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Query: UMLS:C0042963 (vomiting)
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How do you treat diarrhoea?, questionnaires were sent to 586 health workers in 81 countries and 58% replied. Treatments for acute diarrhoea were scored for popularity, including retrospective questions about therapy three years earlier. Oral rehydration was apparently widely used in 1976, and this had increased by 1979. Intravenous therapy was also important. Kaolin and sulphonamides are becoming less popular, but antibiotics are still widely prescribed. The most commonly used oral rehydration mixtures in 1979 were home made, simple salt-sugar solutions. A complete formula, as recommended by WHO, was used by a smaller number. 30% of the responders reported no difficulty with oral rehydration, but many did not favour the method. The main technical complaint in 28% of replies was that patients could not take enough fluid, and vomiting was reported in 22%. Local beliefs about the cause of diarrhoea related to some food or fluid ingested according to 45% of responders. Such diet-related beliefs may adversely affect the use of oral therapy.
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PMID:A worldwide survey on the treatment of diarrhoeal disease by oral rehydration in 1979. 618 70

Budd Chiari Syndrome, characterized by massive ascites, hepatomegaly, abdominal pain, and tenderness, nausea, and vomiting, is caused by obstruction of the hepatic venous outflow. Of the known causes of polycythemia rubra vera, hypernephroma, and other tumors invading the inferior vena cava have been most often reported, while pregnancy and oral contraceptives (OCs) have also been held as causes. In this paper the case is presented of a young woman, previously on OCs for 4 months, who developed the syndrome 2 weeks after delivery; she was also found to have multiple hepatic adenomas on laparotomy. The longterm use of OCs has been estimated to be associated with an annual incidence of liver cell adenoma of 3-4/100,000. Evidence suggests that the estrogen components, rather than the progesterone, of OCs seem more likely to cause liver cell adenoma since estrogens are carcinogenic in other organs and promote liver cell regeneration in rats. By interference with the metabolism of oncogenic bile salt derivatives, estrogen may exert its oncogenic effect. The patient is this case was told never to use OCs again since there is also evidence that the tumor may regress on stopping OCs, and she was advised against further pregnancies.
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PMID:Budd-Chiari syndrome and hepatic adenomas associated with oral contraceptives. A case report. 627 27

A syndrome of renal tubular resistance to aldosterone has been identified in infants with obstructive uropathy and urinary tract infection. Six infants (ages 9 days to 7 months) were seen with fever, vomiting, polyuria, dehydration, or failure to thrive. Urine cultures were positive for Escherichia coli. Radiologic studies demonstrated bilateral ureterohydronephrosis (four patients), left ureteral duplication with upper pole hydronephrosis (one), and left vesicoureteral reflux (one). The infants had hyponatremia, hyperkalemia, and metabolic acidosis. Plasma aldosterone concentration was markedly elevated, and plasma renin activity was similar to or higher than that reported in normal infants of comparable age. Fractional excretion of potassium was not significantly different from control values, both in absolute terms or when related to glomerular filtration rate, but fractional sodium excretion was significantly increased. The UK/UNa ratio was significantly lower in the patients. After medical or surgical therapy (when appropriate), all blood and urine determinations returned to normal, except for UK/UNa values, which although higher, remained significantly diminished. Our data indicate that a hyperkalemic salt-losing state can arise in infants with obstructive uropathy and urinary tract infection as a consequence of tubular unresponsiveness to aldosterone, and that the clinician should rule out such cause before establishing the diagnosis of primary pseudohypoaldosteronism.
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PMID:Transient pseudohypoaldosteronism secondary to obstructive uropathy in infancy. 635 May 53

Alkaline reflux (bile) gastritis and esophagitis result from mucosal injury by duodenal contents. Bile gastritis occurs after gastric surgery, cholecystectomy, ampullary sphincteroplasty, and, rarely, in nonoperated patients. Diagnostic features include chronic, continuous epigastric pain, exacerbated by eating, bilious vomiting, weight loss, iron deficiency anemia, achlorhydria, gastritis, and intragastric bile. The pathophysiology probably relates to excess enterogastric reflux and bile-induced mucosal damage. There is no perfect diagnostic test, but chemical and scintigraphic documentation of enterogastric reflux, as well as provocative testing with alkali solutions, are promising new techniques. Medical therapy with antacids, H2 antagonists, bile salt absorbants, and metoclopramide has been without significant benefit. Prostaglandins and sucralfate are now being evaluated. Surgical therapy that diverts duodenal contents away from the stomach is usually of benefit in appropriately selected patients. Alkaline reflux esophagitis shares many features with alkaline gastritis.
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PMID:Alkaline reflux gastritis and esophagitis. 637 64

The purpose of the present study was to develop a controllable experimental model in the dog that would consistently and predictably produce a malignant hypertensive crisis, and to determine the sequential changes in renal function, salt and water balance, and hormones that are involved in the transition from benign to accelerated hypertension. Norepinephrine (NE) was infused continuously into the renal artery of unilaterally nephrectomized dogs that were maintained on 50 mEq sodium/day. The infusion rate of NE was increased each day according to the following schedule: 0.05, 0.1, 0.2, 0.3, 0.4, and 0.5 microgram/kg/min. During the first 4 to 5 days of intrarenal NE infusion, there was a progressive decrease in glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), and increases in plasma renin activity (PRA), mean arterial pressure (MAP), and filtration fraction. At the end of this period of benign hypertension, MAP had risen from a control value of 91 +/- 4 to 132 +/- 8 mm Hg, in association with approximately a 10-fold increase in PRA and a 40% reduction in renal function. Then, suddenly, during the subsequent 24-hour infusion period, the MAP increased abruptly in all animals (MAP = 156 +/- 8 mm Hg), and a hypertensive crisis occurred. This crisis was associated with the following: salt and water depletion, hyponatremia, hypovolemia and hemoconcentration, polydipsia, marked activation of the renin-angiotensin-aldosterone system, increased plasma cortisol concentration, hemolysis, marked impairment in renal function, lethargy, and vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Malignant hypertensive crisis induced by chronic intrarenal norepinephrine infusion. 637 96

Since the approval of lithium use in treatment of acute mania, there have been numerous clinical trials of lithium in medical and psychiatric disorders. This paper gives a brief review of the literature on lithium trials in approximately fourteen medical conditions. These are: hyperthyroidism, metabolizing thyroid cancer, syndrome of inappropriate secretion of antidiuretic hormone, premenstrual tension syndrome, anorexia nervosa, Felty's syndrome, chemotherapy-induced neutropenia, aplastic anemia, seborrheic dermatitis, eczematoid dermatitis, cyclic vomiting, diabetes mellitus and asthma. Most of the case reports cited showed the efficacy of the side effects from lithium salt in the management of the symptoms and signs of these disorders, however, well-designed and controlled studies give negative results. The positive results are reported in the group of disorders having an underlying subdromal affective syndrome such as premenstrual tension syndrome and anorexia nervosa. Other encouraging reports include the effect of lithium to induce leucocytosis in Felty's syndrome and chemotherapy-induced neutropenia.
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PMID:A review of clinical trials of lithium in medicine. 639 35

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

Seventeen patients with bile duct calculi were treated alternately with a preparation of glycerol octanoate and a bile salt-EDTA solution via a nasobiliary tube. Of 14 patients (group I), it was necessary to operate on four immediately after irrigation therapy, success resulted from this conservative therapy in eight (57%) cases and two were unchanged. Laboratory investigations showed a decrease in zinc and copper concentrations in the serum. Of the patients 50-60% suffered from vomiting and diarrhea. For three patients (group II), there was an interval of 6-26 days between the end of the therapy and operation. Histological findings in the patients in group I and II subjected to operation included acute ulcerative and chronic inflammation in gallbladder and common bile duct walls. Since the alterations were of minor degree in four of the seven patients who subsequently underwent surgery the risk of irrigation therapy seems to be acceptable.
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PMID:Biochemical and morphological investigations of the toxicity of a Capmul preparation and a bile salt-EDTA solution in patients with bile duct stones. 642 34

Between September 1979 and September 1981 a field study was conducted on the etiology of diarrheal disease in the area of Puriscal, Costa Rica. The presence of enteric pathogens was investigated in the stools of 267 diarrheic children and 190 healthy controls. Both groups belong to yearly cohorts recruited at birth as part of a longitudinal multidisciplinary study of mothers and children. Campylobacter fetus jejuni was identified as the only pathogen in the stools of 24 diarrheic children (9%) and in four healthy controls (2%), a significant difference (p less than 0,05). The clinical features of the episodes were: irritability (77%), blood in stools (35%), anorexia (38,5%), and fever and vomiting (36%). Dehydration was not important among infected children (only one with 5% dehydration). All children received oral salt solutions and only two were treated with antibiotics. Rotaviruses were the main etiologic agents (17%) and Campylobacter ranked second (10,5%). The frequency of enterotoxigenic Enterobacteriaceae was similar in sick children and in controls (10% and 12% respectively).
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PMID:[Diarrhea caused by Campylobacter fetus jejuni and other infective agents in children of the rural area of Puriscal, Costa Rica]. 653 79

Lethargy, anorexia and vomiting suggest azotemia in cats with FUS. Clinicopathologic findings may include azotemia, hyperphosphatemia, hyperglycemia, hyperkalemia, and signs of urinary tract inflammation on urinalysis. Treatment of FUS depends on the degree of illness but generally includes removal of the urethral obstruction, bladder lavage, fluid and antibiotic therapy, and subsequent feeding of a canned, low-Mg diet with added table salt.
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PMID:Management of acute illness in cats. Feline urologic syndrome. 673 7


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