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

The antibiotic therapy of salmonellosis has changed during the last decade, due to the development of resistance to classical drugs and also to increased knowledge in the conditions of in vitro and in vivo efficacy of new compounds. These new informations led to clinical studies of efficacy and tolerance of fluoroquinolones in the treatment of acute diarrhea or chronic carriage due to Salmonella, or against typhoid fever. These drugs appeared very efficacious and able to significantly shorten the duration of treatment. However, two potential pitfalls have to be kept in mind deserving additional informations: selection of resistant mutants and increased risk of persistent carriage.
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PMID:[Salmonellosis: therapeutic aspects]. 129 94

Intestinal permeability was assessed with different-sized polyethylene glycols (PEG 400 and PEG 1,000) in small children with acute diarrhea. All children with acute diarrhea absorbed and excreted less PEG of all molecular sizes into the urine when compared with healthy control children (p less than 0.001). Children with acute rotavirus infection excreted significantly less PEG of all sizes than children with Shigella, Salmonella, and enteropathogenic Escherichia coli (EPEC) infection (p less than 0.001-0.01), suggesting a more severe mucosal lesion caused by rotavirus. In patients with severe malnutrition there was also a significant decrease in absorption of PEGs observed. In addition, malnourished patients with rotavirus diarrhea showed a pronounced decrease of PEGs in comparison with well-nourished patients. The ratio between the recovery of a large PEG molecule, 1,074 Da, and a small molecule, 370 Da, was utilized to assess the absorption of large molecules in relation to that of smaller ones. On applying this ratio, it was noted that the intestine in children with Shigella and EPEC infection was relatively more permeable to larger molecules than in healthy controls, while in rotavirus and Salmonella infection it was less permeable to larger molecules. In this study significant differences in the permeability characteristics were observed, suggesting etiology-specific effects on the mucosal barrier.
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PMID:Intestinal permeability assessed with polyethylene glycols in children with diarrhea due to rotavirus and common bacterial pathogens in a developing community. 269 81

In a double-blind, randomized, placebo-controlled trial 50 adult patients with acute diarrhea received either 500 mg ciprofloxacin b.i.d. or a placebo for five days. Results were evaluated in 21 patients in the ciprofloxacin group (10 with Salmonella spp., 11 with Campylobacter jejuni) and 25 patients in the placebo group (16 with Salmonella spp., 5 with Campylobacter jejuni, 4 with Shigella spp.). The duration of fever in patients treated with ciprofloxacin was 1.5 days versus 2.3 days in the placebo group; the difference was not statistically significant. The duration of diarrhea in the ciprofloxacin group was 1.4 days versus 2.6 days in the placebo group (p less than 0.01); the corresponding figures in patients with salmonellosis were 1.6 versus 3.2 (p = 0.01). In the ciprofloxacin group all stool cultures became negative 48 h after start of treatment and remained negative during the follow-up period of three weeks. In the placebo group only one of the 25 patients had negative stool cultures during therapy and only seven after the treatment period (p less than 0.001). Ciprofloxacin was very well tolerated and was found to be a safe compound without major adverse effects.
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PMID:Ciprofloxacin in the treatment of acute bacterial diarrhea: a double blind study. 294 Dec 90

Concentrations of alpha-1-antitrypsin (AT) in random fecal samples from 68 infants (92.7% outpatients) with acute diarrhea and 32 healthy controls were determined. The mean +/- s.d. for AT in infants with diarrhea was 2.07 +/- 1.88 mg/g dry stool (mg/g d.s.) compared with 1.29 +/- 0.72 mg/g d.s. (p less than 0.05) in controls. Fecal AT was significantly greater than that of the controls only for diarrhea caused by Rotavirus or Salmonella. Salmonella patients also had significantly higher fecal levels of AT than patients with diarrhea caused by Campylobacter. Fifty percent of the infants with Salmonella infections excreted more than 2.73 mg/g d.s. AT, which is above the control mean + 2 s.d. Fecal excretion of AT was highest in patients with macroscopic intestinal bleeding, but it still depended more on the causative agent than on bleeding per se. This finding of increased intestinal protein loss during acute diarrhea, even in the less severe diseases, emphasizes the necessity to rapidly restart adequate nutritional intake.
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PMID:Fecal alpha-1-antitrypsin excretion in acute diarrhea: relationship with causative pathogens. 326 14

In a double-blind, randomized trial, 85 adult patients with acute diarrhea (more than three watery stools per day) received either 500 mg of ciprofloxacin twice daily or placebo for five days. Seventy-six patients were evaluated, 38 patients in the ciprofloxacin group (16 with Salmonella species, 19 with Campylobacter jejuni, and three with Shigella species) and 38 patients in the placebo group (21 with Salmonella species, 11 with C. jejuni, and six with Shigella species). The duration of fever in patients treated with ciprofloxacin was 1.3 days versus 3.1 days in the placebo group (p less than 0.05). The mean duration of diarrhea in the ciprofloxacin group was 1.5 days versus 2.9 days in the placebo group (p less than 0.001). The corresponding numbers in patients with salmonellosis were 1.9 versus 3.4 days (p less than 0.01). In the ciprofloxacin group, all stool culture results became negative within 48 hours of treatment. Relapse occurred in four patients with salmonellosis within three weeks after the end of treatment. In the placebo group, only four of 38 patients had negative stool culture results during treatment and results were negative in only 13 at one week after the treatment period (p less than 0.001). Modest transient elevation of serum transaminase levels was detected in three patients in the ciprofloxacin group and in two patients in the placebo group. Epigastric pain occurred in one patient, and leukopenia occurred in one patient in the ciprofloxacin group. Gastrointestinal discomfort was recorded in two patients and rash was found in one patient in the placebo group.
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PMID:Clinical efficacy of ciprofloxacin compared with placebo in bacterial diarrhea. 355 57

A retrospective study on surgical cases of colic in horses (n = 216) revealed that 42 (19.4%) developed post-surgical diarrhoea. Salmonella spp. were isolated in 6 (16.2%) of the cases (n = 37) exhibiting diarrhoea. In 35.7% of the cases (n = 42) recovery from surgery was disturbed by other complications; 23.8% (10/42) died, 2 of which from primary acute diarrhoea due to salmonellosis. Most of the outbreaks of diarrhoea occurred in winter and spring. From the associated variables examined, the duration of colic signs revealed a significant difference between the cases which developed acute postoperative diarrhoea and the other surgical cases.
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PMID:Acute postoperative diarrhoea in colic horses. 378 70

Acute diarrhea due to identifiable pathogenesis is caused in about 50% by bacteria. There are 4 general virulence properties of bacterial enteropathogens, namely adherence, cytotoxicity, enterotoxicity and invasiveness. These problems are discussed for the known enteropathogens. Stool examination for the presence of numerous leukocytes is a valuable screening test indicating diffuse colonic inflammation f.ex. in shigellosis, salmonellosis, campylobacterosis and yersiniosis.
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PMID:Bacterial agents in acute diarrhea. 707 86

Osmolality is an indication of the osmotic pressure of plasma and depends on the amount of solute and solvent (water) present. The mean (+sd) plasma osmolality of 100 clinically normal animals was 282 (+6) mOsm/kg using lithium heparin as anticoagulant. The equation, osmolality=1.86 (sodium + potassium) +glucose +blood urea nitrogen + 9, was found to predict only crudely plasma osmolality. The plasma sodium: osmolality ratio was 0.49. Water and electrolyte disorders are classified into 3 types based on the measurement of electrolytes and osmolality: (1) Hypertonic dehydration (true dehydration desiccation), osmolality greater than 300 mOsm/kg, associated with water deprivation, some gastrointestinal emergencies and some types of diarrhoea; (2) hypotonic dehydration (acute desalting water loss), osmolalities less than 260 mOsm/kg, associated with acute diarrhoea, particularly salmonellosis; (3) isotonic dehydration (normal electrolyte and osmolality levels), in horses losing electrolytes and water in almost equal proportions. The importance of these observations and their significance in rational clinical management are discussed.
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PMID:The concept of osmolality: its use in the evaluation of "dehydration" in the horse. 708 92

The practical implications of equine salmonellosis in the light of present knowledge are reviewed. Emphasis is placed on the various clinical forms which the disease may take. These include asymptomatic infections, signs of fever, anorexia and depression, severe acute diarrhoea and the septicaemic form. Diagnosis depends on recovery of the organism from the blood or faeces or, at necropsy, from tissues. In asymptomatic infections, it may be necessary to make serial faecal cultures over several days before a negative diagnosis may be made with any degree of certainty. Isolation of salmonellae is more readily accomplished when clinical signs, particularly diarrhoea, are present. Treatment depends on the nature of the infection and ranges from no measures in some asymptomatic cases to those in which antimicrobial drugs, fluids, electrolytes and buffers are administered. In both asymptomatic and symptomatic cases, faecal shedding continues during and after antimicrobial therapy. The part played by stress (eg, heat, chilling and over-crowding) is discussed in relation to pathogenesis. Measures of control depend on reducing exposure to the organism and a number of steps to achieve this are described.
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PMID:Equine salmonellosis: a contemporary view. 729 43

An outbreak of acute diarrhoea and deaths was investigated in a group of 1,016 feral goats of varying ages, on a 400 hectare Gippsland pine plantation. The goats had recently been captured in north western New South Wales and transported by truck to Melbourne, Victoria, a journey of 20 to 25 hours, and maintained in holding yards for up to 10 days. They were then transported for a further 3 hours, and released in the Gippsland plantation. Within 1 to 2 weeks of release many goats developed acute, severe diarrhoea, weakness and recumbency. Thirty-eight percent of all goats died in the first 2 months on the farm. Autopsy findings were characteristic of salmonellosis in 13 (43%) of the 30 goats examined and Salmonella sp were cultured from these and one other goat (47%). Four different serotypes of Salmonella were represented (S. adelaide, S. typhimurium, S. muenchen, S. singapore). The findings support the view that stress due to transport and intensive handling caused carriers of Salmonella to develop into active excretors with high cross infection to susceptible goats.
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PMID:Salmonellosis in transported feral goats. 734 46


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