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)

This study determines the ovarian effects, contraceptive efficacy, and effects on serum levels of norethindrone acetate (NET-Ac) and ethinyl estradiol (EE) among women using a single contraceptive vaginal ring (CVR) cyclically over a period of 1 year. A total of 60 women were enrolled and used the ring according to a schedule of 3 weeks "in" and 1 week "out." Assays of serum norethindrone acetate (NET-Ac) ethinyl estradiol (EE) levels were taken twice weekly in cycles 6, 9, and 13. Despite luteal activity in some cycles, no pregnancies were noted within the 12-month study period. Heavier body weight was associated with increased probability of luteal activity. Mean serum levels decreased over the last 3 months of CVR use, accounting for the increase in luteal activity and possible ovulations in cycle 13. Among women in Sydney, by contrast with women in the other centers, a difference in the effect on lipids was seen. However, the changes in lipid levels were very small. The side effects were a little different from those experienced by women using a combined pill. Nausea and vomiting were largely confined to early cycles and most common in the first days of the first cycle. Weight gain was also not a problem, although there was a small mean increase in body weight over the 12-month treatment period. This study indicates that use of a single CVR releasing EE and NET-Ac over a period of 12 months constitutes an acceptable, safe and effective contraceptive method.
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PMID:Efficacy, bleeding patterns, and side effects of a 1-year contraceptive vaginal ring. 1049 85

Mixed adenoneuroendocrine carcinoma (MANEC) is a rare tumour of the gastrointestinal tract that consists of a dual adenocarcinomatous and neuroendocrine differentiation, each component representing at least 30% of the tumour. We report a case of a 68-year-old man who presented with two-month history of postprandial pain and vomiting. Gastric endoscopy revealed a polypoid mass in the lower part of the oesophagus. In contrast to the majority of these tumours, this biopsy was immunohistochemically positive for chromogranin A, and synaptophysin and Ki-67 index was 50% and the tumour was diagnosed as poorly differentiated neuroendocrine carcinoma of the oesophagus. The patient underwent surgery and lower oesophagus resection was performed. Based on the histopathology and immunohistochemistry of the tumour in the oesophagogastrectomy specimen, a mixed adenoneuroendocrine carcinoma (MANEC) was diagnosed. The objective of this case report is to advocate for the focus on the MANEC diagnosis as such patients need to be referred to a centre of excellence with expertise in NET tumours, to have the correct diagnostic work-up, treatment, and secondary diagnostic procedures performed at progression, as this will have paramount influence of the choice of treatment.
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PMID:Mixed Adenoneuroendocrine Carcinoma Is a Rare but Important Tumour Found in the Oesophagus. 2695 90

Weight loss is a common symptom of Parkinson's disease and is associated with impaired quality of life. Predictors of weight loss have not been studied in large clinical cohorts. We previously observed an association between change in body mass index and change in Unified Parkinson's Disease Rating Scale (UPDRS) motor and total scores. In this study, we performed a secondary analysis of longitudinal data (1-6 years) from 1619 participants in the NINDS Exploratory Trials in PD Long-term Study-1 (NET-PD LS1) to explore predictors of weight loss in a large prospective clinical trial cohort of early treated Parkinson's disease. The NET-PD LS1 study was a double-blind randomized placebo controlled clinical trial of creatine monohydrate 10 gm/day in early treated PD (within 5 years of diagnosis and within 2 years of starting dopaminergic medications). Linear mixed models were used to estimate the effect of baseline clinical covariates on weight change over time. On average, participants lost only 0.6 kg per year. Higher age, baseline weight, female gender, higher baseline UPDRS scores, greater postural instability, difficulty eating and drinking, lower cognitive scores and baseline levodopa use (compared to dopamine agonists) were all associated with weight loss. Surprisingly baseline difficulty swallowing, dyskinesia, depression, intestinal hypomotility (constipation) and self-reported nausea/vomiting/anorexia were not significantly associated with weight loss in this cohort of early treated Parkinson's disease patients. On average, participants with Parkinson's disease experience little weight loss during the first 1-6 years after starting dopaminergic replacement therapy, however levodopa use and postural instability were both predictors of early weight loss. Trial Registration clinicaltrials.gov identifier# NCT00449865.
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PMID:Predictors of weight loss in early treated Parkinson's disease from the NET-PD LS-1 cohort. 2871

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant endocrine tumour syndrome characterised by three main manifestations: primary hyperparathyroidism (78-94%), gastroenteropancreatic neuroendocrine tumours (GEP-NETs) (35-78%) and pituitary adenomas (20-65%). For metastatic and inoperable GEP-NETs, there are some interventional and medical therapies. Peptide receptor radionuclide therapy (PRRT) with Yttrium-90 (90Y) and Lutetium-177 (177Lu) is one of the important radiotherapies. Herein we describe a case of MEN1 syndrome with inoperable metastatic GEP-NETs who had excellent response to the treatment with six cycles of 177Lu-DOTATATE. The patient was admitted to our clinic with widening of hands and feet, polyuria, polydipsia, nausea, vomiting and constipation. His laboratory and screening findings were consistent with primary hyperparathyroidism, acromegaly, secondary hypogonadism and central diabetes insipidus. He underwent 3.5 parathyroidectomy and hypophysis adenomectomy. Under treatment with lanreotide and cabergoline, he developed metastatic duodenal NET. PRRT with 177Lu-DOTATATE was administered in six cycles and an excellent response was displayed without any side effect. In conclusion, the dramatic response of the patient to PRRT with 177Lu-DOTATATE, described in our case report and recent published articles indicating the beneficial efficacy and limited adverse effects of 177Lu-DOTATATE, should encourage clinicians to use PRRT for inoperable or metastatic NETs.
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PMID:Metastatic MEN1 Syndrome Treated with Lutetium-177 - A Case Report. 3161 99

Digestive cancers diagnosed during pregnancy are rare and are sporadically reported. The shift of pregnancy towards the age interval of 30-39 years old (and even 40-49 years old) could explain the more and more frequent superposition of pregnancy and cancer. Pancreatic Neuroendocrine Tumours (PNET) originate in the insular endocrine tissue and are extremely rare; they have a slow, less aggressive neoplastic development, with the capacity of secreting and storing different peptides and neuroamines. From the large group of NET tumours, approximately 70% have a gastroenterohepatic (GET) localisation and represent less than 2% of the digestive tract tumours. PNET incidence is extremely reduced, of approximately 1/100.000. The association of pregnancy and PNET in literature is exceptional until now only 39 cases were reported. The most frequent PNET in pregnant patients is the insulinoma with the starting point in pancreatic B-cells, with 27 out of 39 PNET worldwide reported cases until 2012. Establishing a diagnosis in pregnant patients is difficult in the first period of pregnancy because physiologically, the glucose tends to be low. This may be a consequence of the increased secretion of insulin and sensibility to insulin, probably as an effect of increased oestrogen levels. Furthermore, there are other signs which could suggest the existence of a "problem", which are relatively common during the first trimester of pregnancy: unexplained fatigue, vomiting, hypotension, rare episodes of hypoglycaemia. Performing paraclinical tests on these patients is difficult; an essential indicator of the opportunity for the investigation is the pregnancy trimester. The precaution about a foetal injury when indicating an invasive exploration (imaging, endoscopy, etc.) delays the diagnosis. The insulinomas have a rather benign potential than an aggressive nature, and their prognosis is usually favourable, with therapeutic possibilities easy to administrate and control in pregnant patients. Medical treatment is used in patients when there is a positive diagnosis but the topography of the insulinoma was not identified, when the symptomatology is easy to control through conserving therapy until the foetus is mature enough or immediately after birth, in pregnant patients who refuse the surgical procedure, or in the case of metastasis of malignant insulinoma. Surgical treatment indeed remains the only therapeutic method, but most often it is scheduled usually after birth, or if the situation requires, as late as possible after the foetus has a convenient age (after 28 weeks).
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PMID:Pancreatic Neuroendocrine Tumour in Pregnancy - Diagnosis and Treatment Management. 3167 Jun 30