Araştırma Makalesi
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Evaluation of the effects of zinc supplementation on the symptoms and duration of the disease in acute viral gastroenteritis

Yıl 2019, Cilt: 4 Sayı: 1, 11 - 14, 18.03.2019
https://doi.org/10.22391/fppc.471460

Öz

Introduction: Acute viral
gastroenteritis is the second most common cause of high morbidity and mortality
in childhood. Viral gastroenteritis is the most common cause of severe diarrhea
and associated hospitalizations especially in toddlers. It has been shown that
the administration of 20 mg of zinc daily during acute diarrhea reduces the
duration of watery diarrhea by 25% and it has been reported to have protective
and therapeutic effects in the acute period. The aim of this study is to
retrospectively determine the beneficial effects of oral zinc supplementation
on the severity and duration of complaints of toddlers who were treated in our
clinic with the diagnosis of acute viral gastroenteritis.

Methods: Toddlers who were hospitalized
in the Department of Pediatrics for acute viral gastroenteritis between October
2016 and March 2018 were included in the study. The study was retrospective and
the data of the patients were obtained from the patient files. The diagnosis of
acute viral gastroenteritis was made by detecting the adenovirus-rotavirus
antigen in the fresh stool specimens. The patients were divided into two
groups. Group 1: patients who received zinc supplementation in addition to
support treatment. Group 2: patients who received only supportive therapy.

Results: The mean number of vomiting was
3.60 / day and watery diarrhea was 5.20 / day in group-1 while number of
vomiting was 6.1 / day and watery diarrhea was 8.9 / day in group-2 in the 36th
hour during treatment. The tolerability of oral feeding at 36 th hour was
49.39% ( 41) in group-1 and 45.07% (32) in group-2. The mean number of vomiting
and watery diarrhea in group-1 cases at 72th hours was 1.2 / day and 4.30 /
day, while in group-2 cases, 3.90 / day and 7.20 / day.







Conclusions: Although the physiopathology of the effects of zinc on gastroenteritis
is not yet fully understood, diarrhea is seen both as a cause and as a result
of zinc deficiency.  The fact that
patients with gastroenteritis benefit from zinc support suggests that zinc
enhances this effect by increasing intestinal immunity.

Kaynakça

  • 1. Rosenfeldt, V, Vesikari T, Pang XL, Zeng SQ, Tvede M, Paerregaard A. Viral etiology and incidence of acute gastroenteritis in young children attending day-care centers. Pediatr Infect Dis J 2005;24(11):962-5. https://doi.org/10.1097/01.inf.0000183748.41027.a4
  • 2. Qiu FZ, Shen XX, Li GX, Zhao L, Chen C, Duan SX, Guo JY, et al. Adenovirus associated with acute diarrhea: a case-control study. BMC Infect Dis 2018;18(1): 450. https://doi.org/10.1186/s12879-018-3340-1
  • 3. Liu X, Meng L, Li J, Liu X, Bai Y, Yu D, et al. Etiological epidemiology of viral diarrhea on the basis of sentinel surveillance in children younger than 5 years in Gansu, northwest China, 2009-2013. J Med Virol 2015;87(12):2048-53. https://doi.org/10.1002/jmv.24283
  • 4. Karakus YT, Bircan S, Saime E. Incidence of rotavirus and adenovirus 40/41 in children and infants. Eur J Med Sci 2014;1(1):22-25. https://doi.org/10.12973/ejms.2014.104p
  • 5. Bozdayi G, Dogan B, Dalgic B, Bostanci I, Sarı S, Battaloglu NO, et al. Diversity of human rotavirus G9 among children in Turkey. J Med Virol 2008;80(4):733-40. https://doi.org/10.1002/jmv.21120
  • 6. Soriano-Gabarró M, Mrukowicz J, Vesikari T, Verstraeten T. Burden of rotavirus disease in European Union countries. Ped Infect Dis J 2006;25(1):S7-S11. https://doi.org/10.1097/01.inf.0000197622.98559.01
  • 7. Elliott EJ. Acute gastroenteritis in children. BMJ 2007;334(7583):35. https://doi.org/10.1136/bmj.39036.406169.80
  • 8. Karamyyar M, Gheibi S, Noroozi M, Valeshabad AK. Therapeutic effects of oral zinc supplementation on acute watery diarrhea with moderate dehydration: a double-blind randomized clinical trial. Iran J Med Sci 2013;38(2):93-9.
  • 9. Patro B, Golicki D, Szajewska H. Meta-analysis: zinc supplementation for acute gastroenteritis in children. Aliment Pharmacol Ther 2008; 28(6):713-23. https://doi.org/10.1111/j.1365-2036.2008.03787.x
  • 10. Rodriguez-Baez N, O'brien R, Qiu SQ, Bass DM. Astrovirus, adenovirus, and rotavirus in hospitalized children: prevalence and association with gastroenteritis. J Pediatr Gastroenterol Nutr 2002;35(1):64-8. https://doi.org/10.1097/00005176-200207000-00014
  • 11. Guarino A, Albano F, Ashkenazi S, Gendrel D, Hoekstra JH, Shamir R. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: executive summary. J Pediatr Gastroenterol Nutr 2008;46(5):619-21. https://doi.org/10.1097/MPG.0b013e318272b67b
  • 12. Guarino A, Ashkenazi S, Gendrel D, Vecchio AL, Shamir R, Szajewska H. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr 2014;59(1):132-52. https://doi.org/10.1097/MPG.0000000000000375
  • 13. Regagnon C, Chambon M, Archimbaud C, Charbonné F, Demeocq F, Labbé A, et al. Rapid diagnosis of rotavirus infections: comparative prospective study of two techniques for antigen detection in stool. Pathol Biol 2006; 54(6):343-6. https://doi.org/10.1016/j.patbio.2005.12.002
  • 14. Tuerk MJ, Fazel N. Zinc deficiency. Curr Opin Gastroenterol 2009;25(2):136-43. https://doi.org/10.1097/MOG.0b013e328321b395
  • 15. Patel AB, Mamtani M, Badhoniya, N, Kulkarni H. What zinc supplementation does and does not achieve in diarrhea prevention: a systematic review and meta-analysis. BMC Infect Dis 2011;11(1):122. https://doi.org/10.1186/1471-2334-11-122
  • 16. Grahn BH, Paterson PG, Gottschall-Pass KT, Zhang Z. Zinc and the eye. J Am Coll Nutr 2001;20(2):106-18.https://doi.org/10.1080/07315724.2001.10719022

Akut viral gastroenteritlerde oral çinko kullanımının hastalığın semptomları ve süresine etkisinin değerlendirilmesi

Yıl 2019, Cilt: 4 Sayı: 1, 11 - 14, 18.03.2019
https://doi.org/10.22391/fppc.471460

Öz

Giriş: Akut viral gastroenteritler çocukluk çağında
yüksek morbidite ve mortalitenin en sık ikinci sebebidir. Özellikle oyun çağı
ve okul çağı çocukluk döneminde tüm dünyada şiddetli ishallerin ve buna bağlı
hastane yatışları ile bebek ölümlerinin en sık nedeni viral
gastroenteritlerdir. Akut ishal sırasında günlük 20 mg çinko verilmesinin sulu
dışkılama süresini %25 azalttığı gösterilmiştir ve akut dönemde koruyucu ve
terapotik etkileri olduğu bildirilmiştir. Bu çalışmanın amacı, çocukluk çağında
morbiditesi ve mortalitesi yüksek hastalıkların başında gelen akut viral
gastroenterit tanısıyla kliniğimizde tedavi edilen 2-5 yaş arası oyun çağı
çocuk hastaların yakınmalarının şiddeti ve süresi üzerinde oral çinko
kullanımının etkisini retrospektif olarak belirlemektir.

Yöntem: Akut viral gastroenterit
tanısıyla Ekim 2016 – Mart 2018 tarihleri arasında yatırılarak tedavi edilen
2-5 yaş arası oyun çağı dönemindeki çocuk hastalar çalışmaya alındı.Çalışma
retrospektif olup hastaların verileri hasta dosyalarından elde edildi.Akut
viral gastroenteri tanısı taze dışkı örneğinde adenovirüs-rotavirüs antijeni
saptanması ile konuldu.Hastaların verileri Çinko tedavisi alanlar (Grup-1) ile
çinko tedavisi almayanlar (Grup-2) arasında karşılaştırıldı.

Bulgular: Çinko tedavisi verilen grup-1’deki olguların
36.saatteki ortalama kusma ve dışkılama sayısı 3,6/gün ve 5,2/gün iken çinko
almayan grup-2 olgularınki 6,10/gün ve 8,90/gün idi.36. Saatte oral beslenmeyi
tolere etme grup-1 de % 49.39 (41) iken grup-2 de % 45.07 (32) idi.72.saatte
grup-1 olguların ortalama kusma ve dışkılama sayısı 1,20/gün ve 4,30/gün iken
grup-2 olgularda 3,90/gün ve 7.20/gün idi.







Sonuç: Çinkonun gastroenteritler üzerindeki
etkilerinin fizyopatolojisi henüz tam olarak anlaşılamamış olmakla birlikte
ishaller, hem çinko eksikliğinin bir nedeni, hem de bir sonucu olarak
görülmektedir. Gastrenteritli olguların çinko desteğinden fayda görmesi,
çinkonun intestinal immuniteyi arttırarak bu etkiyi sağladığını
düşündürmektedir.

Kaynakça

  • 1. Rosenfeldt, V, Vesikari T, Pang XL, Zeng SQ, Tvede M, Paerregaard A. Viral etiology and incidence of acute gastroenteritis in young children attending day-care centers. Pediatr Infect Dis J 2005;24(11):962-5. https://doi.org/10.1097/01.inf.0000183748.41027.a4
  • 2. Qiu FZ, Shen XX, Li GX, Zhao L, Chen C, Duan SX, Guo JY, et al. Adenovirus associated with acute diarrhea: a case-control study. BMC Infect Dis 2018;18(1): 450. https://doi.org/10.1186/s12879-018-3340-1
  • 3. Liu X, Meng L, Li J, Liu X, Bai Y, Yu D, et al. Etiological epidemiology of viral diarrhea on the basis of sentinel surveillance in children younger than 5 years in Gansu, northwest China, 2009-2013. J Med Virol 2015;87(12):2048-53. https://doi.org/10.1002/jmv.24283
  • 4. Karakus YT, Bircan S, Saime E. Incidence of rotavirus and adenovirus 40/41 in children and infants. Eur J Med Sci 2014;1(1):22-25. https://doi.org/10.12973/ejms.2014.104p
  • 5. Bozdayi G, Dogan B, Dalgic B, Bostanci I, Sarı S, Battaloglu NO, et al. Diversity of human rotavirus G9 among children in Turkey. J Med Virol 2008;80(4):733-40. https://doi.org/10.1002/jmv.21120
  • 6. Soriano-Gabarró M, Mrukowicz J, Vesikari T, Verstraeten T. Burden of rotavirus disease in European Union countries. Ped Infect Dis J 2006;25(1):S7-S11. https://doi.org/10.1097/01.inf.0000197622.98559.01
  • 7. Elliott EJ. Acute gastroenteritis in children. BMJ 2007;334(7583):35. https://doi.org/10.1136/bmj.39036.406169.80
  • 8. Karamyyar M, Gheibi S, Noroozi M, Valeshabad AK. Therapeutic effects of oral zinc supplementation on acute watery diarrhea with moderate dehydration: a double-blind randomized clinical trial. Iran J Med Sci 2013;38(2):93-9.
  • 9. Patro B, Golicki D, Szajewska H. Meta-analysis: zinc supplementation for acute gastroenteritis in children. Aliment Pharmacol Ther 2008; 28(6):713-23. https://doi.org/10.1111/j.1365-2036.2008.03787.x
  • 10. Rodriguez-Baez N, O'brien R, Qiu SQ, Bass DM. Astrovirus, adenovirus, and rotavirus in hospitalized children: prevalence and association with gastroenteritis. J Pediatr Gastroenterol Nutr 2002;35(1):64-8. https://doi.org/10.1097/00005176-200207000-00014
  • 11. Guarino A, Albano F, Ashkenazi S, Gendrel D, Hoekstra JH, Shamir R. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: executive summary. J Pediatr Gastroenterol Nutr 2008;46(5):619-21. https://doi.org/10.1097/MPG.0b013e318272b67b
  • 12. Guarino A, Ashkenazi S, Gendrel D, Vecchio AL, Shamir R, Szajewska H. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr 2014;59(1):132-52. https://doi.org/10.1097/MPG.0000000000000375
  • 13. Regagnon C, Chambon M, Archimbaud C, Charbonné F, Demeocq F, Labbé A, et al. Rapid diagnosis of rotavirus infections: comparative prospective study of two techniques for antigen detection in stool. Pathol Biol 2006; 54(6):343-6. https://doi.org/10.1016/j.patbio.2005.12.002
  • 14. Tuerk MJ, Fazel N. Zinc deficiency. Curr Opin Gastroenterol 2009;25(2):136-43. https://doi.org/10.1097/MOG.0b013e328321b395
  • 15. Patel AB, Mamtani M, Badhoniya, N, Kulkarni H. What zinc supplementation does and does not achieve in diarrhea prevention: a systematic review and meta-analysis. BMC Infect Dis 2011;11(1):122. https://doi.org/10.1186/1471-2334-11-122
  • 16. Grahn BH, Paterson PG, Gottschall-Pass KT, Zhang Z. Zinc and the eye. J Am Coll Nutr 2001;20(2):106-18.https://doi.org/10.1080/07315724.2001.10719022
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi (Original Article)
Yazarlar

Cigdem El 0000-0002-7110-3504

Mehmet Emin Celikkaya 0000-0003-3324-4960

Yayımlanma Tarihi 18 Mart 2019
Gönderilme Tarihi 17 Ekim 2018
Kabul Tarihi 13 Aralık 2018
Yayımlandığı Sayı Yıl 2019Cilt: 4 Sayı: 1

Kaynak Göster

APA El, C., & Celikkaya, M. E. (2019). Evaluation of the effects of zinc supplementation on the symptoms and duration of the disease in acute viral gastroenteritis. Family Practice and Palliative Care, 4(1), 11-14. https://doi.org/10.22391/fppc.471460
AMA El C, Celikkaya ME. Evaluation of the effects of zinc supplementation on the symptoms and duration of the disease in acute viral gastroenteritis. Fam Pract Palliat Care. Mart 2019;4(1):11-14. doi:10.22391/fppc.471460
Chicago El, Cigdem, ve Mehmet Emin Celikkaya. “Evaluation of the Effects of Zinc Supplementation on the Symptoms and Duration of the Disease in Acute Viral Gastroenteritis”. Family Practice and Palliative Care 4, sy. 1 (Mart 2019): 11-14. https://doi.org/10.22391/fppc.471460.
EndNote El C, Celikkaya ME (01 Mart 2019) Evaluation of the effects of zinc supplementation on the symptoms and duration of the disease in acute viral gastroenteritis. Family Practice and Palliative Care 4 1 11–14.
IEEE C. El ve M. E. Celikkaya, “Evaluation of the effects of zinc supplementation on the symptoms and duration of the disease in acute viral gastroenteritis”, Fam Pract Palliat Care, c. 4, sy. 1, ss. 11–14, 2019, doi: 10.22391/fppc.471460.
ISNAD El, Cigdem - Celikkaya, Mehmet Emin. “Evaluation of the Effects of Zinc Supplementation on the Symptoms and Duration of the Disease in Acute Viral Gastroenteritis”. Family Practice and Palliative Care 4/1 (Mart 2019), 11-14. https://doi.org/10.22391/fppc.471460.
JAMA El C, Celikkaya ME. Evaluation of the effects of zinc supplementation on the symptoms and duration of the disease in acute viral gastroenteritis. Fam Pract Palliat Care. 2019;4:11–14.
MLA El, Cigdem ve Mehmet Emin Celikkaya. “Evaluation of the Effects of Zinc Supplementation on the Symptoms and Duration of the Disease in Acute Viral Gastroenteritis”. Family Practice and Palliative Care, c. 4, sy. 1, 2019, ss. 11-14, doi:10.22391/fppc.471460.
Vancouver El C, Celikkaya ME. Evaluation of the effects of zinc supplementation on the symptoms and duration of the disease in acute viral gastroenteritis. Fam Pract Palliat Care. 2019;4(1):11-4.

Family Practice and Palliative Care      ISSN 2458-8865       E-ISSN 2459-1505