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

Much clinical experience has been gained in the use of the glucose/electrolyte oral solutions in the treatment of acute diarrhea. Those patients who are in shock or too weak to drink need intravenous fluids to correct their total deficit. With isotonic polyelectrolyte fluids rehydration may be achieved in 2-4 hours. Subsequently, most of these patients can be given oral fluids to replace continuing stool loss. Patients who are not in shock and who are sufficiently strong to drink at the outset nearly always can be rehydrated with oral fluids alone. Vomiting is most likely caused by acidosis and volume depletion, and these can be corrected in severely dehydrated patients by intravenous therapy and by oral therapy in those not in shock and able to drink by oral therapy. Proponents of oral glucose/electrolyte therapy for diarrhea, like other proponents of new treatments, have great visions of its benefits to the world, yet these visions require validation. The biggest problem will be getting glucose and electrolytes to where they are most needed -- at the level of home and village.
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PMID:Editorial: Oral glucose/electrolyte therapy for acute diarrhoea. 4 28

20 consecutive child admissions to a Calcutta, India, hospital with acute diarrhea and moderate to severe clinical dehydration were studied. They were treated with an oral sucrose/electrolyte solution, which achieved complete hydration in 19 out of the 20 cases; 1 child did not respond and needed intravenous therapy. Vomiting, abdominal distension, and appearance of sugar in the stools during oral therapy did not interfer with its success. A child was considered to have recovered when the body weight had stabilized and when there was no further diarrhea, a process requiring 5-6 days. In addition, recovery involved restoration of plasma-bicarbonate to normal levels, falls in the hematocrit values and in the plasma specific gravidity, and complete clinical recovery. Solutions of glucose/electrolytes have already been used in the treatment of acute diarrhea. Replacement of glucose with sucrose is preferable since it is less expensive and more readily available in developing areas. This study showed that replacement of the glucose with sucrose is as effective.
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PMID:Evaluation of a sucrose/electrolyte solution for oral rehydration in acute infantile diarrhoea. 6 56

Since in the past, Aeromonas hydrophila had been isolated from all cases of human infection described. A. punctata and the anaerogenic sub-species were considered as apathogenic. From the case described, a close association between acute diarrhea with vomiting and the identification of A. punctata subsp. caviae becomes evident so that a conditional pathogenicity of this sub-species must be assumed. The question is discussed whether a preceding disturbance of the intestinal habitat in the presence of a particular susceptibility of the gastrointestinal tract promoted gastro-enteritis. Infection may have been brought about by the ingestion of surface water contaminated by sewage. Attention is again drawn to the fact that in the case of enteritis occuring during the open-air bathing season, faeces samples should also be examined for their Aeromonas content which may be performed by a simple indophenol or so-called cytochrome oxidase reaction of the aerobic flora in feces by rubbing off colonies into a corresponding test strip.
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PMID:[Aeromonas punctata subsp. caviae as the causative agent of acute gastroenteritis (author's transl)]. 17 15

A study of acute gastroenteritis in children was carried out with the aim of establishing the prevalence of human reoviruslike agent (HRLA) and its relation to other enteric pathogens in Israel. The stools of 384 children with acute diarrhea referred to a pediatric emergency service were screened for HRLA by counterimmunoelectroosmorphoresis (CIEOP) and for pathogenic bacteria. Evidence of HRLA infection was found in 65 patients (17%). The highest infection rate prevailed during the cool season (25%), with a peak prevalence (41%) in November, when both the temperature and humidity were low. A very high proportion of HRLA was found in children younger than 36 months and no HRLA infection was observed in those older than nine years. The highest prevalence occurred in infants younger than six months, a situation rarely encountered in other countries. The main clinical features of HRLA infection were fever, vomiting, dehydration, signs of upper respiratory infection and carbohydrate intolerance. Bacterial pathogens accounted for 45% of enteric infections. Shigella species predominated (28%) during the summer season, especially in older children. In 38% of the study group, no etiologic agent could be detected. None of the 50 control subjects showed evidence of viral or bacterial pathogens in stools.
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PMID:Etiology of acute gastroenteritis in children in Israel: role of human reoviruslike agent and bacterial pathogens. 22 84

"Travelers' diarrhea" is an acute diarrhea sometimes associated with vomiting and afflicting travelers recently arrived in tropical or subtropical countries. Its incidence ranges from 20 to 50 p. 100. It may cause severe deshydratation which is dangerous for third age tourists with humoral or visceral impairments. Recovery must not be expected before 3 to 10 days. Viruses do not seem frequently responsible and, among other causes (salmonellae, shigellae, staphylococci), colibacilli have a main role. They give cholera-like syndromes due to two enterotoxines. Treatment is symptomatic. Prophylaxis is important and chemical drugs as methyl-5-oxine must be prescribed rather than antibiotics which may induce resistances.
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PMID:[Travelers' diarrhea (author's transl)]. 39 5

I report five cases of occlusion of the superior mesenteric artery from one general practice; four of these occurred in one year.THE COMMON CLINICAL FEATURES WERE: acute diarrhoea and vomiting in elderly persons (all over 70) with abdominal pain and distension and shock. All had a previous history of auricular fibrillation and cardiac failure and past episodes of clinical arterial occlusive disorders had been experienced by four. Each diagnosis was confirmed at operation and all five patients died. It is important for general practitioners to recognize this syndrome.
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PMID:Acute superior mesenteric artery occlusion: problems of pre-operative diagnosis. 52 38

Twenty-five children with cows' milk protein intolerance were studied. Twenty had presented with an illness clinically indistinguishable from infantile gastroenteritis; an enteropathogenic Escherichia coli was isolated from the stools in two children, and in six another member of the family simultaneously developed acute diarrhoea and vomiting. Twenty-three children had lactose intolerance secondary to cows' milk protein intolerance. Eight out of 20 children were found to be partially IgA deficient. An acute attack of gastroenteritis, in damaging the small mucosa, may act as a triggering mechanism in cows' milk protein intolerance, and a deficiency in IgA may be a predisposing factor in so far as it allows the patient to become sensitised to foreign protein.
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PMID:Cows' milk protein intolerance: a possible association with gastroenteritis, lactose intolerance, and IgA deficiency. 77 36

We studied 27 infants admitted to the hospital with acute diarrhea caused by human rotavirus (HRV) and obtained additional data on fecal excretion from ten outpatients with the same infection. The disease was characterized by watery diarrhea with fever and vomiting at the onset, isotonic dehydration, compensated metabolic acidosis, and increased concentrations of sodium and chloride but low concentrations of sugar in stools. Diarrhea usually ceased in three to four days when oral feedings were reduced or stopped but recurred mildly in four patients. Of 57 household contacts, 12 were symptomatic, 6 had HRV in their stools, and 19 had significantly increased serum HRV antibody titers. These features of the disease accord with available information on the pathogenesis of HRV infection. Knowledge of the clinical pattern of this newly diagnosable infection should help physicians to recognize and treat quickly this highly infectious, potentially dangerous illness.
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PMID:Clinical, laboratory, and epidemiologic features of a viral gastroenteritis in infants and children. 88 36

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

Diarrhoea is regarded as the characteristic symptom of intestinal disturbances. However, cats with intestinal disturbances can also show other symptoms such as vomiting, increased or decreased appetite and loss of weight. Cats with diarrhoea are usually only referred to the clinic if they have a chronic problem. Acute diarrhoea reacts well to symptomatic treatment, but chronic diarrhoea requires a specific diagnosis for a directed therapy and prognosis. It is essential to examine faeces and blood when evaluating a cat with diarrhoea. In contrast to the situation for dogs, there are no good specific digestion and absorption tests available for cats to evaluate pancreatic and intestinal function. Exocrine pancreatic insufficiency rarely occurs in cats. A preliminary diagnosis of small intestine disorders can be made on the basis of the faeces staining positive for fat, an oral fat absorption test and the response to therapy. The definitive diagnosis must usually await the results of histological examination of intestinal biopsy samples. Cats with acute diarrhoea often recover spontaneously, and symptomatic treatment is only necessary for severe cases. A specific diagnosis is needed for cats with chronic diarrhoea, to enable directed treatment. Corticosteroids are used in the treatment of chronic enteritis because of their immunosuppressive and anti-inflammatory actions. Antibiotics are only indicated for specific bacterial infections (such as Salmonella and Campylobacter), bloody diarrhoea, or rampant bacterial growth. Specially formulated diets play a major role in the treatment of both acute and chronic diarrhoea.
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PMID:[Diarrhea in cats]. 146 41


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