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

Focus is on studies of acute diarrheal diseases that have been conducted at the Pediatric Center in Bombay, India and at other Indian centers. The objective is to present the picture of acute diarrheal disease in infancy as seen in a large developing country like India. Of a total admission of 16,252 cases over a 5-year period, 2835 were of acute diarrhea, constituting 17.3% of the total admissions. 89.1% of these cases occurred under age 2; 10.9% were in the age group of 3-12 years. There were 440 deaths in 2835 cases, i.e. the mortality rate in diarrhea was 15.5%, but it varied from 12-19% in a 5-year period. Of a total of 2088 deaths due to all cases in a 5-year period, diarrhea was responsible for 21%. Bacteriological and virological studies in a series of 642 cases studied throughtout India showed pathogenic organisms in 19.7% to 69.7% of cases and non-pathogenic organisms 15.2% to 80.3%. Bacteriological and virological studies of the stools revealed presence of specific type of E. coli in majority, and shigella, strepto- and staphylococci in a few cases. The incidence of malnutrition is very high in acute diarrhea and the importance of correction of nutritional deficits cannot be over stressed. The great hope lies in prevention of diarrhea by improvement in nutrition of children, prevention of malnutrition, improved sanitation, environmental conditions and health education.
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PMID:Trends in the treatment of acute diarrhoeas in infancy. 565 41

In Riyadh, Saudi Arabia, gastroenteritis is a leading cause of admission to Children's Hospital. A prospective study of 254 children between the ages of 0-5 admitted over a 4-month period for acute diarrhea was undertaken. Information was obtained from parents about each child's history and the children were medically examined and weighed before and after treatment. Blood urea and electrolytes were estimated and stools examined for parasites and bacteria. Almost 85% of the babies were under 1 year old, 46.5% were less than 5 months. 35.6% had normal weights for age; 25.6%, 1st degree malnutrition; 26.4%, 2nd degree and 12.4%, 3rd degree malnutrition. The severely malnourished were all marasmic, except for 6 who had kwashiorkor, alone or with marasmus. 65.4% were bottle fed but only 20% of the mothers used boiling or chemical means of sterilizing the bottles. Isonatremic dehydration accounted for 73% of the dehydrated infants or children, hyponatremia for 14% and hypernatremia for 13%. 11.8% were graded severely dehydrated on admission. Mothers of children with hypotonic dehydration tended to dilute the feeds, while mothers of hypertonic dehydrated children tended to concentrate them. The overall isolation rate for bacteria and parasites was 33.8%, including salmonella, entero-pathogenic E. coli, Giardia lambia and shigella species. 23 children died; mortality was highest in the younger age group, among babies who were bottle fed, among the more severely dehydrated and among those with hypertonic and hypotonic dehydration. The study results are comparable with incidence reported in proximal areas. The high incidence of bottlefeeding and the consequences to infant health as a major cause of morbidity is of concern. The mild cases of dehydration could be treated on an outpatient basis if adequate facilities are accessible to the population.
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PMID:Gastroenteritis among children in Riyadh: a prospective analysis of 254 hospital admissions. 618 53

Mucosal adhesion of bacteria has been studied in eight infants with protracted diarrhoea and malnutrition, using a buccal epithelial cell technique. A known non-adhesive strain of Escherichia coli (O1:K1:H7) adhered to a significantly greater (p less than 0.001) proportion of buccal epithelial cells from patients with protracted diarrhoea, compared with children with acute diarrhoea, healthy infants, and healthy adults. Also, Enterobacteria isolated from the jejunum or stools of patients with protracted diarrhoea adhered to far greater numbers of their own buccal epithelial cells compared with healthy adults. These results suggest that bacterial adhesion may play an important role in the pathogenesis of protracted diarrhoea.
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PMID:Increased adhesion of Escherichia coli to mucosal cells from infants with protracted diarrhoea: a possible factor in the pathogenesis of bacterial overgrowth and diarrhoea. 634 98

Forty-five marasmic infants were studied for plasma zinc and copper levels. They were selected from those children admitted to a nutritional recovery center. The mean plasma zinc level was 92.4 +/- 24 micrograms/dl (mean +/- SD); 7% of the infants had low zinc values as defined by zinc less than 70 micrograms/dl. Median copper was 90 micrograms/dl (range 27-172) and 49% of the children had copper levels below 90 micrograms/dl (established as our normal limit). Birth weight, breast feeding and prior hospitalization for acute diarrhea with dehydration were studied as antecedents related to low Cu and Zn. Children with prior diagnosis of acute diarrhea and hospitalization had lower copper levels than those sent from primary care centers. Breast feeding was associated with higher Cu levels. No relationship was found between zinc levels and those antecedents, but differences were found in regard to the degree of malnutrition, season of the year and Zn status. In this investigation no Zn deficiency was found in marasmus cases. Hypocupremia, however, is a very significant problem in marasmic infants, especially when associated with early weaning and the presence of previous hospitalization for acute diarrhea.
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PMID:[Plasma zinc and copper in infants with protein-calorie malnutrition]. 644 37

The passive intestinal permeability of patients seeking care for acute diarrhoea was investigated with a liquid meal containing differently sized, low-molecular weight polyethylene glycols (PEG 400; mol. wt. 282-590). The subjects suffered from acute infections caused either by Giardia lamblia or rotavirus. The patients were studied during infection and 3-4 weeks later when they had recovered clinically. It was found that both giardia and rotavirus infections were associated with decreased 6-h urinary recovery of the PEG molecules, particularly of the larger molecular weight species. After the infection, the permeability properties returned towards normal values. The results show that the permeability and the absorptive capacity is altered in patients with acute Giardia lamblia and rotavirus infections which could be important in relation to chronic infections and malnutrition attributed to these organisms.
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PMID:Acute infections with Giardia lamblia and rotavirus decrease intestinal permeability to low-molecular weight polyethylene glycols (PEG 400). 652 22

Parasitic intestinal infections are among the most common in Africa, Asia, and Latin America. Although the mortality and morbidity caused by intestinal parasitic infections are relatively low, the absolute number of deaths and cases of disease is rather high in relation to other bacterial and viral infections. Scientific evidence for a causal relationship between intestinal parasitic infections and malnutrition is only fragmentary. The overdispersed frequency distribution of helminth parasites in the human population and the stability of giardiasis in some individuals may help only to define the potential target groups for immediate medical intervention, i.e., those patients heavily parasitized and/or severely malnourished. Long-term preventive intervention should include prenatal control of malnutrition, breast feeding and proper weaning food practices, oral rehydration for acute diarrhea, and immunization and possibly control of parasitic infections. Solid arguments in favor of the latter are expected to emerge from the field studies on intestinal parasitic infections and nutrition designed in 1981 by the World Health Organization and the United Nations Children's Emergency Fund. The results of these studies that will be carried out in several countries should serve as a guide for future parasite control projects and nutritional policies, including supplementary feeding programs.
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PMID:Implications of parasite-nutrition interactions from a world perspective. 669 46

The usefulness of a mixture of wheat noodles and a casein-based formula in the early management of 11 children with second or third degree malnutrition and of ten better nourished children with acute diarrhea was studied. Response of the malnourished children, gauged by clinical course and balance studies, paralleled that previously documented using only casein-based formula diets. Children with acute diarrhea recovered well but had expectedly higher fecal energy losses than previously seen in healthy children consuming the same diet. Diets containing substantial amounts of wheat noodles, a low cost widely available staple, can be appropriately used in the refeeding of chronic malnutrition and acute infectious enteritis.
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PMID:Experience with a mixture of wheat-noodles and casein in the initial dietary therapy of infants and young children with protein-energy malnutrition or acute diarrhea. 681 35

The Diarrheal Diseases Control Program in India was started in 1978 with the objective of reducing mortality and morbidity due to diarrheal diseases. With the birth of the National Oral Rehydration Therapy (ORT) Program in 1985-86, focus shifted to strengthening case management of diarrhea for children under the age of five years and improving maternal knowledge related to the use of home available fluids, use of oral rehydration salt (ORS) solution, and continued feeding. Ensuring availability of ORS packets at health facilities and in the community is an important aspect of the program. Since 1992-93, the program has become part of the Child Survival and Safe Motherhood (CSSM) Program. All program activities are integrated with those of the CSSM program. This paper describes the situation in 1985, the current situation, the emergence of malnutrition as an important issue, rationale for standard case management, the standard case management of acute watery diarrhea, types of diarrhea, assessment of a child with diarrhea, principles of managing acute diarrhea, home available fluids, oral rehydration salts, cases with and without signs of dehydration, cases with signs of severe dehydration, feeding in diarrhea, the rational use of drugs, diarrhea associated with other illnesses, and advice to the mother.
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PMID:Oral rehydration therapy programme in India: standard case management of acute watery diarrhoea. 749 92

A 27 month epidemiological survey of cryptosporidiosis in stools was conducted in 288 Gabonese children aged between 0 and 2 years (mean 10.2 months). By at least one of two staining techniques, acid-fast and direct immunofluorescence, the rate of infection was determined to be 24%. The rate was 28% in cases of acute diarrhea, in striking contrast with the low prevalence of 14.8% in uninjured gastroenteritus subjects (p < 0.05). The notion of asymptomatic carriers was clearly demonstrated. The maximum of 34.4% was observed for infants aged between 6 and 12 months (p < 0.02). In cases of malnutrition, this rate increased to 31.8%, whereas it was 16.8% in eutrophic children (p < 0.01). For the rainy and dry seasons, it was 31.7% and 19.4%, respectively (p < 0.02). Water is emerging as an important vehicle for the transmission and spread of Cryptosporidium sp. in tropical areas.
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PMID:[Digestive cryptosporidiosis in young children in an urban area in Gabon]. 754 96

The clinical and epidemiological aspects of rotavirus diarrhoea were studied in hospitalized children with acute diarrhoea in Lusaka, Zambia. Two hundred and fifty-six (24.0%) of 1069 children admitted to the study were shedding rotavirus. The rotavirus-positive rate was highest in children less than 1 year of age (37.0%) and it was also high in those less than 6 months old. Rotavirus diarrhoea was seen throughout the year with a higher rotavirus-positive rate in the dry season. In rotavirus-positive diarrhoea patients, more children were dehydrated (82.4%) than in the rotavirus-negative group (56.2%). Rotavirus infection was more common in the children with normal nutritional status (27.6%, 162/588) than in those with malnutrition (19.3%, 93/482). The associated case fatality rate in the rotavirus-positive group was 6.4%, significantly less than in the rotavirus-negative group (OR 0.44, 95% CI 0.24-0.79), and mortality cases were seen only in children less than 2 years old.
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PMID:Rotavirus gastro-enteritis in hospitalized children with acute diarrhoea in Zambia. 759 36


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