A phase I study of the lipophilic thymidylate synthase inhibitor Thymitaq (nolatrexed dihydrochloride) given by 10-day oral administration. (1/1675)

2-Amino-3,4-dihydro-6-methyl-4-oxo-5-(4-pyridylthio)-quinazoline dihydrochloride (nolatrexed dihydrochloride, Thymitaq, AG337), a specific inhibitor of thymidylate synthase, was developed using protein structure-based drug design. Intravenously administered nolatrexed is active clinically. As oral bioavailability is high (70-100%), nolatrexed was administered orally, 6 hourly for 10 days, at 3-week intervals, and dose escalated from 80 to 572 mg m(-2) day(-1) in 23 patients. Common toxicity criteria (CTC) grade 3 toxicities included nausea, vomiting, stomatitis and liver function test (LFT) abnormalities. Thrombocytopenia (grade 1 or 2) occurred at doses > or = 318 mg m(-2) day(-1) and neutropenia (grade 2) at 429 and 572 mg m(-2) day(-1). An erythematous maculopapular rash occurred at dosages > or = 318 mg m(-2) day(-1) (7 out of 19 patients). LFT abnormalities occurred in two out of six patients (grade 3 or 4 bilirubin and grade 3 alanine transaminase) at 572 mg m(-2) day(-1). Nolatrexed plasma concentrations 1 h after dosing were 6-16 microg ml(-1), and trough 3-8 microg ml(-1), at 572 mg m(-2) day(-1). Inhibition of thymidylate synthase was demonstrated by elevation of plasma deoxyuridine. Six-hourly oral nolatrexed for 10 days was associated with antiproliferative effects, but nausea and vomiting was dose limiting at 572 mg m(-2) day(-1). Nine patients were treated at 429 mg m(-2) day(-1); three out of nine experienced grade 3 nausea, but 17 out of 22 treatment courses were completed (with the co-administration of prophylactic antiemetics) and this dose level could be considered for phase II testing.  (+info)

Phase II trial of primary chemotherapy followed by reduced-dose radiation for CNS germ cell tumors. (2/1675)

PURPOSE: A prospective phase II study was initiated to assess the response rate, survival, and late effects of treatment in patients with newly diagnosed CNS germ cell tumors (GCT), using etoposide plus cisplatin followed by radiation therapy prescribed by extent of disease, histology, and response to chemotherapy. PATIENTS AND METHODS: Seventeen patients aged 8 to 24 years with histologically proven CNS GCT received etoposide (100 mg/m2/d) plus cisplatin (20 mg/m2/d) daily for 5 days every 3 weeks for four cycles, followed by radiation therapy. Nine patients had germinomas; eight had mixed GCT. Four patients (three with germinomas and one with mixed GCT) presented with leptomeningeal dissemination. RESULTS: Radiographically, 14 of 17 patients were assessable for response; 11 patients experienced complete regression, and three had major partial regression before radiation. Six of seven assessable patients with elevated CSF levels of alpha-fetoprotein or betahuman chorionic gonadotropin had normalization with chemotherapy alone; all normalized with combined chemotherapy and radiation therapy. All 17 patients are alive without evidence of disease (median follow-up, 51 months). One patient developed a relapse in the spinal leptomeninges and was rendered free of disease with spinal radiation more than 5 years ago. One patient developed carotid stenosis requiring surgery. Thus far, only minimal long-term deterioration in neurocognitive function has been detected as a consequence of protocol treatment. CONCLUSION: Conventional-dose intravenous chemotherapy with etoposide and cisplatin can effect tumor regression in a high proportion of patients with CNS GCT, including those with leptomeningeal metastases. Acute and long-term toxicities are acceptable. Progression-free survival and overall survival are excellent.  (+info)

A study of the relative bioavailability of cysteamine hydrochloride, cysteamine bitartrate and phosphocysteamine in healthy adult male volunteers. (3/1675)

AIMS: Cysteamine, the only drug available for the treatment of cystinosis in paediatric patients, is available as the hydrochloride, the bitartrate and as sodium phosphocysteamine salts. It has been suggested that cysteamine bitartrate and phosphocysteamine are better tolerated and may have a better bioavailability than cysteamine hydrochloride. This has, however, never been demonstrated. METHODS: We compared the pharmacokinetics and tolerance of these three formulations of cysteamine in 18 healthy adult male volunteers in a double-blind, latin-square, three-period, single oral dose cross-over relative bioavailability study. RESULTS: No statistical difference was found between relative bioavailabilities, AUC (0, infinity) (geometric mean and s.d. in micromol l(-1) h: 169+/-51, 158+/-46, 173+/-49 with cysteamine hydrochloride, phosphocysteamine and cysteamine bitartrate respectively), Cmax (geometric mean and s.d. in micromol l(-1); 66+/-25.5, 59+/-12, 63+/-20) and tmax (median and range in h: 0.88 (0.25-2), 1.25 (0.25-2), 0.88 (0.25-2)) with each of the three forms of cysteamine tested. Bioequivalence statistics (90% confidence intervals) showed non equivalence of Cmax of cysteamine base as the only non equivalence of pharmacokinetics between the three formulations: 90% CI for Cmax relative ratios to cysteamine hydrochloride were [75.6-105.81 for phosphocysteamine and [74.2-124.2] for cysteamine bitartrate. The only significant adverse event was vomiting whose frequency was inversely correlated with body weight (Spearman's r=-0.76, P<0.001). The nature of the salt tested did not influence vomiting. CONCLUSIONS: While none of the three forms of cysteamine tested has a clear advantage over the others in terms of pharmacokinetics and tolerance profile, this should now however be addressed in patients treated for cystinosis during repeat administrations.  (+info)

Antiemetic efficacy of granisetron plus dexamethasone in bone marrow transplant patients receiving chemotherapy and total body irradiation. (4/1675)

Few trials exist regarding the antiemetic efficacy of granisetron in bone marrow transplant (BMT) recipients conditioned with high-dose chemotherapy and total body irradiation (TBI). In this single-center, open-label, prospective, trial, the antiemetic efficacy and safety of granisetron plus dexamethasone were evaluated in 26 patients conditioned with cyclophosphamide-containing regimens (the majority receiving 60 mg/kg per day on 2 consecutive days), and TBI (12 Gy divided over 4 days). Daily intravenous doses of granisetron 1 mg plus dexamethasone 10 mg were given 30 min prior to chemotherapy or radiation, and continued for 24 h after the last conditioning treatment for a median of 6 days (range 3-9). Emetic control was defined by the number of emetic episodes occurring within a 24 h period, or the requirement for rescue medication for nausea or vomiting. A total of 25 patients completed 186 evaluable treatment days. Response (emetic control by treatment days) was complete in 50% of patients, major in 48%, minor in 2%, and there were no failures. Adverse effects were minor, with diarrhea (15%), headache (14%), and constipation (11%) reported most often. Based on these results, the antiemetic regimen of granisetron plus dexamethasone appears effective and well tolerated during BMT conditioning with high-dose cyclophosphamide and TBI.  (+info)

Chronic intermittent vomiting in a cat: a case of chronic lymphocytic-plasmacytic gastritis. (5/1675)

A 3-year-old cat presented for chronic intermittent vomiting was diagnosed with chronic lymphocytic-plasmacytic gastritis via histological examination of an endoscopic gastric biopsy. The condition was effectively managed with prednisone. The author cautions against missing a diagnosis of alimentary lymphosarcoma without a full-thickness gastric biopsy.  (+info)

Assessing discomfort after anaesthesia: should you ask the patient or read the record? (6/1675)

OBJECTIVE: To assess the quality of anaesthesia care from the patients' viewpoint compared with the hospital record. DESIGN: Prospective study during 1988-9. SETTING: Four teaching hospitals (A-D) in Canada. PATIENTS: 15,960 inpatients receiving anaesthetic requiring at least an overnight stay, for whom an interview and review of hospital records within 72 hours of surgery were complete. MAIN MEASURES: Rates of postoperative symptoms of discomfort (nausea or vomiting, headache, back pain, sore throat, eye symptoms, and tingling) according to the hospital record versus interview and the relation between symptoms and patients' satisfaction with the anaesthetic experience. RESULTS: The preparation of completed interviews ranged from 31.0% to 72.7%, owing mainly to patients discharge (hospitals A and B) and severity of illness (C and D). Interviewed patients were similar to all inpatients in the hospitals but were younger and healthier and more had had effective operations and were general surgical than cardiovascular or neurosurgical patients. In all, 26% to 46% of patients at the four hospitals reported at least one symptom of discomfort. Agreement between interviews and hospital records was low, symptoms being more commonly reported by interview than in the record (for example, headache was reported for 5.8%-17% of patients compared with 0.3%-3.0% in hospital records). After controlling for case mix patients who reported at least one symptom were 2.91 times (95% confidence interval 1.89 to 4.50) more likely to be dissatisfied with their anaesthetic care than patients who did not. CONCLUSIONS: Anaesthesia services are typically neglected in studies of hospital quality, yet patients express considerable anxiety about anaesthetic care. Monitoring and recording patients' discomfort clearly need to be improved if the quality of anaesthesia is to be properly evaluated.  (+info)

Significance of vomiting after head injury. (7/1675)

OBJECTIVES: To determine whether the presence and severity of post-traumatic vomiting can predict the risk of a skull vault fracture in adults and children. METHODS: Data were analysed relating to a consecutive series of 5416 patients including children who presented to an emergency service in the United Kingdom during a 1 year study period with a principal diagnosis of head injury. Characteristics studied were age, sex, speed of impact, level of consciousness on arrival, incidence of skull fracture, and the presence and severity of post-traumatic vomiting. RESULTS: The overall incidence of post-traumatic vomiting was 7% in adults and 12% in children. In patients with a skull fracture the incidence of post-traumatic vomiting was 28% in adults and 33% in children. Post-traumatic vomiting was associated with a fourfold increase in the relative risk for a skull fracture. Nausea alone did not increase the risk of a skull fracture and multiple episodes of vomiting were no more significant than a single episode. In patients who were fully alert at presentation, post-traumatic vomiting was associated with a twofold increase in relative risk for a skull fracture. CONCLUSION: These results support the incorporation of enquiry about vomiting into the guidelines for skull radiography. One episode of vomiting seems to be as significant as multiple episodes.  (+info)

Effects of prophylactic nalmefene on the incidence of morphine-related side effects in patients receiving intravenous patient-controlled analgesia. (8/1675)

BACKGROUND: Opioid-related side effects associated with intravenous patient-controlled analgesia can be reduced by a low-dose naloxone infusion. The influence of nalmefene, a pure opioid antagonist with a longer duration of action, on opioid-related side effects has not been evaluated. This study was designed to determine the dose-response relation for nalmefene for the prevention of morphine-related side effects in patients receiving intravenous patient-controlled analgesia. METHODS: One hundred twenty women undergoing lower abdominal surgery were enrolled in the study. General anesthesia was induced using thiopental and rocuronium and maintained with desflurane, nitrous oxide, and fentanyl or sufentanil. All patients received neostigmine and glycopyrrolate to reverse residual neuromuscular blockade. No prophylactic antiemetics were administered. At the end of surgery, patients were randomized to receive saline, 15 microg nalmefene, or 25 microg nalmefene intravenously. The need for antiemetic and antipruritic drugs and the total consumption of morphine during the 24-h study were recorded. The incidences of postoperative nausea, vomiting, pruritus, and pain were recorded 30 min after patients were admitted to the postanesthesia care unit. In addition, patient remembrance of these side effects was noted at 24 h after operation. RESULTS: The need for antiemetic and antipruritic medications during the 24-h study period was significantly lower in the patients receiving nahmefene compared with those receiving placebo. However, the need to treat side effects was similar in the two nahmefene groups. Prophylactic administration of nalmefene reduced the patients remembrance of nausea and itching as assessed 24 h after operation. Although the total consumption of morphine during the 24-h study period was similar in the three groups, retrospectively patients who received nalmefene characterized their pain as less severe in the previous 24 h. CONCLUSION: Compared with placebo, prophylactic administration of nalmefene significantly decreased the need for antiemetics and antipruritic medications in patients receiving intravenous patient-controlled analgesia with morphine.  (+info)

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Bile can enter the vomit during subsequent heaves due to duodenal contraction if the vomiting is severe. Fecal vomiting is ... Wikiquote has quotations related to Vomiting. Look up vomiting in Wiktionary, the free dictionary. Cyclical Vomiting Syndrome " ... Color of vomit Bright red in the vomit suggests bleeding from the esophagus Dark red vomit with liver-like clots suggests ... vomit) may be of medical interest. Fresh blood in the vomit is termed hematemesis ("blood vomiting"). Altered blood bears ...
... is a vomiting compound that has been used as a riot-control agent (military designation, DM). It is released as an aerosol. ... Adamsite (DM) is a vomiting compound that has been used as a riot-control agent (military designation, DM). It is released as ... Exposure to adamsite (DM) causes rapid onset irritation of the eyes, upper airway, and skin and also nausea and vomiting ( ... The effects of exposure to vomiting agents under usual outdoor conditions generally are self-limited, disappearing in 20 ...
Find out what can cause vomiting blood and when it might be a medical emergency. ... Causes of vomiting blood. There are many possible causes of vomiting blood. ... Vomiting blood (called haematemesis) needs to be checked. It often needs emergency treatment. ... Vomit can vary from bright red to brown or black. It may be like liquid or more solid, or look like coffee granules. ...
Most vomiting is caused by gastroenteritis, and usually isnt serious. These home-care tips can help prevent dehydration. ... What Is Vomiting?. Vomiting is the forceful throwing up of stomach contents. Most kids vomit from time to time, but it usually ... How Is Vomiting Treated?. Treatment for vomiting depends on the cause. Vomiting from gastroenteritis usually goes away on its ... How Do Doctors Find the Cause of Vomiting?. Doctors usually can tell if vomiting if part of a stomach flu by hearing about the ...
Cite this: Vomiting in Infancy: Is It FPIES? - Medscape - Jan 02, 2019. ...
However, it is unlikely that teething is a direct cause of vomiting. In this article, we suggest other possible causes of ... Vomiting and fever may sometimes accompany teething. Teething is a normal part of a childs development that may cause some ... vomiting and discuss how to relieve the symptoms of teething. ... Vomiting can occur at the same time as symptoms of teething.. ... People should also take a child to see the doctor if vomiting persists for more than 12 hours or if the child is vomiting with ...
... of all patients suffer from nausea and vomiting after surgery ... Information on Vomiting after Surgery - (Editor Added). On ... Postoperative Vomiting. Author: Deutsches Aerzteblatt International. Published: 2010/11/04. Peer-Reviewed: N/A. On This Page: ... Nausea and vomiting can delay discharge and about 1% of patients scheduled for day surgery require unanticipated overnight ... Vomiting has been associated with major complications such as pulmonary aspiration of gastric content and might endanger ...
A four week old infant is brought to see you by her mother who is concerned that her baby vomits after feeds several times a ... Ongoing vomiting in an infant BMJ 2017; 357 :j1802 doi:10.1136/bmj.j1802 ... The infant might or might not regurgitate or vomit shortly after feeding, several times a day.1 This is known as gastro- ... Ongoing vomiting in an infant. BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1802 (Published 04 May 2017) Cite this as: BMJ ...
Increased Thirst And Nausea Or Vomiting and their most common related conditions. ... Nausea and vomiting can accompany digestive conditions and infections as well as conditions such as labyrinthitis or headache. ... Headache, Increased Thirst And Nausea Or Vomiting. *Medical Author: Melissa Conrad Stöppler, MD ... The most common signs and symptoms of gastroenteritis are nausea, vomiting, diarrhea, and abdominal pain. The most common cause ...
Nausea and vomiting can be symptoms of many health conditions. Here, learn about some common causes, get some treatment tips, ... Several conditions may cause nausea and vomiting.. There are many possible causes of nausea and vomiting, including those below ... Treating the underlying cause may also relieve nausea and vomiting.. Young children. Vomiting is common in infants and young ... Vomiting in young children is common. Causes include reflux, but it can also indicate a more serious problem, such as an ...
... has been implicated as a chemoreceptor trigger zone for vomiting (emesis) for over 40 years. The AP is located on the dorsal ... The area postrema and vomiting Front Neuroendocrinol. 1994 Dec;15(4):301-20. doi: 10.1006/frne.1994.1012. ... However, the AP is not essential for vomiting induced by motion or by activation of vagal nerve afferents. The role of the AP ... Activation of the AP probably leads to nausea and vomiting through its projection to the neighboring NTS. The NTS may serve as ...
Most vomiting is caused by gastroenteritis, and usually isnt serious. These home-care tips can help prevent dehydration. ... What Is Vomiting?. Vomiting is the forceful throwing up of stomach contents. Most kids vomit from time to time, but it usually ... How Is Vomiting Treated?. Treatment for vomiting depends on the cause. Vomiting from gastroenteritis usually goes away on its ... How Do Doctors Find the Cause of Vomiting?. Doctors usually can tell if vomiting if part of a stomach flu by hearing about the ...
Over the counter medicines can provide relief for nausea and vomiting, but there are a number of precautions to be aware of ... They block messages to the part of the brain that controls nausea and vomiting. This is why they work best if you take them ... Bismuth subsalicylate (2 brand names: Kaopectate, Pepto-Bismol). This medicine may help treat some types of nausea and vomiting ... Medicines that treat nausea and vomiting are called antiemetics. Several OTC medicines are used as antiemetics. These include: ...
... recurrent episodes of vomiting. The pathophysiology is unknown (see Pathophysiology and Etiology), but data suggest a strong ... Cyclic vomiting syndrome (CVS), first described in children by Samuel Gee in 1882, is a chronic functional disorder of unknown ... Cyclic vomiting syndrome and functional vomiting in adults: association with cannabinoid use in males. Neurogastroenterol Motil ... Cycling vomiting syndrome (CVS) is characterized by recurrent, discrete, stereotypical episodes of rapid-fire vomiting between ...
Why Some Chemotherapy Agents Cause: Nausea and/or Vomiting. *How Health Care Teams Approach Prevention of: Nausea and/or ...
... recurrent episodes of vomiting. The pathophysiology is unknown (see Pathophysiology and Etiology), but data suggest a strong ... Cyclic vomiting syndrome (CVS), first described in children by Samuel Gee in 1882, is a chronic functional disorder of unknown ... Cyclic vomiting syndrome and functional vomiting in adults: association with cannabinoid use in males. Neurogastroenterol Motil ... encoded search term (Cyclic Vomiting Syndrome) and Cyclic Vomiting Syndrome What to Read Next on Medscape ...
Vomiting or throwing up often goes along with nausea. Several different aspects of cancer care can cause nausea. This handout ... answers questions about nausea and vomiting and offers tips for coping with this side effect. ... Nausea and Vomiting Related to Cancer Treatment (PDQ®) (Patients) Nausea and Vomiting Related to Cancer Treatment (PDQ®) ( ... How are nausea and vomiting treated?. Treatment of nausea and vomiting will depend on its cause. Your provider may suggest:. * ...
Vomiting and nausea are side effects of some types of chemotherapy (chemo) drugs not all. ... Aprepitant (Emend) works in the vomiting center of the brain to prevent nausea and vomiting caused by chemotherapy. It blocks ... When nausea or vomiting becomes severe, it can cause. dehydration. This is a serious condition that should not be. neglected, ... Its important to seek help from your health care team if you experience symptoms, as nausea and vomiting can:. *Cause ...
Over the past 9 months, Ive been plagued by daily nausea and vomiting. Since January, Ive had multiple tests and appointments ... Over the past 9 months, Ive been plagued by daily nausea and vomiting. Since January, Ive had multiple tests and appointments ... Have you taken any heartburn medicine and does it help you? How often do you vomit? ...
Emetophobia or fear of vomit can make daily tasks, including eating and cooking, distressing. Well go over symptoms and ... Emetophobia is a specific phobia that involves an extreme fear of vomiting, seeing vomit, watching other people vomit, or ... The fear of vomiting or seeing other people vomit can become so strong that it leads to panic, making it difficult or even ... For example, you may worry more about vomiting yourself than seeing others vomit. ...
This Primer provides a comprehensive review of the current state of basic science and clinical knowledge on nausea and vomiting ... Nausea and vomiting of pregnancy (NVP) is a common condition that affects as many as 70% of pregnant women. Although no ... Wellcome Open Res. 3, 123 (2018). The first study to show an association between serum levels of GDF15 and vomiting during the ... Fejzo, M.S., Trovik, J., Grooten, I.J. et al. Nausea and vomiting of pregnancy and hyperemesis gravidarum. Nat Rev Dis Primers ...
Cat vomiting and diarrhea are symptoms that often occur at the same time, indicating food intolerance that can go away on its ... Vomiting and diarrhea are symptoms of a heat stroke. In more advanced stages, the cat will have seizures or coma. ... If you have recently changed the type of diet for your pet, he may react by vomiting and having diarrhea. Try to make the ... Visit your vet if the cat displays the symptoms for more than 2 days or if there is blood in the vomit or stool. ...
I cant stop vomiting and I cant keep down any food or drink. Is this normal? ... All about nausea and vomiting *Signs of pregnancy: when does morning sickness start? ...
... the ejection of a ferrets stomach contents through the mouth is known as vomiting. ... Vomiting can also be initiated directly by stimulation of the cells in the vomiting center in animals with CNS disease. ... If your ferret is retching, and heaving from the belly, it is probably vomiting. The food that is in the vomit will be ... Your doctor will ask you to describe the appearance of the vomit, and what your pet looks like when it vomits. ...
How likely you are to have nausea & vomiting depends on many things. Learn more here. ... like chemo or radiation can cause nausea and vomiting. ... Understanding Nausea and Vomiting. *Nausea and Vomiting Caused ... Nausea and vomiting due to radiation therapy. Nausea and vomiting can be caused by radiation therapy based on:. The part of the ... Nausea and vomiting due to chemo and other drugs that treat cancer. You may hear treatment-related nausea and vomiting also ...
Vitamin B6 for nausea and vomiting in pregnancy. The authors have chosen to use an n of 1 trial of vitamin B6 treatment for ... 2. How would you apply this evidence to other patients presenting with nausea and vomiting in pregnancy? ... a pregnant woman suffering from nausea and vomiting is unlikely to be treated efficiently and she will not be able to achieve ... Treating nausea and vomiting during pregnancy: case progression. BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7435.337 ( ...
Are you experiencing chest pain and vomiting? We explain what conditions may cause these two symptoms, your treatment options, ... Vomiting is the forceful discharge of your stomach contents through the mouth. Nausea or stomach upset typically occurs before ... See your doctor within two days if your vomiting doesnt subside or if its severe and you cant keep fluids down after one day ... You cant typically prevent chest pain and vomiting, but you can lower your risk for some of the conditions that may cause ...
All IDPH-OPRs Items,Food Safety Symposium 2014,Clean Up of Vomiting and Diarrheal Events in a Food Establishment ...
... and vomiting. Chronic users require increasing dosages for the analgesic effects. Althou... ... She took two scoops.She proceeded to have multiple episodes of vomiting at home. She came to the ED, where she required ... Intractable nausea and vomiting in naïve ingestion of kratom for analgesia. *Singh V ... Singh, V., Mulla, N., Wilson, J. L., Umansky, A., Lee, J., Stead, T., & Ganti, L. (2020). Intractable nausea and vomiting in ...

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