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

This study has investigated the relationship between duodenogastric reflux, gastritis and certain symptoms 6-12 months after three operations for uncomplicated duodenal ulcer. The operations studied were proximal gastric vagotomy (PGV, 20 cases), truncal vagotomy and pyloroplasty (TV+P, 22 cases) and truncal vagotomy and antrectomy (TV+A, 21 cases). Duodenogastric reflux was assessed both by a radiological technique and by measuring the concentration of bilirubin in the gastric aspirate before and after operation. Incidence and severity of postoperative gastritis were determined by endoscopic biopsy. Symptoms were assessed by symptomatic score and Visick grading. There was a significant correlation between duodenal reflux and histological evidence of both severe superficial gastritis and glandular atrophy (P less than 0-01). There was also a close association between the degree of reflux and the presence of severe heartburn, epigastric pain and bile vomiting after operation. The amount of reflux did not differ before operation. There was significantly less reflux following PGV than after either TV+P (P less than 0-025) or TV+A (P less than 0-001). The results indicate that an operation which preserves an innervated and intact antrum and pylorus will protect against postoperative duodenogastric reflux, gastritis and symptoms.
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PMID:The importance of an innervated and intact antrum and pylorus in preventing postoperative duodenogastric reflux and gastritis. 0 Jan 23

This paper describes a randomised clinical trial in patients with advanced breast cancer, comparing the regimen 3M, mitomycin C 7-8 mg m-2 (day 1), mitozantrone 7-8 mg m-2 (day 1 and 21), methotrexate 35 mg m-2 (day 1 and 21) given on a 42 day cycle with a standard anthracycline containing regimen, VAC, vincristine 1.4 mg m-2 (day 1), anthracycline (adriamycin or epirubicin) 30 mg m-2 (day 1), cyclophosphamide 400 mg m-2 (day 1) given on a 21 day cycle. Of a total of 217 patients, 107 were randomised to 3M and 110 to VAC and a mean of 5.5 courses was given per patient. The overall response rate (complete and partial) was 53% (95% Confidence Limits (CL): 43-62%) for 3M and 49% (CL; 39-58%) for VAC. The response according to sites of metastases was the same for both treatment groups. Symptomatic toxicity including alopecia, neuropathy, vomiting (P less than 0.001) and nausea (P less than 0.01) were significantly less for 3M. Myelosuppression including leucopenia (P less than 0.001) and thrombocytopenia (P less than 0.001) was significantly greater with 3M at day 21, although there was no difference in nadir counts in patients at special risk of myelosuppression and there was no evidence of an increase in infective or bleeding complications. There was no significant difference in the duration of response to 3M (10 months, CL 6-15) and VAC (11 months, CL 7-12), nor in survival (3M, 8 months, CL 6-12; VAC, 10 months, CL 8-12). These results indicate that 3M is as effective as, but has significantly less symptomatic toxicity than, an anthracycline containing regimen for the treatment of advanced breast cancer.
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PMID:A randomised trial comparing combination chemotherapy using mitomycin C, mitozantrone and methotrexate (3M) with vincristine, anthracycline and cyclophosphamide (VAC) in advanced breast cancer. 189 75

Since their discovery in the 1970s, the human rotaviruses have been recognized as the most important cause of acute infectious gastroenteritis among infants and children worldwide. Rotavirus has been found to infect almost all mammalian and avian species tested, and is primarily a disease of the young. In humans, rotavirus is the most frequent gastrointestinal pathogen in infants and children less than 2 years of age. In developing countries, the attack rate peaks at 6 months of age, whereas in developed areas of the world the virus is most commonly found among children 6-12 months of age. Rotavirus displays a marked seasonality in temperate climates, with the number of cases peaking in the colder winter months. In tropical climates, this seasonality is not as apparent, and infection may occur year round. Symptoms of rotavirus infection are non-specific and include vomiting and diarrhoea, occasionally accompanied by a low grade fever. Dehydration is more common with rotavirus infection than with most bacterial pathogens, and is the most common cause of death related to rotavirus infection. Treatment is non-specific and includes the use of oral rehydration therapy, especially in developing countries where malnutrition is common. Strategies for the prevention of rotavirus infection are dependent on advances in the understanding of the molecular biology of the rotavirus. The genetic structure of the virus has been extensively studied, and a number of the structural proteins have been identified. The neutralization antigens, located on VP4 and VP7, may be important in conferring immunity to rotavirus in vivo. Two animal-derived and several reassortant rotavirus vaccines are currently being evaluated in field studies, and a number of other candidate vaccines are being tested in vitro and in animal studies.
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PMID:Rotavirus. 196 26

Over the November 1981 to December 1985 period, a questionnaire was completed by the counselor on 163 patients attending the Parkview clinic (Wellington, New Zealand) for termination of pregnancy due to failure of oral contraception (OC). The reasons for selecting reliable pill takers for special study were: to obtain data on the characteristics of this group; to confirm to what extent previously recognized factors in OC method failure are operating in New Zealand; to determine the numbers who failed on antibiotic medication; and to explore other factors not previously studied such as weight, smoking, stress, and amenorrhea; and, on the basis of the findings, to make practical recommendations for improved instructions in the use of OC. Patients were excluded if there was any question regarding their reliability in OC use. The questionnaire was completed after the abortion had been performed to minimize the effect of withholding information in order to present a better case for termination. 41 patients (25%) were aged 15-19 years, 60 patients (37%) were aged 20-24 years, 40 patients (25%) were aged 25-29 years, and 20 (12%) were aged 30 years and older. 91 patients were under 70 kilograms, and 17 patients were 70 kilograms or more. 82 patients (50%) were nonsmokers; 68 patients smoked more than 10 cigarettes a day (42%), and 13 patients smoked less than 10 cigarettes a day (8%). In 27 patients (7%), there was a history of previous pill failure and in 6 patients there was a previous failure while using an IUD. In 8 of the 27 patients who experienced a 2nd pill failure, there was no obvious predisposing factor on this occasion. In 11 cases (7%) failure occurred in the 1st month of use. In 51 cases (31%) it occurred between 1-6 months. In 35 cases (21%) it occurred between 6-12 months. In 50 cases (31%) it occurred between 1-5 years. In 16 cases (10%) patients had been on the for more than 5 years. In the 11 cases where failure occurred in the 1st month of use, 7 patients had been using another brand in the month before, and this was not necessarily a higher dose pill. In 3 cases they were starting the pill after abstinence and in 1 case after the use of a barrier method. In 6 cases predisposing factors such as diarrhea and/or vomiting, antibiotic use, or breakthrough bleeding were present, but in the remaining 5 cases there were no known predisposing factors. Excluding patients who had failed on a progestogen-only pill when irregular menses may occur, there were 29 patients who gave a history of breakthrough bleeding on the combined pill (21%). This associated with other predisposing factors in 18 cases (13). Vomiting only was associated with 14 failures (9%); diarrhea only was associated with 23 failures (14%). Diarrhea and vomiting was associated with 19 failures (12%). In 37 cases (23%), failure was associated with the use of antibiotics. 2 failures occurred on anticonvulsant medication. Recommendations are made for improved instructions to patients.
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PMID:Pill method failures. 347 Jun 67

Cerebral symptoms were registered in a multicenter study including 64 patients with severe hypertension, diastolic blood pressure (DBP) greater than or equal to 135 mmHg, and more or less pronounced hypertensive encephalopathy. The symptoms were: headache (70%), dizziness (35%), consciousness disturbances (28%), nausea (27%), paresis (23%), blurred vision (22%), paraesthesia (21%) and vomiting (14%). None had convulsions or coma. Initial treatment was furosemide i.v., and if DBP was greater than or equal to 125 mmHg after one hour, patients were randomized to treatment with either i.v. diazoxide (bolus injections of 75-150 mg) or i.m. dihydralazine (bolus injections of 6-12.5 mg). A gradual fall in blood pressure (BP) was obtained in all three groups. Along with BP reduction a substantial regression of neurological symptoms was registered. After 5 hours only minor cerebral symptoms were present without significant difference between diazoxide and dihydralazine. None developed cerebral complications. The study failed to show a significant correlation between BP reduction and regression of neurological symptoms graded semiquantitatively. Reduction of BP by titration using small repeated bolus injections is recommended, but oral treatment should be considered in the patients who are able to ingest peroral medication in spite of neurological symptoms.
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PMID:Reversibility of cerebral symptoms in severe hypertension in relation to acute antihypertensive therapy. Danish Multicenter Study. 353 94

One of the major factors in the development of severe protein-energy malnutrition (PEM) is infection, such as diarrhea, upper respiratory infection, and malaria. Social and environmental factors include family size, access to land and occupation of parents, and exposure of rural populations to urban centers. Breast milk has been shown to play a role in the prevention of infections; however, the mother must be well-nourished to provide the optimum product. Traditional foods available to rural children in most developing countries are difficult to digest and low in energy and protein and inadequate nutritional education prevents the inclusion of good protein sources in children's diets. Severe PEM, called marasmus and kwashiorkor is indicated by wasting of muscles, absence of subcutaneous fat, wrinkled skin, thin and sparse hair, and weakness. The basic treatment for severe PEM is dietary. Treatment of kwashiorkor and marasmus is divided into 3 stages: 1) attending to acute problems, 2) restoring nutritional balance, and 3) ensuring nutritional rehabilitation. Care must be taken to ensure a minimum daily intake of 3-4 gm of protein and 120-150 Kcal of energy/kg of body weight. There must be, in addition, replacement of vitamin A, zinc, potassium, magnesium, and iron. An initial regimen which has been advocated is based on dry skim milk, sugar, and vegetable oil, divided into 6-12 feedings/day, which prevents vomiting. It is not necessary to remove lactose from the diet, and other animal protein sources such as meat and meat extracts are also well accepted. Soy and vegetable protein have been used successfully. In treating mild and moderate PEM it is important to ensure the intake of these food supplements by the child and to avoid a major substitution effect in the household diet. It is crucial for the physicians, nutritionists, public health workers, and educators to convince parents about the safety of using foods that are fed only to adults and older children. In addition nutritional and health education must not be restricted to the rehabilitation of the child but the prevention of nutritonal deterioration of the entire family and sometimes to the entire community.
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PMID:Infantile malnutrition in the tropics. 681 12

In a controlled double blind study [1-(p-chlorobenzoyl)-5-methoxy-2-methylindol-3-acetoxy] acetic acid (acemetacin, TV 1322, Rantudil) was compared with indometacin in 60 (male and female) children and adolescents. the analgesic, anti-inflammatory and antipyretic efficacy and tolerability were investigated postoperatively and post-traumatically. The analgesic effect was good to very good in 76.7% of the patients treated with acemetacin; in the indometacin group it was only 66.7%. The remaining cases received an additional analgesic. The anti-inflammatory effect of both drugs was good. None of the postoperatively or post-traumatically applied plasters had to be opened. The statistical evaluation showed a very good therapeutic effect in both groups after 5 days of treatment (pain reduction approx. 90%, detumescence approx. 85%). The body temperatures in the acemetacin group as well as in the indometacin group also changed significantly. Except for vomiting by one patient of the indometacin group no undesired side effects were observed. Consequently the tolerability of acemetacin is very good. Acemetacin has shown that its analgesic, anti-inflammatory and antipyretic effects are equal to those of the reference substance, indometacin. Whilst taking into consideration the contraindications mentioned in the test design, acemetacin may unhesitatingly be used for the treatment of children and adolescents at the following doses: 3-6 years 30 mg b.i.d., > 6-12 years 30 mg t.i.d., > 12 years 30 mg q.i.d.
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PMID:[Clinical trials with acemetacin on children and adolescents (author's transl)]. 719 16

Given the importance of adequate cervical dilatation to vacuum aspiration abortion, the effectiveness of oral misoprostol and vaginal gemeprost was compared. The 64 study subjects, all in the first 6-12 weeks of pregnancy, were randomly assigned either to take 400 mcg of misoprostol the night before pregnancy termination or were given 50 mg of vitamin B6 (placebo for misoprostol) to be taken the night before the procedure followed by vaginal insertion of 1 mg of gemeprost three hours preoperatively. Preoperative side-effects--nausea, vomiting, abdominal pain, and vaginal spotting--were significantly greater (p 0.01) in the gemeprost group; 28 out of 32 women in the misoprostol group compared to only 17 out of 32 in the gemeprost group experienced no side effects. The mean baseline cervical dilatation of 8.1 mm in the misoprostol group was significantly greater (p 0.01) than that in the gemeprost group (7.0 mm) and the ease of further dilatation was rated by surgeons as easier than normal for 87.5% of women in the former group compared to 59.4% in the latter group (p 0.01). The duration of the procedure and mean blood loss were similar in both groups. In addition to being more effective than gemeprost, misoprostol is less expensive and stable at room temperature. This is the first prospective, randomized study of oral as opposed to vaginal administration of misoprostol for cervical dilatation.
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PMID:Oral misoprostol versus vaginal gemeprost for cervical dilatation prior to vacuum aspiration in women in the sixth to twelfth week of gestation. 755 74

Schistosoma mansoni was introduced in the Richard Toll area (Senegal) around 1988, probably due to man-made ecological changes in the Senegal river basin. Since 1991, we investigate the community of Ndombo, close to Richard Toll. Four random population samples of approximately 400 subjects are surveyed, starting at 8 months intervals. Each cohort is examined parasitologically (Kato-Katz), clinically, serologically (circulating antigen and antibody profiles); treated with praziquantel 40 mg/kg; and followed up 6-12 weeks, 1 and 2 years after treatment. Water contact patterns and snail densities are longitudinally surveyed. In the first cohort, prevalence of infection was 91%, with 41% excreting over 1000 eggs per gram (epg); the mean egg count was 646 epg, individual counts up to 24,000 epg. Prevalences remained almost 100%, but egg counts declined strongly in adults, in spite of continued exposure and the supposed lack of acquired immunity. Antigen detection in serum and urine confirmed that the egg counts genuinely reflect variations of worm burdens. Serum circulating anodic antigen (CAA) provided intriguing epidemiological information on worm burdens, while circulating cathodic antigen (CCA) showed promise for non-invasive diagnosis and screening. So far, similar epidemiological results were found in subsequent cohorts, although some variations were observed, possibly due to seasonal transmission fluctuations. IgE levels increased with age, while IgG4 peaked in the age-group 10-19 years. IgE and IgG4-levels against adult worm antigen (AWA) and soluble egg antigen (SEA) increased between cohort 1 and cohort 3 in almost all age-groups. In all 3 cohorts examined so far a strong correlation between IgG4 and pre-treatment egg-load was observed. Further follow-up and analysis, and comparison with chronically infected populations will provide insight in the development of acquired immunity. Abdominal discomfort was reported by 61% and diarrhoea by 33% of the subjects in the first cohort; mild hepatomegaly was found in 16%, splenomegaly in 0.5%. There was no correlation between frequency of symptoms and egg counts. This low morbidity, in spite of intense infections, was confirmed by ultrasound, and may be due to the recent nature of the focus. In the first cohort, 82% of treated subjects still excreted eggs 12 weeks after treatment, though egg counts declined strongly. Antigen detection confirmed these results. Parasitological negativation rates in subsequent cohorts, followed up sooner after treatment, improved but remained remarkably low. The low drug efficacy may be due to very rapid reinfection (though further reinfection after one year was limited), and/or to the lack of immunity in the population. Reduced susceptibility of the local schistosome strain can not be excluded, however. Praziquantel treatment provoked impressive but transient side effects (colics, vomiting, urticaria, oedema), the frequency of which correlated with intensity of infection.
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PMID:Epidemiology, immunology and chemotherapy of Schistosoma mansoni infections in a recently exposed community in Senegal. 782 23

The US Food and Drug Administration has not yet approved combined estrogen/progesterone compounds for postcoital contraception (PCC), yet administering them has been an accepted practice for at least 10 years. The health service at the University of Rochester in New York has a formal protocol to dispense PCC to female students who have had unprotected intercourse and wish to prevent pregnancy. The women must have experienced unprotected intercourse within 72 hours prior to presenting at the clinic. The clinicians screen the women for absolute contraindications to oral contraceptives (OCs), which include blood clotting disorders, stroke, heart disease, cancer of the breast or reproductive tract, and liver tumors. They also determine whether conception has occurred. If indeed it has occurred, and the patient has given written consent, the clinicians administers 2 times the dosage of 1 OC to the patient and a repeat dose 12 hours later. She is seen at the clinic 3 weeks later. Clinic workers review their protocol every 6-12 months as part of the quality assurance program. Providers who do not approve of PCC are asked not to see students requesting PCC. Between March, 1985, and February, 1991, the service's staff administered PCC 209 times. 18.7% of PCC patients took PCC more than once. Date rape was responsible for 3 episodes of unprotected intercourse. Pregnancy occurred in 4 of the 209 PCC episodes (1.9%). 3 of these pregnancies were not midcycle exposures. All 4 cases had received PCC within 24 hours of unprotected intercourse. They all underwent an abortion. The expected pregnancy rate for unprotected intercourse without PCC would be 11-14%. Side effects were nausea (19%), vomiting (13%), and other symptoms (8%), including headache, cramps, menstrual irregularities, or abdominal pain. Another possible PCC is mifepristone, which was 100% effective in a study in Scotland. It probably will not be available soon in the US because of the controversy surrounding its use as an abortifacient.
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PMID:Six years of clinical experience using postcoital contraception in college women. 824 18


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