J Formos Med Assoc
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Sex differences in response to noxious stimuli or analgesia have been demonstrated. We investigated sex differences in conscious sedation during upper gastrointestinal panendoscopic examination with regard to drug dose and entropy scores. ⋯ Women need more analgesic agents than men during panendoscopic examination. There was no significant difference between men and women with regard to anesthetic depth and response to noxious stimuli, as revealed by similar SE and RE values.
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Cyclic vomiting syndrome (CVS) is a periodic and Stereotypic pattern of intractable nausea or vomiting episodes, which has been well-recognized in previous decades, although the actual pathogenesis is still unclear. Recurrent, discrete, but self-limited symptoms of nausea and vomiting bother children, and increase the cost of family and health care. This report described the clinical features of patients who fulfill the diagnostic criteria for CVS. ⋯ The diagnosis of CVS must be based on the detailed history of the clinical manifestations of vomiting pattern, complete symptom-free intervals between the attacks, and absence of neurological, gastrointestinal, or metabolic abnormalities. Most of our patients improve when they grow up, but prompt diagnosis and early intervention may improve quality of life.
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Psychogenic nausea and vomiting is defined as vomiting without any obvious organic pathology or vomiting with a psychological etiology. The treatment for such a condition is a challenge in clinical practice. The first patient was a 46-year-old married factory worker who was repeatedly hospitalized for recurring bouts of nausea and vomiting. ⋯ She was diagnosed with mixed anxiety-depressive disorder. After treatment with 10 mg/day escitalopram, her episodes of nausea and vomiting decreased. Escitalopram may be an effective treatment for psychogenic nausea and vomiting associated with depression.