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

Accidental acute mercury vapor poisoning in three persons is reported. Three hours after exposure, symptomatology began by chills, vomiting, diarrhea and chest pain. Two patients, respectively 67 and 77 year old, presented severe pulmonary edema, then neurological symptoms with tremor and coma. This toxic pulmonary edema, which entailed artificial ventilation, was followed in both cases by an acute interstitial pulmonary fibrosis which led to death respectively after six and sixteen days. In the third case (a thirty eight year old patient) a skin rash, erythematous and pustuliform was observed. Analysis for total mercury by flameless atomic absorption showed very high mercury levels in blood and urine of the three patients. The effect of treatment by Dimercaptopropanol on renal excretion of mercury was studied. Optic and electron microscopy of the lung of the two patients who died showed the pulmonary changes of acute interstitial fibrosis.
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PMID:Accidental acute mercury vapor poisoning. 50 88

Drug therapy during the Colonial and Revolutionary War period in America is discussed. Therapy in the 17th and 18th centuries remained largely symptomatic rather than curative. Treatment included such "depletion" measures as purging, sweating, bleeding, blistering and vomiting. Purgatives, emetics, opium, cinchona bark, camphor, potassium nitrate and mercury were among the most widely used drugs. European herbals, dispensatories and textbooks were used in the American colonies, and beginning in the early 18th century, British "patent medicines" were imported. During the Revolutionary War, the supply of drugs from Britain was cut off. The Continental Congress established laboratories and storehouses to serve the needs of the army.
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PMID:Drug therapy in colonial and revolutionary America. 78 35

A multicenter open trial involving 50 hypertension patients enabled evaluation of the efficacy and tolerability of Isoptine L.P. (sustained release verapamil) in mild to moderate essential hypertension. Following a 2-week placebo run-in period, patients were given Isoptine L.P. (240 mg/24 h) as a morning dose for 3 months, with a possible dose increase (360 mg/24 h) in case of diastolic blood pressure of 95 mmHg or more at the 30-day evaluation. Blood pressure was measured by mercury sphygmomanometer and, in 20 patients, by a Dinamap type Automatic device. After 3 months of treatment, blood pressure levels in supine and standing position, measured manually and automatically, showed a highly significant decrease, with a mean fall of 18.4 mmHg for systolic (13.7 percent) and 13.2 mmHg diastolic (-14.6 percent). 67 percent of patients were responders after 1 month of treatment and 79 percent at 3 months, including one-fifth at the dose of 360 mg/24 h. Seventeen patients, i.e. 34 percent, reported one or more adverse reactions. Among these, four patients had to stop treatment, twice because of headache and twice for constipation. Adverse events seen most frequently were constipation, headache, tiredness and vomiting. No cardiac adverse events were reported with the exception of one case of atrial premature contractions. The electrocardiogram revealed significant slowing of heart rate, as well as slight prolongation of PR and QT intervals and slight widening of the QRS complex. Tolerability on the basis of laboratory parameters was good.
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PMID:[Efficacy and tolerability of isoptine LP in mild to moderate hypertension. A multicenter study with 50 patients]. 130 Sep 22

The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage and administration of succimer when used for the treatment of lead poisoning are reviewed. Succimer is an orally active, heavy-metal chelating agent that forms stable, water-soluble complexes with lead; it also chelates other toxic heavy metals, such as arsenic and mercury. It is a designated orphan drug that is indicated for the treatment of lead poisoning, specifically in children with blood lead concentrations higher than 45 micrograms/dL. Succimer reverses the adverse metabolic effects of lead on heme synthesis while increasing urinary lead output without adversely affecting essential mineral excretion at the recommended dosage regimen. The rebound in lead concentrations that can occur after short courses of chelating therapies (caused by redistribution of lead from bone stores) may require frequent and multiple courses of chelation therapy. The most common adverse effects reported in clinical trials of succimer in children and adults were nausea, vomiting, diarrhea, appetite loss, and loose stools; these effects may be related to the drug's unpleasant mercaptan odor. There are no known drug interactions between succimer and other drugs, including iron supplements, although data are limited. The recommended initial dosage in children is 10 mg/kg or 350 mg/sq m every eight hours for five days. The dosage is then reduced to 10 mg/kg or 350 mg/sq m every 12 hours for an additional two weeks. Clinical studies indicate that succimer is relatively selective for lead and effectively lowers blood lead concentrations. Although clinical experience is limited, an oral lead chelator may offer advantages over currently available agents.
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PMID:Succimer, an oral lead chelator. 166 40

The first case, a two-month-old female infant, had frequent vomiting since 5 days of age. Dilated esophagus with narrowed distal end was noted on barium meal study. Panendoscopic examination revealed dilated esophagus and a pin-head sized, stenotic lumen at 15 cm from the incisor. Under the impression of esophageal stenosis, gastrostomy was performed for feeding. Esophagogram made at 6 months of age demonstrated good patency of the esophagus without stenosis and gastrostomy was subsequently closed at the age of 1 year. Unfortunately, swallowing disturbance had bothered her intermittently since. Barium esophagogram and panendoscopy made 8 years later again revealed distal esophageal obstruction with dilated proximal esophagus. The second case was a two and half year old boy who suffered from frequent regurgitation of undigested food for 6 months. Dilated esophagus with narrowing of the lower end of esophagus was noted on barium meal study. After admission, panendoscopic examination revealed the esophagus was very narrow at 25 cm from incisor and the proximal esophagus was dilated. The esophageal dilatation with mercury-weighted bougies was performed intermittently. At present he is doing well, and a barium meal study showed adequate esophageal emptying.
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PMID:[Achalasia: report of two cases]. 263 99

An intussusception of the small intestine in association with a long tube usually occurs in the vicinity of the mercury-filled bag and can be visualized radiographically by instilling barium directly into the tube. On rare occasions, an intussusception develops in the proximal jejunum and is difficult to recognize. We report the fifth and sixth cases of a proximal jejunal intussusception with a long tube in situ and outline a clinical approach that facilitates a prompt, accurate diagnosis. A proximal jejunal intussusception should be suspected if copious bilious vomiting and abdominal pain occur following intubation of the small intestine with a long tube.
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PMID:Proximal jejunal intussusception associated with a long tube. 370 30

A patient attempting suicide ingested 5682 mg methoxyethylmercury chloride, which corresponds to 4375 mg mercury. The bulk of the dose was eliminated by vomiting and gastric rinsing. About 706 to 977 mg mercury were absorbed in the gastrointestinal tract. Only 11.2 mg mercury could be removed by two activated charcoal hemoperfusions. Chelating agents were given for 12 weeks. The terminal elimination half-life calculated from blood and urine mercury levels was 23 and 25 d, respectively. No toxic effects on the kidneys and central nervous system were seen. The identification of methoxyethylmercury chloride in the gastric rinsing fluid was done by gas chromatography/mass spectrometry. The protein binding of methoxyethylmercury chloride was determined by ultrafiltration (93%). In the presence of dimercaprol sulfonate and penicillamine, protein binding was 83 and 88%, respectively. Activated charcoal and amberlite hemoperfusion revealed equal in vitro clearances for methoxyethylmercury chloride (62 mL/min at a flow rate of 80 mL/min).
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PMID:Methoxyethylmercury chloride poisoning: clinical findings and in vitro experiments. 681 39

Experimentally, we produced obstruction of the intestine in dogs, and the intraluminal pressure of the small intestine was measured without inducing anesthesia and with the abdominal wall closed. The maximum active intraluminal pressure reached 44.1 +/- 3.3 milligrams of mercury three days after the obstruction was produced. The pressure rose further to 95 millimeters of mercury, or higher, after an intravenous injection of physostigmine or during vomiting. When the intraluminal pressure is artificially increased and the vascular structure is observed by the resin-casting method, impairment of the villous circulation of the mucosa is already seen when the pressure reaches 20 millimeters of mercury. When the pressure was further increased, the circulation impairment spread toward the outer layer of the intestine. Mesenteric blood flow, peripheral vascular resistance and submucosal blood flow did not show significantly lower values than did the control group, unless the intraluminal pressure was 100 millimeters of mercury, or higher, but the oxygen consumption of the intestinal tissues was significantly lower than that for the control group when the intraluminal pressure was 40 millimeters of mercury, or higher. The resin-casting method showed that, at this pressure, a finding believed to indicate an arteriovenous shunt was already present at the mucosal villous base. The aforementioned results indicate that selective mucosal ischemia may occur when the intraluminal pressure increases to a range that is clinically possible when obstruction of the intestine occurs.
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PMID:Experimental studies on the hemodynamics of the small intestine following increased intraluminal pressure. 682 51

Four adults, including a pregnant woman, and three children were admitted to hospital following accidental exposure to mercury vapour produced by heating mercury-gold amalgam. Initial symptoms and signs included a paroxysmal cough, dyspnea, chest pain, tachypnea, nausea, vomiting, fever and leukocytosis. Pulmonary function testing performed on the second day after exposure revealed air-flow obstruction and minor restrictive defects in three patients. The diffusing capacity of the lung for carbon monoxide was reduced in two of these patients. The mean initial blood mercury level (+/- one standard deviation) for the seven patients was 30.8 +/- 1.5 micrograms/dl. A computer analysis showed mercury to behave as a two-compartment system, the compartments having half-lives of 2 and 8 days. The four adults received chelation therapy with D-penicillamine, which did not affect the urinary excretion of mercury. The pregnant woman's infant, born 26 days after exposure, had no detectable clinical abnormalities. The levels of mercury in the blood of the mother and infant at birth and 6 days later were comparable, indicating free transfer of the metal across the placenta.
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PMID:Accidental inhalation of mercury vapour: respiratory and toxicologic consequences. 688 61

Medical records of 150 patients with high-altitude pulmonary edema seen over a 39-month period in a Colorado Rocky Mountain ski area at 2,928 m (9,600 ft) (mean age 34.4 years; 84% male) were reviewed. The mean time to the onset of symptoms was 3 +/- 1.3 days after arrival. Common symptoms were dyspnea, cough, headache, chest congestion, nausea, fever, and weakness. Orthopnea, hemoptysis, and vomiting were rare, occurring in 7%, 6%, and 16%, respectively. Symptoms of cerebral edema occurred in 14%. A temperature exceeding 100 degrees F occurred in 20%, and 17% had a systolic blood pressure of 150 mm of mercury or higher. Blood pressures were higher in patients older than 50 years (142 mm of mercury). Rales were present in 85%, and a pulmonary infiltrate was present in 88%; both were most commonly bilateral or on the right side. The amount of infiltrate was mild. Men appeared to be more susceptible than women to high-altitude pulmonary edema. Pulse oximetry in 45 patients showed a mean oxygen saturation of 74% (38% to 93%). Treatment methods depended on severity and included a return to quarters for portable nasal oxygen, an overnight stay in the clinic for continuing oxygen, or a descent to Denver for recovery or admission to a hospital. All patients received oxygen for 2 to 4 hours in the clinic. There were no deaths or complications.
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PMID:High-altitude pulmonary edema at a ski resort. 877 33


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