Abstracts
Acupuncture (Vomiting)
Acupuncture
Stimulation of acupuncture point P6 (Neiguan: the sixth point on the pericardial meridian) is an effective antiemetic therapy in postoperative, "pregnant" and chemotherapeutic patients.
Acupuncture techniques on P6 include manual needling, electrostimulation and acupressure. It is more effective in preventing vomiting than in treating established "emetic" symptoms.
"Acupuncture and Treatment of Vomiting", Fitzpatrick, Kieran/Mechanisms and Control of Emesis, Bianchi, A.L., et al, Eds, Colloque INSERM/John Libbey Eurotext, Ltd. 1992:307-312.
Adolescents (Vomiting)
Adolescents
Examined and compared a wide range of health behaviors among adolescent boys and girls.
Among boys, factor analysis revealed five factors:
(1) risk-taking behaviors,
(2) school-related behaviors,
(3) "quietly" disturbed behaviors (e.g., frequent dieting, self-induced vomiting, suicide attempts),
(4) health-promoting behaviors; and
(5) exercise.
(6)
Among girls, 4 similar factors emerged.
Boys and girls engaging in health-promoting behaviors were less likely to have unhealthy eating behaviors, while those engaging in quietly disturbed behaviors, risk-taking behaviors, and problematic school behaviors were more likely to have unhealthy eating behaviors.
Neumark-Sztainer D et al., Covariations of eating behaviors with other health-related behaviors among adolescents. J Adolesc Health, 1997 Jun, 20:6, 450-8.
Chiropractic (Vomiting)
Chiropractic
A case report of a 33-year-old woman "suffering" from scapulalgia who was treated by chiropractic manipulation. Immediately after an abrupt rotational head movement, she experienced a severe rotary vertigo with "nausea" and vomiting.
She did not have any "tinnitus" or hearing impairment. She was admitted to the emergency room that day. Her ENT examination was normal. She had a vertical downbeat nystagmus occurring during Roses's positions. She eventually had doppler sonography and vertebral angiograms, which showed a dissection of both extracranial vertebral arteries. She was treated with antiplatelet drugs, a soft collar to limit neck motion and her clinical course was favorable. Two months later, her doppler sonography was normal.
Chiropractic neck manipulation is the most frequent cause of traumatic vertebral artery dissection.
"Vertigo as Manifestation of Vertebral Artery Dissection After Chiropractic Neck Manipulations", Vibert, Dominique, et al, ORL, 1993;55:140-142.
Clear Liquid Diet
Clear Liquid Diet
The reinstitution of oral intake in patients who have undergone intra-abdominal surgery has traditionally progressed in a stepwise fashion. Various retrospective studies and anecdotal reports have suggested that a "regular" diet as the first postoperative meal is well tolerated. Although clear liquids are accepted as the standard first postoperative meal, there appears to be little scientific data to support their use.
Determined whether there is any difference in tolerance to clear liquids versus a regular diet as the first postoperative oral intake.
Those receiving a regular diet were not found to have any statistically significant increase in dietary intolerance in comparison with the clear liquid group.
Nutritional data collected in a subset of patients revealed a higher caloric intake in those assigned to a regular diet.
Results suggest that the routine use of clear liquids as the initial postoperative diet may be unnecessary and nutritionally suboptimal when compared with a regular diet.
Jeffery KM et al., The clear liquid diet is no longer a necessity in the routine postoperative management of surgical patients. Am Surg, 1996 Mar, 62:3, 167-70.
Dental Erosion
Dental Erosion
Determined the influence of oral hygiene practices and additional fluoride on erosive tooth wear in eating disorders.
Only 8 bulimics spent more time brushing after vomiting than at other times. The pH of vomitus from 6 subjects ranged between 2.9 and 5.0, with a mean of 3.8, well below the critical pH for enamel demineralization to occur. Of the 20 follow-up subjects, 12 (60%) exhibited worsening tooth wear.
The contribution by toothbrush abrasion to the overall wear in the eroded dentition of bulimics is not significant. Therefore, immediate post-vomiting oral hygiene practices can be recommended.
Milosevic A et al., Dental erosion, oral hygiene, and nutrition in eating disorders. Int J Eat Disord, 1997 Mar, 21:2, 195-9.
Diarrhea (Vomiting)
Diarrhea
Diarrhea and vomiting are common symptoms in infants up to 6 months of age. While the symptoms often reflect a gastrointestinal disorder, the attending physician needs to be aware of possible non gastrointestinal causes.
Such symptoms occurring in the newborn often point to congenital causes. Dehydration and nutrition are the key points needing attention in the management of diarrhea in infants.
Drugs virtually have no role in the management of diarrhea and vomiting in infants.
Patrick MK: Vomiting and diarrhoea. Aust Fam Physician, 1994 Oct, 23:10, 1913, 1916-9.
Hyperemesis Gravidarum
Hyperemesis Gravidarum
Evaluated the nutritional status of patients with hyperemesis gravidarum and the effect of a treatment regimen administered during hospitalization.
Blood nutrient status was reassessed after 10 days of treatment with an intravenous saline solution containing a multivitamin preparation and again at day 20.
Mean dietary intake of most nutrients fell below 50% of the recommended dietary allowances and differed significantly from that of controls.
More than 60% of the patients had suboptimal biochemical status of thiamine, riboflavin, vitamin B6, vitamin A, and retinol-binding protein. Vitamin C, calcium, albumin, hematocrit, and hemoglobin values were significantly higher in those patients where the duration of vomiting had been longer, suggesting the presence of dehydration.
Treatment was associated with cessation of vomiting and improvement in blood nutrient status. Pregnancy outcome was favorable in all patients.
The hyperemetic pregnant patient is at nutritional risk; prompt initiation of corrective therapy is recommended.
van Stuijvenberg ME et al., The nutritional status and treatment of patients with hyperemesis gravidarum. Am J Obstet Gynecol, 1995 May, 172:5, 1585-91.
Pregnancy (Vomiting)
Pregnancy
The nutritional status of the woman with hyperemesis of pregnancy has been compromised by decreased food intake and increased nutrient loss.
Interventions may begin with dietary and life-style alterations, proceed to oral nutritional supplementation or pharmacologic preparations, and continue on to intravenous vitamin-mineral therapy and either enteral tube feedings, parenteral nutrition, or both.
Newman V et al., Clinical advances in the management of severe nausea and vomiting during pregnancy. J Obstet Gynecol Neonatal Nurs, 1993 Nov-Dec, 22:6, 483-90.
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