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)

New approaches are needed in the treatment of advanced breast cancer. In vitro studies have shown that recombinant tumor necrosis factor (TNF) is a growth inhibitor for the MCF-7, ZR-75-1, and BT-20 human breast cancer cell lines. Based on these considerations, the Southwest Oncology Group performed a Phase II trial of recombinant TNF (Genentech) (150 micrograms/m2) given by 30-minute intravenous infusion on days 1 to 5 of every other week for 8 weeks. Patients with metastatic breast cancer who had received one prior chemotherapy regimen for advanced disease were eligible. Of the 22 patients who were entered, 3 were ineligible. Nineteen patients who had a performance status of 2 or less could be examined (median age, 53 years). One possible fatal toxic reaction has been seen in a patient who had intracranial bleeding caused by a previously undiagnosed brain metastasis; no other treatment-related deaths have occurred. Toxicity has included nausea, vomiting, fever, chills, myalgia, and fatigue. No Grade 4 toxicity has been observed. Grade 3 toxic reactions have included hypotension (two patients), diarrhea (one patient), transient leukopenia (two patients), and reversible elevations of liver function test values (two patients). No objective responses have been observed. Twelve of 19 patients have died (median survival time, 8.5 months). Recombinant TNF is inactive as a single agent in patients with previously treated metastatic breast cancer.
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PMID:A Southwest Oncology Group phase II Trial of recombinant tumor necrosis factor in metastatic breast cancer. 191 10

Twenty-three healthy volunteer subjects received a single dose of amphotericin B colloidal dispersion or placebo (4:2) in a double-blind, randomized, dose-escalating design. Doses ranged from 0.25 to 1.5 mg/kg of body weight. The medication was administered via intravenous infusion at a rate of 0.5 mg/kg/h. Plasma amphotericin B concentrations increased with increasing doses, resulting in a linear increase in the amphotericin B area under the curve. Concentrations in plasma decreased rapidly upon discontinuation of the infusion, indicating rapid tissue distribution. A log-linear biexponential elimination phase was observed. A three-compartment open model was used to describe the distribution and elimination of amphotericin B. The mean terminal elimination half-life ranged from 86 h at the 0.25-mg/kg dose level to 244 and 235 h at the 1.0- and 1.5-mg/kg dose levels, respectively. Mean total body clearance ranged from 219 to 284 ml/kg/h. The volume of distribution increased with dose, from 3.37 liter/kg at the 0.25-mg/kg dose to 7.92 liter/kg at the 1.5-mg/kg dose. At the lowest dose level, 0.25 mg/kg, the medication was generally well tolerated. Progressive increases in the dose led to increasing side effects. At the 1.5-mg/kg dose level, 50% of the patients on active medication experienced nausea, vomiting, and chills. Physical examinations, ophthalmologic examinations, and clinical laboratory parameters remained within normal limits compared with those obtained during prestudy examinations.
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PMID:Single-dose pharmacokinetics and tolerance of a cholesteryl sulfate complex of amphotericin B administered to healthy volunteers. 192 41

Atypical measles syndrome has been reported extensively in the pediatric medical literature. However, the clinical picture in the adult is similar to that of many other diseases, making the diagnosis elusive. The case reported here was unusually morbid. The patient, a young man, had been in excellent health until the onset of a perplexing syndrome. When seen by the author, he had been ill for 1 week with chills, pharyngitis, and vomiting; later, a nonpruritic, maculopapular rash developed. Symptoms progressed to pneumonitis and hepatitis. A rubeola titer was obtained and was found to be considerably elevated. Because of the high titer and the fact that the patient had been immunized against measles in early childhood, the diagnosis was atypical measles syndrome. Two theories are offered to explain the pathogenesis of this disease.
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PMID:Atypical measles: a diagnostic conundrum. 193 6

Nursing management of second trimester abortion by PGE2 suppository after cervical dilatation with laminaria or Lamicel focuses on monitoring and treating side effects, managing pain, and supporting the patient emotionally. Mean abortion time by this method is 15-17 hours, within 24 hours in 80% of women. The side effects expected from PGs are nausea, vomiting, abdominal cramps, and diarrhea. Premedication with transdermal scopolamine, and ancillary methods such as giving ice chips, airing the room, keeping the patient clean are helpful. Acetaminophen is given orally or rectally for fever, headache, or chills. A beta-adrenergic tocolytic drug such as ritodrine HC1 is given if uterine contractions become tetanic, contractions 2-3 per minute or lasting longer than 6-90 seconds, detected by palpation. This drug must be used with caution in patients with asthma. Pain management in midtrimester abortion depends solely on the woman's comfort. Meperidine, morphine, epidural anesthesia with bupivacaine, lidocaine or morphine SO4, or patient-controlled anesthesia may be used. The nurse should monitor side effects such as hypotension, allergic responses, arrhythmias, and inability to void. Midtrimester abortion is often a stress-filled experience, since women may be ambivalent upon learning of fetal abnormalities. The women should be monitored after delivery to ensure that her uterus remains contracted, and assisted if surgical removal of retained products is necessary. Patients teaching for discharge, including medication to prevent lactation, is described. A care plan is suggested for assisting the family with bereavement, based on that used in case of stillbirth or neonatal deaths.
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PMID:Second-trimester termination of pregnancy: nursing care. 156 89

Patients (n = 15) with metastatic malignant melanoma, hypernephroma, and colon carcinoma received a three-phase adoptive immunotherapy protocol: phase 1, 10(5) units (high-dose) interleukin-2 (IL-2) iv every 8 h or 1 mg/m2 continuous intravenous infusion; phase 2, 6.5 d rest + leukapheresis; phase 3, 4 d of high-dose IL-2 plus three infusions of autologous lymphokine-activated killer cells. Toxicities of treatment included fever, chills, tachycardia, hypotension, vomiting, diarrhea, and fluid retention. Patients entering the trial were not malnourished, and mean plasma ascorbic acid concentrations before therapy were normal (36.3 +/- 14.2 mumol/L). Mean concentrations dropped by 80% after the first phase of treatment with high-dose IL-2 alone (to 7.4 +/- 4.5 mumol/L). Mean plasma ascorbic acid concentrations remained severely depleted (between 4.5 and 7.4 mumol/L) throughout the remainder of the 15-d treatment. Ascorbic acid concentrations became undetectable (less than 2.8 mumol/L) in 12/15 patients during this time. Blood pantothenate and plasma vitamin E concentrations remained within normal limits in all patients tested throughout the phases of therapy.
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PMID:Hypovitaminosis C in patients treated with high-dose interleukin 2 and lymphokine-activated killer cells. 196 85

Bacterial infections transmitted by blood or blood products, although rare, remain a serious threat to the recipient of a transfusion. We report on five cases of adverse reactions due to bacterial contamination of blood products, and we review 76 similar cases reported in the English-language literature. Most cases (70%) have been reported from the United States. Various sources of contamination have been suggested, including infection in the donor and invasion of the blood product during the process of collection, preparation, and storage. Frequent clinical manifestations are fever (80%), chills (53%), hypotension (37%), and nausea or vomiting (26%). The overall mortality is 35% (28 of 81 patients). In 38 patients (47%) the adverse reactions have appeared during transfusion; in the others the interval between completion of the transfusion and appearance of symptoms has ranged from 15 minutes to 17 days. A wide spectrum of bacteria have been implicated as causes of adverse reactions, with Pseudomonas species involved in 28% of episodes. Many such reactions are probably misdiagnosed or overlooked, the result being underestimation of the extent of the problem.
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PMID:Transfusion reactions due to bacterial contamination of blood and blood products. 204 64

Cocaine abuse is associated with a constellation of serious medical complications. An unrecognized and recently described complication of cocaine use is rhabdomyolysis with acute renal failure. We describe the first patient identified in our institution with this entity, admitted to the medical services with oliguric acute renal failure. Three days prior to admission the patient had a cocaine snorting binge. He presented with bilateral flank pain, gross hematuria, vomiting and chills. No history of crush injury, prolonged immobilization and or seizures was reported. On admission the vital signs were normal, physical exam revealed periorbital edema and marked soft tissue neck swelling. Lab values: Bun 120 mgs%, Creat. 10.7 mgs%, Na 132 meq/lt, Co2 13mq/lt, Cl, 103meq/lt, Co2 13meq/lt, Ca 5.3 mgs%, CPK 30,800 U/L with a MM fraction of 98%, LDH 600 U/L, SGOT 300 U/L. The urine was dark red with a ph of 6.5 and 100 rbc/hpf. The anti-GBM antibody and blood cultures were negative. An abdominal sonogram was normal. He received peritoneal dialysis and was discharged on his 14th hospital day with a CPK of 2,800 U/L and decreasing azotemia. Cocaine associated rhabdomyolysis has only been recently described in the literature (AJM April, 88). Acute myoglobinuric renal failure needs to be added to the growing list of medical complications of cocaine use.
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PMID:Cocaine and rhabdomyolysis: report of a case and review of the literature. 207 48

A 23-year-old male patient with bacteriologically proven pulmonary tuberculosis was treated with the various regimens of antituberculosis drugs for nearly 15 months. Rifampicin was administered thrice as one of the 3-4 drug regimen and each time he developed untoward side effects like nausea, vomiting and fever with chills and rigors. The last such episode was of acute renal failure at which stage the patient was seen by the authors of this report. The patient, however, made a full recovery.
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PMID:Acute renal failure due to rifampicin. 208 61

In this study we examined the clinical and laboratory findings of 80 in-patients. There is an important difference between sexes (p greater than 0.05). Comparison of ages showed that 7-30 age is more vulnerable than the older group. We found clinical symptoms of fever, chills, headache, abdominal pain, disturbances in bowel function, nausea, vomiting, anorexia, and lassitude in the first two weeks more frequently when compared with the 3rd, 4th, 5th weeks of illness (p less than 0.001). Where physical finding of rose spots, discordant pulse rate are important in the first two weeks (p less than 0.001). Abdominal discomfort is an important symptom both in the first two and in the last three weeks (% 40.3 and % 36 respectively). Hepatomegaly and splenomegaly, were found more frequently in the last three weeks. According to laboratory findings of anemia, leukopenia, increased erythrocyte sedimentation rate and positive blood and feces cultures there is no important difference between the first two and last three weeks (p greater than 0.05). Increase in polynuclear leucocytes is important for the first two weeks, and increase in lymphocytes is important in the last three weeks (p less than 0.001). Positivity of group agglutination tests is 57%, in the first two weeks and 83% in the last three weeks. This difference is found to be important.
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PMID:[Comparison of symptoms and clinical and laboratory findings in the first and last weeks of typhoid fever]. 208 33

In 11 patients with III A stage multiple myeloma in every week before new course of cytostatics started, three times plasmapheresis therapy had been performed. There was no difference in reducing of plasma cell mass, plasma immunoglobulins concentration and proteinuria or disappearance of osteolytic bone lesions between the group of patients treated with combination chemotherapy and plasmapheresis and chemotherapy alone. However there was visible disparity in the disappearance of bony pains: rapidly in the plasmapheresis group. One serious complication after plasmapheresis therapy was notified: gastric haemorrhage. The remaining plasmapheresis complications: tetany, nausea, vomiting, chills and bradycardia were related to citrate toxicity.
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PMID:[Combined therapy of multiple myeloma: cytostatics and plasmapheresis]. 213 16


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