The ketogenic diet is an effective treatment for the patients with intractable epilepsy, however, the diet therapy can sometimes be discontinued by complications. Protein–losing enteropathy is a rarely reported serious complication of the ketogenic diet. We present a 16-month-old Down syndrome baby with protein-losing enteropathy during the ketogenic diet as a treatment for West syndrome. He suffered from diarrhea, general edema and hypoalbuminemia which were not controlled by conservative care for over 1 month. Esophagogastroduodenoscopy and stool alpha-1 antitrypsin indicated protein-losing enteropathy. Related symptoms were relieved after cessation of the ketogenic diet. Unexplained hypoalbuminemia combined with edema and diarrhea during ketogenic suggests the possibility of protein-losing enteropathy, and proper evaluation is recommended in order to expeditiously detect it and to act accordingly.
Diarrhea ; Diet Therapy ; Down Syndrome ; Drug Resistant Epilepsy ; Edema ; Endoscopy, Digestive System ; Humans ; Hypoalbuminemia ; Infant ; Infant, Newborn ; Ketogenic Diet* ; Protein-Losing Enteropathies* ; Spasms, Infantile

OBJECTIVETo investigate the development of lactose intolerance in neonates with non-infectious diarrhea and its association with diarrhea, and to evaluate the diagnostic values of fecal pH value and urine galactose determination for neonatal lactase deficiency.

METHODSSeventy hospitalized neonates who developed non-infectious diarrhea between October 2012 and June 2015 were enrolled as the diarrhea group, and 162 hospitalized neonates without non-infectious diarrhea were enrolled as the non-diarrhea group. Test paper was used to determine fecal pH value. The galactose oxidase method was used to detect urine galactose. The neonates with positive galactose oxidase were diagnosed with lactase deficiency, and those with lactase deficiency and diarrhea were diagnosed with lactose intolerance. According to the results of urine galactose detection, 69 neonates in the diarrhea group who underwent urine galactose detection were classified into lactose intolerance group (45 neonates) and lactose tolerance group (24 neonates), and their conditions after treatment were compared between the two groups. The follow-up visits were performed for neonates with diarrhea at 3 months after discharge.

RESULTSFecal pH value and positive rate of urine galactose (65% vs 54%) showed no significant differences between the diarrhea and non-diarrhea groups (P>0.05). Fecal pH value showed no significant difference between the lactose intolerance and lactose tolerance groups (P>0.05), while the neonates in the lactose intolerance group had a significantly longer time to recovery of defecation than those in the lactose tolerance group (P<0.05).

CONCLUSIONSThe incidence of lactase deficiency is high in neonates, and diarrhea due to lactose intolerance tends to occur. Determination of fecal pH value has no significance in the diagnosis of lactose intolerance in neonates with diarrhea.

Diarrhea, Infantile ; etiology ; Galactose ; urine ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Lactase ; deficiency ; Lactose Intolerance ; complications

Acupuncture Points ; Acupuncture Therapy ; Child, Preschool ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Male

Child, Preschool ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Moxibustion

This study investigated the effect of breast-feeding in protection against protozoan infection in infants with persistent diarrhea. Infants were classified into 2 groups; 161 breast-fed infants and the same number of non-breast-fed infants. Microscopic examinations of stool were done for detection of parasites and measuring the intensity of infection. Moreover, serum levels of IgE and TNF-alpha were measured by ELISA. Cryptosporidium spp., Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, and Blastocystis sp. were demonstrated in infants with persistent diarrhea. The percentage of protozoan infections was significantly lower in breast-fed infants than that in the non-breast-fed infants. The levels of IgE and TNF-alpha were significantly lower in the breast-fed group than in the non-breast-fed group. There were significant positive associations between the serum levels of IgE and TNF-alpha and the intensity of parasite infection in the breast-fed group. It is suggested that breast-feeding has an attenuating effect on the rate and intensity of parasite infection.
Antigens, Protozoan/analysis/*immunology ; Diarrhea, Infantile/*diagnosis/parasitology ; Entamoeba ; Entamoeba histolytica/*isolation & purification ; Entamoebiasis/*diagnosis/parasitology ; Enzyme-Linked Immunosorbent Assay ; Feces/parasitology ; Female ; Giardia lamblia ; Giardiasis/*diagnosis/parasitology ; Humans ; Infant ; Intestines/parasitology ; Protozoan Infections/*diagnosis/parasitology ; Tumor Necrosis Factor-alpha/metabolism

Acupuncture Points ; Bloodletting ; Child ; Child, Preschool ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Male

OBJECTIVEThe study was designed to evaluate adenovirus infection in hospitalized children with diarrhea.

METHODStool specimens were collected from 519 hospitalized children with diarrhea during 2010, including those defined as community-acquired diarrhea (CAD) who developed diarrhea symptoms within 48 hours after admission, and those defined as hospital-acquired diarrhea (HAD) whose symptoms of diarrhea occurred beyond 48 hours after admission. PCR was employed to identify adenovirus in fecal samples by using universal primers for adenoviruses of all types, and specific primers for adenovirus group F. PCR products with expected size were sequenced for adenovirus typing. Clinical data for children with adenovirus positive specimens were analyzed.

RESULTA total of 519 hospitalized children, including 289 with CAD and 230 with HAD, were enrolled in the study. Out of 519 stool specimens, 76 showed PCR products with expected 301 bp and identified as adenovirus by sequencing, and the overall positive rate was 14.6%. Out of 289 CAD samples, 43 were positive (positive rate was 14.9%). Of them, 20 were identified as enteric adenovirus infection (adenovirus type 41, Ad41). Thirty-three out of 230 HAD samples were positive (positive rate was 14.3%). Of them, 13 were characterized as enteric adenovirus infection (one was Ad40 and others were Ad41). Ad41 in this study could be divided into two genotypes by phylogenetic tree analysis. Non-enteric adenoviruses were identified in 43 specimens (43/76, 56.6%) including 5 of serotype 1, 8 of serotype 2, 15 of serotype 3, 10 of serotype 7, 1 of serotype 12, and 4 of serotype 31. In this study, the positive rate of adenovirus between CAD children and HAD children did not differ (χ(2) = 0.03, P > 0.05), while the positive rate of enteric adenovirus was high in CAD children.

CONCLUSIONAdenovirus infection was the main cause of diarrhea in hospitalized children. In this study, the positive rate of adenovirus was similar between children with CAD and with HAD. Enteric adenovirus (adenovirus group F) was the most common adenovirus serotype detected in 2010 in Beijing, and Ad41 was the dominant type.

Adenoviridae ; classification ; genetics ; isolation & purification ; Adenoviridae Infections ; epidemiology ; Age Distribution ; Child, Hospitalized ; Child, Preschool ; China ; epidemiology ; DNA, Viral ; analysis ; Diarrhea ; epidemiology ; virology ; Diarrhea, Infantile ; epidemiology ; virology ; Feces ; virology ; Female ; Humans ; Infant ; Male ; Polymerase Chain Reaction ; Sex Distribution

OBJECTIVETo generalize the application of Tuina in treating infantile diseases and evaluate the validity and safety of Tuina.

METHODSBy a multicentre randomized controlled study, 240 patients were randomly divided into an observation group (n = 180) and a control group (n = 60). The observation group was treated by tonifying Pijing and clarifying Dachangjing, and Tuina on Lanmen, Qi, Fu Shangqijiegu, Guiwei and Zusanli (ST 36), etc. Banmen and Sanguan were used as the supplementary point according to the syndrome differentiation. The control group was treated by oral administration of Smecta. After 5 day treatments, Chinese syndrome score and the clinical effect were evaluated.

RESULTSAfter the third and fifth treatment, the Chinese syndrome score of both groups descended obviously. The decline of the observation group was superior to that of the control group (all P < 0.01). The cured rate of 75.6% (136/180) in the observation group was better than 21.7% (13/60) in the control group (P < 0.001). The clinical cured rate of 95.0% (171/180) according to Chinese syndrome score in the observation group was better than 58.3% (35/60) in the control group (P < 0.001). There was no adverse reaction in both groups.

CONCLUSIONInfantile Tuina has a better therapeutic effect in the treatment of acute infantile diarrhea than oral administration of Smecta.

Acupressure ; Child, Preschool ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Male ; Treatment Outcome

Acupuncture Therapy ; Child, Preschool ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Male

Acupuncture Points ; Acupuncture Therapy ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Male ; Scalp