Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Inpatient extracorporeal shockwave lithotripsy for treatment of gallbladder stones has not previously been compared with open cholecystectomy in terms of cost-effectiveness. In a randomised controlled trial, 163 patients, stratified by gallstone bulk (over 4 cm3 or not), were randomised to lithotripsy or cholecystectomy (38 large-bulk and 27 small-bulk cholecystectomy; 37 large-bulk and 61 small-bulk lithotripsy) and followed up for 1 year. Both treatments gave significant health gains in terms of a reduction in episodes of biliary pain, improved perceived health status, and symptom relief, but few differences between treatments were found. There was some evidence that biliary-pain episodes were less severe after cholecystectomy. Cholecystectomy patients also had greater improvements in mean health gain for three related symptoms: vomiting, feeling sick, and fatty-food upset. However, there were no differences between groups in perceived health status. Among lithotripsy patients, health gain was not related to stone clearance. Lithotripsy was more expensive than cholecystectomy, principally because of the costs of the inpatient stay and adjuvant bile-salt therapy. Conventional lithotripsy appears at least as cost-effective as cholecystectomy for patients with small-bulk stones but less cost-effective for those with large-bulk stones. To some extent treatment choice can be guided by patient preference.
 ...
PMID:Randomised controlled trial of cost-effectiveness of lithotripsy and open cholecystectomy as treatments for gallbladder stones. 135 42

Ondansetron was given as anti-emetic prophylaxis to 429 children receiving a variety of emetogenic cancer treatments for up to 8 days, in three, open, multicentre, European studies. Children aged between 6 months and 17 years with a variety of tumours and receiving chemotherapy or chemotherapy plus total body irradiation (TBI) were studied. Ondansetron was given intravenously, 5 mg/m2 or 8 mg, according to the surface area of the child, immediately before chemotherapy. Intravenous or oral treatment (2, 4 or 8 mg, according to surface area) was continued 3 times a day during chemotherapy or TBI, and for a further 2 days (non-cisplatin chemotherapy or TBI) or 5 days (cisplatin chemotherapy). The number of vomits and retches (each counting as an emetic episode) were recorded daily, as was an assessment of nausea, which was graded as none (not feeling sick at all), mild (feeling sick) or severe (feeling very sick). Responses were graded according to the number of emetic episodes during the worst 24-hour period. In addition, response was expressed in terms of emesis-free days as a proportion of all ondansetron treatment days. During chemotherapy, 66% of children experienced less than 3 emetic episodes on their 'worst day' and 88% had none or mild nausea. Sixty-eight percent of all ondansetron treatment days (2,131) were free of emesis. Of the patients who were poorly controlled with 'customary' anti-emetics, at least 81% experienced better control with ondansetron. When analysed according to the most emetogenic agent given 36, 59 and 75% of children reported less than 3 emetic episodes on their 'worst day' respectively, during cisplatin, ifosfamide and other less emetogenic chemotherapy. During conditioning for bone marrow transplantation with cyclophosphamide and TBI, 80 and 57% of patients, respectively, experienced less than 3 emetic episodes. The overall incidence of adverse events was low and headache (reported in 4% of patients) was the only event reported by more than 1% of patients. These studies show that ondansetron is a safe, well tolerated and an effective anti-emetic in the treatment of children receiving a wide variety of chemotherapy regimens.
 ...
PMID:Ondansetron as prophylaxis for chemotherapy and radiotherapy-induced emesis in children. 138 28

A 5-year-old girl presented to the emergency department (ED) with a parental complaint of vomiting and seizure-like activity. The patient had been in her normal state of health before the onset of this activity and had had no recent illnesses. Shortly after the child had gone to bed, she awoke complaining of feeling sick to her stomach. Over several minutes the child became less responsive to questioning, followed by rightward eye and head deviation and vomiting. Following this, the child's eyes remained fixed in a rightward gaze and she was no longer responsive to questioning despite appearing awake. On the way to the hospital the child became flaccid, which was shortly followed by further vomiting and right upper extremity jerking and finally full upper extremity convulsive activity. In the ED, the child remained in this state for approximately 90 minutes despite the use of intravenous diazepam. Gradually, she became responsive to parental stimulation and questioning.
 ...
PMID:Child presenting to the ED with prolonged autonomic symptoms followed by generalized seizure activity. 2015 22