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Query: UMLS:C0392326 (
discomfort
)
22,423
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Constipation, a common health problem particularly for elderly and hospitalized patients, can cause abdominal pain,
discomfort
, gas, headaches, nausea,
anorexia
, a bad taste in the mouth, and potentially adds to functional loss and length of stay. As part of a quality improvement initiative, a research-based interdisciplinary protocol was developed to prevent constipation in hospitalized immobile vascular surgery patients. Using a combination of dietary fiber, increased fluid, and hygiene measures over a 3-year period, incidence of constipation was reduced from 59% to about 9%. The incidence of impaction was eliminated and requests for laxatives and enemas were reduced from 59% to about 8%.
...
PMID:Managing constipation using a research-based protocol. 787 16
Nutritional support of patients with HIV or acquired immune deficiency syndrome (AIDS) has many similarities to other disease states in that the same nutritional products and techniques are used. Some patients with HIV, and many with AIDS without secondary infection, experience a metabolic milieu similar to patients with cancer cachexia. In providing dietary counselling to the HIV patient, we encounter many of the obstacles that must be overcome to improve nutrition in cancer:
anorexia
, gastrointestinal
discomfort
, lethargy, and poor nutrient utilization, which limit the ability for nutritional repletion. When a secondary infection is superimposed on HIV, patients resemble more highly catabolic trauma patients or patients in the intensive care unit (ICU), where, despite aggressive efforts to feed, there is usually a net nitrogen wasting leading to the more rapid development of cachexia. However, even in this setting, feeding will limit substantially net catabolism when compared to total starvation. Because the nutritional needs of HIV patients vary greatly, individual strategies have to be designed as the patient moves through the stages of disease. Patients are generally able to consume adequate nutrition either as regular food or dietary supplements during the latency period of viral replication. Once secondary infections become prevalent, artificial diets administered by tube or by vein may be required during the period of active secondary infections, with dietary supplements often helpful during more quiescent periods. Patients with HIV are among the most challenging for clinicians providing nutritional support. Knowledge from treatment of patients with other diseases may be useful, but more data must be gathered on the unique aspects of aetiology and treatment of the
anorexia
, malabsorption, and ultimate wasting associated with AIDS.
...
PMID:Nutrition support and the human immunodeficiency virus (HIV). 811 86
Anorexia
, epigastric
discomfort
, nausea, and vomiting may result from disordered gastric motility and emptying. These features have been found in many adults with anorexia nervosa, but have never been investigated in early onset anorexia nervosa. In 14 patients with early onset anorexia nervosa (eight of whom had upper gastrointestinal tract symptoms), six children with other eating disorders, four children with non-ulcer dyspepsia, and 10 controls matched for age and sex, the non-invasive technique of surface electrogastrography was used to measure fasting and postprandial gastric antral electrical control activity, which underlies antral motility. The electrical signal was recorded by four bipolar silver/silver chloride electrodes attached to the upper abdomen, amplified and low pass filtered at 0.33 Hz before being displayed on a polygraph, digitised at 1 Hz, and stored on the hard disk of a personal computer for later offline analysis. Patients with non-ulcer dyspepsia had gastric antral dysrhythmias. No significant difference was found in the mean (SD) dominant frequency of the antral electrical control activity between patients with early onset anorexia nervosa (2.86 (0.35) cycles/minute (cpm)), patients with other eating disorders (3.14 (0.65) cpm), and controls (3.00 (0.46) cpm). The amplitude of electrical control activity increased postprandially in all but one subject and the fasting/postprandial amplitude ratio did not significantly differ between patients with early onset anorexia nervosa and controls, though patients with longer established disease had a smaller increase in amplitude. Gastric antral electrical dysrhythmias are not a feature of early onset anorexia nervosa and therefore do not induce or perpetuate food refusal in this disorder.
...
PMID:Normal gastric antral myoelectrical activity in early onset anorexia nervosa. 821 43
Abdominal angina that is characterized by postprandial pain, and often associated with weight loss, is a well-recognized symptom complex of mesenteric artery insufficiency (mesenteric territory symptoms). In the past 5 years, we have observed six patients with atypical symptoms who had mesenteric artery occlusion combined with stenosis or occlusion of the celiac artery. Atypical symptoms included severe nausea and vomiting at the sight or smell of food,
anorexia
, weight loss, and right upper quadrant or epigastric
discomfort
(celiac territory symptoms). An extensive work-up to rule out gastric, pancreatic, biliary, or colonic pathology was undertaken in these patients. The findings included gallbladder dysfunction, diffuse micro-ulceration of gastric mucosa, and colonic mucosal ulceration. The diagnosis of visceral artery occlusion was initially missed in all six patients. Four patients had cholecystectomy. Visceral angiography confirmed occlusion of the celiac, superior, and inferior mesenteric arteries. Five patients had dramatic resolution of symptoms after restoration of visceral circulation. One patient who developed intestinal infarction before revascularization died. Symptoms suggesting upper abdominal visceral pathology may be a manifestation of celiac artery stenosis/occlusion coexisting with mesenteric artery occlusive disease. Visceral angiography should be part of the work-up in these patients for early diagnosis and prompt management.
...
PMID:Celiac territory ischemic syndrome in visceral artery occlusion. 835 20
Degradable Starch Microspheres (DSM) are spherical starch microspheres prepared from partially hydrolysed potato starch and then cross-linked by epichlorohydrin. PJ-203 is a transient intra-arterial embolic material and suspended in physiological saline at a concentration of 60 mg/ml starch microspheres. In the present multi-center cooperative Phase I clinical study, we examined the embolic effect and safety in patients with primary liver cancer (14 cases) and those with metastatic liver cancer (18 cases). The dose of DSM per patient was 300 mg in one minute. DSM was infused in increments of 300 mg, with a wash-out period of one minute between the increments, until the dose reached 1,200 mg. In addition to these four dose groups, one group consisting of patients with metastatic liver cancer received 900 mg in three minutes without interruption. DSM was infused via a catheter which had been inserted into the hepatic artery by means of the Seldinger method or laparotomy. In either primary liver cancer or metastatic liver cancer patients, a satisfactory embolization could be obtained with 900 mg or more DSM. Also, it was confirmed that the embolic period was one hour before and after. Pain was noted in all the groups. Other frequently observed adverse reaction were nausea.vomiting,
anorexia
and fever (38-39 degrees C). However, these symptoms improved within several hours or days. There was no dose-related incidence in these symptoms. Reduced blood pressure.weak pulse, pressure.heavy sensation in the right hypochondriac region,
discomfort
in the abdominal.chest region, or perspiration.cold sweat, were observed in 2 to 3 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Phase I study on infusion of PJ-203 (degradable starch microspheres) into hepatic. PJ-203 Clinical Study Group]. 837 75
Bile acid concentration and symptoms were evaluated in 24 patients after total oesophagectomy and gastric pull-up. Patients were randomly allocated to receive pyloroplasty or not. After operation all were followed for a minimum of 6 months. Bile acid concentration in the gastric juice was estimated. The mean(s.d.) bile acid concentration 6 months after surgery was similar in patients with and without pyloroplasty (34.9(30.1) and 25.0(24.2) mg/dl respectively). Postprandial
discomfort
and bilious eructations were the two most commonly observed symptoms in both groups. Other features noted were vomiting, anaemia and
anorexia
. These did not however seem to be related to intragastric bile acid concentration of individual patients in either group and occurred irrespective of whether pyloroplasty was performed or not.
...
PMID:Intragastric bile acid and symptoms in patients with an intrathoracic stomach after oesophagectomy. 847 55
A phase I study of orally administered flutamide (a pure anti-androgen) was performed in 26 patients with prostatic cancer. No side effects were observed in 11 patients receiving single doses of either 125, 250, 375 or 500 mg. However, in the daily dosing schedule of 375, 750, 1125 and 1,500 mg/day doses, where medication was taken in three divided doses,
discomfort
in the stomach, nausea, vomiting and
anorexia
were experienced in one of the four patients receiving the highest dose of 1,500 mg. Nine patients receiving the other doses did not complain of toxic symptoms. Laboratory values did not change in the three patients receiving the lowest 375 mg/day dose, but elevation of transaminase was observed in five of the nine patients given higher doses. This elevation was observed in all the three patients receiving 1,500 mg/day dose. Among the serum hormone levels, significant increases of luteinizing hormone were observed. As for efficacy, objective responses were observed in two of the three patients in each of the four daily dosing groups. Improvement of pain, voiding obstruction symptoms, and performance status were also observed. Flutamide was found to be absorbed rapidly and to exist as a hydroxylated form (hydroxy-flutamide) in the plasma. The half-life of hydroxy-flutamide was similar in the single and daily administration, but the peak concentration and area under the concentration versus time curve in the daily administration became greater than those in the single administration. In conclusion, flutamide should be examined for efficacy and safety using doses of 375 to 1,125 mg/day in the phase II study.
...
PMID:[Phase I study of flutamide, a nonsteroidal antiandrogen, in patients with prostatic cancer]. 850 38
An open prospective drug monitoring study was undertaken to assess the efficacy and tolerability of 5 mg cisapride three times daily in 37,925 general practice patients with functional dyspepsia. Short-term (mean, 4 weeks) cisapride treatment was associated with a significant reduction in overall dyspeptic symptom scores and improvements in scores of all eight individual dyspeptic symptoms (epigastric
discomfort
, fullness, nausea, bloating, heartburn, acid regurgitation,
loss of appetite
, and vomiting). Physician's and patient's subjective global evaluations of antidyspeptic efficacy were good or very good in 80% to 90% of cases. The tolerability of cisapride was judged to be satisfactory, good or very good in approximately 95% of patients, with adverse drug reactions being documented in 4.8% of patients. Of these, diarrhea/loose stools (2.5% of all patients) and headache (0.7%) were most frequent. Premature treatment withdrawal due to poor tolerability was necessary in only 0.35% of patients.
...
PMID:A German drug-monitoring study in general practice patients receiving cisapride for functional dyspepsia. 851 60
Cisapride is a substituted benzamide with gastrointestinal prokinetic effects presumed to be due to the enhancement of the physiological release of acetylcholine at the myenteric plexus. In a multicentre study, 189 patients with nonulcer dyspepsia (NUD) received single-blind placebo treatment for two weeks. A total of 123 patients with no or minimal response to placebo and epigastric pain of at least moderate severity and frequency were randomly assigned to one of the three parallel double-blind treatments for six weeks: cisapride 10 mg tid, cisapride 20 mg tid or placebo. The severity and frequency of individual symptoms (epigastric pain, heartburn, nausea, vomiting
anorexia
, postprandial
discomfort
, regurgitation, lower abdominal pain, bloating and constipation) were assessed on a four- and five-point categorical scale, respectively, by the investigator at three on treatment visits and by patients in a daily diary. Analysis of investigator and patient assessments for differences in symptom severity x frequency composite scores among the three treatment groups showed no statistically significant differences for individual symptoms or symptom clusters. As assessed by the investigator, and compared with baseline, cisapride 20 mg tid significantly (P < 0.05) improved epigastric pain, bloating and early satiety as well as improved the total symptom cluster. Investigator evaluation of the five most severe and frequent symptoms for each patient showed statistically significant improvement in each treatment group. For patient diary assessments, statistically significant within-treatment improvement of the total symptom cluster, the five most severe symptoms cluster, bloating and early satiety was observed for both cisapride 20 mg and placebo, whereas epigastric pain significantly (P < 0.05) improved in all three treatment groups. Investigator evaluation of global response (good+excellent) rate at the end of the six week treatment period was 38% for cisapride 20 mg, 47% for cisapride 10 mg and 33% for placebo. No statistically significant difference in this parameter among treatments was noted. Cisapride was well tolerated at both doses with a side effect profile comparable with that of placebo. It is concluded that in this double-blind multicentre study with a single-blind two-week placebo run in phase, cisapride 10 mg tid and 20 mg tid were not effective compared with placebo in improving symptoms in NUD patients. This study re-emphasizes the good prognosis of patients with NUD, with 14% of patients improving in the two-week placebo run-in phase and a further 33% improving in the next six weeks while on placebo. Within-treatment analysis of investigator assessments showed improvement for cisapride 20 mg tid suggesting a trend of efficacy at this dose.
...
PMID:A double-blind randomized study of cisapride in the treatment of nonulcer dyspepsia. The Canadian Cisapride Nud Study Group. 911 11
Classical eosinophilic gastroenteritis is a rare disease but may be misdiagnosed in clinical practice. We report eosinophilic gastroenteritis that was diagnosed in six patients (four males and two females; mean age 31.5 years) using standard criteria (presence of gastrointestinal symptoms, a predominant eosinophilic infiltrate on biopsy, and exclusion of other causes of eosinophilia). All had gastric mucosal disease and presented with dyspepsia. The median duration of symptoms prior to diagnosis was three months (range five weeks to 13 years). Epigastric pain or
discomfort
was the most common symptom (100%) followed by
anorexia
, nausea, and vomiting (67%, 67% and 33%, respectively). None had diarrhea. Half the patients had a history of allergy, while 67% had peripheral eosinophilia. All responded to oral steroids within two months; one third needed to continue on a small dose of maintenance steroids to remain in remission. A high degree of suspicion and biopsy at upper endoscopy is necessary for diagnosis of this rare disease.
...
PMID:Dyspepsia due to eosinophilic gastroenteritis. 939 13
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