Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A prospective, placebo-controlled, triple blind clinical trial was carried out in Pakistan to determine the effect of Lactobacillus GG on the course of acute diarrhea in hospitalized children. Forty children (mean age, 13 months) were enrolled and after rehydration received either oral Lactobacillus GG (n = 21) or placebo (n = 19) twice daily for 2 days, in addition to the usual diet. The clinical course of diarrhea was followed during the treatment period. Features on admission into the study groups were similar and were characterized by severe diarrhea, malnutrition and inappropriate management before presentation. Response was evident on Day 2 when the frequency of both vomiting and diarrhea was less in the Lactobacillus group. In those who had presented with acute nonbloody diarrhea (n = 32), the percentage of children with persistent watery diarrhea at 48 hours was significantly less in the Lactobacillus group: 31% vs. 75% (P < 0.01). No significant difference was observed by 48 hours in those presenting with bloody diarrhea. The relevance of this finding to the management of diarrhea in the tropics is discussed.
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PMID:Lactobacillus GG promotes recovery from acute nonbloody diarrhea in Pakistan. 774 91

Oral rehydration therapy (ORT) has simplified treatment of diarrheal dehydration. Hospitals in India have diarrheal treatment and training units (DTUs) to help manage the many diarrheal cases. DTU staff keep children for 4-6 hours to correct the dehydration with ORT and feeding. Health personnel undergo training in diarrhea management at DTUs. ORT is the preferred treatment in almost all cases of acute diarrhea. It is not best for diarrheal cases which exhibit shock, profuse vomiting (3 times/hour), glucose malabsorption, abdominal distension or paralytic ileus, and high rate of purging (15 ml/kg body weight/hour). ORT successfully treats 95% cases of infantile diarrhea, even Rotavirus-caused diarrhea. Health workers should begin treating cases of severe dehydration with intravenous (IV) therapy and then administer ORT 3-4 hours later for infants and 1-2 hours later for adults. If IV therapy is not possible, the patient should receive oral rehydration solution (ORS) nasogastrically and then referred to a facility with IV therapy. WHO's ORS formula is safe for newborns and young infants. ORT is appropriate even when diarrheal cases are vomiting. ORT tends to stop vomiting 1-2 hours after initial ORS administration because it corrects acidosis. The glucose in WHO's ORS facilitates absorption of adequate sodium across the intestinal mucous membrane. ORS also restores the loss potassium ions and HCO3/citrate. If ORS is not available, sugar salt solution can be used. To achieve the optimum concentration, the amount of sucrose has to be twice that of glucose. ORS should be stored in a cool place, be covered, and used for no more than 24 hours. Antiemetics should not be given during ORT. Most diarrheas do not require any antibiotic. Sterile water is not necessary to prepare ORS. Rice gruel, coconut water, and pulse water are home available fluids which can treat dehydration. Breast feeding and regular feeding should continue during diarrheal episodes.
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PMID:Answers to questions in relation to oral rehydration therapy. 783 4

An open-label, inpatient study was undertaken to compare the efficacy of two oral rehydration solutions (ORS) given randomly to children aged 1-10 years who had acute gastroenteritis with mild or moderate dehydration (n = 45). One solution contained 60 mmol/l sodium and 1.8% glucose, total osmolality 240 mosm/l (Gastrolyte, Rhone-poulenc, Rorer) and the other contained 26 mmol/l sodium, 2.7% glucose and 3.6% sucrose, total osmolality 340 mOsm/l (Glucolyte, Gilseal). Analysis of data indicated that Gastrolyte therapy resulted in significantly fewer episodes and volume of vomiting over all time periods in comparison to Glucolyte and significantly less stool volume during the first 8 h and in the 0-24 h period. The differences between treatments in degree of dehydration at each follow-up period, duration of diarrhoea, and duration of hospital stay were not significant. No adverse drug reactions occurred. Six patients received intravenous rehydration treatment and were considered treatment failures. We conclude that oral rehydration therapy is safe and efficacious in the management of dehydration in acute diarrhoea and that the lower osmolar rehydration solution has clinically marginal advantages.
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PMID:Osmolality electrolyte and carbohydrate type and oral rehydration solutions: a controlled study to compare the efficacy of two commercially available solutions (osmolalities 240 mmol/L and 340 mmol/L). 818 94

We determined the efficacy of a soy-based formula compared with a cow's milk formula in infant refeeding after acute diarrhea in a randomized controlled double-blind clinical trial. Infants 2-12 months of age with diarrhea of less than one week's duration and mild or moderate dehydration admitted to a pediatric hospital or in the practice of a participating primary care pediatrician were investigated. Seventy-six patients were enrolled and 73 completed the study; 39 infants received a soy-based formula (Isomil) and 34 received a cow's milk formula (SMA). Hospitalized patients were rehydrated with an oral glucose-electrolyte solution or an iv dextrose-sodium solution. Outpatients received oral glucose-electrolyte solution. In all patients, the study formula was commenced ad libitum during the first 24 h as determined by the attending pediatrician. The primary outcome measure was duration of diarrhea, defined as time to first normal stool, when subsequent stools were normal for a 24-h period. In addition, a predetermined secondary outcome was proportion of treatment failures, defined as the need to reinstitute clear fluids because of emesis, refusal to accept study formula, need for iv fluids due to negative fluid balance or diarrhea persisting beyond 7 days after enrollment. Total duration of diarrhea was significantly longer (p = 0.03) in those receiving cow's milk (mean +/- SD 6.6 +/- 4.2 days) than in those receiving soy-based formula (4.5 +/- 3.6 days). Volume of formula intake and weight gain at 14 days were not different in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cow's milk versus soy-based formula in mild and moderate diarrhea: a randomized, controlled trial. 819 99

During a period of one year 227 children aged form three days to two years were hospitalized for acute diarrhoea syndrome. In 111 cases (48.9%) the presence of HRV was observed in the faeces (group I). In 116 children (51.1%) no presence was shown of HRV in the faeces (group II). An analysis was done of the significance of differences between the observed clinical sign and abnormalities in laboratory tests in both analyzed groups. It was shown that the general condition of the children in group I was statistically more frequently moderately severe and severe (58.6% and 23.4%) than in group II. Major dehydration over 5% was found in 53.5% of cases in group I, and in 23.4% it was equal to 10% body weight. Body temperature ranged about 38 degrees C in 49.6% of children in group I while in group II in 56.9% it did not exceed 38 degrees C. Vomiting was observed very often (78.4% in group I in comparison to 35.3% in group II), especially preceding the appearance of watery faeces with mucus. The HRV diarrhoea was accompanied significantly more frequently by pharyngitis and rhinitis. Among the results of laboratory investigations of interest was greater tendency of children in group I for hypokalemia and metabolic acidosis and the white blood cell count of below 10,000, observed in 77.5% of patients.
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PMID:[Rotaviruses in acute diarrhea syndrome of infants and small children]. 824 14

A retrospective study was conducted of the daily reports of the Outpatient Emergency Service of the Children's Hospital of the State of Sonora. Records of children receiving oral rehydration therapy between January 1986 and December 1989 were reviewed to assess the efficacy of the treatment and its impact on hospital admissions and mortality. Children of any age and nutritional status with diarrhea of any etiology and duration were included. Children in shock or with contraindications to oral therapy were excluded. 975 of the 14,893 children consulting for diarrhea in the four years (6.5%) received oral rehydration therapy. 868 of the children (89.0%) had acute diarrhea and 107 (11%) had prolonged diarrhea defined as over two weeks duration. The average patient age was 7.4 months and 847 (86.9%) were under one year old. 754 of the children had mild and 221 had moderate dehydration. 315 of the children (32.3%) were malnourished. 123 of the 975 children were hospitalized. Treatment was considered to have failed in 84 cases (8.6%), including 29 with persistent vomiting, 20 who did not accept oral rehydration solution, 18 with fecal output exceeding 10 ml/kg/h, and 17 with complications of diarrhea. The 847 children successfully rehydrated by the oral route represented a reduction of 29.1% in hospitalizations for diarrhea over the four years, during which 2062 children were hospitalized for intravenous rehydration. The magnitude of the reduction in hospital admissions increased from 19.2% in 1986 to 38.4% in 1989. The case fatality rate from diarrhea declined from an average of 7.0% between 1980 and 1985 to an average of 4.0% between 1986 and 1989. Mortality from prolonged diarrhea averaged 6.0% between 1984 and 1989.
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PMID:[Oral rehydration therapy: an analysis of its results and impact on the hospitalization and mortality of children with diarrhea]. 827 31

Out of 539 acute diarrhoea cases studied, Vibrio mimicus was isolated as a sole pathogen in the faeces of 7 (1.3%) cases. The chief clinical presentations of the seven cases were watery diarrhoea and vomiting. Bloody diarrhoea was observed in 2 (28.5%), abdominal pain in 2 (28.57%) and fever in one (14.29) cases. All cases could be effectively treated with ORS except 3 (42.85%) cases who required IV Ringer's lactate. All V. mimicus strains isolated in the study were uniformly susceptible to tetracycline, chloramphenicol, norfloxacin and ciprofloxacin.
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PMID:Acute diarrhoea caused by Vibrio mimicus in Calcutta. 829 47

An epidemiological study of rotavirus infections was conducted in Tananrive, Madagascar, from November 1988 to October 1990. Rotavirus antigen was detected by ELISA in faecal specimens of 183 of 1,659 children with acute diarrhoea (11%) and in 11 of 631 specimens from children without diarrhoea (1.7%). Rotaviral diarrhoeas were most frequently found in infants aged 6 to 18 months and occurred throughout the year with a definite peak during the first winter months. Analysis of the viral RNA by polyacrylamide gel electrophoresis permitted the characterisation of 170 and 194 strains identified. Nine different electropherotypes (A-I) and one mixed infection were observed. The "short" electropherotypes (A-E) were predominant and represented 140 strains (82.4%), and the "long" electropherotypes (F-I and M) represented 30 strains (17.6%). The "short" electropherotype A (cafb) was the most frequent in our environment (45.3% of cases) and was predominant during the first 14 months of the study. The "long" electropherotype F (bbea) appeared in July 1990 and was predominant during the last three months. Among these children with diarrhoea, the presence of rotavirus was significantly associated with vomiting, fever, and moderate to severe dehydration. However, no significant differences in the occurrence of these symptoms were found between the "short" and "long" electropherotypes.
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PMID:Epidemiological study of infantile rotavirus diarrhoea in Tananarive (Madagascar). 840 86

Between July 1993 and March 1994, clinical researchers in Egypt enrolled 190 male children aged 1-24 months with acute diarrhea at the Abu El Reeche Hospital in Cairo in a randomized double-blind clinical trial to evaluate the relative efficacy of a reduced osmolarity oral rehydration solution (ORS) containing 75 mmol/l of both sodium and glucose (total osmolarity, 245 vs. 311 mmol/l for the standard ORS recommended by the World Health Organization and UNICEF) for treating acute noncholera diarrhea. They measured intake and output every three hours. Over the entire course of the study, the mean stool output was significantly lower in the reduced osmolarity ORS group than the standard ORS group (4.3 vs. 5 g/kg/hour; p 0.05). During the rehydration phase, the mean stool output was 36% lower in the reduced osmolarity ORS group than in the standard ORS group (p 0.05). The proportion of children vomiting during rehydration was much lower in the reduced osmolarity ORS group than the standard ORS group (17% vs. 33%; relative risk [RR] = 2.4; p 0.01). During the maintenance phase, the two groups shared similar stool output, mean intake of food and ORS, duration of diarrhea, and weight gain. Treatment failure was significantly more common in the standard ORS group than the reduced osmolarity ORS group (8% vs. 1%; RR = 7.9; p 0.01). The mean serum sodium level at 24 hours were much lower in the reduced osmolarity ORS group (134 vs. 138 mEq/l; p 0.001) but remained within the normal range in both groups. Children in both groups developed hyponatremia or their hyponatremia worsened at the same rate. Urine output was about the same in both groups. These findings suggest that the reduced osmolarity ORS has advantages over the standard ORS as a treatment for acute noncholera diarrhea. This safe and effective rehydration treatment reduces stool output and vomiting during rehydration as well as reduces the need for supplemental intravenous therapy.
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PMID:A double-blind clinical trial comparing World Health Organization oral rehydration solution with a reduced osmolarity solution containing equal amounts of sodium and glucose. 855 20

Amylase from germinating cereal grains enables the preparation of porridge with a higher energy density than conventional weaning foods. This food can be combined with fermentation, which inhibits pathogen growth. These food technologies are inexpensive, can be implemented at the household level, and are therefore particularly appropriate for use in developing countries. In a controlled clinical trial, 75 children aged 6-25 months admitted to hospital with acute diarrhea were rehydrated and then randomly allocated to three corn porridge dietary groups: conventional, amylase-digested (AMD), and fermented and amylase-digested (FAD). The study diets were given ad libitum five times daily, and all intakes except breast milk were weighed. Mean daily energy intakes over 4 days in the conventional AMD, and FAD groups, respectively, were 32.4 (95% CI 28.7-36.6), 46.0 (CI 39.6-53.4), and 37.3 (CI 31.8-43.9) kcal/kg/day. The energy intake in the AMD group was 42% higher than the conventional group (p = 0.003). There were no significant differences between the groups for duration of diarrhea, frequency of stooling, or vomiting. Starch digestion using amylase from germination is an effective way of improving energy intake in children with acute diarrhea.
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PMID:Improved energy intakes using amylase-digested weaning foods in Tanzanian children with acute diarrhea. 857 19


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