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Biomedical subjects

D Pizarro

Publications and source records attributed to D Pizarro.

At least 19 recordsLinked to original sources
PubMed1991

Rice-based oral electrolyte solutions for the management of infantile diarrhea.

BACKGROUND: In infants the treatment of acute diarrhea with glucose-based solutions results in rehydration but does not reduce the severity of diarrhea. Oral rehydration with solutions based on rice powder may reduce stool output as well as restore fluid volume. METHODS: We designed a prospective, randomized, double-blind study to evaluate the efficacy of two rice-based rehydration solutions and a conventional glucose-based solution. Solution A contained only rice-syrup solids, solution B contained rice-syrup solids and casein hydrolysate, and solution C, the glucose-based solution, served as control. The study subjects were 86 mildly to moderately dehydrated infant boys, 3 to 18 months old, who were admitted to a children's hospital with acute diarrhea. We measured fluid intake, fecal and urine output, and absorption and retention of fluid, sodium, and potassium at intervals for 48 hours in all 86 infants. RESULTS: The mean (+/- SE) fecal output was significantly lower in the infants given solution A (group A infants) than in the infants given solution C (group C) (29 +/- 4 vs. 46 +/- 7 ml per kilogram of body weight, P less than 0.05) during the first six hours of therapy. The infants in group A also had greater fluid absorption (221 +/- 16 vs. 167 +/- 9 ml per kilogram, P less than 0.05) over the entire 48 hours of therapy and greater potassium absorption (1.6 +/- 0.2 vs. 0.6 +/- 0.1 mmol per kilogram, P less than 0.05) during the first six hours than the infants in group C. Solution B offered no advantages over solution A. CONCLUSIONS: Solutions containing rice-syrup solids were effective in the rehydration of infants with acute diarrhea. They decreased stool output and promoted greater absorption and retention of fluid and electrolytes than did a glucose-based solution.

Acute Disease↗
PubMed1991

[The maternal-neonatal characteristics of intrauterine growth retardation in a term pregnancy based on a national curve of intrauterine growth].

Using a national curve of fetal growth development, clinical and laboratory characteristics of 100 term neonates small for dates and 130 term adequate for gestational age newborns are studied. A 91% of the small for dates were classified by the ponderal index as having symmetrical growth retardation. At the same time in the 230 mothers we look for clinical features that have been mentioned to produce intrauterine growth retardation. Results showed marked differences (with statistic significance) between both groups of women in relation to: nutritional factors, maternal height, labor activity and presence of oligoamnios. The newborns of both groups didn't show differences, with exception of congenital malformation. The incidence of the classical morbidity of small for dates (asphyxia, hypoglycemia, polycythemia) was no different in both groups. We believe the explanation is that the national curve is more exigent and neonates with higher weight fall under the 10th percentile. We think that in the study group a high percentage of small for dates, are constitutional small and not really growth retarded. We suggest the possibility to use the 5th percentile for better sensibility.

Adolescent↗
PubMed1991

[The treatment and prevention of acute diarrheal disease].

Diarrheal diseases are the main cause of infant mortality in children under five year of age in the Third World. In order to diminish the mortality and morbidity rate, the World Health Organization developed the Diarrhoeal Diseases Control Programme (DDCP). The DDCP recommends two actions: to prevent diarrheal diseases and treatment of dehydration, the main cause of death in diarrheal diseases. Plan A is devoted to prevent dehydration; Plan B to treat orally dehydration; and Plan C to treat severe dehydration by means of rapid intravenous therapy. These plans were devised by health workers skill in the management of adults presenting Asiatic Cholerae. Thereafter the same method was used in non cholerae diarrhea, and finally in infants and children of all ages. The method has proven to be useful for treating all dehydration complications. The pediatric textbooks recommend the use of oral rehydration therapy (ORT) but do not support it very strongly. Plan C is not known by these authors, who recommend the old fashioned method used in the 70's. Here in I present the most advanced rehydration methods.

Acute Disease↗
PubMed1988

Oral rehydration in infants in developing countries.

Diarrhoeal diseases are the major cause of infant mortality in developing countries. Dehydration is the most common complication of diarrhoea, and severe dehydration causes up to 80% of diarrhoeal fatalities. For more than 100 years, physicians focused the treatment of diarrhoeal diseases on the symptom diarrhoea, and there were many 'antidiarrhoeal' drugs, such as water adsorbents (kaolin and pectin) and antiperistaltics (opium, paregoric elixir, diphenoxylate hydrochloride with atropine sulphate and loperamide). This approach focused on a non-dangerous symptom and diverted attention from the real killer, dehydration. A few decades ago, only severely dehydrated patients were treated by intravenous therapy. This treatment was prescribed by a group of professional health workers, administered intravenously by skilled nurses, and reserved for the few patients resident near health facilities. Oral rehydration therapy (ORT), developed 20 years ago, has several advantages over intravenous therapy; it can be administered at home, at health clinics or in modern hospitals, by parents or by nurses or physicians. Most serum disturbances in dehydrated neonates, infants, children, adults and the elderly are resolved by this treatment.

Developing Countries↗
PubMed1987

Efficacy comparison of oral rehydration solutions containing either 90 or 75 millimoles of sodium per liter.

In a randomized trial, 62 infants 2 to 35 months of age with dehydration due to acute watery diarrhea were allocated to one of two groups: group A received solution A (World Health Organization-recommended oral rehydration solution), which contained (mmol/L): Na+ 90, K+ 20, Cl- 80, citrate3- 10, and glucose 110; group B received solution B (Pedialyte RS; Abbott Laboratories, North Chicago), which contained (in mmol/L): Na+ 75, K+ 20, Cl- 65, citrate3- 10, and glucose 139. Oral therapy was given until clinical signs of hydration status were normal. During the 48-hour trial, the following laboratory data were collected: blood gases, serum electrolytes, glucose, urea, and creatinine values and sodium and potassium concentrations in stool and urine; serial weights and clinical signs were also reported. Six of the 62 infants, three in each group, required intravenous fluids because of high stool output. Results of clinical outcome and normalization of altered serum electrolyte values were similar in both groups. During the 48-hour trial, eight patients in group A and four in group B had mild, asymptomatic hypernatremia. Pedialyte RS was found to be a safe glucose/electrolyte solution for oral rehydration therapy.

Administration, Oral↗
PubMed1984

Hypernatremic diarrheal dehydration treated with "slow" (12-hour) oral rehydration therapy: a preliminary report.

Thirty-five infants with hypernatremic diarrheal dehydration were given "slow" oral rehydration therapy, with deficits replaced over a period of 12 hours. A group of 24 infants received glucose-electrolyte solution for 8 hours, followed by plain water for 4 hours in a volume of 2:1; 11 other infants received equivalent volumes of glucose-electrolyte solution alone over 12 hours. Serum sodium concentrations fell to normal at similar rates in both groups. None of the 35 infants manifested convulsions. These preliminary results indicate that further evaluation of slow oral rehydration in infants with hypernatremic dehydration should be considered.

Administration, Oral↗
PubMed1984

Cryptosporidiosis in children from some highland Costa Rican rural and urban areas.

This report summarizes both a prospective study of diarrhea in cohorts of rural children in their natural ecosystem, and a vertical study of diarrheic urban children attending a hospital emergency service. Cryptosporidium oocysts were found in feces of 4.3% of the cases, while all controls were negative. No infection occurred in the first year of life among rural infants, contrasting with a 3% infection rate in children under 1 year of age in the metropolitan area. This could be attributed to intense and exclusive breast-feeding for several months in the rural area while in the urban area many infants are not breast-fed at all, or are weaned prematurely. No infection was found in wholly breast-fed infants. Diarrhea associated with Cryptosporidium was watery and without inflammatory cells. Dehydration was common in urban children, but was rapidly corrected by oral rehydration therapy, or by intravenous fluid therapy in some cases. Infections clustered in the warmer, rainy and humid months of the year.

Child, Preschool↗
PubMed1984

[Cryptosporidiosis in children of Costa Rica: a cross section and longitudinal study].

The present report is a systematic study of children, with and without diarrhea from Costa Rican metropolitan areas and southern rural higlands. Children were observed, respectively, at emergencies, Hospital Nacional de Niños, and in a field station in Puriscal; urban children were studied vertically, rural children were observed prospectively (cohort study). Cryptosporidium sp. was found in 4.3% of the cases of diarrhea; diarrhea was generally severe in urban children, but mild in the rural. Infection was detected in urban children less than one year of age: contrasting, no rural infants were found infected, which might be related to breast-feeding, since Puriscal infants were intensively breast-fed for several months, while many urban infants were not breast-fed or were weaned earlier. Cryptosporidium sp. appeared during the warm, rainy and humid months of May through August, when the coccidium was associated with 14.8% of the urban and 15.4% of the rural diarrheas. All urban cases presented dehydration which was corrected with oral rehydration salt therapy, and occasionally with intravenous fluids; dehydration was not common in the rural cases.

Animals↗
PubMed1983

Oral rehydration in hypernatremic and hyponatremic diarrheal dehydration.

Ninety-four well-nourished, bottle-fed infants with hypernatremic (N = 61) or hyponatremic (N = 33) diarrheal dehydration were treated with oral rehydration. In 61 hypernatremic and 25 hyponatremic infants, two thirds of the fluid volume were given as glucose/electrolyte solution containing 90 mmole of sodium per liter and one third as plain water; the other eight hyponatremic infants were given glucose/electrolyte solution alone. Fluid deficits were successfully and rapidly replaced with oral therapy alone in all 61 hypernatremic infants (mean +/- SEM, 8.5 +/- 0.6 hours) and in 31 of those with hyponatremia (mean +/- SEM, 10 +/- 1.2 hours). Two hypernatremic infants required some intravenous (IV) fluids. The mean serum sodium levels fell in the hypernatremic infants to normal and rose in those with hyponatremia. Only five (8%) of the 61 hypernatremic infants manifested convulsions during oral rehydration; this compared favorably with the 14% rate of convulsions encountered previously when we used IV rehydration.

Administration, Oral↗