Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
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The author relates her experience in Benin during a 3 and 1/2 year tenure as a nurse under the aegis of the German Development Agency. In Malanville, she was responsible for starting the operating room, caring for hygiene, sterility, and the related training of domestic staff. A septic and aseptic operating room was set up along with a storage room for instruments, a sterilization room, and a changing room. For the operating and surgical station, the following personnel were available: 2 nurses with 3 years of training, 1 nurse with 2 years of training, and 3 orderlies without training. A nurse with 3 years of training was assigned to the author to carry on the project after her departure. The standard of operating care was very low. It took a month to teach the staff what was not sterile. There was a even problem with putting on sterile gloves which required an exercise in patience. There were an average of 5 relatives per patient taking care of the patient and cooking. The undernutrition center for infants had 6 beds with 2 German nurses who administered Bacillus Calmette-Guerin (BCG), diphtheria, polio, and tetanus vaccinations. Their activity was strengthened by nutrition counselling and plans for underweight and malnourished children. Abrupt weaning that resulted in harmful diarrhea and vomiting was prevalent. Clinical signs of marasmus and kwashiorkor were frequent. In the middle of 1990, AIDS educators informed students of the public school as well as registered prostitutes about condom use. In the hospital, there were about 900 births per year, and women were asked to follow recommendations for prenatal care, especially to achieve anemia prevention by getting iron tablets. They were urged to deliver in the clinic, not at home assisted by untrained midwives. Oxytocin and syntometrin were available as was a hand-driven, vacuum evacuation pump. This experience made a lasting impression on the author who has resolved to go to another developing country to train traditional birth attendants in midwifery.
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PMID:[In Africa as a nurse]. 161 98

In a retrospective survey, case notes of all children with acute gastro-enteritis (AGE) admitted to our hospital between 1984 and 1988 were reviewed. The total number of cases was 300. The mean age was 14 months (range 1-60 mths): 67% of cases were boys and 33% girls. Eleven per cent were exclusively breastfed. The clinical presentation was diarrhoea and vomiting in 81%, diarrhoea alone in 15%, and vomiting primarily in 4%. All children had good nutritional status, i.e. both their height and weight were between the 5th and 90th percentile for their age and none showed signs of marasmus or kwashiorkor. Forty-six per cent of the children had AGE without dehydration. Mild, moderate and severe dehydration was present in 41%, 10% and 3% of cases, respectively. Isotonic, hypotonic and hypernatraemic dehydration was present in 95%, 3% and 2% of cases of dehydration, respectively. Sixty-five per cent of cases were given intravenous (IV) fluids. The mean duration of IV administration was 1 day, with a range of 1-7 days. Twenty-two per cent of the children were given oral rehydration solution (ORS) initially, and 13% were given IV plus ORS. None of the children died of gastro-enteritis. It is concluded that there was excessive use of IV fluids, and that there is an urgent need to encourage the use of ORS.
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PMID:Clinical presentation and management of acute gastro-enteritis in in-patient children at King Khalid University Hospital, Riyadh, Saudi Arabia. 170 70

In Lesotho's central hospital 55 (25%) of 218 admissions for severe PEM died during 1981 and 1982. Most deaths (62%) occurred in the first week. The most important causes of death were acute GE and pneumonia in marasmus and kwashiorkor, respectively. The cause of death remained obscure in 16 children, however. In marasmus a poor prognosis was significantly associated with the finding on admission of a temperature less than 36.5 degrees C (P less than 0.05), apathy (P less than 0.01) and a depigmented skin (P less than 0.05), while in marasmic kwashiorkor only the finding of the latter was significantly (P less than 0.05) associated with death. In non-survivors with kwashiorkor the following characteristics were observed significantly more often: complaints of diarrhoea and/or vomiting on admission (P less than 0.05), the finding of apathy, pallor, skin defects and hepatomegaly on admission (P less than 0.01), and the finding of a low serum albumen, Na+ and K+ in the first days (P less than 0.05). Irritability was significantly (P less than 0.05) more common in survivors with kwashiorkor. Xerophthalmia was observed only once. Infections were diagnosed in 86% of all and giardiasis in 28% of 146 children. Twenty-eight children contracted measles of whom 5 died. Severe PEM still carries a high mortality despite hospitalisation. The findings confirm the need for intensive management of severe PEM.
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PMID:Severe protein energy malnutrition in Lesotho, death and survival in hospital, clinical findings. 310 Dec 51

The most important cause of infant morbidity and mortality in the Middle East is acute and chronic diarrhea and resulting conditions of dehydration, marasmus, and protein malnutrition. This is particularly the case in summer and autumn months. In recognition of the fact that routine treatment is not wholly satisfactory, a program was developed by the UNRWA (United Nations Relief and Works Agency) Department of health to provide daytime rehydration/nutrition centers to which infants and mothers can be admitted for 6 hours daily. The objectives of these centers include the following: 1) obtaining rapid rehydration of the child; 2) teaching the mother the administration of the repair solution by spoon (after vomiting stops); 3) providing controlled chemotherapy whenever an infectious etiology is clinically suspected by administering the drugs; and 4) advising the mother about the special diet and the prevention of recurrence of diarrhea. A case study of an infant brought to 1 of these centers is presented in an effort to illustrate the advantages of this treatment over the routine treatment previously available.
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PMID:Diarrhoea; a specific treatment programme in Palestinian refugee camps. 555 1

A 2-year-old child is presented with irregular frequent vomiting leading to a very severe marasmus. Only repeated radiological investigations revealed the hepatodiaphragmatic interposition of the colon. Two years after surgery she has nearly doubled her body-weight.
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PMID:Chilaiditi's syndrome--successful surgical correction. 677 17

One of the major factors in the development of severe protein-energy malnutrition (PEM) is infection, such as diarrhea, upper respiratory infection, and malaria. Social and environmental factors include family size, access to land and occupation of parents, and exposure of rural populations to urban centers. Breast milk has been shown to play a role in the prevention of infections; however, the mother must be well-nourished to provide the optimum product. Traditional foods available to rural children in most developing countries are difficult to digest and low in energy and protein and inadequate nutritional education prevents the inclusion of good protein sources in children's diets. Severe PEM, called marasmus and kwashiorkor is indicated by wasting of muscles, absence of subcutaneous fat, wrinkled skin, thin and sparse hair, and weakness. The basic treatment for severe PEM is dietary. Treatment of kwashiorkor and marasmus is divided into 3 stages: 1) attending to acute problems, 2) restoring nutritional balance, and 3) ensuring nutritional rehabilitation. Care must be taken to ensure a minimum daily intake of 3-4 gm of protein and 120-150 Kcal of energy/kg of body weight. There must be, in addition, replacement of vitamin A, zinc, potassium, magnesium, and iron. An initial regimen which has been advocated is based on dry skim milk, sugar, and vegetable oil, divided into 6-12 feedings/day, which prevents vomiting. It is not necessary to remove lactose from the diet, and other animal protein sources such as meat and meat extracts are also well accepted. Soy and vegetable protein have been used successfully. In treating mild and moderate PEM it is important to ensure the intake of these food supplements by the child and to avoid a major substitution effect in the household diet. It is crucial for the physicians, nutritionists, public health workers, and educators to convince parents about the safety of using foods that are fed only to adults and older children. In addition nutritional and health education must not be restricted to the rehabilitation of the child but the prevention of nutritonal deterioration of the entire family and sometimes to the entire community.
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PMID:Infantile malnutrition in the tropics. 681 12

This case control study includes all children aged 12-36 months admitted to the pediatric unit of Sanou Souro Hospital for clinical malnutrition in Bobo-Biolasso, Burkina Faso in 1990 and early 1991. Cases numbered 273 persons, and matched controls numbered 173. 75% of cases have a diagnosis of marasmus, 10% have a diagnosis of kwashiorkor, and 15% have a diagnosis of marasmic kwashiorkor, Mortality includes 50% (14 cases) of the kwashiorkor cases and 30% of each of the other types of malnutrition. All cases show a poor anthropometric status (-4.2 among marasmus cases, -2.75 among kwashiorkor cases, and -3.80 among marasmic kwashiorkor cases). Only 2% show clinical malnutrition. The primary diagnoses are for diarrhea (78%), vomiting (46%), hepatomegaly (25%), dyspnoea (14%). and lymphadenopathy (14%). 35% are aged 12-17 months, 38% are aged 18-23 months, 18% are aged 24-29 months, and 9% are aged 30-36 months. 53% are male. 72% are in receipt of home follow-up visits. Of the 77 not followed up, 30 died. Cases and controls are grouped by feeding patterns (solid foods without breast milk, solid foods and breast milk and without or without porridge, and no solid foods). More malnutrition cases occur among children in the group with no solid food (11 with breast milk and/or other milk or porridge and 7 with porridge only). Those eating solid food with breast milk have a reduced odds of malnutrition. The case-control analysis indicates that more malnutrition occurs among those receiving breast milk or other milk. But with controls for age and supplementation the results indicate that children not receiving breast milk are twice as likely to suffer clinical malnutrition (odds ratio of 2.37), and the occurrence varies with age. Logistic regressions with control for confounding factors indicate that children without breast milk have three times the risk of malnutrition. Prolonged breast feeding and solid food supplements are associated with a 70% reduction in the rate of clinical malnutrition. Caution is urged in accepting wholly the findings due to the potential for reverse causality.
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PMID:Prolonged breast-feeding: no association with increased risk of clinical malnutrition in young children in Burkina Faso. 831 89

Enterotoxigenic Escherichia coli and other related enterotoxigenic species were isolated from 176 (44%) of 399 infants hospitalised in 'Caritas Baby Hospital' in Bethlehem, during April-December 1993. Ninety four of the patients infected by ETEC, were clinically evaluated. Most of them suffered from diarrhoea, quite often with fever and vomiting. Dehydration occurred in 58.3% of the patients and failure to thrive (FTT) in 28.5% of them. Severe illness resulted in marasmus in five patients and in the death of two others. Most of the ETEC strains (84%) were of ST toxin type. Correlation was found between the degree of toxigenity and the severity of the gastroenteritis. The most prevalent ETEC "O' serogroups were 0-6, 0-20, 0-8, 0-86, 0-126, 0-128 and 0167. Colonization Factors Antigens (CFAs) were identified in 36% of the isolates, CFAI was characteristic of group 0-126 and 0-128. In the principal O-groups there were high percentages of sensitivity to the antibiotics ceftriaxone, nalidixic-acid, gentamicin and norfloxacin, with resistance to anoxycillin, tetracycline and cotrimoxazole.
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PMID:Enterotoxigenic Escherichia coli (ETEC) in hospitalised Arab infants from Judea area--west bank, Israel. 903 18

Protein energy malnutrition in dialysis patients has been well-described in the literature. Most malnourished patients with end stage renal disease (ESRD) suffer from a mixed marasmus-kwashiorkor type of malnutrition with loss of both somatic and visceral protein mass. Malnutrition is associated with increased risk of morbidity and mortality. Up to 50% of patients on dialysis have protein energy malnutrition (Mortelmans & Vanholder, 1999). Malnutrition may be under-recognized and under-reported in dialysis patients. Malnutrition may result from inadequate food intake secondary to the uremic condition, nausea, vomiting, loss of appetite, altered taste and other physiologic conditions that impede food intake or metabolism. The usual indices of nutritional assessment--body weight, body mass index (BMI), anthropometrics, etc., may be inaccurate in patients with ESRD, as the results are often skewed by fluid retention. Therefore, we often rely on weight loss, bloodwork, a pre-dialysis low serum potassium, phosphorus and urea, as early signs of a decreased food intake. When patients are malnourished, measures such as oral supplements and/or tube feedings may be used to augment protein and calorie intake. However, when these interventions are inadequate to reverse the malnutrition condition, intradialytic parenteral nutrition (IDPN) should be implemented. Although there is no definite supportive data to show that the use of IDPN improves morbidity and mortality of dialysis patients, there are data to support that IDPN has positive effects on numerous nutritional parameters (Acchiardo, 2000; Capelli et al., 1994; Foulks, 1999; Hiroshige et al., 1998; Ikizler et al., 1995; Korzets et al., 1999; Mortelmans & Vanholder, 1999; Saunders et al., 1999; Smolle et al., 1995). In this article, we will discuss the causes of malnutrition in dialysis patients, the use of IDPN on one of our patients, and the potential complications associated with IDPN.
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PMID:The use of intradialytic parenteral nutrition to treat malnutrition: a case study. 1453 27