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

A clinical trial was conducted to compare the safety and efficacy of a new oral rehydration solution (ORS) with that of the ORS recommended by the World Health Organization (WHO). One hundred thirty infants with dehydration due to acute diarrhea were randomized into two groups: 68 infants received the WHO ORS containing sodium and glucose in a concentration of 90 and 111 mmol/L, respectively, and an osmolality of 311 mosm/kg (ORS-90); 62 infants received an ORS containing sodium and glucose in a concentration of 60 and 90 mmol/L, respectively, with an osmolality of 240 mosm/kg (ORS-60). Treatment failure was noted in seven infants (10.3%) in the ORS-90 group; the causes of failure were high stool output (three cases), persistent vomiting (three cases), and ileus (one case). Only one patient in the ORS-60 group (1.6%) was considered a failure because of high stool output. No significant differences were noted in the serum sodium levels in either group of patients, both in relation to the natremia seen on admittance or that seen after rehydration. A trend was observed toward correction of hypernatremia or hyponatremia with both types of ORS. A similar situation was observed with respect to the variations seen in serum potassium levels. The results from this study suggest that there may be clinical advantages of using an ORS with concentrations of sodium and glucose and a total osmolality lower than that of ORS-90, because of the lower incidence of treatment failures.
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PMID:Clinical experience in Mexico with a new oral rehydration solution with lower osmolality. 234 May 39

This study was designed to assess the effect of loperamide, given to infants in higher than recommended doses, on the severity and duration of acute diarrhea. Thirty infants with acute diarrhea and dehydration were given loperamide (0.8 mg/kg/day), in addition to standard fluid therapy, for 48 hours after admission to the hospital. The stool output in grams per kilograms of body weight per day and the duration of diarrhea in these infants were compared with those in 30 matched control infants receiving only standard fluid therapy. Two infants given loperamide had to be withdrawn from the trial because ileus developed in one and the other had persistent severe vomiting. In four other infants receiving loperamide, drowsiness developed but resolved rapidly on discontinuation of the drug. Infants receiving loperamide had a shorter duration of diarrhea (median 2.5 vs 6.0 days) and lower daily stool output than the control subjects had. The study confirmed the efficacy of loperamide in reducing the duration and severity of diarrhea but raised doubts regarding its safety in the treatment of young infants.
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PMID:Effect of loperamide on stool output and duration of acute infectious diarrhea in infants. 200 49

The aetiology of acute diarrhoea was investigated in 245 children less than 3 years old in a paediatric outpatient clinic in southern India. In 55% of the children organisms were found in the stools, and one quarter were infected with multiple organisms. Viruses, enteropathogenic E. coli, shigella and campylobacter species accounted for 75% of all isolates. Cholera and helminthiasis were rare, and no child had amoebiasis. Clinical findings were useful in the diagnosis of shigella and rotavirus infection only. Children with shigellosis had classical dysentery, and a greater number of stools; they were unlikely to be breast-fed, to be less than 6 months old, or to have watery stools. Rotavirus infections were characterized by vomiting. Only 20% of the 245 children had an infection which could be treated effectively with antimicrobials.
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PMID:Aetiology and clinical features of acute childhood diarrhoea in an outpatient clinic in Vellore, India. 244 63

A major cause of morbidity and mortality among children in developing countries is acute diarrhoea and rotavirus, a reovirus-like agent, is found to be a leading causative agent. We report here the incidence of rotavirus infection among infants and young children with gastro-enteritis treated at the Children's Hospital in Dammam, Kingdom of Saudi Arabia. One hundred and fifty children, aged between 1 and 60 months, suffering from diarrhoeal illness, were selected as the study cohort; another 150 hospitalized children of the same age group, but not suffering from diarrhoea, served as controls. Sixty-two per cent of the study children complained of watery diarrhoea and 39% of vomiting; all had mild to moderate dehydration. Seventy-two per cent had fever and 30% associated respiratory illness. Worst affected were those 7-12 months old, among whom rotavirus was detected by ELISA techniques in 39.6%, compared with 7.5% of the control children of comparable age group. We could not detect any rotavirus from control children aged over 36 months, whereas approximately 15% of the study children in this age group yielded rotavirus from the stool. The second most common pathogen isolated was Shigella ssp. It was isolated from 18.7% of children under study as against 3% of the controls.
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PMID:Rotavirus as an important cause of diarrhoea in a hospital for children in Dammam, Saudi Arabia. 244 64

Rotavirus was detected in 111 (15.9%) of 694 children who presented to our hospital with acute diarrhoea over a period of 45 months (1982-1985). Subgrouping for rotavirus was done on 87 children by ELISA using specific monoclonal antibodies to find out any differences in the epidemiology and clinical profile of the two subgroups. Twenty six (29.9%) were found to belong to subgroup 1 and 61 (70.1%) to subgroup 2. Diarrhoea, vomiting and fever were present in both the subgroups in the same frequency. However, the severity of diarrhoea was more in children having subgroup 2 infection. Rotavirus infection showed two peaks, one during the early months of summer and the other during the early months of winter of each year. During most of the study period, infection was predominantly with subgroup 2, except for a few months in 1983 and 1985 when a majority of children had infection with subgroup 1.
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PMID:Clinical and epidemiological features of acute gastroenteritis associated with human rotavirus subgroups 1 and 2 in northern India. 253 40

In a study involving 104 children hospitalized with diarrhoea, 9% were infected with oocyst Cryptosporidium spp. add 56% with such yeast-fungus as Candida (C. Candida 38%). The manifestations noted in cryptosporidiosis infected children are acute diarrhea, vomiting and hyperthermia. One subject out of five who were tested for antibody to HIV appeared to be antibody positive. The patients immunity from the disease was not checked. A mycological test must be systematically carried out in case of children diarrheal outbreak.
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PMID:[Cryptosporidium and candida in pediatric diarrhea in Abidjan]. 255 87

Rotavirus was looked for in stool specimens from 200 randomly chosen infants and children aged 1-24 months presenting with acute diarrhoea of not more than 5 days duration at the Bab El-Sha'reya University Hospital during a 12-month period (January-December 1986). Forty per cent of cases were positive for rotavirus by the ELISA technique. Considering the seasonal pattern, during the hot months May to August, the monthly percentage of rotavirus positive cases ranged from 24 to 32 per cent while during the rest of the year, the range was from 37 to 60 per cent. There was no statistically significant difference between the rotavirus positive and negative cases as regards mean age in months (9.5 +/- 5.1 and 9.2 +/- 5.5, respectively), type of feeding or nutritional status. However, rotavirus positive cases were significantly more likely to present earlier, to have watery stools, to vomit or even to have vomiting before the onset of diarrhoea and to have respiratory symptoms. On the other hand, the means of dehydration score, rectal temperature and serum Na+ were not significantly different between the two groups.
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PMID:Epidemiological and clinical features of rotavirus associated acute infantile diarrhoea in Cairo, Egypt. 258 79

Cryptosporidia are important causative agents of acute diarrhea among children in tropical countries. The leading symptoms are watery diarrhea lasting from 2 to 8 weeks and vomiting accompanied by crampy abdominal pain. Dehydration occurs frequently. The prevalence of cryptosporidia infections is much higher in tropical regions (an average of up to 10%) than in moderate regions. Cryptosporidia infections are dependent both on the children's age (highest rates among children below 2 years of age) and the season. In most studies, the highest incidence was found during the rainy season. Children who were breast-fed showed lower rates of infection. The transmission is fecal- oral, especially from animals to humans, from person to person, but also by way of contaminated drinking water. For an exact description of the epidemiology of cryptosporidia infections in the tropical countries, especially of the transmission, the seasonal differences and the breast feeding patterns, further studies are needed.
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PMID:Epidemiology of cryptosporidiosis in children in tropical countries. 263 71

Acute diarrhea is a common problem in children. Understanding the different pathologic processes that cause diarrhea, and the agents that are associated with those processes, can aid the clinician in predicting the etiology of the diarrhea in an individual patient. Small bowel involvement, most commonly caused by Rotavirus, produces a high incidence of vomiting, often before the onset of diarrhea, and large, watery, and relatively infrequent stools. Large bowel involvement, usually due to Campylobacter, Salmonella, or Shigella produces frequent, often bloody stools containing leukocytes. Treatment of diarrhea should be focused on correcting dehydration, principally with oral rehydration solutions containing appropriate concentrations of electrolytes and carbohydrates. Early refeeding, avoiding foods containing lactose, should be considered for most pediatric patients with acute diarrhea. Antimicrobial therapy should be reserved primarily for parasitic infectious, pseudomembranous enterocolitis, and the early stages of a Campylobacter dysentery. The etiology of acute pediatric diarrhea can be predicted in most patients and early, appropriate treatment can be instituted.
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PMID:Acute diarrhea in children. 266 48

Early feeding is generally recommended for children with acute diarrhea. The concentration at which the milk should be given to children weaned at an early age remains a matter of debate. The aim of the study was therefore to evaluate the role of milk dilution in the first 24 hours on the outcome of diarrhea. Sixty-nine well nourished and weaned children, aged 1 to 9 months and with moderate watery acute diarrhea were included after oral rehydration therapy (ORT) in a randomised controlled study to receive either half-strength (diluted group) or full strength (undiluted group) milk. Both groups displayed the same clinical characteristics except for the weight. The outcome of the diarrhea until cessation was the same in the 2 groups. No failure requiring a specific treatment was observed. The duration of diarrhea and the total stool output were not statistically different in the 2 groups, i.e. 39 +/- 7 hrs in diluted vs 47 +/- 8 in undiluted, and 883 +/- 205 g in diluted vs 924 +/- 161 g in undiluted. These results are strengthened by the lack of significant differences in the weight gain, the number and volume of vomiting, the volume of ORT and milk intake. However, the energy intake was significantly higher in the group receiving full strength milk. These results suggest that there is no immediate clinical advantage to dilute the milk in the first 24 hours of feeding well nourished children with moderate acute watery diarrhea, if early feeding is associated with the ORT recommended by the WHO.
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PMID:[Is the dilution of milk necessary in benign acute diarrhea in eutrophic infants?]. 271 54


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