Nuevos Conceptos en El Manejo de La Diarrea

8/6/2019 Nuevos Conceptos en El Manejo de La Diarrea

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JAIRO PINILLA BAER

MEDICO PEDIATRA


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Update on prolonged and persistent diarrhea in children

Moore, S.R.

Vol. 27 Nr. 1 Pgina: 19 - 23 Fecha de publicacin: 01/01/2011Resumen:

Purpose of review To highlight recent advances in our understanding of prolongedepisodes of acute diarrhea and persistent diarrhea in children. The focus is on thecontribution of these illnesses to the global burden of diarrhea, their impact onchildhood growth and development, novel epidemiologic links between prolongedand persistent diarrheal episodes, and strategies for their prevention andmanagement. Recent findings Although less common than acute diarrhea, prolongedand persistent episodes of diarrhea in childhood constitute a significant portion of theglobal burden of diarrhea. These episodes also play a key role in the vicious cycle ofchildhood diarrhea and malnutrition in which undernutrition is both a risk factor andan outcome of diarrhea. Increased efforts to provide WHO-recommended zinc

therapy for all children with diarrhea in developing countries will significantlyreduce morbidity and mortality. In children who develop persistent diarrhea, yogurt-based or amino acid-based diets may accelerate their recovery. Summary In additionto increased implementation of strategies already known to effectively prevent andmanage acute diarrhea, further research is needed to address the recognition,prevention, and treatment of prolonged episodes of acute diarrhea and persistentdiarrhea in resource-limited settings.


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New molecular approaches in the diagnosis of acute diarrhea: advantages for clinicians andresearchers

Guarino, A.;Giannattasio, A.


Purpose of review To provide an update of the advantages of new-generation molecular

diagnostics as regards acute diarrhea, and to evaluate how they can help clinicians andresearchers diagnose this condition. Recent findings Thanks to real-time polymerase chainreaction techniques, many enteropathogens can now be identified simultaneously within hours.Most techniques are based on amplification of specific nucleotide sequences. With high-resolutionmelting analyses, microarrays, and metagenomic analyses, multiple genomic sequences can beevaluated in a single sample; thus, a wide range of enteropathogens can be evaluated in one run.Molecular techniques have elucidated the role of major enteropathogens such as norovirus andbocavirus and their evolving epidemiology. They have revealed novel transmission routes, also infood-borne diarrhea outbreaks, and have opened the way to new therapies and preventivemeasures, as well as to surveillance of emerging rotavirus strains after vaccine introduction.Summary Molecular approaches are best suited for epidemiologic purposes and for selectedclinical conditions such as early identification of treatable agents in at-risk patients, rather than forcases requiring only oral rehydration. In the field of acute diarrhea, the major application ofmolecular techniques is the identification of novel agents of gastroenteritis and their epidemiology.


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CURRENT OPINION IN GASTROENTEROLOGY

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Exencin de responsabilidad: La traduccin automtica es orientativa y no taxativa. Puedenaparecer yerros en la sintaxis, la ortografa o el sentido de un concepto. Es un gran avance, animperfecto

The colonic microflora and probiotic therapy in health and disease

Shanahan, F.


Purpose of review Host-microbe dialogue is involved not only in maintenance of mucosalhomeostasis but also in the pathogenesis of several infectious, inflammatory, and neoplasticdisorders of the gut. This has led to a resurgence of interest in the colonic microbiota in health anddisease. Recent landmark findings are addressed here. Recent findings Reciprocal signallingbetween the immune system and the microbiotaplays a pivotal role in linking alterations in gutmicrobiotawith risk of metabolic disease in the host, notably insulin resistance, obesity, andchronic low-grade inflammation. Loss of ancestral indigenous organisms consequent upon a

modern lifestyle may contribute to an increased frequency of various metabolic and immuno-allergic diseases. The potential to address this underpins the science of pharmabiotics. Summary

Advances in understanding host-microbe interactions within the gut can inform rational probioticor pharmabiotic selection criteria. In addition, the gut microbiota may be a repository for drugdiscovery as well as a therapeutic target.


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PEDIATRIC INFECTIOUS DISEASE JOURNAL

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Exencin de responsabilidad: La traduccin automtica es orientativa y no taxativa. Puedenaparecer yerros en la sintaxis, la ortografa o el sentido de un concepto. Es un gran avance, animperfecto

Changes inChildhood Diarrhea Incidence inNicaragua Following 3 Years of UniversalInfant Rotavirus Immunization

Becker-Dreps, Sylvia; Paniagua, Margarita; Dominik, Rosalie; Cao, Hongyuan; Shah, Naman K.;Morgan, Douglas R.; Moreno,Gilberto; Espinoza, Flix

Vol. 30 Nr.3 Pgina: 243 - 247 Fecha de publicacin: 01/03/2011Resumen:

Background: Although the pentavalent rotavirus vaccine was highly efficacious against rotavirusdiarrhea in clinical trials, the effectiveness of vaccine under field conditions in the developing

world is unclear. In October 2006, Nicaragua became the first developing nation to implementuniversal infant immunization with the pentavalent rotavirus vaccine. To assess the effect of theimmunization program, we examined the incidence of diarrhea episodes between 2003 and 2009

among children in the state of Len, Nicaragua. Methods: We extracted data on diarrhea episodesfrom health ministry records. We used scaled Poisson regression models to estimate diarrheaincidence rate ratios for the period following the program's implementation to the period beforeimplementation. Results: Following implementation of the immunization program, diarrheaepisodes among infants were reduced (incidence rate ratios: 0.85, 95% confidence interval: 0.71-1.02) during the rotavirus season, but appear to have increased during other months. Conclusions:

Although the immunization program appears effective in reducing diarrhea episodes during therotavirus season, a large burden of diarrhea still persists during the remainder of the year.


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Nuevos Conceptos en El Manejo de La Diarrea

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