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

This is a case of a 23-year-old male presenting with altered sensorium, vomiting, and right flank pain. Despite a normal osmolal gap, he was found to be suffering from ethylene glycol intoxication. This little-described presentation can result in the clinician failing to consider ethylene glycol as a causative agent.
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PMID:Case report: severe ethylene glycol intoxication with normal osmolal gap--"a chilling thought". 225 6

The propensity to prefer and to consume salty foods varies considerably from person to person, and excessive salt intake has been linked to a number of pathological conditions. Extracellular dehydration occurs in humans after vomiting or diarrhea and is commonly observed during pregnancy. Because the hormonal responses to extracellular dehydration are known to increase salt appetite, we tested the hypothesis that extracellular dehydration during pregnancy increases the propensity of offspring to consume salt. Pregnant rats were treated with polyethylene glycol, which is known to produce extracellular dehydration and to exaggerate sodium appetite. The offspring of these treated pregnant rats showed an increase in salt appetite as compared with the offspring of control untreated dams. These results demonstrate that extracellular dehydration during pregnancy can enhance the natriophilic propensity in offspring and suggest that gravidic vomiting may contribute to the epidemiological factors of hypertension and other pathologies.
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PMID:Extracellular dehydration during pregnancy increases salt appetite of offspring. 230 41

A new sulfate-free polyethylene glycol electrolyte lavage solution (SF-ELS) for colonoscopy was formulated to taste better and have less net water and electrolyte secretion and absorption than a standard polyethylene glycolelectrolyte lavage solution (PEG-ELS). At two centers, 157 patients were prospectively randomized to receive SF-ELS or PEG-ELS to assess adequacy of preparation, patient tolerance, weight changes, and various hematologic and biochemical parameters. Physician assessment of colon cleansing showed no difference between those patients receiving SF-ELS (N = 74) or PEG-ELS (N = 78). Eighty-two percent of all preps were found to be "clinically acceptable." Subjects receiving SF-ELS had significantly less fullness and cramps, while PEG-ELS subjects reported less nausea. There was no difference between groups for vomiting, overall discomfort, or willingness to repeat the preparation received. Eighty percent of all patients would repeat the randomized cleansing methods. There were no clinically significant changes in weight or assessed laboratory parameters, with the exception of potassium where PEG-ELS patients had an mean decrease of 0.22 mEq/liter vs. 0.01 mEq/liter for SF-ELS (p less than or equal to 0.01). Patient taste questionnaires in those patients expressing a preference showed a preference for SF-ELS (76.6%) over PEG-ELS (23.4%) (p less than or equal to 0.001). Thirty-two (22.5%) of total respondents indicated no preference. We conclude that SF-ELS when compared with PEG-ELS is similarly a safe and effective method of colon cleansing for colonoscopy that is well tolerated. Patients prefer the taste of the new solution.
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PMID:Comparison of a new sulfate-free polyethylene glycol electrolyte lavage solution versus a standard solution for colonoscopy cleansing. 236 14

To determine if carbohydrates perfused into the ileum affect gastric emptying and circulating levels of gastrointestinal hormones, 18 healthy subjects were intubated with an oroileal tube. A 400-cal (60% carbohydrate, 20% protein, 20% fat) homogenized meal labeled with 111In-DTPA was then infused into the stomach over 10 min. Simultaneously, a test solution of normal saline (n = 6) or 12.5 (n = 4), 25 (n = 4), 50 (n = 2), or 100 (n = 2) mg/min of carbohydrates (75% rice starch, 25% glucose) containing a nonabsorbable marker, polyethylene glycol, was continuously perfused into the terminal ileum at 3 ml/min for 7 h. In one-half of the subjects the perfusate contained an amylase inhibitor (3.3 mg/ml) that reduced starch digestion and carbohydrate absorption. Gastric emptying was measured by a dual-headed gamma-camera. Plasma concentrations of hormones and the amount of carbohydrates passing the ileum were measured every 10 min. The amylase inhibitor significantly reduced the absorption of complex carbohydrates from the terminal ileum (p less than 0.05). Gastric emptying was significantly slowed by ileal perfusion of carbohydrates (p less than 0.01). This effect was enhanced by the amylase inhibitor (p = 0.06). Plasma concentrations of C-peptide, glucagon, motilin, gastrin, and human pancreatic polypeptide were not related to gastric emptying or ileal perfusates, but decreased concentrations of gastric inhibitory polypeptide and neurotensin and increased concentrations of peptide YY were significantly associated (p less than 0.05) with slowing of gastric emptying. Perfusing carbohydrates into the ileum was associated with nausea, abdominal pain, and vomiting, but we could detect no direct relationship between the onset of these symptoms and gastric emptying. Slowing of gastric emptying of a homogenized mixed meal by the entry of complex carbohydrates into the ileum may be partly mediated by peptide YY or nonvagally mediated neural mechanisms.
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PMID:Effect of ileal perfusion of carbohydrates and amylase inhibitor on gastrointestinal hormones and emptying. 246 4

Eight dogs with ethylene glycol intoxication were treated with 4-methylpyrazole, an alcohol dehydrogenase inhibitor. Dogs had clinical signs referable to ethylene glycol ingestion including ataxia, depression, vomiting, polyuria, and dehydration. Metabolic abnormalities included high anion gap metabolic acidosis, serum hyperosmolality, isosthenuria, and monohydrate and dihydrate calcium oxalate crystalluria. Serum and urine ethylene glycol concentrations were determined to confirm ingestion of ethylene glycol. A 50-mg/ml solution of 4-methylpyrazole in propylene glycol was administered iv as follows: initial treatment, 20 mg/kg of body weight; at 17 hours after admission, 15 mg/kg; at 25 hours after admission, 5 mg/kg. By 24 hours after admission, all dogs had clinical and metabolic improvement. Of the 8 dogs, 7 were released within 3 days of admission. Four of the 8 dogs returned for follow-up evaluation, at which time biochemical or hematologic abnormalities were not observed.
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PMID:4-Methylpyrazole as treatment for naturally acquired ethylene glycol intoxication in dogs. 258 8

Thirty-seven dogs with malignant lymphoma were treated with either polyethylene glycol conjugated (PEG) asparaginase alone (10-30 IU/kg intraperitoneally [IP] weekly--20 dogs) or PEG-asparaginase combined with one cycle of chemotherapy (vincristine, cyclophosphamide, methotrexate, and prednisone), followed by maintenance PEG-asparaginase (30 IU/kg, IP weekly--17 dogs). In the 20 dogs (eight were chemotherapy resistant) treated with PEG-asparaginase alone, seven had a complete response (CR), seven had a partial response (PR), five had no response (NR), and one was not evaluable (NE). The duration of response (CR + PR) ranged from 14 to 102 days (median, 48 days). In the eight chemotherapy-resistant dogs (seven were previously resistant to L-asparaginase) four had responses (one CR and three PR). In the 17 dogs treated with combined PEG-asparaginase and chemotherapy, 13 had a CR, two had a PR, and two had NR. None of the dogs had had prior chemotherapy, and the duration of response (CR + PR) ranged from 7 to 840+ days, with a median of 126+ days. Four dogs are still on maintenance PEG-asparaginase at 16+, 21+, 26+, and 28+ months. Toxicity consisted of death due to massive tumor breakdown (two dogs), disseminated intravascular coagulation (DIC--one dog), hypersensitivity reaction (one dog), vomiting (three dogs) and soft stools (three dogs). Four normal dogs were given very high doses of PEG-asparaginase (200 IU/kg and 1200 IU/kg) once weekly for two treatments without any significant toxicity. These results indicate that PEG-asparaginase has antitumor activity in dog with spontaneously occurring malignant lymphoma.
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PMID:A preliminary study on the evaluation of asparaginase. Polyethylene glycol conjugate against canine malignant lymphoma. 356 63

The use of polyethylene glycol electrolyte lavage solution (PEG-ELS) as a whole-bowel irrigation for colorectal surgery is retrospectively evaluated in 65 consecutive patients. Sixty-three (97%) of the patients were able to complete the lavage. Fifty-five (85%) of these tolerated the preparation without event. Unpleasant reactions of nausea, vomiting, or fullness resolved in most patients by decreasing the rate of ingestion. Twenty-seven patients had associated medical illnesses that may have been aggravated by volume overload, but none of these experienced any adverse effects from the lavage. Most patients completed the total lavage ingestion of 4 L in 4 hours, which resulted in a 1-day preparation prior to operation. There were no wound or septic complications in any of the lavage patients. This clinical review indicates that PEG-ELS is a safe, rapid, and effective mechanical bowel preparation that should be able to reduce in-hospital preparation time for most patients undergoing colorectal surgery.
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PMID:Polyethylene glycol electrolyte lavage solution (PEG-ELS). A rapid, safe mechanical bowel preparation for colorectal surgery. 380 Jan 62

The effects of four different irrigation solutions for preparation of colonoscopy were assessed in 64 patients. Using saline lavage solutions similar to plasma led to predominant symptoms of volume overload. Body weight transitorily increased by 1.7 +/- 0.2 kg, water and electrolytes were retained. Time until appearance of clear lavage fluid was 145 +/- 5 min. Irrigation by mannitol solution was badly tolerated and frequently led to vomiting. Body weight decreased and loss of water and electrolytes was reflected in changes of blood composition. Lavage with a hypertonic salt and mannitol solution (415 mosmol/l) was tolerated somewhat better. It led to minimal loss of weight, sodium (230 +/- 27 mmol) and chloride (270 +/- 24 mmol) were retained. Colonic cleansing was achieved after only 84 +/- 6 min. Isotonic saline mannitol solution with 105 mmol/l sodium, 93 mmol/l chloride, 10 mmol/l potassium and 22 mmol/l bicarbonate as well as 70 mmol/l mannitol (or 70 mmol/l polyethylene glycol) was tolerated best. There was a minimal weight increase (0.5 +/- 0.2 kg). Sodium metabolism was balanced (-2 +/- 7 mmol), chloride was retained to a slight extent (+ 115 +/- 29 mmol). Colonic cleansing was completed by 110 +/- 8 min.
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PMID:[Prograde colonic irrigation without disturbance of the water-electrolyte balance]. 641 6

Twelve taste repellents and 3 oral emetics were tested. The taste repellents were capsaicin, capsicum, oleoresin, sucrose octaacetate, quinine tonic, quassia wood extract, vanillamide, horseradish extract, caffeine, pepperoni enhancer, acorn extract, and commercially available bitter and hot flavors. The emetics tested were: antimony potassium tartrate, apomorphine, and copper sulfate. Intake of a 20% sucrose solution by Beagles was significantly depressed by addition of vanillamide at concentrations greater than 0.001%, by capsicum and capsaicin at concentrations greater than 0.01%, and by horseradish extract, pepperoni enhancer, and a commercially available hot flavor at concentrations greater than 0.1%. Antimony potassium tartrate, when added to the 20% sucrose solution at a concentration of 0.1%, produced emesis as did apomorphine at a concentration of 0.005% and copper sulfate at 1%. When the emetic antimony potassium tartrate was combined with vanillamide in a 20% sucrose solution, intake was reduced to less than 20 ml, and vomiting occurred within 15 minutes. Capsaicin (0.02%) inhibited intake of ethylene glycol to less than the lethal dose in 5 dogs tested. Incorporation of such taste repellents and/or emetics into potentially poisonous substances would reduce accidental poisoning of animals and children.
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PMID:Use of taste repellants and emetics to prevent accidental poisoning of dogs. 647 61

Strychnine toxicosis is characterized by inducible tetanic seizures and metaldehyde poisoning by fine fasciculations progressing to generalized tremors and seizures. Intoxication with 1080 causes seizures, random running movements, vomiting, defecation, urination, acidosis and hyperglycemia. Intoxication with rodenticides causing coagulopathy is characterized by hemorrhage into body cavities but not necessarily external hemorrhage. Anticholinesterase insecticides cause salivation, urination and defecation, while chlorinated hydrocarbon insecticides cause CNS disturbances. Ethylene glycol intoxication results in ataxia, depression, coma, vomiting and tachypnea, followed by acute renal failure. Urea poisoning causes bloat and CNS signs in cattle. Monensin intoxication in horses lasts several days and causes stiffness, colic, uneasiness and recumbency. Salt poisoning results in depression, seizures and hypernatremia. Lead poisoning is associated with central and peripheral nervous system signs, as well as increased numbers of nucleated RBC and basophilic stippling of RBC. Arsenic poisoning results in GI pain, diarrhea, weakness and death. Copper toxicosis in sheep is manifested by hemolytic anemia, hemoglobinemia and hemoglobinuria. Plants that may intoxicate domestic animals include sorghum, greasewood, halogeton, water hemlock, Japanese yew, larkspur, lupine, milk-weed, philodendron, oleander, castor bean and precatory bean.
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PMID:Practical toxicologic diagnosis. 649 3


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