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)

Meeting the increased metabolic demands in the critically injured is a continuing challenge. Benefits of early enteral feeding after abdominal trauma have been previously reported, but the frequency of patient intolerance due to GI complaints remains unclear. One hundred twenty-three patients undergoing emergent laparotomy for major abdominal trauma with an abdominal trauma index greater than or equal to 15 were prospectively randomized to either a control group (n = 52, no enteral nutrition during the first 5 days) or an enteral-fed group (n = 71). The enteral group had a needle catheter jejunostomy (NCJ) placed at laparotomy and an elemental diet begun 12 h postoperatively, advanced in volume and concentration at 8-h intervals to 100-125 ml/h of full-strength diet. Symptoms of GI complaints (nausea, vomiting, cramping, distention, and diarrhea) were monitored daily and graded as minimal, moderate, or significant. Fifty percent of the control group had one or more GI complaints during the study period; six (12%) developed moderate discomfort. In the enteral group, 59 (83%) patients reported some GI discomfort; 11 had significant complaints (two nausea, seven cramping, six distention, two diarrhea). Nine (13%) of the enteral-fed patients ultimately required total parenteral nutrition supplementation due to GI complaints. The remaining 62 (87%) enteral patients were maintained on the elemental diet for a mean of 7 days (range 5 to 20). By postoperative day 5, patients received an average of 35 kcal/kg and 14.5 g N/day; 66% (41/62) were in positive N balance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Gastrointestinal symptoms attributed to jejunostomy feeding after major abdominal trauma--a critical analysis. 250 24

Postoperative ileus is a normal, transient condition following surgical procedures of the abdomen. The restoration of gastrointestinal motility was studied in 50 patients who had abdominal surgery. The motility was evaluated by means of physical signs and clinical symptoms. Physical signs, such as bowel sounds, passage of first flatus and defecation, occurred on relatively constant moments in the postoperative period and did not depend on the type of operation. In the patients who had rectopexy, flatus and defecation passed significantly later, probably due to existing defecation problems before the operation. The moment of resumption of a normal diet varied greatly. None of the physical signs had a predictive value with regard to postoperative nausea or vomiting. No relation could be demonstrated between the moment of removal of the nasogastric tube and the volume of gastric aspirate drained by the tube. The period of postoperative drainage of the stomach in comparable patient groups differed strongly from ward to ward. More attention for nasogastric tube management following abdominal surgery seems desirable. Early removal of the tube is possible in most patients and diminishes unnecessary discomfort.
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PMID:The natural course of postoperative ileus following abdominal surgery. 258 13

Abdominal discomfort after eating cowpeas is known to be a major constraint on their greater consumption. Problems associated with cowpea consumption were identified by questionnaire in 448 randomly selected families. Some (28%) of the respondents had never experienced flatulence. Those who did said it occurred when cowpeas were eaten at all (16.7%), as dinner (42%) or without other foods (15%). A subsample of 40 people who complained of serious abdominal discomfort were fed cowpeas cooked by eight different methods at three consecutive dinners for each method. The problems reported were indigestion, vomiting, diarrhoea, increased belching, bad breath, offensive stool, flatulence, constipation, mild abdominal discomfort and sleepiness. Many respondents complained of mild abdominal discomfort with undehulled cowpeas (72.5%) and dehulled cowpeas (42.5%) that had been cooked at atmospheric pressure. Only 12.5% of the respondents complained of discomfort with dehulled cowpeas cooked under extra pressure. Thus, dehulling resulted in substantial reduction in the frequency and incidence of reported discomforts but pressure cooking also had beneficial effects, probably because of the higher cooking temperature attained.
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PMID:Flatulence and other discomforts associated with consumption of cowpea (Vigna unguiculata). 259 40

As part of a broad phase I study of recombinant human granulocyte-macrophage colony-stimulating factor (rh GM-CSF), four patients were treated who had myelodysplastic syndrome (MDS) with excess blasts. The GM-CSF was given daily as an intravenous injection over a period of 30 min for 5 days. A total of 11 cycles were conducted. Each patient received at least two different dose levels. In three patients, three different dosages were delivered. The treatment course was interrupted by a 10-day rest period. Rh GM-CSF was well tolerated, with only minor side effects seen, which included bone discomfort at the lower back, sternum and ribs, and constitutional symptoms such as low grade fever, nausea/vomiting, and mild myalgias. Whereas no increases in platelet and reticulocyte counts were recorded, elevations of absolute neutrophil counts above 100 cells/microliters occurred in all patients. The most striking finding was, however, the development of increases in the number of circulating and bone marrow blast counts that were observed particularly when doses of greater than or equal to 500 micrograms/m2 of body surface area were administered. In line with data demonstrating in vitro induction of proliferation of leukemic blast cells by rh GM-CSF, one may take advantage of blastogenesis induced in vivo that may favor the use of a therapeutic strategy by recruiting quiescent cells into the mitotic cycle which would then represent optimum targets for a subsequent cycle-specific cytotoxic chemotherapy. Such an approach could form the basis for new clinical trials in MDS.
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PMID:Effect of recombinant human granulocyte-macrophage colony-stimulating factor in patients with myelodysplastic syndrome with excess blasts. 265 95

The consequences of inadequately controlled chemotherapy-related nausea and vomiting range from minor discomfort to dose-limiting toxicity. Physical complications may occur secondary to protracted nausea and emesis. Furthermore, patient discomfort may be reflected in altered quality of life or noncompliance with therapy. As a primary caregiver, the nurse takes an active role in collaborating with the physician to prevent and/or minimize these side effects and their sequelae. An understanding of the patterns, mechanisms, and risk of chemotherapy-related nausea and vomiting is crucial to providing optimal patient care. Concepts of drug therapy are emphasized as the cornerstone of antiemetic management.
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PMID:Managing chemotherapy-related nausea and vomiting: the state of the art. 266 57

Physicians and nurses involved in the care of oncology patients share the responsibility for proper management of chemotherapy-induced nausea and vomiting. Oncology nurses have taken an active part in the research and investigation of new antiemetic agents and the sharing of this knowledge with others. Identifying patient characteristics, using specific guidelines for antiemetic selection, and a knowledge of the antiemetic agents that are active singly or in combination can mean the difference between success and failure in preventing or controlling vomiting induced by chemotherapy. Proper dosing and scheduling of antiemetics using recommendations that have proved efficacious can further decrease a patient's discomfort during a most difficult time in his or her life.
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PMID:Antiemetic therapy: management of chemotherapy-induced nausea and vomiting. 272 52

We describe a benign diffuse neurofibroma of the pylorus, unassociated with von Recklinghausen's neurofibromatosis, which was a cause of pyloric stenosis; epigastric discomfort, vomiting, and weight loss of 60 lb were the most prominent symptoms. Partial gastrectomy resulted in a cure. The literature on nerve-sheath tumors of the stomach is reviewed.
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PMID:Diffuse neurofibroma of the pylorus: a cause of gastric outlet obstruction. 274 71

We assessed the prevalence of Campylobacter pylori in various forms of endoscopic gastritis, including ulcer and nonulcer dyspepsia and bile gastritis and correlated it with histological evidence of inflammation. Multiple biopsy specimens were taken from 120 patients, including four normal controls, who underwent upper gastrointestinal endoscopy for evaluation of upper abdominal pain and discomfort, nausea, bilious vomiting, weight loss, and anemia. The patients included 58 men and 62 women, with a mean age of 53 years. Of these, 16 patients had gastric ulcers, 19 had duodenal ulcers, 26 had reflux gastritis (after either gastric surgery or cholecystectomy), one had a gastric polyp, one had Barrett's esophagus, and the remaining 53 had gastritis due to unspecified causes. Campylobacter-like organisms were demonstrated by light and electron microscopy in 50 of 69 patients of the nonbile gastritis group (72%) and in seven of 15 patients of the bile gastritis group (47%) (p0.05). The presence of bacteria in both groups correlated with histologically significant inflammation (particularly chronic active gastritis); similar histologic changes were noted in both major groups of nonbile gastritis and bile gastritis. Campylobacter pylori is common in all forms of gastritis in association with histologic inflammation.
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PMID:The prevalence of Campylobacter pylori gastritis: a study of symptomatic nonulcer dyspepsia and bile gastritis. 278 19

The authors report transvaginal puncture of ectopic pregnancy and instillation therapy under sonographic control in 10 cases. Only patients with an increase in beta-hCG levels were selected for treatment. In 9 cases, the authors instilled methotrexate and in 1 case, prostaglandin E2 (PGE2). A successful outcome was obtained in 8 cases, 7 having been treated with methotrexate and 1 treated with PGE2. conservative treatment failed in 2 patients. However, these patients were already in the 8th week of pregnancy. There were no side effects after methotrexate; the patient who received PGE2 experienced severe discomfort, vomiting, and cramps.
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PMID:Treatment of unruptured ectopic pregnancy by needling of sac and injection of methotrexate or PG E2 under transvaginal sonography control. Report of 10 cases. 281 65

A combination of the antigestagen mifepristone (RU 486) and a synthetic prostaglandin analogue, gemeprost, was used to induce therapeutic abortion in 100 women in early pregnancy. Local family planning services and general practitioners in Edinburgh referred women of less than 56 days' amenorrhea who had requested abortion. Pregnancy was confirmed by measurement of the serum level of human chorionic gonadotropin. Group I (n=20) received 150 mg mifepristone orally each day for 4 days. Groups II (n=30), III (n=30), and IV (n=20) received a single oral dose of mifepristone, 400 mg, 500 mg, or 600 mg, respectively. Samples of peripheral blood were collected at recruitment for measurement of the concentration of hemoglobin, urea, electrolytes, cortisol, and HCG and for liver function tests. Blood also was taken for estradiol and progesterone essay from women in Groups II, III, and IV. Each woman recorded symptoms in a diary from the day prior to the start of treatment. Study participants were reviewed 1, 2, and 4 weeks after treatment and discharged from followup after the onset of the next menstrual period. The effectiveness of the 4 treatment regimens was similar. Only 10 (14%) of the 74 women who received half a gemeprost pessary required the 2nd half. 95 of the women aborted completely; 5 women needed surgical intervention. Data were pooled for analysis because there was no significant difference between the 4 groups in the onset of bleeding and pain, requirement for analgesia, side effects, duration of bleeding, measured blood loss, and the time until the next menstrual period. The 94 women who experienced pain became aware of pelvic discomfort 46.6 hours after the initiation of treatment. No patient needed analgesia during the first 48 hours of treatment. After insertion of the pessary, 44 women received an oral analgesic drug and 9 an intramuscular opioid. 47 women did not need an analgesia. There was no significant difference in the frequency of nausea before and during treatment, but there was a significant increase in the incidence of vomiting and of diarrhea. 30 women vomited after the pessary was inserted compared with 13 the day before treatment; 10 women had diarrhea compared with 3 before treatment. No women had clinical evidence of pelvic infection. Liver function tests and cortisol levels were similar prior to and following treatment. Levels of HCG, and estradiol and progesterone decreased significantly after treatment. There were no significant differences in the results between those who needed evacuation and those who did not.
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PMID:Induction of therapeutic abortion in early pregnancy with mifepristone in combination with prostaglandin pessary. 289 91


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