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)

Verotoxin producing Escherichia coli, in particular serotype O157:H7, have been implicated as an important cause of acute gastroenteritis in children. This study was undertaken to determine if E. coli O157:H7 is an important cause of acute gastroenteritis in children in metropolitan Sydney. During the period from October 1990 to September 1991, stools from patients presenting with acute diarrhoea to The Children's Hospital, Camperdown, were examined for the presence of common bacterial pathogens. In addition, stools were grown on sorbitol McConkey agar and sorbitol non-fermenting organisms were serotyped with O157 antiserum by slide agglutination. The isolates were then tested with H7 antisera and investigated for the production of verocytotoxin and other pathogenic markers including plasmid-associated EHEC adhesin and chromosomally encoded attachment-effacement gene. Only two strains (isolated from two different patients, 0.1% of specimens tested) were agglutinated by O157 antiserum and both were non-motile (H-). However, both strains produced verotoxin and expressed other virulence markers, suggesting that they were responsible for the diarrhoea. Both patients experienced mild, self limited gastroenteritis. We conclude that E. coli O157:H7 is an uncommon cause of acute gastroenteritis in Sydney children presenting to a children's hospital.
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PMID:Prevalence of verocytotoxigenic Escherichia coli serotype O157:H7 in children with diarrhoea attending a Sydney hospital. 851 99

This practice parameter formulates recommendations for health care providers about the management of acute diarrhea in children ages 1 month to 5 years. It was developed through a comprehensive search and analysis of the medical literature. Expert consensus opinion was used to enhance or formulate recommentations where data were insufficient. The Provisional Committee on Quality Improvement of the American Academy of Pediatrics (AAP) selected a subcommittee composed of pediatricians with expertise in the fields of gastroenterology, infectious diseases, pediatric practice, and epidemiology to develop the parameter. The subcommittee, the Provisional Committee on Quality Improvement, a review panel of practitioners, and other groups of experts within and outside the AAP reviewed and revised the parameter. Three specific management issues were considered: (1) methods of rehydration, (2) refeeding after rehydration, and (3) the use of antidiarrheal agents. Main outcomes considered were success or failure of rehydration, resolution of diarrhea, and adverse effects from various treatment options. A comprehensive bibliography of literature on gastroenteritis and diarrhea was compiled and reduced to articles amenable to analysis. Oral rehydration therapy was studied in depth; inconsistency in the outcomes measured in the studies interfered with meta-analysis but allowed for formulation of strong conclusions. Oral rehydration was found to be as effective as intravenous therapy in rehydrating children with mild to moderate dehydration and is the therapy of first choice in these patients. Refeeding was supported by enough comparable studies to permit a valid meta-analysis. Early refeeding with milk or food after rehydration does not prolong diarrhea; there is evidence that it may reduce the duration of diarrhea by approximately half a day and is recommended to restore nutritional balance as soon as possible. Data on antidiarrheal agents were not sufficient to demonstrate efficacy; therefore, the routine use of antidiarrheal agents is not recommended, because many of these agents have potentially serious adverse effects in infants and young children. This pracrtice parameter is not indended as a sole source of guidance in the treatment of acute gastroenteritis in children. It is designed to assist pediatricians by providing an analytic framework for the evaluation and treatment of this condition. It is not intended to replace clinical judgment or to establish a protocol for all patients with this condition. It rarely will provide the only appropriate approach to the problem. A technical report describing the analyses used to prepare this parameter and a patient education brochure are available through the Publications Department of the AAP.
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PMID:Practice parameter: the management of acute gastroenteritis in young children. American Academy of Pediatrics, Provisional Committee on Quality Improvement, Subcommittee on Acute Gastroenteritis. 898 55

Studies on the rotavirus-associated acute diarrhoeal illness in Jordanian children are non-existent. The present case-control study was conducted to investigate the prevalence of rotavirus diarrhoea among children aged less than 5 years, attending the United Nations Refugee World Aid Clinic in northern Jordan. The potential environmental and behavioural risk factors contributing to the infection were also studied. Using the ELISA technique rotavirus antigens were detected in the stool samples of 35% of the 220 cases of gastroenteritis and in 3% of the control group. The control subjects were matched for age and sex with the cases. The overall prevalence was significantly higher (62%) in children aged less than 24 months [OR = 2.4, 95% CI (1.1-5.1)] than those in the older age groups. Severe cases of diarrhoea were rare. Diarrhoea due to rotavirus was more prevalent during the summer months (June-August). Risk factors for acute diarrhoea in these children are related to the infant feeding practices of using unboiled tap water to prepare the formula milk, and the low educational level of the mothers.
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PMID:Rotavirus-associated diarrhoea in children in a refugee camp in Jordan. 870 26

During 1988-1991, an epidemiological survey was conducted in Tirana (Albania) on group A rotavirus strains which cause gastroenteritis in infants and young children. Rotaviruses were detected in 312 of 1,241 (25.1%) examined specimens from children with acute diarrhoea. Viruses were detected throughout the study period. Among the 72 rotavirus strains tested for double-stranded RNA (dsRNA) electrophoretic migration pattern, 9 different electropherotypes were recognized, 1 of those being more frequent than the others. At the beginning and at the end of the examined period (1988 and 1990-1991) two different long electropherotypes were predominant, whereas in 1989 (middle period) short electropherotypes were common indicating an involvement of virus strains with short electropherotypes in hospitalization-requiring diarrhoeas occurring in the area surveyed in that year.
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PMID:Electropherotypes of rotavirus strains causing gastroenteritis in infants and young children in Tirana, Albania, from 1988 to 1991. 872 94

From September 1994 to April 1995, we encountered eight children, two boys and six girls, (aged 1 year 6 months to 9 years), presented with acute diarrhea followed by afebrile, generalized tonic-clonic seizures, or transient loss of consciousness with urine incontinence. Their biochemical data, including serum electrolyte levels, were within normal limits. The infective agent causing diarrhea was later proved by stool examination to be rotavirus, judged to be serotype G1 by reverse transcription - polymerase chain reaction (RT-PCR) typing. Cerebrospinal fluid (CSF) examinations performed in seven of the eight patients were within normal limits, and cultures for bacteria and virus were negative. The electroencephalograms (EEGs) performed from 1 to 13 days after seizure showed abnormal in six, and normal in two, patients. Follow-up EEGs, performed from 4 to 11 months after onset of seizure, were all normal. None had seizure recurrence despite the fact that no long-term anticonvulsant had been given. From observation here, the authors emphasize that there is a close relationship between rotavirus and afebrile seizure, and the course of afebrile seizure following rotavirus gastroenteritis is usually benign. Further studies are needed to elucidate the underlying pathogenesis.
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PMID:Rotavirus gastroenteritis associated with afebrile seizure in childhood. 875 76

In a total of 720 faecal specimens from patients with secretory diarrhoea, vomiting, dehydration, gastroenteritis, cholera and cholera like illnesses, 18 strains of V. mimicus were isolated as pure culture. These were characterized for various toxin types and virulence factors using conventional in vitro and in vivo assays. Labile and stable toxins were elaborated by 15 and 2 strains respectively by ligated rabbit ileal loop (RIL) and suckling mouse assays. While 15 of the whole cell culture elaborated labile toxin, only 7 strains produced the same when culture filtrate was tested in RIL assay. Culture filtrates of 15 strains exhibited vascular permeability factor (PF) on adult rabbit skin, none of the strains were invasive as indicated by Sereny's test. Culture supernatants of all strains produced a cytotoxic factor to Vero and Chinese hamster ovary cells. Four of the 18 strains (22%) were resistant to multiple drugs (a combination of 3 or more drugs). The results emphasize the significance of continuous screening and identification of V. mimicus and to include in the differential diagnosis of patients with acute diarrhoea.
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PMID:Toxigenicity & drug sensitivity of Vibrio mimicus isolated from patients with diarrhoea. 899 33

The prevalence of carbohydrate intolerance in Polish children during an acute episode of gastroenteritis was determined. One hundred and seven consecutive children, less than 3 years old, with acute diarrhoea were enrolled into the study. Carbohydrate intolerance (diagnostic criteria: >0.5% reducing substances and stool pH less than 5.5) was diagnosed in 14/107 (13.08%) children: lactose intolerance was present in 12 (11.2%) patients; glucose polymer intolerance in 1 (0.93%) and monosaccharide intolerance in 1 (0.93%). The most important predisposing factor was rotavirus. In all cases the carbohydrate intolerance was transient, resolving within 5 days. Carbohydrate intolerance is also an infrequent problem in Polish children. Restriction of lactose-containing foods (use of lactose-free or low lactose formulas) for the majority of children with gastroenteritis does not seem to be justified.
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PMID:Carbohydrate intolerance after acute gastroenteritis--a disappearing problem in Polish children. 917 17

Group A human rotavirus (HRV) is the most common cause of acute gastroenteritis among infants worldwide. 7 G serotypes of group A HRV have thus far been identified by neutralization tests, of which 4, serotypes G1 through G4, have a global distribution. Enzyme immunoassay (EIA) was used to detect the relative frequency and temporal distribution of HRV G serotypes 1-4 among the community of neonates and infants with and without acute diarrhea who attended Cairo University Children's Hospital between August 1992 and October 1993. Fecal samples were collected from 20 neonates and 109 infants under age 1 year with acute diarrhea and from 20 neonates and 30 infants without acute diarrhea. Samples were then tested for the presence of rotavirus antigen using a commercial EIA. Rotavirus was identified in 64 of the 180 neonates and infants; in 15 neonates with diarrhea, 6 neonates without diarrhea, and 43 infants aged 1-12 months. Infection peaked between August and December. Serotypes G1 and G4 predominated in all age groups. Mixed (G1 and G4) and nontypeable specimens represented 16.1% and 38.7% of the total number serotyped, respectively.
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PMID:Serotyping of group A rotaviruses in Egyptian neonates and infants less than 1 year old with acute diarrhea. 935 Jul 78

Despite recommendations from several bodies such as the World Health Organization and others that feeding should be continued during diarrhea, the practice of withholding food during the early stages of diarrhea is still widespread. This contributes to a deterioration in patients' nutritional state. The principal controversy in the nutritional therapy of acute gastroenteritis centers on the relative risks of cows'-milk feeds. The two things that need to be considered in determining the optimum approach to feeding the child with acute diarrhea are the optimum timing for feeding children in relation to the onset of and recovery from symptoms and, secondly, the effects of specific food ingredients in the diet. Recent studies have demonstrated that the vast majority of young children with acute diarrhea can be successfully managed with continued feeding of undiluted non-human milk. Routine dilution of milk and routine use of lactose-free formula are not necessary, especially when oral rehydration therapy and early feeding (in addition to milk) form the basic approach to the clinical management of diarrhea in children. Confounding factors are the severity of the diarrhea, coexistent malnutrition, and young age (< 1 y); such infants are much more likely to have complications from early feeding with undiluted milk and some would advocate use of specifically designed lactose-free formula in such children. Children who are fed exclusively with human milk and those who receive solid foods with or without human milk may safely continue to receive their usual diets during diarrhea. Those who are fed exclusively with non-human milk--especially when very young and with severe diarrhea or malnutrition--should be closely observed if they continue to consume milk or they should receive a special formulation (e.g., a cereal-milk mixture or fermented milk product). The use of nutrient-dense mixtures of common foods may be advisable to promote compensatory growth in those who lose weight during illness or because of anorexia or malabsorption.
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PMID:Nutritional management of acute diarrhea. 978 56

The burden of disease attributable to childhood rotavirus infection in Finland was assessed from data on hospital admissions for acute gastroenteritis and from reported virological diagnoses of rotavirus from 1985 to 1995. The mean number of hospitalizations (3584 annually in children under 5 y of age) corresponded to approximately 5.6% of the birth cohort. Rotavirus was estimated to be responsible for 54% of cases; accordingly, 3% of all children in Finland are hospitalized for rotavirus diarrhoea. The monthly distribution of hospitalizations for acute diarrhoea showed a similar pattern as monthly diagnoses of rotavirus, with a long epidemic period starting as early as November or December and lasting until June or even July. The prevalent rotavirus G-type throughout the study period was G1, which was detected in over 60% of the cases; however, in the season 1988-89 G4 was the prominent type. Improved case management has led to a shorter duration of hospital stay (3.3 d in 1985 vs. 2.3 d in 1995), but otherwise these was no significant trend for rotavirus gastroenteritis over the years. These findings underscore the need to control rotavirus gastroenteritis with a specific intervention, notably rotavirus vaccination.
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PMID:Rotavirus gastroenteritis in Finland: burden of disease and epidemiological features. 1008 8


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