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

Oral rehydration therapy has gained worldwide acceptance as the standard treatment for acute diarrhoeal diseases in infants and children. Besides the high sodium glucose-electrolyte solution based on the WHO/UNICEF recommendations, many diverse formulations of oral rehydration solutions (ORS) have withstood the trial of prolonged clinical use, their main differences concerning the concentration of sodium, the choice of the glycidic component, the use of bicarbonate as buffer or its substitution with acetate or citrate. It was recently hypothesized that glucose polymers-containing ORS markedly improve the intestinal sodium/glucose cotransport by delivering glucose at its critical site on the luminal villous membrane and therefore diminish stool output and duration of the diarrhoea. To investigate this hypothesis, the efficacies of two marketed ORS (table I), one containing sucrose and maltodextrin (solution A) and the other containing glucose (solution B) were compared. The study group comprised 13 infants and toddlers, 1 to 18 months old, who presented with acute diarrhea; 5 were males and 8 females; 7 were randomly allocated to receive solution A (Group A), 6 solution B (Group B). There were no significant differences between the groups in age, sex, causation of diarrhea or severity of dehydration before receiving ORS. Both groups showed a satisfactory response to 24 hours of treatment with either ORS, but a significantly lower stool output (number and global weight of stools) and higher blood glucose and bicarbonate levels were detected in group A (table II).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Importance of oral rehydration in acute infantile diarrhea. Comparison of 2 rehydration solutions]. 233 56

A strain of Enteroinvasive Escherichia coli was isolated from the stool with blood and mucus of a child suffering from acute diarrhea. The strain shows the following characteristics: rapid fermentation of glucose (with gas), no fermentation of lactose, beta-galactosidase reaction positive, growth in acetate media, lysine decarboxylase negative, non-motility causing keratoconjunctivitis in guinea pigs and invading into epithelial cells, with a plasmid of 140 Md, Serotype is O121:H- which is a new serotype of Enteroinvasive Escherichia coli.
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PMID:[The discovery and study on invasive strain of Escherichia coli O121]. 267 72

The literature on oral sugar-electrolyte mixtures for treatment of acute diarrhoea is reviewed. Several trials have shown that the solution proposed by the WHO for developing countries containing inter alia 90 mmol/l of sodium and 111 mmol/l of glucose is safe for short term oral rehydration. When used in this manner there is no risk for development of hypernatraemia. The surplus base of the solution is not essential and, furthermore, other anions e.g. acetate may be substitute for bicarbonate. Other modifications of the WHO formula have also been successfully tried, e.g. sucrose 4% (117 mmol/l) instead of glucose 2% (111 mmol/l). A somewhat lower concentration of sucrose may, however, prove to be better. Most acute childhood diarrhoeas are not mediated by enterotoxin and thus not of the secretory type, but temporary malabsorption is common. Therefore, the amount of carbohydrate in oral sugar-electrolyte mixtures should be limited. Osmotic diarrhoea due to carbohydrate malabsorption is a more likely cause of hypernatraemia in dehydrated children than too much dietary sodium. In developed countries prepacked oral sugar-electrolyte mixtures are mainly designed for moderately sick children treated at home. There is no reason to raise the carbohydrate content of these mixtures above that of the WHO formula, but the sodium content must be lower. For most situations in home treatment 50 mmol/l of sodium will be adequate.
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PMID:High sugar worse than high sodium in oral rehydration solutions. 634 Apr 10

Oral glucose-electrolytes solutions have been first developed for treatment of watery diarrhea in situations where resources are limited. However, oral therapy proved by no means to be a limited or alternative form of treatment and it must be now considered as the treatment of choice for acute diarrhea of practically all etiologies. Furthermore, it must be pointed out that, whatever the additional treatments (antibiotics essentially), oral therapy and suppression of milk feeding have to be effected as soon as possible. Glucose-facilited sodium transport is one of the main processes involved in efficiency of oral formulations. However, recent investigations in our laboratory have shown that acetate (and propionate) brought about a substantial stimulation of sodium and water absorption in the small intestine. This effect was all the more interesting since it was observed throughout the small intestine, in contrast to solutes such as glucose, aminoacids or chloride. Furthermore, acetate affords the possibility of having a more physiological Na/Cl ratio, for correction of acidosis. Besides, acetate may display a delayed alkalinizing effect after metabolization. Propionate also exhibits interesting properties on sodium absorption and as glucogenic substrate after absorption. Field evaluation have demonstrated the efficiency of oral formulations including acetate and propionate (treatment of more than 100 000 diarrheic calves), with generally more than 95% success. Further progress should be expected from improvement in energy supply from oral formulations. The problem is at present the matter of investigations, particularly by utilization of lactose in carefully balanced electrolytes formulations.
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PMID:Utilization of volatile fatty acids and improvement of fluid therapy for treatment of dehydration in diarrheic calves. 667 88

From 1987-1989, researchers conducted a double blind randomized controlled clinical trial among 301 infants 3-24 months old with acute or persistent diarrhea in Bangladesh to determine the impact of 2 weeks of zinc acetate (15mg/kg/day) supplementation on intestinal function, morbidity, and growth. A significant increase in mean serum levels of zinc occurred in infants with acute diarrhea, but levels did not change in those with persistent diarrhea. Zinc supplementation substantially improved the intestine's mucosal permeability after 1 week in infants with persistent diarrhea and after 2 weeks in those with acute diarrhea. Moreover, infants with acute diarrhea who received zinc experienced significant weight gain during hospitalization. In addition, the weight of those with persistent diarrhea who received zinc did not falter. All children with acute diarrhea who received zinc grew taller than the placebo group (18.9mm vs. 14.5mm; p.03). Among persistent diarrhea children, zinc supplementation resulted in a significant 22% decrease in the number of lighter children (70% weight/age) and a significant 30% decrease in wasted children (78% height/age) during hospitalization. These same children experienced significantly higher linear growth and height gain after leaving the hospital. Further, zinc supplemented infants with persistent diarrhea had a significantly lower diarrhea attack rate and lower duration of diarrhea than those in the placebo group. Similarly, zinc supplementation in the lighter children with acute diarrhea substantially decreased mean diarrhea attack rate (.4 vs .1) and duration (.8 vs. 3 days). In addition, it also significantly reduced attacks and duration of both diarrhea and respiratory tract infections in shorter children (90% height/age). Physiological and nutritional studies are needed to learn the mechanisms involved.
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PMID:Effect of zinc supplementation in patients with acute and persistent diarrhoea. 1228 14

Zoonotic coronaviruses represent an ongoing threat, yet the myriads of circulating animal viruses complicate the identification of higher-risk isolates that threaten human health. Swine acute diarrhea syndrome coronavirus (SADS-CoV) is a newly discovered, highly pathogenic virus that likely evolved from closely related HKU2 bat coronaviruses, circulating in Rhinolophus spp. bats in China and elsewhere. As coronaviruses cause severe economic losses in the pork industry and swine are key intermediate hosts of human disease outbreaks, we synthetically resurrected a recombinant virus (rSADS-CoV) as well as a derivative encoding tomato red fluorescent protein (tRFP) in place of ORF3. rSADS-CoV replicated efficiently in a variety of continuous animal and primate cell lines, including human liver and rectal carcinoma cell lines. Of concern, rSADS-CoV also replicated efficiently in several different primary human lung cell types, as well as primary human intestinal cells. rSADS-CoV did not use human coronavirus ACE-2, DPP4, or CD13 receptors for docking and entry. Contemporary human donor sera neutralized the group I human coronavirus NL63, but not rSADS-CoV, suggesting limited human group I coronavirus cross protective herd immunity. Importantly, remdesivir, a broad-spectrum nucleoside analog that is effective against other group 1 and 2 coronaviruses, efficiently blocked rSADS-CoV replication in vitro. rSADS-CoV demonstrated little, if any, replicative capacity in either immune-competent or immunodeficient mice, indicating a critical need for improved animal models. Efficient growth in primary human lung and intestinal cells implicate SADS-CoV as a potential higher-risk emerging coronavirus pathogen that could negatively impact the global economy and human health.
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PMID:Swine acute diarrhea syndrome coronavirus replication in primary human cells reveals potential susceptibility to infection. 3304 44