Cases reported "Nausea"

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1/8. The iowa follow-up of chemically sensitive persons.

    Clinical symptoms and self-reported health status in persons reporting multiple chemical sensitivities (MCS) are presented from a 9-year follow-up study. Eighteen (69%) subjects from a sample of 26 persons originally interviewed in 1988 were followed up in 1997 and given structured interviews and self-report questionnaires. In terms of psychiatric diagnosis, 15 (83%) met DSM-IV criteria for a lifetime mood disorder, 10 (56%) for a lifetime anxiety disorder, and 10 (56%) for a lifetime somatoform disorder. Seven (39%) of subjects met criteria for a personality disorder using the Personality Diagnostic Questionnaire-IV. Self-report data from the illness behavior Questionnaire and Symptom checklist-90-Revised show little change from 1988. The 10 most frequent complaints attributed to MCS were headache, memory loss, forgetfulness, sore throat, joint aches, trouble thinking, shortness of breath, back pain, muscle aches, and nausea. Global assessment showed that 2 (11%) had "remitted", 8 (45%) were "much" or "very much" improved, 6 (33%) were "improved", and 2 (11%) were "unchanged/worse". Mean scores on the SF-36 health survey showed that, compared to U.S. population means, subjects reported worse physical functioning, more bodily pain, worse general health, worse social functioning, and more emotional-role impairment; self-reported mental health was better than the U.S. population mean. All subjects maintained a belief that they had MCS; 16 (89%) acknowledged that the diagnosis was controversial. It is concluded that the subjects remain strongly committed to their diagnosis of MCS. Most have improved since their original interview, but many remain symptomatic and continue to report ongoing lifestyle changes.
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keywords = motion
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2/8. Intractable vomiting in diabetic patients.

    Intractable nausea and vomiting have been described in individuals without any underlying physical etiology explaining these complaints. Physical or emotional abuse has been described in individuals suffering from these symptoms and associated with somatoform disorders manifesting primarily as gastrointestinal complaints. We present five patients with long-standing Type 1 diabetes who suffered from intractable vomiting. personality disorders, profound depression and emotional abuse dramatically influenced the course of these patients' illness. In most of the patients, physical symptoms remarkably improved after identification and removal of the triggering factors. Therefore, psychogenic vomiting must be considered among the differential diagnoses of intractable nausea and vomiting, especially in individuals with chronic illnesses. A careful search for a physical etiology and medical treatment that does not cause relief of symptoms should suggest that there is almost certainly a psychological issue at the root of the problem.
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ranking = 2
keywords = motion
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3/8. U.S. navy diver/aviator/skydiver with AGE from a previously unknown PFO.

    A 32 year old US Naval aerospace physiologist with dive, jump and flight qualifications presented to a US Navy hyperbaric medicine department complaining of nausea, unsteadiness and left hand and forearm paresthesia that began almost immediately after completing a 28ft/ 40min recreational dive. Following an abbreviated history and physical examination the patient was diagnosed to be suffering from an arterial gas embolism. He was treated with hyperbaric therapy during which his symptoms resolved. Follow-on transesophageal echocardiography revealed an atrial septal aneurysm with a patent foramen ovale resulting in a right-to-left shunt after valsalva maneuver, but no evidence of ventricular dysfunction, wall motion abnormalities, or abnormal ejection. His episode was attributed to paradoxical air embolism and he was disqualified from further special duty. In order to regain his dive, jump and flight qualifications, the patient elected to undergo repair of the cardiac defect with a device that is relatively new in the operational military setting. The procedure was a success, he was granted waivers for his prior qualifications, and remains in that status to this day. This is the first known case where an atrial septal occluder has been used to preserve these special duty qualifications.
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keywords = motion
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4/8. psychotherapy during radiotherapy: effects on emotional and physical distress.

    The authors determined the effects of ongoing weekly individual psychotherapy on the symptoms of patients undergoing a 6-week course of radiotherapy for cancer. Forty-eight patients were given weekly psychotherapy sessions for 10 weeks; another 52 patients served as control subjects. A statistically significant reduction was found in both emotional and "physical" manifestations of distress in the patients receiving psychotherapy compared with the control group. This was true regardless of gender, ward or private patient status, or knowledge of diagnosis. Patient gender and knowledge of diagnosis did affect the pattern and magnitude of the response to psychotherapy.
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ranking = 5
keywords = motion
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5/8. Chronic intestinal pseudo-obstruction.

    intestinal pseudo-obstruction (IP) is an uncommon disorder of gut motility which must be differentiated from mechanical intestinal obstruction. We have seen 11 such patients over the last 5 years. Characteristic symptoms, shared by mechanical obstruction, include abdominal distention and pain, nausea, and vomiting. Radiologic studies reveal dilated loops of bowel with air fluid levels. In most patients a major differentiating feature from obstruction may be the presence of diarrhea rather than obstipation. steatorrhea is secondary to an overgrowth of anaerobic bacteria in the motionless dilated loops of bowel. IP has been associated with various disorders: in our series two patients had scleroderma, one multiple small bowel diverticula, one systemic amyloidosis, one celiac disease, and one spinal cord injury; in only two patients was the disorder considered "idiopathic." Three patients had previously undergone a jejuno--ileal bypass for morbid obesity. During the acute episode, the patients were treated symptomatically with decompression by nasogastric or rectal tube with fluid and electrolyte replacement. Malabsorption treated with broad spectrum antibiotics reversing the steatorrhea but not episodes of pseudo-obstruction. magnesium deficiency was present in seven patients and its correction resulted in amelioration of the symptom complex. In two patients episodes of pseudo-obstruction were markedly reduced by metoclopramide which was not effective in two others.
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keywords = motion
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6/8. Group psychotherapy during radiotherapy: effects on emotional and physical distress.

    OBJECTIVE: The purpose of this study was to ascertain whether group psychotherapy during radiotherapy for cancer significantly decreases patients' emotional and physical distress. METHOD: Twenty-four patients receiving radiotherapy were randomly selected for group psychotherapy (six patients per group, 90-minute weekly sessions for 10 weeks). Another 24 patients served as control subjects. Each patient was given the Schedule for Affective Disorders and schizophrenia (SADS) at the onset of radiotherapy, midway through radiotherapy, at the end of radiotherapy, and 4 and 8 weeks after radiotherapy ended. RESULTS: The combined SADS items for depression, pessimism and hopelessness, somatic preoccupation and worry, social isolation and withdrawal, insomnia, and anxiety and agitation were used as a measure of emotional distress. The combined SADS items for anorexia, nausea and vomiting, and fatigue were used as a measure of physical distress. By 4 weeks after the end of radiotherapy, the patients who received group psychotherapy showed significant decreases in both emotional and physical symptoms, and the decreases were greater than those for the control patients. The subjects who initially seemed unaware of their cancer diagnoses had the lowest baseline levels of emotional and physical distress, but 4 weeks after the end of radiotherapy they had high distress levels. CONCLUSIONS: Group therapy may enhance quality of life for cancer patients undergoing radiotherapy by reducing their emotional and physical distress. The degree to which patients acknowledge the diagnosis of malignancy may be a factor in their initial distress level and their response to radiotherapy and group therapy.
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ranking = 9
keywords = motion
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7/8. A 33-year-old white female with abdominal pain, nausea, vomiting and hypotension.

    A thirty-three year old female presented to our emergency department complaining of severe abdominal pain, nausea, and vomiting. On physical examination she was hypotensive with a firm, tender abdomen, cervical motion tenderness and a diffuse erythematous rash. A surgical diagnosis of Acute pelvic inflammatory disease was made during laparoscopy. Coagulant studies, liver function tests, culture results, and the desquamation of the patient's palms led to the additional diagnosis of Toxic shock syndrome. A literature search failed to reveal any similar cases of pelvic inflammatory disease (PID) and Toxic shock syndrome (TSS) occurring concomitantly. patients may present severely ill with either of these disease entities but potential for serious illness is greater when both of these syndromes occur in the same patient. We conclude that in patients with a similar presentation, the symptoms should not be attributed completely to PID without further investigation and consideration of a concomitant disease process including TSS.
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keywords = motion
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8/8. Sopite syndrome: a sometimes sole manifestation of motion sickness.

    Drowsiness is one of the cardinal symptoms of motion sickness; therefore, a symptom-complex centering around "drowsiness" has been identified which, for convenience, has been termed the sopite syndrome. Generally, the symptoms characterizing this syndrome are interwoven with other symptoms but under two circumstances the sopite syndrome comprises the main or sole overt manifestation of motion sickness. One circumstance is that in which the intensity of the eliciting stimuli is closely matched to a person's susceptibility, and the sopite syndrome is evoked either before other symptoms of motion sickness appear or in their absence. The second circumstance occurs during prolonged exposure in a motion environment when adaptation results in the disappearance of motion sickness symptoms, except for responses characterizing the sopite syndrome. Typical symptoms of the syndrome are: 1) yawning, 2) drowsiness, 3) disinclination for work, either physical or mental, and 4) lack of participation in group activities. Phenomena derived from an analysis of the symptomatology of the sopite syndrome are qualitatively similar but may differ quantitatively from abstractions derived in other motion sickness responses. One example is the sometimes unique time course of the sopite syndrome. This implies that the immediate eliciting mechanisms not only differ from those involved in evoking other symptoms, but, also, that they must represent first order responses. diagnosis is difficult unless the syndrome under discussion is kept in mind. Prevention poses a greater problem than treatment.
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ranking = 10
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