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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute gastroenteritis in children under 5 years of age is caused mainly by rotaviruses. Severe dehydration is commonly associated with this condition, which may lead to death if left untreated. Epidemiologic studies have attempted to describe the etiology of acute gastroenteritis caused by rotaviruses; however, much is still not understood. This paper describes a diarrhea outbreak in a children's day care center in Brazil that was caused by rotavirus serotype 1, subgroup II. 17 infants and 15 adults had their feces virologically analyzed. Rotavirus-positive samples were analyzed by enzyme immunoassay (EIA). Bacteriological analysis was performed after culturing. All samples were negative for both parasites and pathogenic bacteria. Rotavirus was found in 10/17 (58.8%) of the infant and in 1/15 (6.7%) of the adult fecal samples tested. The major clinical symptoms observed in rotavirus-positive children were fever (70%), vomiting (60%), and diarrhea (100%).
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PMID:An outbreak of diarrhoea associated with rotavirus serotype 1 in a day care nursery in Rio de Janeiro, Brazil. 782 20

Acute gastroenteritis is one of the most common diseases affecting children and rotavirus is the major etiological agent worldwide. Although the role of rotavirus as a causal agent of gastroenteritis has been previously established in Thailand, little is known about the epidemiology of Norwalk-like viruses. The present study was designed to determine the epidemiology and clinical manifestation of Norwalk-like viruses in comparison with rotavirus in Thailand. One hundred and one children with watery diarrhea between November 2002 and October 2003 were recruited into the study. The clinical data and stool specimens were collected for clinical analysis and rotavirus and Norwalk-like virus detection. Rotavirus and Norwalk-like viruses were detected viral agent by RT-PCR method. Of 101 stool samples obtained, rotavirus was detected in 25/101 (24.7%). Norwalk-like viruses were detected in 23/101 (22.7%). Dual infections were detected in 6/101 (5.9%). Rotavirus and Norwalk-like viruses peaked in the winter time. Clinical manifestations of rotavirus and Norwalk-like viruses were watery stool, nausea, vomiting, abdominal pain and fever Norwalk-like viruses and rotavirus were the most common etiologic agents in children with acute gastroenteritis in Thailand Epidemiology and clinical manifestations of rotavirus and Norwalk-like viruses were not different.
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PMID:Epidemiology and clinical manifestation of rotavirus and norwalk-like viruses in Thai children. 1608 61

Acute gastroenteritis is associated with significant morbidity in developed countries and each year is the cause of death of several million children in developing countries. Acute gastroenteritis is usually self-limiting. Oral rehydration therapy (ORT) is effective and successful in the majority of patients. Vomiting is common at the outset of viral gastroenteritis and can limit the effectiveness of ORT. Treatment with newer anti-emetic medications has been reported to facilitate ORT and to minimize the risk of dehydration and the need for intravenous hydration and hospitalization. The role of anti-emetic medications in the treatment of gastroenteritis-related vomiting is not clear. Some physicians agree with the use of anti-emetic medications because vomiting is unpleasant and distressing for the child and parents alike, and because vomiting can increase the likelihood of dehydration, electrolyte imbalance, and the need for intravenous hydration or hospitalization. Several surveys have shown that anti-emetic medications are commonly prescribed in the treatment of pediatric gastroenteritis and that adverse events are uncommon. Efficacy studies of the newer anti-emetic medications are now available and reveal that some are effective and help facilitate ORT. Other physicians disagree with the use of anti-emetic medications because acute gastroenteritis is a self-limiting condition, vomiting might help rid the body of toxic substances, there was previously a relative lack of published evidence of clinical benefit, and there are potential adverse events associated with the use of an anti-emetic medication. Anti-emetic medications that are currently available include ondansetron, granisetron, tropisetron, dolasetron, ramosetron, promethazine, dimenhydrinate, metoclopramide, domperidone, droperidol, prochlorperazine, and trimethobenzamide. Randomized, placebo-controlled trials suggest that ondansetron is efficacious and superior to other anti-emetic medications in the treatment of gastroenteritis-related vomiting. A recent double-blind clinical trial showed that a single oral dose of ondansetron reduces gastroenteritis-related vomiting and facilitates ORT without significant adverse events. Ondansetron shows promise as a first-line anti-emetic, and judicious use of this agent might increase the success of ORT, minimize the need for intravenous therapy and hospitalization, and reduce healthcare costs. Ondansetron should be considered in situations where vomiting hinders ORT, but a larger randomized, placebo-controlled trial is necessary before the medication can be routinely recommended for the treatment of gastroenteritis-related vomiting in children.
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PMID:Acute gastroenteritis in children: role of anti-emetic medication for gastroenteritis-related vomiting. 1752 98

Acute gastroenteritis is a common reason for children to seek health care. Among the potential complications of acute gastroenteritis, the most common is dehydration. For mild to moderate dehydration, treatment options include oral and intravenous rehydration. Outpatient treatment failure for either method, when it occurs, is often due to persistent nausea and vomiting. Some authorities have suggested that the early administration of dextrose to patients receiving intravenous rehydration may help terminate vomiting and result in fewer outpatient treatment failures. The purpose of this report was to review the evidence supporting the effectiveness of early intravenous dextrose administration in the outpatient management of dehydration in children with acute gastroenteritis.
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PMID:Rehydration: role for early use of intravenous dextrose. 1914 16

Acute gastroenteritis (AGE) is a typical illness seen in outpatient children, usually treated by Family Pediatricians (FP). To analyze the characteristics of community AGE, we have collected all the case histories of children observed in a FP office, analyzing computerized clinical file (FIMED Infantia), taken from the period 2003-2007. We enrolled 1140 children with AGE were gathered, for an average of 228 cases/year; 578 (51%) males and 562 (49%) females; the month with highest number of cases is October (120 cases, 10.5%), followed by September and April (105 cases in both, 9.2%). The month with the lowest incidence is February (75 cases, 6.6%) followed by August (81 cases, 7.1%); children's mean age is 4.6 +/- 3.4 years with a wide range (10 days divided by 16 years). As regards the clinical pattern, 314 children (27.5%) presented high fever, 395 (34.6%) vomiting and 24 cases (2.1%) bloody diarrhea; mean daily stools is 3.9 +/- 1.1; only 4 children suffered from severe dehydration. 255 children (22.4%) received antibiotic prescription, mainly cotrimoxazole (51%), followed by cephalosporins (39%) and macrolides (10%); 893 children (78.3%) were prescribed probiotics. Oral rehydrating solution was always offered to all children, followed by normal diet and only 4 children (0.4%) need the administration of a lactose free formula. Mean duration of diarrhea was 3.4 +/- 1.7 days, only 10 children (0.9%) suffered from chronic diarrhea and only 2 children (0.2%) were hospitalized due to severe dehydration. In conclusion, the child that refers to the FP office, is often a child with minor symptoms, for whom admission is not required; he/she presents a regular course and slight complications.
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PMID:[Clinical pattern of pediatric acute gastroenteritis in the community]. 2117 43

Acute gastroenteritis is one of the most common infectious diseases of childhood. Its symptoms are vomiting, diarrhea, and dehydration. In the emergency ward, intravenous rather than oral rehydration is usually preferred because of the high likelihood of emesis. Treatments to reduce emesis are of value in improving the rehydration procedure. Our study is a double-blind randomized trial and proposes the use of ondansetron as an antiemetic drug to treat children with acute gas-troenteritis. Seventy-four in-patients, aged 3 months to 15 years, were enrolled and randomly assigned to an ondansetron or placebo group. Inclusion criteria were the diagnosis of acute gastroenteritis and the absence of other diseases or allergies to drugs. A single bolus (0.15 mg/kg) of ondansetron was injected intravenously; normal 0.9% saline solution was used as a placebo. This treatment induced vomiting cessation in the ondansetron group significantly in comparison to the placebo group. The length of the hospital stay and the oral rehydration fluid volume were similar in the two groups and no adverse effects were noticed. Thus, safety, low cost, and overall benefit of ondansetron treatment suggests that this drug can be administered successfully to children with acute gastroenteritis.
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PMID:Efficacy of intravenous ondansetron to prevent vomiting episodes in acute gastroenteritis: a randomized, double blind, and controlled trial. 2158 30

Acute gastroenteritis is a very common disease. It causes significant mortality in developing countries and significant economic burden to developed countries. Viruses are responsible for approximately 70% of episodes of acute gastroenteritis in children and rotavirus is one of the best studied of these viruses. Oral rehydration therapy is as effective as intravenous therapy in treating mild to moderate dehydration in acute gastroenteritis and is strongly recommended as the first line therapy. However, the oral rehydration solution is described as an underused simple solution. Vomiting is one of the main reasons to explain the underuse of oral rehydration therapy. Antiemetics are not routinely recommended in treating acute gastroenteritis, though they are still commonly prescribed. Ondansetron is one of the best studied antiemetics and its role in enhancing the compliance of oral rehydration therapy and decreasing the rate of hospitalization has been proved recently. The guidelines regarding the recommendation on antiemetics have been changed according to the evidence of these recent studies.
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PMID:Acute gastroenteritis: from guidelines to real life. 2169 53

Acute gastroenteritis is one of the most common causes of emergency room visits. Although it is usually a self-limited infection, vomiting related to this illness can cause various degrees of dehydration, leading to intravenous insertion, electrolyte abnormalities and/or hospital admission. Ondansetron is a highly potent antiemetic drug that is effective in preventing chemotherapy-and radiation-induced nausea and vomiting with a very low risk of adverse effects. Recently, ondansetron has been used to control vomiting related to acute gastroenteritis. The present article examines evidence for the use of oral ondansetron for acute gastroenteritis-related vomiting in infants and children, and provides a recommendation for treatment based on the evidence-based review.
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PMID:Emergency department use of oral ondansetron for acute gastroenteritis-related vomiting in infants and children. 2237 83

Acute gastroenteritis is a common infectious disease syndrome, causing a combination of nausea, vomiting, diarrhea, and abdominal pain. There are more than 350 million cases of acute gastroenteritis in the United States annually and 48 million of these cases are caused by foodborne bacteria. Traveler's diarrhea affects more than half of people traveling from developed countries to developing countries. In adult and pediatric patients, the prevalence of Clostridium difficile is increasing. Contact precautions, public health education, and prudent use of antibiotics are necessary goals in decreasing the prevalence of Clostridium difficle. Preventing dehydration or providing appropriate rehydration is the primary supportive treatment of acute gastroenteritis.
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PMID:Acute gastroenteritis. 2395 66

Acute gastroenteritis, characterized by the onset of diarrhea with or without vomiting, continues to be a major cause of morbidity and mortality in children in mostly resource-constrained nations. Although generally a mild and self-limiting disease, gastroenteritis is one of the most common causes of hospitalization and is associated with a substantial disease burden. Worldwide, up to 40% of children aged less than 5 years with diarrhea are hospitalized with rotavirus. Also, some microorganisms have been found predominantly in resource-constrained nations, including Shigella spp, Vibrio cholerae, and the protozoan infections. Prevention remains essential, and the rotavirus vaccines have demonstrated good safety and efficacy profiles in large clinical trials. Because dehydration is the major complication associated with gastroenteritis, appropriate fluid management (oral or intravenous) is an effective and safe strategy for rehydration. Continuation of breastfeeding is strongly recommended. New treatments such as antiemetics (ondansetron), some antidiarrheal agents (racecadotril), and chemotherapeutic agents are often proposed, but not yet universally recommended. Probiotics, also known as "food supplement," seem to improve intestinal microbial balance, reducing the duration and the severity of acute infectious diarrhea. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the European Society of Paediatric Infectious Diseases guidelines make a stronger recommendation for the use of probiotics for the management of acute gastroenteritis, particularly those with documented efficacy such as Lactobacillus rhamnosus GG, Lactobacillus reuteri, and Saccharomyces boulardii. To date, the management of acute gastroenteritis has been based on the option of "doing the least": oral rehydration-solution administration, early refeeding, no testing, no unnecessary drugs.
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PMID:Management strategies in the treatment of neonatal and pediatric gastroenteritis. 2419 46


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