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These cytokines launch the inflammatory cascade by activating transcription factors like NF-κB, which subsequently upregulate the expression of other cytokines, chemokines, and adhesion molecules

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Chocolate, cheese, monosodium Glutamate) Daily Cannabinoid use (see Cannabinoid Hyperemesis Syndrome) Phases Prodromal: Aura (variably present, lasts minutes to days) Anorexia Abdominal Pain Lethargy Pallor Autonomic Symptoms (Sweating, Salivation) Acute Vomiting and Hyperemesis Episodic intense Nausea and Vomiting Children with 9 to 10 episodes per year on average Adults with 14 to 15 episodes per year on average Vomiting may occur as often as 8 times every hour Onset typically in early morning or middle of the day Duration 1 to 5 days Children average 3 to 4 days Adults average 6 days Recovery Vomiting ceases Energy recovers Appetite returns Inter-episode Remission Asymptomatic between episodes VI