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Dehydration in children

Rola Abu Dalfa, Khaled I Abu El Aish, Mohamed El Raai, Nermeen El Gazaly, Ahmed Shatat
BACKGROUND: Diarrhoea causes 15% of under-5 mortality in developing countries. Zinc (Zn) stores in the body are known to be depleted during acute diarrhoea. The aim of this study was to evaluate the efficacy of Zn given with standard treatment to children with acute or moderate diarrhoea. METHODS: In this quasi-unmasked, parallel-group study, we enrolled children with diarrhoea at El-Dorra Paediatric Hospital, Gaza Strip, occupied Palestinian territory. Inclusion criteria were children with more than three unformed stools in the preceding 24 h, duration of diarrhoea up to 72 h, and ability to accept oral fluids or feeds...
February 21, 2018: Lancet
Firdausi Qadri, Mohammad Ali, Julia Lynch, Fahima Chowdhury, Ashraful Islam Khan, Thomas F Wierzba, Jean-Louis Excler, Amit Saha, Md Taufiqul Islam, Yasmin A Begum, Taufiqur R Bhuiyan, Farhana Khanam, Mohiul I Chowdhury, Iqbal Ansary Khan, Alamgir Kabir, Baizid Khoorshid Riaz, Afroza Akter, Arifuzzaman Khan, Muhammad Asaduzzaman, Deok Ryun Kim, Ashraf U Siddik, Nirod C Saha, Alejandro Cravioto, Ajit P Singh, John D Clemens
BACKGROUND: A single-dose regimen of inactivated whole-cell oral cholera vaccine (OCV) is attractive because it reduces logistical challenges for vaccination and could enable more people to be vaccinated. Previously, we reported the efficacy of a single dose of an OCV vaccine during the 6 months following dosing. Herein, we report the results of 2 years of follow-up. METHODS: In this placebo-controlled, double-blind trial done in Dhaka, Bangladesh, individuals aged 1 year or older with no history of receipt of OCV were randomly assigned to receive a single dose of inactivated OCV or oral placebo...
March 14, 2018: Lancet Infectious Diseases
Claire M Lawlor, Charles A Riley, John M Carter, Kimsey H Rodriguez
Importance: The 1996 Tonsillectomy and Adenoidectomy Inpatient Guidelines of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Pediatric Otolaryngology Committee recommended that children younger than 3 years be admitted following tonsillectomy. Recommendations for hospital observation were not included as a key action statement in the 2011 AAO-HNS Clinical Practice Guidelines for Tonsillectomy in Children. Objective: To examine the association between posttonsillectomy complication rate and the age and weight of the child at the time of surgery...
March 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
Mohammed Qadori, Elmira Flem, Terese Bekkevold, Henrik Døllner, Ann Marit Gilje, Astrid Rojahn, Ketil Størdal
AIM: Using routine blood sampling in a gastroenteritis diagnostic work-up is debatable. This study examined the relationship between the severity of acute gastroenteritis and blood test abnormalities. METHODS: We prospectively enrolled children under five years referred for outpatient or inpatient management for gastroenteritis from February 2014 to April 2016. The four study hospitals cared for 30% of Norwegian children. The severity of gastroenteritis was assessed using Vesikari scores...
March 13, 2018: Acta Paediatrica
William Bortcosh, Ashkon Shaahinfar, Sakina Sojar, Jean E Klig
PURPOSE OF REVIEW: The diagnostic capability, efficiency and versatility of point-of-care ultrasound (POCUS) have enabled its use in paediatric emergency medicine (PEM) and paediatric critical care (PICU). This review highlights the current applications of POCUS for the critically ill child across PEM and PICU to identify areas of progress and standardized practice and to elucidate areas for future research. RECENT FINDINGS: POCUS technology continues to evolve and advance bedside clinical care for critically ill children, with ongoing research extending its use for an array of clinical scenarios, including respiratory distress, trauma and dehydration...
March 9, 2018: Current Opinion in Pediatrics
Emmanuel Ademola Anigilaje
The survival of a child with severe volume depletion at the emergency department depends on the competency of the first responder to recognize and promptly treat hypovolemic shock. Although the basic principles on fluid and electrolytes therapy have been investigated for decades, the topic remains a challenge, as consensus on clinical management protocol is difficult to reach, and more adverse events are reported from fluid administration than for any other drug. While the old principles proposed by Holliday and Segar, and Finberg have stood the test of time, recent systematic reviews and meta-analyses have highlighted the risk of hyponatraemia, and hyponatraemic encephalopathy in some children treated with hypotonic fluids...
2018: Frontiers in Pediatrics
Romaine F Johnson, Andrew Chang, Ron B Mitchell
OBJECTIVES: 1) Investigate incidence and predictors of readmissions after tonsillectomy with or without adenoidectomy (T&A) in children. 2) Identify factors that may predict readmission. SETTINGS: Nationwide cross-sectional survey of US hospital admissions. SUBJECTS: and Methods: The 2013 Nationwide Readmission Database (NRD) was used to examine all-cause readmissions within 30 days of T&A in children (age <18 years). Logistic regression was used to analyze the associations of demographics, diagnosis, insurance status, length of index stay, and median household income with readmission...
April 2018: International Journal of Pediatric Otorhinolaryngology
Erin K Stenson, Rajesh Punn, Musaab Ramsi, Saraswati Kache
OBJECTIVES: The ability to plot the inferior vena cava (IVC) size on a normal curve for pediatric patients may prove beneficial. First, in patients with normal cardiac anatomy who present in shock, assessing IVC size may be valuable for evaluating the degree of dehydration. Second, in children with heart disease, understanding how a child's IVC size compares to normal could be particularly beneficial for patients with right heart disease. We sought to create normal curves for the IVC and aorta in children younger than 6 years...
February 26, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Dominika Pomorska, Piotr Dziechciarz, Esto Mduma, Joshua Gidion, Anna Falszewska, Hania Szajewska
AIM: We explored the diagnostic accuracy of the Clinical Dehydration Scale (CDS), the World Health Organization (WHO) scale and the Gorelick scale for assessing dehydration in children admitted to a Tanzanian referral hospital. METHODS: This was a prospective, observational study, carried out from April 2015 to January 2017 on children aged one month to five years admitted to the hospital with acute diarrhoea lasting less than five days. Before rehydration therapy, each patient's weight was recorded and the degree of dehydration was assessed based on the three scales...
February 20, 2018: Acta Paediatrica
Suat Biçer, Defne Çöl, Öznur Küçük, Gülay Ç Erdağ, Tuba Giray, Meltem Uğraş, Ayça Vitrinel, Çiğdem Kaspar
BACKGROUND: Acute gastroenteritis is responsible for dehydration in many children. The viruses like rotavirus, norovirus, and adenovirus are considered the main causative agents of gastroenteritis. The goal of this study is the evaluation of the symptoms, clinical findings and hospitalization requirements in pediatric patients with dehydration secondary to viral gastroenteritis. METHODS: The distribution of age, symptoms, clinical and laboratory findings and hospitalization requirements of 156 viral acute gastroenteritis patients with moderate dehydration were evaluated retrospectively...
April 2018: Minerva Pediatrica
Pedro Ordunez, F Javier Nieto, Ramon Martinez, Patricia Soliz, Gloria P Giraldo, Susan Anne Mott, Wendy E Hoy
BACKGROUND: In Central America, chronic interstitial nephritis of agricultural communities (CINAC) has reached epidemic proportions. Clusters of cases have been described in several farming communities. Its aetiology remains uncertain and a controversy exists on its key triggers, among them the heat stress-dehydration mechanism and the toxic exposure to agrochemicals. METHODS: This study analysed the mortality pattern and trend of chronic kidney disease code N18 (CKD-N18) according to the International Statistical Classification of Diseases and Related Health Problems-10th Revision, the proxy and the underlying cause of death, in four selected Central American countries from 1997 to 2013...
February 2, 2018: Journal of Epidemiology and Community Health
Gregg D Stoner
Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Although there are multiple precipitating causes, underlying infections are the most common. Other causes include certain medications, nonadherence to therapy, undiagnosed diabetes mellitus, substance abuse, and coexisting disease. In children and adolescents, hyperosmolar hyperglycemic state is often present when type 2 diabetes is diagnosed. Physical findings include profound dehydration and neurologic symptoms ranging from lethargy to coma...
December 1, 2017: American Family Physician
Y Ganie, C Aldous, Y Balakrishna, R Wiersma
BACKGROUND: Congenital adrenal hyperplasia (CAH) caused by deficiency of the 21-hydoxylase (21-OH) enzyme is the most common form of CAH worldwide. OBJECTIVE: To evaluate the prevalence of CAH due to 21-OH deficiency, and its clinical presentation and biochemical profiles in affected children. METHODS: We performed a retrospective subset analysis of 44 children with confirmed CAH. RESULTS: All the children had classic CAH...
February 1, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Andréanne Côté, Julie Turmel, Louis-Philippe Boulet
Transient airway narrowing can occur during or following exercise, a phenomenon called exercise-induced bronchoconstriction (EIB). The main mechanism of EIB is considered to be airway dehydration, resulting from increased ventilation during exercise. In asthma, such water loss causes an increase in airway fluid osmolarity, inducing airway smooth muscle contraction following the release of mediators from airway inflammatory cells. Asthmatics frequently experience EIB, but it may also be observed in others not reporting asthma symptoms, particularly elite endurance athletes...
February 2018: Seminars in Respiratory and Critical Care Medicine
M A Iro, T Sell, N Brown, K Maitland
BACKGROUND: The World Health Organization (WHO) recommends rapid intravenous rehydration, using fluid volumes of 70-100mls/kg over 3-6 h, with some of the initial volume given rapidly as initial fluid boluses to treat hypovolaemic shock for children with acute gastroenteritis (AGE) and severe dehydration. The evidence supporting the safety and efficacy of rapid versus slower rehydration remains uncertain. METHODS: We conducted a systematic review of randomised controlled trials (RCTs) on 11th of May 2017 comparing different rates of intravenous fluid therapy in children with AGE and moderate or severe dehydration, using standard search terms...
February 9, 2018: BMC Pediatrics
Frans P van der Westhuizen, Amy L Slogrove, H Marlize Kunneke, Mariana Kruger
Background: Acute diarrhoea (AD) remains a leading cause of childhood death. We evaluated whether delayed healthcare seeking was associated with severe dehydration in rural South Africa. Methods: In a prospective cohort study of children with AD admitted to a secondary-level hospital, data were collected through structured caregiver interviews and hospital record review. The primary outcome was severe dehydration/death, and the primary determinant was delay >12 h between AD symptom onset and healthcare facility presentation...
February 5, 2018: Journal of Tropical Pediatrics
Ahmed Nahari, Salem M AlGhamdi, Abdulsalam Alawfi, Hassan Faqeehi, Saeed Alzahrani, Amani Abu-Shaheen, Abdulrahman Al-Hussaini
Background In Saudi Arabia, there is a lack of recently published, appropriately conducted epidemiological studies on rotavirus (RV) diarrhea, which emphasizes the need for up-to-date and comprehensive studies. Objective Our objective was to provide more recent data on the clinical and epidemiological characteristics as well as the economic burden of RV diarrhea among young children admitted to a tertiary care hospital in the city of Riyadh in the year prior to the initiation of the RV vaccine. Design We conducted a prospective observational study at a children's specialized hospital at King Fahad Medical City...
December 2, 2017: Curēus
Minesh P Shah, Aron J Hall
Norovirus is a leading cause of childhood vomiting and diarrhea in the United States and globally. Although most illnesses caused by norovirus are self-resolving, severe outcomes may occur from dehydration, including hospitalization and death. A vast majority of deaths from norovirus occur in developing countries. Immunocompromised children are at risk for more severe outcomes. Treatment of norovirus illness is focused on early correction of dehydration and maintenance of fluid status and nutrition. Hand hygiene, exclusion of ill individuals, and environmental cleaning are important for norovirus outbreak prevention and control, and vaccines to prevent norovirus illness are currently under development...
March 2018: Infectious Disease Clinics of North America
Evelien de Vos-Kerkhof, Dorien H F Geurts, Ewout W Steyerberg, Monica Lakhanpaul, Henriette A Moll, Rianne Oostenbrink
In this study, we aimed to identify characteristics of (unscheduled) revisits and its optimal time frame after Emergency Department (ED) discharge. Children with fever, dyspnea, or vomiting/diarrhea (1 month-16 years) who attended the ED of Erasmus MC-Sophia, Rotterdam (2010-2013), the Netherlands, were prospectively included. Three days after ED discharge, we applied standardized telephonic questionnaires on disease course and revisits. Multivariable logistic regression analysis was used to identify independent characteristics of revisits...
February 3, 2018: European Journal of Pediatrics
Patricia B Pavlinac, Rebecca L Brander, Hannah E Atlas, Grace C John-Stewart, Donna M Denno, Judd L Walson
BACKGROUND: Although acute diarrhea often leads to acute dehydration and electrolyte imbalance, children with diarrhea also suffer long term morbidity, including recurrent or prolonged diarrhea, loss of weight, and linear growth faltering. They are also at increased risk of post-acute mortality. The objective of this systematic review was to identify interventions that address these longer term consequences of diarrhea. METHODS: We searched Medline for randomized controlled trials (RCTs) of interventions conducted in low- and middle-income countries, published between 1980 and 2016 that included children under 15 years of age with diarrhea and follow-up of at least 7 days...
February 1, 2018: BMC Public Health
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