Altered antioxidant status and increased lipid peroxidation in children with acute gastroenteritis admitted to a pediatric emergency service.

Acute gastroenteritis is a common illness worldwide and has a great impact on children. Our aim was to examine possible alterations in the antioxidant defense in pediatric gastroenteritis. To comprehensively examine the reaction of the antioxidant system, all possible components of the system were measured. The whole blood malondialdehyde and reduced glutathione, serum beta-carotene, retinol, vitamin C, vitamin E, catalase, ceruloplasmin, albumin, total bilirubin, uric acid, erythrocyte superoxide dismutase, and glutathione peroxidase levels were studied. Superoxide dismutase and glutathione peroxidase antioxidant enzyme activities and malondialdehyde levels were found to be increased; however, beta-carotene, retinol, vitamin C, vitamin E, reduced glutathione, and albumin levels were observed to be significantly decreased. Catalase activity remained unchanged, whereas some of the other non-enzymatic antioxidants such as ceruloplasmin, total bilirubin, and uric acid levels were increased compared to the control group. We have shown an association between antioxidant levels and gastroenteritis in children. Further study is needed to assess whether antioxidant supplementation will be beneficial as an adjunct to conventional relevant therapy of the disease.

[Infectious acute gastroenteritis in the emergency department of an urban hospital]. / Gastroenteritis aguda infecciosa en urgencias de un hospital urbano.

OBJECTIVES: To examine the etiology, clinical, analytical and evolutionary characteristics of gastroenteritis in the pediatric population in the Emergency Department of Dr. Peset University Hospital in Health Care Area 10 in Valencia, Spain, over a 1-year period (2005). PATIENTS AND METHODS: Children < 15 years of age with acute diarrhea were prospectively enrolled in the Emergency Department. Data were collected through information sheets. Their stools were examined for diarrheagenic bacteria and viruses (rotavirus and adenovirus). RESULTS: 794 episodes of gastroenteritis were recorded. The incidence of rotavirus was 22 %, adenovirus 8 %, Campylobacter jejuni 7 % and Salmonella spp. 4 %. Socioeconomic characteristics were not helpful in differentiating disease due to specific enteropathogens. Ninety per cent cases caused by viruses only affected children under three years of age. Rotavirus gastroenteritis had a marked seasonal pattern (90 % cases in December-February). Among infants < or = 6 months of age rotavirus was less frequent as cause of diarrhea in breast-fed infants than in bottle-fed. Macroscopic blood in stools was reported almost exclusively among patients with a bacterial infection. In 96 % of all cases of diarrhea there was no dehydration, in 2 % it was mild, in 2 % moderate and none severe. Ten of the seventeen cases (59 %) of moderate dehydration were caused by rotavirus. Six percent of all children were hospitalised. CONCLUSIONS: Rotavirus was significantly more associated with the need for intravenous fluid therapy and hospitalisation than episodes negative for rotavirus. Rotavirus accounted for 3 % of hospitalisations in infants aged 1 month-2 years.

Factors affecting length of hospitalization of infants and children for recurrent gastroenteritis in Western Australia.

AIM: Aboriginal infants in Western Australia (WA) have much higher rates of hospitalization for gastroenteritis than do their non-Aboriginal peers. The aim of this 7-y retrospective study was to investigate the factors affecting the duration of hospitalizations due to recurrent gastroenteritis in WA. METHODS: All infants born in WA in 1995 and 1996 who had indexed gastroenteritis admissions during their first year of life (n = 1009) were followed until 31 May 2002. Linked hospitalization and birth records were retrieved to derive the outcome measures, associated co-morbidities and other demographic variables. A proportional hazards frailty model was then used to determine factors influencing discharge from hospital for the study cohort. RESULTS: Aboriginal patients were readmitted to hospital more frequently and stayed in hospital more than twice as long as non-Aborigines. Factors that slowed the rate of discharge from hospital included Indigenous status and the presence of coexisting conditions such as dehydration, sugar intolerance, failure to thrive and iron-deficiency anaemia. CONCLUSION: Gastrointestinal infections are common illnesses in infants and children, particularly for those who live in overcrowded and unhygienic conditions. Coexisting morbidities including undernutrition, nutrient deficiencies, other infections and gastrointestinal carbohydrate intolerance contribute to prolonged and recurrent hospitalization. Multifaceted clinical, disease prevention and health/hygiene promotion are needed to lessen the burden of these infections.