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)

We experienced a rare case of the gastric cancer occurred after the coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA). On April, 1990, a 74-year-old woman underwent CABG using RGEA for angina pectoris due to 99% stenosis of the right coronary artery. Anorexia and vomiting appeared from December 1992. Examination of the stomach by an oral procedure led to a diagnosis of the pyloric stenosis due to the gastric cancer. The coronary arterial lesion was progressive, and 90% stenosis of LAD (#6, #7) was noted. On February 1993, the re-CABG and the gastrectomy were performed simultaneously. The re-CABG using the saphenous vein was performed to #3, and additional CABG using the bilateral internal thoracic artery were performed to #8 and #9. At the same time, the gastrectomy were performed and RGEA was resected to remove the R2 lymph node completely. If the root of RGEA had been exposed completely at the first operation, RGEA could be preserved as the bypass graft.
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PMID:[A case of gastric cancer occurred after coronary artery bypass grafting using the right gastroepiploic artery]. 830 66

Hemodialysis is frequently complicated by hypotension and associated symptoms. It has been suggested that these symptoms may be related to the biochemical changes caused by cellulosic dialysis membranes. In this study, a prospective randomized crossover trial was conducted comparing the incidence of hypotension and acute symptoms during dialysis with large-surface-area (1.6 m2) cellulosic (cuprophane [CUP]) and noncellulosic (polyacrylonitrile [PAN], AN69) membranes. Dialyzers were used for a single use only. There was no difference in predialysis BUN, predialysis blood pressure, intradialytic weight gain, blood flow, dialysis efficiency (urea reduction), dialysis duration, hematocrit, or erythropoietin dose between the two study phases. When these clinical characteristics were matched, there was no difference in the number of episodes of hypotension (CUP, 19 +/- 3; PAN, 22 +/- 3; P = not significant [NS]). The incidence of symptomatic hypotension, as reflected by the number of episodes of hypotension requiring more than 100 mL of saline for correction, was also not different between study phases (CUP, 10 +/- 1; AN69, 11 +/- 2; P = NS). The incidence of intradialytic symptoms, including emesis, cramping, headache, angina, pruritus, and bronchospasm, was similar during the two study phases (CUP, 11 +/- 2; AN69, 10 +/- 1; P = NS). It was concluded that noncellulosic membranes do not offer any significant advantage over cellulosic membranes in reducing the acute complications of hemodialysis.
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PMID:Tolerance of hemodialysis: a randomized prospective trial of high-flux versus conventional high-efficiency hemodialysis. 840 77

Sumatriptan is a potent and selective agonist at the vascular 5HT1 receptor which mediates constriction of certain large cranial blood vessels and/or inhibits the release of vasoactive neuropeptides from perivascular trigeminal axons in the dura mater following activation of the trigeminovascular system. The mode of action of this drug in migraine and cluster headache is discussed. On the basis of a detailed review of all published trials and available data from post-marketing studies, the efficacy, safety, tolerability and the place of oral and subcutaneous sumatriptan in the treatment of both conditions are assessed. A number of double-blind clinical trials have demonstrated that sumatriptan 100 mg administered orally is clearly superior to placebo in the acute treatment of migraine headache and achieves significantly greater response rates than ergotamine or aspirin. In other studies, 70 to 80% of patients receiving sumatriptan 6 mg sc experienced relief of migraine headaches by 1 or 2 h after administration, and patients consistently required less rescue medication for unresolved symptoms. Sumatriptan was also effective in relieving associated migraine symptoms like nausea and vomiting. Sumatriptan was equally effective regardless of migraine type or duration of migraine symptoms. Overall, approximately 40% of patients who initially responded to oral or subcutaneous sumatriptan experienced recurrence of their headache usually within 24 h, effectively treated by a further dose of this drug. In 75% of patients with cluster headache treated with sumatriptan 6 mg sc, relief was achieved within 15 min. Based on pooled study data, sumatriptan is generally well tolerated and most adverse events are transient. Adverse events following oral administration include nausea, vomiting, malaise, fatigue and dizziness. With the subcutaneous injection, injection site reactions occur in approximately 30%. Chest syumptoms are reported in 3 to 5% but have been associated with myocardial ischaemia only in rare isolated cases. The recommended dosage of sumatriptan at the onset of migraine symptoms is 100 mg orally or 6 mg subcutaneously. The recommended dosage for cluster headache is 6 mg sumatriptan sc. Sumatriptan must not be given together with vasoconstrictive substances, e.g., ergotamines, or with migraine prophylactics with similar properties, e.g., methysergide. Sumatriptan should not be given during the migraine aura. It is contraindicated in patients with ischaemic heart disease, previous myocardial infarction, Prinzmetal (variant) angina and uncontrolled hypertension.
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PMID:Migraine and cluster headache--their management with sumatriptan: a critical review of the current clinical experience. 853 93

To estimate the frequency of adverse effects associated with the use of the transdermal nicotine patch, we abstracted and analysed data from 47 reports of 35 clinical trials. The meta-analysis presented here represents a synthesis of data from 41 groups of nicotine patch recipients totalling 5501 patients, and 33 groups of placebo recipients totalling 3752 patients. Smoking abstinence was the primary outcome in 32 of the trials, and relief of colitis symptoms was the primary outcome in 2 of the trials; 1 study of contact sensitisation was included in the skin irritation analysis. The patch was clearly effective as an aid to smoking abstinence. Despite the large number of patients in the analysis, few adverse cardiovascular outcomes (myocardial infarction, stroke, tachycardia, arrhythmia, angina) were reported, and no excess of these outcomes was detected among patients assigned to nicotine-patch use. The incidences of several minor adverse effects were clearly elevated among the nicotine-patch groups, especially sleep disturbances, nausea or vomiting, localised skin irritation and respiratory symptoms, but the background rates and risk ratios varied considerably across studies. The incidence of nausea or vomiting appeared to be lowest when the patch dose was tapered. The results of this meta-analysis indicate that very large studies would be needed to assess the effect of the patch, if any, on serious, rare outcomes. These results also suggest that the rate of minor adverse effects might be lowered by modifying patch-use protocols.
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PMID:A meta-analysis to assess the incidence of adverse effects associated with the transdermal nicotine patch. 956 40

Out of 195 cases of Takayasu's arteritis who presented in our institute between January 1988 and December 1997, 12 (5.58%) had dilated cardiomyopathy. Age of these patients ranged from 10 to 30 years (17.25 +/- 5.30 years) and male-female ratio was 1:11. All the cases had cardiovascular system features (dyspnoea, oedema, palpitation, angina, etc. but without hypertension), three had central nervous system features (headache, vomiting, convulsion etc.) and all had general systemic features like weight loss, malaise, fever, arthralgia etc. Electrocardiography, chest X-ray and echocardiographic findings were consistent with dilated cardiomyopathy. Haemodynamic findings showed raised left ventricular end-diastolic pressure and pulmonary capillary wedge pressure in all; raised pulmonary artery pressure, pulmonary vascular resistance, right ventricular pressure and right atrial pressure in 6, 6, 4 and 2 cases, respectively; reduced left ventricular peak systolic pressure in 10 cases but central aortic pressure and systemic vascular resistance in all the cases were within normal limits. Angiography showed type I, II and III involvement in 7 (majority), 3 and 2 cases, respectively. Coronary and pulmonary angiography were normal and left ventricular angiography showed poor left ventricular systolic function in all the cases. Histopathological study (on 3 autopsy cases) showed non-specific inflammation of myocardium with lymphocyte/mononuclear cell infiltration and normal coronary vessels. So, dilated cardiomyopathy in Takayasu's arteritis is not rare, though not much reported, and can influence the prognosis of aortoarteritis cases.
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PMID:Dilated cardiomyopathy in non-specific aortoarteritis. 1072 44

Previous studies showed that increased QT dispersion (QTd) has been observed during episodes of myocardial ischemia or infarction and identify the patients at risk of arrhythmia or sudden death. The objective of this study is to investigate the relationship between coronary artery disease and QTd during the Valsalva maneuver. The study population included 85 subjects (21 with normal coronary arteries, 35 with stable angina pectoris, and 29 with unstable angina pectoris). Twelve-lead surface ECGs were recorded at 50-mm/sec paper speeds and were obtained before the Valsalva maneuver and during the strain phase. The results indicate a significant difference in mean time increase between the control group and the group with stable angina pectoris (mean difference = 16.10 milliseconds, p<0.000), and between the control group and the group with unstable angina pectoris (mean difference = 35.26 milliseconds, p<0.000). The mean difference in time between these groups was also compared (mean difference = 19.17 milliseconds), and was statistically significant (p<0.000). There are some conditions like constipation, severe coughing spells, nausea, vomiting, and carrying or lifting heavy objects that increase intrathoracic pressure and may increase QT dispersion. Therefore, all these conditions should be treated appropriately and carrying or lifting heavy objects is forbidden, especially in patients with coronary artery disease.
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PMID:Effects of Valsalva maneuver on QT dispersion in patients with ischemic heart diseases. 1171 25

In order to verify the safety of an ideal length of hospital stay (5-6 days) after open colectomy, we reviewed complications after 371 consecutive, elective colorectal resections for cancer at our institution between April 1991 and December 1998. Specifically, age of the patient, length of hospital stay and when the complication was diagnosed were registered. The median postoperative hospital stay was 9 days (range, 4-34 days). No difference in length of hospital stay was detected in patients < or = 65 years old versus > 65 years old (P = NS). All major complications (anastomotic leak, intestinal bleeding, intestinal occlusion, pneumonia, pulmonary embolism, pulmonary edema, stroke, angina pectoris, and fascial dehiscence) were diagnosed before the fifth postoperative day (P < 0.05). Among the minor complications (vomiting, packed red blood cells transfusion, diarrhea, wound infection, urinary tract infection, and pleural effusion), none requiring hospitalization was detected later then 5 days after the operation. We conclude that postoperative length of stay after colorectal resection for cancer can be reduced safely to five to six days after the operation.
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PMID:[The ideal length of hospital stay in the surgical treatment of colorectal cancer]. 1214 16

When a renal recipient in Turkey develops a postoperative problem, consultation by the transplant team in the emergency unit is often the first step toward a solution. The main aim of this study was to identify the types of postoperative problems that cause renal transplantation patients to visit the emergency room. Gathering this information was believed to be an important step toward developing new management strategies for these problems, in line with the quality management systems used throughout our hospital network. We collated the physical signs in the 78 patients when they presented to the emergency room. The most common one was fever (26.9%) followed by nausea/vomiting, diarrhea, abdominal pain, dyspnea, skin lesions, headache, musculoskeletal trauma, hematuria/dysuria, epistaxis, psychological disorders, angina pectoris, hypertension, epilepsy, and rectal bleeding. Among the 78 patients, 45 (57.7%) were hospitalized and 33 (42.3%) were discharged with medical advice or drug treatment. Among the 45 hospitalized patients, 97.8% were initiated on medical treatment. Knowing the surgical and medical emergency issues prevalent in recipients enables the development of new procedures and algorithms, leading to more effective management and follow-up of renal transplant recipients.
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PMID:Problems in postoperative renal transplant recipients who present to the emergency unit: experience at one center. 1501 41

Coronary artery aneurysms are uncommon and the prevalence in patients undergoing coronary artery angiography is 1.5-4.9%. The most common cause of coronary artery aneurysm is arteriosclerosis, followed by Kawasaki disease, periarteritis nodosa, systemic lupus erythematosus, syphilis, rheumatic fever, congenital heart disease and trauma. Most coronary aneurysms remain asymptomatic. Patients may present symptoms of angina or myocardial infarction due to thrombosis within the aneurysm. This would lead to occlusion of the coronary artery or to distal thromboembolisms. There is no consensus on how to manage coronary artery aneurysms. Medical therapies include aspirin as well as warfarin. Surgery may be performed in patients with a large aneurysm, i.e. when the risk of rupture or thrombosis is high. We present a 60-year-old female patient with symptoms of a transient ischaemic attack followed by a period of fever, nausea, vomiting and ecchymoses on the lower extremity. Transthoracic and transoesophageal echocardiography was suggestive of a tumour located at the basis of the lateral wall of the right atrium. Heart surgery revealed, however, a large right coronary aneurysm and an atrial septum defect of the secundum type.
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PMID:[A 60-year-old woman with asthenia and dyspnoea]. 1576 62

Addisonian crisis represents a state of acute adrenocortical insufficiency and occurs in patient with Addison's disease who are exposed to stress of infection, surgery, trauma, vomiting and diarrhea. We present a case with a 39-year-old female patient who admitted to the hospital with Addisonian crisis and, interestingly, her electrocardiograph showed ST depression and inverted T waves on inferior and V4-V6 leads. She did not have a history of angina pectoris and coronary artery disease, and her cardiac enzymes were normal. Exercise stress testing and echocardiographic assessment revealed normal findings. When faced with such a patient who has hypotension and ischemic ECG changes without having underlying angina, Addisonian crisis should be considered in differential diagnosis.
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PMID:Inverted T waves in patient with Addisonian crisis. 1633 1


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