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

A 17-year-old female weighing 37 kg and 140 cm in height was referred to our hospital for evaluation of dwarfism and primary amenorrhea. She was delivered with 3350 g in weight and 50 cm in height after a ten month pregnancy without complications. No abnormal findings were revealed in physical appearance except critomegaly. Episodes of nausea, vomiting and dehydration were rare throughout her childhood, but she had a tendency to salt craving. At the age of 14, her height was 140 cm. On admission, her physical development was markedly retarded for her age, except external genitalia. Diffuse pigmentations on the trunk and extremities were observed. Her blood pressure was normal (112/62 mm Hg). Serum potassium concentration was 2.9 mEq/L. Arterial-blood gas analysis revealed metabolic alkalosis. Both of renin activity (PRA) and aldosterone concentration (PAC) in plasma at rest were markedly elevated to 15.5 ng/ml/h and 107.1 ng/dl, respectively. The plasma concentrations of pregnenolone (1449 ng/dl), progesterone (178 ng/dl), 17-OH-pregnenolone (1613 ng/dl), 17-OH-progesterone (180 ng/dl), dehydroepiandrosterone (3706 ng/dl), androstendione (824.6 ng/dl) and testosterone (900 ng/dl) were high, whereas deoxycorticosterone (15.7 ng/dl), corticosterone (0.65 microgram/dl) and cortisol (6.8 micrograms/dl) were within normal limits. Urinary 17-KS excretion showed high levels between 65.7 and 109.4 mg/day, while urinary 17-OHCS excretion was normal (5.7-7.0 mg/day). Vascular response to angiotensin II (A-II) was attenuated. Distal fractional chloride reabsorption was decreased (CH2O/CH2O+CCl = 0.62, normal: 0.92 +/- 0.04). Moderate hyperplasia of the juxtaglomerular cells was demonstrated in biopsy specimen of the kidney. Cytogenetic studies showed a 46, XX chromosome constitution with translocation of the long arm of chromosome 6 to the short arm of chromosome 9. Her mother as well as younger brother and sister, whose electrolytes and arterial-blood gas analysis showed normal values, had chromosomes with the same translocation. Treatment with dexamethasone (2 mg/day) reduced every adrenal steroids to normal range, but PRA and PAC remained high levels. Furthermore, neither hypokalemic alkalosis nor vasoreactivity to exogenous A-II was improved. Indomethacin (75 mg/day) decreased urinary excretion of prostaglandin E2 from a high level of 738.4 ng/day to 433.4 ng/day and normalized metabolic alkalosis. Vascular response to A-II was moderately improved. However, serum potassium remained low.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A case of 21-hydroxylase deficiency and Bartter's syndrome associated with a balanced 6-9 translocation]. 349 Oct 9

In a double-blind randomized study, amoxicillin-clavulanic acid (AM-CL) was compared with cefaclor for the treatment of acute urinary tract infections in 107 college women. A total of 53 patients received amoxicillin (250 mg) and clavulanic acid as the potassium salt (125 mg), and 54 received cefaclor (250 mg); each drug was administered every 8 h for 10 days. The cure rates at 1 and 4 weeks after treatment were 96 and 78%, respectively, in the AM-CL group and 92 and 75%, respectively, in the cefaclor group (P greater than 0.10). After AM-CL treatment, the prevalence of amoxicillin-resistant Escherichia coli significantly increased in the rectal flora. Also, the frequency of bacterial resistance to amoxicillin, AM-CL, and cefaclor increased among the urinary pathogens causing subsequent urinary tract infections (P less than 0.05). There were no adverse reactions in the cefaclor group; however, six patients in the AM-CL group (12%) experienced diarrhea, nausea, or vomiting (P less than 0.05). Elevated transaminase enzyme levels were observed in 23% of the patients in the AM-CL group and in 6% of the patients in the cefaclor group (P less than 0.05). Symptomatic Candida vaginitis developed in 16 and 13% of the patients in the AM-CL and cefaclor groups, respectively (P greater than 0.10).
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PMID:Amoxicillin-clavulanic acid versus cefaclor in the treatment of urinary tract infections and their effects on the urogenital and rectal flora. 352 18

The authors report a case of acquired polydipsia in an infant. The case was unusual in its presentation, its late onset (without anorexia, nor vomiting), and the normal salt-water balance contrarily to what is observed in water intoxication. The course was favourable after progressive conditioning.
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PMID:[Acquired polydipsia in infants]. 356 45

We compared the therapeutic efficacy of a World Health Organization standard bicarbonate-based oral rehydration salt solution (BBORS) with a citrate-based oral rehydration solution (CBORS) in a randomized, double-blind, controlled trial in 130 dehydrated patients with cholera aged three to 82 years. On admission the 70 patients who received CBORS and the 60 who received BBORS were similar except that the serum CO2 content (mmol/liter) was significantly lower in the CBORS group (10.8 +/- 3.6 vs. 12.5 +/- 5.3). The incidence of vomiting postadmission (41% vs. 62%, respectively), the stool output during the first 24 hr (4,252 +/- 3,900 ml vs. 6,025 +/- 4,389 ml, respectively), and the time until the patients' conditions were considered normal (38.9 +/- 14.5 hr vs. 46.3 +/- 22.7 hr, respectively) were all significantly less in the CBORS group. The serum CO2 content increased more rapidly during the first 48 hr in the CBORS group (87% +/- 74% vs. 61% +/- 68% for the BBORS group); 23% of the patients receiving CBORS and 35% of the patients receiving BBORS were considered oral-therapy treatment failures. The results indicate that CBORS was superior to BBORS for rehydration and maintenance therapy of hospitalized cholera patients in Jakarta.
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PMID:Rehydration and maintenance therapy of cholera patients in Jakarta: citrate-based versus bicarbonate-based oral rehydration salt solution. 390 81

Presented is the case of a normal two-month-old girl who developed seizures secondary to water intoxication. The infant had been fed 20 to 30 oz of water daily for three days, while her usual formula was withheld because of vomiting and diarrhea. On the day of admission, the infant exhibited signs of water intoxication in the form of lethargy, vomiting, and seizures. Hyponatremia, hypothermia, and hyperglycemia were noted on admission, and are common features of the syndrome. The patient responded well to fluid restriction and salt replacement. Previous reports have attributed water intoxication to feeding mismanagement, vigorous hydration, dilute formulas, and swimming lessons.
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PMID:Water intoxication with seizures. 396 5

Unexpected differences in clinical and biochemical findings in two brothers occupationally exposed to the same source of lead for dissimilar lengths of time are presented. Only the brother with the shorter period of lead exposure was anemic and afflicted by nausea, vomiting, abdominal colic and arthralgia. His urinary PBG output yielded the high orders of magnitude found in acute intermittent porphyria in relapse. Prior to administration of a single dose of EDTA (1 g of the calcium disodium salt given intravenously in 325 mL 0.15 mol/L NaCl), his blood lead levels averaged 3.6 mumol/L. The amount of chelatable lead retrieved from his urine, 31 mumol/day, was more than twice that found in his asymptomatic counterpart who was exposed to lead for 13 months and whose pre-EDTA blood lead levels averaged 4.0 mumol/L. Not only the activity of delta-aminolaevulinic acid dehydratase, but also that of uroporphyrinogen I synthetase, was markedly inhibited by lead in red cells of both brothers. These activities were restored to normal levels in vitro by addition to the assay system of zinc and dithiothreitol. This ruled out a coexisting genetic deficiency of either enzyme. The anemia of the symptomatic brother with the shorter period of lead exposure was alleviated by folic acid, 15 mg/day. The differences in findings between the two brothers point to differential susceptibility to lead and illustrate the extent to which symptomatic lead poisoning may mimic biochemical and clinical features of the acute porphyrias.
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PMID:Occupational lead exposure: studies in two brothers showing differential susceptibility to lead. 401 20

The etiology, epidemiology, pathophysiology, and complications, therapy, and prognosis of hypernatremic (hypertonic) dehydration in infants are briefly discussed. The most likely causal condition for hypernatremic states in infants is enteric disease, because the symptoms of diarrhea and vomiting result in water loss and inability to take in water for replenishment. Other causes include dubious feeding practices, diabetes mellitus, diabetes insipidus, and maladroit diagnostic and therapeutic maneuvers, including administration of radiologic contrast medium or hypertonic sodium bicarbonate or mannitol infusions, or the use of salt solutions as an emetic. Epidemiologically, 2 factors are apparent: high saline diet and winter season. The clinical hallmarks of hypernatremic disturbance are relative preservation of circulation and early presence of neurologic symptomatology. Renal tube necrosis is also occasionally encountered. Therapy is rehydration, but the bone of contention is the technique for replacing water in the face of the fact that water administered without electrolyte causes the brain to swell and frequently results in convulsions. The management of hypernatremic dehydration begins with a replenishment phase if neither shock nor apparent anuria is present. The principle is to replenish the body slowly, and 48 hours has been chosen as the target, so that for volume the deficit plus 2 days of ongoing losses should be allocated. However, the sodium and other ion contents are derived solely from the deficit, without factoring the 2-day maintenance period. A recipe for rehydration fluid is presented.
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PMID:Hypernatremic (hypertonic) dehydration in infants. 457 33

This study determines the efficacy and incidence of side effects associated with intravaginal prostaglandin F2alpha (PGF2alpha). 20 healthy patients (16 to 30 years of age; 9-16 weeks gestational age) with no history of threatened abortion in the current pregnancy were studied. Baseline hematologic, metabolic, urinary, and hormonal studies were conducted. Transabdominal amniocentesis was performed in 7 patients. The uterus was observed for spontaneous contractility. Lactose tablets with 50 mg PGF2alpha (THAM salt) were administered vaginally. The intensity and frequency of uterine contractions in the 7 monitored patients determined the treatment regimen. Prostaglandin tablets were inserted at hourly intervals to maintain frequency of contractions at 5 per 10 minute time interval and/or intensity of contractions greater than an average of 40 mm Hg over a 10 minute-period. 13 patients whose uterine activity during the abortion process was assessed by clinical observation were given a similar time schedule. Blood studies were peformed 6 hours after the onset of therapy and immediately following abortion. Analgesia were used intramuscularly as antiemetic agents where necessary. Prepared questionnaires and personal interviews were completed at the 4-week clinic visit to determine patient acceptability of the method. 19 of 20 patients aborted, with 7 classified as complete and the remaining 12 requiring a uterine exploration and curettage for removal of retained placental fragments. Average induction-complete abortion interval was 17 hours and 50 minutes. There was no difference between multiparous and primiparous patients. In 1 patient who failed to abort with the prostaglandin tablet, administration of 900 mg PGF2alpha and hypertonic saline were used to facilitate abortion which occurred 24 hours later. Emesis occurred in 18 patients, diarrhea in 13, and fever in 11. Of 15 patients who agreed to an interview during the clinic visit, 14 stated they would choose the method again. Vaginal administration of PGs appears to exert effects by systemic, rather than by local mechanism. Although this method is effective, it has a high incidence of side effects and is associated with increased utilization of professional time.
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PMID:Abortifacient efficacy of intravaginal prostaglandin F2 . 468 31

This study was undertaken to help formulate standardized dosage schedules of intraamniotic prostaglandin F2alpha (PGF2alpha) with respect to time to abort, completeness of abortion, and incidence and severity of side effects. The subjects were 100 healthy volunteer pregnant women (aged 14 to 42, gestational age 16 to 22 weeks) seeking abortion. 52 were nulliparous. There were 67 black patients and 33 whites. Blood studies and treatment urinalysis were performed. A test dose of 5 mg PGF2alpha (THAM salt) was given followed by saline to clear the catheter of the drug. Different protocols were formulated with respect to subsequent dosage. Oxytocics and laminaria were used where necessary. The first 10 patients (Group 1) were given a loading dose of 20 mg PGF2alpha and subsequent doses. There were 6 complete abortions and 4 incomplete abortions. Average time to abortion was 26 hours. Group 2 (n=10) was treated with an initial dose of 30 mg and another dose of 25 mg at 12 hours. There were 6 complete, 1 incomplete, and 3 failed abortions; average time to abortion was 25 hours. Group 3 (n=40) was given an initial dose of 30 mg, followed by 25 mg at hour 6, 30 mg at hours 18-24 and 25 mg at hours 24-30. There were 28 complete, 11 incomplete, and 1 failed abortion; average time to abortion was 21 hours. Group 4 (n=20) was given a large loading dose of 40 mg with no further therapy for 18-24 hours. There were 11 complete and 9 incomplete abortions; average time to abortion was 21 hours. Group 5 (n=20 gravidas) was treated with a loading dose of 40 mg followed by 20 mg in 6 hours and 40 mg after 24 hours. There were 14 complete, 5 incomplete, and 1 failed abortion. Overall, 65 patients aborted completely and 30 incompletely, giving a total of 95 successes in 100 patients. 40 had diarrhea and 8 had vomiting. There were no statistically significant linear regression between time to abort and patient age, parity, or gestational age. A comparison of nulliparous and parous patients in Group 5 showed a near significant difference in mean interval time to abort at p 0.05 level. A comparison of PGF2alpha with hypertonic saline shows little difference between the 2 methods with respect to proportion of complete abortion. 15-methyl analogues may reduce the high incidence of vomiting and diarrhea in the PGF2alpha method.
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PMID:Intra-amniotic prostaglandin F2 alpha to induce midtrimester abortion. 472 75

The increased risk of thromboembolism in women using estrogen-containing (OCs) oral contraceptives has been related to decreased (AT3) antithrombin 3 levels of about 10%. A dose-dependent effect on AT3 has been suggested. Using an automated chromogenic technique, we have studied the effect on AT3 of a very high dose of ethinyl estradiol (5 mg daily for 5 days), popularly known as the "morning after pill," which in the Netherlands is prescribed to 45,000 women. The mean decrease in AT3 level in 13 patients of average age 23 was 17% of the pretreatment value (p=0.0013). Values in U/ml as mean + or - 50 were 1.03 + or - 0.12 on day 0, 0.86 + or - 0.12 on day 5, and 0.97 + or - 0.15 on day 12. The day 0 samples were taken immediately before the start of therapy and those on day 12 were taken 1 week after discontinuing therapy. The normal range is 0.80-1.40 U/ml. The effect of this dose was also studied in 2 volunteers. The 1st volunteer did not wish to continue after the first dose of 5 mg ethinyl estradiol because of vomiting. On day 2 AT3 had increased by 22% and on day 4 had decreased by 12% of the pretreatment level. The 2nd volunteer also vomited on day 1, but continued the medication. AT3 increased on day 2 and then fell to 18.5% of pretreatment level on day 4. Changes in AT3 ran parallel with changes in hematocrit (seen in figure). High doses of estrogen have been reported to cause an increase in blood volume of 18% and a decrease in hematocrit of 15%. Plasma volume increases by 11% during OC use. Estrogen induced retention of salt and water causing hemodilution rather than increased consumption or decreased synthesis, may explain the reported decreases in AT3 levels. This does not rule out the possibility that subnormal values contribute to a hypercoagulable state. In 1 of our patients on day 5 of treatment AT3 fell to 0.60 U/ml, which is within the range where thromboembolism may occur in certain settings, such as emergency surgery or a history of thrombosis.
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PMID:"Morning after pill" and antithrombin III. 611 73


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