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

Clinical investigation was carried out into the coagulation and fibrinolytic systems in a series of patients undergoing intraamniotic instillation of dinoprost tromethamine (prostaglandin F2alpha, or PGF2alpha) for 2nd-trimester abortion. 20 healthy women, aged 14-27 years, were studied. The 1st 8 patients received PGF2alpha, 30 mg at hour 0 and 25 mg at hour 6 and again at hour 24 if needed. The last 12 patients received 30 mg at hour 0, and 25 mg at hour 8, 24, and 32 if necessary. The PGF2alpha used did not contain sodium chloride. 18 of the patients aborted in an average of 16 hours and 7 minutes; 2 required additional procedures. Some vomiting and 1 instance of fever but no other significant side effects were noted. Coagulation studies in these patients were normal. The prothrombin time, thrombin time, euglobulin lysis time, and plasminogen levels were normal and unchanged from the control blood value. Plasma fibrinogen concentration increased slightly 6 hours after the initial infusion of PGF2alpha. Red blood cell fragmentation was not observed at any time during labor, delivery, or the postpartum period. The increased white blood count was statistically significant but without clinical significance. Previous studies have shown that use of saline solution to achieve abortion causes alterations in the coagulation and fibrinolytic systems. This study with PGF2alpha showed no such effects.
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PMID:Abortion and coagulation by prostaglandin. Intra-amniotic dinoprost tromethamine effect on the coagulation and fibrinolytic systems. 474 Jun 10

Over a period of 16 months 510 children with diarrhoea were admitted to the Al-Adan Hospital, Kuwait, of whom 26 (5.1%) developed hypernatraemic dehydration. Prominent clinical features included vomiting (92.3%), fever (84.6%) and convulsions (19.2%). The majority were below six months of age with a mean age of 3.1 months. The sex distribution was equal. Twenty infants (77%) had severe metabolic acidosis and were treated with a combination of sodium bicarbonate and 5% glucose in water until the acidosis was corrected after which a solution of sodium chloride replaced the use of sodium bicarbonate. The sodium concentration of the intravenous fluid varied from 15 to 30 mmol/l and was given at a rate of 100 to 120 ml/kg/day. One infant died. The 25 survivors, (96.15%), which included three who developed convulsions during treatment, recovered without any neurologic sequelae.
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PMID:Hypernatraemic dehydration in infants in Kuwait with special reference to therapy of associated metabolic acidosis. 621 38

Supravesical urinary diversion using a jejunal conduit may be associated with hyponatremia, hypochloremic-acidosis, hyperkalemia, azotemia, and a clinical picture of nausea, vomiting, dehydration, muscular weakness, elevated temperature, and lethargy. This syndrome is secondary to the loss of sodium chloride into the urine passing through the conduit and absorption of potassium and urea from it. Treatment and prevention of this syndrome consist of adequate supplements of sodium chloride and hydration. Intravenous hyperalimentation as the precipitating factor of a severe form of this syndrome and its successful management are described. The pathophysiology of the jejunal conduit syndrome is also discussed. Great selectivity and extreme caution are recommended with respect to the use of intravenous hyperalimentation in patients with jejunal conduits.
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PMID:The pathophysiology of the jejunal conduit syndrome and its exacerbation by parenteral hyperalimentation. 642 49

This prospective, double-blind study examined the antiemetic effectiveness of the addition of droperidol to a morphine solution for use in patient-controlled analgesia in a group of 50 patients undergoing elective lumbar laminectomy. The addition of 20 mg droperidol to 120 mg morphine in 60 ml saline given by a Baxter 'Infusor' patient-controlled analgesia device reduced the incidence of vomiting as compared to the addition of sodium chloride from 42.8% to 12.5% (p = 0.028) and of nausea from 71.4% to 29.2% (p = 0.005). The proportion of patients requiring rescue antiemetic therapy was reduced from 47.6% to 16.7% (p = 0.025) and the time interval to the first use of rescue antiemetic agent was significantly prolonged (p = 0.029). The use of droperidol was associated with an increased degree of sedation during the first 12 h after operation.
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PMID:The antiemetic effectiveness of droperidol during morphine patient-controlled analgesia. 761 77

Postoperative analgesia after intrathecal co-administration of clonidine hydrochloride (75 micrograms) and morphine sulfate (0.5 mg) was compared with analgesia produced after either intrathecal morphine (0.5 mg) or 0.9% sodium chloride in 90 patients undergoing total hip replacement under bupivacaine spinal anesthesia. Patient-controlled morphine requirements were significantly reduced (P < 0.001) postoperation by both clonidine/morphine (median 5 mg/24 h) and morphine (median 7 mg/24 h) compared with control (saline) (median 28 mg/24 h). However, no significant additional reduction in postoperative analgesic requirements was shown with the clonidine/morphine combination compared with morphine alone. Visual analog pain scores, although good in all groups at all times, were significantly poorer in the control group at 2 h (P < 0.04) and 4 h (P < 0.001) after operation compared with both treatment groups, and significantly poorer than the clonidine/morphine group at 6 h (P < 0.002) and 24 h (P < 0.009) postoperation. Mean arterial blood pressure was significantly lower in the clonidine/morphine group than in the two other groups (P < 0.001) between 2 and 5 h after operation. The incidence of emesis was similar in the clonidine/morphine and morphine groups and was significantly more than in the control group.
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PMID:Postoperative analgesia after co-administration of clonidine and morphine by the intrathecal route in patients undergoing hip replacement. 780 7

Diarrhea is one of the most common causes of morbidity and mortality in infants and children less than 5 years old in developing countries. Diarrheal diseases are a major cause of childhood malnutrition. Toxin-producing bacteria are responsible for many acute diarrheas. Oral rehydration solution (ORS) treats dehydration caused by acute diarrheal episodes. WHO promotes the use of a single oral rehydration formula which contains 3.5 g sodium chloride, 2.5 g sodium bicarbonate or 2.9 g trisodium citrate dihydrate, 1.5 g potassium chloride, and 20 g glucose to 1 liter of water. This ORS formula can safely be used for all age groups and all etiologies of diarrhea. ORS replaces the lost fluid and electrolytes and maintains fluid and electrolytes. Pediatricians in most developed countries do not accept this ORS formula in cases of rotavirus-caused diarrhea because rotavirus blunts some absorptive villi and reduces the activity of lactase and other disaccharidase, resulting in reduced absorption. Yet, the unaffected villus cells may absorb enough water and electrolytes to be effective. In cases of vomiting, ORS should be administered in small amounts and slowly. Some health workers are concerned that 90 mmol/l sodium in the WHO formula causes hypernatremia in neonates and young infants who have low sodium levels in their stools. Specialists suggest ORS with 30-60 mmol/l or additional water administered in a 2:1 ratio for these young infants. Hypernatremia is also a concern for malnourished children, but studies show that WHO's ORS is safe and effective in treating malnourished children. Bottle fed children are more vulnerable to hypernatremia than breast fed children. Hypernatremia has neurological effects. Hyponatremia is more common in developing countries than developed countries. It also has neurological effects. In severe dehydration cases, intravenous fluid or ORS delivered via a nasogastric tube should be given immediately.
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PMID:Usefulness of ORT in certain special situations of diarrhoeal diseases. 783 95

A 4-year-old boy was treated with oxybutinine and desmopressine because of bladder instability associated with secondary enuresis. He was admitted with obnubilation, vomiting and experienced two seizure episodes concomitantly with hyponatremia and hypoosmolality. The child healed promptly under water restriction and intravenous administration of sodium chloride. This case report suggests that desmopressine may be responsible for severe side-effects. This drug should not be widely used and its indications should be restricted to patients with proven antidiuretic hormone secretion abnormalities.
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PMID:[Desmopressin and water intoxication. Apropos of a case treated for enuresis]. 801 69

Most of its clinical manifestations are the result of hypokalemia. The diagnosis is one of exclusion, mainly of surreptitious vomiting and diuretic abuse. The primary cause remains unknown but the most likely candidate is reduced sodium chloride reabsorption in the thick ascending limb of Henle's loop. Current therapy focuses on multiple agents to reduce massive potassium loss.
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PMID:Understanding and treating Bartter syndrome. 817 28

The characteristic clinical features of Bartter syndrome consist of hypokalemia, hypochloremic metabolic alkalosis, and normal blood pressure despite hyperreninemia and hyperaldosteronism. Some are constantly present, such as juxtaglomelular hyperplasia, decrease of the pressor response for angiotensin II infusion, impairment of concentrating ability, and elevated prostaglandin E2 and I2, while others such as hypomagnesemia are observed in some cases. The primary cause remains unknown, but the most likely candidate is reduced sodium chloride reabsorption in the thick ascending limb of Henle's loop. Exclusion of pseudo-Bartter syndrome, mainly of surreptitious vomiting and diuretic abuse, is necessary to diagnose the syndrome. The current therapy focuses on multiple agents to reduce massive potassium loss and to inhibit the syntheses of prostaglandin.
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PMID:[Bartter syndrome]. 890 40

This case illustrates severe hyponatremia following an acute overdose of paroxetine. An 83-year-old woman was admitted to our hospital after an attempt to commit suicide. She had consumed an overdose of 360 mg paroxetine. The treatment was started 3 days previously with 10 mg/day because of regular suffering from obsessive and suicidal thoughts. An initial sign of overdose was excessive vomiting. Five days late she developed hyponatremia (serum sodium 112 mmol/l) with somnolence, confusion, muscle spasms, dehydration of arms and legs and slow reflexes. Ecchymoses and myxoedema were also observed. Treatment included fluid restriction and sodium chloride infusion. Levothyroxin was prescribed and the hyponatremia resolved.
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PMID:Hyponatremia following acute overdose with paroxetine. 966 41


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