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Oral rehydration therapy

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https://www.readbyqxmd.com/read/29095384/hyperglycemic-hyperosmolar-state-during-induction-chemotherapy-for-acute-lymphoblastic-leukemia
#1
Randall Yimbong Chan, Ankit V K Shah, Keith E Lewis, Jeffrey L Johnson, Paola Sequeira, Cynthia H Ho
We present the case of a 16-year-old boy who presented with fatigue, polyuria, and polydipsia while on chemotherapy for his relapsed acute lymphoblastic leukemia (ALL). Blood gas examination confirmed the diagnosis of hyperosmolar hyperglycemic state. The etiology for his hyperglycemia was most likely a result of oral glucocorticoid therapy combined with asparaginase therapy-both are a cornerstone of induction chemotherapy for ALL. The patient was aggressively rehydrated with saline, and medications were administered to correct his hyperkalemia...
October 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29090271/oral-rehydration-of-malnourished-children-with-diarrhoea-and-dehydration-a-systematic-review
#2
Kirsty A Houston, Jack G Gibb, Kathryn Maitland
Background: Diarrhoea complicates over half of admissions to hospital with severe acute malnutrition (SAM). World Health Organization (WHO) guidelines for the management of dehydration recommend the use of oral rehydration with ReSoMal (an oral rehydration solution (ORS) for SAM), which has lower sodium (45mmols/l) and higher potassium (40mmols/l) content than old WHO ORS. The composition of ReSoMal was designed specifically to address theoretical risks of sodium overload and potential under-treatment of severe hypokalaemia with rehydration using standard ORS...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/29057220/iatrogenic-dysnatremias-in-children-with-acute-gastroenteritis-in-high-income-countries-a-systematic-review
#3
Silviu Grisaru, Jianling Xie, Susan Samuel, Stephen B Freedman
BACKGROUND: Acute gastroenteritis (AGE) causing dehydration with or without dysnatremias is a common childhood health challenge. While it is accepted that oral rehydration therapy is preferred, clinical factors or parent and healthcare provider preferences may lead to intravenous rehydration (IVR). Isotonic solutions are increasingly recommended in most scenarios requiring IVR. Nevertheless, children with AGE, having ongoing losses of water and electrolytes, represent a unique population...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29033540/assay-development-and-high-throughput-screening-for-small-molecule-inhibitors-of-a-vibrio-cholerae-stress-response-pathway
#4
Laura Stanbery, Jyl S Matson
Antibiotics are important adjuncts to oral rehydration therapy in cholera disease management. However, due to the rapid emergence of resistance to the antibiotics used to treat cholera, therapeutic options are becoming limited. Therefore, there is a critical need to develop additional therapeutics to aid in the treatment of cholera. Previous studies showed that the extracytoplasmic stress response (σ(E)) pathway of Vibrio cholerae is required for full virulence of the organism. The pathway is also required for bacterial growth in the presence of ethanol...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29018599/qualitative-study-of-healthcare-providers-current-practice-patterns-and-barriers-to-successful-rehydration-for-pediatric-diarrheal-illnesses-in-kenya
#5
Darlene R House, Philip Cheptinga, Daniel E Rusyniak, Rachel C Vreeman
BACKGROUND: For children worldwide, diarrhea is the second leading cause of death. These deaths are preventable by fluid resuscitation. Nasogastric tubes (NGs) have been shown to be equivalent to intravenous fluids for rehydration and recommended by the World Health Organization (WHO) for use in severe dehydration. Despite this, NGs are rarely used for rehydration in Kenya. Our objective was to evaluate clinicians' adherence to rehydration guidelines and to identify barriers to the use of NGs for resuscitating dehydrated children...
2017: PeerJ
https://www.readbyqxmd.com/read/28991918/rapid-enteric-testing-to-permit-targeted-antimicrobial-therapy-with-and-without-lactobacillus-reuteri-probiotics-for-paediatric-acute-diarrhoeal-disease-in-botswana-a-pilot-randomized-factorial-controlled-trial
#6
RANDOMIZED CONTROLLED TRIAL
Jeffrey M Pernica, Andrew P Steenhoff, Margaret Mokomane, Banno Moorad, Kwana Lechiile, Marek Smieja, Loeto Mazhani, Ji Cheng, Matthew S Kelly, Mark Loeb, Ketil Stordal, David M Goldfarb
INTRODUCTION: Diarrhoeal disease is the second-leading cause of death in young children. Current guidelines recommend treating children with acute non-bloody diarrhea with oral rehydration solutions and zinc, but not antimicrobials. However, in many resource-limited settings, infections with treatable enteric bacterial and protozoan pathogens are common. Probiotics have shown promise as an adjunct treatment for diarrhoea but have not been studied in sub-Saharan Africa. METHODS: We conducted a pilot, factorial, randomized, placebo-controlled trial of children aged 2-60 months hospitalized in Botswana for acute non-bloody diarrhoea...
2017: PloS One
https://www.readbyqxmd.com/read/28963679/clinical-practice-nausea-and-vomiting-in-acute-gastroenteritis-physiopathology-and-management
#7
REVIEW
Beatrice C Canziani, Peter Uestuener, Emilio F Fossali, Sebastiano A G Lava, Mario G Bianchetti, Carlo Agostoni, Gregorio P Milani
Currently recommended management of acute gastroenteritis is supportive. Although the affected children habitually have vomiting, recommendations do not focus on the correction of this symptom. In this condition, elevated ketone bodies and stimuli initiated by gut mucosa damage produced by the enteral pathogen likely underlay nausea and vomiting. As compared to 0.9% saline, intravenous administration of a dextrose-containing bolus of 0.9% saline is associated with a greater reduction of circulating ketones and a shorter duration of nausea and vomiting...
September 30, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28957470/treatment-of-severe-cholera-a-review-of-strategies-to-reduce-stool-output-and-volumes-of-rehydration-fluid
#8
Thomas Butler
Background: Severe cholera is a life-threatening illness of hypovolemic shock and metabolic acidosis due to rapid and profuse diarrheal fluid loss. Emergency life-saving therapy is i.v. saline, optionally supplemented with potassium and alkali to correct the fluid deficit, potassium losses and acidosis. After this initial rehydration, for the next 2 days ongoing stool losses are replaced with oral rehydration solution (ORS), which contains sodium chloride, potassium and alkali together with glucose or rice powder as a source of glucose to serve as a carrier for sodium...
May 1, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28952662/cholera-the-new-strike-of-an-old-foe
#9
Anna Kuna, Michał Gajewski
Cholera is an acute bacterial gastrointestinal infection caused by ingestion of water or food containing the pathogen Vibrio cholerae. The incubation period can be very short and it takes between several hours and 5 days. During the 19th century, cholera was spreading from India across the world. Its original reservoir was located in the Ganges delta. So far, there have been six epidemics of cholera; the current outbreak is the seventh. It started in Asia, attacked Africa and then the Americas. Cholera causes thousands of illnesses and deaths annually, mostly in South Asia and Sub-Saharan Africa...
2017: International Maritime Health
https://www.readbyqxmd.com/read/28948025/does-access-to-credit-services-influence-availability-of-essential-child-medicines-and-licensing-status-among-private-medicine-retail-outlets-in-uganda
#10
Lorraine Nabbanja Kabunga, Paschal Mujasi
BACKGROUND: Despite making great progress in reducing under five mortality in the last three decades. Uganda still ranks high among countries with the highest under five mortality rates. More than a third (36%) of these deaths are caused by pneumonia (15%), malaria (12%), or diarrhea (9%). For many mothers and caregivers, private drug shops are a point of care seeking for these illnesses. However, many drug-shops, are unlicensed and do not stock essential commodities due to insufficient capital and operational funds...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28944301/intravenous-rehydration-of-malnourished-children-with-acute-gastroenteritis-and-severe-dehydration-a-systematic-review
#11
Kirsty A Houston, Jack G Gibb, Kathryn Maitland
Background: Rehydration strategies in children with severe acute malnutrition (SAM) and severe dehydration are extremely cautious. The World Health Organization (WHO) SAM guidelines advise strongly against intravenous fluids unless the child is shocked or severely dehydrated and unable to tolerate oral fluids. Otherwise, guidelines recommend oral or nasogastric rehydration using low sodium oral rehydration solutions. There is limited evidence to support these recommendations. Methods: We conducted a systematic review of randomised controlled trials (RCTs) and observational studies on 15 (th) June 2017 comparing different strategies of rehydration therapy in children with acute gastroenteritis and severe dehydration, specifically relating to intravenous rehydration, using standard search terms...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28932313/serum-zinc-level-and-its-correlation-with-vesikari-system-scoring-in-acute-pediatric-diarrhea
#12
Ayman E Eskander, Lobna S Sherif, Mohammad Nabih, Nevine R El Baroudy, Ghobrial C Marcos, Ehsan A Badawy, Amira S El Refay
BACKGROUND: Diarrhea remains the most common infectious disease worldwide. Zinc has been studied extensively recently for its potential effect on prevention, control and treatment of acute diarrhoea. AIM: This study was designed to correlate the level of zinc with the severity of pediatric diarrhoea estimated by Vesikari Scoring System. PATIENTS AND METHODS: The present study included 80 children aged two months to 30 months from those suffering from the acute diarrheal episode and admitted to Pediatric Hospital "Abo El Rish" Cairo University...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28893243/impact-of-pharmacy-worker-training-and-deployment-on-access-to-essential-medicines-for-children-under-five-in-malawi-a-cluster-quasi-experimental-evaluation
#13
Joseph B Babigumira, Solomon J Lubinga, Alisa M Jenny, Erin Larsen-Cooper, Jessica Crawford, Charles Matemba, Andy Stergachis
BACKGROUND: Poor access to essential medicines is common in many low- and middle-income countries, partly due to an insufficient and inadequately trained workforce to manage the medicines supply chain. We conducted a prospective impact evaluation of the training and deployment of pharmacy assistants (PAs) to rural health centers in Malawi. METHODS: A quasi-experimental design was used to compare access to medicines in two districts where newly trained PAs were deployed to health centers (intervention) and two districts with no trained PAs at health centers (comparison)...
September 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28882877/clinical-pathway-produces-sustained-improvement-in-acute-gastroenteritis-care
#14
Lori Rutman, Eileen J Klein, Julie C Brown
BACKGROUND AND OBJECTIVES: Despite widespread use of the rotavirus vaccine in the last decade, dehydrating illnesses impact almost 2 billion children worldwide annually. Evidence supports oral rehydration therapy as a first-line treatment of mild to moderate dehydration. Ondansetron has proven to be a safe and effective adjunct in children with vomiting. We implemented a clinical pathway in our pediatric emergency department (ED) in January 2005 to improve care for this common condition...
October 2017: Pediatrics
https://www.readbyqxmd.com/read/28851766/modelling-the-cost-of-community-interventions-to-reduce-child-mortality-in-south-africa-using-the-lives-saved-tool-list
#15
Lungiswa Ll Nkonki, Lumbwe L Chola, Aviva A Tugendhaft, Karen K Hofman
OBJECTIVE: To estimate the costs and impact on reducing child mortality of scaling up interventions that can be delivered by community health workers at community level from a provider's perspective. SETTING: In this study, we used the Lives Saved Tool (LiST), a module in the spectrum software. Within the spectrum software, LiST interacts with other modules, the AIDS Impact Module, Family Planning Module and Demography Projections Module (Dem Proj), to model the impact of more than 60 interventions that affect cause-specific mortality...
August 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28835355/efficacy-of-lactobacillus-reuteri-dsm-17938-for-the-treatment-of-acute-gastroenteritis-in-children-protocol-of-a-randomized-controlled-trial
#16
Henryk Szymański, Hania Szajewska
BACKGROUND: Acute gastroenteritis (AGE) is one of the most common diseases among children. Oral rehydration therapy is the key treatment. However, despite proven efficacy, it remains underused. This is because oral rehydration solution neither reduces the frequency of bowel movements and fluid loss nor shortens the duration of illness. Hence, there is interest in adjunctive treatments. According to the 2014 guidelines developed by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, the use of the following probiotics may be considered in the management of children with AGE in addition to rehydration therapy: Lactobacillus rhamnosus GG (low quality of evidence; strong recommendation) and Saccharomyces boulardii (low quality of evidence; strong recommendation)...
August 23, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28678057/hyaluronidase-assisted-resuscitation-in-kenya-for-severely-dehydrated-children
#17
Hijab Zubairi, Brett D Nelson, Priyanka Tulshian, Karla Fredricks, Zaid Altawil, Sarah Mireles, Fred Odongo, Thomas F Burke
BACKGROUND: Dehydration, mainly due to diarrheal illnesses, is a leading cause of childhood mortality worldwide. Intravenous (IV) therapy is the standard of care for patients who were unable to tolerate oral rehydration; however, placing IVs in fragile, dehydrated veins can be challenging. Studies in resource-rich settings comparing hyaluronidase-assisted subcutaneous rehydration with standard IV rehydration in children have demonstrated several benefits of subcutaneous rehydration, including time and success of line placement, ease of use, satisfaction, and cost-effectiveness...
July 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28675983/fluid-supplementation-in-management-of-neonatal-hyperbilirubinemia-a-randomized-controlled-trial
#18
Prachi Goyal, Akshay Mehta, Jasbinder Kaur, Suksham Jain, Vishal Guglani, Deepak Chawla
OBJECTIVE: To evaluate the efficacy of oral or intravenous fluid supplementation in accelerating the decline of serum bilirubin with intensive phototherapy among healthy term and late preterm neonates with hyperbilirubinemia. STUDY DESIGN: This open-label randomized controlled trial randomized neonates with severe hyperbilirubinemia (serum total bilirubin ≥18 mg/dL or within 2 mg/dL of threshold for exchange transfusion) to receive 50 mL/kg of intravenous fluid over 8 h (IVF group, n = 51), 50 mL of oral rehydration solution over 8 h (oral rehydration solution (ORS) group, n = 50) or only standard therapy (control group, n = 49)...
July 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28603456/cost-effectiveness-analysis-of-the-diarrhea-alleviation-through-zinc-and-oral-rehydration-therapy-dazt-program-in-rural-gujarat-india-an-application-of-the-net-benefit-regression-framework
#19
Samuel D Shillcutt, Amnesty E LeFevre, Christa L Fischer-Walker, Sunita Taneja, Robert E Black, Sarmila Mazumder
BACKGROUND: This study evaluates the cost-effectiveness of the DAZT program for scaling up treatment of acute child diarrhea in Gujarat India using a net-benefit regression framework. METHODS: Costs were calculated from societal and caregivers' perspectives and effectiveness was assessed in terms of coverage of zinc and both zinc and Oral Rehydration Salt. Regression models were tested in simple linear regression, with a specified set of covariates, and with a specified set of covariates and interaction terms using linear regression with endogenous treatment effects was used as the reference case...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28551933/-recommendations-for-the-diagnosis-and-management-of-pediatric-acute-gastroenteritis-in-israel-update-2017
#20
Firas Rinawi, Shai Ashkenazi, Michael Wilschanski, Eli Somekh, Raanan Shamir
AIMS: The aim of these guidelines is to update and extend evidence-based recommendations for the diagnosis and management of children with acute gastroenteritis (AGE) in Israel, based on new data and the recently published European update. METHODS: The recommendations, which are based on a systematic review of the literature, were graded by the level of evidence. The guidelines were endorsed by the Israeli societies for Pediatric Gastroenterology, Pediatric Infectious Diseases and the Israeli Association of Pediatrics...
March 2017: Harefuah
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