDH level, thrombocytopenia, or age younger than two years old. These treatments were clinically effective.
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PMID:[Predictive factors for development of hemolytic uremic syndrome (HUS) and early intensive treatments for prevention of HUS enterohemorrhagic Escherichia coli infection]. 965 3

To investigate the clinical character of an outbreak of aseptic meningitis in Iwamizawa 1997 caused by echovirus 30, and to investigate the spreading of the outbreak, we analyzed clinical character of 75 hospitalized patients in our hospital, and mapped the patients' distribution in Iwamizawa City each week. We detected in our hospital an epidemic outbreak of acute enteroviral meningitis caused by echovirus type 30 in Iwamizawa, from September to December, 1997. Regarding the patients, there was little prevalence in males, with an average age of 6 years and a range of 0 to 13 years of age. The most constant symptoms were three major one such as headache (90%), fever up (89%), vomiting/nausea (87%), sometimes sorethroat (30%) and abdominal pain (15%). One case had a febrile convulsion temporally, and two cases had acute meningoencephalopathy and- encephalitis. In the cereblospinal fluid (CSF), we found no predominance of mononuclear cell (MNC) (58%) in the differential cell count. The mean of the peak of CSF cell counts was 654/3. White blood cell (WBC) was 8940/microliters, and CRP 1.4 mg/dl. None of them was detected in the bacterial culture of the CSF. Viral cultures were performed on CSF in 26 cases. Echovirus type 30 was isolated in 4 cases of hospitalized patients, and in one case with meningismus without pleocytosis. The beginning of the outbreak was observed in two kindergarten and one elementary school side by side. The peak of the whole outbreak was detected in the 3rd to 6th week, however the school spreading peak was detected in the 3rd and 4th week, and spreading was going in the whole city.
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PMID:[Outbreak of aseptic meningitis in Iwamizawa, 1997, caused by echovirus 30]. 974 26


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