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

Forty children (less than or equal to 2 years of age) were admitted to hospital with acute gastroenteritis and were randomly assigned to receive either an oral rehydration solution (ORS) containing bicarbonate (Na 35, K 20, Cl 37, HCO3 18, glucose 202 mmol litre-1) or an identical solution in which bicarbonate was replaced by chloride ions. Groups were matched for age, sex, ethnic origin, duration of diarrhoea and nutritional status. On admission, degree of dehydration, biochemical and haematological parameters were similar. The majority had minimal or no dehydration and only 30% had moderate to severe dehydration. All children were treated successfully with no complications. Oral rehydration solution intake by each group was similar. Clinical outcome, as judged by speed of rehydration or maintenance of hydration, duration of diarrhoea, stool frequency and length of hospital stay, was the same in both groups. After 24 h of ORS there was no difference between groups in venous pH, serum bicarbonate, urea and electrolytes. In hospitalized children with acute gastroenteritis in the United Kingdom an ORS without bicarbonate is a safe, effective means to prevent dehydration and maintain hydration and acid-base status where dehydration is not severe. Exclusion of bicarbonate would simplify production, increase stability and reduce the cost of ORS without apparent impairment of efficacy.
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PMID:Oral rehydration therapy without bicarbonate for prevention and treatment of dehydration: a double-blind controlled trial. 297 49

Diarrheal diseases constitute a major cause of childhood morbidity and mortality in Zimbabwe. Since 1982, it has been the policy in Zimbabwe to use home-based Salt Sugar Solution (SSS) as standard Oral Rehydration Solution (ORS) therapy for both prevention and management of dehydration. The recommended formula is incomplete, lacking both potassium and bicarbonate. It may not, therefore, be as efficacious as complete ORS for the prevention or correction of hypokalemia and acidosis during diarrhea. For this reason, a study was carried out at Harare Central Hospital to assess the type and prevalence of electrolyte abnormalities in dehydrated children who had previously been managed with oral salt sugar solution for acute gastroenteritis. 121 such referred patients had their serum urea and electrolytes estimated on admission prior to further management in the Unit; .38 (27.5%) cases of hypokalemia, 12 (8.9%) of hypernatremia, 52 (5.5%) of hypoatremia and 65 (45.7%) of severe acidosis (bicarbonate level 10 mmol/1) were documented. It is concluded that simple salt sugar solution is ideal for the prevention of dehydration but in cases of established dehydration the WHO complete formula is more appropriate for combating hypokalemia and severe metabolic acidosis.
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PMID:Serum electrolytes in children admitted with diarrhoeal dehydration managed with simple salt sugar solution. 345 1

Alterations in serum ionized and total calcium, magnesium, and phosphate concentrations, during recovery from acute dehydrating gastroenteritis, were studied. Fifteen children with acute dehydrating gastroenteritis had serum concentrations of ionized and total calcium, magnesium, phosphate, sodium, potassium, chloride, urea, creatinine, and albumin, as well as acid-base status, evaluated during rehydration and up to 72-h postadmission. The total serum calcium corrected for albumin did not change significantly during rehydration and remained within the normal range. Although serum ionized calcium fell significantly at 24 and 72 h, its concentration was not sufficiently decreased to cause symptomatic hypocalcemia. Serum ionized calcium correlated significantly with pH (r = -0.57), bicarbonate (r = -0.63), and albumin (r = +0.65), but not with total serum calcium, magnesium, and phosphate. Serum magnesium remained within the normal range during the study period. Serum phosphate was increased on admission (2.64 +/- 0.77 mmol/L), decreased by 12 h (to 0.84 +/- 0.32 mmol/L), and then followed by a gradual increase. This study suggests that changes in serum ionized calcium in dehydrating gastroenteritis are not of clinical significance. However, changes in serum phosphate concentration need further evaluation.
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PMID:Serum calcium and phosphate disturbances during rehydration in acute dehydrating gastroenteritis. 369 49

The main purpose of this study was to evaluate the effectiveness of an oral fluid therapy alone or combined with parenteral administration of a 5% dextrose solution to attenuate the clinical signs and the pathophysiological consequences of transmissible gastroenteritis in neonatal piglets. Eighteen two day old conventional piglets were infected with transmissible gastroenteritis virus while six others were used as controls (Group 1). At the onset of diarrhea, infected piglets were divided into three groups of six (Groups 2, 3 and 4). Piglets in group 2 were not treated and were fed a milk replacer ad libitum. Piglets in group 3 were removed from the milk replacer and placed on an oral glucose-glycine-electrolyte solution ad libitum. Those in group 4 were placed on oral fluid therapy and received a 5% dextrose solution intraperitoneally at the rate of 25 mL/kg of body weight once a day. Blood samples were collected in heparin within minutes after the infected piglets became comatose and from the controls at four or five days of age. The following variables were measured: packed red cell volume, blood pH, total plasma protein and bicarbonate, blood urea nitrogen, and plasma glucose, creatinine, chloride, inorganic phosphorus, sodium, potassium, magnesium and calcium. Vomiting and diarrhea appeared 12 to 24 hours postinoculation in the infected piglets. There was a sudden and rapid progression into a comatose and moribund state one or two days later whether the infected piglets were treated or not.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fluid therapy trials in neonatal piglets infected with transmissible gastroenteritis virus. 407 36

In Singapore the World Health Organization's (WHO's) oral electrolyte solution for the treatment of infantile gastroenteritis has been used for 6 years and rice water has been used for 8 years. The rice water is the water used in preparing boiled rice or congee and is a slightly starchy solution. As the impression was that rice water was as effective as or even better than the oral electrolyte solution, a trial was conducted of the 2 solutions in babies with gastroenteritis admitted to the Department of Pediatrics of the National University of Singapore. Alternate cases were assigned consecutively to the oral electrolyte solution or to rice water. There were 63 patients on oral electrolyte and 67 on rice water. Milk was totally withdrawn for 24 hours after admission and the babies were put on 1 or the other oral solution. Intravenous 3.75% glucose and 0.23% saline was given at the same time to babies considered to be more dehydrated. On day 2, quarter strength powdered milk was given, followed by half strength on day 3, three-quarters strength on day 4, and full strength on day 5. Electrolyte and urea values were compared, both for "drip" versus "no drip" within oral treatment groups and between electrolyte solution and rice water groups (20 comparisons altogether). There were only 3 significant differences, and these might be explained by the intravenous drip and by the better water absorption from rice water than from the oral electrolyte solution. The most obvious difference in the 2 groups was in the effect on diarrhea (stools/day). Rice water cut down the number of stools more effectively than did oral electrolyte solution. No patient died, and there were no pathological sequelae in any of the 130 patients. Rice water can be tried as a more practical alternative to oral electrolyte solutions since there are problems with providing oral elecrolyte solutions to all babies with diarrhea in the developing countries and ensuring sterility.
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PMID:Rice water in treatment of infantile gastroenteritis. 611 34

In Riyadh, Saudi Arabia, gastroenteritis is a leading cause of admission to Children's Hospital. A prospective study of 254 children between the ages of 0-5 admitted over a 4-month period for acute diarrhea was undertaken. Information was obtained from parents about each child's history and the children were medically examined and weighed before and after treatment. Blood urea and electrolytes were estimated and stools examined for parasites and bacteria. Almost 85% of the babies were under 1 year old, 46.5% were less than 5 months. 35.6% had normal weights for age; 25.6%, 1st degree malnutrition; 26.4%, 2nd degree and 12.4%, 3rd degree malnutrition. The severely malnourished were all marasmic, except for 6 who had kwashiorkor, alone or with marasmus. 65.4% were bottle fed but only 20% of the mothers used boiling or chemical means of sterilizing the bottles. Isonatremic dehydration accounted for 73% of the dehydrated infants or children, hyponatremia for 14% and hypernatremia for 13%. 11.8% were graded severely dehydrated on admission. Mothers of children with hypotonic dehydration tended to dilute the feeds, while mothers of hypertonic dehydrated children tended to concentrate them. The overall isolation rate for bacteria and parasites was 33.8%, including salmonella, entero-pathogenic E. coli, Giardia lambia and shigella species. 23 children died; mortality was highest in the younger age group, among babies who were bottle fed, among the more severely dehydrated and among those with hypertonic and hypotonic dehydration. The study results are comparable with incidence reported in proximal areas. The high incidence of bottlefeeding and the consequences to infant health as a major cause of morbidity is of concern. The mild cases of dehydration could be treated on an outpatient basis if adequate facilities are accessible to the population.
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PMID:Gastroenteritis among children in Riyadh: a prospective analysis of 254 hospital admissions. 618 53

The main purpose of this work was to study changes in the balance of fluids, electrolytes and blood metabolites in neonatal piglets with severe transmissible gastroenteritis. Six two day old conventional piglets were infected with transmissible gastroenteritis virus while six others were used as normal controls. Blood samples were collected in heparin when the infected piglets were moribund. The following variables were measured: packed red cell volume, total plasma protein and bicarbonate, blood pH, blood urea nitrogen and plasma glucose, creatinine, chloride, inorganic phosphorus, sodium, potassium, magnesium and calcium. Vomiting and diarrhea appeared 12 to 24 hours postinoculation in the infected piglets and they were moribund one or two days later. Before becoming moribund, most of the piglets fell rapidly into a lethargic and comatose state. The most evident changes in their blood variables were an increase in packed cell volume, total protein, blood urea nitrogen, phosphorus and magnesium levels and a decrease in pH and bicarbonate concentration as well as a severe hypoglycemia. The results suggest that severe hypoglycemia coupled with metabolic acidosis and dehydration might be an important factor contributing to the high mortality rates caused by transmissible gastroenteritis in neonatal piglets. The hypoglycemia results from a combination of the inadequate glucose metabolism inherent to neonatal piglets and the acute maldigestion and malabsorption resulting from the diffuse and severe villous atrophy induced by the virus.
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PMID:Hypoglycemia: a factor associated with low survival rate of neonatal piglets infected with transmissible gastroenteritis virus. 647 97

The mean serum aldosterone concentration of 37 infants with acute gastroenteritis and dehydration was markedly elevated on admission (mean +/- SE 94.3 +/- 12.1 ng/ml) and approximated to normal values (18.2 +/- 3.7 ng/ml) following recovery from the acute disease (t=3.56 p less than 0.005). Serum aldosterone levels were significantly positively correlated with the percent weight loss (r=0.41, p less than 0.05) and with the blood urea nitrogen levels (r=0.55, p less than 0.001). There was no correlation between either serum sodium levels or blood osmolarity and aldosterone concentrations. Serum potassium levels were positively correlated with aldosterone levels (r=0.53, p less than 0.001). These findings indicate that small infants when dehydrated respond appropriately with elevated aldosterone levels. The amount of body fluid depletion and hyperkalemia are the major factors determining the amount of aldosterone response.
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PMID:Aldosterone concentrations in dehydrated infants. 670 40

During a 3-month period in the late summer and fall of 1981, six cases of gastroenteritis and one wound infection due to Vibrio parahaemolyticus were reported to public health agencies in Washington and Oregon. An investigation revealed that all of the gastroenteric illnesses were associated with eating raw oysters; that oysters eaten by five of the six patients were harvested at four divergent sites at Willapa Bay, Washington, a large commercial growing area; and that the V. parahaemolyticus isolates from those five patients were all Kanagawa positive, belonged to serotype 04:K12, and exhibited an atypical biochemical reaction, urea hydrolysis. No further cases linked to Willapa Bay oysters have been reported, and the infecting strain could not be found in sediment samples from the bay in February 1982. Thus, even though the origin of this self-limiting outbreak is obscure, the investigation demonstrated that the geographic distribution of V. parahaemolyticus infection in the United States includes the Pacific seacoast . Furthermore, oysters must be considered, along with crabs, shrimp, and lobster, as a vehicle of transmission of this infection in the United States.
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PMID:Vibrio parahaemolyticus gastroenteritis. An outbreak associated with raw oysters in the Pacific northwest. 671 8

Alternate cases of infantile gastroenteritis (IGE) admitted to the Department of Pediatrics, National University of Singapore, were put on rice water (RW) or the standard World Health Organization oralyte solution (WOS) to compare the effect of oral RW to WOS. On admission, each patient's hydration status was assessed. Serum electrolytes were taken before any treatment was initiated. Milk was totally withdrawn for 24 hours, or longer, as the situation demanded. Those who needed intravenous fluid hydration were dripped accordingly for 24 hours usually and then the oral fluids (RW or WOS) were given depending on the protocol. There were 63 patients on WOS and 67 on RW. All recovered fully, and there were no deaths nor any sequelae from the episode of gastroenteritis. The compability of the 2 groups was assessed in terms of the age groups, sex, race, number of days of diarrhea before admission, degree of dehydration, and the electrolytes prior to treatment. There were no statistical differences between the serum sodium (Na), chloride (Cl), urea, potassium (K), and bicarbonate (HCO3) in the 2 groups. The 2 groups were comparable. After each group had been treated with WOS or RW, the serum electrolytes were repeated on day 3 to see if there were any differences in the results. The only statistically significant difference was between C and H, i.e., in the WOS group the serum urea was lower in those with intravenous drip, between N and S, i.e., in the RW group. Babies on rice water passed fewer stools/day compared to those on WOS. The most important finding from this controlled trial with WOS and RW in the management of IGE was the effectiveness of RW in reducing the frequency of stools and hence faster rehydration compared to WOS. The 2 groups were eminently comparable, yet RW was as effective or even more effective than WOS in controlling the diarrhea. It is recommended that in the Singapore context rice water is a convenient, sterile, and effective antidiarrheal agent.
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PMID:Gastroenteritis: III. Rice-water in the management of infantile gastroenteritis in Singapore. 705 47


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