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

The role of feeding breast milk, unmodified bovine milk or adapted infant formula during acute diarrhoea in protecting against or causing persistence of the episodes was investigated in a population-based case control study in an urban area of north India. After adjustment for confounding variables, exclusive breast-feeding was associated with an odds ratio of 0.06 (95% CI 0.002-2.1), a 16.5 times lower odds in favour of developing persistence of an episode. Infants fed unmodified bovine milk in addition to breast milk had an odds of 2.5 times (95% CI 1.0-9.9) in favour of developing persistence of acute diarrhoea (p = 0.04). In infants receiving unmodified bovine milk and no breast milk, this odds ratio was 11.1 (95% CI 1.0-228.8) (p = 0.05). This study indicates that promoting exclusive breastfeeding may reduce the persistence of diarrhoea over and above its effect in decreasing the incidence of acute diarrhoea. In urban areas of the developing countries where working mothers often use milk supplementation beyond the age of three months, our findings suggest that use of adapted spray dried formula may be safer than unmodified bovine milk with respect to the risk of developing persistent diarrhoea.
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PMID:Type of milk feeding during acute diarrhoea and the risk of persistent diarrhoea: a case control study. 142 49

Hyperkalemia has been associated with cardiac abnormalities and muscular disorders. Hyperkalemia is a common problem associated with the acid-base and electrolyte disturbances that occur in neonatal calves having acute diarrhea. Occasional calves with acute neonatal diarrhea, metabolic acidosis, and hyperkalemia have cardiac rate or rhythm abnormalities. Bradycardia observed in three such calves was found to represent atrial standstill and was attributed to hyperkalemia.
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PMID:Hyperkalemic atrial standstill in neonatal calf diarrhea. 143 3

Worldwide, diarrhea remains one of the most common illnesses among children. In the United States, children < 5 years of age experience > 20 million episodes of diarrhea each year, leading to several million doctor visits, 200,000 hospitalizations, and approximately 400 deaths. Much of this morbidity is due to the dehydration associated with acute watery diarrhea. Consequently, the proper management of children with acute diarrhea is important for all practitioners as well as for parents of small children. The development of oral therapy for the rehydration and maintenance of children with dehydrating diarrhea has become the worldwide mainstay of national diarrheal control programs. More recently, proper nutrition for children with diarrhea is viewed as an important adjunct to therapy, whereas antibiotics and other drugs play only a limited role. Intravenous therapy remains essential for diarrheal episodes associated with severe dehydration. This document reviews the proper management of diarrhea among children. Particular attention is given to the use of oral therapy for rehydration and maintenance therapy for the dehydrated child and nutritional management. In the United States, the improved management of children with diarrhea could lead to a noticeable decrease in the number of children who are hospitalized or die as a result of diarrheal illness. This report contains recommendations prepared by the Centers for Disease Control and Prevention (CDC), with input from a panel of pediatric and diarrheal management experts, which are consistent with recommendations endorsed by the American Academy of Pediatrics.
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PMID:The management of acute diarrhea in children: oral rehydration, maintenance, and nutritional therapy. Centers for Disease Control and Prevention. 143 68

An investigation of child mortality in a semi-urban community, Bandim II, in the capital of Guinea Bissau was carried out from April 1987 to March 1990. 153 deaths were recorded among 1426 live-born children who were followed for 2753 child-years. The under-five mortality risk was 215 per 1000 children (95% confidence interval [CI] 176-264), infant mortality 94 per 1000 (95% CI 73-115), and perinatal mortality 52 per 1000 (95% CI 41-63). By prospective registration of morbidity, post-mortem interviews, and examination of available hospital records, a presumptive cause of death was established in 86% of the deaths. Persistent and acute diarrhoea were the most frequent causes of death, accounting for 43 and 31 deaths per 1000 children, respectively. Fever deaths (possibly malaria), neonatal deaths, acute respiratory infections, and measles were other frequent causes. The access to health services was relatively easy: 75% of the children who died had attended for treatment at a hospital or a health centre. It is important to find ways of preventing and managing persistent diarrhoea, the major cause of death, and to improve the control of acute diarrhoea by a targeted approach.
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PMID:Persistent and acute diarrhoea as the leading causes of child mortality in urban Guinea Bissau. 144 Jul 94

This work argues that rapid intravenous rehydration is desirable in cases of acute diarrhea. It provides detailed instructions for preparing and administering the correct solutions and for recognizing patients who are hyponatremia or suffering from acute acidosis. With widespread use of oral rehydration therapy, i.v. rehydration is limited to patients with acute dehydration or contraindications to oral rehydration. For purposes of prognosis, dehydration is usually classified according to the concentration of serum sodium or the degree of fluid loss. The objectives of i.v., rehydration are to eliminate the deficits of water and electrolytes, replace losses so that the patient will not become dehydrated again, and permit early feeding. The water deficit is variable and may amount to 100-150 ml/kg in the severely dehydrated. The sodium deficit is 9-17 mmol/kg and the potassium deficit is 3-15 mmol/kg. Early feeding after no more than 8 hours of fasting is currently considered more effective in preventing malnutrition in children with diarrhea and dehydration. Since the presence of deficits prevents feeding, the initial period of dehydration should not be prolonged beyond 4 hours. In developed countries, i.v. rehydration takes place over 12-24 hours with periods of fasting of 24-48 hours, but the mortality associated with this method of treatment in dehydrated children with diarrhea is higher. To meet its objectives, i.v., rehydration should take place in 3 phases, a rapid initial phase followed by simultaneously occurring phases of maintenance and of replacement in which normal and abnormal losses are replaced. The initial rapid phase should restore the normal perfusion of vital organs by eliminating deficits of sodium and water in no more than 2 hours. All sings of dehydration should disappear. The weight of the child before dehydration and thus the weight loss is seldom known, but experience with the method allows adequate approximations to be made. The solution used in almost all patients is a mixture of physiological solution of NaCl .9% and 5% dextrose solution (PS:DS5% 1:1). The only exceptions are patients with very low sodium levels or severe acidosis, who can be recognized by the experienced practitioner based on their characteristic clinical symptoms. The final concentration of sodium in the solution is .45% of NaCl and that of dextrose 2.5%. The patient is always reevaluated after 1 hour of treatment to detect possible complications. Treatment of hyponatremia and acidosis requires adjusting levels in the 1st hour of treatment with special formulas so that the standard formula may be administered. Instructions are provided for calculating the quantity and content of fluids for the maintenance and replacement stages, which are customarily administered in segments of 6-8 hours.
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PMID:[Rapid intravenous rehydration in acute diarrhea]. 144 37

Diarrhoea is regarded as the characteristic symptom of intestinal disturbances. However, cats with intestinal disturbances can also show other symptoms such as vomiting, increased or decreased appetite and loss of weight. Cats with diarrhoea are usually only referred to the clinic if they have a chronic problem. Acute diarrhoea reacts well to symptomatic treatment, but chronic diarrhoea requires a specific diagnosis for a directed therapy and prognosis. It is essential to examine faeces and blood when evaluating a cat with diarrhoea. In contrast to the situation for dogs, there are no good specific digestion and absorption tests available for cats to evaluate pancreatic and intestinal function. Exocrine pancreatic insufficiency rarely occurs in cats. A preliminary diagnosis of small intestine disorders can be made on the basis of the faeces staining positive for fat, an oral fat absorption test and the response to therapy. The definitive diagnosis must usually await the results of histological examination of intestinal biopsy samples. Cats with acute diarrhoea often recover spontaneously, and symptomatic treatment is only necessary for severe cases. A specific diagnosis is needed for cats with chronic diarrhoea, to enable directed treatment. Corticosteroids are used in the treatment of chronic enteritis because of their immunosuppressive and anti-inflammatory actions. Antibiotics are only indicated for specific bacterial infections (such as Salmonella and Campylobacter), bloody diarrhoea, or rampant bacterial growth. Specially formulated diets play a major role in the treatment of both acute and chronic diarrhoea.
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PMID:[Diarrhea in cats]. 146 41

To explore the optimal dosing regimen for trimethoprim-sulfamethoxazole (TMP-SMX) when used in combination with loperamide to treat traveler's diarrhea, 190 U.S. adults with acute diarrhea were enrolled in a double-blind, randomized trial in Guadalajara, Mexico. All patients received loperamide (4-mg loading dose; 2 mg after each loose stool, not to exceed 16 mg/day for 3 days) and were randomized to receive a 3-day course of TMP-SMX (160:800 mg twice daily for six doses) (group A), a single large dose of TMP-SMX (320:1,600 mg) (group B), or a large loading dose (320:1,600 mg) followed by standard doses for 3 days (160:800 mg twice daily for five doses) (group C). Patients in group C responded best (P < 0.01), with 75% of subjects recovered from diarrhea in 12 h compared with 34 h (group A) and 33 h (group B). Similar differences in favor of group C were noted in the subset of patients who presented with moderate to severe diarrhea. On average, patients in group C took significantly (P < 0.05) less loperamide (1.2 mg) after the 4-mg loading dose compared with patients in group A (2.4 mg) or group B (2.0 mg). We conclude that the most efficacious treatment of traveler's diarrhea in the interior of Mexico is to take loperamide in usual doses to control symptoms in combination with a single large dose of TMP-SMX, which should then be continued for 3 days in standard doses.
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PMID:Optimal dosing of trimethoprim-sulfamethoxazole when used with loperamide to treat traveler's diarrhea. 148 52

From May 1989 to January 1991, 20 patients were investigated for antibiotic-associated acute diarrhea. Colonoscopy or rectosigmoidoscopy was performed in each patient. Cultures of colonic mucosal biopsies were carried out using conventional culture grounds (cystine-lactose-electrolyte-deficient). The aim of this study was to investigate the role of a gram negative bacillus: Klebsiella oxytoca. Among the 20 patients with antibiotic-associated acute diarrhea, 11 had bloody and mucus diarrhea and colitis ranging from a right-sided hemorrhagic to diffuse acute ulcerative or erosive colitis, 7 had a grossly normal colonic appearance, while 2 had mucus diarrhea and pseudomembranous colitis. Of colonic biopsies cultures obtained from 36 control patients, 15 had a normal colonic appearance, 15 had ulcerative or crohn's colitis, 6 had well-tolerated amoxicillin therapy. Klebsiella oxytoca was never found in the 36 control patients; Klebsiella oxytoca was noted among 8/11 patients with mucus-discharging and bloody diarrhea. These results suggest that antibiotic-associated, non pseudomembranous colitis is frequently associated with Klebsiella oxytoca infection, which may be the cause of this type of colitis.
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PMID:[Post-antibiotic diarrheas: role of Klebsiella oxytoca]. 148 55

Data regarding factors contributing to acute diarrhoea in children under five years in urban populations in Sri Lanka is meagre. Studies of diarrhoeal disease have been limited mainly to descriptive epidemiological investigations. A case control study on 200 families in the Galle Municipality was undertaken to identify some of the social, behavioural and environmental factors contributing to childhood diarrhoea. Twelve variables were studied by logistic regression, and the following variables were identified as conferring a significant risk of causing diarrhoeal disease in children below five years in an urban setting in Sri Lanka; (1) unavailability of pipe-borne water in the house (2) lack of water-seal latrine in the household (3) low level of mother's education and her lack of awareness regarding infectious nature and mode of spread of diarrhoea (4) not disposing of children's faeces in a latrine (5) improper disposal of garbage.
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PMID:Risk factors contributing to acute diarrhoeal disease in children below five years. 148 45

Dioctahedral smectite, a non systemic antidiarrheal agent, is mucoprotective and absorbs enterotoxins and rotavirus as demonstrated in animal models. Smectite has been successfully used in various countries in children and adults with acute diarrhea. This study was to assess the efficiency of smectite associated with rehydration in infants with acute secretory diarrhea. Sixty-two hospitalized Thai infants, aged 1-24 months, with acute secretory diarrhea were randomly divided into 2 groups receiving (1) oral rehydration solution (ORS) (30 cases), (2) ORS and Smectite (3.6 g/day) (32 cases). Both groups were comparable for age, weight, nutritional status and duration of symptoms before treatment. All 62 infants received lactose free formula and chicken rice soup as the standard diet. Stool frequency, weight change and duration of diarrhea were recorded. The mean duration of diarrhea was 84.7 +/- 48.5 hours in group 1, and 43.3 +/- 25.1 hours in group 2 (p = 0.005). The number of infants with diarrhea was significantly lower in group 2 on Day 1 (p < 0.01) and Day 3 (p = 0.001); furthermore 27% of infants in group 1 and 3% in group 2 had still diarrhea on Day 5. The stool frequency and weight changes were not statistically different in the two groups. No major side effects were observed except two cases of vomiting and hardened stools. It is concluded that (1) Smectite shortens the course of acute secretory diarrhea in Thai infants; (2) smectite may reduce the occurrence of prolonged diarrhea; furthermore (3) in our study dioctahedral smectite was found to be safe in children aged 1 to 24 months.
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PMID:Control study of oral rehydration solution (ORS)/ORS + dioctahedral smectite in hospitalized Thai infants with acute secretory diarrhea. 148 94


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