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

In a double-blind trial in 94 children attending outpatients the value of glucose or a sucrose addition to a basic electrolyte mixture for the management of acute gastroenteritis was compared. Of the children treated with added sucrose 10% failed to respond compared with 27% of those treated with added glucose. This difference was significant (P=0-05), but the time to recovery in those in the two groups who responded to treatment was not significantly different. Thus, despite theoretical advantages, there was no practical advantage in using glucose rather than sucrose. A 5% sucrose electrolyte solution with its relatively low osmolality, ready availability, and ease of preparation is recommended as the treatment of choice in the outpatient management of acute gastroenteritis in infancy.
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PMID:Clinical comparison between glucose and sucrose additions to a basic electrolyte mixture in the outpatient management of acute gastroenteritis in children. 94 22

Infants and young children are particularly susceptible to a recently identified viral enteritis which is highly contagious and seems both common and universal. In this disease, virus invades the upper intestinal epithelium, causing acute diarrhoea with early fever and vomiting. We studied a similar disease in pigs, infecting three-week-old animals with transmissible gastroenteritis virus (TGE), which also invades the upper intestinal epithelium. In this model, diarrhoea is massive 16-40 hours after infection, when stools contain increased electrolytes but no excess of sugar. In the jejunum of intact pigs at the 40-hour stage we found altered Na+ and water flux, decreased mucosal activities of disaccharidases and Na+, K+-ATPase, but normal adenylate cyclase activity. At the same stage the response of Na+ flux to glucose was blunted in jejunal epithelium studied in Ussing short-circuit chambers and in suspensions of villous cells; Cl- flux responded normally to theophylline, and thymidine kinase and sucrase activities of cells isolated from jejunal villi were similar to those found in crypt cells. Probably by 40 hours after infection most virus has been shed from the mucosa. Viral diarrhoea clearly differs from enterotoxigenic diarrhoea. Consideration of its pathogenesis must take into account the dynamic nature of the mucosal epithelium and the factors governing differentiation of enterocytes as they migrate from crypt to villus. Sufficient information is available now to characterize one specific and apparently prevalent viral enteritis in man and to identify additional viral enteritides. There is hope that preventative therapy can be developed. Our understanding of the mechanisms of viral diarrhoea is limited, but the availability of an animal model and the promise of others makes us optimistic that these deficiencies can be remedied. Greater understanding of the pathogenesis of viral diarrhoea should better the active therapy of affected infants and children.
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PMID:Viral gastroenteritis: recent progress, remaining problems. 104 55

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

Ion transport in the jejunal mucosa of 14-to 16-day-old piglets with severe diarrhea 40 hr after infection with transmissible gastroenteritis (TGE) virus was studied. In infected pigs Na+ transport failed to respond normally to glucose when studied either in Ussing short-circuited chambers or in suspensions of enterocytes isolated selectively from jejunal villi. Theophylline, 10mM, added to the chambers produced the same brisk electrical responses and increments in net Cl- secretion in tissue from both infected and control groups. A defect in glucose-stimulated Na+ absorption in the acute stage of a viral enteritis has been identified which probably contributes to the impaired lumen-to-extracellular fluid flux of Na+ found previously in the jejunum of intact TGE-infected pigs. The mechanisms causing diarrhea in this invasive viral enteritis differ from those causing toxigenic diarrhea.
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PMID:Transmissible gastroenteritis. Mucosal ion transport in acute viral enteritis. 126 68

An infant girl with congenital heart disease was fed glucose polymers as dietary supplements. During an attack of gastroenteritis with severe diarrhoea she developed hypernatraemic dehydration, probably due to the high osmotic load of the glucose polymers. This case illustrates the importance of giving adequate amounts of free water to a child on glucose polymers, especially during excessive fluid loss.
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PMID:Glucose polymers in diarrhoea--risk of hypernatraemia. 160 Mar 10

Selected clinical and laboratory parameters were studied respectively in patients with meningitis caused by enterococci and viridans streptococci in an academic children's hospital. During a nine-year period (1981-1989), enterococci or viridans streptococci were isolated from the cerobrospinal fluid (CSF) of 48 patients. In nine of these 48 patients, enterococci or viridans streptococci were the causative agents of meningitis. These nine children constituted 2.0% of 450 patients with bacterial meningitis in this period. All nine children suffered from underlying diseases; neurosurgical procedures were performed in six of these patients, of whom four had ventricular drains. A head trauma preceded the development of meningitis in another patient. Drainage of the lacrimal duct was associated with the development of meningitis in another patients. One child concurrently suffered from severe gastroenteritis. CSF leukocyte count and CSF protein levels were moderately elevated, whereas CSF glucose levels were either slightly decreased or within the normal range. Meningitis due to enterococci or viridans streptococci is seen predominantly in children under the age of one year. Predisposing factors, including neurosurgical procedures, head trauma and severe gastroenteritis, are usually present in these patients. The prognosis for recovery is generally good.
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PMID:Childhood meningitis caused by enterococci and viridans streptococci. 164 84

Comparative examinations of renal function using inulin- and endogenous creatinine-clearance tests in 5 pigs showed nearly identical values of glomerular filtration rate (GFR). Based on this relation 79 healthy pigs, weighting 2 kg to 230 kg were investigated using the creatinine-clearance test for determination of normal values of GFR and urine flow rate (Vu) as well as renal excretion (E), renal clearance (Clr) and fractional excretion (FE) of urea, sodium, potassium, calcium, phosphorus, glucose and lactate. The renal excretion of creatinine (E-Creat) was closely correlated with the body weight. Therefore it is possible to use the body weight for estimation of E-Creat and to calculate GFR and Vu using plasma and urine concentrations of creatinine independent of a timed volumetric urine collection. Subsequently E, Clr and FE of electrolytes or other endogenous substances can be evaluated. Finally the practicability of this procedure for detection of disturbed glomerular filtration or tubular reabsorption was demonstrated in piglets suffering from colidiarrhoea and/or transmissible gastroenteritis.
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PMID:[Creatinine clearance as the foundation for clinical determination of kidney function in swine]. 194 84

Animal and human perfusion studies suggest that water absorption can be optimized by glucose-electrolyte solutions with low total osmolality. A new oral rehydration solution (ORS), reformulated Dioralyte (RD), containing 60 mmol/L of sodium and 90 mmol/L of glucose with an osmolality of 240 mosm/kg, was tested for safety and efficacy in children in the United Kingdom with acute gastroenteritis. In a double-blind, controlled trial, RD was compared with standard Dioralyte (SD), a widely used low-sodium, high-glucose solution containing 35 mmol/L of sodium and 200 mmol/L of glucose, with an osmolality of 310 mosm/kg. Infants and children aged 2 weeks to 3 years admitted with acute gastroenteritis of less than five days' duration and mild to moderate dehydration were randomized to receive either RD or SD. Clinical and laboratory assessments were made on admission and 12, 24, and 48 hours after treatment. Thirty-two children were enrolled in the study; 14 received RD and 18 SD. No adverse effects from either ORS were reported. Efficacy was evaluated in 24 patients, of whom eight received RD and 16 SD. Total ORS intake and intake in milliliters per kilogram were similar in both treatment groups. Mean fluid balance, mean percentage weight change, and median stool frequency did not differ between the groups at 12, 24, and 48 hours after onset of treatment. Three (12.5%) patients had greater than or equal to 0.05% reducing substances in the stool during treatment, and the incidence was similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical experience with a hypotonic oral rehydration solution for treatment of pediatric gastroenteritis in the United Kingdom. 218 14

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

We wished to characterize the carbohydrate fermentation by intestinal flora in formula-fed infants and in breast-fed infants. We also wished to compare the carbohydrate fermentation process in the two groups to determine whether differences that existed between groups could help explain the observation that breast-fed infants usually have milder forms of acute gastroenteritis. We performed in vitro incubations of fecal samples from nine formula-fed and 14 breast-fed infants and examined the samples for fermentation characteristics, the effect of acid pH on bacterial fermentation, and changes in carbohydrate fermentation in relation to the age of the infant. Fecal samples were incubated, with and without the addition of lactose, at a pH of 6.8 and at a pH of 5.5. Volatile fatty acids and carbohydrates were determined in the incubates. The addition of lactose to the incubate at pH 6.8 resulted in significantly increased volatile fatty acid production and larger amounts of lactose, glucose, and galactose compared with the values observed in 1-h incubates to which no lactose was added. At pH 5.5, volatile fatty acid production was significantly lower in both groups compared with that at pH 6.8, and the accumulation of monosaccharides in the incubate of feces of formula-fed infants increased significantly (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Characterization of carbohydrate fermentation in feces of formula-fed and breast-fed infants. 231 45


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