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

Acute diarrhea is a leading cause of childhood morbidity and mortality. Primary care physicians and pediatricians should be familiar with its clinical features and management. Rehydration and maintenance of proper fluid and electrolyte balance are the most important aspects of treatment. While intravenous rehydration is the best form of treatment for children who are in shock or unable to drink, oral rehydration is the treatment of choice for the majority of children who have mild to moderate dehydration. Oral rehydration therapy is simple, practical, inexpensive, effective, and safe for children in developing as well as developed countries. We recommend the use of commercially available rather than homemade solutions. Antibiotic and antidiarrheal agents are usually not indicated. Early reintroduction of milk, formula, or solid food is important, as is instruction of parents in measures to minimize transmission of infectious agents.
Postgrad Med 1989 Dec
PMID:Acute diarrhea in children. What to do and what not to do. 268 91

A 1-year study of the etiology of acute diarrhea complicated by severe (10%) dehydration, active bleeding, shock and cardiovascular collapse, pneumonia, acute renal failure, or seizures in infants under 18 months of age was performed in Cairo, Egypt. Of 145 infants, 19 (13%) died or left the hospital moribund; the remaining 126 patients were classified as having potentially fatal illness. A variety of enteropathogens were identified with approximately equal frequency in the fatal and nonfatal complicated cases as well as in 135 controls with severe uncomplicated diarrhea. The agents most frequently detected in infants with severe diarrhea in this population which were felt to be etiologically important were rotavirus (33%), heat-stable enterotoxin-producing Escherichia coli (20%), heat-labile enterotoxin-producing E. coli (11%), enteropathogenic E. coli (8%), and Salmonella spp. (5%). The high rate of occurrence of Giardia lamblia (35%) probably represented the high carriage rate of the protozoan in this population. Complicated (fatal and potentially fatal) cases differed from control cases in a number of ways: the onset of diarrhea was more sudden, the course was progressive and of greater initial intensity, vomiting occurred more frequently, the patients more often had visited another physician before coming to the hospital, the patients more often had respiratory symptoms and pulmonary abnormalities on auscultation, hypoactive bowel sounds and abdominal distention were more common, as was oliguria, and the patients showed lower mean body weights.
J Clin Microbiol 1986 Dec
PMID:Detection of enteropathogens in fatal and potentially fatal diarrhea in Cairo, Egypt. 302 41

Researchers studied the incidence of diarrheal diseases in a cohort of 131 infants in Ibadan, Nigeria Primary health care workers visited each infant every week to learn of any diarrheal episodes. In additions, each child was to attend a clinic monthly for further evaluation. Of these infants recruited at birth, 95 (73%) finished 1 year of follow up. The incidence rate for acute diarrhea was 3.2 episodes/child, and each infant experienced at least 1 episode. For those infants aged 6-8 months, the incidence rate was 9 episodes/100 child weeks which was the highest mean incidence rate of all the age groups (ranging from 0-2 months to 18-23 months). In addition, the highest number of diarrhea days/child was for this same age group and it was 5.2 days/child/interval. In the 1st year of life, the mean number of diarrhea days/child/year was 16 (range 3-34) and the mean duration of each episode was 5 days. Additionally, laboratory personnel examined 280 fecal samples from diarrheal episodes for rotavirus. 22 (8%) of these were positive and the majority of these cases occurred in infants 3-5 months old. Rotavirus diarrheal episodes ranged from 5-12 days with a mean of 8 days. 12 (55%) of the infants who tested positive for rotavirus were males, and the mean duration was longer for them (8.4 days) than for the females (7 days), but the difference was not significant. The rotavirus infections caused no deaths. In addition, none of the infants with rotavirus had a 2nd episode of rotavirus infection during the surveillance period.
Int J Epidemiol 1988 Dec
PMID:An epidemiological study of rotavirus diarrhoea in a cohort of Nigerian infants: II. Incidence of diarrhoea in the first two years of life. 322 2

The efficacy of a commercial oral rehydration solution (ORS) was compared with that of the standard WHO formula ORS in treating infants hospitalized with acute diarrhea in Saudi Arabia. The commercial product contained less sodium and more glucose than the standard ORS. Among patients more than 2% dehydrated, 16 of 17 who received the standard ORS, were free of clinical signs of dehydration within 24 hours. Of 17 who received the commercial product, 9 needed intravenous therapy because of worsening dehydration. Patients on standard ORS had a greater mean weight gain in the 1st 8 hours and lower mean stool output. They showed significantly more rapid correction of acidosis and of azotemia, with higher intestinal absorption and urinary excretion of sodium. Diarrheal stools in patients on the commercial product were low in sodium and contained reducing substances, findings which suggest osmotic diarrhea from unabsorbed glucose.
J Diarrhoeal Dis Res 1986 Dec
PMID:Oral rehydration therapy: comparison of a commercial product with the standard solution. 331 89

We describe a two-step predictive method to assess the probability of bacterial etiology in cases of diarrhea. The patients are divided into three probability groups (high, intermediate, low) according to a clinical score. Thereafter the patients in the intermediate group are further assigned to the high or low probability group according to the presence or absence of fecal leukocytes. We developed the method in an initial series of 157 children with acute diarrhea; the reproducibility of the method was tested in a second series of 180 cases. Eighty-six percent of patients in the first series and 81% in the second were correctly classified by our method. We suggest its use, especially in pediatric practice, to identify children with the highest probability of bacterial diarrhea, thus reserving stool culture to a few selected cases because only a minority of children with diarrhea have a recognized bacterial etiology.
Pediatr Infect Dis J 1987 Dec
PMID:Simple clinical score and laboratory-based method to predict bacterial etiology of acute diarrhea in childhood. 343 82

When a patient presents for the first time with acute diarrhoea, it can be difficult to distinguish acute self-limited colitis from idiopathic inflammatory bowel disease. This study was designed to determine whether detailed interpretation of rectal histology can enable this distinction to be made early in the course of the illness. Seventy-two rectal biopsies, taken at the time of presentation from patients with undiagnosed colitis, were reviewed independently by two observers without access to clinical information. Distorted crypt architecture, crypt atrophy, basal lymphoid aggregates and dense lymphocytic infiltrates each emerged as features with a 76 to 86 per cent probability of predicting idiopathic inflammatory bowel disease, but their discriminant value was limited by inter-observer disagreement (16-29 per cent). Isolated basal giant cells, epithelial surface erosions and epithelioid granulomas were found to be the most reliable histological features in the early diagnosis of idiopathic inflammatory bowel disease, and their interpretation was associated with the lowest inter-observer disagreement (6 per cent).
Q J Med 1987 Dec
PMID:The value of rectal biopsy in distinguishing self-limited colitis from early inflammatory bowel disease. 345 54

The efficacy of 1-(2,6-dimethylphenyl)-3-methyl-amidinourea hydrochloride (lidamidine HCl, WHR-1142 A) an aryl-substituted amidinourea recently synthesized, was compared with that of loperamide in 32 patients with acute diarrhoea. The results of the study show that lidamidine HCl and loperamide had comparable effects in the pharmacological treatment of acute non-specific diarrhoea. Lidamidine HCl was also shown to be well tolerated; side-effects were generally minor and self-limiting.
Arzneimittelforschung 1986 Dec
PMID:A multicenter double-blind controlled trial comparing lidamidine HCl and loperamide in the symptomatic treatment of acute diarrhoea. 355 69

In a prospective survey carried out over 9 months in 1984 in the Department of Bacteriology, Belfast City Hospital, Campylobacter jejuni was isolated from 24 out of 1200 faecal specimens (2%) from patients with acute diarrhoea. This isolation rate is much lower than that from other parts of mainland Britain which report an isolation rate of between 8 and 15%. It is difficult to explain this large discrepancy but the limited availability of unpasteurized milk and the generally worse summer here (fewer barbecues, picnics) may be some reasons to explain this low incidence in N. Ireland.
J Hyg (Lond) 1986 Dec
PMID:Low incidence of campylobacter enteritis in Northern Ireland. 379 24

Direct plating of faecal specimens on blood agar was compared with the use of enrichment culture for isolation of Aeromonas spp. from faeces during a large epidemiological study. Of enterotoxigenic strains isolated by direct plating, 89% were associated with acute diarrhoea and 7% with an episode of diarrhoea during the month before collection, but 79% of enterotoxigenic strains isolated only after enrichment were not associated with acute diarrhoea. With Aeromonas spp., as with intestinal pathogens, it appears that enrichment allows isolation of the bacteria when in low faecal concentrations likely to be found in convalescent patients, carriers and those with subclinical infection. The routine use of enrichment for isolation of faecal aeromonads, by detecting Aeromonas spp. in low numbers in patients without diarrhoea, is likely to confuse interpretation of epidemiological studies seeking to clarify the relationship between Aeromonas spp. and acute diarrhoea.
J Med Microbiol 1986 Dec
PMID:Comparison of direct plating with the use of enrichment culture for isolation of Aeromonas spp. from faeces. 379 52

This study investigated the prevalence of unusual infant feeding practices among 204 mothers of infants aged 1-12 months, who were admitted with acute diarrhoea to the only two national hospitals in Kuwait. Ninety per cent of the mothers boiled water to prepare a powdered milk formula, but only 15% boiled water for drinking. Thirty nine infants (19%) were admitted more than once. Better family state in terms of socioeconomic class, maternal education, and breast feeding gave some protection against re-admission, though this was not significant. It seems that the condition of drinking water is an important cause of diarrhoea and hence of re-admission. The number of re-admissions was twice as high among infants drinking unboiled (unfiltered or mineral) water than among those drinking boiled or unboiled but filtered water. Breast feeding is protective if no extra water is given.
Arch Dis Child 1986 Dec
PMID:Infantile diarrhoea due to water complementation of breast and bottle feeding. 381 13


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