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Vomiting

Emesis


Presentation

  • Clinical and radiologic presentation closely resembles those of vestibular schwannomas. Their clinical presentation varies from vestibulocochlear dysfunction to glossopharyngeal and vagal nerve dysfunction.[ncbi.nlm.nih.gov]
  • This case report aims to describe the non-specific presentation of a poorly understood disease entity that presents a diagnostic and therapeutic challenge for the medical community. 2016 BMJ Publishing Group Ltd.[ncbi.nlm.nih.gov]
  • Through this case, we hope to draw attention to an unusual neurological presentation of NMOSD which should be included in the differential diagnosis of intractable nausea and vomiting.[ncbi.nlm.nih.gov]
  • The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission.[ncbi.nlm.nih.gov]
  • We present three cases of NMOSD that presented with intractable vomiting and were treated in a Gastroenterology facility prior to their diagnosis.[ncbi.nlm.nih.gov]
Pleural Effusion
  • Except for the neonatal period, chylothorax is an infrequent finding of pleural effusion in children.[ncbi.nlm.nih.gov]
Vomiting
  • […] of stomach through the mouth. cyclic vomiting recurring attacks of vomiting. dry vomiting attempts at vomiting, with the ejection of nothing but gas. pernicious vomiting vomiting in pregnancy so severe as to threaten life. vomiting of pregnancy that[medical-dictionary.thefreedictionary.com]
  • Irrespective of the content, vomit tends to be malodorous.The content of the vomitus (vomit) may be of medical interest. Fresh blood in the vomit is termed hematemesis ("blood vomiting").[en.wikipedia.org]
  • […] nausea, 0.69 [0.57-0.84] for next-day postoperative nausea, 0.78 [0.63-0.98] for early postoperative vomiting, 0.57 [0.45-0.72] for late postoperative vomiting, and 0.61 [0.43-0.86] for next-day postoperative vomiting.[ncbi.nlm.nih.gov]
  • Ira Todd Cohen, Ondansetron for postoperative nausea and vomiting, Therapy, 3, 5, (571), (2006).[doi.org]
  • RESULTS:: The total incidence of nausea and vomiting was extremely low (0.071%), and no aspiration developed. There was no significant difference in the incidence of nausea and vomiting between the two groups in all respects (p 0.05).[ncbi.nlm.nih.gov]
Cheilitis
  • In examination of oral mucosa, keratinisation, tongue covered with removable coating and exfoliative cheilitis associated with drying and cracking of lips, were detected.[ncbi.nlm.nih.gov]
Heart Disease
  • Old blood may look brown (like coffee grounds) Vomiting won't stop and the person is unable to keep any fluids down You have a known head injury before vomiting occurred There are other medical conditions present such as heart disease , kidney disease[emedicinehealth.com]
Dysarthria
  • This report describes a rare case of repeated, voluntary, TMJ in a 73-year-old woman with dysphagia and dysarthria.[ncbi.nlm.nih.gov]
Papilledema
  • Red flags include unstable vital signs, acidotic breathing, presence of bile or blood stained vomitus, features of gastrointestinal (GI) obstruction, encephalopathy and papilledema.[ncbi.nlm.nih.gov]

Workup

Hyponatremia
  • The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission.[ncbi.nlm.nih.gov]
Pleural Effusion
  • Except for the neonatal period, chylothorax is an infrequent finding of pleural effusion in children.[ncbi.nlm.nih.gov]

Treatment

  • Patients were followed up in acute (day 1 of treatment to day 1 after treatment) and delayed phases (days 2-10 after treatment). The primary endpoint was control of vomiting.[ncbi.nlm.nih.gov]
  • Riboflavin is currently used as a prophylactic treatment in patients with migraine. WHAT IS NEW: Riboflavin may be an effective and safe prophylactic treatment for children with CVS.[ncbi.nlm.nih.gov]
  • Therefore, it is important that pharmacists stay up-to-date on the most current guidelines available for CINV treatment.[ncbi.nlm.nih.gov]
  • It is important to determine whether the nausea and vomiting is related to treatment (chemotherapy, radiation) or is independent of cancer treatment.[ncbi.nlm.nih.gov]
  • Abstract Here we present a case of successful treatment employing a mixed approach including pharmacological and psychosomatic treatments for a 72-year-old woman who experienced severe nausea and vomiting in reaction to postoperative stress from gastric[ncbi.nlm.nih.gov]

Prognosis

  • These are severe cases and in the elderly, a person with a serious chronic ailment or after severe trauma, this may not bode well for the prognosis if it does not resolve within a few days.[healthhype.com]
  • Vomiting and Nausea Prognosis Most nausea and vomiting go away without treatment, but depending on the cause, may become severe. Even if the situation leads to dehydration, medicine and fluids can usually correct the problem.[emedicinehealth.com]

Etiology

  • There are various causes, including trauma, malignancy, infection, and inflammatory diseases; however, the etiology described in this study is poorly reported in the literature.[ncbi.nlm.nih.gov]
  • In patients developing such symptoms, allergy as an etiological cause is often not considered by primary care physicians.[ncbi.nlm.nih.gov]
  • Nausea/vomiting unrelated to chemotherapy and/or radiation may have an etiology for which there is a specific and potentially successful intervention.[ncbi.nlm.nih.gov]
  • It has a varied etiology encompassing many organ systems, ranging from a benign physiological behavior to a life-threatening systemic disease. Most often, it is benign and self-limiting.[ncbi.nlm.nih.gov]
  • The role of peripheral receptors or peripherally released agents in the etiology of cyclic vomiting is unknown, but multiple pathways have been identified that can form a brain-gut interaction to provide a possible mechanism of cyclic vomiting.[ncbi.nlm.nih.gov]

Epidemiology

  • Background: Data on norovirus epidemiology among all ages in community settings are scarce, especially from tropical settings.[ncbi.nlm.nih.gov]
  • The Question “Epidemiological studies have suggested that norovirus can be ‘aerosolized’ through vomiting, meaning that small particles containing norovirus can become airborne when someone throws up,” says Grace Thompson, a recent Ph.D. graduate whose[news.ncsu.edu]
  • J Epidemiology and Community Health. 1992; 46 447-454 14 Fink WV. Fällestatistiken und Lebenserwartung. Wien Med Wschr. 2001; 151 240-244 15 Asher MI, Montefort S, Björkstén B. et al, and the ISAAC Phase Three Study Group.[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • Improved understanding of CINV pathophysiology has triggered the development of new antiemetic therapeutic options, such as selective neurokinin-1 (NK 1 ) receptor antagonists (RAs), which effectively prevent CINV when added to a standard antiemetic regimen[ncbi.nlm.nih.gov]
  • Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. . Accessed Oct. 30, 2017. Merck Manual Professional Version. . Accessed Oct. 30, 2017.[mayoclinic.org]
  • Therapy is often directed at the presumed pathophysiological cause or extrapolated from evidence in other settings. How the intervention might work The pathophysiology of nausea and vomiting is a complex process.[doi.org]

Prevention

  • BACKGROUND: Postoperative nausea and vomiting is a distressing complication of surgery, and 5-HT3 receptor antagonists are often prescribed to prevent it. Ondansetron is the agent typically administered to prevent postoperative nausea and vomiting.[ncbi.nlm.nih.gov]
  • It is important to address these issues from both prevention and treatment standpoints so that patients remain adherent to their regimens.[ncbi.nlm.nih.gov]
  • Various national and international antiemetic guidelines have been developed for the prevention of chemotherapy- and radiotherapy-induced nausea and emesis.[ncbi.nlm.nih.gov]
  • Fortunately, there are several tenets for the successful prevention and treatment of PONV we have extracted from the literature and summarize here.[ncbi.nlm.nih.gov]
  • Recently, a Phase III trial prospectively evaluated fosaprepitant-based antiemetic therapy for CINV prevention in a large, well-defined nonanthracycline- and cyclophosphamide-based moderately emetogenic chemotherapy population.[ncbi.nlm.nih.gov]

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