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

Controversy continues regarding the optimal composition of glucose electrolyte oral rehydration solutions for the treatment of acute diarrhoea. Four perfusion models (normal human jejunum, normal rat small intestine, cholera toxin treated secreting rat small intestine and rotavirus infected rat small intestine) have been developed and used to compare the efficacy of a hypotonic oral rehydration solution with standard United Kingdom British National formulary and developing world oral rehydration solutions (WHO). Despite obvious physiological and pathophysiological differences between these models there was general congruence in the water and solute absorption profiles of the different oral rehydration solutions. Hypotonic oral rehydration solution promoted significantly greater water absorption than other oral rehydration solutions in all rat models (p < 0.001) but apparently increased water absorption failed to achieve significance in human jejunum. British National Formulary-oral rehydration solution was unable to reverse net water secretion in both rotavirus and cholera toxin models. Net sodium absorption from hypotonic and WHO-oral rehydration solutions was significantly greater than from the low sodium British National Formulary-oral rehydration solutions (p < 0.001) except in the rotavirus model when absorption was similar to hypotonic-oral rehydration solutions. These findings show that there is agreement in the apparent efficacy of oral rehydration solutions in these animal and human perfusion models, and that improved water absorption with adequate sodium absorption may be achieved by reducing oral rehydration solution osmolality.
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PMID:Water and solute absorption from a new hypotonic oral rehydration solution: evaluation in human and animal perfusion models. 148 67

Controversy continues regarding the ideal composition of glucose/electrolyte solutions used for oral rehydration of infants and children with acute diarrhea. We have used cholera toxin-treated rat small intestine as a model of secretory diarrhea to assess the efficacy of oral rehydration solutions by intestinal perfusion. All solutions tested reversed net water secretion but a hypotonic bicarbonate-free solution was more effective than other solutions, including the World Health Organization oral rehydration solution (p less than 0.003). Net sodium secretion persisted with all solutions tested but there was a significant linear relationship between sodium concentration of the solution perfused and net sodium transport (r = 0.75, p less than 0.05). Cholera toxin treatment alone and in combination with perfusion of oral rehydration solutions significantly reduced plasma sodium concentration and osmolality (p less than 0.05), the effects being most marked with low sodium solutions. Although direct parallelism between observations in this animal model of secretory diarrhea and human diarrheal disease has not been established as yet, the model may be useful in assessing clinical efficacy of new oral rehydration solutions and in systematic analysis of the relative benefits of their individual components.
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PMID:Efficacy of oral rehydration solutions in a rat model of secretory diarrhea. 343 Feb 70

Intestinal water and electrolyte transport was investigated in vivo and in vitro in rats made tolerant to morphine and subsequently withdrawn with naloxone. Rats were rendered tolerant by injection of a slow-release emulsion containing morphine (75 mg/rat over 48 h), and when challenged with naloxone, they exhibited a characteristic withdrawal syndrome that included acute diarrhea. Morphine tolerance did not influence water absorption from ileal or colonic loops in vivo but naloxone-induced withdrawal provoked a rapid and sustained reduction in absorption. Naloxone did not affect absorption in control animals. In further experiments, sodium and chloride fluxes were measured in isolated stripped ileal mucosa derived from animals made tolerant to morphine and withdrawn with naloxone. Net sodium and chloride absorption was markedly reduced in mucosa derived from withdrawn animals compared with that derived from tolerant animals (Na+: 1.12 +/- 0.76 vs. 5.52 +/- 0.46, and Cl-: 0.60 +/- 0.52 vs. 4.70 +/- 0.80 microEq/cm2 X h, in withdrawn and tolerant animals, respectively; n = 8; p less than 0.001 and p less than 0.005). When an attempt was made to induce withdrawal by adding naloxone in vitro to isolated mucosa derived from tolerant animals, no effect on transport was detected whether the mucosa was stripped of muscle layers or not. Thus naloxone had to be given in vivo to produce withdrawal effects in mucosa studied subsequently in vitro. Naloxone also had an effect in control rats when a 50% reduction in net chloride absorption was observed in isolated ileal mucosa derived from these animals. Net sodium absorption was unaffected. These data support a role for endogenous opiates in the control of intestinal transport and provide a mechanism for the diarrhea associated with opiate withdrawal.
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PMID:Influence of morphine tolerance and withdrawal on intestinal salt and water transport in the rat in vivo and in vitro. 654 Nov 71

The effects of a maltodextrin (dextrose equivalent 12)-electrolyte solution and a maltodextrin-electrolyte solution with added nutrients on net water and electrolyte transport in the secreting rat intestine was compared with the citrate-World Health Organization oral rehydration solution to determine the need for a clinical trial to evaluate the efficacy of these maltodextrin solutions in acute diarrhoea treatment. Cholera toxin consistently produced net water secretion (-36.5 +/- 9.9 mean +/- SEM microliter/min/g dry weight of intestine). All three solutions reversed the cholera toxin-induced net intestinal water secretion to net absorption. Significantly greater net water absorption occurred from the maltodextrin-electrolyte solution compared to the World Health Organization solution (P < 0.05) but not when compared to the maltodextrin-electrolyte-nutrient solution. Net sodium, potassium and chloride fluxes due to the World Health Organization-solution were not significantly different from the maltodextrin-electrolyte solution. These data provide a rationale for initiating a clinical trial.
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PMID:Effect of a maltodextrin-electrolyte, a maltodextrin-nutrient-electrolyte and a standard electrolyte solution on water and electrolyte fluxes in the secreting rat intestine. 818 93

Faecal concentrations and output of short chain fatty acids (SCFA) were assessed on successive days by gas-liquid chromatography in 24 patients with acute watery diarrhoea. Absorption of water and sodium from the rectum was also measured by a dialysis technique in 17 of these patients and in nine normal subjects in the presence and absence of luminal SCFA. Faecal SCFA concentrations were low on the first day of diarrhoea (mean (SEM) 9.9 (5.8) mmol/kg) and increased to 94.8 (16.4) mmol/kg by the fifth day. Faecal output of SCFA corresponded to these figures. Net water absorption, in the absence of luminal SCFA, was stopped in patients with acute diarrhoea (-59 (81) nl/cm2/min) compared with healthy controls (+322 (63) nl/cm2/min) (p < 0.01). Luminal SCFA restored net water absorption to +184 (67) nl/cm2/min in patients with acute diarrhoea (p < 0.01). Net absorption of sodium decreased in patients with acute diarrhoea in the absence of luminal SCFA, but returned to normal with luminal SCFA. Net secretion of potassium increased in acute diarrhoea, and did not change in the presence of SCFA. Defective absorption from the rectum in acute diarrhoea is reversed by luminal SCFA. The reduction of luminal SCFA in acute diarrhoea treated conventionally may be a factor contributing to colonic dysfunction.
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PMID:Colonic dysfunction in acute diarrhoea: the role of luminal short chain fatty acids. 840 57

Campylobacter infection is one of the most frequent causes of gastroenteritis in the world and the third in Chile according to some studies. The routinary culture for Campylobacter in our country is not performed because of its high cost, and it is known, that the Hucker stain is a reasonable screening alternative. The objective of this study was to know the utility of the Hucker stain and estimate the frequency of Campylobacter in stool samples. A total of 5,750 stool samples received in the Catholic University Health Net Microbiology Laboratories, from March 2002 to May 2004, were studied with conventional stool culture and Hucker stain. In order to validate the Hucker stain with culture, during one month, all the stool samples were also studied with Campylobacter culture, with 35% sensitivity and 100% specificity. In 115/5.750 samples (2%), curved bacilli suggesting Campylobacter were observed by Hucker stain, and another 233 enteropathogens (4%) which corresponded to: 151 Salmonella sp, 55 Shigella sp, 25 enterohemorrhagic E coli, and 2 Yersinia sp were isolated. When analyzing the patients in whom the Hucker stain was positive, 62.2% were younger than 5 years and of these, 63.8% were infants. We conclude that the Hucker stain is a simple and specific method, although not very sensitive, that allows us to increase the yield of diagnosing enteric pathogens in a 33%. Campylobacter sp was in the second place after Salmonella sp in stool samples, and most frequent in young children. The active search for Campylobacter by means of culture is fundamental in the diagnosis of acute diarrhea.
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PMID:[Evaluation of Hucker stain as Campylobacter sp screening detection during an acute diarrhea disease]. 1607 91