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

This report describes a series of hyponatremia hospitalizations associated with heat-related injuries and apparent over-hydration. Data from the U.S. Army Inpatient Data System were used to identify all hospitalizations for hyposmolality/hyponatremia from 1996 and 1997. Admissions were considered as probable cases of overhydration hyponatremia if this was the only, or primary, diagnosis or if it was associated with any heat-related diagnosis. Seventeen medical records were identified, and the events leading to hospitalization were analyzed. The average serum sodium level was 122 +/- 5 mmol/L (range, 115-130 mmol/L). All 17 patients were soldiers attending training schools. Seventy-seven percent of hyponatremia cases occurred in the first 4 weeks of training. Nine patients had water intake rates equal to or exceeding 2 quarts per hour. Most patients were in good health before developing hyponatremia. The most common symptoms were mental status changes (88%), emesis (65%), nausea (53%), and seizures (31%). In 5 of 6 cases in which extensive history was known, soldiers drank excess amounts of water before developing symptoms and as part of field treatment. The authors conclude that hyponatremia resulted from too aggressive fluid replacement practices for soldiers in training status. The fluid replacement policy was revised with consideration given to both climatic heat stress and physical activity levels. Field medical policy should recognize the possibility of overhydration. Specific evacuation criteria should be established for exertional illness.
Mil Med 2001 May
PMID:Hyponatremia associated with overhydration in U.S. Army trainees. 1137 Feb 3

The general public, the mass media, and many government officials believe that the use of weapons of mass destruction (WMD) will inevitably lead to mass panic and/or mass hysteria. However, studies of disasters and wars show that disorganized flight in the presence of a real or perceived danger (i.e., mass panic) is rare. On the other hand, in a real or perceived WMD scenario, outbreaks of multiple unexplained symptoms (i.e., mass psychogenic illness, mass sociogenic illness, mass hysteria, or epidemic hysteria) may be prevalent. Many of the symptoms (fatigue, nausea, vomiting, headache, dizziness/lightheadedness, and anorexia) are common in combat and after toxic chemical exposure, chemical weapon exposure, prodromal infectious illness, and acute radiation sickness.
Mil Med 2001 Dec
PMID:Collective behaviors: mass panic and outbreaks of multiple unexplained symptoms. 1177 31

The purpose of this study was to determine the incidence of Clostridium perfringens-associated vomiting and diarrhea in canine and feline patients at the Okinawa Branch Veterinary Service and to establish a relationship between dietary indiscretion and the presence of clostridial enterotoxemia. Stool samples were obtained from 38 control animals and 44 animals with vomiting and diarrhea during a 3-month period. For each sample, fecal cytology were examined for the presence of C. perfringens, white blood cells, and red blood cells. A survey was also completed by the animal's owner, which provided the researcher with information on the owner's pet feeding practices. After the data were analyzed, 27% of animals with vomiting and diarrhea were found to have C. perfringens upon examination of their fecal samples (p < 0.05), compared with 11% for control animals. Results of our survey revealed that when owners were questioned regarding their feeding practices, 45% of the animals with C. perfringens-positive fecal samples and with clinical signs of vomiting and/or diarrhea had an episode of dietary indiscretion soon before the illness (p < 0.05). Therefore, we conclude that C. perfringens is an important cause of vomiting and diarrhea in our patient population and that a causal relationship may exist between dietary indiscretion and C. perfringens-associated intestinal disease.
Mil Med 2002 Mar
PMID:An epidemiological survey of Clostridium perfringens-associated enterotoxemia at an army veterinary treatment facility. 1190 70

Medical personnel use suction pumps to clear a patient's airway of mucous, blood, and emesis. Because of size, weight, and durability, many commercially available suction pumps are not suited for battlefield application. The objective of this study was to identify a well-designed suction pump for use in the far forward environment. We report on the performance of seven candidate battlefield suction pumps, all of which are human-powered devices and intended to be carried by medics. Three commercially available pumps, one modified device, a syringe, and two new prototypes are evaluated and compared. We show that all of the devices are capable of generating suction pressure, but one pump stands out in terms of size, weight, and performance.
Mil Med 2002 Oct
PMID:Evaluation of possible battlefield suction pumps for the far-forward setting. 1239 44

This study surveyed health care providers about their evaluation and treatment of mild traumatic brain injury (TBI) in adults. We presented two vignettes describing mild TBI cases to staff in the emergency department (N = 22) and primary care clinics (N = 16) at Wilford Hall Air Force Medical Center and asked how they would evaluate and treat these patients. Most providers said they would assess visual changes, nausea/vomiting, headache, and neck pain. More emergency department personnel than primary care clinic providers would make referrals to different specialties, whereas more primary care clinic providers would schedule a follow-up appointment. Neither group of providers mentioned assessing common postconcussive symptoms of fatigue, emotional changes, and problems sleeping. Comparing findings to current literature suggest that added focus on emotional, cognitive and psychosocial factors, and education of the patient and family could improve early identification of mild TBI patients at risk for poor recovery.
Mil Med 2006 Jun
PMID:A survey of mild traumatic brain injury treatment in the emergency room and primary care medical clinics. 1680 33

We present the case of a 19-year-old woman with feeding intolerance, due to superior mesenteric artery (SMA) syndrome, after weight loss experienced during basic military training. She had previous good health and presented with vomiting 8 weeks after starting military training. She had experienced a 16-pound (7 kg) weight loss during the course of training and was increasingly unable to tolerate meals, solids worse than liquids. Computed tomography of the abdomen with oral contrast revealed gastric and duodenal distention, with narrowing of the second portion of the duodenum at the SMA. A nasojejunal feeding tube was placed and she was given tube feedings. Weight increased and she eventually tolerated oral feedings. She completed military training and remains in good health. SMA syndrome is a rare cause of feeding intolerance, but can follow periods of acute weight loss, as is experienced by some basic military trainees.
Mil Med 2007 Jan
PMID:Superior mesenteric artery syndrome in a basic military trainee. 1727 60

Intramuscular injection is routinely used and rarely leads to adverse events such as abscess or tissue necrosis. Intramuscular promethazine has been documented to cause these problems. We discuss the case of a previously healthy 19-year-old U.S. Marine, who was diagnosed with methicillin sensitive Staphylococcus aureus bacteremia and abscess formation after receiving intramuscular promethazine for vomiting. After confirmation of abscess formation via magnetic resonance imaging, he underwent percutaneous drainage. He improved and was treated with 6 weeks of cefazolin. This case demonstrates an unusual and severe adverse reaction associated with intramuscular promethazine administration. Additionally, this case highlights the importance of proper antiseptic technique before promethazine administration and calls into question the utility and safety of intramuscular promethazine when oral dissolving antiemetic medications are available.
Mil Med 2015 Jun
PMID:Gluteal abscess and bacteremia following promethazine injection in a Marine. 2603 94

Superior mesenteric artery (SMA) syndrome is an uncommon disorder that can lead to small bowel obstructions or perforations. Typical populations include young females with anorexia. However, there have been a few reports of healthy males with acute vomiting reported to have SMA syndrome. Our case report highlights an active duty Marine who developed SMA syndrome and the importance of recognizing this disease given the severity in delay of diagnosis in population of young healthy active duty members.
Mil Med 2015 Oct
PMID:A Case of Superior Mesenteric Artery Syndrome in a Healthy Active Duty Marine. 2644 81

Chilaiditi's sign is a radiological finding that occurs when the small or large intestine is positioned superior to the liver in the sub-diaphragmatic space. This is typically an asymptomatic radiological sign, but when symptoms occur, e.g., abdominal pain, nausea, emesis, it is termed Chilaiditi's syndrome. Currently, majority of the cases of Chilaiditi's syndrome, described in the literature, requiring operative intervention are due to large bowel obstruction or colonic volvulus. The following is a single case report of a patient presenting to Keesler Medical Center in Biloxi, Mississippi. This report details a 57-yr-old female who has found to have Chilaiditi's syndrome causing a high-grade small-bowel obstruction. She failed non-operative intervention and required exploratory laparotomy, lysis of adhesions, and manual reduction of small bowel from the sub-diaphragmatic space. The rate of failure of non-operative management of Chilaiditi's syndrome has not been established. Our patient had a surgical history of laparotomy and was found to have adhesions superior to her liver. Patients with prior abdominal surgery may require a lower threshold for operative management for Chilaiditi's syndrome due to the possibility of concomitant adhesive disease particularly if the prior procedure involved the upper abdomen.
Mil Med 2018 05 01
PMID:Chilaiditi's Syndrome Causing High-Grade Small-Bowel Obstruction Requiring Exploratory Laparotomy. 2941 92

Diabetic ketoacidosis (DKA) is a severe medical condition involving the uncontrolled hyperglycemia and ketoacidosis that results from impaired insulin utilization. The biochemical response to insulin resistance or deficiency is a ketotic state in which fatty acids are converted to ketone bodies for an alternative energy source. Patients in DKA acutely develop severe symptoms, typically over the course of 24-48 hours. Classic symptoms include nausea, vomiting, lethargy, altered mental status, and abdominal pain. As the time course of ketoacidosis is relatively rapid, it is rare to identify a developing case of DKA prior to symptom onset. In this atypical case, the author presents an asymptomatic 37-year-old active duty male without a history of diabetes, whose DKA detection was inspired by an elevated breathalyzer reading. The Sailor underwent routine breath alcohol analysis per command instruction upon reporting for duty. In the absence of recent alcohol intake, the elevated breathalyzer reading is associated with the Sailor's metabolic ketoacidosis. Acetone, one of three primary ketone bodies generated in DKA is notable as the cause of the hallmark fruity odor breath of DKA patients. In this case, it is converted to isopropanol, an agent that is detectable by breathalyzers.
Mil Med 2019 12 01
PMID:Early Detection of Diabetic Ketoacidosis by Breathalyzer in a Sailor Reporting for Duty. 3114 Nov 43


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