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 report a patient with classical features of amiodarone hepatotoxicity who died of progressive liver failure. Throughout the course of his illness, he had epigastric pain, nausea, vomiting, and persistent mild to moderate elevation of amylase and lipase in his serum and peritoneal fluid. Pancreatitis due to amiodarone has not been reported. We raise the question of whether or not the pancreas is yet another organ subject to amiodarone toxicity and speculate as to possible pathogenesis. We suggest that patients on amiodarone who develop abnormal liver enzymes, nausea, vomiting, or abdominal pain be evaluated not only for hepatotoxicity, but for pancreatitis as well.
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PMID:Can pancreatitis be associated with amiodarone hepatotoxicity? 168 30

Among 51 patients with refractory symptomatic reflux esophagitis seen during an 18-month period, 8 (16%) had undergone previous partial gastrectomy. Either Billroth II (n = 6) or Billroth I (n = 2) resection had been carried out for peptic ulceration 18 months to 30 years beforehand. Each patients was evaluated by symptom scoring, endoscopy, and 24-hour pH monitoring plus a 16-hour esophageal aspiration study, in which 2-hourly aliquots were measured for acid, pepsin, conjugated and unconjugated bile acids, and trypsin. After conversion to a 45 cm Roux-en-Y gastroenterostomy, symptom scoring and endoscopy were repeated at 6 to 12 months in all eight patients. Pepsin, acid, and unconjugated bile acids were seldom present in esophageal aspirates. Conjugated bile acids in concentrations up to 30 mmol/L and trypsin up to 428 micrograms/ml were found in cases of severe esophagitis, mostly during nocturnal rest. Esophagitis, heartburn, regurgitation, and bilious vomiting were eradicated by Roux-en-Y conversion, but other postgastrectomy symptoms (early satiety, dumping, epigastric pain, and diarrhea) were largely unchanged. Postgastrectomy esophagitis resistant to medical therapy seems likely to be caused by nocturnal exposure to trypsin and conjugated bile acids; it is well controlled by a 45 cm Roux-en-Y conversion.
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PMID:Evaluation and surgical correction of esophagitis after partial gastrectomy. 172 72

In order to observe the incidence of dysrhythmia in 20 patients who had undergone cholecystectomy, we recorded gastric electrical activity by means of serosal electrodes from the day of surgery to the 6th postoperative day. The difference between the incidence of dysrhythmia on the day of the operation and the other days is statistically significant (t test: p less than 0.001). Bradygastria was the most frequently observed dysrhythmia, both on the day of surgery and on the following days. It had a frequency of around 1.0-1.5 cpm and the episodes lasted for a minimum of 10 min to a maximum of 105 min (mean duration 32.6 min). Episodes of tachygastria were of varying duration, ranging from a minimum of 3 min to a maximum of 60 min (mean duration 18.5 min), whereas episodes of gastric tachyarrhythmia lasted between 2 min and 21 min (mean duration 5.4 min). Only 1 patient had an episode of nausea and biliary vomiting, associated with an episode of gastric tachyarrhythmia on the 1st postoperative day. None of the other patients had symptoms of impaired gastric function, such as nausea, vomiting, bloating and epigastric pain, at any time during the recording sessions. These findings suggest that in most cases, gastric electrical rhythm returns to normal within 24 h of cholecystectomy and further that gastric dysrhythmia is not related to symptoms of impaired gastric function. The etiological mechanism and clinical significance of gastric dysrhythmia, therefore, are still unclear.
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PMID:Gastric electrical dysrhythmia following cholecystectomy in humans. 176 28

Sixteen patients acutely poisoned with aldrin were examined to evaluate a possible correlation between serum aldrin and dieldrin levels and clinical complaints. The patients were classified as having mild (N = 8), moderate (N = 5) or severe (N = 3) poisoning according to clinical symptoms. Concentrations of less than 20 micrograms/l were usually associated with mild poisoning, which involved complaints such as nausea, vomiting and epigastric pain, whereas concentrations of 100 to 200 micrograms/l were considered to represent moderate intoxication and were associated with nausea, vomiting, epigastric pain, headache, dizziness, and convulsions. Severe or fatal cases were associated with levels above 700 micrograms/l. Taken together, these results suggest that serum aldrin and dieldrin levels can be used as indicators of clinical prognosis after acute poisoning with these insecticides and that convulsions could suddenly occur even in the absence of prodromal signs or symptoms.
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PMID:Human aldrin poisoning. 179 80

The Chinese traditional drug "Hua Jiao" specified in the Chinese Pharmacopoeia 1990 edition is the dried pericarp of ripe fruit of Zanthoxylum schinifolium Sieb. et Zucc. or Z. bungeanum Maxim., family Rutaceae. It has been used for epigastric pain accompanied by cold sensation, vomiting, diarrhea and abdominal pain due to intestinal parasitosis, ascariasis and used externally for eczema. By the investigation of the drug resources in the main producing areas and distributing regions (Sichuan, Guangxi, Henan, Liaoning, Zhejiang, Anhui, Jiangsu and Shandong Provinces or Autonomous Regions), we found that there are pericarps derived from more than 18 spp. of Zanthoxylum used as drugs in China. In this paper, the morphological and histological characters of crude drugs derived from the following 8 species, viz. Zanthoxylum bungeanum Maxim., Z. schinifolium Sieb. et Zucc., Z. armatum DC., Z. simulans Hance, Z. avicennae (Lam.) DC., Z. ailanthoides Sieb. et Zucc., Z. molle Rehd. and Z. nitidum (Roxb.). DC. were described with illustrations. It was discovered that such features as the external characters of pericarp, the occurrence of hairs on fruit stalk, the presence and location of pigment and crystals of hesperidin, the thickness of the cell walls of endocarp and the presence and shape of nonglandular hairs on fruit stalk were important for the identification of these drugs.
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PMID:[Morphological and histological studies of Chinese traditional drug "hua jiao" (pericarpium zanthoxyli) and its allied drugs]. 182 95

A 42-year-old woman presented with epigastric pain and vomiting. Upper gastrointestinal endoscopy revealed three gastric ulcers. Histologic examination of biopsies from the ulcers showed cytomegalovirus inclusion bodies. The appearance of IgM antibodies to cytomegalovirus indicated a recent and primary infection. Stored serum from her last pregnancy 17 months previously contained no cytomegalovirus antibodies. A thorough evaluation of her immune system revealed no abnormality. We are aware of only two other cases where seroconversion was documented in normal hosts. Cytomegalovirus infections in the gastrointestinal tract of normal hosts are very unusual but a common cause of morbidity in immunocompromised hosts. We believe that cytomegalovirus may have a role in the pathogenesis of gastrointestinal lesions in nonimmunocompromised patients.
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PMID:Primary cytomegalovirus infection and gastric ulcers in normal host. 184 62

Gastric volvulus is a rare disease. We recently encountered a gastric volvulus associated with Bochdalek hernia and severe hypopotassemia. A 32-year-old woman experienced epigastric pain and recurrent vomiting. The changes of the electrocardiogram in this patient (K1.8mEq/l) were inverted T wave and ST depression. She was diagnosed as having gastric volvulus associated with Bochdalek hernia by chest X-ray films, contrast radiography of the upper digestive tract and thoraco-abdominal CT scans. Symptoms did not disappear with the administration of conservative therapy. At laparotomy, the stomach was rotated around its mesenteric axis in the sagittal plane. After operative repair, symptoms disappeared, and serum potassium level returned to normal. Gastric volvulus is rather easily diagnosed if its existence is kept in mind.
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PMID:[A case of Bochdalek hernia in an adult with volvulus of the stomach and hypopotassemia]. 189 66

A 37-year-old chronic alcoholic female was admitted with epigastric pain, complete anorexia, vomiting and diarrhoea. She was dehydrated, and had polypnoea. Laboratory investigations revealed severe metabolic acidosis (pH 7.14) with a major anion gap (37.4 mmol.l-1), and ketone bodies in blood and urine. Blood glucose concentration was 6.1 mmol.l-1, there was no glycosuria. Rehydration (2 l.day-1 of 5% glucose) together with sodium bicarbonate (500 ml of 1.4% sodium bicarbonate over the first four hours) normalized the pH (7.37). The ketone bodies disappeared on the following day. During the acute illness, were found high blood levels of glucagon and low levels of insulin. The diagnosis of alcoholic ketoacidosis, the pathogenesis of which remains unknown, is discussed.
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PMID:[Acidoketosis in a chronic alcoholic woman]. 192 62

Since intestinal microsporidiosis might be of importance in the pathogenesis of gastrointestinal symptoms in patients infected with HIV, we examined duodenal biopsies of HIV-infected patients by electron microscopy. Enterocytozoon bieneusi infection of the small intestine was found in one of 23 patients studied, which gives a 95% confidence interval for the prevalence rate between 0.1% and 22%. The infected patient was a 24-year-old homosexual male with AIDS who underwent upper endoscopy because of acute epigastric pain, nausea, and vomiting. These symptoms were obviously due to mesenterial Kaposi's sarcoma obstructing the duodenal passage, as was later revealed at autopsy. However, microsporidiosis might have caused the patient's eight-month history of diarrhea and weight loss, since infected cells showed signs of degeneration, and no other pathogens were ever detected in stool or biopsy. Our finding of Enterocytozoon bieneusi infection in a German AIDS patient supports the concept of a worldwide distribution of this parasite; further studies are needed to define its exact prevalence in HIV-infected patients and its pathogenic relevance.
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PMID:Intestinal microsporidiosis in a German patient with AIDS. 194 57

The syndrome of haemolysis, elevated liver enzymes and low platelets (HELLP Syndrome) is a consequence of severe preeclampsia/eclampsia. The clinical course is characterized by an unusual presentation with abdominal pain, and manifestations of inadequate haemostasis and excessive bleeding are common. Maternal and perinatal morbidity and mortality are high. We report our experience with 33 patients over a five-year period. The mean gestational age (GA) of the pregnancies was 34 +/- 2.8 wk including 11 patients who delivered 12 neonates of less than 34 wk GA. The most common presenting complaints were right upper quadrant or epigastric pain in 25 patients (76%) and nausea or vomiting in 14 patients (42%). Diagnosis was missed or delayed in 12 patients (36%). Thirty-one patients (94%) were delivered by Caesarean section and a deteriorating maternal condition was the most common indication for operative delivery. Twenty-three patients received general anaesthesia, eight received epidural anaesthesia and there were no complications related to the anaesthetic. There was clinical evidence of abnormal haemostasis: seven patients had excessive blood loss at Caesarean section, two had postpartum haemorrhage, three developed DIC and four developed wound haematoma. The average decrease in haemoglobin concentration was 32 g.L-1 and twelve patients (36%) received blood transfusions. There was one stillbirth. There were no neonatal deaths but morbidity was prominent and related primarily to prematurity. Delayed or missed diagnosis is common in HELLP syndrome and a premature delivery by Caesarean section is usual.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Obstetrical anaesthesia for patients with the syndrome of haemolysis, elevated liver enzymes and low platelets. 173 44


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