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

Acute diarrhoea is an important health problem in developed countries, particularly in young children. The attack rates for viral diarrhoea are similar in developed and developing countries. Rotavirus is the most common pathogen, followed by adenovirus. Bacterial diarrhoea is less common in developed than developing countries. The 2 most common bacterial pathogens are Campylobacter jejuni and Salmonella. The most serious consequence of diarrhoea is dehydration, and the treatment for this is the same whatever the pathogen. Recently, there have been major changes in the management of diarrhoea with emphasis on oral rehydration and early feeding. Two controversial areas are the sodium content of solutions designed for developed countries and the best route of administration of fluids to children with moderately severe dehydration. There have been 4 randomised controlled trials in developed countries comparing oral and intravenous rehydration. The findings have confirmed the experience in developing countries that most children without shock can be rehydrated orally, thus substantially reducing the need for intravenous fluids. It is important to give physiologically balanced solutions which contain 2% glucose and 50 to 90 mmol/L of sodium. Many of the commercially available oral solutions are appropriate for rehydration and maintenance of hydration in infants with diarrhoea of all types. They are recommended particularly for the prevention of dehydration in children of all ages with severe diarrhoea and for the treatment of dehydration. Children with mild diarrhoea and no dehydration can be given commercial clear fluids diluted with water, or homemade solutions made with table sugar and water. Salt must not be used. Babies should continue on breast milk or formula with extra water. Education is the key to successful oral rehydration, and the ultimate aim should be the prevention of dehydration.
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PMID:Oral rehydration in infantile diarrhoea in the developed world. 306 44

The protective effect of a human strain of Bifidobacterium bifidum (B. bifidum) against murine Group A rotavirus (MRV) was examined in the intestines of BALB/c infected mice. In experiments designed to determine whether B. bifidum mediated MRV shedding during diarrheal disease, pregnant dams (and their expected litters) were randomly assigned to the following groups: 1. Mice infected with MRV alone; 2. B. bifidum treated + MRV infected mice; 3. B. bifidum treated controls; 4. Saline control animals. An enzyme-linked immunosorbent assay (ELISA) for the detection of group A rotavirus was used to measure virus protein. Treatment with B. bifidum significantly reduced shedding of MRV antigen (P < 0.009) days 2-10 post-inoculation. The reduction in shedding of virus protein corresponded well with delayed onset of acute diarrhea (P < 0.02). Closer examination of tissue cross-sections under electron microscopy revealed that the B. bifidum ingested strain adhered to the epithelium of the small intestine. In further experiments, adherent properties of the ingested strain were related to enhancement, although nonsignificant, in immunoglobulin secreting cell responses in Peyer's patch lymphocytes. These results suggest that priming the intestine with B. bifidum is effective against experimental MRV challenge. Closer examination of B. bifidum and related growth factors in suckling neonates on gut physiology and enhancement of local immune responses has potential dietary implications in formulas for newborns.
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PMID:Effectiveness of Bifidobacterium bifidum in experimentally induced MRV infection: dietary implications in formulas for newborns. 806

We aimed to detect the etiological agents of acute diarrhea by a molecular gastrointestinal pathogen test (MGPT) and to assess the impact of MGPT on antimicrobial stewardship programs (ASP). This is a prospective observational study and was conducted between 1 January 2015 and 30 June 2017. We included consequent patients who had acute diarrhea. At the end of 2015, we implemented ASP in acute diarrhea cases and compared the outcomes in the pre-ASP and post-ASP periods. An FDA-cleared multiplexed gastrointestinal PCR panel system, the BioFire FilmArray (Idaho Technology, Salt Lake City, UT), which detects 20 pathogens in stool, was used. In 499 out of 699 patients (71%), at least one pathogen was detected. Among 314 adults with positive MGPT, 101 (32%) enteropathogenic Escherichia coli (EPEC), 71 (23%) enteroaggregative E. coli (EAEC), 68 (22%) enterotoxigenic E. coli (ETEC), 55 (18%) Shiga toxin-producing E. coli (STEC) (17%) Norovirus, 48 (15%) Campylobacter, 21 (7%) Salmonella, and 20 (6%) Clostridium difficile strains were detected. Among 185 children, 55 (30%) EPEC, 37 (20%) C. difficile, 32 (17%) Norovirus, 29 (16%) EAEC, 22 (12%) STEC, 21 (11%) ETEC, 21 (11%) Campylobacter, 20 (11%) Salmonella, and 16 (5%) Rotavirus strains were detected. Inappropriate antibiotic use decreased in the post-ASP period compared with the pre-ASP period among inpatients (42.9% and 25.8%, respectively; P = 0.023). Using MGPT in clinical practice significantly decreased the unnecessary use of antibiotics. Detection of high rates of C. difficile in children and Salmonella spp., as well as relatively high rates of Campylobacter spp., which were hard to isolate by routine stool culture, were remarkable.
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PMID:Rapid Molecular Detection of Gastrointestinal Pathogens and Its Role in Antimicrobial Stewardship. 2951 35