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

A technique of 'crash induction' using thiopentone and suxamethonium with cricoid pressure was studied in 100 unselected patients at risk from vomiting or regurgitation. No episode of regurgitation occurred. There was difficulty with intubation due to poor relaxation in 7 patients and, in 61 cases, it was believed that there was some evidence of a potential hazard from raised intra-abdominal pressure other than due to fasciculation. Systolic blood pressure rose more than 20% in 19 patients, and fell more than 20% in 9 patients.
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PMID:Thiopentone and suxamethonium crash induction. An assessment of the potential hazards. 76 96

Our follow-up of 250 gynaecology patients and 100 dental patients who had received anaesthesia for elective outpatient surgical procedures indicates: (1) The practice of outpatient anaesthesia in proper facilities with proper selection of patients appears to be safe. (2) There is widespread patient acceptance of surgery and anaesthesia on an outpatient basis. (3) Complications are frequent but minor. (4) Many of the complications may be minimized: (i) Adequate depth of anaesthesia preferably with a volatile agent will do away with awareness during operation. (ii) Methoxyflurane should be avoided to minimize late arousal. Volatile agents such as enflurane or halothane would seem to be preferable to intravenous agents. (iii) Post-fasciculation pain could be minimized by avoiding succinylcholine for short procedures like D & C and using adequate depth instead. For dental procedures requiring tracheal intubation, one could perhaps use non-depolarizing muscle relaxants, like pancuronium, with reversal at the end of the procedure. (5) Nausea, vomiting, dizziness and headache are complications that occur very frequently in all series reported and this is an area where more research is indicated.
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PMID:An evaluation of the anaesthetic techniques used in an outpatient unit. 87 44

During May and June of 1985 the Health Protection Branch and several other agencies were involved in the investigation of over 300 reports of illness reported in the Vancouver area of British Columbia, Canada. Symptoms reported included nausea, vomiting, dizziness, muscle fasciculation and blurred vision. A review of the onset of symptoms and food consumed suggested that at least 140 people had become ill from eating cucumbers adulterated with a carbamate pesticide. The presence of residues of aldicarb in cucumbers from one particular producer was confirmed by laboratory analysis.
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PMID:Report of illnesses caused by aldicarb-contaminated cucumbers. 336 Feb 4

We report 250 rapid induction anesthesias performed for the purpose of preventing regurgitation and vomiting in patients with full stomach. The anesthetic technique includes administration of morphine 20 mg and droperidol 5 mg intravenously 10-15 minutes before induction, a voluntary air hyperventilation at the anesthetist's command, during which induction drugs are introduced and an induction with a mixture containing suxamethonium 2 mg/kg and thiopentone 1.4 mg/kg, administered within 1-2 seconds. Eighteen seconds after the onset of injection the loss of lid reflex is observed followed 7 seconds later by masseter muscle relaxation. Within the following 5-10 seconds intubation is carried out in full fasciculation process, before cardia relaxation. With this technique, a mean intubation time of 35 seconds is achieved. The interval of maximum regurgitation risk is lowered to 15 seconds, so that ventilation by mask and cricoid pressure are no more necessary. The technique is indicated in the young and vigorous adult and contraindicated in the old and tainted patient, in coronary patients, in those with low heart output and slowing of circulation.
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PMID:Ultrarapid induction. 403 42

This paper investigates the acute effects of carbofuran in workers of two pesticide-formulating plants. Mean airborne carbofuran concentrations ranged from 0.025 to 1.115 mg/m3 in plant A and from 0.018 to 0.067 mg/m3 in plant B, respectively. In workers of plant A the post-shift blood cholinesterase activity was significantly reduced, compared to pre-shift values. No difference in blood cholinesterase activity was found between pre- and post-shift values in workers of plant B. During the investigation, 25 cases of acute carbofuran poisoning were diagnosed by their clinical picture and depressed cholinesterase activity in blood. Usual symptoms included dizziness, weakness, blurred vision, nausea and sweating. Pallor, epigastric pain, vomiting and chest tightness occurred only in a few cases. Myosis was recorded in 24 cases. Fasciculation of muscle gastrocnemius induced by percussion was found in 6 cases, and four of them had also fasciculation of muscle orbicularis oculi. Inhibition of cholinesterase activity in the blood was related with the clinical features; however, the inhibition was rapidly reversible. In most cases, recovery was complete within 2-3 hours, with or without atropine treatment, after the subjects were removed from exposure. Rapid onset, mild illness and quick recovery are typical characteristics of occupational acute carbofuran poisoning.
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PMID:Acute effects of carbofuran in workers of two pesticide plants. 1021 31

Chlorophenoxy herbicides are used widely for the control of broad-leaved weeds. They exhibit a variety of mechanisms of toxicity including dose-dependent cell membrane damage, uncoupling of oxidative phosphorylation and disruption of acetylcoenzyme A metabolism. Following ingestion, vomiting, abdominal pain, diarrhoea and, occasionally, gastrointestinal haemorrhage are early effects. Hypotension, which is common, is due predominantly to intravascular volume loss, although vasodilation and direct myocardial toxicity may also contribute. Coma, hypertonia, hyperreflexia, ataxia, nystagmus, miosis, hallucinations, convulsions, fasciculation and paralysis may then ensue. Hypoventilation is commonly secondary to CNS depression, but respiratory muscle weakness is a factor in the development of respiratory failure in some patients. Myopathic symptoms including limb muscle weakness, loss of tendon reflexes, myotonia and increased creatine kinase activity have been observed. Metabolic acidosis, rhabdomyolysis, renal failure, increased aminotransferase activities, pyrexia and hyperventilation have been reported. Substantial dermal exposure to 2,4-dichlorophenoxy acetic acid (2,4-D) has led occasionally to systemic features including mild gastrointestinal irritation and progressive mixed sensorimotor peripheral neuropathy. Mild, transient gastrointestinal and peripheral neuromuscular symptoms have occurred after occupational inhalation exposure. In addition to supportive care, urine alkalinization with high-flow urine output will enhance herbicide elimination and should be considered in all seriously poisoned patients. Haemodialysis produces similar herbicide clearances to urine alkalinization without the need for urine pH manipulation and the administration of substantial amounts of intravenous fluid in an already compromised patient.
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PMID:Poisoning due to chlorophenoxy herbicides. 1557 61

Accidental or intentional ingestion of carbofuran can produce a life-threatening syndrome that requires prompt diagnosis and treatment. This paper investigates unintentional carbofuran poisoning in farm workers. Thirteen patients were admitted to the emergency department with carbofuran poisoning between January 2002 and August 2004 (2 female, 11 male). The patients had been poisoned while mixing the liquid form of carbofuran with seeds. Their hands were red on admission. Complaints most commonly reported by the patients on admission were nausea, vomiting, headache, weakness, dizziness and blurred vision. The most commonly observed signs were tachycardia, tachypnea, salivation, miosis, elevated blood pressure, and fasciculation. Three patients were agitated and one was lethargic on admission. We reviewed the patients' medical charts retrospectively, as well as the demographic data, intoxication route, clinical and laboratory presentations, and outcomes. We made the diagnosis according to a compatible exposure history and clinical findings. The most commonly observed laboratory finding was hyperglycemia, which was found in 6 patients. Serum pseudocholinesterase level was low in only one patient. All the patients were cured and discharged from the hospital in good physical condition. Rapid onset, mild illness and quick recovery are typical characteristics of acute occupational carbofuran poisoning. We conclude that public health efforts should educate farm workers about the dangers of pesticide application so that its threat can be diminished.
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PMID:Carbofuran poisoning among farm workers. 1635 64

Sarin is a highly toxic organophosphonate and neural enzyme acetylcholinesterase (AChE) inhibitor. Inhibition of AChE causes large accumulation of acetylcholine at synaptic cleft leading to hyper activation of nicotinic and muscarinic acetylcholine receptors, causing excessive secretions, muscle fasciculation, nausea, vomiting, respiratory distress and neurological effects. There are cases in which long term psychomotor function deficiency, reduced learning and memory functions have been observed several years after exposure of sarin among survivors. This phenomenon is called Organophosphorus ester Induced Chronic Neurotoxicity (OPICN) and cannot be explained by AChE inhibition alone. Plasma proteomics at earlier stages was carried out to study changes reflected at blood level that can help predict possible neurological insults at an early time point to take proper therapeutic interventions against OPICN. In the present study, a 0.5 LD50 dose of sarin was administered to Wistar rats and possible changes in blood plasma proteomic profile were investigated after one and seven days of sarin exposure. Proteins were separated on 2-dimensional gel electrophoresis and identified by MALDI-TOF/MS. Expression profile of major proteins was validated by Western blot. Result showed that after exposure of sarin inhibition of AChE persisted after one week of exposure. There were 14 plasma proteins that showed significant changes in expression (>1.5-fold). It included proteins related to immune function, neurodegenerative condition and chaperone function. Interestingly sarin exposure caused decreased expression of plasma Apolipoprotein A-1 and Haptoglobin on day seven, which are the putative early molecular markers for cognitive impairment and neurodegenerative changes.
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PMID:Increased expression of immune modulator proteins and decreased expression of apolipoprotein A-1 and haptoglobin in blood plasma of sarin exposed rats. 2677 79