Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Vomiting”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources
PubMed2006

Systematic review on the recurrence of postoperative nausea and vomiting after a first episode in the recovery room - implications for the treatment of PONV and related clinical trials.

BACKGROUND: Despite the presence of a plethora of publications on the prevention of postoperative nausea and vomiting (PONV) only little is known how to treat established symptoms. Besides the high effort of performing these efficacy trials (much more patients must give their consent than are actually included in a study) and ethical concerns, little is known about the rate of re-occurring PONV/vomiting after placebo. As a consequence investigators will have difficulties defining a clinically relevant effect for the new treatment which is crucial for any planning. A quantitative systematic review was performed in order to provide more reliable estimates of the incidence of re-occurring PONV/vomiting after placebo and to help investigators defining a clinically relevant treatment effect. METHODS: A systematic search of the literature was performed using an extended search strategy of a previous review. Data on the recurrence of PONV (any nausea or emetic symptom) and vomiting (retching or vomiting) was extracted from published reports treating PONV with placebo and unpublished results from two observational trials where no treatment was given. A nonlinear random effects model was used to calculate estimates of the recurrence of symptoms and their 95%-confidence intervals (95%-CI). RESULTS: A total of 29 trials (including the unpublished data) were eligible for the calculations. Depending on the length of observation after administering placebo or no treatment the recurrence rate of PONV was between 65% (95%-CI: 53%...75%) and 84% (95%-CI: 73%...91%) and that of vomiting was between 65% (95%-CI: 44%...81%) and 78% (95%-CI: 59%...90%). CONCLUSION: Almost all trials showed a considerable and consistently high rate of recurrence of emetic symptoms after placebo highlighting the need for a consequent antiemetic treatment. Future (placebo) controlled efficacy trials may use the presented empirical estimates for defining clinically relevant effects and for statistical power considerations.

Journal Article↗
PubMed2000

Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials.

Ginger (Zingiber officinale) is often advocated as beneficial for nausea and vomiting. Whether the herb is truly efficacious for this condition is, however, still a matter of debate. We have performed a systematic review of the evidence from randomized controlled trials for or against the efficacy of ginger for nausea and vomiting. Six studies met all inclusion criteria and were reviewed. Three on postoperative nausea and vomiting were identified and two of these suggested that ginger was superior to placebo and equally effective as metoclopramide. The pooled absolute risk reduction for the incidence of postoperative nausea, however, indicated a non-significant difference between the ginger and placebo groups for ginger 1 g taken before operation (absolute risk reduction 0.052 (95% confidence interval -0.082 to 0.186)). One study was found for each of the following conditions: seasickness, morning sickness and chemotherapy-induced nausea. These studies collectively favoured ginger over placebo.

Double-Blind Method↗
PubMed2003

Benefits and risks of newer treatments for chemotherapy-induced and postoperative nausea and vomiting.

Nausea and vomiting are common adverse effects of chemotherapy, radiation therapy, anaesthesia and surgery. The incidence of chemotherapy-induced nausea and vomiting (CINV) is estimated to vary from 30 to 90%, depending on the type of chemotherapeutic agent used. Radiation-induced emesis varies with anatomical site radiated but is estimated to have an overall incidence of approximately 40%. The incidence of postoperative nausea and vomiting (PONV) depends on the type of anaesthesia and surgery, but overall is estimated to be 20-30%. Evidence-based medicine and meta-analysis have been used to direct medical therapy to help determine equivalence, optimal dose, timing, safety and efficacy of antiemetic medications. Concepts such as the number needed to treat and number needed to harm are helpful to guide the clinician regarding the benefits and risks of a particular treatment. The serotonin 5-HT(3) receptor antagonists ondansetron, granisetron, tropisetron and dolasetron have been important additions to the antiemetic armamentarium. The 5-HT(3) receptor antagonists are similar in chemical structure, efficacy and adverse effect profile. They appear to have no important differences among themselves in clinical outcomes for CINV and PONV. Headache, dizziness, constipation and diarrhoea are their most common adverse effects, and when they occur they are usually mild and easily managed. Haemodynamic changes and extrapyramidal adverse effects are uncommon. ECG changes such as prolonged corrected QT (QTc) interval are infrequent, dose-related and overall judged to be clinically insignificant. As most studies with the 5-HT(3) antagonists have been conducted on relatively healthy patients, caution should be exercised when these drugs are used in susceptible patients with co-morbidities. The clinician must weigh the benefit of administering an antiemetic for CINV or PONV against the risk of occurrence of an adverse event.

Animals↗
PubMed2001

Prophylaxis with oral granisetron for the prevention of nausea and vomiting after laparoscopic cholecystectomy: a prospective randomized study.

HYPOTHESIS: Laparoscopic cholecystectomy is associated with a relatively high incidence of postoperative nausea and vomiting when no prophylactic antiemetic is given. This study assesses the efficacy and safety of oral granisetron hydrochloride for the prevention of nausea and vomiting after laparoscopic cholecystectomy. DESIGN: A prospective, randomized, double-blind, placebo-controlled study. SETTING: University teaching hospital. PATIENTS: The study comprised 120 patients, 92 women and 28 men, undergoing laparoscopic cholecystectomy. INTERVENTIONS: Patients received orally either placebo or granisetron at 3 different doses (1 mg, 2 mg, and 4 mg; n = 30 of each) 60 minutes before surgery. A standard general anesthetic technique and postoperative analgesia were used. MAIN OUTCOME MEASURES: Emetic episodes were recorded during the first 24 hours after anesthesia. RESULTS: The incidence of patients who were emesis-free 24 hours after anesthesia was 60% with 1 mg of granisetron (P =.40), 83% with 2 mg of granisetron (P =.01), and 83% with 4 mg of granisetron (P =.01), compared with placebo (53%). No clinically important adverse effects were observed in any of the groups. CONCLUSION: Preoperative oral granisetron in doses higher than 2 mg is effective for the prevention of nausea and vomiting after laparoscopic cholecystectomy.

Administration, Oral↗
PubMed1978

Self-induced vomiting. Psychiatric considerations.

Self-induced vomiting has been associated with the psychiatric diagnosis of anorexia nervosa and a newly proposed disorder named bulimia. Two patients with a self-induced vomiting compulsion did not fulfill criteria for either of these diagnoses. One patient had an affective disorder, and the other had no psychiatric illness, but the habit had developed as a weight control measure. Systematic studies of these symptoms are not available. Clinical diagnostic decisions should not be base on one outstanding sign or symptom, eg, self-induced vomiting, unless research clearly relates the sign or symptom to only one disorder.

Adult↗
PubMed1997

Serum electrolytes as markers of vomiting in bulimia nervosa.

OBJECTIVE: Patients with bulimia nervosa often have serum electrolyte abnormalities that result from vomiting and/or laxative or diuretic use. Thus, serum electrolytes could serve as an objective marker of such behaviors. METHOD: This study is a retrospective examination of serum electrolyte levels and vomiting behavior in 138 bulimic women, and of serum electrolyte levels in 70 control women. RESULTS: Logistic regression analyses demonstrated that only potassium values distinguished bulimic subjects from controls. Potassium levels below the lower limit of normal (3.7 mg/l) occurred only in the bulimic group. DISCUSSION: Abnormally low values for potassium are a specific, but not sensitive, predictor of recent vomiting episodes.

Adult↗
PubMed1985

Combination antiemetic therapy in cisplatin-induced nausea and vomiting.

Twenty-seven consecutive patients with advanced gynecologic malignancies undergoing chemotherapy with cisplatin in combination with other agents were studied in a prospective, randomized fashion to compare the antiemetic efficacy of a combination regimen with high-dose metoclopramide. The combination regimen consisted of prochlorperazine, dexamethasone, and pentobarbital. Patients treated with the combination regimen had significantly less vomitus (P less than 0.01, Student's t test) and fewer vomiting episodes (P less than 0.001, test for homogeneity) than patients treated with metoclopramide. In addition, the sedative and sleep-inducing effect of the barbiturate made the experience of vomiting more tolerable, even in those instances where the combination regimen was not superior to metoclopramide in the control of vomiting.

Adult↗
PubMed2005

Maternal inheritance in cyclic vomiting syndrome.

Cyclic vomiting syndrome (CVS), characterized by severe discrete episodes of nausea, vomiting, and lethargy, is a fairly common, disabling, predominately-childhood condition most often associated with migraine and dysautonomic features. Our group recently reported that children with CVS and additional neuromuscular disease manifestations demonstrate strong maternal inheritance of multiple disease manifestations and abnormal urine organic acids, suggesting the presence of predisposing mitochondrial DNA (mtDNA) sequence variants. In order to determine if maternal inheritance is present in CVS in general, a clinical interview was administered regarding 80 unrelated individuals with CVS ascertained randomly from the database of the Cyclic Vomiting Syndrome Association (CVSA). Disease manifestations consistent with potential mitochondrial dysfunction were far more common in matrilineal (sharing the same mtDNA sequence) versus in non-matrilineal relatives, including mothers versus fathers (P = 3 x 10(-9)) and maternal versus paternal grandmothers (P = 2 x 10(-6)). Maternal inheritance is suggested in 52% of the 23 subjects with two or more neuromuscular abnormalities ("CVS+") and in 54% of the 44 subjects without any neuromuscular abnormalities ("CVS-"). In both the CVS+ and CVS- sub-groups, subjects, and affected matrilineal relatives of all ages suffer at a far higher incidence from several dysautonomic-related conditions, including migraine and irritable bowel, as well as depression and hypothyroidism, while neuromuscular and cognitive disorders such as hypotonia and ADHD are common only in affected children. We conclude that mtDNA sequences predispose towards the development of protean disease manifestations in CVS patients ascertained through a disease-specific association, as well as among their matrilineal relatives, whether or not neuromuscular disease is present in the proband. Since CVS was absent in all but one matrilineal relative of our probands, CVS is apparently a rare clinical presentation in individuals carrying the predisposing mtDNA sequences. The four conditions reported most frequently among the matrilineal relatives of our cases, migraine, depression, irritable bowel, and hypothyroidism, are known to segregate together in families, and our findings suggest that a common predisposing genetic factor is likely present on the mtDNA.

DNA, Mitochondrial↗
PubMed1977

Hydrotalcite in the treatment of bile vomiting.

Seventeen patients have completed a double-blind cross-over study of hydrotalcite against placebo in the treatment of bile vomiting after surgery for peptic ulcer. Overall there was no significant difference between the two treatments, with 9 patients improving on hydrotalcite and 5 on placebo. The original operation had been peformed less than 3 years before the study in 9 patients; in this subgroup there was an improvement on hydrotalcite treatment in 8 patients but in only 1 on placebo. These differences are statistically significant (P less than 0.005). Nausea, vomiting, heartburn and epigastric tenderness were improved although gastritis and endoscopic changes were not affected. It appears that hydrotalcite can help palliate symptoms of bile vomiting occuring soon after surgery for peptic ulcer.

Adult↗
PubMed1990

Vomiting after Roux-en-Y biliary diversion: relationship to surgical technique.

Vomiting is a frequent complaint after revisional gastric surgery using a Roux-en-Y biliary diversion. This is believed to be due to gastric stasis or stasis in the jejunal component of the Roux-en-Y. Thirty-three patients, ten with a satisfactory outcome following Roux-en-Y diversion and 23 with an unsatisfactory outcome, were studied using a semisolid, radiolabelled meal and compared with 12 normal subjects. Outcome was assessed by modified Visick grading. Seven patients with an unsatisfactory outcome because of frequent vomiting had gastric stasis and two had delay in emptying of the jejunal component of the Roux-en-Y. Vomiting was more likely in patients with a dependent sump (P less than 0.006) and emptying was significantly prolonged where a sump was present (P = 0.0009). Surgical technique contributed to the dependent sump.

Adult↗
PubMed2001

Postnatal depression, eating, exercise, and vomiting before and during pregnancy.

OBJECTIVE: To examine the postnatal distress and the eating, exercise, and weight losing behavior of women before and during pregnancy. METHOD: The subjects were healthy women who had given birth to a singleton healthy baby in the week before the study. They were drawn from two consecutive series of mothers of babies whose birth weights were either < or =2,500 g or >2,500 g. A total of 181 women were interviewed using a standardized interview modified for pregnancy and related behaviors. They also completed the Edinburgh Postnatal Distress Questionnaire. RESULTS: Regression analysis produced a final model containing variables that made a unique contribution to predicting the level of distress of women in the week following childbirth. The model accounted for 25% of the variance and included four variables that were associated with greater distress: fear of weight gain before and during pregnancy, being distracted by thoughts of food during pregnancy, being afraid of gaining more weight than the pregnancy would explain, and vomiting more frequently during the first 3-4 months of pregnancy. A fifth variable accounted for less distress, that is, participating in low-intensity exercise for reasons of shape and weight during months 3-4 of pregnancy. Other variables associated with distress only in the preliminary analysis were maternal age, binge eating, and vomiting before pregnancy. The most distressed mothers were suffering from an eating disorder at the time of pregnancy. The binge and/or purge type of eating disorder was associated with more distress than a food restriction type. DISCUSSION: Postnatal distress is associated with body weight and shape concerns, with disordered eating before and during pregnancy, and with vomiting during pregnancy. The protective role of low-intensity exercise during early pregnancy needs to be explored. Women with eating disorders should be considered at risk for postnatal problems.

Adult↗
PubMedDate not supplied

Phylogenic and neurologic aspects of the vomiting process.

Hindbrain morphology is compared in a variety of animals representing species that vomit and those that do not. Special attention is given to the nucleus of the tractus solitarius (NTS) and its synaptic connections with surrounding structures. The role of the area postrema is examined from the standpoints of containing the chemoreceptor trigger zone (CTZ) for vomiting, of its functional relationship to the blood-brain barrier, and of its significance as part of the circumventricular organ system. A survey is made of the manifold behavioral contributions of NTS to cardiovascular and respiratory regulation, appetite control, arousal, water balance, and digestive and neuroendocrine functions. An overview is presented of neurochemical distribution in the brain stem with respect to aminergic, cholinergic, and peptidergic substances. Finally, causes and prevention of vomiting are discussed in light of the above considerations.

Animals↗
PubMed1995

Tropisetron in the prevention of nausea and vomiting in 131 children receiving cytotoxic chemotherapy.

Tropisetron (Navoban, Sandoz Pharma Ltd., Basel, Switzerland), a selective antagonist of the serotonin receptor (5-HT3) dosed once-daily at 0.2 mg/kg (with a maximum of 5 mg daily), was evaluated in the prevention of chemotherapy-induced nausea and vomiting in 131 children with a median age of 5 years (age 10 weeks to 21 years). Acute lymphocytic leukemia was the most common malignancy (49%). Most children (82%) had received cytotoxic chemotherapy before enrollment. Patients received tropisetron during one or more courses of chemotherapy (455 courses in total). Tropisetron was administered slowly intravenously as a single dose before the start of chemotherapy on day 1 and intravenously or by mouth the subsequent days as a single daily dose (median treatment duration: 5 days). Response to tropisetron per 24 hour period on the first 5 days of each chemotherapy course was graded as complete (absence of both nausea and vomiting), partial (one to four vomits and/or less than 5 hours of nausea), or failure. Overall complete response on day 1 was observed in 305 out of 455 chemotherapy courses (67%). The patients receiving intravenous chemotherapy (N = 92) had a 70% complete response rate and a 26% partial response rate on day 1, both for course 1 and course 2. The percentage of complete responders increased the subsequent days of the course. Emesis after day 1 was observed primarily during courses with the most emetogenic chemotherapy. No side-effects of tropisetron other than a single case of diarrhoea were documented in this study.

Adolescent↗
PubMed1980

Rapid plasma clearance and reduced rate and extent of urinary elimination of parenterally administered methotrexate as a result of severe vomiting and diarrhoea.

A patient received 200 mg methotrexate IM as part of a treatment schedule for malignant melanoma. Severe vomiting and diarrhoea began shortly after treatment and persisted for 4 h. During this period the methotrexate renal clearance rate was 37 ml . min-1, increasing to 97 ml . min-1 when vomiting and diarrhoea ceased. Only 26% of the administered dose was recovered in the urine up to 48 h after treatment, whilst the plasma clearance of methotrexate assessed over the same period was 208 ml . min-1. We conclude that a considerable proportion of the dose was lost from the gastrointestinal tract during the period of vomiting and diarrhoea, and that consequently enterohepatic circulation of methotrexate plays an important role in the pharmacokinetics of the drug.

Diarrhea↗
PubMed1978

Cytostatic-associated vomiting effectively inhibited by domperidone (R 33 812).

The effect of domperidone on vomiting due to cytostatic treatment was studied during a double-blind trial involving 41 patients. One group received the sequence domperidone-placebo and the other the reverse sequence during two consecutive courses of cytostatic therapy (chlormethine alone or in combination with other cytostatics). Domperidone 2 mg/ml or the placebo was injected IV 1 h before the start of the cytostatic treatment. A similar injection was given 4 h later. Presence, duration, and incidence of nausea and vomiting before, during, and after the peak period (period from the second up to and including the sixth hour after cytostatic injection) were measured. With respect to vomiting, domperidone was significantly superior to placebo concerning duration and effect before and after the peak period in both sequences. There was no difference during the peak period. With respect to nausea, domperidone was superior to placebo concerning duration and effect during the peak period in the placebo-domperidone sequence. No difference was observed in the reverse order. A significant superiority of domperidone was noted before the peak period.

Adult↗
PubMed1981

High-dose dexamethasone for prevention of cis-platin-induced vomiting.

Severe, debilitating nausea and vomiting are seen in almost 100% of patients treated with cis-platinum. These side-effects can be so severe and prolonged as to preclude therapy in a large number of patients. Commonly used antiemetics have had only limited success in controlling cis-platinum-induced nausea and vomiting. Various reports have indicated benefits from steroids in this setting. We have tested a high-dose dexamethasone regimen with or without neuroleptics, which inhibits chemotherapy-induced vomiting in 50% of patients failing with prior antiemetics and in 71% of those who had not received prior antiemetics. This treatment was administered on an out-patient basis as it involved oral administration of the antiemetic. Neuroleptic therapy was not randomly assigned, but the results of this pilot study suggest that it did not enhance dexamethasone's efficacy. There were no significant side-effects due to the steroids. The antiemetic effectiveness of dexamethasone was retained through repeated courses of chemotherapy.

Adult↗
PubMed1989

A phase I study of a new 5HT3-receptor antagonist, BRL43694A, an agent for the prevention of chemotherapy-induced nausea and vomiting.

In a phase I study of BRL43694A, a 5HT3-receptor antagonist, a single dose of 40 micrograms/kg was given to 24 patients. All patients received cytostatic treatment expected to cause nausea and vomiting. During the first 24 h, 12 patients were completely protected from nausea and vomiting, 4 experienced nausea and 8 had moderate vomiting; mild headache occurred in 10 patients. No cardiovascular (including ECG) changes took place. Apart from headache, no neurological side effects occurred.

Adult↗