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1.
Medicine (Baltimore) ; 100(10): e24947, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725858

RESUMO

BACKGROUND: Bowel preparation is essential to the success of colonoscopy. However, many patients cannot finish the preparation due to nausea and vomiting when taking polyethylene glycol (PEG). Dopamine-2 receptor antagonists, such as domperidone and sulpiride, are classical antiemetic drugs. This study aimed to explore the effect of domperidone and sulpiride on reducing the discomforts associated with PEG. METHODS: Patients scheduled for colonoscopy were enrolled and randomly allocated into 3 groups. Patients in the domperidone group (Dom group) or sulpiride group (Sul group) took 2 doses of domperidone or sulpiride before PEG. Patients in the control group (Con group) followed the regular routine of PEG. Discomforts during bowel preparation and the quality of bowel preparation were assessed. RESULTS: A total of 306 patients were enrolled. The participants in the Dom group and Sul group completed PEG better and had fewer abdominal discomforts than those in the Con group. The severity of nausea and abdominal fullness was lower in the Dom group and Sul group. The quality of bowel preparation was better in the Dom group and Sul group than Con group. CONCLUSIONS: Domperidone and sulpiride could reduce the PEG-related discomfort and improve the quality of bowel preparation. This method may be a promising way to improve the satisfaction of bowel preparation for both patients and endoscopists.


Assuntos
Antieméticos/uso terapêutico , Catárticos/efeitos adversos , Colonoscopia , Náusea/epidemiologia , Polietilenoglicóis/efeitos adversos , Vômito/epidemiologia , Adulto , Idoso , Colo/diagnóstico por imagem , Domperidona/uso terapêutico , Feminino , Humanos , Incidência , Mucosa Intestinal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Náusea/diagnóstico , Náusea/prevenção & controle , Satisfação do Paciente , Índice de Gravidade de Doença , Sulpirida/uso terapêutico , Resultado do Tratamento , Vômito/induzido quimicamente , Vômito/diagnóstico , Vômito/prevenção & controle
2.
Anticancer Drugs ; 32(5): 589-591, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33587356

RESUMO

Encorafenib (Braftovi) is indicated for the treatment of adult patients with unresectable or metastatic melanoma with a BRAF V600 mutation, in combination with binimetinib (Mektovi). According to the product label of encorafenib, there are no specific treatment recommendations in case of an overdose. We report on a 63-year-old man who ingested a double dose (900 mg) of encorafenib for 16 days. He developed overall minor chronic overdose symptoms such as nausea and vomiting grade 1 and muscle pain. Based on the most occurring adverse events of encorafenib, liver values, kidney function parameters and QTc interval were measured. Kidney function parameters were normal, whereas liver values were slightly increased (grade 1) and QTc slightly prolonged. The plasma concentration 3 h after the last dose was 2110 ng/mL. We describe the course of a case with a chronic overdose during 16 days of the double dose of encorafenib as well as the followed approach, which could be taken into account when observing an encorafenib overdose. Providing information in times of Covid-19 is challenging, but remains necessary for good clinical care.


Assuntos
Carbamatos , Overdose de Drogas , Testes de Função Hepática/métodos , Síndrome do QT Longo , Conduta do Tratamento Medicamentoso/normas , Melanoma , Neoplasias Cutâneas , Sulfonamidas , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Antineoplásicos/sangue , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Benzimidazóis/administração & dosagem , Benzimidazóis/efeitos adversos , Carbamatos/administração & dosagem , Carbamatos/efeitos adversos , Carbamatos/sangue , Controle de Doenças Transmissíveis , Relação Dose-Resposta a Droga , Monitoramento de Medicamentos/métodos , Overdose de Drogas/sangue , Overdose de Drogas/diagnóstico , Overdose de Drogas/etiologia , Overdose de Drogas/fisiopatologia , Humanos , Síndrome do QT Longo/induzido quimicamente , Síndrome do QT Longo/diagnóstico , Masculino , Melanoma/tratamento farmacológico , Melanoma/genética , Melanoma/patologia , Pessoa de Meia-Idade , Mutação , Proteínas Proto-Oncogênicas B-raf/antagonistas & inibidores , Proteínas Proto-Oncogênicas B-raf/genética , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Sulfonamidas/administração & dosagem , Sulfonamidas/efeitos adversos , Sulfonamidas/sangue , Vômito/induzido quimicamente , Vômito/diagnóstico
3.
Artigo em Inglês | MEDLINE | ID: mdl-33593727

RESUMO

Coronavirus disease 2019 (COVID-19), which is caused by infection with SARS-CoV-2, presents with a broad constellation of both respiratory and nonrespiratory symptoms, although it is primarily considered a respiratory disease. Gastrointestinal symptoms-including nausea, abdominal pain, vomiting, and diarrhea-rank chief among these. When coupled with the presence of viral RNA in fecal samples, the presence of gastrointestinal symptoms raises relevant questions regarding whether SARS-CoV-2 can productively infect the upper or lower gastrointestinal tract. Despite the well-documented prevalence of gastrointestinal symptoms and the high rate of SARS-CoV-2 fecal RNA shedding, the biological, clinical, and epidemiological relevance of these findings is unclear. Furthermore, the isolation of replication-competent virus from fecal samples has not been reproducibly and rigorously demonstrated. Although SARS-CoV-2 shedding likely occurs in a high proportion of patients, gastrointestinal symptoms affect only a subset of individuals. Herein, we summarize what is known about gastrointestinal symptoms and fecal viral shedding in COVID-19, explore the role of the gut microbiome in other respiratory diseases, speculate on the role of the gut microbiota in COVID-19, and discuss potential future directions. Taking these concepts together, we propose that studying gut microbiota perturbations in COVID-19 will enhance our understanding of the symptomology and pathophysiology of this novel devastating disease.


Assuntos
Dor Abdominal/etiologia , Diarreia/etiologia , Microbioma Gastrointestinal , Náusea/etiologia , Vômito/etiologia , Dor Abdominal/diagnóstico , Dor Abdominal/microbiologia , Dor Abdominal/patologia , Animais , /microbiologia , Diarreia/diagnóstico , Diarreia/microbiologia , Diarreia/patologia , Fezes/microbiologia , Fezes/virologia , Humanos , Náusea/diagnóstico , Náusea/microbiologia , Náusea/patologia , Vômito/diagnóstico , Vômito/microbiologia , Vômito/patologia
4.
BMJ Case Rep ; 14(1)2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33472809

RESUMO

Acute abdominal pain is a common presentation to the emergency department (ED). Ruling out life-threatening causes and giving pain relief are the most important tasks in ED. We describe a 32-year-old man who presented to ED with abdominal pain and vomiting which was unrelieved by usual doses of analgesic. Extensive investigations revealed no significant abnormalities. On further probing, he admitted taking traditional medications for infertility. The toxicological panel revealed a high blood lead level, leading to a diagnosis of acute lead toxicity. Chelation therapy with D-penicillamine was initiated and the patient's abdominal pain resolved within 4 days.


Assuntos
Dor Abdominal/diagnóstico , Medicamentos Falsificados/efeitos adversos , Intoxicação por Chumbo/diagnóstico , Charlatanismo , Vômito/diagnóstico , Dor Abdominal/tratamento farmacológico , Dor Abdominal/etiologia , Doença Aguda , Adulto , Anemia/etiologia , Antieméticos/uso terapêutico , Quelantes/uso terapêutico , Clordiazepóxido/uso terapêutico , Antagonistas Colinérgicos , Constipação Intestinal/etiologia , Medicamentos Falsificados/química , Combinação de Medicamentos , Serviço Hospitalar de Emergência , Humanos , Intoxicação por Chumbo/complicações , Intoxicação por Chumbo/tratamento farmacológico , Masculino , Parassimpatolíticos/uso terapêutico , Penicilamina/uso terapêutico , Fenetilaminas/uso terapêutico , Quinuclidinas/uso terapêutico , Tomografia Computadorizada por Raios X , Vômito/tratamento farmacológico , Vômito/etiologia
6.
Adv Biol Regul ; 77: 100745, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32773101

RESUMO

Coronavirus disease 2019 caused by SARS-CoV-2 originated from China and spread across every corner of the world. The scientific interest on COVID-19 increased after WHO declared it a pandemic in the early February of 2020. In fact, this pandemic has had a worldwide impact on economy, health, and lifestyle like no other in the last 100 years. SARS-CoV-2 belongs to Coronaviridae family and causes the deadliest clinical manifestations when compared to other viruses in the family. COVID-19 is an emerging zoonotic disease that has resulted in over 383,000 deaths around the world. Scientists are scrambling for ideas to develop treatment and prevention strategies to thwart the disease condition. In this review, we have attempted to summarize the latest information on the virus, disease, prevention, and treatment strategies. The future looks promising.


Assuntos
Betacoronavirus/patogenicidade , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Antivirais/uso terapêutico , Ataxia/diagnóstico , Ataxia/fisiopatologia , Ataxia/virologia , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Humanos , Hidroxicloroquina/uso terapêutico , Náusea/diagnóstico , Náusea/fisiopatologia , Náusea/virologia , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Pneumonia Viral/transmissão , Quarentena/métodos , Quarentena/organização & administração , Fatores de Risco , Índice de Gravidade de Doença , Vômito/diagnóstico , Vômito/fisiopatologia , Vômito/virologia
7.
Blood ; 136(7): 914, 2020 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-32790856
9.
Arch Virol ; 165(10): 2213-2227, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32666145

RESUMO

In this study, we investigated the epidemiology and molecular characteristics of enteroviruses associated with severe hand, foot and mouth disease (HFMD) in Shenzhen, China, during 2014-2018. A total of 137 fecal specimens from patients with severe HFMD were collected. Enterovirus (EV) types were determined using real-time reverse transcription polymerase chain reaction (RT-PCR), RT nested PCR, and sequencing. Sequences were analyzed using bioinformatics programs. Of 137 specimens tested, 97 (70.8%), 12 (8.8%), and 10 (7.3%) were positive for EV-A71, coxsackievirus A6 (CVA6), and CVA16, respectively. Other pathogens detected included CVA2 (2.9%, 4/137), CVA10 (2.9%, 4/137), CVA5 (0.7%, 1/137), echovirus 6 (E6) (0.7%, 1/137) and E18 (0.7%, 1/137). The most frequent complication in patients with proven EV infections was myoclonic jerk, followed by aseptic encephalitis, tachypnea, and vomiting. The frequencies of vomiting and abnormal eye movements were higher in EV-A71-infected patients than that in CVA6-infected or CVA16-infected patients. Molecular phylogeny based on the complete VP1 gene revealed no association between the subgenotype of the virus and disease severity. Nevertheless, 12 significant mutations that were likely to be associated with virulence or the clinical phenotype were observed in the 5'UTR, 2Apro, 2C, 3A, 3Dpol and 3'UTR of CVA6. Eight significant mutations were observed in the 5'UTR, 2B, 3A, 3Dpol and 3'UTR of CVA16, and 10 significant mutations were observed in the 5'UTR, VP1, 3A and 3Cpro of CVA10. In conclusion, EV-A71 is still the main pathogen causing severe HFMD, although other EV types can also cause severe complications. Potential virulence or phenotype-associated sites were identified in the genomes of CVA6, CVA16, and CVA10.


Assuntos
Proteínas do Capsídeo/genética , Encefalite/epidemiologia , Enterovirus Humano C/genética , Doença de Mão, Pé e Boca/epidemiologia , Mioclonia/epidemiologia , Taquipneia/epidemiologia , Vômito/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Encefalite/diagnóstico , Encefalite/fisiopatologia , Encefalite/virologia , Enterovirus Humano C/classificação , Enterovirus Humano C/isolamento & purificação , Fezes/virologia , Feminino , Expressão Gênica , Genótipo , Doença de Mão, Pé e Boca/diagnóstico , Doença de Mão, Pé e Boca/fisiopatologia , Doença de Mão, Pé e Boca/virologia , Humanos , Lactente , Recém-Nascido , Masculino , Epidemiologia Molecular , Mutação , Mioclonia/diagnóstico , Mioclonia/fisiopatologia , Mioclonia/virologia , Fenótipo , Filogenia , Índice de Gravidade de Doença , Taquipneia/diagnóstico , Taquipneia/fisiopatologia , Taquipneia/virologia , Virulência , Vômito/diagnóstico , Vômito/fisiopatologia , Vômito/virologia
10.
Microbes Infect ; 22(9): 481-488, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32561409

RESUMO

Clinical descriptions about influenza-like illnesses (ILI) in COVID-19 seem non-specific. We aimed to compare the clinical features of COVID-19 and influenza. We retrospectively investigated the clinical features and outcomes of confirmed cases of COVID-19 and influenza in Nord Franche-Comté Hospital between February 26th and March 14th 2020. We used SARS-CoV-2 RT-PCR and influenza virus A/B RT-PCR in respiratory samples to confirm the diagnosis. We included 124 patients. The mean age was 59 (±19 [19-98]) years with 69% female. 70 patients with COVID-19 and 54 patients with influenza A/B. Regarding age, sex and comorbidities, no differences were found between the two groups except a lower Charlson index in COVID-19 group (2 [±2.5] vs 3 [±2.4],p = 0.003). Anosmia (53% vs 17%,p < 0.001), dysgeusia (49% vs 20%,p = 0.001), diarrhea (40% vs 20%,p = 0.021), frontal headache (26% vs 9%,p = 0.021) and bilateral cracklings sounds (24% vs 9%,p = 0.034) were statistically more frequent in COVID-19. Sputum production (52% vs 29%,p = 0.010), dyspnea (59% vs 34%,p = 0.007), sore throat (44% vs 20%,p = 0.006), conjunctival hyperhemia (30% vs 4%,p < 0.001), tearing (24% vs 6%,p = 0.004), vomiting (22% vs 3%,p = 0.001) and rhonchi sounds (17% vs 1%,p = 0.002) were more frequent with influenza infection. We described several clinical differences which can help the clinicians during the co-circulation of influenza and SARS-CoV-2.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/diagnóstico , Vírus da Influenza A/patogenicidade , Vírus da Influenza B/patogenicidade , Influenza Humana/diagnóstico , Pneumonia Viral/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Diagnóstico Diferencial , Diarreia/diagnóstico , Diarreia/fisiopatologia , Diarreia/virologia , Disgeusia/diagnóstico , Disgeusia/fisiopatologia , Disgeusia/virologia , Dispneia/diagnóstico , Dispneia/fisiopatologia , Dispneia/virologia , Feminino , França , Cefaleia/diagnóstico , Cefaleia/fisiopatologia , Cefaleia/virologia , Humanos , Influenza Humana/fisiopatologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/fisiopatologia , Transtornos do Olfato/virologia , Pandemias , Faringite/diagnóstico , Faringite/fisiopatologia , Faringite/virologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Vômito/diagnóstico , Vômito/fisiopatologia , Vômito/virologia
12.
Tunis Med ; 98(2): 164-167, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32395808

RESUMO

INTRODUCTION: Intestinal duplications are rare malformations and hail sites are the most common. Today, the diagnosis is made in antenatal because of the performances of antenatal ultrasound. OBSERVATION: This was a 15-month-old male infant received for constant crying, vomiting and increased abdominal volume that had been evolving for two weeks. An abdominal ultrasound was performed and objectified an intraperitoneal cyst formation of 30 x 27 mm, surrounded by a stratified wall and contiguous to a digestive loop. Surgery was performed and confirmed the existence of non-communicating ileal duplication. CONCLUSION: Intestinal duplication is a rare malformation. Ultrasound is often sufficient for diagnosis based on the presence of a characteristic double-walled cystic mass.


Assuntos
Abdome/patologia , Cistos/diagnóstico , Anormalidades do Sistema Digestório/complicações , Anormalidades do Sistema Digestório/diagnóstico , Íleo/anormalidades , Doenças Peritoneais/diagnóstico , Abdome/diagnóstico por imagem , Abdome Agudo/diagnóstico , Abdome Agudo/etiologia , Abdome Agudo/patologia , Abdome Agudo/cirurgia , Cistos/patologia , Diagnóstico Diferencial , Anormalidades do Sistema Digestório/cirurgia , Humanos , Íleo/cirurgia , Lactente , Masculino , Tamanho do Órgão , Doenças Peritoneais/patologia , Ultrassonografia , Vômito/diagnóstico , Vômito/etiologia , Vômito/cirurgia
15.
Pediatrics ; 145(5)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32317307

RESUMO

Electronic cigarette or vaping product use-associated lung injury (EVALI) is a newly emerging diagnosis in the United States, yet the incidence has surged greatly in the past year. With the trend of using electronic cigarettes (e-cigarettes) and vaping rising at an alarming rate among teenagers, many are resorting to friends, illicit drug dealers, and other informal sources to obtain their e-cigarettes, which is greatly contributing to the national outbreak of EVALI. The incidence of adolescents presenting with the constellation of respiratory, gastrointestinal, and constitutional symptoms characteristic of EVALI has been widely reported within the nation. We present one such case of an adolescent boy with a 2-year history of daily vaping who presented with nausea, vomiting, weight loss, and fever but lacked the respiratory symptoms that have been reported in the majority of EVALI cases reported thus far. Computed tomography scan of the abdomen and pelvis revealed an incidental finding of lung pathology characteristic of EVALI, prompting further workup and diagnosis of EVALI. In this case, it is demonstrated that the presentation of EVALI can be variable and is still poorly defined. The rising morbidity and mortality from EVALI reveal the importance of considering EVALI in all patients with a history of vaping or e-cigarette use, regardless of the presence or absence of respiratory symptoms.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Lesão Pulmonar/diagnóstico , Transtornos Respiratórios , Vaping/efeitos adversos , Vaping/tendências , Adolescente , Febre/diagnóstico , Febre/etiologia , Humanos , Lesão Pulmonar/etiologia , Lesão Pulmonar/fisiopatologia , Masculino , Náusea/diagnóstico , Náusea/etiologia , Vaping/fisiopatologia , Vômito/diagnóstico , Vômito/etiologia
16.
J Med Virol ; 92(7): 786-790, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32320066

RESUMO

An outbreak of a novel coronavirus (SARS-CoV-2) infection has recently emerged and rapidly spreading in humans causing a significant threat to international health and the economy. Rapid assessment and warning are crucial for an outbreak analysis in response to serious public health. SARS-CoV-2 shares highly homological sequences with SARS-CoVs causing highly lethal pneumonia with respiratory distress and clinical symptoms similar to those reported for SARS-CoV and MERS-CoV infections. Notably, some COVID-19 patients also expressed neurologic signs like nausea, headache, and vomiting. Several studies have reported that coronaviruses are not only causing respiratory illness but also invade the central nervous system through a synapse-connected route. SARS-CoV infections are reported in both patients and experimental animals' brains. Interestingly, some COVID-19 patients have shown the presence of SARS-CoV-2 virus in their cerebrospinal fluid. Considering the similarities between SARS-CoV and SARS-CoV-2 in various aspects, it remains to clarify whether the potent invasion of SARS-CoV-2 may affect in COVID-19 patients. All these indicate that more detailed criteria are needed for the treatment and the prevention of SARS-CoV-2 infected patients. In the absence of potential interventions for COVID-19, there is an urgent need for an alternative strategy to control the spread of this disease.


Assuntos
Betacoronavirus/patogenicidade , Sistema Nervoso Central/virologia , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Antivirais/uso terapêutico , Betacoronavirus/genética , Sistema Nervoso Central/efeitos dos fármacos , Sistema Nervoso Central/patologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Cefaleia/diagnóstico , Cefaleia/fisiopatologia , Cefaleia/virologia , Humanos , Pulmão/efeitos dos fármacos , Pulmão/patologia , Pulmão/virologia , Coronavírus da Síndrome Respiratória do Oriente Médio/genética , Coronavírus da Síndrome Respiratória do Oriente Médio/patogenicidade , Náusea/diagnóstico , Náusea/fisiopatologia , Náusea/virologia , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Saúde Pública/métodos , Vírus da SARS/genética , Vírus da SARS/patogenicidade , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/prevenção & controle , Síndrome Respiratória Aguda Grave/virologia , Vacinas Virais/biossíntese , Vacinas Virais/uso terapêutico , Vômito/diagnóstico , Vômito/fisiopatologia , Vômito/virologia
17.
Support Care Cancer ; 28(11): 5343-5351, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32130508

RESUMO

PURPOSE: Chemotherapy-induced nausea (CIN) is a relevant problem for gynaecological cancer patients. The evaluation of CIN is a key aspect in its management, along with the identification of associated risk factors. The objective of the study was to compare different measurements of nausea and to investigate personal risk factors in CIN development. METHOD: Eighty-one women treated for gynaecological cancers took part. The presence of CIN was evaluated using the MASCC Antiemesis Tool (MAT) and a patient's report to clinicians at the subsequent chemotherapy cycle. Personal risk factors were assessed using the State-Trait Anxiety Inventory and a self-report questionnaire. RESULTS: The study shows that the agreement between patients' assessment of CIN with MAT and what they referred to clinicians was only moderate for acute nausea (Cohen's Kappa = 0.55; p < 0.001), while good for delayed nausea (Cohen's Kappa = 0.68; p < 0.001). At multiple logistic regression analysis, younger age, anticipatory nausea, patient medium-high expectations of CIN, and parity emerged as risk factors for the development of acute nausea (p = 0.0087, 0.0080, 0.0122 and 0.0021, respectively). Patient medium-high expectations of CIN and being single resulted to be risk factors for delayed nausea (p = 0.0397 and 0.0024, respectively). CONCLUSIONS: Our findings confirm that personal factors contribute to individual differences in the development of CIN; moreover, we highlight the importance of CIN evaluation by clinicians, underlining the need to use reliable instruments.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias dos Genitais Femininos/tratamento farmacológico , Náusea/induzido quimicamente , Náusea/epidemiologia , Vômito/induzido quimicamente , Vômito/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bevacizumab/administração & dosagem , Bevacizumab/efeitos adversos , Carboplatina/administração & dosagem , Carboplatina/efeitos adversos , Feminino , Neoplasias dos Genitais Femininos/diagnóstico , Neoplasias dos Genitais Femininos/epidemiologia , Humanos , Quimioterapia de Indução/efeitos adversos , Masculino , Pessoa de Meia-Idade , Náusea/diagnóstico , Náusea/etiologia , Paclitaxel/administração & dosagem , Paclitaxel/efeitos adversos , Prognóstico , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Vômito/diagnóstico , Vômito/etiologia
18.
Medicine (Baltimore) ; 99(5): e18927, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000406

RESUMO

Cytomegalovirus (CMV) gastritis is a rare opportunistic infection with diverse clinical manifestations. Our study aimed to investigate the clinical features of Chinese patients with CMV gastritis.Six inpatients diagnosed with CMV gastritis were retrospectively enrolled, based on the finding of inclusion bodies in routine hematoxylin and eosin staining or positive anti-CMV monoclonal antibodies under immunohistochemistry in the gastric biopsy. Data, including demographics, diagnostic measurements, and medications, were collected.Abdominal pain was the most frequently reported symptom, occurring in 4 patients. Five patients were immunocompromised with associated underlying diseases, and 3 patients had decreased leukocyte differentiation antigen 4 positive (CD4) T lymphocyte counts. Only 3 patients had either positive cytomegalovirus (CMV)-immunoglobulin (Ig) M or increased copies of CMV-DNA peripherally. All patients had gastric lesions in the antrum of the stomach, including ulcers or erosions observed by gastroscopy. All patients received ganciclovir by intravenous injection (IV) as the first line anti-CMV therapy, and attained complete (4) or partial remission (2) during the follow-up.CMV gastritis should be taken into consideration in patients with immunocompromised status who have abdominal pain, nausea, or vomiting. Gastroscopy and necessary biopsy are the major diagnostic methods for CMV gastritis. Early diagnosis leads to a better prognosis for these patients.


Assuntos
Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/epidemiologia , Gastrite/diagnóstico , Gastrite/epidemiologia , Dor Abdominal/diagnóstico , Dor Abdominal/tratamento farmacológico , Dor Abdominal/epidemiologia , Dor Abdominal/etiologia , Adulto , Idoso , Biomarcadores/sangue , Biópsia , Infecções por Citomegalovirus/tratamento farmacológico , Infecções por Citomegalovirus/patologia , Feminino , Gastrite/tratamento farmacológico , Gastrite/patologia , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/diagnóstico , Náusea/tratamento farmacológico , Náusea/epidemiologia , Náusea/etiologia , Prognóstico , Estudos Retrospectivos , Estômago/diagnóstico por imagem , Estômago/patologia , Centros de Atenção Terciária , Vômito/diagnóstico , Vômito/tratamento farmacológico , Vômito/epidemiologia , Vômito/etiologia
19.
J Med Virol ; 92(6): 552-555, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32104915

RESUMO

Following the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), another highly pathogenic coronavirus named SARS-CoV-2 (previously known as 2019-nCoV) emerged in December 2019 in Wuhan, China, and rapidly spreads around the world. This virus shares highly homological sequence with SARS-CoV, and causes acute, highly lethal pneumonia coronavirus disease 2019 (COVID-19) with clinical symptoms similar to those reported for SARS-CoV and MERS-CoV. The most characteristic symptom of patients with COVID-19 is respiratory distress, and most of the patients admitted to the intensive care could not breathe spontaneously. Additionally, some patients with COVID-19 also showed neurologic signs, such as headache, nausea, and vomiting. Increasing evidence shows that coronaviruses are not always confined to the respiratory tract and that they may also invade the central nervous system inducing neurological diseases. The infection of SARS-CoV has been reported in the brains from both patients and experimental animals, where the brainstem was heavily infected. Furthermore, some coronaviruses have been demonstrated able to spread via a synapse-connected route to the medullary cardiorespiratory center from the mechanoreceptors and chemoreceptors in the lung and lower respiratory airways. Considering the high similarity between SARS-CoV and SARS-CoV2, it remains to make clear whether the potential invasion of SARS-CoV2 is partially responsible for the acute respiratory failure of patients with COVID-19. Awareness of this may have a guiding significance for the prevention and treatment of the SARS-CoV-2-induced respiratory failure.


Assuntos
Betacoronavirus/patogenicidade , Sistema Nervoso Central/virologia , Infecções por Coronavirus/epidemiologia , Cefaleia/virologia , Pandemias , Pneumonia Viral/epidemiologia , Vírus da SARS/patogenicidade , Betacoronavirus/fisiologia , Sistema Nervoso Central/fisiopatologia , China/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Cefaleia/diagnóstico , Cefaleia/fisiopatologia , Humanos , Pulmão/fisiopatologia , Pulmão/virologia , Mecanotransdução Celular , Náusea/diagnóstico , Náusea/fisiopatologia , Náusea/virologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/fisiopatologia , Insuficiência Respiratória/virologia , Vírus da SARS/fisiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/fisiopatologia , Síndrome Respiratória Aguda Grave/transmissão , Síndrome Respiratória Aguda Grave/virologia , Vômito/diagnóstico , Vômito/fisiopatologia , Vômito/virologia
20.
Adv Emerg Nurs J ; 42(1): 30-36, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32000189

RESUMO

There is an emerging subset of patients who present to the emergency department (ED) with cannabinoid hyperemesis syndrome (CHS). Cannabinoid hyperemesis syndrome is a relatively new clinical condition and despite a long documented marijuana use in humans, little is known about the pathophysiology of this emerging problem. The focus of this article is to present a patient who presented with CHS. The clinical presentation, diagnostics, and treatment for this patient will be discussed. The nurse practitioner can anticipate high utilization of patients presenting to the ED with CHS. Nurse practitioners need to provide early recognition and careful management of patients who present with this condition.


Assuntos
Canabinoides/efeitos adversos , Uso da Maconha/efeitos adversos , Vômito/induzido quimicamente , Adulto , Diagnóstico Diferencial , Serviço Hospitalar de Emergência/organização & administração , Humanos , Masculino , Vômito/diagnóstico
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