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)

Eleven patients, aged 36 to 55 years, with silicone breast implants had episodes of severe chest pain similar to heart attacks 6 weeks to 7 years after breast implantation; one patient had a severe attack 1 month after explantation. The chest pain, which was not related to physical exertion, lasted from 15 minutes to 4 days, and descriptions of it varied from a "pressing" type of pain to "stabbing" pain with radiation to the shoulders, left arm, and jaw. The associated symptoms were diaphoresis, nausea, vomiting, dyspnea, and palpitations. All of the patients had a normal electrocardiogram (ECG) with the exception of one, whose ECG showed nonspecific ST changes. Ten had cardiac evaluations, all of which yielded normal results. All had implant removal, and five were found to have at least one ruptured implant. Nine had an implant capsule biopsy; all had chronic inflammatory rinds, and five had free silicone in tissue whether or not the implants were ruptured. All eight who had a pectoralis major muscle biopsy had abnormal results: (neurogenic atrophy [six], fasciitis [three], myositis [one], chronic inflammation [one], free silicone [one], and neuroma [one]). We concluded that silicone breast implants may cause an atypical chest pain syndrome, probably due to local inflammatory reactions and neuroma formation.
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PMID:Atypical chest pain syndrome in patients with breast implants. 854 8

We prospectively studied 110 adult patients coming to Black Lion Hospital between August 1987 and July 1989 with community acquired pneumonia (CAP) for various etiologic agents and clinical and radiographic presentation. Streptococcus pneumoniae was the most common offending pathogen in 72% and 67.5% from sputum and lung aspirate (LA) Gram stain respectively, and in 41% by pneumococcal serotyping of sputum. Blood and LA culture grew Streptococcus pneumoniae in 4 (6%), Staphylococcus aureus in 4 (6%), Enterobacteriaceae in (3%), Pseudomonas, Klebsiella and Streptococcus viridans in one case each. Non-bacterial pathogens included Mycoplasma pneumoniae in 3 (3%), Influenza A in 4 (4%), Influenza B in 3 (3%) and psittacosis/LGV in 4 (4%). Fever, cough, chest pain, tachypnea and coarse crepitations/bronchial breathing were the most common presenting signs and symptoms. Thirty per cent had associated diarrhoea and vomiting initially and 9% had altered state of consciousness at admission. Six patients came in a state of shock. Thirty-nine per cent had underlying illnesses. Ninety-three per cent had either segmental or lobar consolidation. Parapneumonic effusion occurred in 14%. The mortality was 11%. Tachypnea, the presence of underlying illness, altered state of consciousness, extreme leucocytosis and the presence of bilateral and multilobar lung involvement were found to be signs of poor prognosis. Our finding is similar to those from other African countries, except that we are reporting psittacosis/LGV for the first time in Africa.
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PMID:Community acquired pneumonia in adults in Addis Abeba: etiologic agents, clinical and radiographic presentation. 803 77

Although chronic alcoholics frequently present with gastrointestinal (GI) symptoms, the precise prevalence of GI symptoms in this group is unknown. Accordingly, we compared the frequency and severity of GI symptoms in 48 male alcoholics with those of 48 nonalcoholic controls. A standardized questionnaire was administered on two separate occasions to all subjects, and 14 GI symptoms were evaluated for three periods (during active drinking, early withdrawal, and sobriety). Symptom severity was assessed with a visual analog scale (1-10). Both actively drinking and withdrawing alcoholics had more frequent heartburn, nausea, vomiting, diarrhea, and flatulence, and more severe chest pain, milk intolerance, and postprandial fullness. These symptoms were transient and did not correlate with the quantity of alcohol consumed. Thus, alcoholics have more frequent and more severe GI symptoms which resolve quickly during abstinence and which predominantly occur while actively drinking rather than during withdrawal.
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PMID:Increased gastrointestinal symptoms in chronic alcoholics. 812 50

To assess the incidence of penicillin allergy as reported by patients to doctors, a 5-month study was undertaken in a university teaching hospital. The study design was prospective, and included all hospital patients for whom advice on clinical management was given by one bacteriology registrar and in whom the previous response to penicillin was considered. Of the 271 patients included in the study, 21 reported penicillin allergy. The most commonly reported symptom was localised rash (8 cases), followed by unknown reaction symptoms (6), nausea with or without vomiting (3), generalised itchy rash with difficulty in breathing (3), and localised rash with chest pain (1). Three of 21 cases reported generalised rash with difficulty in breathing; two of these followed intravenous penicillin administration. If the three cases of generalised itchy rash with difficulty in breathing are taken as true type-1 hypersensitivity to penicillin, the incidence of this was 1.11% (3 of 271), and the incidence of true allergy among patient-reported allergy was 14.3% (3 of 21). In two cases of reported penicillin allergy a penicillin was administered for treatment of the current infection, despite the history and without any ill-effects. Penicillins are non-toxic and inexpensive and, despite the number of alternatives for antibacterial therapy, are still the treatment of choice for many infections. More attention should therefore be paid to details of the clinical history relating to penicillin allergy with a view to decreasing the number of patients labelled 'penicillin-allergic'.
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PMID:Penicillin allergy: a study of incidence as reported by patients. 817 85

A diagnosis of diffuse esophageal spasm (DES) based on radiological and manometric studies was made in a 70-year-old man who presented with severe dysphagia, vomiting, and spontaneous chest pain. The manometric studies revealed a simultaneous onset of high amplitude contractions and a hypertensive lower esophageal sphincter (LES) that was well relaxed in response to deglutition, in contrast to the incomplete relaxation seen in achalasia. Because his dysphagia was so severe and did not respond to pneumatic dilatation, the patient was treated by a long esophageal myotomy with a full thickness incision through the LES and mucosa, adding a Thal-Hatafuku procedure. The patient made a good postoperative recovery and has since been eating normally without any further dysphagia or chest pain. Good manometric and radiological results have been obtained in this patient during 5 years of follow-up.
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PMID:Long esophageal myotomy with a fundic patch procedure for treating diffuse esophageal spasm: report of a case. 831 91

From 1982 to 1991, we experienced 76 patients with Mycoplasma pneumoniae pneumonia which were confirmed by serologic tests. There were 32 (42%) male and 44 (58%) female patients. One patient had underlying disease of diabetes mellitus while the other patients were in good health. The age ranged from 9 months old to 72 years old. All the patients complained of fever and coughing; 63% had dry cough and 37% had sputum production. Upper respiratory tract complaints such as rhinorrhea, sore throat, or earache were noted in 57% of the patients. Fifty-five percent of the patients had GI symptoms of anorexia, nausea, vomiting, or diarrhea. Other complaints included myalgia/arthralgia (29%), headache (30%), and general malaise (32%). Dyspnea (17%) and chest pain (20%) were occasional complaints. Seventy-one percent of the patients had WBC counts < 10000/cu mm and 29% > 10000/cu mm. The mean value of C-reactive protein (CRP) was 53.1 micrograms/ml, while 16% of the patients had a CRP value above 100 micrograms/ml. Thirty-one percent of the patients were noted to have a transient elevation of serum transaminase. Four different patterns of infiltration were seen in chest radiographic manifestation: 1) peribronchial and perivascular interstitial infiltrates (18.4%), 2) nonhomogeneous patchy consolidations (22.4%), 3) homogeneous acinar consolidations (27.6%), and 4) mixed interstitial and alveolar infiltrates (27.6%). Interstitial infiltration was more commonly seen in pediatric than adult patients (46% vs 20%). Other features of the radiologic manifestation were as follows: unilateral lesions in 80% of patients, single lobe lesions in 77%, lower lobe predominant in 69%, pleural effusion in 7%, and radiographic deterioration in 10%. Mycoplasmal pneumonia should be considered in the differential diagnosis of community-acquired pneumonias.
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PMID:Clinical study of Mycoplasma pneumoniae pneumonia. 832 Jul 55

Two cases of Morgagni's hernia comprising protrusion of the omentum alone are reported. The treated patients were 65- and 63-year-old obese women. They were referred to our hospital because of chest pain or vomiting accompanied by abnormal shadow in right cardiophrenic angle on chest roentgenogram. Computed tomogram (CT) demonstrated a mass of fat density behind the sternum for the both patients. The first patient was diagnosed as Morgagni's hernia by pneumoperitoneum, and surgical repair was done by the transabdominal approach. Magnetic resonance imaging (MRI) was carried out for the second patient, and showed intrathoracic mass lesion which was continuous with the subphrenic tissue. Although the second patient was diagnosed as mediastinal lipoma, median sternotomy revealed that the mass lesion was Morgagni's hernia. Postoperatively, both patients recovered uneventfully. The Morgagni's hernia has been reported to be about 3% of all diaphragmatic hernia. This disease may be discovered either because it causes respiratory or gastrointestinal complaints, or because an abnormal shadow in right cardiophrenic angle on a chest roentgenogram. If air-filled structures are present in the hernia, a barium study will confirm the diagnosis. In a case with a hernia containing only omentum, the diagnosis is difficult. CT has been regarded as the procedure of choice by several authors. The coronal and sagittal views of MRI can demonstrate the relationship between the herniated structures and the diaphragm, heart, pericardium. We emphasize the role of MRI for the diagnosis of Morgagni's hernia.
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PMID:[Two cases of Morgagni's hernia]. 847 1

Dipyridamole stress 201Tl scintigraphy is widely used in the investigation of myocardial ischaemia. We report our experience of adverse effects observed during this diagnostic procedure. A prospective study was undertaken of 435 consecutive patients (mean age 59 years; 273 males) referred to two nuclear medicine departments for assessment of myocardial perfusion was undertaken. Patients were monitored prior to and following the infusion of dipyridamole. All symptomatic, haemodynamic and electrocardiographic changes were documented. No deaths occurred in this series. Adverse events were observed in 174 (40%) patients. Of these, three patients experienced 'major' adverse events (0.6%) requiring hospitalization (myocardial infarction = 1; chest pain = 1; simple partial seizure = 1). 'Moderate' adverse events occurred in 39 (8.9%) patients and required intravenous aminophylline to reverse effects (ST segment abnormalities = 26; nausea = 7 headache = 3; chest pain = 2; bronchospasm = 1; protracted vomiting = 1; diarrhoea = 1). 'Minor' adverse events were experienced by 132 (30.3%) patients and did not require aminophylline. Sixty per cent of our patients experienced no ill effects from dipyridamole given as an exercise substitute in conjunction with 201Tl imaging. The rest had symptoms which were mostly mild, although a few patients found the experience unpleasant. Only one patient experienced a life-threatening episode.
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PMID:Safety of intravenous dipyridamole thallium myocardial perfusion imaging: experience in 435 patients. 847 71

The treatment of choice for advanced inoperable non-small cell lung cancer (NSCLC) is radiation therapy. Palliative radiotherapy schedules vary considerably in different centers, but a 30-Gy dose given in ten fractions over two weeks is a typical standard schedule. Our study was aimed at investigating whether a shorter course of only one 10-Gy fraction allows good palliation in the treatment of inoperable NSCLC patients whose main symptoms are related to an intrathoracic lesion. Patients of both sexes and any age, untreated with radiotherapy, with inoperable and histologically or cytologically proved NSCLC were examined. Seventeen patients, too advanced for radical "curative" radiotherapy and whose main symptoms were related to primary intrathoracic lesions, entered the study even though they had metastases. On admission, 76% (13/17) of patients had cough 76% (13/17) dyspnea, 70.7% (12/17) chest pain and 23.6% (4/17) hemoptysis. They received a single dose of 10 Gy, delivered with an 18-Mv linear accelerator via anteroposteriorly opposing portals without spinal cord shielding. Treatment volume usually included the macroscopically detected lesion identified with a CT simulator. Palliation of symptoms was achieved in high rates of patients: 46% for cough, 69% for dyspnea, 83% for pain and 75% for hemoptysis. These results were obtained within one month of treatment. Unfortunately, palliation of symptoms did not last long, decreasing to 42% within two months of the end of treatment and to 32% at three months. Four patients were retreated, one patient three months and three patients two months after the end of radiotherapy. Ten Gy to the target volume were administered as retreatment with spinal cord shielding. Side-effects were mild: nausea in 3 patients (17%), vomiting in one patient (5%) and grade-II dysphagia in two patients were observed and classified according to WHO criteria. Pain increased 24 hours after radiotherapy in five patients. We can conclude that single dose radiotherapy yields good, but short, palliation of symptoms with acceptable side-effects.
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PMID:[Single-dose palliative radiotherapy in inoperable non-small-cell lung carcinoma]. 868 68

The purpose of this study was to describe the course of preterm labor in patients receiving a standard intravenous infusion of the oxytocin antagonist atosiban. An open-labeled, non-randomized study was conducted at 4 sites. Successful tocolysis was defined as delay of delivery larger than 48 hours from starting atosiban and no need for an alternate tocolytic. Atosiban was administered by continuous intravenous infusion at a rate of 300 micrograms per minute until uterine contractions were absent for 6 hours, or up to a maximum infusion time of 12 hours. Sixty-two patients of between 20 and 36 weeks' gestation were enrolled over 6 months. One had rupture of membranes and was excluded. Successful tocolysis was noted in 43 of 61 (70.5%). Four delivered spontaneously within 48 hours and 14 (23.0%) required an alternate tocolytic agent. The chance of successful tocolysis was related to the degree of cervical dilation at the start of therapy. Cessation of uterine contractions was noted in 38 patients (62.3%). A decrease in uterine contraction frequency of 50% or more was noted in 50 of 61 patients (82.0%). Four patients reported side effects (nausea, vomiting, headache, dysguesia, chest pain), but in no case did side effects require discontinuation of the medication. Intravenous administration of atosiban is associated with a delay in delivery comparable to that seen with other tocolytics. If this effect is confirmed in planned placebo-controlled trials, its favorable side effect profile may give it a place in the armamentarium.
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PMID:Treatment of preterm labor with the oxytocin antagonist atosiban. 868 3


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