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)

We evaluated the efficacy and toxicity of aclarubicin for acute non-lymphocytic leukemia (ANLL) refractory to daunorubicin in childhood. Twenty-four patients were treated with aclarubicin and prednisolone with or without 6-mercaptopurine and behenoyl-cytosine arabinoside daily for 5 to 14 days. Of 21 evaluable patients, 14 (67%) responded: 12 obtained complete remission and 2 partial remission. The median time to reach complete remission was 37 days (range, 16 to 60 days), and the median duration of complete remission was 5.5 months (range, 2 to 41 months). The cumulative dose of anthracycline administered before the study was not considered significant for the response. The only major complication was severe bone marrow suppression; infectious episodes occurred in 14 patients (58%) and three died of sepsis and/or bleeding. The observed non-hematologic toxicities included hematuria, an elevation of serum amylase, nausea/vomiting, and angitis. In addition, one patient showed abnormal cardiac function. Aclarubicin is therefore considered a highly active drug for remission reinduction of previously treated children suffering from ANLL with an acceptable toxicity.
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PMID:An effective salvage regimen with aclarubicin for daunorubicin-resistant acute non-lymphocytic leukemia in children. 764 Jan 78

We report a fatal case of haemorrhagic pancreatic necrosis in a 15-year-old mentally retarded epileptic male who had been taking sodium valproate (VPA) in the recommended dosage for one and a half years. The patient was admitted to hospital because of acute abdominal pain, with nausea and vomiting. Serum amylase was 609 U/l (normal range 100-360 U/l). Two exploratory laparotomies were performed. The second revealed haemorrhagic pancreatitis with areas of necrosis. VPA therapy was discontinued after the second laparotomy, but the patient died 25 days after admission. Autopsy showed extensive haemorrhagic pancreatic necrosis. Non-specific vomiting and abdominal pain occur frequently during VPA therapy, but VPA-related pancreatitis should be considered when there is severe abdominal pain with nausea and vomiting. Awareness of this problem and early discontinuation of VPA therapy may prevent serious reactions.
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PMID:[Fatal pancreatitis associated with valproate therapy]. 764 93

Phosphorus abnormalities among patients suffering from eating disorders, although cited, have received relatively little attention. Studies generally report decreased concentrations of phosphorus for both bulimia and anorexia nervosa. We have recently noted hyperphosphatemia in several consecutive hospitalized bulimic patients who appeared to have normal renal function and calcium levels. Case files of 30 inpatient and outpatient female bulimic patients and 30 sex- and age-matched physically healthy psychiatric inpatients and outpatients were reviewed. Phosphorus and electrolytes related to phosphorus metabolism were compared between the two groups. Twenty-four of 30 bulimic patients (80%) were found to have at least one elevated serum phosphorus concentration, whereas all but one of 30 age-matched controls had values within normal limits. Elevated phosphorus levels were generally in the mild to moderate range. No correlation was found between phosphorus levels and any of the other electrolytes examined in both patients and controls. No correlation was found between phosphorus levels and the reported frequency of bingeing and vomiting or the number of laxatives ingested. Since bulimic patients are generally of normal weight and tend to deny their disturbed eating habits, diagnosis is often delayed. However, bulimia may be suspected from biochemical abnormalities such as hypokalemia, hypochloremia, elevated amylase, and acid-base disturbances. This preliminary study indicates that elevated serum phosphorus levels may serve as an additional objective marker for the presence of bulimia nervosa.
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PMID:Hyperphosphatemia: an objective marker for bulimia nervosa? 764 49

The authors investigated the significance of vomiting for hyperamylasemia and sialadenosis in patients with bulimia nervosa. Hyperamylasemia was found in 61% of the bulimics and in 20% of the restrictor anorectics but in no patients with binge-eating syndrome. In more than three fourths of the bulimics there was a close positive correlation between the frequency of vomiting and total serum amylase levels. Both frequency and type of vomiting seem to be relevant to the extent of salivary gland enlargement. The significance of vomiting for the etiopathology of hyperamylasemia and for the diagnosis of eating disorders will be discussed.
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PMID:Significance of vomiting for hyperamylasemia and sialadenosis in patients with eating disorders. 768 85

Pancreatic pseudocysts is a complication of acute posttraumatic pancreatitis. They usually cause recurrent abdominal pain, nausea, vomiting and elevation of serum amylase levels. A history of epigastric blunt trauma, the before mentioned clinical signs and echographic or scanning studies may lead to a certain diagnosis. Although most of them resolve spontaneously, some persist and active therapeutic measures are required. Surgical internal drainage has been the operative technique of choice in children. Nevertheless, treatment can be achieved by percutaneous aspiration or drainage of pancreatic recurrent collections. We present our experience in two children with posttraumatic pancreatic pseudocyst, treated successfully by means of a percutaneous transabdominal pig-tail catheter (Huisman catheter). The technique of catheter placement and clinical aspects are discussed.
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PMID:[Treatment of post-traumatic pancreatic pseudocyst by percutaneous Huisman's drainage]. 776 74

This report presented a twelve-year experience from 1981 to 1992. Seventy-four cases of congenital biliary tract dilatation were at diagnosed an age of 6 days to 16 years. Twenty-two cases were infants. There were 54 females and 20 males. The ratio of female to male was 2.7:1. The classic triad of abdominal pain, jaundice and a palpable mass was seen in eleven cases (14.9%). Most children suffered from abdominal pain (50/74), vomiting (45/74), anorexia (42/74) and jaundice (34/74). Prolonged jaundice was the main symptom in infancy (15/22). A long common pancreatico-biliary channel was seen in six cases (6/47); the bile amylase level was elevated in five cases (5/20), one patient had a complex union with obstructive jaundice. All these cases were diagnosed by preoperative sonography accurately (100%). According to the Todani's classification, type Ia was the most common (40/74), followed by type IV-A (25/74) and type Ic (8/74). Cholelithiasis (13/74), perforation (9/74), and atresia/stenosis of distal choledochus (8/74) were the most common associated conditions. Cyst excision with biliary tract reconstruction was performed in all cases. Reoperation was needed in ten cases. Two cases died postoperatively due to sepsis and cholangitis induced hepatic failure.
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PMID:Congenital biliary tract dilatation in infancy and childhood--74 cases experience. 785 Jun 45

A retrospective study was undertaken of 14 patients (eleven men, three women; mean age 52 [33-68] years in whom haemolysis had occurred during chronic haemodialysis (n = 12) or haemofiltration (n = 2). The haemolysis was of mechanical cause in eight patients, by an osmotic mechanism in one, and of unknown cause in five. Cardinal symptoms were nausea in 14 patients, abdominal pain in nine, vomiting in eight and raised blood pressure in ten. The plasma was discoloured in all patients and there was also an increase in free haemoglobin (110-2400 mg/dl) and (or) lactate dehydrogenase (311-7403 U/l). In all of eleven patients in whom it was measured the activity of serum amylase and (or) lipase was more than doubled (to 73-2400 U/l and 473-16,740 U/l, respectively). All patients were treated symptomatically, three had a blood exchange, two others plasma separation. Eight patients recovered within a few days, but necrotizing pancreatitis developed in six, three of whom died while two had permanent sequelae. This series shows that dialysis-induced acute haemolysis can cause life-threatening pancreatitis. Narrowings within the extracorporeal circuit, not always recognized in current dialysis equipment, are the most frequent cause of the mechanical haemolysis.
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PMID:[Acute hemolysis with subsequent life-threatening pancreatitis in hemodialysis. A complication which is not preventable with current dialysis equipment]. 792 17

Aetiologic factors (gallstones, hyperlipidemia I-IV, hypertriglyceridaemia) make their occurrence, mainly, in the third trimester of gestation. Two cases of acute pancreatitis in pregnancy are described; in both cases patients referred healthy diet, no habit to smoke and no previous episode of pancreatitis. An obstructive pathology of biliary tract was the aetiologic factor. Vomiting, upper abdominal pain are aspecific symptoms that impose a differential diagnosis with acute appendicitis, cholecystitis and obstructive intestinal pathology. Laboratory data (elevated serum amylase and lipase levels) and ultrasonography carry out an accurate diagnosis. The management of acute pancreatitis is based on the use of symptomatic drugs, a low fat diet alternated to the parenteral nutrition when triglycerides levels are more than 28 mmol/L. Surgical therapy, used only in case of obstructive pathology of biliary tract, is optimally collected in the third trimester or immediately after postpartum. Our patients, treated only medically, delivered respectively at 38th and 40th week of gestation. Tempestivity of diagnosis and appropriate therapy permit to improve prognosis of a pathology that, although really associated with pregnancy, presents high maternal mortality (37%) cause of complications (shock, coagulopathy, acute respiratory insufficiency) and fetal (37.9%) by occurrence of preterm delivery.
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PMID:[Acute pancreatitis and pregnancy]. 813 93

Acute pancreatitis in patients on CAPD treatment is an infrequent, but serious complication. We studied the records of all CAPD patients with acute pancreatitis in the Netherlands from 1979 until May 1992. The incidence of acute pancreatitis during CAPD treatment was 0.46 per 100 treatment-years. In all patients at least one risk factor was present. Hypercalcaemia was the most frequently observed risk factor in our patients. The clinical picture consisted of abdominal pain and vomiting, with normal temperature and normal peristalsis. Plasma amylase was elevated in 18 episodes. Dialysate amylase concentrations exceeded 100 U/l in seven of ten episodes. The dialysate could either be clear, haemorrhagic, or cloudy. Positive dialysate cultures were found in five patients, in most cases with skin flora. No direct correlation with the pancreatitis could be established. Mortality was 58%. Continuation of CAPD or transfer to haemodialysis had no apparent effect on the outcome, but the best prognosis was found in patients with a persistently clear dialysate.
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PMID:Acute pancreatitis during CAPD in The Netherlands. 815 8

We report the first known case of an annular pancreas associated with pancreaticobiliary maljunction without cholangiectasis in an infant, aged 2 years and 5 months in Japan. Only two other cases have been reported in Japan both of which were in adults. In our case, the main clinical features were abdominal pain, vomiting and an increasing level of plasma amylase. Endoscopic retrograde cholangiopancreatography (ERCP) was not successful in demonstrating the pancreaticobiliary maljunction due to duodenal stenosis. At operation, a complete type of annular pancreas was found with no enlargement of the common bile duct. We could visualize the pancreaticobiliary maljunction using cholangiopancreatography from the gallbladder during the operation. We then performed duodeno-duodenostomy (side-to-side anastomosis, diamond anastomosis) and portal jejunostomy (Roux en Y anastomosis). The infant was discharged in a good condition at 13 days after the operation. The pattern of the pancreatic ducts was Millbourn's 2a and the type of the duct in the annular portion was Yumura's type I. These results correspond to Lecco's hypothesis that the ring formation originates from the ventral pancreas. It has been further suggested that the cacogenesis and/or dysplasia of the ventral pancreas plays a role in the development at the stage of the pancreaticobiliary maljunction.
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PMID:Annular pancreas associated with pancreaticobiliary maljunction in an infant. 821 78


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