OBJECTIVETo explore prodromes of chemotherapy-induced vomiting (CIV) and their association with CIV in lung cancer patients.

METHODSThe prodromes of CIV in 250 lung cancer patients were analyzed. Logistic regression was used to determine the symptoms most likely correlated with CIV. One hundred fifty-seven patients received medical interventions. The development of correlative symptoms and occurrence of CIV between the intervention and non-intervention groups was analyzed.

RESULTSAmong the 250 patients with the prodromes of CIV, the incidence rate of CIV was 67.2%. Logistic regression indicated that nausea, constipation, insomnia, hiccups, anorexia, and history of drinking were correlated with CIV (P < 0.05 for all). Among the 20 symptoms observed in this study, the incidence rates of relatively common symptoms were nausea (72.0%), anorexia (68.4%), taste changes (48.8%), constipation (45.6%), abdominal distension (45.6%), stomach distension(40.4%), and insomnia (40.0%). The incidence rats of all symptoms except hiccups before and after intervention had significant difference (P < 0.05 for all). The incidence rates of CIV were 30.0% in the intervention group and 50.6% in the non-intervention group, with a significant difference between the two groups (P = 0.009).

CONCLUSIONSProdromes of CIV are closely related to the occurrence of CIV. Timely intervention for prodromes of CIV can reduce the incidence rate of CIV during chemotherapy in lung cancer patients.

Animals ; Antineoplastic Agents ; adverse effects ; Humans ; Lung Neoplasms ; epidemiology ; Nausea ; chemically induced ; diagnosis ; epidemiology ; Rats ; Vomiting ; chemically induced ; diagnosis ; epidemiology

BACKGROUND/AIMS: Gastrointestinal (GI) symptoms are common among patients with non-insulin dependent diabetes mellitus (NIDDM). Our aim was to investigate the frequency of chronic GI symptoms in Korean patients with NIDDM. METHODS: A cross-sectional survey, using a reliable and valid questionnaire, was performed in diabetes clinics from seven hospitals of the Catholic University of Korea. RESULTS: A total of 608 patients (249 males and 359 females, mean age 53.7+/-10.9 years) were investigated. The frequencies of weekly heartburn and acid regurgitation (esophageal symptoms) were 7.1% (95% confidence interval [CI], 5.0 to 9.2) and 4.4% (95% CI, 2.8 to 6.1), respectively. The frequency of dyspepsia was 13.2% (95% CI, 10.5 to 15.8). The frequencies of constipation and diarrhea were 15.0% (95% CI, 12.2 to 18.0) and 5.3% (95% CI, 3.5 to 7.1), respectively. Nausea and the use of manual maneuvers to facilitate defecation were more prevalent in women than in men. Constipation and fecal incontinence were more common in diabetes patients with long duration (>10 years). Fecal incontinence and using laxatives were more frequent in the complicated diabetes group. Using laxatives was more frequent in the uncontrolled diabetes group. CONCLUSIONS: Two-thirds of diabetic patients experienced GI symptoms. The prevalence of GI symptoms was more common in patients who had diabetic complications and a long duration of diabetes.
Adult ; Aged ; Constipation/epidemiology ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*complications ; Dyspepsia/epidemiology ; Female ; Gastrointestinal Diseases/*epidemiology ; Humans ; Male ; Middle Aged ; Nausea/epidemiology ; Prevalence ; Sex Characteristics ; Vomiting/epidemiology

BACKGROUND/AIMS: Migraine is frequently accompanied by symptoms consistent with functional gastrointestinal disorders (FGIDs). This study evaluated the prevalence of functional gastrointestinal symptoms and assessed the symptoms' relationship with the concomitant functional symptoms of anxiety, depression, and headache-related disability. METHODS: This prospective study included 109 patients with migraine who were recruited from a headache clinic at a teaching hospital. The participants completed a self-administered survey that collected information on headache characteristics, functional gastrointestinal symptoms (using Rome III criteria to classify FGID), anxiety, depression, and headache-related disability. RESULTS: In total, 71% of patients met the Rome III criteria for at least one FGID. In patients with FGID, irritable bowel syndrome was the most common symptom (40.4%), followed by nausea and vomiting syndrome (24.8%) and functional dyspepsia (23.9%). Depression and anxiety scores were significantly higher in patients meeting the criteria for any FGID. The number of the symptoms consistent with FGID in individual patients correlated positively with depression and anxiety. CONCLUSIONS: FGID symptoms defined by the Rome III criteria are highly prevalent in migraine. These symptoms correlate with psychological comorbidities, such as depression and anxiety.
Adolescent ; Adult ; Aged ; Anxiety/epidemiology/psychology ; Comorbidity ; Depression/epidemiology/psychology ; Disability Evaluation ; Dyspepsia/epidemiology/psychology ; Female ; Gastrointestinal Diseases/*epidemiology/*psychology ; Humans ; Male ; Middle Aged ; Migraine Disorders/*epidemiology/*psychology ; Nausea/epidemiology/psychology ; Prevalence ; Prospective Studies ; Republic of Korea ; Vomiting/epidemiology/psychology ; Young Adult

Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.
Antidepressive Agents ; Chronic Pain ; Citalopram ; Dopamine ; Epidemiology* ; Fibromyalgia ; Fluvoxamine ; Headache ; Humans ; Nausea* ; Norepinephrine ; Psychiatry ; Psychophysiologic Disorders ; Serotonin ; Sertraline ; Treatment Failure ; Vomiting* ; Weight Gain*

The familial environment may also play an important role in the epidemiology of HCV infection through vertical and horizontal transmission by infected household members. However, it is still controversial whether familial clustering of HCV occurs. We experienced a case of familial clustering of hepatitis C virus. A 10-year old girl presented with nausea, vomiting and anorexia for a month was diagnosed as hepatitis C. Her mother, grandmother, a maternal aunt and her daughter had contracted with HCV. Her laboratory findings showed AST/ALT 63/122 IU/L, positive anti-HCV Ab and HCV RNA (3.54 x 10(5) copies/mL). Pathologic findings of the liver biopsy revealed chronic hepatitis with minimal lobular activity, mild porto-periportal activity and mild portal fibrosis. After treatment with interferon-alpha 2b for 6 months, the clinical symptoms and laboratory findings were normalized.
Anorexia ; Biopsy ; Child ; Cluster Analysis* ; Epidemiology ; Family Characteristics ; Female ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Interferon-alpha ; Liver ; Mothers ; Nausea ; Nuclear Family ; RNA ; Vomiting

OBJECTIVES: This study was carried out to understand the prevalence and risk factors of green tobacco sickness (GTS) among Korean tobacco harvesters. METHODS: The authors conducted a questionnaire among the tobacco harvesters (842 persons from 449 out of 500 tobacco harvesting households) in Cheongsong-gun for 4 days from Sep 1 to 4, 2003. RESULTS: The study subjects contained 440 males and 402 females. The prevalence of GTS in 2003 was 39.2%, and was significantly higher in females (53.4%) than in males (25.6%, p<0.01). The incidence density of GTS according to the number of workdays in 2003 was 11.5 spells/100 person-days. The GTS symptoms reported by the tobacco harvesters in 2003 were nausea in 320 cases (97.0%), dizziness in 311 cases (94.2%), headache in 264 cases (80.0%) and vomiting in 209 cases (63.3%) etc. Through multiple logistic regression, the factors significantly associated with GTS were found. Odds ratio for smoking, age over sixty(compared with under forties), and working over 10 hours(compared with under 10 hours) were respectively 0.23 (95% CI: 0.16~0.33), 0.46 (95% CI: 0.23~0.93), and 1.53 (95% CI: 1.12~2.10). CONCLUSIONS: Our studies before this, there were significant recall bias by time lag between harvesting period and survey time. We tried to study promptly after harvesting tobacco leaves to solve this recall bias. More extensive epidemiologic studies, and educations for harvesters are expected.
Bias (Epidemiology) ; Dizziness ; Epidemiologic Studies ; Female ; Headache ; Humans ; Incidence ; Logistic Models ; Male ; Nausea ; Nicotine ; Odds Ratio ; Poisoning ; Prevalence* ; Risk Factors* ; Smoke ; Smoking ; Tobacco* ; Vomiting ; Surveys and Questionnaires

OBJECTIVETo investigate the treatment time dependence of electroacupuncture (EA) on Neiguan (PC6) for preventing postoperative nausea and vomiting (PONV).

METHODSOne hundred and seventy-eight patients, who had received intravenous patient-controlled analgesia (PCA) with Fentanyl, were assigned randomly to three groups using random numbers: a pre-operative EA group (PrEA), a post-operative EA group (PoEA), and a non-acupuncture control group (NC). An anesthetist evaluated the incidence and severity of nausea and vomiting for 48 h after surgery blindly. The main outcomes were severity and freguency of PONV, which were measured with a self-reported questionnaire and a confirmation from the anesthetist. The data were analyzed with ANOVA and Z-test.

RESULTSThe incidence of nausea and vomiting was significantly lower in the PrEA group than the NC group during 48 h after surgery (P<0.01, P<0.05). The incidence of vomiting was also significantly lower in the PrEA group than the PoEA group (P<0.05). The PoEA subjects evidenced no significant differences compared with the NC subjects in terms of the incidence of nausea and vomiting (P<0.05). The severity of nausea was significantly lower in the PrEA group than in the NC and PoEA groups (P<0.05).

CONCLUSIONSEA on PC6 is effective in the prevention of PONV, and pre-operative acupuncture is more effective than post-operative acupuncture.

Acupuncture Points ; Adult ; Analgesics, Opioid ; adverse effects ; Electroacupuncture ; Female ; Humans ; Incidence ; Laparoscopy ; adverse effects ; Male ; Middle Aged ; Postoperative Nausea and Vomiting ; epidemiology ; etiology ; prevention & control

Postoperative nausea and vomiting (PONV) is one of the most common and distressing complications after surgery. An identification of risk factors associated with PONV would make it easier to select specific patients for effective antiemetic therapy. We designed a case-controlled study to identify the risk factors for PONV in 5,272 surgical patients. At postoperative 2 and 24 hr, patients were visited and interviewed on the presence and severity of PONV. Thirty nine percent of patients experienced one or more episodes of nausea or vomiting. Five risk factors were highly predictive of PONV: 1) female, 2) history of previous PONV or motion sickness, 3) duration of anesthesia more than 1 hour, 4) non-smoking status, and 5) use of opioid in the form of patient controlled analgesia (PCA), in the order of relevance. The formula to calculate the probability of PONV using the multiple regression analysis was as follows: P (probability of PONV)=1/1+e(-Z), Z=-1.885+0.894 (gender)+0.661 (history)+0.584 (duration of anesthesia)+0.196 (smoking status) +0.186 (use of PCA-based opioid) where gender: female=1, male=0; history of previous PONV or motion sickness: yes=1, no=0; duration of anesthesia: more than 1 hr=1, less than or 1 hr=0; smoking status: no=1, yes=0; use of PCA-based opioid: yes=1, no=0.
Anesthesia/*statistics and numerical data ; Case-Control Studies ; Female ; Humans ; Korea/epidemiology ; Male ; Outcome Assessment (Health Care)/*methods ; Postoperative Nausea and Vomiting/*epidemiology ; Prevalence ; Prognosis ; *Proportional Hazards Models ; Reproducibility of Results ; Research Support, Non-U.S. Gov't ; Risk Assessment/*methods ; Risk Factors ; Sensitivity and Specificity

OBJECTIVE: To investigate the advantages and disadvantages of sevoflurane-N2O inhalation anesthesia with laryngeal mask airway (LMA) and propofolketamine total intravenous anaesthesia in children undertaking strabismus surgery. METHODS: Eighty children undertaking strabismus surgery were randomly divided into sevoflurane-N2O inhalation anaesthesia group with LMA (volatile group, n=40) and propofol-ketamine total intravenous anesthesia group (TIVA group, n=40). LMA was used to secure respiratory airway in the volatile group, but LMA or endotracheal intubation was not used in the TIVA group. All children breathed spontaneously during operative period. The anesthesia was maintained with 2%-3% sevoflurane-50% N2O-50% O2 in the volatile group, and continuous intravenous infusion with propofol 5-10 mg/(kg x h) plus ketamine 1-2 mg/(kg x h) in the TIVA group. The incidence of SpO2 less than 95% and the movement of the limbs and head induced by operative stimulation, oculocardiac reflex (OCR) and postoperative vomiting (POV) were recorded in all children. RESULTS: The incidence of limbs and head movement, the incidence of SpO2 less than 95% and OCR were significantly lower in the volatile group than those in the TIVA group (P < 0.01); but the incidence of POV was significantly higher in the volatile group than that in the TIVA group (P < 0.01). CONCLUSION Sevoflurane-N2O-O2 anesthesia with LMA can secure respiratory airway of patients, avoid hypoxemia, and have good anesthetic quality and low OCR incidence. It is a new anesthesia method with more advantages in children undertaking strabismus surgery, but the prevention and treatment of POV must be noticed.
Anesthesia, Intravenous ; Anesthetics, Inhalation ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Ketamine ; Laryngeal Masks ; Male ; Methyl Ethers ; Nitrous Oxide ; Ophthalmologic Surgical Procedures ; Postoperative Nausea and Vomiting ; chemically induced ; epidemiology ; Propofol ; Sevoflurane ; Strabismus ; surgery

OBJECTIVETo evaluate the efficacy of transcutaneous electroacupoint stimulation with a train-of-four (TOF) mode for the prevention of postoperative nausea and vomiting (PONV) in the patients undergoing laparoscopic cholecystectomy.

METHODSNinety-six ASA Grade I - II patients scheduled for laparoscopic cholecystectomy were randomized into Neiguan (P6) electroacupoint stimulation group (treated group) and a placebo control group (placement of electrodes without electroacupoint stimulation). The anesthetic regimen was standardized by needling at Neiguan on the left side and connecting the TOF peripheral nerve stimulator. The incidence of nausea, vomiting, severity, antiemetic dosage and the degree of pain were assessed at 0, 60, 120 min, and 24 h after surgery.

RESULTSThe incidence of nausea and vomiting, the dose of antiemetics and the occurrence of severe nausea were all significantly lower in the treated group compared with the control group and the score for pain was obviously reduced in patients of the treated group at 24 h post-operation (P<0.05 or P<0.01).

CONCLUSIONTranscutaneous electroacupoint stimulation at P6 with the TOF mode could reduce the incidence and severity of nausea and vomiting with analgesic effects.

Acupuncture Points ; Adult ; Antiemetics ; therapeutic use ; China ; epidemiology ; Cholecystectomy, Laparoscopic ; adverse effects ; Female ; Humans ; Incidence ; Intraoperative Period ; Male ; Pain ; pathology ; Postoperative Nausea and Vomiting ; drug therapy ; epidemiology ; prevention & control ; Transcutaneous Electric Nerve Stimulation ; methods