The 13C-urea breath test (13C-UBT) is a safe, noninvasive, and accurate test for the detection of Helicobacter pylori (H. pylori) infection in adults. The aim of this study was to evaluate sensitivity and specificity of 13C-UBT in children using different types of test meal, doses of 13C-urea and breath sampling intervals. As yet, a validated, standardized 13C-UBT protocol for children has not been formulated.13C-UBT was performed in 115 children and repeated within 3 days, modifying the test meal or the dose of 13C-urea. H. pylori status was assessed by histology and rapid urease test. 13C-UBT was performed using 100 mg or 50 mg of 13C-urea and a fatty test meal (100 FA; 50 FA), 50 mg of 13C-urea, and a carbohydrate test meal (50 CA). Breath samples were collected every 10 min for 60 min.The 13C-UBT in children was highly sensitive and specific with all three protocols used. The best combination of sensitivity (97.92%) and specificity (97.96%) was obtained with Protocol 50 FA at 30 min with a cut-off of 3.5 per mil.The 13C-UBT is an accurate test for the detection of H. pylori infection also in children. Administration of 50 mg of 13C-urea, a fatty test meal, and breath sampling at 30 min appears to be the most convenient protocol.
Background: The probiotic Lactobacillus GG is effective in promoting a more rapid recovery of acute, watery diarrhea in children with rotavirus enteritis. Very limited information is available, however, on the potential role of such agents in nonrotaviral diarrheal episodes. Furthermore, no evidence is available concerning the efficacy of Lactobacillus GG administered in the oral rehydration solution during oral rehydration therapy. A multicenter trial was conducted to evaluate the efficacy of Lactobacillus GG administered in the oral rehydration solution to patients with acute-onset diarrhea of all causes. Methods: Children 1 month to 3 years of age with acute-onset diarrhea were enrolled in a double-blind, placebo-controlled investigation. Patients were randomly allocated to group A, receiving oral rehydration solution plus placebo, or group B, receiving the same preparation but with a live preparation of Lactobacillus GG (at least 1010 CFU/250 ml). After rehydration in the first 4 to 6 hours, patients were offered their usual feedings plus free access to the same solution until diarrhea stopped. Results: One hundred forty children were enrolled in group A, and 147 in group B. There were no differences at admission between the groups in age, sex, previous types of feeding, previous duration of diarrhea, use of antibiotics, weight, height, weight–height percentile, prevalence of fever, overall status, degree of dehydration, and percentage of in-versus outpatients. Duration of diarrhea after enrollment was 71.9 ± 35.8 hours in group A versus 58.3 ± 27.6 hours in group B (mean ± SD;P = 0.03). In rotavirus-positive children, diarrhea lasted 76.6 ± 41.6 hours in group A versus 56.2 ± 16.9 hours in groups B (P < 0.008). Diarrhea lasted longer than 7 days in 10.7% of group A versus 2.7% of group B patients (P < 0.01). Hospital stays were significantly shorter in group B than in group A. Conclusions: Administering oral rehydration solution containing Lactobacillus GG to children with acute diarrhea is safe and results in shorter duration of diarrhea, less chance of a protracted course, and faster discharge from the hospital.
Seventy-six normal full-term infants have been observed from birth to the fourth month of life. Thirty-six were breast-fed; the others were fed four different feeds (conventional or adapted formulas) containing different amounts of calories, protein, fat, and carbohydrate. The control mechanism of volume intake appears to be well functioning in infants fed human milk and adapted formulas providing conventional calorie concentrations. The other formulas were associated with either a high BUN or high base insulin concentrations. It is concluded that uncontrolled amounts of milk should be fed only to breast-fed infants and those receiving adapted formulas but not to those fed formulas that provide high calorie or protein concentrations.
ABSTRACT Background Childhood gastroenteritis is associated with considerable health costs. The natural clay dioctahedral smectite increases intestinal barrier function and is effective against infectious diarrhea in children in developing countries. The purpose of this work was to investigate the efficacy of smectite in Italian children with acute diarrhea of mild to moderate severity. Methods A national, prospective, randomized, case‐controlled study was performed in collaboration with primary care pediatricians. Children seen by pediatricians for acute gastroenteritis were treated with oral rehydration solution (ORS) alone or ORS with smectite. Parents returned a form in which total duration of diarrhea, incidence of vomiting and fever, persistence of diarrhea for more than 7 days and hospital admissions were recorded. Results Eight hundred four children with acute diarrhea were randomly assigned to treated or control groups. Administration of smectite was associated with significant reduction of the duration of diarrhea, as judged by stool frequency and consistency. The incidence and duration of vomiting and fever were not different. Diarrhea lasted more than 7 days in 10% of treated and in 18% of control children ( P < 0.01). Hospital admission was necessary in seven treated and six control children. No side effects were observed. Conclusions Smectite reduces the duration of diarrhea and prevents a prolonged course. It may therefore consistently reduce the costs of gastroenteritis.
ABSTRACT Background: The probiotic Lactobacillus GG is effective in promoting a more rapid recovery of acute, watery diarrhea in children with rotavirus enteritis. Very limited information is available, however, on the potential role of such agents in nonrotaviral diarrheal episodes. Furthermore, no evidence is available concerning the efficacy of Lactobacillus GG administered in the oral rehydration solution during oral rehydration therapy. A multicenter trial was conducted to evaluate the efficacy of Lactobacillus GG administered in the oral rehydration solution to patients with acute‐onset diarrhea of all causes. Methods: Children 1 month to 3 years of age with acute‐onset diarrhea were enrolled in a double‐blind, placebo‐controlled investigation. Patients were randomly allocated to group A, receiving oral rehydration solution plus placebo, or group B, receiving the same preparation but with a live preparation of Lactobacillus GG (at least 10 10 CFU/250 ml). After rehydration in the first 4 to 6 hours, patients were offered their usual feedings plus free access to the same solution until diarrhea stopped. Results: One hundred forty children were enrolled in group A, and 147 in group B. There were no differences at admission between the groups in age, sex, previous types of feeding, previous duration of diarrhea, use of antibiotics, weight, height, weight–height percentile, prevalence of fever, overall status, degree of dehydration, and percentage of in‐versus outpatients. Duration of diarrhea after enrollment was 71.9 ± 35.8 hours in group A versus 58.3 ± 27.6 hours in group B (mean ± SD; P = 0.03). In rotavirus‐positive children, diarrhea lasted 76.6 ± 41.6 hours in group A versus 56.2 ± 16.9 hours in groups B ( P < 0.008). Diarrhea lasted longer than 7 days in 10.7% of group A versus 2.7% of group B patients ( P < 0.01). Hospital stays were significantly shorter in group B than in group A. Conclusions: Administering oral rehydration solution containing Lactobacillus GG to children with acute diarrhea is safe and results in shorter duration of diarrhea, less chance of a protracted course, and faster discharge from the hospital.
In view of the pharmacodynamic and therapeutic properties of a broad-spectrum semisynthetic penicillin recently introduced in Italy, namely sulbenicillin, the authors conducted a multicentre clinical and bacteriological trial of the drug administered by intramuscular or intravenous injection in daily doses of 4, 6 or 8 g given in two or three administrations daily to a group of 66 patients with acute bronchopulmonary infection, mainly exacerbation of chronic infection, hospitalized in four Pneumology Centres of Sardinia. The authors assessed clinical, radiological, microbiological, and biohumoral parameters before and after treatment to provide a basis for assessing test product effectiveness and tolerability. On the strength of their findings, the authors concluded that the clinical and bacteriological activity of sulbenicillin was satisfactory and its local and general tolerability was excellent. The assembled findings indicate that the new antibiotic molecule can be used to advantage in the treatment of nontubercular bronchopulmonary infections, including severe or otherwise "difficult" cases, providing that the drug is administered at adequate dosages and for sufficiently long treatment periods.
Background Childhood gastroenteritis is associated with considerable health costs. The natural clay dioctahedral smectite increases intestinal barrier function and is effective against infectious diarrhea in children in developing countries. The purpose of this work was to investigate the efficacy of smectite in Italian children with acute diarrhea of mild to moderate severity. Methods A national, prospective, randomized, case-controlled study was performed in collaboration with primary care pediatricians. Children seen by pediatricians for acute gastroenteritis were treated with oral rehydration solution (ORS) alone or ORS with smectite. Parents returned a form in which total duration of diarrhea, incidence of vomiting and fever, persistence of diarrhea for more than 7 days and hospital admissions were recorded. Results Eight hundred four children with acute diarrhea were randomly assigned to treated or control groups. Administration of smectite was associated with significant reduction of the duration of diarrhea, as judged by stool frequency and consistency. The incidence and duration of vomiting and fever were not different. Diarrhea lasted more than 7 days in 10% of treated and in 18% of control children (P < 0.01). Hospital admission was necessary in seven treated and six control children. No side effects were observed. Conclusions Smectite reduces the duration of diarrhea and prevents a prolonged course. It may therefore consistently reduce the costs of gastroenteritis.
