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This Symposium highlights the recognition that this year reaches half a century of the Medical Movement (1964-1965), and 27 years of publishing the book titled, "Documental Memories and Reflections" ("Crónica Documental y Reflexiones") edited by the Faculty of Medicine of the UNAM, at that time directed by the prestigious Dr. Fernando Cano Valle. Our President Dr. Graue indicated that Dr. Alejandro Treviño-Becerra assumed the coordination of this session with the commitment to be published in the Medical Gazette of Mexico for current and future generations. The Academic participants were: Norberto Treviño García-Manzo, president of the Academy in 1988. Dr. Felipe Mota Hernández was the Recording Secretary of the Mexican Medical Alliance ("Alianza de Médicos Mexicanos"). Now he is the Dean of the Children's Hospital of Mexico "Federico Gómez". Dr. Cesar Gutiérrez Samperio, surgeon at IMSS and professor at Medicine School, University of Queretaro until a year ago. Dr. Fernando Cano Valle, former Head of the Medical Faculty, UNAM, presently a researcher in Medicine and Human Rights in the Institute for Juridical Research, UNAM. I quote the Academic Treviño Zapata: "I believe that it will be difficult to bring again the conditions and circumstances that made possible the vigorous realization of the Medical Movement, the enthusiastic and hopeful creation of the Mexican Medical Alliance, and the promising start and progress of the integration of the national medical union." more...

The aim of the study was to analyze mothers home practices among children with acute diarrhea.A cross sectional study was carried out in a group of 260 mothers of children with diarrhea. Mothers were requested to answer the "verbal biopsy" questionnaire to assess their practices concerning effective diarrhea management at home according to the World Health Organization and corresponding to the Norma Oficial Mexicana recommendations. Descriptive statistics and Chi square for differences were used.Two groups of mothers' were identified: those who had consulted a physician before attending the hospital (n = 191), and those who came to the hospital as their first choice (n = 69). The first group used antibiotics, antiemetics, breast-feeding and Oral Hydration Therapy more frequently than the second group (p0.05).The "verbal biopsy " instrument was useful to assess home management of children with diarrhea. This questionnaire was also useful to detect medical malpractice (unjustified prescription of antibiotics and antiemetics) as well as to identify best practices (continued breast feeding and oral hydration). more...

This report is of a community-based case control study to assess whether the severity of acute diarrhea by rotavirus (RV) in young children is associated with a particular VP7 (G) or VP4 (P) RV serotype. Five hundred twenty children younger than 2 years of age with diarrhea lasting less than 3 days were age and gender matched with 520 children with no diarrhea. The G and P serotypes were determined with specific monoclonal antibodies, and the VP4 serotype specificity in a subgroup was confirmed by genotyping. Infection with a G3 serotype led to a higher risk of diarrhea than infection with a G1 serotype. Infection with a G3-nontypeable-P serotype was associated with more severe gastroenteritis than infection with a G3 (or G1) P1A[8] serotype. A child with diarrhea-associated dehydration was almost five times more likely to be infected with a G3-nontypeable-P serotype than a child without dehydration ( P < 0.001). Moreover, the two predominant monotypes within serotype P1A[8] had significantly different clinical manifestations. In this study, the severity of RV-associated diarrhea was related to different P serotypes rather than to G serotypes. The relationship between serotype and clinical outcomes seems to be complex and to vary among different geographic areas. more...

To evaluate the safety and effectiveness of two oral rehydration techniques.A randomized clinical trial was conducted at the oral rehydration unit of Hospital Infantil de Mexico "Federico Gomez", between September 1998 and June 1999. Forty patients five-year old and younger children, dehydrated due to acute diarrhea, were given oral rehydration solution (ORS) ad libitum (AL group); another forty patients received ORS in fractionated doses (FD group). Clinical characteristics were similar in both groups. Results are presented as means, standard deviations and medians, according the distribution of simple and relative frequencies.The mean stool output in the AL group was 11.0 +/- 7.5 g/kg/h; as compared to 7.1 +/- 7.4 in the FD group (p = 0.03). ORS intake, rehydration time, and mean diuresis values were similar in both groups (p0.05). Six patients in the AL group and five in the FD group had high stool output (10 g/kg/h), that improved after administration of rice starch solution. One patient in the AL group and two in the FD group had persistent vomiting that improved with gastroclisis. No patient required intravenous rehydration.These results suggest that ORS administration ad libitum under supervision, is a technique as safe and effective as the fractionated doses technique, for the treatment of dehydrated children due to acute diarrhea. more...

Objective. To evaluate the safety and effectiveness of two oral rehydration techniques. Material and Methods. A randomized clinical trial was conducted at the oral rehydration unit of Hospital Infantil de Mexico “Federico Gomez”, between September 1998 and June 1999. Forty patients five- year old and younger children, dehydrated due to acute diarrhea, were given oral rehydration solution (ORS) ad libitum (AL group); another forty patients received ORS in fractionated doses (FD group). Clinical characteristics were similar in both groups. Results are presented as means, standard deviations and medians, according the distribution of simple and relative frequencies. Results. The mean stool output in the AL group was 11.0±7.5 g/kg/h; as compared to 7.1±7.4 in the FD group (p=0.03). ORS intake, rehydration time, and mean diuresis values were similar in both groups (p0.05). Six patients in the AL group and five in the FD group had high stool output (10 g/kg/h), that improved after administration of rice starch solution. One patient in the AL group and two in the FD group had persistent vomiting that improved with gastroclisis. No patient required intravenous rehydration. Conclusions. These results suggest that ORS administration ad libitum under supervision, is a technique as safe and effective as the fractionated doses technique, for the treatment of dehydrated children due to acute diarrhea. The English version of this paper is available at: http://www.insp.mx/salud/index.html more...

Objective. To compare the severity of rotavirus diarrhea (RV) and non-rotavirus diarrhea. Material and Methods. Between October 1994 and March 1995, a cross-sectional study was performed in 520 infants with acute diarrhea, at seven primary care level centers in five states of Mexico. Diagnosis of RV was done through immunoenzymatic assay or electrophoresis. Central tendency measures were used for data analysis. Results were presented as means and standard deviations, or median and variation. Results. RV was isolated from 264 children; most of them were males aged 6 months to 1 year. Differences in clinical manifestations were statistically significant between the rotavirus-positive group and the rotavirus-negative group, in the following variables: median number of stools/24 hours; frequency of vomiting; temperature > 38°C; dehydration; and clinical severity scoring. Conclusions. These results showed a poorer prognosis and a higher severity of rotavirus diarrhea, as compared to non-rotavirus diarrhea in infants. The English version of this paper is available at: http://www.insp.mx/salud/ index.html more...

• We sought to determine the efficacy of three different types of treatment in children with acute diarrhea who, during the oral rehydration period, had high stool output (>10 mL/kg per hour). Sixty-six children, aged 1 to 18 months, with an average stool output of 22.6 mL/kg per hour were randomly distributed into three groups: group 1 received a rice flour solution, group 2 received the World Health Organization rehydration solution by gastric infusion, and group 3 continued to receive this solution orally. In all three groups, a decrease in stool output was observed, with the higher decrease observed in group 1 patients. Such a decrease facilitated rehydration of all 22 patients in group 1 (100%) in 3.3±1.5 hours, 16 (73%) in group 2 in 4.3±2.1 hours, and 15 (69%) in group 3 in 4.9±2.0 hours. No complications were observed. These data indicate that the rice flour solution is effective in children with high stool output diarrhea. ( AJDC . 1991;145:937-940) more...