[The etiological agents in viral infantile diarrhea in Toulouse].
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Biomedical subjects
Publications and source records attributed to J Ghisolfi.
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In order to study the dietary intakes of children having lunch at school, 150 children were observed: 60 aged 5-6 years, 60 aged 9-10 years and 30, aged 5-13 years, attending 5 different schools (4 in town, 1 in the country). The estimation of spontaneous ingesta was made according to the weighing method. Energizing rations, the percentages of caloric intakes, the amounts of total, animal and vegetal lipids, of total carbohydrates and pure carbohydrates, of total, animal and vegetal proteins were estimated for each meal and each child. The analysis of these ingesta suggests that the dietary habits of children at school is a major factor of nutritional lack of balance, much more important than that related with the quality of the proposed food.
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The value of oral re-hydratation in acute diarrhoea has been demonstrated in a study of 161 infants (mean age 6.8 months, range 1 to 26 months). One litre of solution contained sodium 50 mEq, potassium 25 mEq, bicarbonate 2 g, glucose 20 g, sucrose 20 g with an osmolarity of 300 milliosmoles/kg. Using this solution, rapid replacement of water osses was possible. Dehydratation, the major complication of acute diarrhoea, was thereby prevented and treated without the use of parenteral therapy. However parenteral treatment is still necessary in severe cases (shock, acidosis or severe diarrhoea).
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Eighty-four cases of obstinate severe diarrhoea in infants are reported. Criteria for clinical and biological severity are precised. Histological examination of the small bowel was performed in 57 cases; a total atrophy of intestinal villi was found in only 33% of the cases during the first 3 months. Exclusive parenteral feeding, from the beginning or after failure of enteral feeding was given to 71 infants. Later on, enteral renutrition at constant flow, was administered, after simple preparation, in most cases. Seventeen died out of 84 infants, 7 of them within 2 weeks. For the others, the average time for recovery was 4 months. The conditions of prevention of obstinate severe diarrhoea in infancy are emphasized.
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