Navegando por Palavras-chave "Acute diarrhea"
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- ItemAcesso aberto (Open Access)Diarréia aguda grave associada à Escherichia coli enteropatogênica clássica (EPEC): características clínicas e perdas fecais em lactentes hospitalizados(Associação Médica Brasileira, 1997-12-01) Oliva, C.a.g. [UNIFESP]; Scaletsky, Isabel Cristina Affonso [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Fagundes Neto, U. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Enteropathogenic Escherichia coli (EPEC) strains are the most prevalent enteropathogenic agents isolated in the stools of hospitalized infants with severe acute diarrhea in São Paulo. These microorganisms induce a severe intestinal secretion of fluids and electrolytes that can cause dehydration leading to hospital admission in the majority of the cases. OBJECTIVES. This investigation aims at the following objectives: 1) to study the clinical features of acute diarrhea in male infants who were hospitalized owing to EPEC infection; 2) to determine the fecal fluid losses, formula intake and variation of the body weight during the evolution of the disease. PATIENTS AND METHODS. Thirty eight male infants with acute diarrhea due to EPEC strains were studied. The clinical and epidemiological features of the patients were recorded and the different EPEC serogroups were identified. The infants were kept in a metabolic bed in order to allow the collection of stools and urine separately during the whole period of the disease, and daily metabolic balances were also obtained. The mean duration of the metabolic study was 5.8 days, and during this period of time 220 daily metabolic balances were accumulated and analyzed. RESULTS. The main clinical features of the studied group were as follows: age below 12 months; low birth weight; precocious weaning; severe protein-calorie malnutrition. EPEC O111 was the most frequent serogroup identified, present in 68.4% of the infants. The average daily fecal fluid losses were 66 ml/kg and the mean daily formula intake was 85.2 ml/kg. Cow's milk was the most precocious food utilized and the infants who received cow's milk feeding presented the largest stool losses in comparison with lactose free formulas and total parenteral nutrition. CONCLUSION. EPEC strains are able to induce moderate to severe fecal fluid losses in infants and the duration of diarrhea is usually below 15 days, although in several circumstances diarrhea can show a protracted evolution owing to food intolerance associated or not with intestinal secretion.
- ItemAcesso aberto (Open Access)Incidence of diarrhea: poor parental recall ability(Brazilian Society of Infectious Diseases, 2007-12-01) Melo, Maria Clotildes Nunes de; Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]; Diniz-Santos, Daniel Rui; May, Daniel Simões; Carneiro, Nadya Bustani; Silva, Luciana Rodrigues; Federal University of Bahia School of Medicine Professor Hosannah Oliveira Pediatric Center; Universidade Federal de São Paulo (UNIFESP)Several methodological issues may have an impact on the incidence rates of childhood acute diarrhea reported by community-based studies. This study was performed to assess the impact of parental recall ability and definition of diarrhea on the estimate of incidence of acute diarrhea. Eighty-four children younger than 40 months were randomly selected and visited every other day for four weeks and the occurrence of diarrhea was registered. On the last day of the study, another visit was performed and the informants were inquired about the occurrence of diarrhea during the previous four weeks. Data gathered during the four weeks were compared to those obtained on the last visit. Additionally, the informants' definition of diarrhea was investigated and compared to the one adopted by this study. During the observation period, 33 children suffered diarrhea, but only 10 (30.3%) informants reported the occurrence of diarrhea. Although 42.4% of those informants reported that their children had been ill over that period, they did not report diarrhea. Further, 60.6% children who had diarrhea suffered at least one episode in the two weeks prior to the visitation. The same definition of diarrhea used in this study was adopted by 52.1% of the informants inquired. Parental recall is an unreliable method to estimate the incidence of diarrhea and studies with a short interval between the visits should be necessary to correctly evaluate this important health problem. Moreover, assessing the informants' own definition of diarrhea is a significant contribution to the interpretation of the results.
- ItemAcesso aberto (Open Access)Letalidade em crianças hospitalizadas com diarréia aguda - fatores de risco associados ao óbito(Associação Médica Brasileira, 1999-04-01) Andrade, Jacy Alves Braga de [UNIFESP]; Oliveira, J.o.t. De [UNIFESP]; Fagundes-Neto, Ulysses [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVES: Acute diarrhea is a very frequent disease in developing countries and is the first cause of death in infants under 2 years of age. This study was designed to evaluate the clinical and epidemiological factors associated to the death of 17 out of 511 infants hospitalized owing to severe acute diarrhea, between January 1989 and December 1995. PATIENTS AND METHODS: The patients were divided into two groups according to their clinical evolution: Group I - Death and Group II - Survival. The following parameters were evaluated: birth weight, sex, age, duration of diarrhea (days) prior to admission, nutritional status, hydration, presence of an enteropathogenic agent in the stools, food intolerance and duration of hospitalization. RESULTS: The analyzed factors have shown a significant association with death for the following variables: age, relative risk (RR)=4.0 for infants less than 6 months of age, identification of an enteropathogenic Escherichia coli (EPEC) strain in the stools (RR=3.3), severe malnutrition at admission to the hospital (RR=4.5), Occurrence of food intolerance during hospitalization (RR=2.7). Some enteropathogenic agent was identified in the stools of 253 (54.9%) infants, among the 461 (90.2%) studied. Group I revealed the presence of an enteropathogenic agent in 75% of the cases. The most frequent agents identified in Group I was: EPEC (56.3%) and Shigella (12.5%), while in Group II EPEC was identified in 26.5% of the patients. CONCLUSIONS: The association of some factors such as age less than 6 months, severe malnutrition, food intolerance and the identification of EPEC strains in the stool culture are indicators of high risk of death in infants hospitalized due to severe acute diarrhea.