Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical manifestations in 595 children hospitalized with gastroenteritis during a 15-month time frame were studied. They were divided into eight groups according to etiologic agent: rotavirus (203 patients); Salmonellae (98); Escherichia coli (55); Campylobacter (36); Shigella (22); combined rotavirus and salmonellae (44); combined rotavirus and other bacteria (26); and no pathogen (111). The mean duration of diarrhea was shortest in the rotavirus and "no pathogen" groups (4.8 and 5.6 days, respectively) and longest with pure and mixed salmonella infections (12.3 and 12.9 days, respectively). Associated manifestations were most frequent with salmonellae and least frequent with rotavirus and E. coli infections. Malnutrition also was most common with salmonellae and lowest with rotavirus and E. coli. There were no differences in the frequency of hypernatremia. Hyponatremia was most frequently encountered with salmonella (25% compared to 9% in the rest of the patients). Evidence of septicemia was found in 22 patients, 21 of whom were in the salmonella groups. The four deaths in this series (0.7%) also were in the salmonellae groups. The clinical severity of salmonella infection in developing countries, particularly in young and malnourished children, warrants attention to more intensive management. The selective use of antibiotics may help reduce the mortality and morbidity of gastroenteritis.
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PMID:Acute gastroenteritis: clinical features according to etiologic agents. 340 53

A standardized questionnaire was administered to 65 mothers attending the Nutrition Clinic of the Ahmadu Bellow University Teaching Hospital, Kaduna, Northern Nigeria, over the October-December 1978 period to determine at what age the 1st supplementary diet was introduced, the age the child was weaned, and the weaning practices. The questionnaire dealt with various aspects of weaning knowledge, attitudes, and practices. The mothers were referred to the Nutrition Clinic because their babies already were suffering from protein energy malnutrition, had failed to thrive, or had severe infections, e.g., measles, gastroenteritis, or respiratory diseases. 58 (89.2%) of the families were of low socioeconomic status. 36 mothers (55.4%) introduced supplementary feeds to their babies between 4-6 months of life; 27 (41.5%) mothers introduced supplementary feeds when their children were between 7-9 months. All the mothers used corn, guinea corn, or millet gruel. A decision to wean a child may be made if the child can crawl, walk, or has a good set of erupted milk teeth, even if the child has not reached the traditional weaning age of 20-24 months. The mean age of weaning was 17 months in this study. 51 (78.5%) of the mothers responded to the question about weaning food taboos, prohibitions, and their reasons during the weaning period. Even when protein is available, a child may be denied the protein because of sociocultural factors. The use of carbohydrate gruels among these low socioeconomic families coupled with sociocultural factors compounded the feeding problem, and, consequently, protein energy malnutrition was common during the weaning period.
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PMID:Weaning practices in Kaduna, Northern Nigeria. 361 Feb 98

The 97 infant deaths occurring in June 1982-May 1983 in the Kopay Health Unit in northern Sri Lanka were analyzed to increase understanding of regional differences in infant mortality rates. During the study period, the birth rate was 24.5/1000 and the infant mortality rate was 35.4/1000 for the health unit area of Kopay compared with 28.6/1000 and 18.0/1000, respectively, for the district (Jaffna) to which Kopay belongs. Only 35 (36%) of the 97 infant deaths in Kopay were registered; thus, the official infant mortality rate would have been only 12.8/1000. 51 (53%) of the infant death occurred in the neonatal period, predominantly within the first 7 days of life. Of the 46 postneonatal deaths, 21 involved children over 6 months of age. Lower respiratory tract infections and gastroenteritis accounted for 47% of infant deaths; low birthweight was responsible for an additional 16%. Malnutrition, measles, and unsatisfactory housing conditions contributed to the deaths from lower respiratory tract infection, while severe dehydration and lack of medical treatment accounted for many of the deaths due to gastroenteritis. Overall, 6 of the 26 deaths due to lower respiratory tract infection and 14 of the 20 deaths due to gastroenteritis are considered to have been preventable through improvements in health education and nursing care. Practitioners of indigenous medicine need training on the management of dehydration in infants, and mothers should be taught the proper use of oral rehydration solution. The study also illustrates the impact of social caste on infant mortality. 49 (50%) of the deaths investigated involved families of laborers, who belong to the lowest social ranks in the Hindu caste system in Sri Lanka.
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PMID:Infant deaths in a health unit area of Northern Sri Lanka. 383 24

Between October 1980 and August 1982, 100 patients in the pediatric population at Curran Lutheran Hospital, Zorzor, Liberia were identified as having multiple drug-resistant Salmonella enteritidis serotype enteritidis. The illness usually presented as an enteric fever but also as meningitis, gastroenteritis, empyema, subcutaneous abscesses, chronic otitis media, or a combination of these conditions. Predisposing factors were young age and debilitation from malnutrition or measles. The mortality of infected patients was 27.8%. The organism was originally misidentified as a Citrobacter species because of a delayed reaction on lysine decarboxylase medium. Incubation of the medium for five days resulted in a positive reaction that identified the organism as a Salmonella species. The isolates were resistant to multiple antibiotics. Genes mediating resistance were located on a 120-megadalton conjugative plasmid. A cryptic nonconjugative 40-megadalton plasmid was also present in several isolates.
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PMID:An outbreak of antibiotic-resistant Salmonella enteritidis in Liberia, West Africa. 388 5

To investigate the effect of chronic protein-calorie malnutrition on intestinal repair after an enteric infection, we examined small intestinal structure, enzyme activity, and sodium transport in undernourished piglets during the acute and convalescent phases of a viral enteritis, transmissible gastroenteritis (TGE). Gnotobiotic pigs, nutritionally deprived from the age of 7 days, gained less weight than dietary controls from 14 days of age until the end of the study. Animals from malnourished and control diet groups were inoculated with TGE virus at 22-23 days and studied during the acute (40 h) and convalescent (4, 10, and 15 days) stages of this experimental enteritis along with noninfected dietary controls. After TGE infection, we observed a further decrease in weight gain and an increased mortality only in undernourished pigs. In jejunum and ileum of both dietary groups at 40 h after TGE infection, we observed comparable structural lesions, similar decreased activities of mucosal enzymes (sucrase, lactase, sodium-potassium-dependent ATPase), and increased thymidine kinase activities. Also we noted comparable diminution of glucose-stimulated jejunal sodium absorption in both dietary groups at 40 h. In control diet pigs, transport abnormalities recovered by 4 days after TGE infection and normal mucosal structure and enzyme activity returned over 4-15 days. In undernourished piglets, structural repair and enzyme abnormalities were prolonged when compared with the control diet group; glucose-stimulated sodium transport did not recover until 10 days after infection and never regained the enhanced activity seen in noninfected undernourished controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impact of chronic protein-calorie malnutrition on small intestinal repair after acute viral enteritis: a study in gnotobiotic piglets. 392 24

The leucocyte migration inhibition (LMI) was determined in an assay after in vitro challenge with beta-lactoglobulin. The assay was considered positive when migration inhibition index was greater than 20% (mean +3 SD of healthy infants). Ninety-eight infants with protracted diarrhoea and failure to thrive, 16 healthy, 12 malnourished, and 16 infants suffering from acute gastroenteritis were studied. Of the 98 patients with protracted diarrhoea, 12 fulfilled Goldman's criteria for cow's milk protein intolerance, 63 had lactose malabsorption, and in 15 no associated causative factor was identified. The mean index of migration inhibition in the cow's milk allergic group (58.83 +/- 11.98) was higher than in healthy controls (8.25 +/- 3.91), the difference being statistically significant (p less than 0.05). The test was positive in all patients with cow's milk protein intolerance. The assay was also positive in four other patients suffering from protracted diarrhoea, two of whom had lactose malabsorption. All the infants with acute gastroenteritis and malnutrition had values within the normal range. The migration inhibition index in five patients with cow's milk intolerance had declined to 24.74 +/- 4.87 in assays performed 1-6 weeks after return of clinical tolerance to cow's milk (p less than 0.05) but the test was still within the positive range in three of the five infants. These results suggest that this cell mediated immune assay is a sensitive test for the diagnosis of cow's milk protein intolerance in infants. The specificity needs to be reassessed in the light of more objective criteria for the diagnosis of cow's milk protein intolerance.
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PMID:Leucocyte migration inhibition in cow's milk protein intolerance. 396 62

Successful management of diarrhoea depends firstly on restoring fluid and electrolyte balance. Following this, the child needs to be fed, to prevent malnutrition and morbidity. Conventionally, this is achieved by regrading onto the previous feed. In our series of 42 infants with mild gastroenteritis, six out of 12 infants had persistent diarrhoea after one week on normal infant formula. Twenty-five out of 27 infants who were given a low-lactose formula (HN25) had normal stools within 4 days. (chi2 = 18.487; P less than 0.001). Only two out of 27 infants had a recurrence of loose stools at 1 week and these became normal after regrading back on to HN25. Recovery time was shortened, while nutritional status was maintained. Short-term substitution of a low-lactose formula after rehydration speeds recovery from gastroenteritis.
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PMID:Diarrhoea: after rehydration, what next? 401 54

This editorial reviews current knowledge of the mechanisms by which breastfeeding protects infants against gastroenteritis and other infections. Breast milk averts the disadvantage of contamination with micro-organisms in the handling process common to indigenous foods used in the weaning period and commercial milk products. The infections caused by contaminated food and water compound the malnutrition already caused by inadequate weaning food. Human milk is thought to contain several nonspecific and specific factors that provide protection against infections such as gastroenteristis and upper respiratory tract infections. Analogues to epithelial cell receptors may prevent the mucosal attachment of potential pathogens. Protection of the breast-fed infant against cholera has been shown to be related to the level of the IgA antibodies in the mother's milk against the cholera lipoplysaccharide and enterotoxin.
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PMID:Breast-feeding as a protection against gastroenteritis and other infections. 405 Apr 10

Hospitalized infants suffering from acute diarrhea were used to test simple bedside methods of determining reducing substances and pH in multiple fresh stool specimens. 332 infants were tested, and thetests were useful in detecting a reduced capacity to tolerate lactose in 77% of these patients. Lactose intolerance was considered to be present when the stools had a carbohydrate content greater than .25% and/or a pH of less than 6. 75 of 77 lactose-tolerant patients recovered within 3 weeks of administration of a milk formula, whereas 111 of 195 with mild intolerance and 13 of 60 with severe lactose intolerance recovered while receiving the milk formula. Diarrhea of greater than 3 weeks duration occurred in 27% of those cases with mild and in with untreated severe intolerance; however, with prompt dietary treatment, a 62% of those cases favorable response always occurred. Lactose intolerance was positively correlated with increased severity of malnutrition; there were no correlations with previous episodes of gastroenteritis, with presence of enteropathogens or with associated infections. When antibiotic therapy was instituted, the stool pH increased toward alkaline, but the excretion of carbohydrates was not modified.
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PMID:Carbohydrate intolerance in infants with diarrhea. 517 Nov 4

Dr. Grayson (February 21, p. 445) asks about changes in vital statistics of 3rd world populations as they develop. Of African populations, those in Johannesburg and other large South African cities, while still in transition, have now reached a relatively high level of sophistication. Their health pattern is likely to be that of other African countries as they prosper. The (IMR) infant mortality rate of blacks in Soweto, Johannesburg, is about 40/1000 live births, although nearer 30 in the regularly employed elite. This figure is similar to that for blacks in New York in 1965 and for class 5 persons in the United Kingdom. Small-town dwellers have higher IMRs and in rural areas the rates are higher still although they are decreasing everywhere. Family size is decreasing; in urban areas the average family has 3-4 children and the elite have 2-3. In Johannesburg during the 1960s, the birth rate was about 40/1000 and it is now 25. While the rate is higher in rural areas, it is falling. In the very young, gastroenteritis with or without malnutrition is still the leading cause of sickness and death in both urban and rural areas. Rates are however decreasing. Deficiency diseases, especially pellagra, remain a health problem in some areas. Tuberculosis still continues to be a major hazard although it is being dealt with. With the rise in socioeconomic status and associated changes in diet and lifestyle, obesity, especially in urban areas and especially among women, is becoming very prominent. Hypertension is more common and is the leading cause of natural death among urban dwellers. The toll from coronary heart disease and noninfective bowel disease remains inexplicably low, but diabetes is only somewhat less prevalent than it is among whites. Changes in cancar pattern and rates are slight; however, esophageal cancer in men and cervical cancer in women are the main causes of concern in the urban centers and some rural areas. Rising alcohol consumption is a major problem with its ramifications in pancreatic, liver, and heart problems. Cigarette smoking is now as common as among whites. Because of low rates for most degenerative diseases, blacks have, at middle age, a life expectancy exceeding that of whites. As sections of the 3rd world population prosper, the IMR decreases enormously as does family size. However, infections and malnutrition among the very young and tuberculosis in older groups remain important problems. Among adults, rises occur in some degenerative diseases but not in others, and diseases linked with hypertension and alcohol consumption have become formidably common, as they have in other developing and developed countries.
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PMID:Third World policies and realities. 611 Sep 78


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