Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0740577 (acute abdominal pain)
 1,982 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 17-year-old female with a 5-year history of disseminated lupus erythematosus has remained without immunosuppressive therapy for the last 3 years. She was admitted to the hospital for acute abdominal pain, generalized edema, and rapidly developing dyspnea and somnolence. Although all symptoms were consistent with active SLE, septicemia was suspected because of leukocytosis (20,000/microliters), greatly elevated C-reactive protein (45 mg/dl), and normal complement values (C3 0.74 g/l, C4 0.21 g/l). Directly after bacterial blood cultures were prepared, a combined treatment was instituted consisting of plasmapheresis (3 x 2.1 l against fresh frozen plasma), antibiotics, prednisolone, and cyclophosphamide following the last plasmapheresis. Within three days cerebral function returned to normal, edema improved, and CRP fell to 0.5 mg/dl. The blood cultures and pericardial effusion displayed meningococcal colonies.
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PMID:Successful therapy of meningococcal sepsis in acute disseminated lupus erythematosus with plasmapheresis, immunosuppression, and antibiotics. 223 29

A young, previously healthy woman developed bilateral exudative tonsillitis that was associated with severe systemic symptoms. This was followed by evidence of multisystem disease with acute abdominal pain, raised liver enzyme levels, respiratory difficulty, increasing drowsiness and multiple vesicular skin lesions. Herpes simplex virus type-1 was isolated from skin lesions and a throat swab and herpes simplex virus type-1 antigen was detected in a liver biopsy sample. She recovered rapidly without any sequelae after treatment with intravenously administered acyclovir.
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PMID:Disseminated herpes simplex virus infection in an apparently immunocompetent woman. 230 19

The long term development of periodic syndromes among children is little known. Our research has revealed that about one third of periodic headaches, two thirds of cyclic vomiting and half the cases of recurring abdominal pain disappear either before puberty or during adolescence. Other Authors have shown that this also happens in most cases of early-onset vertigo. The remaining headache cases develop into migraines in adults. When there is persistent cyclic vomiting, the collateral neurologic phenomena (headaches, vertigo, pallor, hypotonia, drowsiness) become more intense. This also happens in some cases of abdominal pain and paroxysmal vertigo which start in late childhood. Other sufferers from acute abdominal pain develop ulcers, gastroduodenitis and colitis as adults. Altogether, some infantile periodic syndromes (in particular the multi-symptomatic ones) have a common outcome, i.e. develop into more or less typical migraine syndromes. In these cases one can presume a common pathogenetic mechanism. In those cases where the outcome is favorable the pathogenesis may be different. These cases may often be spotted in early childhood on account of the monosymptomatic nature of the complaint or the absence of collateral neurologic symptoms as well as of the infrequency of critical episodes.
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PMID:[Childhood periodic syndromes and their long-term development]. 692 13

Ninety episodes of diabetic ketoacidosis (DKA) in 72 Sudanese children seen during a one year period were investigated. The age of the patients ranged from 3 to 16 years with a median of 12 years. Twenty-two episodes (24%) occurred in newly diagnosed patients and 68 (76%) in previously known diabetic children. The mean observation period defined as the number of days from each one of the episodes until next episode or end of survey divided by the total number of the episodes was 180 days. During this short period of observation 18 recurrent episodes were observed giving an annual recurrent rate of 40%. The classical triad of polyuria, polydipsia and weight loss was a presentation in 83 (92%) episodes; acute abdominal pain and/or vomiting were observed in 69 (77%) episodes and drowsiness or deep coma was seen in 31 (34%) episodes. The most common precipitating causes of DKA in the studied patients with known diabetes were acute infections accounting for 38% of episodes, insulin non-availability for 34% of episodes and errors of treatment for 25%. The outcome of treatment in the whole group was good in the 69 (96%) patients who recovered without complications, but 3 (4%) patients died.
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PMID:Diabetic ketoacidosis in children in Khartoum city, Sudan. 792 36

Introduction and aim Pain is a frequent symptom in emergency patients and opioids are commonly used to treat it at emergency departments and at pre-hospital settings. The aim of this systematic review is to examine the efficacy and safety of parenteral opioids used for acute pain in emergency medicine. Method Qualitative review of randomized controlled trials (RCTs) on parenteral opioids for acute pain in adult emergency patients. Main outcome measures were: type and dose of the opioid, analgesic efficacy as compared to either placebo or another opioid and adverse effects. Results Twenty double-blind RCTs with results on 2322 patients were included. Seven studies were placebo controlled. Majority of studies were performed in the emergency department. Only five studies were in prehospital setting. Prehospital studies Four studies were on mainly trauma-related pain, one ischemic chest pain. One study compared two different doses of morphine in mainly trauma pain showing faster analgesia with the larger dose but no difference at 30 min postdrug. Three other studies on the same pain model showed equal analgesic effects with morphine and other opioids. Alfentanil was more effective than morphine in ischemic chest pain. Emergency department studies Pain models used were acute abdominal pain seven, renal colic four, mixed (mainly abdominal pain) three and trauma pain one study. Five studies compared morphine to placebo in acute abdominal pain and in all studies morphine was more effective than placebo. In four out of five studies on acute abdominal pain morphine did not change diagnostic accuracy, clinical or radiological findings. Most commonly used morphine dose in the emergency department was 0.1 mg/kg (five studies). Other opioids showed analgesic effect comparable to morphine. Adverse effects Recording and reporting of adverse effects was very variable. Vital signs were recorded in 15 of the 20 studies (including all prehospital studies). Incidence of adverse effects in the opioid groups was 5-38% of the patients in the prehospital setting and 4-46% of the patients in the emergency department. Nausea or vomiting was reported in 11-25% of the patients given opioids. Study drug was discontinued because of adverse effects five patients (one placebo, two sufentanil, two morphine). Eight studies commented on administration of naloxone for reversal of opioid effects. One patient out of 1266 was given naloxone for drowsiness. Ventilatory depression defined by variable criteria occurred in occurred in 7 out of 756 emergency department patients. Conclusion Evidence for selection of optimal opioid and dose is scarce. Opioids, especially morphine, are effective in relieving acute pain also in emergency medicine patients. Studies so far are small and reporting of adverse effects is very variable. Therefore the safety of different opioids and doses remains to be studied. Also the optimal titration regimens need to be evaluated in future studies. The prevention and treatment of opioid-induced nausea and vomiting is an important clinical consideration that requires further clinical and scientific attention in this patient group.
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PMID:Parenteral opioids in emergency medicine - A systematic review of efficacy and safety. 2991 51