Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A prospective study was conducted with Bangladeshi children with rotavirus (RV) diarrhea to assess whether nutritional and clinical parameters, RV serotypes, levels of interleukin-10 (IL-10), tumor necrosis factor alpha (TNF-alpha), and gamma interferon (IFN-gamma), and RV-specific antibody titers in plasma and stool were associated with the development of persistent diarrhea. Children with watery diarrhea for 6 to 8 days, selected from the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), were enrolled in the study and monitored until diarrhea improved. Children were classified as having acute diarrhea (AD) if diarrhea resolved within 14 days of onset and as having persistent diarrhea (PD) if diarrhea persisted for more than 14 days after onset. Uninfected, control children (n = 13) from the Nutrition Follow-Up Unit of ICDDR,B were also enrolled. Of the 149 children with diarrhea enrolled, 29 had diarrhea with RV alone, of which 19 had AD and 10 developed PD. Samples of stool and blood were collected from all children on enrollment. Stool samples were collected again from children when they developed PD. Of the 10 children who had an initial RV infection and then developed PD, only one had persistent RV infection. Plasma levels of IL-10 and TNF-alpha were higher in children with diarrhea compared to uninfected controls but were similar in children with AD and PD. Plasma IFN-gamma levels were higher in children who developed PD than in those with AD (P = 0.008) or uninfected controls (P = 0.001). In stools, the levels of TNF-alpha, the only cytokine detected, were similar in the three groups of children. RV-specific immunoglobulin G (IgG) titers in plasma were higher in uninfected children than in those with AD (P < 0.001) or PD (P = 0.024) but titers were similar in children with AD and PD. RV-specific IgA titers in plasma and stool were similar in the three groups of children. From all observed parameters, only elevated plasma IFN-gamma levels were associated with subsequent development of PD. However, a larger sample size is necessary to substantiate this observation.
Clin Diagn Lab Immunol 1999 Sep
PMID:Immune response of children who develop persistent diarrhea following rotavirus infection. 1047 19

In four cities of Venezuela a study was carried out to evaluate the epidemiological, clinical, and etiological characteristics of acute diarrhea in children under 5 years of age. The study was done between June 1993 and May 1995 and involved children who were seen in a hospital, 2,552 with diarrhea and 793 controls. The Fisher exact test was used for the statistical analysis of the results. Rotaviruses were the most important agents, both in terms of their frequency (30%) and their association with dehydration (58%). Following in importance were Campylobacter spp. (13%) and Escherichia coli classical O serogroups (9%), but their association with diarrhea was only statistically significant among children less than 3 months old, a fact that is particularly important from the standpoint of treatment. The importance of age was confirmed as a determining factor in the prevalence and severity of diarrhea.
Rev Panam Salud Publica 1999 Sep
PMID:[Etiologic, clinical and socio-democratic characteristics of acute diarrhea in Venezuela]. 1051 91

Rotavirus is the most common cause of severe acute diarrhea, responsible for 30 to 40 deaths of children each year in France. In order to decrease both mortality and morbidity, vaccines have been designed first from attenuated bovine strains, then from monovalent simian strains, and more recently from reassortant rhesus strains. The live tetravalent human-rhesus reassortant vaccine (RRT-TV) has been shown to be protective in the United States, Finland, and Venezuela despite different environments, in prospective double-blind studies. This vaccine, as the natural infection, decreases by 50% the risk of acute rotavirus diarrhea and by 70 to 100% the risk of severe diarrhea with dehydration. At the present time, its cost limits its use to developed countries. It was put on the market in the United States in October 1998. The challenge is now to make it available in developing countries.
Arch Pediatr 1999 Sep
PMID:[Anti-rotavirus vaccinations]. 1051 34

Vaccination has been proposed for the prevention of disease due to enterohemorrhagic Escherichia coli (EHEC), but the immune response following human infection, including the choice of potential antigens, has not been well characterized. To study this, sera were obtained from five pediatric patients with acute diarrhea caused by E. coli O157:H7 0, 8, and 60 days after hospitalization. These sera were used to examine the immune response to four different EHEC virulence factors: Tir (translocated intimin receptor, which is inserted into the host cell membrane), intimin (bacterial outer membrane protein which binds to Tir), EspA (secreted protein which forms filamentous structures on EHEC surface), and EspB (inserted into the host membrane and cytoplasm). The response to O157:H7 lipopolysaccharide was also examined. Sera were assayed against purified recombinant proteins using immunoblot analysis and by enzyme-linked immunosorbent assay to determine the sera's titers to each of the antigens in all patients. We found that there was little reaction to EspA, EspB, and intimin in the acute-phase sera, although there was some reactivity to Tir. By day 8, titers of antibody to all four virulence factors were present in all patients, with a very strong response against Tir (up to a titer of 1:256,000), especially in hemolytic-uremic syndrome patients, and lesser strong responses to the other three antigens. The titer to the antigens 60 days after hospitalization was decreased but was still highest for Tir. These results suggest that there is a strong immune response to Tir, and to a lesser extent to the other three virulence factors, following EHEC disease, indicating that these bacterial molecules are potential vaccine candidates for preventing EHEC disease. They also suggest that bacterial virulence factors that are inserted into host cells during infection by type III secretion systems (Tir or EspB) are still recognized by the host immune response.
Infect Immun 2000 Sep
PMID:Human response to Escherichia coli O157:H7 infection: antibodies to secreted virulence factors. 1094 30

Fecal samples from a 1-year prospective study were investigated to establish the role of group C rotavirus infections in acute diarrhea in Swedish adults (>15 years old). Rotaviruses were found in samples from 3% of the patients, and, in 35% of these, group C rotavirus was detected. Clinical symptoms of group C rotavirus infection were generally milder than those of group A rotavirus infection. Gene 8 (vp7) from 12 group C isolates, including strains from the prospective study, a military outbreak, and a sporadic case, was sequenced. The gene was found to be extremely conserved, with identities of 99.1%-100% at the amino acid level. This study has systematically investigated the prevalence and genetic diversity of group C rotavirus in adults. The data confirm the extreme sequence conservation within human group C rotavirus strains and suggest that symptomatic group C rotavirus infections occur more frequently in adults than has been previously recognized.
J Infect Dis 2000 Sep
PMID:Incidence and genetic diversity of group C rotavirus among adults. 1095 Jul 59

This prospective cohort study was carried out in the neonatal unit of the Yangon Children Hospital, Myanmar, to gather more information on the types of feedings and hand-washing practices of mothers as the determinant of severe dehydration in infants with acute diarrhoea due to Escherichia coli. The study subjects included 100 infants with diarrhoea, aged less than 4 months, admitted to the hospital from June 1997 to May 1998. Data on isolation of E. coli from rectal swab samples, types of feedings, hand-washing practices, and dehydration status were collected. Of the 100 cases, E. coli was isolated from rectal swab samples of 48 infants. Of these 48 cases, 28 had some dehydration and 20 had severe dehydration. Exclusive breast-feeding was observed only in the age group < 1 and > 1-2 month(s). The association of the severity of dehydration with other types of feedings compared to exclusive breast-feeding was not statistically significant. In this study, most mothers washed their hands with water only after cleansing their children's defaecation, and before and after feeding their children. The severity of dehydration was statistically significant in hand-washing practices when compared to washing with water only and washing with soap and water. This study has shown the association between types of feedings and hand-washing practices with dehydration in infants with acute diarrhoea due to E. coli. The results of the study suggest that there is a need for appropriate intervention programmes to promote exclusive breast-feeding and hand-washing practices with soap and water after cleansing children's defaecation, and before and after feeding children.
J Health Popul Nutr 2000 Sep
PMID:Relationship of breast-feeding and hand-washing with dehydration in infants with diarrhoea due to Escherichia coli. 1105 64

The prevalences of nightblindness and xerophthalmia were assessed in 400 children, aged 6-59 months, with acute diarrhoea in a rural community in Bangladesh. The prevalences of nightblindness, conjunctival xerosis, and Bitot's spot were 7.8%, 9.5%, and 2.7% respectively. Fifty-two percent of the children who complained of nightblindness had ocular signs of vitamin A deficiency compared to 9% of those without nightblindness (p < 0.000). The nightblindness was significantly higher among the male children, aged 24-59 months, who were dysenteric and undernourished, did not consume vitamin A-containing foods daily, and were not breastfed. The coverage of periodic administration of vitamin A capsule was inversely related to the prevalence of nightblindness. This finding was determined by logistic regression analysis of data indicating that a combination of male sex, history of dysentery, absence of periodic administration of vitamin A treatment, and daily intake of vitamin A-containing foods gave the best-fitted model with an overall prediction of 92.5% of being nightblind. The findings of the study suggest that mothers should be educated to observe their diarrhoeal children about development of nightblindness and to seek treatment for it. The locally-relevant nutrition education should also be offered to them.
J Health Popul Nutr 2000 Sep
PMID:Vitamin A deficiency in children with acute diarrhoea: a community-based study in Bangladesh. 1105 69

Chronic diarrhoea of the adult is defined as diarrhea during 30 days or longer. Frequent causes of chronic diarrhea in the immunocompetent adult without recent travel to developing countries are noninfectious processes, including laxatives misuse, diseases causing chronic maldigestion, osmotically active artificial sweeteners (i.e. sorbitol), hormonal disorders or drugs with intestinal side effects. Infectious agents as the cause of chronic diarrhea are important in two populations, namely in travelers returning from tropical countries bearing a significant risk of intestinal parasitic infections and in immunocompromised patients, especially AIDS patients with CD4 cell counts below 50 per microliter. Intestinal parasites and C. difficile, Y. enterocolitica, Shigellae and Cytomegalovirus are the most important causative agents of chronic diarrhea. Intestinal pathogens were identified in 46% of chronic, but only in 16.5% of acute diarrhea episodes of HIV-infected patients. An extensive medical history including recent travel as well as the detailed characteristics of onset of symptoms and of their time course is essential for the diagnosis. All patients should have a complete differential blood count, ESR, determination of electrolytes, liver enzymes, creatinine, blood glucose, and serum albumin. Tests to exclude hyperthyriodism, or pancreatic insufficiency as well as a d-xylose absorption test can be included, if appropriate. Microbiological-parasitological investigations are obligatory in patients with chronic diarrhea returning from countries with increased risk of traveler diarrhea, in cases of suspected immunodeficiency, if sudden onset of symptoms with fever is reported, after antibiotic treatment, and in children below six years of age. As a rule, stool specimens are appropriate, for the detection of cytomegalovirus colonic biopsies are necessary. In the latter case colonosigmoidoscopy has no diagnostic advantage. One single stool specimen is sufficient for the detection of bacteria or toxins, in contrast to parasitological investigations, where only three consecutive specimens provide sufficient diagnostic sensitivity.
Praxis (Bern 1994) 2000 Sep 28
PMID:[Chronic diarrhea: value of microbiology in diagnosis]. 1106 10

Acute infectious diarrhea is a major global health problem. Issues for the developed and developing regions of the world differ. Awareness of disease pathophysiology and epidemiology are essential, however, for clinical evaluation and management. The immense human and economic burden imposed by acute diarrhea illness can be addressed only by thoughtful strategies aimed at prevention as well as cost-efficient evaluation and treatment.
Gastroenterol Clin North Am 2001 Sep
PMID:Clinical evaluation and management of acute infectious diarrhea in adults. 1158 47

Campylobacter infection of the gastrointestinal tract has been observed as an antecedent illness in some patients with Guillain-Barre syndrome (GBS); these patients have been reported to have poor prognosis. We investigated 29 patients with GBS, admitted to our hospital from January 1996 to December 1999 for recent Campylobacter enteritis by culture of their stool specimens. Campylobacter upsaliensis and C. jejuni were isolated from stools of one patient each with acute motor axonal neuropathy (AMAN) and acute inflammatory demyelinating polyradiculoneuropathy (AIDP) respectively. The patient with C. upsaliensis infection was a 7 year-old male child who developed features of AMAN, 7 days after onset of diarrhea. He recovered gradually within 24 days with residual deficit in the form of foot drop. This deficit has persisted for last three and half years. The other patient with C. jejuni infection was a 9 year-old boy, who developed AIDP after 9 days of acute diarrhea. This patient recovered completely within 28 days of illness without any deficit. None of the patients had relapse of GBS. The present findings indicate the need of planned systematic studies to explore the role of C. upsaliensis and other campylobacters as agents of antecedent diarrhea in patients of GBS with different clinical presentations and prognosis.
Southeast Asian J Trop Med Public Health 2001 Sep
PMID:Guillain-Barre syndrome and Campylobacter infection. 1194 11


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