Effects of unrestricted diet on mild infantile diarrhea: a practice-based study

Article Abstract:

There is disagreement over the best initial treatment for mild diarrhea in infants. It has been reported that more than 50 percent of pediatricians in the United States recommend that the baby's diet be restricted to clear fluids until the second or third day of diarrhea. However, continuation of regular feeding is recommended by the World Health Organization. The American Academy of Pediatrics recommends that feeding be withheld for no more than 24 hours. A study was made at two suburban pediatric practices. There were 176 healthy babies under one year old enrolled in the study. If diarrhea was reported (there were 63 episodes), the baby was assigned to either a treatment or control group. The treatment group received 24 hours of clear fluid, followed by either dilute and progressively stronger soy-based formula, full-strength soy formula, or dilute and progressively stronger cow's milk formula. The control group continued their usual formula or breast-feeding. Both treatment and control groups discontinued solid food for the first 24 hours. Outcomes evaluated were duration of diarrhea, weight loss, and number of stools. The results showed that the difference in outcomes for both groups was not significant. The control group had fewer stools, less weight loss and recovered quicker. In the treatment group the babies appeared hungrier and 30 percent of the parents did not comply with the prescribed treatment. This rate was extremely high for this population, which previously has shown a greater than 90 percent compliance rate. This study evaluated the effectiveness of diet restriction in the usual pediatric office setting. It is concluded that modifying the diet does not seem to affect mild diarrhea in infants. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Diet therapy, Diarrhea in children, Childhood diarrhea, Diarrhea, Infantile

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Calciphylaxis and systemic calcinosis: collective review

Article Abstract:

Calciphylaxis has been defined as a condition of hypersensitivity in which the sensitizing agent causes local calcification. The sensitizing agent may be systemic, as in the case of vitamin D or parathyroid hormones, or topical, as in the case of egg proteins and metallic salts. Calcification may occur in the connective tissue of many organs, the most common being the heart, lungs, kidneys, stomach, and skin. The condition is very serious, and a review of the literature indicates that over half the patients die. A common cause of death is the development of uncontrolled bacterial infection of the blood. Although the precise mechanisms for the pathogenesis of calciphylaxis and its subsequent calcinosis (abnormal deposition of lime salts in the tissues) are not certain, the condition is always associated with hypercalcemia (excessive calcium in the blood). Calciphylaxis needs to be vigorously treated by identifying and eliminating the sensitizing agent, which is the only specific therapy for this condition. The hypercalcemia should also be directly treated. If cutaneous calcification is noted in a patient with chronic kidney failure, it is recommended that an immediate total parathyroidectomy (removal of parathyroid glands) be performed. One parathyroid might be transplanted to the forearm, where it can be easily removed if the patient's condition does not improve. The disease is fairly rare, and most physicians who are not involved in nephrology will not encounter this condition. However, physicians treating bone cancer, hypercalcemia, hyperparathyroidism, and dealing with transplant patients, must be familiar with this potentially elusive yet very important diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Causes of, Physiological aspects, Calcium in the body, Calcium (Nutrient), Calcification, Hypercalcemia

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