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

We studied the ultrastructure of the jejunal epithelium of six children suffering from acute episodes of gastroenteritis. Ultrastructural alterations of the jejunal mucosa occurred in practically all of the fragments analyzed, although the intensity of the abnormalities observed varied considerably. In most of the patients the alterations were confined to the microvilli, which appeared shortened and tufted in comparison with controls. These ultrastructural alterations are nonspecific and may represent a general response of the intestinal mucosa against different noxious agents. Severe alteration of the epithelial cells was observed in only one patient. In this case the cytoplasm contained multiple vacuoles that may correspond to dilated endoplasmic reticulum. It is hypothesized that the small intestinal lesions observed in these patients may allow penetration of food antigens, resulting in the appearance of food intolerance frequently described in children suffering from acute diarrhea.
J Pediatr Gastroenterol Nutr 1984 Sep
PMID:Ultrastructural study of alterations in the small intestinal epithelium of children with acute diarrhea. 648 62

One hundred and eighteen consecutive cases of childhood acute diarrhoea (mean age: 10.5 months) were studied after admission to our Pediatric Unit in Naples over a 13-month period. A diagnosis was established in 92 patients (78%): 55% of patients were found to have an infectious enteritis (among them, 5 had ETEC infections and 1 had an ST-producing Klebsiella infection), 12% a parenteral infection, 11% cow's milk intolerance. The occurrence of gross blood (P less than 0.01), leukocytes, and reducing substances in the stools was more commonly associated with infectious enteritis than with diarrhoea due to all other causes. In 14 patients (8 of whom were malnourished), diarrhoea ran a prolonged course. In all, the eventual outcome was favourable. Our findings, while confirming that infectious enteritides account for most of acute diarrhoeas in children, stress the importance of parenteral infections and cow's milk intolerance in this condition. Also, the need for an accurate search for enterotoxigenicity of enterobacteria before ruling out their pathogenetic role is stressed.
Eur J Pediatr 1984 Sep
PMID:Enteric infections, cow's milk intolerance and parenteral infections in 118 consecutive cases of acute diarrhoea in children. 648 79

Thirty-five patients with various diarrheal syndromes and 22 controls were studied. All stool samples were carefully cultured for Clostridium difficile, using selective isolation media. Cytotoxin assays with proper antitoxin neutralization were done in MRC-5 cells. The stool samples were extracted four times, three times at pH 2 and once at pH 10, using CHCl3 or ether. Derivatizations of extracts were done with trichloroethanol, heptafluorobutyric anhydride, and heptafluorobutyric anhydride-ethanol, and all derivatives were analyzed by frequency-pulsed electron capture gas-liquid chromatography (FPEC-GLC). A dedicated computer was used to assist in both qualitative and quantitative data analysis. Isocaproic acid (iC6) was always found in stool from which C. difficile was isolated and was absent in C. difficile-negative specimens. p-Cresol was found frequently in both persons with pseudomembranous colitis and controls. Tryptamine was found in stool containing C. bifermentans. The FPEC-GLC profiles of persons with acute diarrhea were very different from those of normal persons. Diarrhea associated with adenovirus and rotavirus, Klebsiella spp., and Escherichia spp. showed different FPEC-GLC patterns. Stools from well persons consistently contained full-scale peaks of pyruvic, acetic, propionic, isobutyric, butyric, isovaleric, and valeric acids. In rotavirus stools isobutyric, isovaleric, and valeric acids were reduced in quantity from those found in control stools, whereas propionic and butyric acids were increased.
J Clin Microbiol 1984 Sep
PMID:Studies of stools from pseudomembranous colitis, rotaviral, and other diarrheal syndromes by frequency-pulsed electron capture gas-liquid chromatography. 649 Aug 36

The age distribution and seasonal pattern of rotavirus infection were investigated in infants and young children admitted with acute diarrhea at the Kenyatta National Hospital from December 1981 through June 1983. They had acute diarrhea of not more than 10 days duration and had not received antibiotic treatment. Presence of rotavirus in stool was detected by using the WHO enzyme linked immnoabsorbent assay (ELISA) kit. The rotavirus isolation rate ranged from 14% to 54% in infants aged 1-12 months and peaked in the 6-12 month age group. Rotavirus peak incidences were observed in the January-March periods of both 1982 and 1983 which are times of hot, dry weather, with low relative humidity. These peak periods differ from results reported by Schoub et el. where no seasonal rotavirus infection variation in black infants in South Africa was observed. Other reports of rotavirus infection prevalence and weather conditions are cited. This study fails to show that rainfall influences the occurrence of rotavirus infection, as has been reported in Ethiopia by Stintzng et al.
J Diarrhoeal Dis Res 1984 Sep
PMID:Age distribution and seasonal pattern of rotavirus infection in children in Kenya. 651 14

The study was conducted by the Rehydration Unit of Bab El-Sha'reya Hospital, Cairo to determine the impact on the mixing accuracy of oral rehydration solution (ORS) of a group of mothers of infants suffering from acute diarrhea. 1 group received a special 200 ml cup and brief verbal instructions; a control group received neither the cup nor instructions. The mothers were illiterate and of a low socioeconomic class. Results show that the median capacity of home containers used was 160ml/L. The mean ORS sodium concentration (98mmol/L) for the group supplied with the specified container was significantly lower than the ORS sodium concentration (123 mmol/L) of the group that used home containers (p 0.02). All mothers who received the 200 ml cup from the medical unit used it. 96% of mothers in both groups were ready to use ORS in the future. The present study showed that mothers mixing premarked ORS containers along with brief instructions and the 200 ml cups dispensed with the ORS container were more accurate because the standard container was provided. There is no financial obstacle to providing such containers since the cost in Egypt is US$0.1. Such containers could be provided free if Egyptian companies producing pediatric medicines would agree to such containers away as promotional tools.
J Diarrhoeal Dis Res 1984 Sep
PMID:Accuracy of mixing oral rehydration solution at home by Egyptian mothers. 651 15

Changes in sodium balance and urinary and stool output during orally administered rehydration therapy were studied in 22 well-nourished Turkish infants, aged 2 to 13 months, with acute diarrhea mainly of viral origin. The infants randomly received a rehydration solution containing either 90 mmol Na/L (ORS90) or 40 mmol Na/L (ORS40). Slight transient hypernatremia was noted in a few infants receiving ORS90, and slight transient hyponatremia in a few infants receiving ORS40. In both groups, sodium balance increased most rapidly during the first 12 hours of rehydration, and then more slowly because of increased urinary as well as stool sodium output. Sodium balance was always more positive after ORS90 than after ORS40, but the difference did not change much from 12 to 36 hours after therapy was started. Changes in fractional sodium excretion, urinary K/Na quotient, and urinary aldosterone-creatinine quotient were used as indexes of changes in sodium balance. All values were interpreted to indicate that the sodium deficit on admission was corrected within 12 to 18 hours after ORS90 and, in most cases, after 24 to 36 hours after ORS40. Both groups of infants responded well to orally administered rehydration therapy from the clinical viewpoint.
J Pediatr 1983 Sep
PMID:Salt and water homeostasis during oral rehydration therapy. 688 1

The occurrence of human cholera along the Gulf of Mexico and the isolation of Vibrio cholerae O1 from the Gulf and Chesapeake Bay make it imperative that microbiology laboratories along estuaries develop the capabilities to culture for these pathogens. In attempts to devise a simplified but efficient culture procedure, a selective medium, thiosulfate-citrate-bile salts-sucrose (TCBS) agar, was compared with a nonselective medium, gelatin agar (GA), and the utility of enrichment was examined. TCBS agar detected 99% of the stools found to be positive by all techniques combined, whereas GA identified only 80%. Of acute diarrheal stools, 96% were positive on direct plating, whereas only 66% of formed stools containing V. cholerae were detected by direct plating. Stools from patients with acute diarrhea can be plated directly into TCBS agar alone; stools from persons shedding low numbers of organisms (such as contacts, carriers, or patients receiving antibiotics) should be incubated first in an enrichment broth and then on TCBS agar.
J Infect Dis 1980 Sep
PMID:Selective vs. nonselective media and direct plating vs. enrichment technique in isolation of Vibrio cholerae: recommendations for clinical laboratories. 700 31

Empiric treatment with ciprofloxacin and norfloxacin has been recommended recently for patients with acute diarrhoeal disease. In a retrospective 6-month study period the results of stool cultures from 209 patients with acute diarrhoea admitted to the emergency room were analysed. Seventy-eight cultures (37%) were positive for one or more bacteria. Shigella was the most commonly isolated pathogen (68%). Shigella sonnei comprised 72% and Shigella flexneri 19% of all the bacterial isolates. While no antimicrobial resistance to ciprofloxacin was found for both Shigella species, only 36 and 26% of the Shigella isolates were sensitive to ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ), respectively. These findings point out to the emergence of drug resistance to commonly used antimicrobial drugs. Shigella's high sensitivity to the newer quinolones should make this the treatment of choice for the very sick patient, although physicians should be cautioned to the fact that indiscriminate use of this drug could result in the emergence of resistance similar to that noted with ampicillin and TMP-SMZ.
J Accid Emerg Med 1994 Sep
PMID:Acute bacterial diarrhoea in the emergency room: therapeutic implications of stool culture results. 780 82

In a clinic-based case-control study in Bangladesh we evaluated whether children with diarrhoea due to V. cholerae O1 in association with other enteric pathogen(s) are likely to manifest more severe disease as indicated by development of moderate or severe dehydration. Children with moderate or severe dehydration were defined as cases and those with no dehydration were controls; both cases and controls had acute diarrhoea. A systematic sample of 268 dehydrated cases and 699 nondehydrated controls aged 1-35 months with acute watery diarrhoea of 6 days or less was included. In a multivariate analysis it has been shown that infection with Vibrio cholerae O1 in association with another diarrhoea pathogen (odds ratio = 7.07) was strongly correlated with status of dehydration than those with the V. cholerae O1 infection as a single pathogen (odds ratio = 3.63). Either group was associated with significant risk of dehydration. The results of the study suggest that more than one enteropathogen may be simultaneously involved in causing severe diarrhoea, and appropriate public health measures to reduce environmental contamination should be beneficia
J Diarrhoeal Dis Res 1994 Sep
PMID:Severity of cholera during concurrent infections with other enteric pathogens. 786 29

A group of 245 well nourished infants with acute diarrhea were screened for carbohydrate malabsorption by evaluating stool pH and reducing substances in the stools. Carbohydrate malabsorption was diagnosed in 28 cases (11%). Clinical features of carbohydrate intolerance were present in only one case. The duration of diarrhea after admission ranged from 1 to 13 days (mean 3.9 days). An oral lactose tolerance test was consistent with lactase deficiency in 32% of all cases. Thin layer chromatography showed many carbohydrates including monosaccharides in the stools, indicating that the defect in intestinal absorption was not specific for lactose.
Indian Pediatr 1994 Sep
PMID:Carbohydrate malabsorption in acute diarrhea. 788 63


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