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

In acute diarrhea of infancy we distinguish between infectious and noninfectious causes. In the latter we know some autosomal recessive disorders, e.g. the glucose-galactose-malabsorption, the lactase deficiency as well as the sucrase-isomaltase deficiency. In addition the most frequent acquired disorders like the cow's milk protein intolerance and celiac disease contribute also to the group of noninfectious causes of diarrhea. Here the most effective therapy consists of the elimination of the toxic agent from the diet. In infectious diarrhea we find most frequently rotavirus as the agent but also yersinia, campylobacter fetus, salmonella, shigella, E. coli, lamblia giardia and entameba hystolytica. Generally a conservative treatment with a dietetic regimen is preferred. Only in severe cases with yersinia and campylobacter infection the addition of antibiotic drugs is necessary. Giardia lamblia and amebiasis however have to be treated with metronidazol. As the absorption of glucose is coupled with that of sodium within the small intestine in acute gastroenteritis we find a combined disturbance between salt and carbohydrate absorption. A solution containing glucose and salt is recommended therefore for oral rehydration. The amount administered within the first 24 hours should be between 150-250 ml/kg per day. So called "antidiarrhoic drugs" are questionably effective.
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PMID:[Useful and superfluous measures in the treatment of infant diarrhea]. 717 37

During July 6-August 2, 1990, at the outpatient clinic at Children's Hospital in Bangkok, Thailand, pediatricians recruited the first 5-7 children aged less than 5 with acute diarrhea to a study to determine the incidence, clinical presentation, and severity of human rotavirus (HRV) diarrhea during the monsoon season. The study also aimed to examine the reliability of the detection methods for HRV and the different HRV electropherotypes. 103 cases of gastroenteritis were compared with 44 controls. 17% of cases had a household diarrheal contact. 18% of cases excreted HRV, while none of the controls did. 69% of HRV cases were infants. Vomiting and moderate dehydration occurred significantly more often in HRV cases than non-HRV cases (84% vs. 57% and 47% vs. 12%, respectively; p 0.05). HRV cases were more likely to receive intravenous fluids than non-HRV cases (47% vs. 19%; p 0.01). The researchers used IDEIATM ELISA as the standard for comparison with other screening methods since it is highly reliable. Electron microscopy (EM) and polyacrylamide gel electrophoresis (PAGE) had the highest sensitivity and specificity levels (84 and 90 vs. 80 for latex particle agglutination [LPA] and 100 vs. 81 for LPA, respectively). PAGE found 94.7% of HRV positive samples were of subgroup II and 5.3% of subgroup I. Nine different HRV electropherotypes were identified. EM identified adenovirus in 11 cases. These findings suggest that IDEIATM ELISA and PAGE can be both diagnostically and epidemiologically useful for HRV infection in areas with limited access to expensive equipment.
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PMID:Rotavirus diarrhoea in Thai infants and children. 767 16

In 1991, in the rural Butajira district in southcentral Ethiopia, field workers visited every household weekly to collect morbidity data on 1315 under-five children so researchers could estimate morbidity and public health risk factors of childhood disease. The Butajira Rural Health Project, begun in 1986, is a continuous demographic surveillance system. 13.2% of the children had more than five episodes of illness. 24.2% had no episodes. 22% of the children had more than 50% of all illness episodes. The incidence of overall illness was 2.34 episodes/person-year, equalling 5.8% of child days. The incidence of reported illness and derived entities fell sharply after a child reached 1 year. The peak incidences of acute respiratory infection (ARI) and acute lower respiratory infection (ALRI) were 3-6 months and 1-6 months, respectively. Gastroenteritis incidence peaked at 1-6 months. The most prevalent conditions were ARIs (prevalence 2.8%) and acute diarrhea (2.4%). The sanitation index had a significant impact on gastroenteritis and ARI, especially gastroenteritis. Parental indices also affected gastroenteritis and ARI. Living in a rural area increased the likelihood of ARI. Lack of electricity or piped water were also important determinants of illness. Illiteracy among parents was associated with an increased morbidity rate among under-fives.
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PMID:A one-year community study of under-fives in rural Ethiopia: patterns of morbidity and public health risk factors. 771 57

Epidemics of cholera caused by Vibrio cholerae 01 occur regularly in India. Until recently, Vibrio cholerae non-01 have been the the causative agents of sporadic cases of gastroenteritis and septicaemia, especially in immunocompromised children. We describe a large outbreak of cholera-like illness from North India caused by Vibrio cholerae non-01, later serotyped as Vibrio cholerae 0139. Forty-one of a total of 391 patients with acute diarrhoea during a 2-month period (May-July 1993) were identified as having Vibrio cholerae in faecal samples. All patients were aged 1.5-12 years. Vibrio cholerae 0139 was isolated in 30 patients (73%-group I) and Vibrio cholerae 01 biotype eltor in 11 patients (27%-group II). The clinical presentation and severity of the cholera-like illness were similar to typical cholera. This strain is toxigenic with an epidemic potential and should be monitored carefully.
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PMID:Diarrhoeal outbreak of Vibrio cholerae 0139 from north India. 775 10

The prevalence of infections with H1N1- and H3N2-influenza viruses, porcine respiratory coronavirus (PRCV), transmissible gastroenteritis virus (TGEV) and porcine epidemic diarrhoea virus (PEDV) in feeder pigs shortly after their entry into fattening units was examined. Ten groups of pigs with acute respiratory disease during the months September to October 1991 and seven groups of pigs with acute diarrhoea during the months February to March 1992 were investigated. On arrival in the fattening herds, more of the pigs were negative for antibodies against H1N1-influenza virus and against PRCV during September to October (61 and 50 per cent, respectively) than in February to March (51 and 34 per cent, respectively). There was serological evidence of a triple infection with PRCV and both influenza viruses in seven of the 17 groups; dual infections with PRCV and H1N1-influenza virus occurred in nine groups and with H1N1- and H3N2-influenza viruses in one group. Seroconversion against TGEV was not detected in any of the 17 groups, but seven of them had seroconverted to PEDV. Multiple infections with PRCV and either one or both of the influenza viruses were thus very common shortly after the introduction of feeder pigs into the fattening herds. There was no association between the type and/or multiplicity of these infections and respiratory disease, but infections with PEDV were clearly associated with outbreaks of diarrhoea.
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PMID:Prevalence of infections with enzootic respiratory and enteric viruses in feeder pigs entering fattening herds. 790 Feb 43

In Latin America, acute gastroenteritis remains to be an important cause of morbidity in adults and a major cause of morbidity and mortality in children. A child under 5 years of age belonging to a low income segment of the Latin American population will develop 5 to 10 bouts of diarrhea every year. The bacterial and viral enteropathogens associated with acute diarrhea are reviewed in this article. Updated information on epidemiologic, clinical, and pathogenic aspects for the relevant enteropathogens is discussed with special emphasis on regional data when available. The current diarrheogenic E. coli classification is particularly discussed. A diagnostic approach to acute gastroenteritis for both the clinical and research laboratories in Latin America as well as guidelines for treatment are proposed.
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PMID:Acute gastroenteritis in Latin America. 802 50

Gastroenteritis in children is usually treated with the graded introduction of milk feeds after rehydration. Although having never been rigorously tested, the practice of gradually increasing milk strength over several days has been considered an appropriate means of warding against lactose intolerance and preventing sensitization to cow's milk antigens. These guidelines were formulated in Europe and North America and invariably lead to a reduction in nutrient intake. Malnourished children in developing countries, however, may experience an average 5-6 episodes of acute diarrhea per year and the nutrient effects are cumulative. A recent study from Latin America explored whether continued feeding is safe for infants under age 6 months and whether malnourished children respond adversely. Infants randomly assigned to receive full strength cow's milk immediately after rehydration did not have more treatment failures, higher stool outputs, or longer lasting diarrhea than those whose feeds were regarded to full strength over 48 hours. It is unclear, however, whether the youngest or more malnourished subjects were overrepresented in the treatment failures. Results also indicate that deciding to change treatment should not be dictated by the presence of reducing substances in the faeces; the majority of infants with reducing substances in their stools did well. This study offers the first scientific support for rapidly reintroducing full-strength milk formula after gastroenteritis is malnourished patients under 6 months of age. The 10% of infants in which dehydration recurs after reintroducing milk feeds are still difficult to manage. In the absence of yogurt or lactose-free formula, a locally-produced modular feed of chicken, starch, and vegetable oil may be suitable.
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PMID:Dietary management of acute diarrhoea in childhood. 809 51

Diagnostic and therapeutic approach to children admitted because of acute gastroenteritis has been retrospectively evaluated by auditing the hospital records in two periods respectively before (A: 103 patients) and after (B: 133 patients) the use of oral rehydration solution. Incomplete history taking was found out without differences between the two periods; in many cases the weight loss, one of the main criteria for hospitalization in acute diarrhoea, was not recorded at admission. In period B therapeutic behaviour was adequate to literature guidelines as regards both antibiotic prescription and use of oral rehydration solution. Nevertheless even if oral rehydration was carried out in more than 70% of patients, parenteral fluid administration was not significantly reduced in comparison with period A. Oral rehydration solution contributed to reduce the length of hospital stay in the more recent period. The study confirms the usefulness of medical audit to improve quality care.
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PMID:[Approach to acute gastroenteritis in children: comparison over the years]. 814 85

An open-label, inpatient study was undertaken to compare the efficacy of two oral rehydration solutions (ORS) given randomly to children aged 1-10 years who had acute gastroenteritis with mild or moderate dehydration (n = 45). One solution contained 60 mmol/l sodium and 1.8% glucose, total osmolality 240 mosm/l (Gastrolyte, Rhone-poulenc, Rorer) and the other contained 26 mmol/l sodium, 2.7% glucose and 3.6% sucrose, total osmolality 340 mOsm/l (Glucolyte, Gilseal). Analysis of data indicated that Gastrolyte therapy resulted in significantly fewer episodes and volume of vomiting over all time periods in comparison to Glucolyte and significantly less stool volume during the first 8 h and in the 0-24 h period. The differences between treatments in degree of dehydration at each follow-up period, duration of diarrhoea, and duration of hospital stay were not significant. No adverse drug reactions occurred. Six patients received intravenous rehydration treatment and were considered treatment failures. We conclude that oral rehydration therapy is safe and efficacious in the management of dehydration in acute diarrhoea and that the lower osmolar rehydration solution has clinically marginal advantages.
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PMID:Osmolality electrolyte and carbohydrate type and oral rehydration solutions: a controlled study to compare the efficacy of two commercially available solutions (osmolalities 240 mmol/L and 340 mmol/L). 818 94

Serum interleukin 6 (IL-6) and tumour necrosis factor (TNF) were measured in children with dysentery during an epidemic caused by Shigella dysenteriae 1. IL-6 and TNF were also measured in fresh stool filtrates from children with acute gastroenteritis. The median serum IL-6 concentration was raised significantly in the children with complications (haemolytic uraemic syndrome, leukemoid reaction, thrombocytopenia, thrombocytosis, and severe colitis lasting more than one week) during the first week (n = 18, 9-7728 pg/ml; median 107) and in the second week (n = 13, 5-312 pg/ml; median 77), compared with convalescent sera (n = 10, < 3-85 pg/ml; median 39; p < 0.02 and < 0.05 respectively). The median IL-6 concentration during the first week was significantly higher in the group with complicated disease than in those with no complications (n = 8, < 3-37 pg/ml; median 5; p < 0.001). Although serum TNF concentrations were significantly raised in the complicated group during the first and second weeks of the illness and in the uncomplicated group compared with convalescence, there was no significant difference in the TNF concentrations between the complicated and uncomplicated groups. IL-6 was detectable in stool filtrates from eight of 13 children with S dysenteriae 1 infection and four of eight children with S flexneri infection. It was not detectable in Cryptosporidia, rotavirus, or adenovirus infections, those with pathogen-negative acute diarrhoea or controls. Seven of 13 children with S dysenteriae 1 and three of nine children with S flexneri infections had TNF detectable in stools. None of the children with Salmonella, Cryptosporidia, rotavirus of children with pathogen-negative diarrhoea and controls had detectable TNF in stool filtrates. It is postulated that the local and generalised vasculitis observed in shigellosis may be related to a direct effect of Shiga toxin on endothelial cells or caused by cytokine production stimulated by endotoxin, or both.
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PMID:Concentrations of interleukin 6 and tumour necrosis factor in serum and stools of children with Shigella dysenteriae 1 infection. 830 92


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