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

A hypotonic (osmolality 224 mmol/l, sodium 60 mmol/l) oral rehydration solution (ORS) was compared with an isotonic high glucose ORS (osmolality 304 mmol/l, sodium 60 mmol/l) in children with acute diarrhoea in a randomised double blind study. The stool output and hence the mean consumption of ORS for maintenance hydration was less (p = 0.036) in patients receiving hypotonic (69 ml/kg) than isotonic (97 ml/kg) ORS. Hypotonic ORS was more effective in patients with rotavirus positive than with rotavirus negative diarrhoea.
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PMID:Randomised double blind study of hypotonic oral rehydration solution in diarrhoea. 913 72

The prevalence of carbohydrate intolerance in Polish children during an acute episode of gastroenteritis was determined. One hundred and seven consecutive children, less than 3 years old, with acute diarrhoea were enrolled into the study. Carbohydrate intolerance (diagnostic criteria: >0.5% reducing substances and stool pH less than 5.5) was diagnosed in 14/107 (13.08%) children: lactose intolerance was present in 12 (11.2%) patients; glucose polymer intolerance in 1 (0.93%) and monosaccharide intolerance in 1 (0.93%). The most important predisposing factor was rotavirus. In all cases the carbohydrate intolerance was transient, resolving within 5 days. Carbohydrate intolerance is also an infrequent problem in Polish children. Restriction of lactose-containing foods (use of lactose-free or low lactose formulas) for the majority of children with gastroenteritis does not seem to be justified.
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PMID:Carbohydrate intolerance after acute gastroenteritis--a disappearing problem in Polish children. 917 17

The acceptability of prepackaged rice-based (Oresol-R) and flavoured (Oresol-F) glucose-based oral rehydration salts (ORS) solutions was compared with that of standard glucose-based ORS (Oresol-G) in a randomized field trial. Additionally, it is determined if presenting rice-based ORS as a solution that would help stop diarrhoea (Oresol-K) enhanced its acceptability. A total of 437 non-dehydrated children aged less than five years presenting to health centres with acute diarrhoea were randomly assigned to the three ORS groups. Acceptability was determined by the amounts of ORS consumed at home by children still with diarrhoea on 24- or 48-hour follow-up. The amounts of ORS consumed by children given Oresol-R (54 [95% CL 38-70] mL/kg/24 h) and Oresol-F (47 [24-70]) were similar to the amount of Oresol-G (44 [32-56]). ORS consumption was not affected by the child's age, nutritional status, feeding before the episode, duration of diarrhoea at health centre visit, maternal education and previous ORS use. Informing the caretaker that rice-based ORS would help stop diarrhoea did not lead to increased consumption of the solution (Oresol-R 54 [38-70] mL/kg/24 h; Oresol-K 50 [32-68]). Solution preparation was likewise similar among the treatment groups. Reactions to the different ORS types were generally favourable but did not differ between the groups.
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PMID:Acceptability of rice-based and flavoured glucose-based oral rehydration solutions: a randomized controlled trial. 936 Mar 40

The discovery of oral rehydration solution (ORS) for the treatment of diarrheal disease has been heralded as the most important medical discovery of the century. Cereal-based ORS is able to decrease stool output and the duration of diarrheal illness more than the standard glucose-based ORS, through the increased absorption provided by oligosaccharides without the imposition of a greater osmotic penalty. Moreover, the peptides in cereals enhance amino acid and water absorption, while providing nutritional benefits. UNICEF's glucose-based ORS is becoming more widely used in Papua New Guinea (PNG). 20 children aged 6-37 months (mean age, 15 months) who presented to the Children's Outpatient Department at Port Moresby General Hospital during September-October 1993 with acute diarrhea and mild dehydration were randomly assigned to receive either a rice-based ORS or standard glucose ORS, and measurements were taken over the following 3 hours. The patients were paired by weight for analysis. No statistically significant difference was found between the amount of rice ORS and the amount of glucose ORS taken over 3 hours.
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PMID:A 3-hour quantitative comparison of glucose-based versus rice-based oral rehydration solution intake by children with diarrhoea in Port Moresby General Hospital. 952 69

Important inroads are being made into understanding the pathophysiology of acute diarrhea. Clear understanding of key mechanisms should suggest new approaches to combat disease. Exciting developments are occurring in terms of super-ORS solutions, particularly with the promise of short-chained glucose polymers and glutamine. Perhaps the most important development is the prospect of a good rotavirus vaccine being available before the end of the decade. Chronic diarrhea seems to be on the increase globally, probably because of the success of ORS. The mechanisms that lead to mucosal injury are elusive and therapy is still largely supportive and empiric. Celiac disease continues to be a puzzle, not least because of the uncomfortable feeling that a majority of cases may be being missed because of atypical presentations. The successful use of long-term parenteral nutrition has allowed survival and better characterization of cases that otherwise would have perished as "lethal protracted diarrhea". Microvillus inclusion disease may be the most common congenital secretory diarrhea. The role of the recently reported high prevalence of glucoamylase deficiency may be important. Lastly attention to micronutrients, particularly low vitamin A and probably zinc, may prove to be important in prevention and amelioration of diarrhea and growth failure.
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PMID:Chronic diarrhea in infancy and childhood. 978 54

Two hypotonic oral rehydration solutions with osmolarities of 224 mosmol/l (Na+ 60 mmol/l, glucose 84 mmol/l) and 204 mosmol/l (Na+ 60 mmol/l, glucose 64 mmol/l), respectively, and oral treatment with Lactobacillus GG were evaluated in a double blind trial in children aged 6-36 months hospitalised for acute diarrhoea. Early administration of Lactobacillus GG at the start of oral rehydration resulted in the shortest duration of diarrhoea, best weight gain, and fastest correction of acidosis. A reduced osmolarity oral rehydration solution (224 mosmol/l) combined with early administration of Lactobacillus GG is an effective treatment for acute diarrhoea in young children; further reduction of osmolarity may not be beneficial.
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PMID:Management of acute diarrhoea with low osmolarity oral rehydration solutions and Lactobacillus strain GG. 979 99

We review the pathophysiology of intestinal water and electrolyte transport leading to diarrhoea, the currently available pharmacological strategies for its treatment, and the economic implications of such treatments. Diarrhoea occurs most frequently and is associated with highest mortality in children under 5. Oral rehydration therapy (ORT) is the cornerstone of its management. The safety and efficacy of ORT in the prevention of death from dehydration, both in field and also in hospital settings, are now well established. Because it is also inexpensive, ORT is widely applicable worldwide. More recently, rice-based ORT has emerged, based on well known traditional remedies for diarrhoea in southeast Asia and the Far East. Rice-based ORT has the advantage of being more culturally acceptable, readily available even in rural homes in developing countries, and is more effective in reducing stool output and the duration of diarrhoea, compared with conventional glucose-electrolyte solutions such as World Health Organization ORT. For infants, the well known antidiarrhoeal properties of human milk needs emphasis for a variety of reasons including economic ones. Data concerning the economic benefits to a nations' health budget as a result of nationwide implementation of oral rehydration solution (ORS) use are limited. Available data from individual centres in developing countries, if projected to national level, would incur considerable economic advantage. Except for a few notable infections such as shigellosis, cholera, amoebiasis and giardiasis, the widespread use of antibiotics in acute diarrhoea, still a common practice in many developing countries, has no proven value and may be detrimental. The economic implications of antibiotic abuse in the treatment of diarrhoea in developing countries is enormous. Despite the availability of a wide spectrum of pharmacological agents for diarrhoea reviewed in this article, only a few such agents are of proven clinical efficacy: corticosteroids, aminosalicylates and immunosuppressants in the treatment of inflammatory bowel disease and opioid derivatives such as loperamide which may be useful in protracted diarrhoea in children and in disorders where rapid gastrointestinal transit is the main cause of diarrhoea. Opioids are not recommended for acute infective diarrhoea in childhood. Octreotide, a somatostatin analogue, is reported to be useful in the treatment of secretory diarrhoea due to noninfective causes and in the treatment of intractable diarrhoea associated with AIDS. Its high cost and need for parenteral administration prevent its wider application.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pharmacoeconomics of the therapy of diarrhoeal disease. 1015 Jan 56

Transient glucose intolerance (TGI) is an important cause of WHO G-ORS (Glucose-Oral Rehydration Solution) treatment failure and hospitalization in dehydrated children during acute diarrhoea. This retrospective case-control study was designed to determine some risk and predictive factors for developing TGI among moderately dehydrated patients with acute diarrhoea while under G-ORS therapy. Among moderately dehydrated patients, files of 22 patients with TGI and 66 other dehydrated patients without intolerance were reviewed. Patients with TGI were younger (9.7+/-10.5 mo and 11.6+/-7.8 mo, respectively, p < 0.05), the median age being 6 mo in the TGI group and 10 mo in non-TGI group. There was no difference between groups for sex, admission season, history of fever or vomiting, frequency of vomiting, presence of blood, mucous or leukocyte in stool, presence of associated disease and duration of diarrhoea on admission. The admission haemoglobin, white blood cell, blood pH, sodium and potassium levels were similar in both groups. The mean serum chloride level (116.8+/-6.9, 109.6+/-7.9 mEq/l, respectively, p<0.05) was higher in the TGI group and the bicarbonate level was lower (12.9+/-3.8, 15.3+/-6.0, respectively, p < 0.05). Stool frequency was also higher in patients with TGI (11.2+/-5.3/24 h, 5.9+/-4.4/24 h, respectively, p < 0.05). No difference was found between the nutritional status of children in both groups. More children were breastfed in the group without TGI (34/56, 61%, 6/18, 33% respectively, p=0.079, OR=0.32, 95% CI [0.09-1.11]). It was concluded that patients with TGI are younger and have high stool frequency. Although statistical significance could not be shown, breastfeeding seems to protect children from TGI, as it protects from diarrhoea.
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PMID:Clinical characteristics of transient glucose intolerance during acute diarrhoea. 1056 51

Type II diabetes is an hemorheological disease in which hyperglycemia increases the shear stress contributing to inflammation and dysfunction of endothelium. The purpose of this study was to identify the relationship between serum C-reactive protein and glucose levels in noncontrolled type II diabetic subjects. A cross-sectional study was conducted, including 62 noncontrolled type II diabetic subjects that were assigned to two groups. One group was patients with acute diarrhea or urinary tract infection and the other group was diabetic subjects who were infectious-disease free. Sixty-two subjects without diabetes constituted the respective control groups. Heart failure, other acute febrile illnesses, asymptomatic infection, renal, hepatic, malignant or chronic inflammatory illness, and macrovascular disease were considered as exclusion criteria. Laboratory measurements were performed. Thirty (96.7%) and 29 (93.5%) diabetic patients in the groups with and without infectious disease, and 28 (90.3%) control subjects with infectious disease had elevated C-reactive protein levels (> or =10 mg/L). In contrast, healthy control subjects did not have elevated serum C-reactive protein levels. Multiple regression analysis showed a significant association between C-reactive protein levels and hyperglycemia (Odds ratio = 7.4; IC95% 2.3-11.2). This study show that hyperglycemia is a related factor to the increase of serum CRP levels in noncontrolled type II diabetic subjects.
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PMID:Increased levels of C-reactive protein in noncontrolled type II diabetic subjects. 1061 61

World Health Organization (WHO) recommended standard ORS solution has sodium (90 mmol/L) and glucose (111 mmol/L) almost in the ratio of 1:1 and a total osmolarity of 311 mmol/L. There are concerns that the sodium or glucose concentration and the overall osmolarity in the formulation is not appropriate. Therefore, the efficacy of standard and reduced-osmolarity ORS solutions in young children with acute diarrhea was evaluated in a recent WHO supervised multicentre trial conducted in India (New Delhi), Brazil, Mexico and Peru. The implications of trial results are discussed. In non-cholera diarrhea, both the standard and reduced osmolarity ORS solutions were effective in achieving clinical rehydration. The stool output was 39% higher in the standard ORS solution group as compared to the reduced-osmolarity ORS solution group. The duration of diarrhea was 22% higher in the standard ORS solution group. The risk of requiring supplementary intravenous infusion was increased in children treated with standard ORS solution [relative risk 1.4 (0.9-2.4)]; this benefit was not observed in Indian patients due to high breast feeding rate. The mean sodium concentration at 24 hours after admission was lower in the reduced osmolarity ORS solution group [135 (134-136) vs 138 (136-139), p < 0.01). The low osmolarity ORS deserves to be evaluated in adult cholera to determine its efficacy and any excess hyponatreamia. Meanwhile, it is reassuring that the WHO formulation was effective and its use was not associated with hypenatremia even in young children. Efforts must continue to be made to promote WHO-ORS while research to improve it further is welcome.
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PMID:Reduced-osmolarity oral rehydration salts solution multicentre trial: implications for national policy. 1083 67


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