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

A case of prolonged diarrhoea following Escherichia coli 0111 gastroenteritis is reported. Electron microscopy of the jejunal biopsy revealed effacement of the brush border and attachment of bacteria by pedestal formation. Specific activities of brush border enzymes showed marked depression of disaccharidases, zinc-resistant alpha-glucosidase, and alkaline phosphatase. In contrast, marker enzymes for basolateral membranes and endoplasmic reticulum were unaffected. The biochemical changes support the pathogenic mechanism suggested by ultrastructural studies previously reported.
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PMID:Ultrastructural and biochemical changes in human jejunal mucosa associated with enteropathogenic Escherichia coli (0111) infection. 351 Dec 12

Vibrio parahaemolyticus, an important agent of seafood-borne gastroenteritis, expresses several putative virulence factors that could account for the disease symptoms of infected humans, namely, diarrhea, nausea, and abdominal cramps. The pathogenicity of V. parahaemolyticus correlates well with the Kanagawa phenomenon (the hemolytic ability of strains grown on Wagatsuma blood agar), implicating the thermostable direct hemolysin (TDH) as the predominant toxin responsible for pathogenicity. TDH-induced hemolysis could be inhibited by the addition of the osmolyte sorbitol to the extracellular solution, supporting the hypothesis that hemolysis occurs through colloid osmosis secondary to an increase in the cation permeability of the membrane. The effect of TDH on cation permeability was investigated by measuring K+ (congener, 86Rb+) influx into human erythrocytes in which the endogenous cation transporters had been blocked (by use of ouabain, bumetanide, and nitrendipine). TDH increased K+ influx into these cells; this increase was rapid in onset and constant in magnitude, suggesting a direct action by TDH on the membrane. The kinetics of leak generation were examined; the relationship between counts accumulated and hematocrit indicated that the TDH-induced lesion is multihit in nature. TDH-induced K+ influx was sensitive to Zn2+. Time courses of hemolysis in isosmotic solutions of monovalent cation chlorides were used to obtain the selectivity series for the TDH-induced leak: Cs+ > Li+ > K+ > Rb+ > Na+. Both the Zn2+ sensitivity and this selectivity series were obtained for crude culture supernatants, suggesting that TDH is the predominant leak-inducing agent. Thus, we have identified several features of the TDH-induced leak likely to be important in the diarrhetic action of V. parahaemolyticus in the human intestine.
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PMID:Cation flux studies of the lesion induced in human erythrocyte membranes by the thermostable direct hemolysin of Vibrio parahaemolyticus. 840 20

In Nigeria, the beginning of the structural adjustment program (SAP) in 1986 marked the beginning of a considerable decrease in real income and an unparalleled increase in food prices. This economic crisis stimulated reduced food consumption, particularly that of nutritious foods, and an increase in malnutrition. For example, in Borno/Yobe States in 1987, SAP contributed to an average decrease in energy and protein intake of 27% and 33%, respectively. SAP also contributed greatly to the almost complete destruction of nutrition oriented health delivery services. Different surveys of nutritional assessment in Nigeria reveal low intakes of protein, energy, iron, calcium, zinc, thiamin, and riboflavin in almost all age groups and in both sexes. Malnutrition and related diseases (diarrhea, measles, anemia, and gastroenteritis) are the cause of most deaths in infants and young children. The underlying causes of malnutrition in Nigeria are poverty, inadequate food production, inadequate food intake, ignorance and uneven distribution of food, poor food preservation techniques, improper preparation of foods, food restrictions and taboos, and poor sanitation. Economic reforms will likely continue into the first decade of the 21st century, so Nigeria really needs sustainable remedies to alleviate malnutrition. Recommended remedial programs are more support for rural farmers through input subsidies and high producer prices, improving rural credit schemes (e.g., the People's Bank) that target the poor, distribution of vitamin A and iron supplements in rural health centers, promoting production of low cost weaning diets, and integrating nutrition education in primary health care programs and in educational curricula.
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PMID:Undernutrition in Nigeria: dimension, causes and remedies for alleviation in a changing socio-economic environment. 841 69

Vibrio mimicus is a causative agent of human gastroenteritis. This pathogen secretes a pore-forming toxin, V. mimicus hemolysin (VMH), which causes hemolysis by three sequential steps: binding to an erythrocyte membrane, formation of a transmembrane pore, and disruption of the cell membrane. VMH with a molecular mass of 63 kDa was purified by ammonium sulfate precipitation and column chromatography with phenyl Sepharose HP and Superose 6 HR. The hemolytic reaction induced by VMH continued up to disruption of all erythrocytes in the assay system. Moreover, VMH that bound preliminarily to erythrocyte ghosts showed a sufficient ability to attack intact erythrocytes. These results suggest reversible binding of the toxin molecule to the membrane. The final cell-disrupting stage was effectively inhibited by various divalent cations. Additionally, some cations, such as Zn2+ and Cu2+, blocked the pore-forming stage at high concentrations. Although VMH could disrupt all kinds of mammalian erythrocytes tested, those from horses were most sensitive to the hemolysin. Horse erythrocytes were found to have the most toxin-binding sites and to be hemolyzed by the least amount of membrane-bound toxin molecules, suggesting that toxin binding to and pore formation on erythrocytes are more effective in horses than in other mammals. Purified VMH induced fluid accumulation in a ligated rabbit ileal loop in a dose-dependent manner. In addition, the antibody against the hemolysin obviously reduced enteropathogenicity of living V. mimicus cells. These findings clearly demonstrate that VMH is probably involved in the virulence of this human pathogen.
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PMID:Purification and characterization of a hemolysin produced by Vibrio mimicus. 912 68

When diarrhoea caused by gastroenteritis persists for more than two weeks it is referred to as persistent diarrhoea in developing countries. Whilst the Control of Diarrhoeal Diseases programme has decreased mortality from acute diarrhoea, mortality from persistent diarrhoea has not been so responsive. A number of factors have been identified which are determinants for the progression of an acute episode to one which persists in developing communities. In one study from west Africa, current infection with Cryptosporidium parvum was the most significant factor. In studies from Brazil and India, continuing infection with enteropathogenic Escherichia coli was identified in 50% of infants with persistent diarrhoea. Persistent small intestinal mucosal damage is of key importance in such children. Management of established cases is complex and difficult. However, there is clear evidence that zinc is involved in the recovery of small intestinal mucosa after injury. Zinc supplementation may indeed significantly reduce the duration of persistent diarrhoea. However, the whole question of public health supplementation with zinc, vitamin A, or other supplements, is contentious at present.
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PMID:Post-infective diarrhoea. 1196 77

Acute gastroenteritis remains a common illness among infants and children throughout the world. Among children in the United States, acute diarrhea accounts for >1.5 million outpatient visits, 200,000 hospitalizations, and approximately 300 deaths/year. In developing countries, diarrhea is a common cause of mortality among children aged <5 years, with an estimated 2 million deaths annually. Oral rehydration therapy (ORT) includes rehydration and maintenance fluids with oral rehydration solutions (ORS), combined with continued age-appropriate nutrition. Although ORT has been instrumental in improving health outcomes among children in developing countries, its use has lagged behind in the United States. This report provides a review of the historical background and physiologic basis for using ORT and provides recommendations for assessing and managing children with acute diarrhea, including those who have become dehydrated. Recent developments in the science of gastroenteritis management have substantially altered case management. Physicians now recognize that zinc supplementation can reduce the incidence and severity of diarrheal disease, and an ORS of reduced osmolarity (i.e., proportionally reduced concentrations of sodium and glucose) has been developed for global use. The combination of oral rehydration and early nutritional support has proven effective throughout the world in treating acute diarrhea. In 1992, CDC prepared the first national guidelines for managing childhood diarrhea (CDC. The management of acute diarrhea in children: oral rehydration, maintenance, and nutritional therapy. MMWR 1992;41[No. RR-16]), and this report updates those recommendations. This report reviews the historical background and scientific basis of ORT and provides a framework for assessing and treating infants and children who have acute diarrhea. The discussion focuses on common clinical scenarios and traditional practices, especially regarding continued feeding. Limitations of ORT, ongoing research in the areas of micronutrient supplements, and functional foods are reviewed as well. These updated recommendations were developed by specialists in managing gastroenteritis, in consultation with CDC and external consultants. Relevant literature was identified through an extensive MEDLINE search by using related terms. Articles were then reviewed for their relevance to pediatric practice, with emphasis on U.S. populations. Unpublished references were sought from the external consultants and other researchers. In the United States, adoption of these updated recommendations could substantially reduce medical costs and childhood hospitalizations and deaths caused by diarrhea.
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PMID:Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. 1462 48

An elaborate feeding regimen of animals, which takes advantage of the Achilles' heels of enteropathogenic bacteria, can possibly enable prophylaxis in the intestinal tract, attenuate actual disease symptoms, accelerate recovery from a bacterial gastroenteritis or ensure food safety. There is a wide spectrum of conceivable weak spots in bacteria. Some pathogenic bacteria cannot use certain compounds, or use them less efficient than beneficial bacteria. By addition of such substances to animal feed, non-pathogenic bacteria can grow better than pathogens and competitively exclude the latter ones. Other compounds even have an inhibitory effect on pathogens. Calcium phosphate for example protects against Salmonella, Zn2+ has a prophylactic effect against Brachyspira, and Fe2+ has an inhibiting effect on the enterotoxin synthesis of Yersinia enterocolitica. Besides, there are antimicrobial substances as plant extracts, essential oils, organic acids and other compounds, which inhibit pathogens more than other bacteria. A simultaneous application of several anti-pathogen agents suggest an enhanced effect. Some countermeasures aim at a distinct group of bacteria, while others are more universal. General strategies to repel different pathogenic bacteria are the supply of health-stimulating milk components, antagonistic bacteria for competitive exclusion, and mucus-related attractants for misguidance of adhering and invasive bacteria. This paper gives an overview of Achilles' heels of enteropathogenic bacteria that can be exploited to develop strategies for keeping control over these pathogens in the gastrointestinal tract of livestock.
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PMID:Physiological Achilles' heels of enteropathogenic bacteria in livestock. 1610 37

Cereals are the most common complementary foods all over the world and there is now a novel possibility to add functional components to target health problems that are not caused by a simple nutritional deficiency. So far there have been very few published trials on the addition of functional components to infant cereals. A single trial has suggested that infant cereals containing a combination of probiotics, prebiotics and zinc are an effective adjunct to oral rehydration solution in the treatment of acute gastroenteritis. Up to now there has been no evidence that infant cereals supplemented with probiotics or prebiotics have a preventive effect on diarrhea but a recent study has suggested that a milk fat globule membrane (MFGM) protein fraction added to an infant cereal reduces the risk of diarrhea in a developing country. There are some promising results suggesting that infant cereals supplemented with probiotics or prebiotics may prevent atopic eczema. The addition of prebiotic oligosaccharides to infant cereals may lead to softer stools, likely to benefit those infants who are suffering from constipation. More studies are needed to verify these results and to assess the effects of other functional components - especially probiotics, prebiotics, nucleotides, novel protein fractions and recombinant human milk proteins - added to infant cereals.
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PMID:Processed infant cereals as vehicles of functional components. 1766

Worldwide diarrheal diseases are a leading cause of childhood morbidity and mortality. Improvements in gastroenteritis management have reduced the annual number of pediatric deaths attributable to gastroenteritis from 5 million in 1982 to 2 million over 20 years. Recent advances are likely to contribute further to a reduction in morbidity and mortality secondary to acute infectious gastroenteritis. A new generation of vaccines against rotavirus is entering into routine use. Research into antisecretory agents has demonstrated that this class of medications may play a significant role in the future management of acute infectious gastroenteritis. A significant body of literature has recently emerged supporting the use of the antiemetic agent ondansetron. In developing countries, the routine use of zinc is now recommended by many experts, while, in developed countries, the use of probiotic agents has been associated with significant benefits in acute infectious gastroenteritis. Finally, more aggressive intravenous rehydration strategies are being employed; however, at present, limited data from randomized clinical trials are available to support its routine use.
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PMID:Acute infectious pediatric gastroenteritis: beyond oral rehydration therapy. 1768 83

Acute gastroenteritis remains a common and often severe illness among infants and children throughout the world. The management of a child with acute diarrhea includes rehydration and maintenance fluids with oral rehydration solutions (ORS), combined with continued age-appropriate nutrition. However, although substantial data support the role of continued nutrition in improving gastrointestinal function and anthropometric, biochemical, and clinical outcomes, the practice of continued feeding during diarrheal episodes has been difficult to establish as accepted standard of care. Recommendations for maintenance dietary therapy depend on the age and diet history of the patient. It has been clear for many years that, when affected by gastroenteritis, breastfed infants should be continued on breast milk without any need for interruption and, by that way, will get faster recovery and improved nutrition. Moreover, many well-conducted studies have provided evidence that in formula-fed children not severely dehydrated, a rapid return to full feeding is well tolerated. Lactose intolerance and/or secondary cow's milk allergy are not a clinical concern for the vast majority of patients. In fact early refeeding i.e resumption of normal diet, in amounts sufficient to satisfy energy and nutrient requirements, should be the rule. However, in children younger than 6 months of age, the lack of suitable studies must lead to caution and use of specific lactose-free or extensively hydrolysate formulae, especially in case of severe and/or prolonged diarrhea. Several studies support the use of zinc supplementation or probiotics for acute diarrhea but some doubts persist in infant in developed countries.
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PMID:[Feeding infants and young children with acute diarrhea]. 1796 12


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