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

The efficacy in acute childhood diarrhea of oral rehydration therapy (ORT) based on staple foods (maize, millet, wheat, sorghum, rice or potato) was compared with that of standard ORT based on glucose. 266 children aged 1-5 years, with a history of acute diarrhea for 48 hours in a Nigerian population or less, moderate to severe dehydration, and no complications, were assigned to treatment with one of the food-based oral rehydration salt solutions (ORS) or standard ORS. The mean stool output over the first 24 hours of treatment in the group receiving standard ORS was significantly higher than that of any other treatment group, and the groups receiving food-based ORT showed substantial reductions in stool output compared with the standard ORT group. Abnormalities in electrolyte concentrations were corrected in all treatment groups with similar efficiency. The digestibility of the food-based ORS was assessed by the stool pH, glucose content before and after acid hydrolysis, and osmolality; there were no significant differences between the standard ORS and food-based ORS groups. Food-based ORT should be more acceptable to users in developing countries since the mixtures are similar to traditional weaning foods since, unlike standard ORT, it reduces stool output substantially.
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PMID:Food-based oral rehydration salt solution for acute childhood diarrhoea. 257 96

A total of 257 boys (age range 4-55 months), who had acute diarrhoea with moderate to severe dehydration, were randomly assigned to treatment with either the World Health Organisation/United Nations Childrens Fund (WHO/Unicef) recommended oral rehydration solution or cereal based oral rehydration solution made either of maize, millet, sorghum, or rice. After the initial rehydration was achieved patients were offered traditional weaning foods. Treatment with oral rehydration solution continued until diarrhoea stopped. Accurate intake and output was maintained throughout the study period. Efficacy of the treatment was compared between the different treatment groups in terms of intake of the solution, stool output, duration of diarrhoea after admission, and weight gain after 24, 48, and 72 hours, and after resolution of diarrhoea. Results suggest that all the cereal based solutions were as effective as glucose based standard oral rehydration solution in the treatment of diarrhoea.
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PMID:Cereal based oral rehydration solutions. 262 24

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

Infant mortality from acute diarrhoea has sharply declined in the last few decades throughout Europe. However, acute diarrhoea is still a very common occurrence in European children, who experience, in their first 3 years of life, approximately 1 episode/year. The commonest agent responsible for infectious diarrhoeas appears to be rotavirus, followed by campylobacter. Although water loss may be high, the mean sodium loss is close to 40 mmol/l of stool in rotaviral diarrhoea, and to 60 mmol/l in diarrhoeas due to invasive pathogens such as campylobacter and salmonella. Larger fluid losses but a somewhat lower sodium loss accompanies non-cholera secretory diarrhoeas, which appear to be commoner in infants than in older children. This evidence indicates that an ORS for European children should have a sodium concentration lower than 90 mmol/l which was primarily intended for use in developing countries. Clearly, the glucose concentration is crucial, as it is now evident that concentrations higher than the recommended 110 mmol/l may lead, particularly in rotaviral enteritis, to worsening of diarrhoea and development of hypernatraemia. Finally, it appears that in Europe the use of commercially available ORS is strikingly low, so that infants and children are often given a variety of "clear fluids", generally inadequate to ensure proper rehydration or maintenance of hydration. Thus an effort should be made not only to devise the "ideal" solution, but also to effectively implement its use.
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PMID:Overview of childhood acute diarrhoea in Europe: implications for oral rehydration therapy. 270 36

We studied the electrolyte composition, pH and osmolality of six solutions for oral rehydration available in drug stores in Venezuela, and also their combinations with whole milk in a dilution of 6.6%. The solutions such as Pedialyte, Hidramilac and Hidramines showed an acid pH (4.30-5.10) in direct relationship to the concentration of carbohydrates (5% or more). Also, Pedialyte and Hidramilac had greater osmolalities (360-365 mOsm/kg) than plasma. Some of the levels of sodium and potassium in the solutions were found to be under the concentrations given by the producers. The combination of whole milk with oral solutions diminishes the concentrations of sodium and potassium in the mixture, changing the sodium-glucose relationship, pH and osmolality. The therapeutic implications for the use of oral rehydration solutions with low concentrations of sodium, acid pH, large content of glucose and elevated osmolality are discussed. It is concluded that the combination of whole milk with Sueroral (WHO) is not adequate for the optimum absorption of sodium and therefore to prevent dehydration. Therefore, except for the WHO solution and Oralite, other solutions are not adequate for the correction of the electrolytic and acid-base alterations present in infants with dehydration secondary to acute diarrhea.
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PMID:[Biochemical composition of oral rehydration solutions and their combinations suggested for use in Venezuela]. 271 71

A controlled, randomized trial was conducted in 50 infants with acute dehydrating diarrhea to evaluate the effect of oral zinc supplementation in acute diarrhea. After completion of rehydration, 25 infants in Group A received oral zinc sulfate (20 mg elemental zinc twice daily) and an equal number in Group B were given placebo (glucose). Both groups were comparable with respect to various initial characteristics including nutritional status, diarrheal disease, serum alkaline phosphatase, and serum and rectal mucosal zinc content. During therapy all the assessed parameters of zinc status (serum alkaline phosphatase and serum and rectal zinc) recorded significant elevation and reduction in Groups A and B, respectively. At recovery the zinc status of Group A was significantly better and was nearer that of healthy controls. The diarrheal duration and frequency in the zinc-supplemented group were lower, but the differences were not significant (0.05 less than p less than 0.1). However, when only subjects with relatively severe initial zinc depletion (rectal zinc lower than the 15th percentile of healthy controls; 11 in Group A and 14 in Group B) were considered, the diarrheal duration and frequency were significantly (p less than 0.05 and p less than 0.01, respectively) lower in the zinc-supplemented cases. Weight gain in both groups was similar. It is concluded that oral zinc administration in acute diarrhea can replenish body zinc status and this may shorten the diarrheal duration and frequency in children with relatively severe zinc depletion.
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PMID:A controlled trial on utility of oral zinc supplementation in acute dehydrating diarrhea in infants. 305 19

Acute diarrhoea is an important health problem in developed countries, particularly in young children. The attack rates for viral diarrhoea are similar in developed and developing countries. Rotavirus is the most common pathogen, followed by adenovirus. Bacterial diarrhoea is less common in developed than developing countries. The 2 most common bacterial pathogens are Campylobacter jejuni and Salmonella. The most serious consequence of diarrhoea is dehydration, and the treatment for this is the same whatever the pathogen. Recently, there have been major changes in the management of diarrhoea with emphasis on oral rehydration and early feeding. Two controversial areas are the sodium content of solutions designed for developed countries and the best route of administration of fluids to children with moderately severe dehydration. There have been 4 randomised controlled trials in developed countries comparing oral and intravenous rehydration. The findings have confirmed the experience in developing countries that most children without shock can be rehydrated orally, thus substantially reducing the need for intravenous fluids. It is important to give physiologically balanced solutions which contain 2% glucose and 50 to 90 mmol/L of sodium. Many of the commercially available oral solutions are appropriate for rehydration and maintenance of hydration in infants with diarrhoea of all types. They are recommended particularly for the prevention of dehydration in children of all ages with severe diarrhoea and for the treatment of dehydration. Children with mild diarrhoea and no dehydration can be given commercial clear fluids diluted with water, or homemade solutions made with table sugar and water. Salt must not be used. Babies should continue on breast milk or formula with extra water. Education is the key to successful oral rehydration, and the ultimate aim should be the prevention of dehydration.
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PMID:Oral rehydration in infantile diarrhoea in the developed world. 306 44

There is continuing uncertainty about the appropriate level of sodium in oral fluid therapy for children with acute gastroenteritis in developed countries. The present study was undertaken in order to assess whether an oral glucose/electrolyte solution designed for fluid replacement (Na+ concentration 75 mmol/l) and an oral glucose/electrolyte solution designed for maintenance of hydration (Na+ concentration 45 mmol/l) would be safe and effective in the treatment of acute childhood diarrhea in a developed country. Children aged 3-24 months (n = 54) with acute diarrhea and less than 5 percent dehydration were randomized to receive either maintenance (n = 27) or rehydration (n = 27) fluid. Outcome was assessed at 24 and 48 hours after entry to the study. Both solutions were found to be equally effective and safe. The fluid was refused by one child in each group. Analysis of efficacy showed that hydration status was maintained in all patients and 98 percent of children showed significant improvement in diarrheal status at 24 hours. We conclude that for well-nourished ambulatory children aged 3-24 months with acute diarrhea and minimal (less than 5%) or no dehydration, the use of an oral fluid containing 75 mmol/l of sodium is as safe and effective as the use of an oral fluid containing 45 mmol/l of sodium.
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PMID:Efficacy and safety of two oral solutions as maintenance therapy for acute diarrhea. A double-blind, randomized, multicenter trial. 307 36

Infantile diarrhea in France is usually benign and self limiting, but in rare cases dehydration or malnutrition with continuing diarrhea can occur. Dehydration may almost always be prevented and treated with an oral solution containing glucose and electrolytes. Rapid feeding adapted to the age of the child can help prevent nutritional problems. The need for antibiotics and other medications is very limited. Intestinal infection is the cause of most cases of infantile diarrhea. 10-15% of cases are caused by bacteria of various types and the vast majority of the remainder by viruses, with the rotavirus alone accounting for around 1/2 of cases. Oral rehydration can compensate for the exaggerated loss of water and electrolytes. No matter how serious the diarrhea or its cause, some potential for absorption of water and sodium is always retained. Sodium absorption is facilitated by the concomitant presence of glucose in the intestines. Oral rehydration solutions commercially available in France have an electrolyte content adapted to the average fecal loss locally observed in acute diarrhea. Oral rehydration solution is offered to infants at short intervals in a bottle, allowing the child to drink as the need arises. Significant quantities may be absorbed in the 1st 24 hours. Any vomiting usually ceases after administration of a small amount of glucose. Traditional dietary preparations for diarrhea such as carrot soup and products based on rice have essentially an absorbent power and do not diminish intestinal loss of water and electrolytes. In cases of severe dehydration with weight loss of over 10% and unconsciousness, intravenous rehydration is indicated. Whether oral or parietal, rehydration should always be rapid so that feeding can begin. Feeding should start after 24 or at most 48 hours of rehydration to maintain the nutritional state. Rapid feeding is usually well tolerated, but there may be a transitory intolerance to lactose or a secondary sensitivity to proteins in cow's milk. Breast feeding should not be interrupted, but bottle feedings should be stopped for 24-48 hours and reintroduced for infants under 3 months with protein formula not based on cow's milk and for those over 3 months with diluted formula.
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PMID:[Current treatment of acute diarrhea in infants]. 314 1

We report a controlled clinical trial of rice powder-based oral rehydration solution (ORS) versus glucose ORS on the outcome of acute diarrhea in infants. The rice ORS group (n = 30) received ORS containing 50 g rice powder instead of standard WHO solution (20 g glucose, n = 30). Formula-fed male infants were enrolled to enable calculation of milk intake and excretion of urine. Patient allocation to either group depended on the method of random permuted blocks. Both groups were comparable regarding age (4-18 months), duration of diarrhea, number of bowel movements or vomiting per 24 h, rectal temperature, dehydration score, and nutritional status. Results revealed that the rice ORS group had a shorter duration of diarrhea (28.4 +/- 5.1 vs 34.3 +/- 2.3 h) and greater mean weight gain in the first 24 h as percentage of recovery weight (5.7 +/- 0.5% vs 4.1 +/- 0.6%). Furthermore, the mean amount of ORS intake, mean stool output, and mean number of episodes of vomiting were lower in the rice-ORS group as compared with the glucose ORS group. All differences were statistically significant. Due to its observed superiority and low cost, the widespread use of rice ORS should be considered for treatment of acute diarrhea.
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PMID:Controlled clinical trial on the efficacy of rice powder-based oral rehydration solution on the outcome of acute diarrhea in infants. 329 71


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