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

Dr. Mujibur Rahaman, senior scientist at the International Center for Diarrheal Disease Research in Bangladesh, was interviewed recently in regard to oral rehydration therapy (ORT), a simple and inexpensive way of treating the loss of essential fluids and minerals that accompanies diarrhea. According to Rahaman, ORT, developed quite a while ago, is recently gaining more publicity and wider acceptance as a menas of replacing the water and electrolytes lost during acute diarrhea attack. The standard ingredients of the ORT mixture, as it is used in Bangladesh, are 3.5 gm of sodium chloride, or common salt, 2.5 gm sodium bicarbonate, and 1 gm of potassium chloride. To this one should add either 20 gm of glucose or 40 gm of sugar. This mixture should be dissolved in 1 liter of plain drinking water. Plain sugar is good enough. How much is needed depends on the severity and the duration of diarrhea. Calculations have shown that, as a rule of thumb, a child of 10-12 kg may require little more than a liter in about 24 hours. If the child has diarrhea of sufficient severity, it may require more than a liter. If the diarrhea is prolonged, it may require 2 liters. For children who are in danger of dying from dehydration, parents are warned to be watchful because further treatment and follow-up may be required. In Bangladesh a national program is currently providing the ORT in remote rural areas. At present about 1/3 of Bangladesh is covered. The national health service is distributing the solution free of cost in the villages where they have health volunteers. Although ORT is simple to make and simple to administer, one has to exercise some degree of caution with it in order to prevent infants getting dangerous symptoms like hypernatremia. ORT makes it possible for health educators to enter into the family. It is not totally correct to say water is the main problem or causative factor in producing diarrhea. In infantile diarrhea, the cause is most often a virus. Viral transmission is not associated with water. Water can affect the incidence of diarrhea in several ways. The mother's hygiene can be affected by the availability of water, not just the quality but also the quantity. A most exciting study going on now is measuring the impact of water and sanitation on diarrheal diseases.
 ...
PMID:A saving solution. 1233 24

In Bangladesh, the director of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) gave the introductory address at an awards ceremony to celebrate its key role in the discovery of oral rehydration solution (ORS) 25 years ago. ORS, a simple and affordable treatment for diarrheal disease, has specific amounts of glucose, salts, and water. Oral rehydration therapy (ORT) includes ORS and other solutions made with effective and safe salt concentrations and cereals. In South Asia, rock salt with cooked rice in a thick gruel was used to treat diarrhea as long as 3000 years ago. Researchers at the Cholera Research Laboratory in Dhaka during 1964-1968 learned that adding glucose to a solution of salts greatly helps the intestine's ability to absorb water and electrolytes, and that the intestine could absorb them during acute diarrhea. In November, 1987, the researchers set up a large scale field treatment center at a hospital in Malumghat, between Cox's Bazaar and Chittagong. It treated more than 300 cholera patients. No one died, but the trial was a failure. The researchers designed another clinical trial which showed that ORS reduced the need for intravenous fluids by 75% when treating acute cholera in adults. Another ORS trial in Calcutta yielded the same results. The laboratory also showed that ORS alone could rehydrate people with acute dehydrating diarrhea and that medical auxiliaries could administer it. In 1971, ORS successfully treated Bangladeshi refugees with cholera. The international health community officially accepted ORT in 1978. In developed countries, the potential health care cost savings of ORS use is greater than a few billion dollars at the very least and US$ 10-15 billion from optimal ORS use. Government officials from what is now Bangladesh and the US established the Cholera Research Laboratory 32 years ago. 18 years later, it became ICDDR,B. We must recognize the miracle of ORS.
 ...
PMID:Introductory address by Dr Demissie Habte on the occasion of the 25th anniversary of ORS. 1234 76

The observation that the intestinal Na(+)-glucose cotransporter remains intact in most diarrheal illnesses led to development of the life-saving, low-cost technology of oral rehydration salt (ORS) solutions. The primary therapeutic role of ORS solutions is in prevention and treatment of dehydration during management of acute gastroenteritis. Successful oral rehydration therapy involves early use of ORS with maintenance or timely resumption of regular feeding. Since the inception of the oral rehydration approach more than three decades ago, the widespread use of ORS solutions has revolutionized the management and outcomes of acute gastroenteritis in children and adults. The efficacy of the World Health Organization ORS solution and of commercial ORS formulations has been enhanced by reducing osmolarity. Newer formulations of ORS are under active investigation, with promise of added benefits, including promotion of intestinal healing. This article reviews fluid and electrolyte transport in the gastrointestinal tract, the pathophysiologic mechanisms of acute diarrhea, and the basis and formulation of current and newer ORS solutions. Guidelines for efficacious use of ORS in the management of acute gastroenteritis and short gut syndrome are also provided.
 ...
PMID:The use of oral rehydration solutions in children and adults. 1524

Acute diarrhoeal diseases rank second amongst all infectious diseases as a killer in children below 5 years of age worldwide. Globally, 1.3 billion episodes occur annually, with an average of 2-3 episodes per child per year. The important aetiologic agents of diarrhoea and the guidelines for management are discussed. Management of acute diarrhoea is entirely based on clinical presentation of the cases. It includes assessment of the degree of dehydration clinically, rehydration therapy, feeding during diarrhoea, use of antibiotic(s) in selected cases, micronutrient supplementation and use of probiotics. Assessment of the degree of dehydration should be done following the WHO guidelines. Dehydration can be managed with oral rehydration salt (ORS) solution or intravenous fluids. Recently WHO has recommended a hypo-osmolar ORS solution for the treatment of all cases of acute diarrhoea including cholera. Feeding during and after diarrhoea (for at least 2-3 weeks) prevents malnutrition and growth retardation. Antibiotic therapy is not recommended for the treatmentof diarrhoea routinely. Only cases of severe cholera and bloody diarrhoea (presumably shigellosis) should be treated with a suitable antibiotic. Pilot studies in several countries have shown that zinc supplementation during diarrhoea reduces the severity and duration of the disease as well as antidiarrhoeal and antimicrobial use rate. Probiotics may offer a safe intervention in acute infectious diarrhoea to reduce the duration and severity of the illness.
 ...
PMID:Acute diarrhoeal diseases--an approach to management. 1705 65

The purpose of this study was to determine the cytotoxic effect on CaCo-2 intestinal cells of dialysates obtained from bacterial cultures of some enterobacterial opportunistic strains with different sources of isolation (food, stool culture, acute diarrhoea, urine culture), previously tested and selected for their intensive adherence and invasion capacity to the cellular substratum and also for their cytotoxic effect on cell monolayers. In this study the level of cytotoxicity was measured quantitatively by means of the MTT assay and qualitatively by transmission electron microscopy (TEM). The MTT method uses a tetrazolium salt for the quantitative spectrophotometric assay of CaCo-2 cells survival and proliferation rates in the presence of bacterial dialysates. This test detects the viable cells, which are able to reduce the tetrazolium salt and offers the advantages of a very simple, rapid and precise method. For TEM examination the ultrathin sections were prepared following the standard protocols. The most cytotoxic strains proved to be Citrobacter freundii 93 strain isolated from stool culture, and Enterobacter cloacae 43, isolated from food followed by E. coli 115 strain isolated from acute diarrhoea. These results correlate well with TEM results pointing out the cytotoxic effect of Enterobacter cloacae 43 strain and also its ability to induce attachment and to destroy the cell surface (A/E) of HEp-2 cells. Besides their great adherence and invasion capacity, the production and release of cytotoxic factors into the extracellular medium represent virulence factors in these strains. This could be responsible for the increase of the pathogenic potential of opportunistic bacteria and explain their implication in the etiology of severe infections and food-borne diseases. This study proved that the virulence of opportunistic pathogens is not correlated with the strain's origin, the most evident virulence features being exhibited by an Enterobacter cloacae strain isolated from food.
 ...
PMID:Investigation of the cytotoxic capacity of some adherent opportunistic enterobacterial strains by the MTT assay and transmission electron microscopy. 2105 82

We conducted this study to determine the prescribing practices of doctors in management of acute diarrhea in children in the age group of 6 month -5 year. Antimotility agents and low/zero lactose formula was prescibed in 9.8% and 24.7% cases, respectively by general practitioners. In about 66.6% and 5.7% cases pre/probiotics were prescribed and oral rehydration salt (ORS) were not prescribed by the pediatricians.
 ...
PMID:Prescribing practices of doctors in management of acute diarrhea. 2208 Jun 86

Enterotoxigenic Escherichia coli (ETEC) is an important cause of acute watery diarrhoea in developing countries. Colonization factors (CFs) on the bacterial surface mediate adhesion to the small intestinal epithelium. Two of the most common CFs worldwide are coli surface antigens 5 and 6 (CS5, CS6). In this study we investigated the expression of CS5 and CS6 in vivo, and the effects of bile and sodium bicarbonate, present in the human gut, on the expression of CS5. Five CS5+CS6 ETEC isolates from adult Bangladeshi patients with acute diarrhoea were studied. The level of transcription from the CS5 operon was approximately 100-fold higher than from the CS6 operon in ETEC bacteria recovered directly from diarrhoeal stool without sub-culturing (in vivo). The glyco-conjugated primary bile salt sodium glycocholate hydrate (NaGCH) induced phenotypic expression of CS5 in a dose-dependent manner and caused a 100-fold up-regulation of CS5 mRNA levels; this is the first description of NaGCH as an enteropathogenic virulence inducer. The relative transcription levels from the CS5 and CS6 operons in the presence of bile or NaGCH in vitro were similar to those in vivo. Another bile salt, sodium deoxycholate (NaDC), previously reported to induce enteropathogenic virulence, also induced expression of CS5, whereas sodium bicarbonate did not.
 ...
PMID:Expression of colonization factor CS5 of enterotoxigenic Escherichia coli (ETEC) is enhanced in vivo and by the bile component Na glycocholate hydrate. 2256 7

Probiotics are living micro-organisms that do not naturally have shelf life, and normally are weakly protected against the digestive action of the GI tract. A new dual coating technology has been developed in an effort to maximize survival, that is, to be able to reach the intestine alive and in sufficient numbers to confer the beneficial health effects on the host. Dual-coating of lactic acid bacteria (LAB) is the result of fourth-generation coating technology for the protection of these bacteria at least 100-fold or greater than the uncoated LAB. This innovative technique involves a first pH-dependent protein layer that protects bacteria from gastric acid and bile salt, and a second polysaccharide matrix that protects bacteria from external factors, such as humidity, temperature and pressure, as well as the digestive action during the passage through the GI tract. Dual-coated probiotic formulation is applicable to different therapeutic areas, including irritable bowel syndrome, atopic dermatitis, acute diarrhea, chronic constipation, Helicobacter pylori eradication, and prevention of antibiotic-associated diarrhea. An updated review of the efficacy of doubly coated probiotic strains for improving bacterial survival in the intestinal tract and its consequent clinical benefits in humans is here presented.
...
PMID:Dual-coated lactic acid bacteria: an emerging innovative technology in the field of probiotics. 2678 Jan 16

Oral rehydration salt (ORS) treatment in young children with acute diarrhoea (AD) has contributed to decrease mortality associated with dehydration although effective strategies to reduce morbidity associated with this disease are required. The aim of this study was to evaluate the diarrhoea duration when using combined colloidal bismuth hydroxide gel (CBHG) and oral rehydration salt treatment compared with ORS therapy in children with AD. We designed a double-blind, randomised prospective study with treatment and control groups. Patients aged one to 12 years, with no prior pathology and with AD of less than 48 h were included. The Chi-squared and Mann-Whitney tests were used, as well as the Cox proportional hazards model and the Kaplan-Meier estimator. Patients were randomised into an ORS and CBHG treatment group and a control group for ORS plus placebo. (Average age: 3.2 years). The result of the post-treatment evaluation with respect to the average duration of AD was 25.5 h for the treated group vs. 41.5 h for the control group (p = 0.015). The average number of stools was 4.8 in the treated group and 8.2 in the control group (p = 0.032). We conclude that the use of CBHG plus ORS significantly reduced the duration of AD, the number of stools and the percentage of children with persistent AD after 24 h of treatment compared to the control group. AD remitted almost twice as fast in patients treated with CBHG and ORS compared to those who received ORS plus placebo.
 ...
PMID:Acute Diarrhoea in Children: Determination of Duration Using a Combined Bismuth Hydroxide Gel and Oral Rehydration Solution Therapy vs. Oral Rehydration Solution. 2800 23


<< Previous 1 2 3 4