SUMMARY / RELATED TOPICS

Nausea

Nausea is an unpleasant, diffuse sensation of unease and discomfort perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged, has been described as placing discomfort on the chest, upper abdomen, or back of the throat. Nausea is a non-specific symptom; some common causes of nausea are gastroenteritis and other gastrointestinal disorders, food poisoning, motion sickness, migraine and low blood sugar. Nausea is a side effect of many medications including chemotherapy, or morning sickness in early pregnancy. Nausea may be caused by disgust and depression. Medications taken to prevent and treat nausea are called antiemetics; the most prescribed antiemetics in the US are promethazine and the newer effective ondansetron. The word nausea is from Latin nausea, from Greek ναυσία – nausia, "ναυτία" – nautia, motion sickness, "feeling sick or queasy". Gastrointestinal infections and food poisoning are the two most common causes of acute nausea and vomiting. Side effects from medications and pregnancy are relatively frequent.

There are many causes of chronic nausea. Nausea and vomiting remain undiagnosed in 10% of the cases. Aside from morning sickness, there are no sex differences in complaints of nausea. After childhood, doctor consultations decrease with age. Only a fraction of one percent of doctor visits by those over 65 are due to nausea. Gastrointestinal infection is one of the most common causes of acute vomiting. Chronic nausea may be the presentation of many gastrointestinal disorders as the major symptom, such as gastroesophageal reflux disease, functional dyspepsia, peptic ulcer, celiac disease, non-celiac gluten sensitivity, Crohn's disease, upper gastrointestinal malignancy, pancreatic cancer. Uncomplicated Helicobacter pylori infection does not cause chronic nausea. Food poisoning causes an abrupt onset of nausea and vomiting one to six hours after ingestion of contaminated food and lasts for one to two days, it is due to toxins produced by bacteria in food. Many medications can cause nausea; some of the most associated include cytotoxic chemotherapy regimens for cancer and other diseases, general anaesthetic agents.

An old cure for migraine, ergotamine, is well known to cause devastating nausea in some patients. Nausea or "morning sickness" is common during early pregnancy but may continue into the second and third trimesters. In the first trimester nearly 80% of women have some degree of nausea. Pregnancy should therefore be considered as a possible cause of nausea in any sexually active woman of child bearing age. While it is mild and self-limiting, severe cases known as hyperemesis gravidarum may require treatment. A number of conditions involving balance such as motion sickness and vertigo can lead to nausea and vomiting. Dysmenorrhea can cause nausea. Nausea may be caused by anxiety disorders and eating disorders. While most causes of nausea are not serious, some serious conditions are associated with nausea; these include: pancreatitis, small bowel obstruction, cholecystitis, Addisonian crisis, diabetic ketoacidosis, increased intracranial pressure, Spontaneous Intracranial Hypotension, brain tumors, heart attack, carbon monoxide poisoning and many others.

Obstructing disorders Pyloric obstruction Small bowel obstruction Colonic obstruction Superior mesenteric artery syndromeEnteric infections Viral infection Bacterial infectionInflammatory diseases Celiac disease Cholecystitis Pancreatitis Appendicitis HepatitisSensorimotor dysfunction Gastroparesis Intestinal pseudo-obstruction Gastroesophageal reflux disease Irritable bowel syndrome Chronic idiopathic nausea Functional vomiting Cyclic vomiting syndromeOther Non-celiac gluten sensitivity Biliary colic Abdominal irradiation Cardiopulmonary Cardiomyopathy Myocardial infarction Inner-ear diseases Motion sickness Labyrinthitis MalignancyIntracerebral disorders Malignancy Hemorrhage Abscess Hydrocephalus Meningitis EncephalitisPsychiatric illnesses Anorexia and bulimia nervosa DepressionOther Post-operative vomiting Nociception Drugs Chemotherapy Antibiotics Antiarrhythmics Digoxin Oral hypoglycemic medications Oral contraceptivesEndocrine/metabolic disease Pregnancy Uremia Ketoacidosis Thyroid and parathyroid disease Adrenal insufficiencyToxins Liver failure Alcohol Taking a thorough patient history may reveal important clues to the cause of nausea and vomiting.

If the patient's symptoms have an acute onset drugs and infections are likely. In contrast, a long-standing history of nausea will point towards a chronic illness as the culprit; the timing of nausea and vomiting after eating food is an important factor to pay attention to. Symptoms that occur within an hour of eating may indicate an obstruction proximal to the small intestine, such as gastroparesis or pyloric stenosis. An obstruction further down in the colon will cause delayed vomiting. An infectious cause of nausea and vomiting such as gastroenteritis may present several hours to days after the food was ingested; the contents of the emesis is a valuable clue towards determining the cause. Bits of fecal matter in the emesis indicate obstruction in the colon. Emesis, of a bilious nature localizes the obstruction to a point past the stomach. Emesis of undigested food points to an obstruction prior to the gastric outlet, such as achalasia or Zenker's diverticulum. If patient experiences reduced abdominal pain after vomiting obstruction is a eti

Christian Vilches

Christian Alberto Vilches González, known as Christian Vilches, is a Chilean professional footballer who plays as a central defender for Unión La Calera. Vilches began his career at a humble club of his country's third division. In 2004 he signed with a club of the professional first division, he made his professional debut against Unión San Felipe and scored his first goal in the professional football against Cobresal in a 3–3 draw. In 2005, the player was loaned to Unión La Calera, where he remained until June of the following year before returning to the Colony Club. After a nondescript year in 2007, in the following season Vilches was part of his club's historic season, in which the team advanced to the 2008 Clausura final. After his successful participation with Palestino, it was reported that Colo-Colo, one of the Big Three of Chilean football, was interested in him, but he joined Audax Italiano; the player scored. In the following season, after an irregular tournament start, Vilches had a good season with The Italians, being a starter in every match, was nominated in the Chilean team of the year.

He scored 2 goals during the season. After several rumors of Vilches' incorporation to Colo-Colo, his signing was confirmed, he was introduced as club's new player on 23 June 2011. Christian Vilches at Soccerway Cristian Alberto Vilches at BDFA

Ioanel Sinescu

Ioanel C. Sinescu is a Romanian physician, he was born in Iaşi County. Following secondary studies in Iaşi and Câmpulung Moldovenesc, from 1971 to 1977 he attended the military section of the General Medicine Faculty at the Carol Davila University of Medicine and Pharmacy in Bucharest. From 1976 to 1979, he interned at a number of hospitals in Bucharest. From 1980 to 1983, he prepared as a urologist at Fundeni Hospital in the national capital, has worked there as such since 1983, he became a Doctor of Medicine following the publication of a thesis at Carol Davila. Sinescu has studied abroad: in 1984, urological microsurgery at the University of California, Los Angeles School of Medicine and the University of Louisville School of Medicine; that year, Evenimentul Zilei newspaper named him one of Romania's ten best doctors, citing the fact that in the previous eight years, he had performed over 600 kidney transplants with a success rate of more than 97%. Sinescu's mentor and predecessor was Professor Eugeniu Proca.

Sinescu is president of the Romanian Urology Society and belongs to a number of international urological organisations. He has published and is the editor of a four-volume Tratat de Urologie. In addition to several specialty treatises, he is the author of over 200 journal articles, medical films and courses for students. Since 1997, he has headed the Centre for Urological Surgery and Kidney Transplantation at the Fundeni Clinical Institute. Concurrent with his medical practice, he has had Fundeni and Carol Davila. From 1979 to 1983, he was intern teaching assistant, he became prorector at Carol Davila in 2004, advancing to rector in 2012. Sinescu was elected a titular member of the Romanian Academy in 2011. Sinescu's hold on the prorectoral position came under attack in the summer of 2007, when he was accused of copying entire fragments and drawings from a 1957 American textbook for a work on clinical urology he published in 1998. A 2012 report by the National Ethics Council exonerated Sinescu of the plagiarism charges.

In 2007, he drew criticism for the way he handled the prostate operation of the 92-year-old Patriarch of the Romanian Orthodox Church, Teoctist Arăpaşu, following which the latter died. However, he called such statements "irresponsible", was cleared of any wrongdoing several months by an investigative body. Other patients of his have included Radu Câmpeanu. Sinescu and his wife Crina, a professor and cardiologist, have one daughter a physician. In 2000, President Emil Constantinescu awarded him the rank of Commodore of the Order of the Star of Romania. Official site