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)

With worldwide use of oral rehydration solutions, the treatment of acute diarrhea does not pose much of a problem. However, chronic diarrhea is still harmful, especially for the growth and development status of the children. Between January 1993 to December 1996, patients who suffered from chronic diarrhea for more than one month duration and admitted to Dr. Sami Ulus Children's Hospital were evaluated for epidemiological and etiologic factors. Seventy consecutive patients were evaluated. The mean age was 40.8 months and 52% were males. Malnutrition was detected in 80% of cases. Etiologic factors included celiac disease 30%, cow milk allergy 17%, bacterial and parasitic factors 26%, cystic fibrosis 10% and postinfectious gastroenteritis 10%. Eosinophilic gastroenteritis, chronic nonspecific diarrhea, pseudo-obstruction, neurofibromatosis and inflammatory bowel disease were rarely detected. Celiac disease and cow milk allergy were implicated as the most common causes of chronic diarrhea. The vicious cycle of faulty nutrition, malnutrition and infection and postinfectious enteropathy were also significant factors in the etiology of chronic diarrhea. It may be considered that cow milk protein prick test, sweat test, immunologic tests and mucosal biopsies should be performed for the definite diagnosis of chronic diarrhea.
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PMID:Etiology of chronic diarrhea. 1079 25

Twenty-seven out of five hundred and fifty three patients hospitalized for visceral leishmaniasis (Kala-azar) died during treatment with sodium antimony gluconate. Data from these patients were evaluated to find out the cause of death. Eight patients had associated diseases such as pulmonary tuberculosis (3), severe malnutrition (1), acute gastroenteritis (1), spleenic infarction (1), acute renal failure (1) and atrial septal defect (1) which could be attributed to death. Twelve patients developed spontaneous haemorrhages from nose, gums and gastrointestinal tract and died, despite of adequate supportive measures. Seven other patients who were improving slowly with antimony therapy died unexpectedly. Though, cause of death could be explained in some patients with associated disease conditions, it could not be explained in others as significant clinical manifestations, haematological, biochemical and electrocardiographic alterations were not evident prior to death. Our impression is that mortality in Kala-azar patients during standard antimonial therapy is more related to the drug rather than the disease process.
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PMID:Deaths in visceral leishmaniasis (Kala-azar) during treatment. 1096 76

The present population in South Africa, roughly 43 million inhabitants, is made up of Africans (77.2%), whites (10.5%), Coloureds (mixed race) (8.8%) and Indians (2.5%). In 1900 the infant mortality rate (IMR) among Africans was 330 per 1,000 live births; this has now fallen to 50-60. In Soweto, a primarily African city, IMR averages 20-25. Life expectancy in the past was only 25-30 years; by 1995, this reached 63 years. However, this could fall again due to the rapidly spreading HIV/AIDS epidemic. Life expectancy could fall to 40-45 years by 2010 with the AIDS epidemic being the cause of half of all deaths--a disastrous change from the previous relatively commendable public health situation. Formerly, the most common causes of deaths in young people were infections, diseases associated with malnutrition and gastroenteritis. Adults died almost solely from infections, including typhoid, dysentery, malaria and tuberculosis (TB). Even though diseases associated with malnutrition are less common today, many infections still remain a major problem, particularly TB, which is increasing. As late as 1970, Africans who reached 50 years had longer life expectancy than whites due to the low prevalences of the chronic diseases of lifestyle. This is no longer so, due to the recent rises in non-communicable disorders/diseases, principally obesity in women, hypertension, diabetes, stroke and the cancers of prosperity. In the not so distant future, the level of control of HIV/AIDS related diseases will be the major health/disease regulating factor among Africans. Among white, Coloured and Indian populations, there have been falls in the mortality rates of the young and, despite rises in lifestyle diseases, increases in life expectancy are continuing. For all populations other important public health regulatory factors include water supply, sanitation, clinic/hospital services and personal environmental factors, employment, dietary pattern and intake, smoking practices and alcohol consumption and physical activity, particularly in urban dwellers. Unfortunately, public health expenditure, also a highly regulating factor, has fallen from 8.2% of the gross domestic product in 1994 to 4.1% in 2000.
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PMID:Changes in public health in South Africa from 1876. 1146 13

The effects of measles are relatively mild in well-nourished children, but are associated with high mortality in those who are malnourished and in those who have other diseases. Complications may include bacterial pneumonia, bronchitis, otitis media, gastroenteritis, myocarditis, hepatitis, and encephalomyelitis. The Expanded Program on Immunization was introduced to India in 1978, but measles immunization did not commence until 1985 under the Universal Immunization Program. Total district coverage was achieved in 1990, followed by a peak immunization coverage figure of 90.9% in 1991. Coverage rates declined, however, to 85.8% in 1992-93. Impressive though they may be, these coverage rates obfuscate the reality that measles remains a major cause of morbidity and childhood mortality in India. Coverage levels remain under 50% in many tribal and remote areas, with 49,453 notified cases at the time of printing. Overall case fatality rates for the country are in the range of 2-15% due to a synergistic relationship between malnutrition and infection. One must therefore not rest in the fight against measles. Sudden outbreaks should be reported immediately and vitamin A supplements and immunization supplies readied in anticipation of epidemic. The many reasons why vaccine coverage rates remain low in some areas include the failure of many parents, health personnel, and some doctors to regard measles as a serious disease; restrictive vaccine administration directives requiring the presence of a physician; physician reticence to open a 10-dose vial for 1-2 patients; and parental and physician reluctance to immunize children who are slightly ill or where minor adverse side reactions such as fever and rash may be anticipated.
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PMID:Measles is down but not out. 1217 72

Staff from a maternal and child health (MCH) center in urban Shebeen El Kom and from an MCH center in rural Om-khnan in Menoufia Governate, Egypt followed 200 newborn infants for 6 months. The mean birth weight stood at 3.3 kg, mean birth length 50.2 cm, mean head circumference at birth 34.5 cm, and the mean mid arm circumference at birth 10.2 cm. Infants which were exclusively breast fed lost 14 percentiles of weight for age from birth-6 months while those which were exclusively formula fed lost 18 percentiles. On the other hand, those which received solid food in addition to breast milk gained 24 percentiles. Similarly, exclusively breast fed infants lost 6 percentiles of length for age and exclusively formula fed infants lost 8 percentiles. Infants which breast fed and had solid food supplements gained 14 percentiles. In addition, breast fed infants regardless of solid food supplementation maintained their percentiles for age for head circumference while formula fed infants lost 8 percentiles. The reduced growth velocity in formula fed infants may be due to dilutions of formula and an increased incidence of infections, especially gastroenteritis. After 3-4 months of lactation, the breast milk yield fell in the mothers who exclusively breast fed their infants which may have caused a reduction in growth velocity. No group of infants experienced an increase in protein energy malnutrition. Even though there was a reduced growth velocity in these infants, research shows that breast fed infants maintain a better health status and have fewer infections than nonexclusively breast fed infants. In fact, no evidence exists that shows more rapid growth of normal neonates to be desirable.
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PMID:Breast feeding and infant growth, a follow-up study in Menoufia, Egypt. 1228 20

Almost two-thirds of the deaths of children around the world are directly or indirectly associated with nutritional deficiencies. Both protein-energy malnutrition and micronutrient deficiencies increase the risk of death from common diseases such as acute gastroenteritis, pneumonia and measles. Iron deficiency anemia is estimated to affect almost 25% of the world's population (equivalent to 3.5 billion people) resulting in high economic costs by adding to the burden on healthcare services, affecting learning in school and reducing adult productivity. Dietary practices frequently seen in older children and adolescents from industrialized countries, leading to frequent consumption of often nutrient-poor foods, may also put them at risk of micronutrient deficiencies. Marginal nutrient deficiencies in the developed world are increasingly accepted as risk factors for the development of chronic disease such as cardiovascular disease or some cancers.
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PMID:Global patterns of child health: the role of nutrition. 1242 75

Azathioprine is commonly prescribed for autoimmune hepatitis and inflammatory bowel disease. An acute gastroenteritis-like syndrome has been ascribed to azathioprine use, but chronic diarrhea has not. We report a patient with autoimmune hepatitis who developed severe small-bowel villus atrophy and chronic diarrhea after azathioprine was initiated (50 mg/day). We present a case report of a patient followed up prospectively. Duodenal mucosal histology and expression of brush border enzyme dipeptidyl peptidase IV and peptide transporter PepT1 messenger RNA levels were determined before and after azathioprine discontinuation. Chronic diarrhea developed several weeks after the initiation of azathioprine and resulted in micronutrient depletion and severe protein-calorie malnutrition, which was unresponsive to oral pancreatic enzyme therapy or a gluten-free diet. Severe malabsorption required parenteral nutrition support for longer than 1.5 years; this was complicated by unstable blood glucose control, acute calculous cholecystitis, catheter sepsis, and severe venous thrombosis. When the temporal association between azathioprine and diarrhea was identified, the drug was tapered while the patient consumed an unrestricted diet. Within 2 weeks after azathioprine was discontinued, diarrhea had completely resolved, and parenteral nutrition was discontinued. Mucosal biopsies obtained before and 4 months after azathioprine discontinuation showed complete reversal of severe duodenal villus atrophy and marked up-regulation of mucosal dipeptidyl peptidase IV and PepT1 messenger RNA. The patient has subsequently maintained normal liver function tests on low-dose prednisone alone, with normal stools and stable nutritional status for longer than 4 years. Azathioprine can induce severe small-bowel villus atrophy, diarrhea, and malabsorption that is reversible with drug discontinuation.
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PMID:Severe villus atrophy and chronic malabsorption induced by azathioprine. 1280 28

Australian Aboriginal children hospitalized with diarrhoeal disease have severe manifestations with acidosis, hypokalaemia, osmotic diarrhoea and abnormal small bowel permeability. Nitric oxide (NO) production is increased in diarrhoeal disease, but its relationship to mucosal function and diarrhoeal complications is not known. We examined the relationship between NO production and complications of acute diarrhoea in Aboriginal and non-Aboriginal children between February 1998 and February 2000. We enrolled 318 children admitted to Royal Darwin Hospital into one of three groups: acute diarrhoea, non-diarrhoeal controls with no inflammatory illness, and non-diarrhoeal controls with inflammatory illness. Nitric oxide production was measured by urine nitrate-creatinine (NOx/Cr) excretion on a low nitrate diet. Small bowel intestinal permeability was measured by the lactulose-rhamnose (L/R) ratio on a timed blood specimen. The NOx/Cr ratios were markedly elevated in Aboriginal diarrhoeal cases (geometric mean [GM] = 1.23, 95% confidence interval [95% CI] 1.07-1.44), lowest in non-Aboriginal non-inflammatory controls (GM = 0.13, 95% CI 0.10-0.16) and intermediate in all other groups (GM = 0.35, 95% CI 0.28-0.43). Convalescent levels (day 5) in the Aboriginal diarrhoeal group (GM = 1.02, 95% CI 0.82-1.28) were slower to fall than L/R ratios. Multivariate analysis in the diarrhoeal group indicated that high NO production was associated with abnormal permeability, hypokalaemia and malnutrition, but not with the severity of diarrhoea, acidosis or osmotic diarrhoea. We concluded that increased NO production may contribute to impaired mucosal barrier function and hypokalaemia in acute gastroenteritis, which may be the cost of the known gut-protective and antimicrobial effects mediated by NO in acute intestinal inflammation.
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PMID:Increased nitric oxide production in acute diarrhoea is associated with abnormal gut permeability, hypokalaemia and malnutrition in tropical Australian aboriginal children. 1288 17

Despite much progress in the understanding of pathogenesis and of management, diarrhoeal illnesses remain one of the most important causes of global childhood mortality and morbidity. Infections account for most illnesses, with pathogens employing ingenious mechanisms to establish disease. In the developed world, an upsurge in immune-mediated gut disorders might have resulted from a disruption of normal bacterial-epithelial cross-talk and impaired maturation of the gut's immune system. Oral rehydration therapies are the mainstay of management of gastroenteritis, and their composition continues to improve. Malnutrition remains the major adverse prognostic indicator for diarrhoea-related mortality, emphasising the importance of nutrition in early management. Drugs are of little use, except for specific indications although new agents that target mechanisms of secretory diarrhoea show promise, as do probiotics. However, preventive strategies on a global scale might ultimately hold the greatest potential to reduce the burden of diarrhoeal disease. These strategies include vaccines and, most importantly, policies to address persisting inequalities between the developed and developing worlds with respect to nutrition, sanitation, and access to safe drinking water.
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PMID:Diarrhoea in children: an interface between developing and developed countries. 1498 92

We present a group of 18 illegal immigrant stowaways who arrived in a shipboard cargo container suffering from gastroenteritis, dehydration, and malnutrition and showing evidence of viral myocarditis in 3 of 4 fatalities. Our investigation included an evaluation of the 2-week ocean voyage, analysis of medical records and laboratory results of the survivors, autopsies on the decedents, and viral studies on their heart tissue. Of 3 stowaways who died shipboard, 2 showed lymphocytic myocarditis and 1 could not be evaluated histologically due to decomposition. A fourth stowaway died 4 months after arrival with dilated cardiomyopathy and lymphocytic myocarditis. Reverse-transcriptase polymerase chain reaction and nucleotide sequencing of viral isolates from the decedents' heart tissues demonstrated Coxsackie virus B3 genome. We believe that these cases represent an outbreak of viral myocarditis, exacerbated by acute dehydration and malnutrition, due to confinement within the shipping container. Our evidence indicates that close confinement promoted the spread of the virus, and nutritional deprivation increased the stowaways' vulnerability. Furthermore, our observations support the conclusion, based on experimental studies, that nutritionally induced oxidative stress increased the virulence of the etiologic viral agent. In summary, these cases represent a potential infectious disease hazard of illegal immigration.
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PMID:Unexpected hazard of illegal immigration: Outbreak of viral myocarditis exacerbated by confinement and deprivation in a shipboard cargo container. 1516 61


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