Page 199 - 15Diarrhoeaandvomiting

Diarrhoea and vomiting caused by gastroenteritis in children under 5 years

structured interview, xxi see also enteric adenovirus infection; rotavirus
study checklist, xxi infection; other specific viruses
study population, xxi vitamin A
study quality. see methodological quality deficiency, 117
study type, xxi GDG interpretation of evidence, 125
subject, xxi vitamin A supplements, 121
sulfamethoxazole evidence overview, 121
prior to pathogen identification, 97 evidence summary, 122
Salmonella gastroenteritis, 91 placebo vs, 121
Yersinia enteritis, 93 volume, percentage lost, 41
sulphonamide, prior to pathogen identification, 96 vomiting, 1
surgical disorders anti-emetic therapy, 104
diarrhoea/vomiting, 26 definition, 22
indication for investigations, 32 used by GDG, 22
survey, xxi differential diagnosis, 26
systematic error, ix duration, 22
systematic review, xxi evidence summary, 23
systemic, definition, xxi GDG interpretation of evidence, 23
recommendation, 11, 23
tachycardia, xxi, 45 frequency, dehydration risk factor, 39
tachypnoea, xxi IVT vs ORT in severe dehydration, 58
target population, xxi onset, 21
tertiary centre, xxi predictor of haemolytic uraemic syndrome (HUS),
toxic shock syndrome, xxi, 26 100
training of clinicians, dehydration/shock prevention of spread, 138
detection, 45 recommendations, 17, 139
traveller’s diarrhoea viral gastroenteritis, 24
antibiotic therapy, 98 zinc therapy effect, 118, 119
evidence overview, 98
evidence summary, 99 water, tap, clear fluids vs, dehydration management, 60
GDG interpretation, 102 weighted mean difference (WMD), xvi, xxi
evidence summary, 32 World Health Organization (WHO)
GDG interpretation of evidence, 32 dehydration severity classification, 43
indications for investigations, 34 IVT administration rate, 72, 73
most common pathogens, 32 see also intravenous fluid therapy (IVT)
trimethoprim oral rehydration solution composition, 61, 63, 64
prior to pathogen identification, 96, 97 post-rehydration fluid management, 75
Salmonella gastroenteritis, 91 Ringer’s lactate recommendation, 71
Yersinia enteritis, 93
triple-blind study, xxi Yersinia enteritis, antibiotic therapy, 93, 102
trust (NHS), xxii
zinc, 117
ulcerative colitis, xxii, 26 loss/deficiency, 117
indication for investigations, 32 zinc therapy/supplements, 117
undernutrition, dehydration risk factor, 39, 40 diarrhoea duration, effect, 118
updates (to guideline), schedule, 8 effect on stool frequency, 119
uraemia, incidence, 49 evidence overview, 117
urea evidence summary, 120
normal, in dehydration, 51 GDG interpretation of evidence, 125
raised levels in dehydration, 52 multivitamin preparation with, 118
urinary tract infection, 26 ORT with, 118
urine output placebo vs, effect on diarrhoea, 119
accuracy of dehydration diagnosis, 50 safety//efficacy, 118
normal, dehydration detection and, 42 vomiting, effect on, 118, 121
urine specific gravity, accuracy of dehydration
diagnosis, 50

validity, xxii
variable, xxii
Vibrio, community and GP practice incidence, 30
viral gastroenteritis
clinical features, 24, 25
incidence in community, 29, 30
suggested prevalence unreported, 30

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