[Oral rehydration therapy in acute diarrheal syndrome. A critical analysis of various aspects]. / Terapéutica de hidratación oral en el síndrome diarreico agudo. Análisis crítico de algunos aspectos.

The use of the "universal" glucoelectrolytic solution proposed by the World Health Organization (WHO) for the treatment of the acute diarrheal syndrome, has now been recognized worldwide and successfully employed in the treatment of diarrhea and the maintenance of the normohydrated state once the patient has recuperated. All in all, it is necessary to comment and distinguish its beneficial aspects once placed into practice. This article primarily focuses on: 1. The recognition that local health indicators will determine importantly, the evaluation of the results obtained from the use of oral rehydration therapy; 2. The establishment of sound elements of judgement for the evaluation of the rehydrating solution from its composition to the volume employed; 3. Comment on the contraindications of oral rehydration therapy and describe the treatment plan suggested by the WHO; 4. Explain why in some parts of the world a sodium concentration of 60 is preferred over the 90 mmol/L found in the rehydrating solution; 5. Point out the risk of producing hypernatremia in patients rehydrated with the WHO solution and mechanisms which tend to reduce it; and finally, establish individualized management of water and electrolytic disturbances for certain regions of the world according to their health characteristics. Acute diarrhea; oral rehydration; critique.

[Balance technic in the syndrome of infantile diarrhea]. / Técnica de balance en el síndrome diarreico del lactante.

Ninety-six infants were studied with water balance technique at the Infant Unit of Hospital Roberto del Río, Santiago de Chile. Sixty-eight with acute diarrhoea and twenty-eight with protracted diarrhoea associated to carbohydrate intolerance. Total water losses in most of them were in the range of 150 to 225 ml/kg day. Stool loses were in the range of 25 to 75 gm/kg/day, with humidity percentage varing from 97.4 to 92.5%. In patients with acute diarrhoea, stool losses and humidity percentage showed slight decreasing tendency in the following balances. By contrast, those with protracted diarrhoea showed a definite decreasing tendency in both parameters. Most infants showed a urinary output in the range of 20 to 80 ml/kg/day. Ten percent showed oliguria. Polyuria was observed occasionally. Insensible water losses were in the range of 50 to 80 ml/kg/day. Most patients showed weight gain of 0.1 to 5.0% in the first balance. Stool acidity and presence of reductant substances (tested by positivity of Fehling reaction) were found in 24% of infants with acute diarrhoea in the first balance. Sodium concentration in stools varied from 40 to 70 mEq/l; and potassium varied between 20 and 40 mEq/l. Bacterial pathogens were isolated in 64% of patients with acute diarrhoea; most of them E. coli enteropathogenic.

[Cholestyramine in the treatment of acute bacterial diarrhea in infants]. / Colestiramina en el tratamiento de la diarrea aguda bacteriana del lactante.

32 infants admitted to Hospital "Roberto del Río" with infectious diarrhea and dehydration were assigned random to two groups, one of them receiving the usual therapeutic regimen of rehydration, refeeding and furazolidone and the other group the same treatment plus cholestyramine. The patients were studied with balance technique on days 1st, 3rd., and 5th. after admission, analyzing clinical progress, features of the stools, total digestive transit time, pH of the feces and the presence of reducing substances, volume of the stools, water excretion and sodium, potassium and chloride elimination in the feces. The patients receiving cholestyramine showed an earlier improvement in the appearance of the stools, less excretion of feces and water and diminished sodium and potassium elimination. Chloride excretion was similar in both groups. Cholestyramine tolerance was excellent. No side effects or complications were observed.

[Metabolic balance technic as applied to the study of the protracted diarrheal syndrome in infants]. / Metódica de balance en cama metabólica aplicada al estudio del síndrome diarréico agudo del lactante. Interpretación de resultados.

Balance technique applied to the study of infants with protracted diarrhea is discussed. Normal balance pattern in a group of healthy infants in presented and compared to data obtained in patients admitted with dehydration and diarrhea. Three cases considered to be representative examples are presented in detail.