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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Immediate oral therapy at home by the mother using a sugar-salt solution offers a real prospect of reducing mortality from gastroenteritis among preschool children in the developing world. The sugar-salt solution enables the mother to take action against a disease which is the most frequent cause of death among young children. In Lagos, Nigeria, knowledge of the treatment has diffused rapidly in a low-income community served by a clinic run by the Institute of Child Health. In a recent study, women expecting their 1st child and others who had never used the service were able to describe the sugar-salt solution treatment taught to all who attend the clinic. However, of the 217 women who described the method, less than 1/2 (34%) could give the correct proportions of sugar and salt to be used (4 teaspoons and 1/4 teaspoon respectively in a standard local beer bottle filled with water). Most errors involved the use of too much salt. In nearly 1/2 these cases, 4 times too much salt was described, and in 3 cases, 16 times too much salt. Under these circumstances, we can expect a possible increase in children admitted with hypernatremia, a situation which would bring the method into disrepute. Any attempt to transfer health skills to mothers in developing countries must recognize, as in this example, the problems posed by lack of education and unfamiliarity with measurement terms such as "1/4" or even "a teaspoon." What is required is a simple measuring spoon giving the actual quantity to be used. Manufactured on a large scale in plastic, this would be inexpensive. Ideally, every mother of a preschool child should have 1, but where this is not possible, all health workers should have such spoons so that they can measure into a mother's hand the correct amounts. In this way the mother can make correct use of a treatment which has such potential for saving lives.
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PMID:Oral therapy of infant diarrhoea. 7 26

The feeding habits of 70 infants under 6 months old hospitalized with acute gastroenteritis were studied to determine whether current efforts to discourage high-solute feeding were having an effect on the incidence of hypernatremic dehydration. Fifteen infants (21%) were fed modified (low-solute) milks and 55 (79%) unmodified (high-solute) milks. Of 47 infants under 3 months old, 15 (32%) had commenced mixed feeding. Plasma sodium level was estimated in 60 infants. Mean values in the modified and unmodified groups were the same, at 137 mEq/liter. Only one infant was hypernatremic (sodium level, 152 m/eq/liter). Osmolalities of 65 samples of milk were measured to provide a measure of milk concentration. Only ten (16%) exceeded by more than 25% that recommended by the manufacturers. Twenty-two (34%) were less than 75% of the recommended concentrations. These improved feeding practices have probably contributed largely to the very low incidence of hypernatremia by preventing dangerously high solute intakes at a time of particular vulnerability.
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PMID:The declining incidence of infantile hypernatremic dehydration in Great Britain. 58 18

In a survey of 674 children admitted to the main gastroenteritis unit in Newcastle upon Tyne from 1971 to 1975 there was a noticeable reduction in the incidence of severe dehydration and hypernatraemia, though there was no appreciable change in many characteristics of the patients. This period coincided locally (and nationally) with a determined effort on the part of health visitors and doctors to encourage mothers to breast-feed and to advise them to avoid giving concentrated milk feeds and ensure an adequate water intake during febrile illnesses. This may have contributed towards a reduction in the severity of the illness in children with gastroenteritis admitted to hospital. The overall mortality and the incidence of neurological complications in cases of hypernatraemia are low compared with previous reports.
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PMID:Survey of gastroenteritis in children admitted to hospital in Newcastle upon Tyne in 1971-5. 84 40

This paper describes an infant with gastroenteritis, who developed hypertension and oedema after administration of inaccurately prepared oral glucose salt solution. The renin aldosterone system was suppressed in this child and it was suggested that this may be a factor in the development of hypernatraemia when abnormal water losses occur in infants fed on hyperosmolar feeds. Unless salt can be given accurately in small amounts it may be safer to advise feeds of glucose only in infants with mild diarrhoea.
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PMID:Hypertension, oedema, and suppressed renin aldosterone system due to unsupervised salt administration. 119 Aug 14

Gangrene of the extremities complicating diarrhoea and severe hypernatraemic dehydration occurred in 6 infants. This is a rare complication of gastroenteritis, and its association with hypernatraemia does not seem to have previously been emphasized. The increased blood viscosity resulting from serum hyperosmolarity may have been responsible for the gangrene, and studies in our patients suggested that disseminated intravascular coagulation was present. In addition to fluid and electrolyte replacement, the infants were treated with heparin with some recovery of the affected extremities.
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PMID:Peripheral gangrene in hypernatraemic dehydration of infancy. 120 Jun 77

Infants presenting with hypernatraemic dehydration were studied prospectively in order to describe its incidence and the predisposing factors. Five hundred and twenty children with gastroenteritis were admitted to the Paediatric Unit of Hail General Hospital over a 1-year period from 1 June 1985 to 1 June 1986. Twenty-five children (4.8%) had hypernatraemia (Na+ greater than 150 mmol/l) and all 25 were under 1 year of age, 23 (92%) being under 6 months. Twenty (80%) came from families living in the villages and had a poor educational background. All the babies were bottle-fed. The majority of the mothers did not know how to prepare food hygienically and with the appropriate water/milk proportions. Most of the infants presented with high fever (+39 degrees C) and the majority were underweight for their age. Two babies died and one had evidence of neurological damage. This study indicates that the incidence of hypernatraemic dehydration is significant in this region and causes serious morbidity and mortality. It confirms the importance of breast-feeding and the need to educate the public in the proper preparation of bottle feeds when breast-feeding is not possible.
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PMID:Hypernatraemic dehydration in the Hail region of Saudi Arabia. 170 42

We evaluated the efficacy and safety of an oral rehydration solution containing glycyl-glycine, glycine, and maltodextrin (GGG-ORS), in comparison to the glucose based ORS (standard ORS). The osmolality of the GGG-ORS (305 mOsm/l) and standard ORS (311 mOsm/l) was similar. Ninety-two children presenting with acute gastroenteritis and moderate dehydration, aged 3 months to 3 years, were randomly assigned to receive standard ORS or GGG-ORS. All the patients were successfully rehydrated orally. The two groups were comparable for baseline characteristics including the microbial etiology. Rotavirus (49%, 36%), ETEC (11%, 18%) or a combination of rotavirus and ETEC (15%, 9%) were the main stool pathogens isolated. There was no significant difference in the mean stool output or duration of diarrhoea between the two groups. Patients in the GGG-ORS group had higher urine output (p less than 0.01) and weight gain (p less than 0.05) in the initial 6 hours when feeding was withheld, but no such differences were observed beyond this period. Hypernatremia did not develop in any patient during the study. We conclude that glycine and glycyl-glycine supplemented oral rehydration solution does not have any therapeutic advantage in the treatment of acute gastroenteritis with moderate dehydration caused predominantly by rotavirus.
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PMID:Glycine, glycyl-glycine and maltodextrin based oral rehydration solution. Assessment of efficacy and safety in comparison to standard ORS. 220 Nov 65

A prospective study over a one year period examined preadmission illness and its treatment, social characteristics and referral patterns, and inpatient illness progression in 1148 children admitted with a primary diagnosis of gastroenteritis. Admissions were predominantly from socially disadvantaged families: 712 (62%) from social classes IV and V. Approximately a quarter were referred with minimal symptoms, only 12 (1%) with moderate to severe dehydration, and eight (less than 1%) with hypernatraemia. One hundred and ninety two of 1101 (17%) had not seen their general practitioner during the acute illness. One third had received no treatment and one third inappropriate antibiotics, antidiarrhoeals, antiemetics, or changes of milk. Gastroenteritis is a less severe illness than formerly but remains a significant cause of paediatric morbidity. Suboptimal treatment is common. Improved local district hospital and community based resources are needed.
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PMID:Admission to hospital with gastroenteritis. 237 13

One hundred and sixteen children (less than 2 years old) admitted to a London hospital with acute gastroenteritis were randomized to receive either an oral rehydration solution (ORS) with low sodium and high glucose concentration (Na+ 35, glucose 200 mmol/L), an ORS with a high sodium but low glucose concentration (Na+ 60, glucose 111 mmol/L), or an ORS containing glycine and a glucose polymer (Na+ 50, glucose 50, glycine 50 mmol/L). Clinical, biochemical and haematological features of the three groups were similar on admission. Rotavirus was common (31%); the majority of children had minimal dehydration or acid-base disturbance. The clinical outcome, including ORS intake, prevention of dehydration, rehydration, and duration of hospital stay was similar in the three treatment groups. All initial electrolyte abnormalities were corrected; no child developed hypernatraemia or hyponatraemia. At 24 h, the mean serum urea was higher in those who received the ORS containing glycine than in other groups, and it had not fallen significantly since admission. Eighteen per cent of children had carbohydrate intolerance: four children with greater than or equal to 2% reducing substances in their stool had all received ORS with a high glucose content and had numerous watery green stools containing rotavirus. All ORS solutions were safe and effective for rehydration and correction of biochemical abnormalities, however carbohydrate intolerance was more prevalent in children who received the ORS with a high glucose content.
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PMID:Evaluation of three oral rehydration solutions designed for use in developed communities. 252 Jun 19

During seven epidemics of rotavirus from 1978 to 1987, 575 children younger than 3 years were admitted to hospital with acute gastroenteritis. The management before and during hospitalization, the status on admission and the outcome are reviewed. The mean age of the patients rose significantly during the study period, with the proportion younger than 12 months decreasing from 50 to 26%. Mild to moderate iso-osmolal dehydration was found in most cases, both hypernatraemia and hyponatraemia were rare. The home management had usually consisted of fasting except for "clear fluids". Oral rehydration and rapid feeding in hospital according to modern principles accelerated weight gain, shortened the duration of diarrhoea and the hospital stay and reduced the requirement for intravenous fluid therapy. This experience, together with the current rarity of acute gastroenteritis in young infants and of delay in recovery, suggests that oral rehydration and realimentation should be more extensively used in general practice.
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PMID:Acute gastroenteritis. Changing pattern of clinical features and management. 259 74


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