nausea vomiting and bowel disturbance

... including postprandial fullness, early satiety (an inability to complete a meal due to premature fullness), bloating, eructation (belching), and anorexia Nausea and Vomiting Mechanisms Vomiting is ... stem and is effected by neuromuscular responses in the gut, pharynx, and thoracoabdominal wall The mechanisms underlying nausea are poorly understood but likely involve the cerebral cortex, as nausea ... abdominal complaints including nausea, vomiting, heartburn, regurgitation, and dyspepsia (the presence of symptoms thought to originate in the gastroduodenal...

Ngày tải lên: 06/07/2014, 15:21

... obstruction and inflammation of hollow and solid viscera may produce vomiting as the main symptom Gastric obstruction results from ulcer disease and malignancy, while small -bowel and colonic ... Postoperative Gastroparesis vomiting Intestinal pseudoobstruction Functional dyspepsia Gastroesophageal reflux Chronic idiopathic nausea Functional vomiting and Cyclic vomiting syndrome Biliary ... and induces strictures Biliary colic causes nausea via action on visceral afferent nerves Vomiting with pancreatitis, cholecystitis, and appendicitis is due to localized visceral irritation and...

Ngày tải lên: 06/07/2014, 15:21

... benefit in patients with chronic idiopathic nausea and functional vomiting as well as in diabetic patients with nausea and vomiting whose disease is of long standing ... reactions, hyperprolactinemic effects (galactorrhea and sexual dysfunction), and irreversible tardive dyskinesia Table 39-2 Treatment of Nausea and Vomiting Treatm Mechanism Examples ent Clinical ... intestinal biopsy to evaluate for smooth muscle or neuronal degeneration Nausea and Vomiting: Treatment General Principles Therapy of vomiting is tailored to correction of medically or surgically remediable...

Ngày tải lên: 06/07/2014, 15:21

... include prior caustic ingestion, achalasia, and the hereditary disorder tylosis Esophageal adenocarcinoma usually complicates long-standing acid reflux Between and 20% of GERD patients exhibit intestinal ... calcium channel blockers, theophylline, and progesterone promote acid reflux Other exogenous stimuli that induce acid reflux include ethanol, tobacco, and caffeine via LES relaxation Genetic ... ulcer disease are gastric infection with H pylori and use of NSAIDs Other rare causes of gastroduodenal ulcer include Crohn's disease (Chap 289) and Zollinger-Ellison syndrome (Chap 287), a condition...

Ngày tải lên: 06/07/2014, 15:21

... individuals with upright symptoms Sucralfate is a salt of aluminum hydroxide and sucrose octasulfate that buffers acid and binds pepsin and bile salts Its efficacy in GERD is felt to be comparable to that ... on demand depending on symptom severity Many patients initially started on a proton pump inhibitor can be stepped down to an H2 antagonist Combination therapy with a proton pump inhibitor and an ... for severe disease unless given at high doses that elicit side effects (diarrhea and constipation with magnesium- and aluminum-containing agents, respectively) Alginic acid in combination with...

Ngày tải lên: 06/07/2014, 15:21

... of nausea and vomiting Approach to the Patient: Nausea and Vomiting History and Physical Examination The history helps define the etiology of unexplained nausea and vomiting Drugs, toxins, and ... infarction and congestive heart failure are cardiac causes of nausea and vomiting Postoperative emesis occurs after 25% of surgeries, most commonly laparotomy and orthopedic surgery, and is more ... carcinoma Patients with gastroesophageal reflux may report nausea and vomiting, as some individuals with functional dyspepsia and irritable bowel syndrome Three other functional disorders without...

Ngày tải lên: 06/07/2014, 15:21

... anticipatory nausea and vomiting Therapy of delayed emesis 1–5 days after chemotherapy is less successful Neurokinin NK1 antagonists (e.g., aprepitant) exhibit antiemetic and antinausea effects ... current drug regimens produce greater reductions in vomiting than in nausea The clinician should exercise caution in managing the pregnant patient with nausea Studies of the teratogenic effects of available ... both the acute and delayed periods after chemotherapy Cannabinoids such as tetrahydrocannabinol, long advocated for cancer-associated emesis, produce significant side effects and exhibit no more...

Ngày tải lên: 06/07/2014, 15:21

... associated bloating, belching, or nausea Functional dyspepsia overlaps with other functional bowel disorders such as irritable bowel syndrome The physical exam with GERD and functional dyspepsia usually ... mesenteric ischemia, thyroid and parathyroid disease, and abdominal wall strain cause dyspepsia Extraperitoneal etiologies of indigestion include congestive heart failure and tuberculosis Approach ... is intermittent and not generalized or localized to other regions Others experience a postprandial distress syndrome characterized by fullness occurring after normal-sized meals and early satiety...

Ngày tải lên: 06/07/2014, 15:21

... review on the diagnosis and treatment of gastroparesis Gastroenterology 127:1592, 2004 [PMID: 15521026] Schwartzberg LS: Chemotherapy-induced nausea and vomiting: Clinician and patient perspectives ... response to proton pump inhibitors, and those who have esophageal motor disturbances Fundoplications are performed laparoscopically when possible and include the Nissen and Toupet procedures in which ... esophageal disorders Gastroenterology 130:1459, 2006 [PMID: 16678559] Hasler WL, Chey WD: Nausea and vomiting Gastroenterology 125:1860, 2003 [PMID: 14724837] Kahrilas PJ, Lee TJ: Pathophysiology...

Ngày tải lên: 06/07/2014, 15:21

... fracture and a Colles’ fracture, and one woman had a hip fracture and another lower radial fracture ‡One woman had a hip fracture and a Colles’ fracture, one woman had a hip fracture and a spine ... endometrial sampling before randomization if they had a uterus and were randomly assigned after July 8, 1994 (Endometrial sampling upon study entry was optional for participants randomly assigned before ... mammogram within 180 days before randomization that showed no evidence of breast cancer; 6) had normal white blood cell and platelet counts and normal hepatic and renal function tests; 7) not...

Ngày tải lên: 15/02/2014, 04:20

... number of features, m1 and m2 , and D2 and D2 are the means and variances vec1 tors of parameters vectors p1,k , k = 1, 2, , M p , and p2,k , k = 1, 2, , M p p1,k and p2,k are feature vectors ... in Section and v(n) is independently and identically distributed (i.i.d.) noise as normal N (0, σv ) and independent of { f (n)}, {h(n)}, {i(n)}, and {t(n)} In (2), A0 (n), f0 (n), and θ0 (n) ... voltage signals with and without disturbances and M p denotes the total number of feature vectors for the classes of disturbances associated with the presence or not of disturbances The symbol...

Ngày tải lên: 22/06/2014, 20:20

... cm, and 43% between 16 to 20 cm These increases differ from those presented by Adams and Froehlich (1981) and Incerti et al (1987) but can be explained by different soil types and conditions, and ... core sampler, and all sample points were randomly selected Traffic and sampling occurred during the wet period Soil water content in undisturbed areas 84% in surface (0-10 cm deep) and 66% in the ... (1987) the median and the range for each treatment can indicate the difference between treatments In the skid trails with a 10 and 20% the median and also the mean, geometric mean and the range decreased...

Ngày tải lên: 08/08/2014, 23:21

... extracellular domain: ligand binding Apart from the intrinsic interest of unravelling the molecular basis of ligand binding and the mechanism of receptor activation, understanding of ligand–receptor interactions ... Grb10/Grb14 and cell motility in the case of Grb7 Grb10 is most highly expressed in muscle, and also in fat and in foetal but not adult liver Grb14 on the other hand is most highly expressed in liver, and ... resistance, dyslipidaemia and the risk of cardiovascular disease Conclusions References 460 461 461 15 Insulin Resistance, Hypertension and Endothelial Dysfunction Stephen J Cleland and John M C Connell...

Ngày tải lên: 09/08/2014, 15:20

... Tiengo, A and Soeters, P B., eds Amino Acids and Protein Metabolism in Health and Disease London: Smith-Gordon, 133–139 93 Barrett, E J., Revkin, J H., Young, L H., Zaret, B L., Jacob, R and Gelfand, ... including liver and intestine are the main contributors to protein turnover WHOLE BODY AND REGIONAL PROTEIN TURNOVER 119 Insulin and regional protein metabolism in type diabetic patients and healthy ... Draznin, B and Rizza, R A., eds Clinical Research in Diabetes and Obesity, Part I: Methods, Assessment, and Metabolic Regulation Totowa, NJ: Humana, 137–170 Giffin, B F., Drake, R L., Morris, R E and...

Ngày tải lên: 09/08/2014, 15:20

... input and gut- and stomachderived hormones such as ghrelin and cholecystokinin may influence food intake and energy homeostasis via neuronal circuitries that overlap with those of leptin and insulin.31, ... Figdor, R., Allen, A M and Mendelsohn, F A (1987) Localization and characterization of insulin receptors in rat brain and pituitary gland using in vitro autoradiography and computerized densitometry ... Castillo, M J and Lefebvre, P J (1994) How to measure insulin action in vivo Diabetes Metab Rev 10, 151–188 Landau, B R., Wahren, J., Chandramouli, V., Schumann, W C., Ekberg, K and Kalhan, S...

Ngày tải lên: 09/08/2014, 15:20

... Labrie, F., Belanger, A., Cusan, L and Candas, B (1997) Physiological changes in dehydroepiandrosterone are not reflected by serum levels of active androgens and estrogens but their metabolites: ... troglitazone,112 – 114 rosiglitazone115, 116 and pioglitazone117 all reduce fasting and postprandial plasma glucose by around mmol/l, and glycosylated haemoglobin A1 by between and 1.5 per cent When combined ... Guy-Grand, B., Froguel, P and Vaisse, C (2000) The Pro115Gln and Pro12Ala PPAR gamma gene mutations in obesity and type diabetes Int J Obes Relat Metab Disord 24, 391–393 Poulsen, P., Andersen,...

Ngày tải lên: 09/08/2014, 15:20

... PA level and fasting (p < 0.002) and h insulin (p < 0.001) Direction and magnitude of effect 320 PHYSICAL ACTIVITY AND INSULIN RESISTANCE To assess the association between PA and fitness and insulin ... Wolever and Bolognesi examined the effect of both the amount and source of carbohydrate consumed on postprandial glucose and insulin responses to mixed meals of varying total energy, fat, protein and ... BMI (or BF%) and waist circumference Body composition (DXA) and BMI Confounders adjusted for Positive relationship between PA and IS (p = 0.06) and an inverse association between PA and fasting...

Ngày tải lên: 09/08/2014, 15:20

... melanocortin receptors and is a potent appetite effector276 and therefore represents a strong case as a candidate gene for obesity and consequently the metabolic syndrome The murine and human AgRP orthologs ... robust, and intense work lies ahead in order to define the genetic aetiology of the disease The present review of epidemiological, Mendelian and syndromic data; candidate genes and polymorphisms; and ... distribution and health in obesity Ann NY Acad Sci 904, 491–501 Randle, P J., Garland, P B., Hales, C N and Newsholme, E A (1963) The glucose fatty acid cycle: its role in insulin sensitivity and metabolic...

Ngày tải lên: 09/08/2014, 15:20

... ovarian hyperandrogenism and without hyperinsulinaemia (+, − and −), with ovarian hyperandrogenism and without hyperinsulinaemia (+, + and −) and with both ovarian hyperandrogenism and hyperinsulinaemia ... analogues, Rosenfield and colleagues have coined the term ‘functional ovarian hyperandrogenism,’ as an alternative to PCOS.19 HYPERANDROGENISM AND HYPERINSULINISM 16.3 489 Hyperandrogenism and hyperinsulinism ... they are too laborious, time consuming and invasive, especially in children and adolescents Surrogates based on fasting glucose and insulin and on insulin and glucose responses to oral glucose...

Ngày tải lên: 09/08/2014, 15:20

... and ketogenesis, and decreases triglyceride and cholesterol synthesis and lipogenesis in liver It also decreases lipolysis and lipogenesis in adipose tissues while increasing glucose uptake and ... level of Acrp30 is reduced in obesity and type diabetes and is correlated with insulin resistance and hyperinsulinaemia.173, 174 PPARγ ligands increase expression and plasma concentrations of this ... 54 Crave, J C., Fimbel, S and Lejeune, H et al (1995) Effects of diet and metformin administration on sex hormone binding globulin, androgens, and insulin in hirsute and obese women J Clin Endocrinol...

Ngày tải lên: 09/08/2014, 15:20