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

The clinical response and changes in water and salt homeostasis during ORT was studied in 15 infants less than 2 months old (range 2-50 days) with acute diarrhoea. Eight patients were neonates and 7 were 1-2 months old. The oral rehydration solution contained 60 mmol sodium per litre. All patients except one were successfully rehydrated. The fluid retention was significantly higher in neonates and young infants than in infants above 3 months of age treated in the same way. One patient in the group of neonates who had a normal sodium level on admission developed hypernatremia with a sodium level of 162 mmol/l 36 hours after the start of ORT. The urinary sodium excretion was lower in the neonates than in the young infants. The results show that neonates and young infants have a lower capacity than older infants to excrete water and salt and therefore run a great risk of developing fluid and salt retention during ORT. The risk is most pronounced in neonates who, due to immaturity of the renal function, are unable to excrete excess fluid and salt.
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PMID:Oral rehydration therapy in neonates and young infants with infectious diarrhoea. 330 Jan 47

The clinical response and changes in water and salt homeostasis was studied for 36 hours during oral rehydration therapy with a rehydration solution containing 60 mmol sodium/l (ORS60) in 14 malnourished 3- to 15-month-old Turkish infants with acute infectious diarrhoea. All patients were successfully rehydrated with this treatment. Sodium was efficiently absorbed from the gut and water balance was rapidly restored. Because of excess fluid retention following the initial rehydration period about 50% of the patients became oedematous. Urine volume and urinary sodium excretion were found to be much lower than in well-nourished patients of the same age with acute diarrhoea who were treated in the same way. In all of the malnourished infants the serum sodium level remained within the normal range during treatment. The results show that malnourished infants retain much more fluid and sodium than infants who are in a normal nutritional state. Excessive retention of water and salt seem to be due to an inability of the kidneys to control sodium and fluid homeostasis while orally administered sodium and fluid are being absorbed from the gut. The results show that ORT is safe and efficient in the treatment of malnourished infants with acute diarrhoea. But since these infants run a high risk of developing a severe retention of fluid and salt, and consequently may develop circulatory failure due to hypervolaemia during oral rehydration therapy, it is important to carefully monitor the volume of fluid that is given.
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PMID:Oral rehydration therapy in malnourished infants with infectious diarrhoea. 352 4

A 4-month-old male infant with severe hyponatremic dehydration due to an enteropathogenic E. coli O125: B15-induced diarrhoea had continued very high stool fluid output with a very elevated sodium concentration after hospitalization and the institution of oral rehydration therapy (ORT). Thirty-six hours after start of ORT intravenous therapy was required. The results of studies of fluid and salt homeostasis in this patient have been compared with those obtained in 3 other patients who had acute diarrhoea of the same severity but caused by another strain of enteropathogenic E. coli (O111:B14) and who were successfully treated with ORT. On ORT the patient with treatment failure had a stool volume which was almost 8 times larger and a stool sodium output which was about 5 times higher than in the successfully treated patients. During the 36-hour-period of ORT fluid losses were about the same as the fluid intake. The results as regards urinary fractional sodium excretion and the urinary potassium/sodium quotient indicate that the severe sodium depletion which was present on admission in the unsuccessfully treated patient persisted during ORT. The reason for ORT failure may be that the infectious E. coli strain had bacilli-adherent qualities that cause damage of microvilli.
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PMID:Unsuccessful oral rehydration therapy in an infant with enteropathogenic E. coli diarrhoea. Studies of fluid and electrolyte homeostasis. 389 Apr 66

How do you treat diarrhoea?, questionnaires were sent to 586 health workers in 81 countries and 58% replied. Treatments for acute diarrhoea were scored for popularity, including retrospective questions about therapy three years earlier. Oral rehydration was apparently widely used in 1976, and this had increased by 1979. Intravenous therapy was also important. Kaolin and sulphonamides are becoming less popular, but antibiotics are still widely prescribed. The most commonly used oral rehydration mixtures in 1979 were home made, simple salt-sugar solutions. A complete formula, as recommended by WHO, was used by a smaller number. 30% of the responders reported no difficulty with oral rehydration, but many did not favour the method. The main technical complaint in 28% of replies was that patients could not take enough fluid, and vomiting was reported in 22%. Local beliefs about the cause of diarrhoea related to some food or fluid ingested according to 45% of responders. Such diet-related beliefs may adversely affect the use of oral therapy.
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PMID:A worldwide survey on the treatment of diarrhoeal disease by oral rehydration in 1979. 618 70

In acute diarrhea of infancy we distinguish between infectious and noninfectious causes. In the latter we know some autosomal recessive disorders, e.g. the glucose-galactose-malabsorption, the lactase deficiency as well as the sucrase-isomaltase deficiency. In addition the most frequent acquired disorders like the cow's milk protein intolerance and celiac disease contribute also to the group of noninfectious causes of diarrhea. Here the most effective therapy consists of the elimination of the toxic agent from the diet. In infectious diarrhea we find most frequently rotavirus as the agent but also yersinia, campylobacter fetus, salmonella, shigella, E. coli, lamblia giardia and entameba hystolytica. Generally a conservative treatment with a dietetic regimen is preferred. Only in severe cases with yersinia and campylobacter infection the addition of antibiotic drugs is necessary. Giardia lamblia and amebiasis however have to be treated with metronidazol. As the absorption of glucose is coupled with that of sodium within the small intestine in acute gastroenteritis we find a combined disturbance between salt and carbohydrate absorption. A solution containing glucose and salt is recommended therefore for oral rehydration. The amount administered within the first 24 hours should be between 150-250 ml/kg per day. So called "antidiarrhoic drugs" are questionably effective.
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PMID:[Useful and superfluous measures in the treatment of infant diarrhea]. 717 37

The treatment of diarrheal diseases involves replacement of water and electrolytes lost. This is done by nasogastric and intravenous routes in severe cases but can be done successfully by oral administration of fluid electrolytes in mild to moderately severe cases. The ORS formula (a WHO-developed formula containing 90 mEq/1 of sodium, 20 mEq/1 of potassium, 80 mEq/1 of chloride, 30 mEq/1 of bicarbonate with 2% of glucose), hospital-prepared solutions, and home-made salt/sugar solutions are possibilities. 3 studies using the ORS showed that the solution is effective in replacing fluid and electrolyte loss in acute diarrhea in infants. Results from a study with 30 patients under 2 showed that the amount of oral electrolyte intake is sufficient to correct dehydration. Weight gain was 3.8 +or- 3/3% in 24 hours. When edema developed in a 2nd study with 16 patients under 6 months, it was concluded that the ORS intake should be restricted to the amount lost through diarrhea. This strategy was tried with 18 infants under 6 months and was successful. Although weight gain with oral rehydration is lower than with intravenous therapy, it can reduce the need for intravenous therapy in more than 80% of cases.
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PMID:Oral electrolyte therapy for acute diarrhea in infants. 726 96

The Diarrheal Diseases Control Program in India was started in 1978 with the objective of reducing mortality and morbidity due to diarrheal diseases. With the birth of the National Oral Rehydration Therapy (ORT) Program in 1985-86, focus shifted to strengthening case management of diarrhea for children under the age of five years and improving maternal knowledge related to the use of home available fluids, use of oral rehydration salt (ORS) solution, and continued feeding. Ensuring availability of ORS packets at health facilities and in the community is an important aspect of the program. Since 1992-93, the program has become part of the Child Survival and Safe Motherhood (CSSM) Program. All program activities are integrated with those of the CSSM program. This paper describes the situation in 1985, the current situation, the emergence of malnutrition as an important issue, rationale for standard case management, the standard case management of acute watery diarrhea, types of diarrhea, assessment of a child with diarrhea, principles of managing acute diarrhea, home available fluids, oral rehydration salts, cases with and without signs of dehydration, cases with signs of severe dehydration, feeding in diarrhea, the rational use of drugs, diarrhea associated with other illnesses, and advice to the mother.
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PMID:Oral rehydration therapy programme in India: standard case management of acute watery diarrhoea. 749 92

Interviews were conducted with 293 mothers in six villages with a total population of 54,324 in a study to determine factors associated with the use of oral rehydration solution (ORS) in West Lombok, Indonesia. The mothers had children younger than two years old who had experienced an episode of diarrhea in the past week during the three-month survey period of June-August 1991. The participants were questioned about when ORS was used, how often it was used, how to make ORS, and the availability and accessibility of ORS in the community. The mothers were also observed preparing ORS. More than 66% of the mothers questioned had used oral rehydration therapy for the home management of diarrhea, either as packaged ORS or as salt-sugar solution (SSS); 56% of mothers reported giving ORS and 10% reported giving SSS. Only 37% and 9% of mothers, however, were able to properly prepare ORS and SSS, respectively. The following factors significantly increased the likelihood that a mother would use ORS: watching a demonstration of how to prepare ORS, the availability of ORS, and accessibility of ORS. The ability to properly prepare ORS did not significantly increase the likelihood of feeding ORS. Study findings indicate that demonstrations of the preparation of ORS and availability of ORS are necessary to increase the use of ORS for the management of acute diarrhea in the study district.
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PMID:Factors associated with the use of oral rehydration solution among mothers in west Lombok, Indonesia. 775 66

Oral rehydration therapy (ORT) has simplified treatment of diarrheal dehydration. Hospitals in India have diarrheal treatment and training units (DTUs) to help manage the many diarrheal cases. DTU staff keep children for 4-6 hours to correct the dehydration with ORT and feeding. Health personnel undergo training in diarrhea management at DTUs. ORT is the preferred treatment in almost all cases of acute diarrhea. It is not best for diarrheal cases which exhibit shock, profuse vomiting (3 times/hour), glucose malabsorption, abdominal distension or paralytic ileus, and high rate of purging (15 ml/kg body weight/hour). ORT successfully treats 95% cases of infantile diarrhea, even Rotavirus-caused diarrhea. Health workers should begin treating cases of severe dehydration with intravenous (IV) therapy and then administer ORT 3-4 hours later for infants and 1-2 hours later for adults. If IV therapy is not possible, the patient should receive oral rehydration solution (ORS) nasogastrically and then referred to a facility with IV therapy. WHO's ORS formula is safe for newborns and young infants. ORT is appropriate even when diarrheal cases are vomiting. ORT tends to stop vomiting 1-2 hours after initial ORS administration because it corrects acidosis. The glucose in WHO's ORS facilitates absorption of adequate sodium across the intestinal mucous membrane. ORS also restores the loss potassium ions and HCO3/citrate. If ORS is not available, sugar salt solution can be used. To achieve the optimum concentration, the amount of sucrose has to be twice that of glucose. ORS should be stored in a cool place, be covered, and used for no more than 24 hours. Antiemetics should not be given during ORT. Most diarrheas do not require any antibiotic. Sterile water is not necessary to prepare ORS. Rice gruel, coconut water, and pulse water are home available fluids which can treat dehydration. Breast feeding and regular feeding should continue during diarrheal episodes.
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PMID:Answers to questions in relation to oral rehydration therapy. 783 4

The safety and efficacy of a rice-based oral rehydration salt (ORS) solution for the treatment of acute diarrhea in infants < 6 months of age was compared to those of a standard glucose-based ORS solution. A total of 97 infants aged 1-6 months who had a history of acute diarrhea for 120 h or less and showed signs of mild to moderate dehydration and no complications was recruited. Subjects were assigned to two treatment groups and received either standard glucose-based ORS solution or rice-based ORS solution until cessation of diarrhea. There was no significant difference between the two treatment groups with regard to the main outcome variables, including total stool output (84 [95% confidence interval (CI), 56-126] vs. 106 (95% CI, 76-148) g/kg], total ORS solution intake [171 (95% CI, 149-197) vs. 187 (95% CI, 161-218) ml/kg], or duration of diarrhea (35 +/- 31 vs 38 +/- 32 h). In addition, the fact that there was no difference between treatment groups in the presence of reducing substances in the stools suggests that rice was digested and absorbed by these infants. The results of our study support the conclusion that for infants < 6 months of age, rice-based ORS solution is safe and as efficacious as standard glucose-based ORS solution in the treatment of acute diarrhea.
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PMID:Safety and efficacy of a rice-based oral rehydration salt solution in the treatment of diarrhea in infants less than 6 months of age. 796 82


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