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

We describe a rare presentation of acute cardiac tamponade in a patient with gastric cancer in pregnancy. A 32-year-old woman developed dyspnea and tachycardia during the 28(th) week of her pregnancy. These symptoms were interpreted initially by the patient as a condition related to the normal state of pregnancy; however, her symptoms persisted over the next two weeks, and she was hospitalized for evaluation. The diagnostic work-up revealed metastatic gastric carcinoma to the pericardium associated with pericardial tamponade. Large pericardial and pleural effusions were the primary causes of her shortness of breath. Gastric cancer is very rare in pregnancy, and therefore may be not be suspected by physicians. Diagnosis may be further delayed because of overlapping symptoms occurring during normal pregnancy (nausea, vomiting, and shortness of breath). All these factors may contribute to a very high mortality of this malignancy during pregnancy.
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PMID:Gastric carcinoma presenting as pericardial tamponade during pregnancy. 2008 72

A 21-year-old college athlete was seen on the first day of football practice because of an acute onset of severe chest pain. The pain was noted during conditioning drills before any body contact had begun. The sharp, intermittent, left inframammary pain was aggravated by twisting or turning. The pain did not radiate and was not associated with shortness of breath, palpitations, nausea, or vomiting.
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PMID:ECG Quiz: Chest Pain in a College Football Player. 2008 16

This multicenter study was intended to validate the French version of the M. D. Anderson Symptom Inventory (MDASI-Fr) in French cancer patients (n=162) with solid tumors or hematological malignancies. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was used as a part of the validation. Factor analysis showed three underlying constructs for symptom items: general symptoms (pain, fatigue, disturbed sleep, shortness of breath, drowsiness, dry mouth, and numbness or tingling items); emotional and cognitive components (distress, sadness, and remembering items); and a gastrointestinal component (nausea, vomiting, and lack of appetite items), with Cronbach's alphas of 0.79, 0.73, and 0.71, respectively. Convergent validity was established by comparing MDASI-Fr items with the EORTC QLQ-C30 scale and the Brief Pain Inventory (BPI). Overall, the 19-item MDASI-Fr score correlated well with the QLQ-C30 global health status, and the pain item of the MDASI-Fr was highly correlated with the short form of the BPI. The most prevalent symptoms were fatigue, distress, dry mouth, and pain. Twenty-five percent of patients reported moderate or severe pain (numeric rating scale >4 on 0-10 severity ratings). Physician ratings of global change on a second visit were significantly associated with changes in patient ratings on the MDASI-Fr, supporting the sensitivity of the measure. Symptoms interfered most with work and general activity. The MDASI-Fr is a valid and reliable tool for measuring symptom severity and interference in French cancer patients.
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PMID:Cancer-related symptom assessment in France: validation of the French M. D. Anderson Symptom Inventory. 2041 59

A case of pulmonary infiltrates with eosinophilia attributed to piperacillin tazobactam therapy is described. A 54-year-old woman was treated for a suspected severe urinary tract infection with piperacillin tazobactam. Four days later, she developed fever, chills, shortness of breath and intermittent chest pains. Eosinophilia was noted in peripheral blood and, subsequently, on bronchoalveolar lavage. Transbronchial biopsy showed tissue infiltrates with eosinophilia. No evidence of bacterial, fungal and parasitic infection, or vasculitis was observed. Her symptoms and peripheral eosinophilia subsided after drug discontinuation and oral prednisone treatment. Piperacillin is an extended-spectrum penicillin antibiotic prescribed for moderate to severe infections. The common adverse reactions to piperacillin include nausea, vomiting, diarrhea and rash. Pulmonary infiltrates with eosinophilia is a rare adverse reaction, but one that may result in significant morbidity. Physicians should be aware of this rare but important adverse reaction to piperacillin.
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PMID:Piperacillin-associated pulmonary infiltrates with eosinophilia: a case report. 2042 64

In recent years, complementary and alternative medicine modalities, including acupuncture, have been incorporated intohospice careboth to address symptom distress and to enhance quality of life. Beginning in 1997, Kaiser Permanente Northwest Hospice began offering limited acupuncture services to hospice patients and, in some cases, their caregivers. Data collection-comprising a chart review (n = 71) and in-depth interviews with the two program acupuncturists-was initiated to explore in a preliminary fashion both the processes involved in acupuncture delivery and outcomes associated with this intervention. Information culled from the patient charts (representing the year 2003) revealed a median age of 68.5 years, a cancer diagnosis in 63% of cases, and a median hospice length of stay of 102 days. The most commonly cited chief complaints presented to the acupuncturists included pain (70%), anxiety (45%), shortness of breath (27%), and nausea/vomiting (14%). Patients received a median of three acupuncture treatments; excellent or good results were noted in the charts of 34% of patients whose chief complaint was pain, in 31% of anxiety chief complaints, in 22% of shortness-of-breath chief complaints, and in 29% for nausea/vomiting chief complaints. The program acupuncturists described their practice with this group of patients as a departure from how they treat patients in a typical practice context. They described a greater focus on providing comfort through ameliorating symptoms and a diminished focus on more holistic goals, which often are typical elements in an acupuncture intervention. Nonetheless, acupuncturists also observed instances of outcomes in psychologic, social, and spiritual domains, regardless of whether these outcomes were the principal focus of treatment. These data add to the accumulating anecdotal reports suggesting that acupuncture is a promising adjunctive therapy for those nearing the end of life in the home hospice setting. More in-depth and precise assessment is warranted to comprehensively evaluate acupuncture as a viable adjunct to current usual and customary hospice care.
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PMID:Home hospice acupuncture: a preliminary report of treatment delivery and outcomes. 2136 8

Mrs FW, 83 years of age, presented to the emergency department with repeated episodes of attacks of vomiting over several months, coughing, weight loss and worsening shortness of breath. On examination she was not distressed, but mildly dehydrated. Chest examination revealed decreased air entry in both sides of the chest. Heart sounds were muffled. Other examination was within normal limits.
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PMID:Cough from megaoesophagus. 2159 49

A 12-year-old boy consulted a local physician with complaints of cough, abdominal pain, shortness of breath and general malaise. Medications for symptomatic relief and bed rest were suggested. The flu-like symptoms were relieved on the 2nd day, and the general malaise with repeated vomiting, chest pain and chest tightness attenuated on the 3rd day. A chest x ray showed multiple pneumonic patches with borderline cardiomegaly. Poor left ventricular function was noted, and the left ventricular ejection fraction was reduced to 21%. Although multiple episodes of sustained ventricular tachycardia were converted by six repeated cardiac defibrillations and a xylocaine (intravenous) bolus infusion, his general condition went downhill to shock and proceeded to several episodes of heart standstill that necessitated cardiopulmonary resuscitation. Extracorporeal cardiopulmonary resuscitation was installed via femoral cannulation. Cardiac function progressively recovered to normal, and extracorporeal membrane oxygenation was removed on the 7th day. The patient completely recovered and was discharged on the 15th day with no neurological sequelae.
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PMID:Acute fulminant carditis presenting with sustained ventricular tachycardia, and recovery after extracorporeal cardiopulmonary resuscitation. 2168 46

Stress cardiomyopathy is an acute transient left ventricular dysfunction, associated with emotional stress. In the course of alcohol withdrawal abnormalities of perfusion and myocardial contractility have been described, manifested in the scintigraphic study, with the absence of changes in ECG and echocardiography and probably caused by sympathicotony, in analogy to severe emotional stress. We present a case of acute left ventricular dysfunction during alcohol withdrawal with significant changes in echocardiography and ECG mimicking acute coronary syndrome. In a 53-year-old woman, treated in the internal ward because of abdominal pain, vomiting, and moderately elevated pancreatic amylase in serum and urine, chest pain and shortness of breath at rest occurred during the first day of hospitalization. These symptoms were accompanied by ST segment elevation in V2-V3, negative T waves in V2-V6 and an increase in troponin. Coronarography excluded significant changes in the arteries, the echocardiography revealed apical akinesis with left ventricular ejection fraction (LVEF) 30%. By hospital day 3 disorientation and behavior disorders corresponding of alcohol withdrawal appeared. In subsequent days improvement in LV systolic function was observed with LVEF increase to 53%. ECG changes in the form of a deep negative T waves in I, II, aVL and V2-V6 persisted to the end of hospitalization.
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PMID:[Acute transient left-ventricular systolic disfunction during alcohol withdrawal]. 2201 Apr 59

Typical symptoms of duodenal ulcers include epigastric pain, nausea, vomiting, chest pain and shortness of breath. Here we present the case of a 39-year-old man who had a sudden onset of chest and epigastric pain following the use of recreational amphetamines. There were ST changes in the inferior leads of his electrocardiogram, indicating the possibility of a myocardial infarction. Following double contrast computed tomography of the abdomen and an urgent laparotomy, a diagnosis of a perforated duodenal ulcer was made. We discuss the aetiologies, presentation, investigation and treatment of the disorder, and make recommendations on the management.
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PMID:A perforated duodenal ulcer presenting as inferior lead ST elevation following amphetamine use. 2261 81

A 64-year-old woman presented with shortness of breath, right-sided pleuritic chest pain and dry cough. She was systemically anticoagulated with warfarin for a pulmonary embolism diagnosed 3 months previously, with an international normalised ratio (INR) of 3.0 on presentation. Chest radiograph demonstrated a new right paratracheal abnormality, and CT scan showed a large mediastinal mass not present 3 weeks earlier. MRI demonstrated an ovoid mass with a fluid/fluid level with high T2 and dark T1 signal consistent with a mediastinal haematoma. The patient's anticoagulation was emergently reversed and a temporary inferior vena cava filter was placed. The haematoma slowly resolved on serial follow-up with no additional intervention. Spontaneous mediastinal haematoma is a rare but life-threatening diagnosis that frequently presents with chest pain, dry cough and dysphagia. It is frequently associated with therapeutic anticoagulation and may potentially be caused by sudden, atraumatic rise in intrathoracic pressure (ie, cough or emesis).
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PMID:Spontaneous mediastinal haematoma: a rare complication of warfarin therapy. 2271 29


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