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

Since 1974 we have seen 320 cases of Reye's syndrome in our department. There were 163 boys and 157 girls of a mean age of 20 months. While the number of Reye's syndrome patients admitted increased from 1979 to 1982, it has declined since 1984. Two different approaches to management were used. Prior to 1976 only simple supportive measures were given: Intravenous 10% dextrose solution and electrolytes (Darrow-glucose solution) in equal amounts at a rate of 50-100 ml/kg/day with or without dexamethasone (0.5 mg/kg/day). From 1976, in addition, measures were taken to lower the intracranial pressure by infusing mannitol 1-2 gm and glycerol 1 g/kg given at a frequency related to the severity of the illness, i.e., for grade II, the above combination was given 8 hourly, for grade III 6 hourly, and for grades IV and V 4 hourly, while for grade I only fluid and electrolytes were given. In all cases, clinical progress was closely followed. Intravenous dexamethasone was also given at a dose of 0.5 mg/kg/day. The fatality rate was 50 to 60% prior to 1976 and has fallen to around 20% at present. In contrast to reports from Western countries, we observed more convulsions, respiratory infections and gastrointestinal disorders but less vomiting and no chicken-pox.
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PMID:Treatment of Reye's syndrome at Sumber Waras Hospital. 212 7

A case of a patient with organic hyperinsulinism complicated by the development of hyperosmolar state is described. The hyperosmolar state was induced by vomiting and dehydration during an acute urinary tract infection. Impairment of glucose metabolism was confirmed by the finding of reduced tissue sensitivity to insulin during a euglycaemic clamp.
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PMID:Glucose metabolism in a patient with insulinoma complicated by hyperosmolar non-ketotic state. 215 61

A case with acute disturbance of consciousness associated with calcium hopanthenate (HOPA) administration was reported. He was a 3-year-old boy with autistic developmental delay, had orally taken 1.5 g of HOPA daily for 3 months. Clinical manifestations consisted of fever, vomiting and coma. Laboratory examination revealed severe hypoglycemia and metabolic acidosis, but there were no hepatic enzyme abnormalities. Analysis of urinary organic acid profile showed that very large amounts of medium and long chain dicarboxylic acids and omega-1 hydroxy-fatty acids were excreted. In particular, 2-hydroxysebacic acid, the accumulation of which has only been reported in the urine of patients with Zellweger syndrome and neonatal adrenoleukodystrophy (NALD), was observed. Analysis of urinary acylcarnitines showed that acetylcarnitine was predominant and C6-C10 dicarboxylic acylcarnitines were also excreted. He was treated with and rapidly responded to intravenous glucose and bicarbonate. After withdrawal of the drug he has had no problems and dicarboxylic aciduria disappeared. A CT scan showed symmetric, low density areas in periventricular white matter, especially around the posterior horns of the lateral ventricles. A T2-weighted MRI scan revealed high-intensity signal in the white matter corresponding to areas of low density on CT scan. We conclude that that a large amount of HOPA administration may cause encephalopathy by the inhibition of both mitochondrial and peroxisomal beta-oxidation.
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PMID:[Clinical and biochemical studies in a case of acute encephalopathy associated with calcium hopanthenate administration]. 219 43

The purpose of this study was to determine if a small dose of intrathecal meperidine would achieve adequate spinal anaesthesia while minimizing complications and to compare its effectiveness with lidocaine. The spinal anaesthetic effects of five per cent lidocaine 0.5 mg.kg-1 in 7.5 percent glucose (n = 20) or five per cent meperidine 0.5 mg.kg-1 (n = 22) were evaluated in 42 ASA physical status II or III patients. Intrathecal injection of the anaesthetic agent was given with the patient in the sitting position in which he remained for ten minutes before being placed in the lithotomy position. The onset time for sensory blockade was seven minutes in the lidocaine group and ten minutes in the meperidine group. Final sensory levels were identical in both groups. Mean arterial blood pressure decreased significantly in the lidocaine group but not in the meperidine group. Motor block was absent in ten patients in the meperidine group but was present in all the patients in the lidocaine group. Duration of postoperative analgesia was 968 min in the meperidine group and 681 min in the lidocaine group (NS). Complications such as nausea, vomiting, itching, drowsiness and respiratory depression were similar in the two groups. It is concluded that low-dose meperidine, 0.5 mg.kg-1, is effective as a spinal anaesthetic agent and has few complications.
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PMID:Comparison of intrathecal meperidine and lidocaine in endoscopic urological procedures. 219 5

Alcoholic ketoacidosis is characterized by a metabolic acidosis with an elevated anion gap. It generally is seen in the chronic alcoholic patient who has recently gone on a "binge" that was terminated because of complaints such as nausea, vomiting or abdominal pain. Caloric intake is diminished. Treatment includes volume repletion and glucose administration. Morbidity and mortality usually result from intercurrent illness.
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PMID:Alcoholic ketoacidosis. 222 84

Low does pills have an effectiveness of 0.2-1.0 pregnancies/100 woman-years. The pill functions by multiple modes of action, namely: inhibition of ovulation by suppressing cyclic follicle stimulating hormone and luteinising hormone release; reducing sperm penetrability of cervical mucus; rendering the endometrium hostile to implantation; and probably affecting tubal transit time. Patients will no longer have their 'periods' but will experience hormone withdrawal bleeds. The greatest risk of ovulation is at the end of the pill-free week, not in the middle of the pack. Make sure you determine that it is an appropriate contraceptive: make sure the patient and her partner both want to use it and understand its advantages and disadvantages; is the risk of pregnancy high enough to justify its use (low coital frequency might indicate that a less effective method could be acceptable); how critical is pregnancy avoidance? (is it merely for child spacing?) Make sure you determine the medical appropriateness; absolute contraindications include pregnancy, undiagnosed vaginal bleeding, 1st 2-weeks postpartum, history of thromboembolic disease, CVAs, focal migraines, coronary artery disease, recent impaired liver function, and steroid-dependent tumors. Perform a physical examination including at least: blood pressure, weight, urine test for glucose and protein, heart, breasts, Papanicolaou smear and bimanual vaginal examination. Always choose the lowest possible dose pill. Often times this means a levonorgestrel-containing triphasic or low dose norethisterone-containing monophasic. Give the patient adequate information including: effectiveness, safety, how to start, possible side effect, what to do about late or missed pills, action to take in case of vomiting or diarrhoea, interactions with other drugs, postponed or missed periods, and special considerations for vegetarians. Offer preventative measures and give take home pamphlets.
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PMID:The combined oral contraceptive. A practical guide. 224 82

Most inborn errors of intermediary metabolism presenting in the neonatal period fall schematically into three clinical categories: (1) those which lead to a neurological distress 'intoxication type' with a symptom-free interval, vomiting, comas, hypertonia, abnormal movements and frequent humoral disturbances (organic acidaemias, congenital urea cycle defects); (2) those which lead to a neurological distress 'energy deficiency' type. Frequent symptoms in this group include hyperlactacidaemia, severe hypotonia, cardiomyopathy, failure to thrive and malformations (congenital lactic acidaemias, fatty acid oxidation defects, peroxysomal disorders); (3) those which present evidence of liver dysfunction and hepatomegaly (glycogenesis, neoglucogenesis defects, galactosaemia, fructosaemia, tyrosinaemia type I). According to these three major clinical presentations and according to the proper use of few screening tests (blood gases, glucose, ammonia, lactic acid, electrolytes, acetest), we propose a method of diagnosis which groups these children into five schematical syndromes: type I MSUD; type II organic acidaemias; type III; congenital lactic acidosis; type IVa, urea cycle defects; type IVb, non-ketotic hyperglycinaemia, sulfite oxidase deficiency, peroxisomal disorders; type V liver dysfunctions. Once the above classification has been made, sophisticated and specific investigations can be planned (amino acid chromatography, organic acid chromatography, enzymatic studies, etc).
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PMID:Clinical approach to inherited metabolic disorders in neonates. 226 19

A total of 186 infants, suffering from acute diarrhea were studied and divided into two groups: 84 children were placed in group A and given the ORS recommended by the World Health Organization which contains sodium and glucose at concentrations of 60 and 90 mmol/L respectively and an osmolality of 311 mOsm/kg (mmol/kg) (ORS-90). Group B included 82 children who received an ORS containing sodium and glucose at concentrations of 60 and 90 mmol/L respectively and with an osmolality of 240 mOsm/kg (mmol/kg) (ORS-60). Seven belonging to group A (8.3%) required intravenous rehydration due to the severity of the diarrhea (three cases), persistent vomiting (three cases) and paralytic ileus (one case), while only two cases belonging to group B (2.5%) required intravenous rehydration due to severe losses through feces (one case) and another due to paralytic ileus (one case). No differences were observed due to the variations in sodium concentrations among either of the groups of patients, whether that be in the natremias when admitted or once rehydrated, with a general tendency towards the correction of the hypernatremia or hyponatremia seen during admittance with both types of ORS. A similar situation was observed with the variations in serum potassium. The results obtained from this study show the different advantages of using an ORS with lesser sodium and glucose concentrations as well as minor osmolality with those from using the solution recommended by the World Health Organization, when a lesser index of failures is observed in the treatment of children with acute diarrhea with oral rehydration therapy. Yet before widely recommending its' use, it should be demonstrated that the new ORS induces lesser losses through feces during the rehydrating period in children dehydrated due to acute diarrhea.
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PMID:[Comparative study of 2 oral rehydration solutions containing 60 or 90 mmol/L of sodium and with different osmolalities]. 227 Nov 25

Chylous ascites in neonates is an unusual and etiologically poor understood entity. Our first case was a female newborn who suffered from abdominal distension and recurrent vomiting after birth. The history, physical, laboratory, and radiologic evaluations were not diagnostic except the evidence of obvious ascites. Paracentesis was performed and ascitic fluid was obtained. She was later discharged on a strict low-fat medium-chain triglycerides formula. She was found to have continue increase in abdominal girth, poor growth and development, and respiratory distress in which led her to readmission at 8 months of age. Exploratory laparotomy was done in order to rule out an anatomical lesion in which may be obstructing the lymphatic flow; but no such lesion could be found. She expired at 1 year of age with chylothorax, chylopericardium and lobar pneumonia. The second case, a 37-day-old male baby, who was admitted because of right inguinal hernia. Milky ascitic fluid in the abdomen was incidentally found during herniorrhaphy. Analysis of the fluid revealed protein 1,616 mg/dl, glucose 487 mg/dl, and triglyceride 796 mg/dl. Culture of peritoneal fluid grew no bacteria. Other laboratory findings were: serum protein 4.8 mg/dl, and BUN 14 mg/dl. A plain film of abdomen and sonogram showed massive ascites. The infant was then put on Pregestimil with the hope that the medium-chain triglyceride formula would improve his condition. Since then the child's abdominal girth did not increase and he continued to growth and develop normally at 4 months follow up.
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PMID:[Neonatal chylous ascites: report of two cases]. 227 29

A total of 186 infants suffering from dehydration due to acute diarrhea were studied and divided into two groups: 84 children were placed in group A and received the oral rehydration solution (ORS) recommended by the World Health Organization (WHO), know as ORS-90 and those placed in group B were given an ORS with 60 and 90 mmol/L of sodium and glucose, respectively, with an osmolality of 240 mOsm/kg (ORS-60). Seven patients from group A (8.3%) and two from group B (2.5%) could not be orally rehydrated and required intravenous rehydration. The children were divided according to their weight for their age into eutrophics, grade I malnutrition (10 to 25% deficit), grade II (26 to 40% deficit) and grade III (more than 40% deficit). In those patients who evolved favorably, the average rehydration time was 4.5 to 5.3 hours, independently from their nutritional state. In the same way, no important variations were seen in the average sodium and potassium serum levels once the dehydration was corrected, in either of the groups. Yet, both groups showed a persistence in hypokalemia and hyperkalemia seen when admitted, once the dehydration was corrected, demonstrating that the short time needed for the correction of the dehydration was insufficient to completely corrected the changes in serum potassium. Closer studies must be conducted on the hydric balance to adequately demonstrate if the new ORS-60 induces lesser losses through vomiting and feces when compared to the ORS-90 recommended by the WHO.
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PMID:[Oral rehydration solutions with 60 or 90 nmol/L of sodium for infants with acute diarrhea in accord with their nutritional status]. 228 64


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