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

Twenty-five serious cases of diabetic ketoacidosis, representing 23 patients, with ages ranging from 4 to 15 years are reported. School agers and adolescents were the groups most affected without existing significant predilection for sex. In 40% there was no success in finding the precipitating cause of the crisis; 32% was attributed to infectious processes, specially of the respiratory ducts and the rest, due to negligence in the application of insulin. The clinical signs showed: vomiting, dehydration, Kussamaul's respiration, sopor, stupor and in 5 cases a state of coma. Determinations of glucose, were integrated in 88% within the range of 451 to 750 mg % and the rest in lower figures. The pH in most was reported below 7.10 and CO2 lower than 10 mEq/l. Electrolytes in blood were generally evaluated within normal limits. Potassium in 20% was reported high, but we consider this was due to dehydration and because of its influence we recommend an electrocardiographic evaluation. Our classification which attempts to correlate the clinic and the laboratory is reported and our therapeutic scheme is discussed as well as the possible causes in two patients who died.
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PMID:[Diabetic ketoacidosis in children and adolescents. Clinical and therapeutical considerations in 25 severe cases]. 2 Sep 2

Much clinical experience has been gained in the use of the glucose/electrolyte oral solutions in the treatment of acute diarrhea. Those patients who are in shock or too weak to drink need intravenous fluids to correct their total deficit. With isotonic polyelectrolyte fluids rehydration may be achieved in 2-4 hours. Subsequently, most of these patients can be given oral fluids to replace continuing stool loss. Patients who are not in shock and who are sufficiently strong to drink at the outset nearly always can be rehydrated with oral fluids alone. Vomiting is most likely caused by acidosis and volume depletion, and these can be corrected in severely dehydrated patients by intravenous therapy and by oral therapy in those not in shock and able to drink by oral therapy. Proponents of oral glucose/electrolyte therapy for diarrhea, like other proponents of new treatments, have great visions of its benefits to the world, yet these visions require validation. The biggest problem will be getting glucose and electrolytes to where they are most needed -- at the level of home and village.
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PMID:Editorial: Oral glucose/electrolyte therapy for acute diarrhoea. 4 28

The successful termination of 19 consecutive late 1st and 2nd trimester pregnancies using a combination of intravenous prostaglandin E2 (PGE2) and oxytocin (Syntocinon) is reported. PGE2 (5 mg in 500 ml of 5% glucose) was initially infused at the rate of 2.5 mcg/minute and then increased to 5 mcg/minute after half an hour. The infusion was increased to a maximum of 10 mcg/minute. Oxytocin was infused 2 hours after the PGE2 at a constant rate of 128 mU/minute. Mean total dose of PGE2 used was 5.9 mg at an overall rate of 6.1 mcg/minute. Average induction/delivery interval was 16 hours, with only 1 patient taking more than 24 hours. Abortion was complete in 13 cases (68%). Vomiting occurred in 13 women; pain was minor and was controlled by pethidine. Mild and transient thrombophlebitis was also reported. There were no reported cases of diarrhea and or cervical damage. Compared to the use of intravenous PG alone, PG given intraamniotically alone or with intravenous oxytocin, and PG given extraamniotically alone or with intravenous oxytocin, this study shows that a combination of intravenous PGE2 and oxytocin at the dose level described is closer to meeting all the desired criteria for the acceptability of any abortion method (ease and safety of administration, side effects, lengths of induction delivery interval, and effectiveness in terms of success rate and uterine evacuation).
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PMID:Letter: Intravenous prostaglandins and oxytocin for mid-trimester abortion. 4 97

The use of sucrose in oral rehydration therapy solutions in place of glucose was tested in 18 patients, 17 males and 1 female, admitted for treatment of severe dehydration due to diarrhea and vomiting. 13 of these patients were positive for cholera (1 with untyped vibrio), whereas 4 others cultured no recognizable pathogen. Patients received an average 1100 ml of intravenous fluids to keep the intravenous drip open during the oral therapy period, and the intravenous therapy was stopped or slowed during oral (or nasogastric) therapy. Average patient age was 32 years. Oral solutions contained either 48 or 38 gm of sucrose per liter plus (in all solutions) sodium chloride (4.2 gm/liter), sodium bicarbonate (2 gm/liter), and potassium citrate (2.7 gm/liter). Of the 18 patients, 15 could be maintained using this solution, but 3 developed massive increases in net fluid losses with increases in plasma specific gravity, which necessitated terminating the therapy. In these failure cases, plasma specific gravity increased over 1.031. Stool samples of 12 patients tested were found to contain reducing sugar: prehydrolysis 436 mg/100 ml, posthydrolysis 957 mg/100 ml. The breakdown of sucrose by intestinal enzymes or by bacteria accounts for the presence of reducing sugar in the stool. These data contrast with the rarity of treatment failures of oral glucose therapy; therefore, glucose is the preferable component in oral rehydration electrolyte solution therapy.
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PMID:Sucrose in oral therapy for cholera and related diarrhoeas. 4 61

20 consecutive child admissions to a Calcutta, India, hospital with acute diarrhea and moderate to severe clinical dehydration were studied. They were treated with an oral sucrose/electrolyte solution, which achieved complete hydration in 19 out of the 20 cases; 1 child did not respond and needed intravenous therapy. Vomiting, abdominal distension, and appearance of sugar in the stools during oral therapy did not interfer with its success. A child was considered to have recovered when the body weight had stabilized and when there was no further diarrhea, a process requiring 5-6 days. In addition, recovery involved restoration of plasma-bicarbonate to normal levels, falls in the hematocrit values and in the plasma specific gravidity, and complete clinical recovery. Solutions of glucose/electrolytes have already been used in the treatment of acute diarrhea. Replacement of glucose with sucrose is preferable since it is less expensive and more readily available in developing areas. This study showed that replacement of the glucose with sucrose is as effective.
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PMID:Evaluation of a sucrose/electrolyte solution for oral rehydration in acute infantile diarrhoea. 6 56

The potential toxicity of FE-S15 (B. Braun-Melsungen), a soybean-oil fat emulsion used in parenteral nutrition, was studied in dogs. Forty pure-bred beagles, in two experimental groups (FE-S15 at 9 and 4 g/kg/day) and two corresponding control groups (receiving Dextrose-Ringer's solution), were given daily infusions for 28 days via a central venous catheter. Vital signs and hematologic, biochemical, and bacteriologic changes were monitored closely. When compared with control groups, no significant weight loss was observed in either group; the food intake decreased only in animals receiving fat in high doses. Hemoglobin and hematocrit decreased in all groups during infusion, the greatest fall observed in the group receiving high-dose fat infusion where the hematocrit declined from 45.5% to 31.7%. This decrease was significantly different from the controls only during one observation period. Clinical signs, such as lethargy, vomiting, diarrhea, loss of appetite and fever were observed infrequently in both experimental and control animals, more often in those treated with high-dose fat infusion. It appears that the fat emulsion FE-S15 causes only minor side effects but otherwise is well tolerated in dogs at a potentially toxic level.
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PMID:Studies of the toxicity of an intravenous fat emulsion. i. Hematologic changes and survival after administration of a soybean oil (FE-S15) in beagles. 11 23

A 3-yr-old boy was investigated for numerous episodes of fatigue, irritability, pallor, and sweating, which began at 11 mo of age, when he had an episode of symptomatic hypoglycemia with ketonuria. He had euphoria, mental confusion, drowsiness, nausea, and vomiting 1-5 hr after oral administration of glycerol in doses of 0.5-1.0gm/kg. Orally administered MCT (1 gm/kg) had similar effects. On one occasion, oral glycerol also provoked hypoglycemia, as had a 16 1/2 hr fast. Intravenously administered glycerol (0.09 gm/kg) induced an immediate loss of consciousness from which he recovered spontaneously after 30 min; there were no changes in blood glucose values. Intravenously administered fructose (0.25 gm/kg) was tolerated normally. Leukocytes showed normal activities for FDPase, glycerol kinase, and glycerol phosphate dehydrogenase. The restriction of dietary intake of fat has been associated with a marked improvement in physical and mental activities. These observations suggest a unique, yet undifined intolerance to glycerol, which suggest caution in the diagnostic use of glycerol in the investigation of hypoglycemia as well as in the therapy of increased intracranial or intraocular pressure.
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PMID:Glycerol intolerance in a child with intermittent hypoglycemia. 16 54

The most important part of treatment of watery diarrhea is hydration. An oral glucose electrolyte solution is often used in place of intravenous therapy in diarrheal diseases caused by Vibrio cholerae, enterotoxigenic E. coli, and undiagnosed watery diarrheal diseases. In cholera and enterotoxigenic E. coli diarrhea, sucrose can be used in place of glucose, as sucrose can be hydrolized to fructose and glucose by intestinal dissacharidases, and it is also more readily available and cheaper than glucose. In a randomized double-blind trial of 57 male children (aged 5 months to 2 1/2 years) with rotavirus diarrhea, 28 were rehydrated with sucrose electrolyte solution and 29 were given glucose solution. The children were compared with 44 children, also with rotavirus diarrhea but treated only with intravenous hydration. There were no significant differences in the rate of rehydration or rate of purging between the 2 groups. Vomiting was not a factor in administering oral therapy during hospital admission. Patients with rotavirus infection may have defects of absorption and digestion of carbohydrates but such abnormalities should not prevent the use of sugar-electrolyte oral solution for hydration. Rotavirus infection is one of the most common causes of infantile diarrhea which necessitates hospital treatment. Either glucose or sucrose can be used in the solution, and this fact is especially important in developing countries where medical supplies are limited.
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PMID:Oral hydration rotavirus diarrhoea: a double blind comparison of sucrose with glucose electrolyte solution. 20 63

The outcome of administering ORT (oral rehydration therapy) to 62 infants admitted to a Costa Rican hospital with acute rotavirus or bacterial diarrheas and with 5-10% dehydration was described. 94% of the infants were successfully treated by administering only ORT. There were no significant differences in the success rates for rotavirus diarrhea patients and for various bacterial diarrhea patients. Success rates were 92% for rotavirus patients, 93% for Escherichia coli patients, 96% for idiopathic diarrhea patients, and 100% for salmonella and shigella patients. Upon admission, the average duration of diarrhea was 2.9 days, vomiting was present 88% of the cases, and all patients exhibited some signs of dehydration. The infants were administered the oral formula recommended by the World Health Organization. Patients received 400 ml of oral solution followed by 200 ml of water. The treatment was repeated until skin tuger was normal. 34% of the infants were rehydrated within 6 hours and 76% within 20 hours. Patients were admitted with a variety of electrolyte abnormalies. 24% had hyponatraemia, 27% had hypokalaemia, and 23% had hypernatraemia. Sodium levels were improved within 24 hours for all patients except for 5 hyponataemia patients. Although rotavirus patients had higher stool glucose concentrations than the other patients, they apparently absorbed enough of the solution to rehydrate successfully. Specific data on changes in weight, plasma protins, hematocrit, blood composition, and stool composition and on therapeutic failures was provided. Investigators concluded that ORT was a safe and effective form of therapy for both rotavirus and bacterial diarrhea and for severe cases of dehydration.
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PMID:Oral rehydration and maintenance of children with rotavirus and bacterial diarrhoeas. 22 48

100 infants with 1-10% dehydration resulting from acute watery diarrhea were treated in an emergency room setting with oral glucose-electrolytes therapy. The acute episode was utilized to instruct mothers in the technique of oral therapy for diarrhea. After initial rehydration, when the stools had lost their totally watery character, children were discharged and mothers were instructed to continue oral therapy as needed at home and to resume milk feedings. 92% of the infants were successfully rehydrated during the initial visit without any intravenous fluids. 8% required intravenous therapy because of persistent vomiting or refusal to take the oral solution in the face of significant diarrhea. 13% of the infants were brought back to the emergency room by their mothers due to continued diarrhea and recurrent dehydration. Of these, 8 were rehydrated again with oral therapy and 7 were given intravenous fluids. Oral therapy alone was successful in 85% of the cases. The mean duration of stay in the hospital was reduced, with 74% of the infants staying less than 24 hours as compared with 36% in previous studies in this hospital. (Authors' modified)
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PMID:Evaluation of oral therapy for infant diarrhoea in an emergency room setting: the acute episode as an opportunity for instructing mothers in home treatment. 31 26


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