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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

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

The paper describes the first controlled trial of an oral glucose electrolyte solution designed on the basis of the optimum pathophysiological needs for rehydration in infantile diarrahoea. The solution, having a sodium concentration of 50 mmol/l, was tried in a group of 20 infants with moderate to severe dehydration due to acute diarrhoea and was compared with a matched group of 19 infants predominantly under 2 years of age taking a 'standard' oral solution with a sodium concentration of 90 mmol/l. They could be hydrated as well with a low sodium oral solution alone as with the standard solution. Intravenous fluid was not required in either group. The group treated with the high soldium 'standard' solution appeared to develop hypernatraemia and/or periorbital oedema more frequently than the other group. Also, the low sodium solution eliminated the need for additional free water orally.
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PMID:Oral rehydration in infantile diarrhoea. Controlled trial of a low sodium glucose electrolyte solution. 34 25

Lomotil liquid in a dose of 0.3 mg/kg/day has been compared with plain mist kaolin in controlling acute diarrhoea in young children aged 6 weeks to 2 years. Lomotil was found to stop the diarrhoea faster and significantly shorten the period of hospital admission than kaolin (P less than 0.05) in children whose diarrhoea was complicated by moderate dehydration. In those with mild dehydration lomotil had no advantage over kaolin. Children with severe dehydration treated with lomotil spent on the average much shorter period in hospital than those on kaolin, but the numbers were too small to allow for useful comparison. There was no adverse effect observed in any of subjects at the dose of lomotil used.
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PMID:A comparative trial of liquid lomotil and mist kaolin in childhood diarrhoea. 41 69

For oral treatment of acute dehydration in infants a solution of electrolytes and glucose in water is indicated. Selfmixing of this solution is not advisable. 30 infants with dehydration caused by acute diarrhoea were treated with a granulat (Normolyt) dissolved in water resulting in a solution of appropriate composition. The solution was well accepted and well tolerated. All babies without clinical signs of shock were successfully rehydrated by the solution. No untoward effects were observed.
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PMID:[Oral treatment of acute dehydration in infants by an electrolyte-glucose-solution (author's transl)]. 46 68

Diarrheal disease is bacterial in much of the Third World and viral elsewhere. In the poorest underdeveloped country, as many as 15% of children die from diarrheal disease before their third birthday. This association with geographical or climatic areas of the world, however, is actually a reflection of low socioeconomic levels and poor sanitation for practically all of diarrhea's infectious agents are in fact ubiquitous worldwide. Clinical problems associated with acute diarrhea, irrespective of etiology, relate to dehydration that results from abnormal loss of water and electrolytes in stools. Because an infant's total body weight is 70% water (as opposed to 60% in adults), diarrhea is a particular threat. During diarrheal disease, the major event is the disruption of the recycling of electrolyte-rich digestive fluids, which are nomally secreted into the gastrointestinal tract and then 99% reabsorbed. Treatments include preventive methods, such as public health improvements, and rehydration with glucose-water solutions, either orally or intravenously, depending on extent of dehydration. Vaccine development against rotavirus infection has been stymied by inability to cultivate the organism. However, immunoprophylaxis of bacterial diarrheas has made progress in developing vaccines against enterotoxigenic Escherichia coli. The role of immunity transmitted by breastfeeding is also emphasized.
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PMID:Acute diarrheal infections in infants. I. Epidemiology, Treatment, and prospects for immunoprophylaxis. 51 Nov 28

22 infants under age two years were admitted to the Ubol Provincial Hospital in Northeast Thailand with acute diarrhea. The house physician saw them and judged them to have moderate dehydration. 11 infants aged from 4-10 months were given nasogastric infusion; another 11 infants aged from 5-17 months received intravenous fluid. The absorption of nasogastric infusion fluid was remarkable as could be seen by the amount of stool loss, weight gain, reduction of serum specific gravity and urea nitrogen. Biochemical study showed high incidence of hypernatremia which could be explained by the limited fluid intake in these infants during diarrhea. Nasogastric infusion fluid which contained only table salt and cane sugar could provide effective volume. Electrolyte imbalance and metabolic acidosis were gradually corrected at a similar rate to bicarbonate containing solution as reported by others. Balance study indicated taht nasogastric infusion retained less nitrogen and sodium during the course of treatment as compared to intravenous infusion. All the infants recovered from diarrheal disease once dehydration was corrected without complications.
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PMID:Oral hydration in infantile diarrhoea. 74 26

The reported incidence of "pathogenic" bacteria, as judged by serotype, in the stools of children with acute diarrhoea has varied from 4 to 33% over the last twenty years. Techniques such as tissue culture provide a means for detecting enterotoxin-producing strains of bacteria, strains which often do not possess "pathogenic" serotypes. "Pathogenicity" requires redefinition, and the aetiological importance of bacteria in diarrhoea is probably considerably greater than previous reports have indicated. Colonization of the bowel by a pathogen will result in structural and/or mucosal abnormalities, and will depend on a series of complex interactions between the external environment, the pathogen, and the host and its resident bacterial flora. Enteropathogenic bacteria may be broadly classified as (i) invasive (e.g. Shigella, Salmonella and some Escherichia coli) which predominantly affect the distal bowel, or (ii) non-invasive (e.g. Vibrio cholerae and E. coli) which affect the proximal bowel. V. cholerae and E. coli elaborate heat-labile enterotoxins which activate adenylate cyclase and induce small intestinal secretion; the secretory effects of heat-stable E. coli and heat-labile Shigella dysenteriae enterotoxins are not accompanied by cyclase activation. The two major complications of acute diarrhoea are (i) hypernatraemic dehydration with its attendant neurological, renal and vascular lesions, and (ii) protracted diarrhoea which may lead to severe malnutrition. Deconjugation of bile salts and colonization of the small bowel with toxigenic strains of E. coli may be important in the pathophysiology of the protracted diarrhoea syndrome. The control of bacterial diarrhoea requires a corrdinated political, educational, social, public health and scientific attack. Bacterial diarrhoea is a major health problem throughout the world, and carries an appreciable morbidity and mortality. This is particularly the case during infancy, and in those developing parts of the world where malnutrition is common. This paper is concerned mainly with acute bacterial diarrhoea, and reviews the problem as a whole.
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PMID:The problem of bacterial diarrhoea. 79 97

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

Previous evaluation of diagnostic tests for acute renal failure in children demonstrated that osmolality urine/plasms (U/P) ratio below 1.3, urea ratio below 4.8 and a negative mannitol test (absence of a diurteic response within one hour after intravenous administration of 60 ml/m2 of 12.5% mannitol solution) may be considered as valuable factors in this diagnosis. However, the validity of those ratios were in doubt in selected populations such as newborns and in severe malnourished children in whom an impairment in concentrating urine capacity can be anticipated. With the purpose to test the validity of these parameters, a group of 53 newborns and 68 children with severe malnutrition were studied. They were admitted to the hospital with dehydration secondary to acute diarrhea presenting oliguria and hyperpnea and before any treatment was given, urine and blood samples were taken to determine urea and osmolality U/P ratios besides routine chemistries. Mannitol test was performed when urine could not be obtained and in some cases in whom U/P results deserved confirmation with the biological test. Seven of the 53 newborn patients developed acute renal failure with negative mannitol test and further clinical course of persistent oliguria. Urea and osmolality U/P ratios were 3.0 +/- 1.5 and 1.07 +/- 0.01 respectively, whereas the remaining 46 newborns had afterwards an uneventful recovery presenting U/P ratios of 12.4 +/- 8.5 for urea and 1.32 +/- 0.57 for osmolality. The difference between the average values of urea U/P ratio of the patients with acute renal failure and those with functional oliguria, were statistically significant at the level of p less than 0.01, but there was no significant difference between osmolality ratio values.
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PMID:[Evaluation of the urinary and plasma urea ratio and osmolarity in newborn infants and malnourished children with pathological and normal renal function]. 127 67


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