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

Twenty-four male Guatemalan children, aged 7 to 23 mo, suffering dehydration due to acute diarrhea were studied to assess their fecal endogenous losses of trace minerals zinc, iron, and copper while treated with oral rehydration therapy, either with standard or glycine-added solutions. Sodium and potassium excretions (from endogenous and exogenous sources) were also monitored. No statistically significant effect of glycine was observed on any of the minerals studied, although a tendency to higher output was seen with zinc. Median rates of fecal excretion of zinc, iron, and copper were 6.08, 6.33, and 1.61 micrograms/kg/h, respectively, whereas those for sodium and potassium were 11.2 and 9.7 mg/kg/h. All of the minerals' excretion showed significant linear correlations with fecal volume, r values were 0.47 (Zn), 0.64 (Fe), 0.77 (Cu), 0.98 (Na), and 0.97 (K). Mineral-mineral interactions also were evident, with such correlations in fecal excretion rates as: Zn versus Cu, r = 0.75; Zn versus Fe, r = 0.62; Fe versus Cu, r = 0.76.
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PMID:Mineral excretion during acute, dehydrating diarrhea treated with oral rehydration therapy. 231 46

To evaluate the effect of copper supplementation during recovery from acute diarrhea, we randomly assigned 14 hospitalized infants to receive either 80 micrograms copper sulfate.kg body wt-1.d-1 or a placebo. Metabolic balance and plasma copper and zinc concentrations were measured before randomization (period 1) and 6 d after admission (period 2). Fifteen control subjects were studied after respiratory illness. Fecal copper was not affected by supplementation; fecal zinc during period 2 rose significantly only in the copper-supplemented group. Copper retention was significantly higher in the supplemented infants; plasma concentrations increased for period 2 but were similar to those in the placebo group. Zinc concentrations improved over time in both groups but zinc retention was higher in the placebo group for period 2. A significant interference by copper supplementation on zinc absorption was noted. Copper supplementation during the early phase of recovery from diarrhea is not recommended.
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PMID:Oral copper supplementation: effect on copper and zinc balance during acute gastroenteritis in infants. 234 23

Serum and rectal mucosal zinc content was estimated in children (6-18 months old) with acute diarrhea (Group I: n = 50), chronic diarrhea (Group II: n = 25), extraintestinal infections (Group III: n = 15) and apparently healthy controls (Group IV: n = 20). The sex and nutritional status of various groups was comparable. The mean serum and tissue zinc levels in acute (p less than 0.001) and chronic (p less than 0.05 for serum; p less than 0.001 for tissue) diarrhea groups were significantly lower than healthy and infected controls. Group II had significantly lower (p less than 0.001) serum and rectal zinc content in comparison to Group I. There was a significant negative correlation between serum zinc and diarrheal duration (r = 0.5676; p less than 0.001). Repeat estimation at discharge in 38 patients (25 in Group I, 13 in Group II) revealed a significant reduction in both tissue and serum zinc and only tissue zinc in acute and chronic diarrhea, respectively. A total of 23 patients (16 in Group I, and 7 in Group II) were evaluated 2 weeks after discharge. After discharge, at recovery there was no alteration in serum zinc, but tissue zinc was marginally higher (p greater than 0.05). It is concluded that zinc depletion occurs in diarrhea, more so in the chronic state; with the continuation of diarrhea, depletion progresses; and there is a tendency for repletion during convalescence.
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PMID:Serum and rectal mucosal zinc levels in acute and chronic diarrhea. 236 56

A controlled, randomized trial was conducted in 50 infants with acute dehydrating diarrhea to evaluate the effect of oral zinc supplementation in acute diarrhea. After completion of rehydration, 25 infants in Group A received oral zinc sulfate (20 mg elemental zinc twice daily) and an equal number in Group B were given placebo (glucose). Both groups were comparable with respect to various initial characteristics including nutritional status, diarrheal disease, serum alkaline phosphatase, and serum and rectal mucosal zinc content. During therapy all the assessed parameters of zinc status (serum alkaline phosphatase and serum and rectal zinc) recorded significant elevation and reduction in Groups A and B, respectively. At recovery the zinc status of Group A was significantly better and was nearer that of healthy controls. The diarrheal duration and frequency in the zinc-supplemented group were lower, but the differences were not significant (0.05 less than p less than 0.1). However, when only subjects with relatively severe initial zinc depletion (rectal zinc lower than the 15th percentile of healthy controls; 11 in Group A and 14 in Group B) were considered, the diarrheal duration and frequency were significantly (p less than 0.05 and p less than 0.01, respectively) lower in the zinc-supplemented cases. Weight gain in both groups was similar. It is concluded that oral zinc administration in acute diarrhea can replenish body zinc status and this may shorten the diarrheal duration and frequency in children with relatively severe zinc depletion.
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PMID:A controlled trial on utility of oral zinc supplementation in acute dehydrating diarrhea in infants. 305 19

To evaluate the magnitude of copper and zinc losses during acute diarrhea requiring hospitalization, we studied 14 infants, 3 to 14 months of age, and compared them with a control group of 15 infants of similar age, birth weight, and nutritional status. Metabolic balance studies were conducted in the study group during an initial 48 hours (period 1) and on days 6 and 7 after admission (period 2). The control group was studied after recovery from respiratory disease. Copper and zinc content of feces, urine, and food samples was measured by atomic absorption spectrophotometry. Mean (+/- SD) fecal losses were higher for period 1 in the diarrhea group than in control subjects: Cu 55.7 +/- 21.2 versus 28.8 +/- 6.7 micrograms/kg/body weight/day (p less than 0.01); Zn 159.4 +/- 59.9 versus 47.4 +/- 6.4 micrograms/kg/day (p less than 0.0001). For period 2, Zn losses were similar in both groups, but Cu balance remained negative only in the study group. Retention of Zn for the study group went from -21.2 +/- 46.7 in period 1 to 204.5 +/- 103.0 micrograms/kg/day in period 2 (p less than 0.0001), and fecal weight decreased from 70.5 +/- 20.6 in period 1 to 36.8 +/- 20.0 gm/kg/day in period 2. Fecal weight and fecal losses were correlated: r = 0.71 (p less than 0.01) for Cu and r = 0.81 (p less than 0.001) for Zn. Plasma mean Cu and Zn levels were low in period 1 but rose in period 2, especially for Zn. A negative correlation was found between fecal Zn losses and plasma Zn: r = 0.74 (p less than 0.001). We conclude that acute diarrhea leads to Cu and Zn depletion and that plasma levels and Cu balance remain abnormal a week after admission.
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PMID:Trace mineral balance during acute diarrhea in infants. 341 89

Forty-five marasmic infants were studied for plasma zinc and copper levels. They were selected from those children admitted to a nutritional recovery center. The mean plasma zinc level was 92.4 +/- 24 micrograms/dl (mean +/- SD); 7% of the infants had low zinc values as defined by zinc less than 70 micrograms/dl. Median copper was 90 micrograms/dl (range 27-172) and 49% of the children had copper levels below 90 micrograms/dl (established as our normal limit). Birth weight, breast feeding and prior hospitalization for acute diarrhea with dehydration were studied as antecedents related to low Cu and Zn. Children with prior diagnosis of acute diarrhea and hospitalization had lower copper levels than those sent from primary care centers. Breast feeding was associated with higher Cu levels. No relationship was found between zinc levels and those antecedents, but differences were found in regard to the degree of malnutrition, season of the year and Zn status. In this investigation no Zn deficiency was found in marasmus cases. Hypocupremia, however, is a very significant problem in marasmic infants, especially when associated with early weaning and the presence of previous hospitalization for acute diarrhea.
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PMID:[Plasma zinc and copper in infants with protein-calorie malnutrition]. 644 37

Plasma zinc levels, in a cohort of 116 children aged 12-59 months recently recovered from an episode of acute diarrhoea attending a community health clinic in an urban slum, were related to diarrhoeal and respiratory morbidity in the 3 month period following recovery. Children with low plasma zinc levels (< 60 micrograms dl-1) spent a significantly greater number of days with watery diarrhoea (rate ratio 1.69 (95% confidence intervals 1.03-2.78)), diarrhoea associated with fever (rate ratio 1.88 (95% confidence intervals 1.05-3.34)), and acute lower respiratory tract infections (rate ratio 2.69 (95% confidence intervals 1.64-4.38)).
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PMID:Increased diarrhoeal and respiratory morbidity in association with zinc deficiency--a preliminary report. 864 39

Diarrhoea that begins acutely but lasts longer than two weeks is defined to be persistent. Revised estimates in developing countries including India showed that acute diarrhoea accounts for 35 per cent, dysentery 20 per cent and non-dysenteric persistent diarrhoea (PD) for 45 per cent of total diarrhoeal deaths. PD also often changes marginal malnutrition to more severe forms. Factors that increase the risk of acute diarrhoea becoming persistent have been identified in India and other developing countries. These include antecedent malnutrition, micronutrient deficiency particularly for zinc and vitamin A, transient impairment in cell mediated immunity, infection with entero aggregative Escherichia coli and cryptosporidium, sequential infection with different pathogens and lack of exclusive breast feeding during the initial four months of life particularly use of bovine milk. Several issues regarding the management of persistent diarrhoea in hospitalized children in India have been resolved. Diets providing modest amounts of milk mixed with cereals are well tolerated. In those who fail on such diets providing carbohydrate as a mixture of cereals and glucose or sucrose hasten recovery. The role of antimicrobial agents and individual micronutrients in PD is currently being investigated. A management algorithm appropriate for India and other developing countries has been developed and found to substantially reduce case fatality in hospital settings to about 2-3 per cent. Recent epidemiological and clinical research related to persistent diarrhoea is also reviewed.
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PMID:Epidemiology & management of persistent diarrhoea in children of developing countries. 878 12

During June 1990 to June 1991, weekly home visits and periodic clinical examinations were conducted among 1872 children 0-5 years old living in northern Ghana. The data obtained from the home visits and the clinical examinations were analyzed to determine whether diarrhea incidence (number of episodes experienced by each child over a defined period) or longitudinal prevalence (number of days of diarrhea divided by the total number of days of observation for each child) had the strongest association between weight gain over a 4-month period and subsequent mortality. Diarrhea burden, be it diarrhea incidence or prevalence, was strongly associated with weight gain in children 6-23 months old only. Yet, longitudinal prevalence of diarrhea had more explanatory power with regards to weight gain than did incidence (likelihood ratio statistic: 28.95 on 1 degree of freedom vs. 19.70). When the researchers adjusted for longitudinal prevalence, the strength of the association between the number of incident episodes and weight gain declined. On the other hand, when they adjusted for incidence, the strength of the association between longitudinal prevalence and weight gain remained very strong. Longitudinal prevalence was also a strong predictor of subsequent mortality (5% absolute increase in longitudinal prevalence associated with a 17% relative increase in the risk of mortality; p = 0.002 vs. p = 0.557 for incidence). These findings suggest that longitudinal prevalence of diarrhea is a stronger predictor of long-term health outcome than incidence. Longitudinal prevalence may be best suited for studies of interventions expected to improve host response to diarrhea (e.g., vitamin A supplementation or treatment of acute diarrhea with zinc) or those seeking to quantify the burden on children of morbidity from diarrhea. In conclusion, longitudinal prevalence should receive greater attention as a measure of outcome in studies of childhood diarrhea.
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PMID:Is prevalence of diarrhea a better predictor of subsequent mortality and weight gain than diarrhea incidence? 879 18

Oral rehydration solution (ORS), the best treatment of dehydration due to acute diarrhea, is the most important medical advance of this century since it is key to reducing infant and child morbidity and mortality. Pathogens responsible for acute diarrhea include those which produce enterotoxin at the intestinal mucosal surface, inducing secretion but are not invasive (e.g., Vibrio cholerae); those which invade and disrupt the mucosal lining (e.g., shigella species); and rotavirus. The World Health Organization (WHO)/UNICEF ORS is considered a universal ORS. Much research has been done on the ideal composition of an ORS. An ORS must have sufficient sodium to replace losses on a volume to volume basis, a glucose concentration that matches that of sodium to ensure its delivery to the ileum, sufficient amounts of potassium and base (e.g., sodium bicarbonate or trisodium citrate dihydrate) to correct acidosis and to enhance sodium absorption, and sufficient amounts of liquid. The risk of hypernatremia with use of the WHO/UNICEF ORS is a concern since infants and young children have an immature renal concentrating capacity, increased insensible water losses, and an impaired natriuretic response. Neonates and young infants may be prone to relatively slow correction of acidosis. It appears that the potassium content (20 mmol/l) of WHO-ORS should be higher to promote a net positive potassium retention. Too much glucose in the ORS will induce reverse osmosis of water into the gut, effectively making the ORS a dehydrating solution rather than a hydrating solution. Some carbohydrates other than glucose have proven effective glucose substitutes (e.g., sucrose, rice starch and powder, other cereals). Cereals have higher acceptability levels in developing countries. Research is investigating the nutritional benefits of supplementing ORS with micronutrients (e.g., vitamin A, folic acid, and zinc). ORS use with early refeeding has a beneficial effect on nutritional status after an acute diarrhea episode.
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PMID:Oral rehydration therapy. 885 79


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