Wikipedia

Gastroenteritisi

Gastroenteritisi ni hali mbaya ya afya yenye sifa ya kuvimba ("-itis") kwa eneo la utumbo ambayo inahusu tumbo ("gastro"-) pamoja na chango ("entero"-), na kusababisha kuhara, kutapika, maumivu ya tumbo na kupata kiharusi.[1] Ingawa haihusiani na mafua, imeitwa pia mafua ya tumbo na homa ya tumbo.

Gastroenteritisi
Gastroenteritisi
Mwainisho na taarifa za nje
Kundi MaalumuGastro-enterolojia Edit this on Wikidata
ICD-10A02.0, A08., A09., J10.8, J11.8,K52.
ICD-9008.8 009.0, 009.1, 558
DiseasesDB30726
eMedicineemerg/213
MeSHD005759

Kimataifa, kesi nyingi katika watoto husababiswa na rotavirusi.[2] Kwa watu wazima, norovirusi[3] na kampilobakteria[4] ni kawaida zaidi. Chini ya kawaida ni pamoja na sababu nyingine bakteria (au sumu yao) na vimelea.

Maambukizi yanaweza kutokana na matumizi ya vyakula visivyo tayari au maji yenye vimelea au kupitia mahusiano ya karibu na watu ambao wameambukizwa. Gastroenteritisi kimsingi huathiri watoto na wale walio katika nchi zinazoendelea.

Msaada muhimu zaidi ni kunywa maji yenye chumvi na sukari. Kwa kesi kali zaidi, maji katika mishipa inaweza kuhitajika.

Dalili na Ishara

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Bristol Stool Scale inoanyesha aina 7 za kuharisha.

Gastroenteritisi kwa kawaida inahusisha kuharisha na kutapika,[5] au chini ya kawaida, inatoa moja au nyingine.[1] kupata kiharusi Msokoto inaweza pia kuwa sasa.[1] Ishara na dalili kwa kawaida huanza masaa 12–72 baada ya kuambulizwa.[6] Ikitokana na virusi, hali kawaida kusudi ndani ya wiki moja.[5] Sababu baadhi ya virusi pia inaweza kuhusishwa na homa, uchovu, maumivu ya kichwa na maumivu ya misuli.[5] Kama ni ugonjwa wa kuhara damu, sababu ni chini ya uwekano wa kuwa na virusi[5] na uwezekano mkubwa wa kuwa bakteria.[7] Maambukizi ya bakteria baadhi yake yanaweza kuhusishwa na maumivu makali ya tumbo na kudumu kwa wiki kadhaa.[7]

Watoto walioambukizwa na rotavirusi kwa kawaida hupona ndani ya siku tatu mpaka nane.[8] Hata hivyo, katika nchi maskini matibabu kwa maambukizi makali ni mara nyingi nje ya urahisi wa kufikiwa na kuendelea kuharisha ni ya kawaida.[9] Kuishiwa maji mwilini ni matatizo ya kawaida ya kuharisha,[10][11]Maambukizo ya kurudia ni kawaida kuonekana katika maeneo yenye usafi duni wa mazingira, na utapiamlo,[6] kudumaa ukuaji, na ya muda mrefu ucheleweshaji utambuzi inaweza kusababisha.[12]

Tendaji arthritis hutokea katika 1% ya watu kufuatia maambukizi na aina kampylobakta, na Dalili ya Guillain-Barre hutokea katika 0.1%.[7] Dalili ya Hemolytic uremic (HUS) yanaweza kutokea kama matokeo ya maambukizi kwa Shiga sumu- ya kuzalisha Escherichia coli au Shigella, kusababisha thrombocytopenia, figo kushindwa kazi, na anemia.[13] Watoto ni wepesi zaidi kupata HUS kuliko watu wazima.[12] Baadhi ya maambukizi ya virusi huweza kuzalisha kifafa cha watoto.[1]

Sababu

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Virusi (hasa rotavirusi) na bakteria Escherichia coli na aina Kampilobakteria ni msingi wa sababu za uvimbe wa tumbo.[14][6] Hata hivyo kuna mawakala wengine wengi ambao wanaweza kusababisha hii dalili.[12]Sababu zisizo kuambukiza ni kuonekana juu ya tukio, lakini wao mdogo kuliko etiolojia ya virusi au bakteria.[1] Hatari ya maambukizi ni kubwa kwa watoto kutokana na ukosefu wao wa kingamwili na usafi duni.[1]

Virusi

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Virusi ambavyo vinajulikana kusababisha uvimbe wa tumbo ni pamoja na rotavirusi, norovirusi, adenovirusi, na astrovirusi.[5][15] Rotavirus ni sababu ya gastroenteritis katika watoto,[14] na inazalisha viwango vya matukio yanayofanana katikadeveloped ulimwengu zinazoendelea na ulimwengu zilizoendelea zote mbili.[8] Virusi kusababisha kuhusu 70% ya matukio ya kuharisha kuambukiza katika kundi watoto umri.[16] Rotavirus ni sababu chini ya kawaida kwa watu wazima kutokana na kinga yachuma.[17]

Norovirus ni sababu inayoongoza ya gastroenteritisi miongoni mwa watu wazima nchini Marekani, na kusababisha zaidi ya 90% ya kuzuka.[5] Hizi kufanya ya mahali magonjwa ya milipuko kawaida kutokea wakati makundi ya watu kutumia muda katika ukaribu wa karibu wa kimwili kwa kila mmoja, kama vile kwenye cruise meli,[5] katika hospitali, au katika migahawa.[1] Watu wanaweza kubaki kuambukiza hata baada ya kuhara zao kumalizika.[5] Norovirus ni sababu ya juu ya 10% ya kesi katika watoto.<refname=EBMED2010/>

Bakteria

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Salmonella enterica serovar Typhimurium (ATCC 14028) as seen with a microscope at 1000 fold magnification and following Gram staining.

Katika dunia ya maendeleo Kampylobakta jejuni ni sababu ya msingi ya gastroenteritis bakteria, na nusu ya kesi ya hizi zinazohusiana na yatokanayo yakuku.[7] Kwa watoto, bakteria ni sababu katika kuhusu 15% ya kesi, na aina ya kawaida kuwa Escherichia coli, Salmonella,Shigella,na aina kampilobakta.[16] kama chakula inakuwa kuingiwa na bakteria na kuzidisha kuongeza hatari ya maambukizi katika wale ambao hutumia chakula.[12] Baadi ya vyakula kawaida yanayohusiana na ugonjwa ni pamoja na mbichi au nyama,kuku,daga, mayai na ; sprouts ghafi; maziwa siomalisho na jibini laini; na matunda na juisi za mboga.[18] Katika nchi zinazoendelea , hasa Afrika kusini mwa Sahara na Asia, kipindupindu ni sababu ya kawaida ya gastroenteritis.Maambukizi hii ni kawaida ya zinaa na maji yenye vimelea au chakula.[19]

Clostridium difficile ni sababu muhimu ya kuharisha kwamba hutokea mara nyingi zaidi katika wazee.[12] Watoto wachanga wanaweza kubeba bakteria hawa bila dalili zinazoendelea.[12] Ni sababu ya kawaida ya kuharisha katika wale hospitalini na ni mara nyingi zinazohusiana na matumizi na kiuvijasumu.[20]Staphylococcus aureus kuharisha kuambukiza pia huweza kutokea katika wale ambao wamekuwa wakitumia kiuvijasumu.[21] "Kuharisha traveler" ni kawaida ya aina ya gastroenteritis bakteria. Acid-kukandamiza dawa inaonekana kuongeza hatari ya maambukizi ya muhimu baada ya kukumbana na idadi ya viumbe, ikiwa ni pamojaClostridium difficile, Salmonella, na aina Kampylobakta.[22] Hatari ni kubwa zaidi katika wale kuchukuproton pump inhibitors kuliko na H2 antagonists pinzani.[22]

Vimelea

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Idadi ya Protozoa inaweza kusababisha uvimbe wa tumbo – kawaida Giardia lamblia – lakini histolytica Entamoeba naCryptosporidium pia wamekuwa wakihusishwa.[16] Kama kikundi, hawa mawakala wanaunda kuhusu 10% ya kesi katika watoto.[13] Giardia hutokea zaidi ya kawaida katika nchi zinazoendelea , lakini hii wakala etiologic husababisha aina hii ya ugonjwa kwa kiasi fulani karibu kila mahali.[23]Ni kawaida hutokea zaidi katika watu ambao alisafiri kwa maeneo yaliyo na kiwango cha maambukizi ya juu,watoto ambao kuhudhuria siku ya huduma, wanaume wanafanya mapenzi na wanaume, na majanga kufuatia.[23]

Uenezi

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Maambukizi yanaweza kutokea kupitia matumizi ya maji machafu, au wakati watu kushiriki vitu binafsi.[6] Katika maeneo na misimu ya mvua na ukame, ubora wa maji kwa kawaida ina ongezeka wakati wa mvua, na hii ina uwiano na wakati wa milipuko.[6] Namaeneo ya dunia na misimu, maambukizi ni zaidi ya kawaida katika majira ya baridi.[12] Chupa-kulisha watoto mchanga na chupa yenye ya udhibiti afya ni sababu muhimu kwa kiwango cha kimataifa.[6] Maambukizi Viwango ni pia kuhusiana na hali duni ya usafi, hasa miongoni mwa watoto,[5] ,Katika kaya inaishi,[24] and in na katika wale walio na hali ya awali iliyopo maskini wa lishe.[12] Baada ya kuendeleza uvumilivu, watu wazima wanaweza kubeba viumbe fulani bila kuonyesha ishara au dalili, na hivyo kitendo kama hifadhi ya asilinatural reservoirs ya uambukizaji.[12] Wakati Baadhi ya mawakala(kama vile Shigella) tu kutokea katika jamii ya nyani, wengine huwezi kutokea katika aina mbalimbali ya wanyama(kama vile Giardia).[12]

Pasho-Kuambukiza

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Kuna idadi ya sababu zisizokuambukiza ya kuvimba njia ya utumbo.[1] Baada ya zaidi ya kawaida ni pamoja na dawa (kamaNSAIDs), baadi ya vyakula kama vile laktosi ( katika wale ambao ni siovumilivu), na gluten (katika wale wenyeugonjwa wa coeliac).Ugonjwa ya Crohn pia ni Chanzo zisizo maambukizi ya ( mara nyingi kali) gastroenteritis.[1] Mangonjwa ya sekondari kwa sumuinaweza pia kutokea. Baadi ya chakula kuhusiana hali ya kuhusiana na kichefuchefu, kuhara kutapika, na ni pamoja na: Ciguatera ciguatera sumu kutokana na matumizi ya samaki zilizosibikwa walao nyama, scombroid yanayohusiana na matumizi ya aina fulani ya samaki kuharibiwa, tetrodotoxin sumu kutoka matumizi ya samaki puffer miongoni mwa wengine, na botulism kawaida kutokana na chakula enye sio vizuri na salama.[25]

Pathofiziolojia

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Gastroenteritisi hufafanuliwa kama kutapika au kuharisha kutokana na maambukizi ya bowel ndogo au bowel kubwa.[12] Mabadiliko katika tumbo ni kawaida enye aiko - uvimbe, wakati wale katika matumbo kubwa ni uchochezi .[12]Idadi ya vijidudu ina shurutishwa kusababisha maambukizi inatofautiana kutoka wachache kama moja (kwa Cryptosporidium)kama wengi kama 108 (kwaVibrio cholerae).[12]

Uagizi

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Gastroenteritis ni kawaida kukutwa hospitalini, kwa kuzingatia dalili ya mtu na dalili.[5] Kuamua sababu Halisi ni kawaida si zinahitajika kama haina kubadilisha usimamizi wa hali hiyo.[6] Hata hivyo, kinyesi utamadunilazima kufanywa katika wale walio na damu katika kinyesi, wale ambao wanaweza kuwa wazi kwasumu ya chakula, na wale ambao hivi karibuni walisafiri kwa nchi zinazoendelea.[16] Kupima uchunguzi pia inaweza kufanyika kwa uchunguzi.[5] kama hypoglycemia hutokea katika 10% ya watoto wachanga na watoto wadogo ,kupima serum ya glucose katika idadi hii ni ilipendekeza.[11] Elektroliti na shuguli ya figo lazima pia kuwa kagua wakati kuna wasiwasi kuhusu kupungua maji mwilini.[16]

Kuishiwa maji

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Uamuzi wa kama au mtu ana upungufu wa maji mwilini ni sehemu muhimu ya tathmini, pamoja na upungufu wa maji mwilini kawaida kugawanywa katika kali(3–5%), wastani (6–9%), na kali (≥10%)kesi.[1] Kwa watoto, sahihi zaidi ishara za kuishiwa maji wastani au kali ni wa muda mrefu kapilari refill, maskini ngozi turgor, na kinga isiyo ya kawaida.[11][26] Nyingine muhimu matokeo(wakati kutumika katika macho ) ni pamoja na macho sunken,shughuli ilipungua, ukosefu wa machozi, na kinywa kavua.[1] Kawaida ya mkojo pato na ulaji simulizi maji ni ya kuridhisha.[11] Maabara ya kupima ni ya faida ndogo ya kliniki katika kuamua kiwango cha upungufu wa maji mwilini..[1]

Tofauti ya utambuzi

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Sababu nyingine ya uwezo wa ishara na dalili kwamba mwigaji kuonekana katika gastroenteritis kwamba haja ya kuwa ilitawala nje ni pamoja na ugonjwa wa kidole tumbo,volvulus, Ugonjwa wa vuimbe wa tumbo, maambukizi ya njia ya mkojo,s, na kisukari mellitus.[16] Kutojitosheleza kongosho,short bowel syndrome, ugonjwa ya whipple, ugonjwa ya coeliac, na unyanyasaji haluli lazima pia kuchukuliwa.[27] utambuzi tofauti unaweza kuwa mgumu kiasi fulani kama mtu ku onyesha tu kutapika au kuharisha (kuliko wote).[1]

Kidole tumbo yanaweza kuwasilisha na kutapika, maumivu ya tumbo, na kiasi kidogo cha kuhatisha katika hadi 33% ya kesi .[1] Hii ni tofauti na kiasi kikubwa cha kuharisha kwamba ni mfano wa gastroenteritis.[1] Maambukizi ya mapafu au njia ya mkojo kwa watoto huweza pia kusababisha kutapika au kuharahisha.[1] dkisukari ketoasidosisi ya zamani (DKA) kwa wakati huu na maumivu ya tumbo, kuchefuchefu, na kutapika, lakini bila kuharisha.[1] Utafiti mmoja kupatikana kwamba 17% ya watoto wenye DKA awali walikuwa wametambuliwa kama kuwa gastroenteritis.[1]

Kinga

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Percentage of rotavirus tests with positive results, by surveillance week, United States, July 2000 – June 2009.

Mtindo wa maisha

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Usambazaji wa maji kwa urahisi siochafuka na mazoea mazuri ya usafi wa mazingira ni muhimu kwa ajili ya kupunguza Viwango vya maambukizi na gastroenteritis hospitalini muhimu.[12] Hatua ya binafsi ( kama vile kuosha mkono) wamekuwa kupatikana kupungua matukio na viwango vya maambukizi ya gastroenteritis katika ulimwengu zinazoendelea na maendeleo kwa % kama vile 30%.[11] Pombe makao mageli inaweza pia kuwa na ufanisi.[11] Kunyonyesha ni muhimu, hasa katika maeneo na hali duni ya usafi, kama ni uboreshaji wa usafi kwa ujumla.[6] Maziwa ya Matiti inapunguza wote mzunguko wa maambukizo na muda wao.[1] Kuepuka zilizosibikwa chakula au kinywaji lazima pia kuwa na ufanisi.[28]

Chanjo

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Kutokana na ufanisi wake wote na usalama, mwaka 2009 Shirika la Afya Duniani ilipendekeza kwamba Chanjo rotavirus itatolewa kwa watoto wote duniani.[29][14] Mbili ya kibiashara chanjo ya rotavirus zipo na zaidi kadhaa ni katika maendeleo.[29] Katika Afrika na Asia hizi chanjo kupunguzwa ugonjwa kali miongoni mwa watoto wachanga [29] na nchi ambazo kuweka katika mipango ya kitaifa ya chanjo mahali nimeona kushika kwa viwango na ukali wa ugonjwa huo. [30][31] Chanjo hii pia inaweza kuzuia ugonjwa katika watoto wasio chanjo kwa kupunguza idadi ya maambukizi zinazozunguka.[32] Tangu mwaka 2000, utekelezaji wa programu ya chanjo katika rotavirus Marekani imekuwa kikubwa kupungua idadi ya kesi ya kuhara kwa asilimia nyingi kama 80kwa kila mia.[33][34][35] dozi ya kwanza itolewe kwa watoto wachanga kati ya wiki 6 na 15 ya umri.[14] The oral cholera vaccine simuiizi chanjo ya kipindupindu imekuwa kupatikana kwa kuwa 50–60% ufanisi zaidi ya miaka 2  .[36]

Utaratibu wa Kimatibabu

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Gastroenteritis ni kawaida ugonjwa papo hapo na kujitegemea kikwazo kwamba hauhitaji dawa.[10] matibabu kupenda zaidi katika wale wenye mpole na maji mwilini wastani ni simulizi kuweka maji tiba (ORT).[13] Metoclopramide na/au ondansetron, hata hivyo, inaweza kuwa msaada katika baadhi ya watoto,[37] nabutylscopolamine ni muhimu katika kutibu katika maumivu ya tumbo.[38]

Kuongeza maji

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Matibabu ya msingi ya gastroenteritis katika bote watoto na watu ni kuweka maji. Hii ni ikiwezekana mafanikio kwa tiba ya mdomo ya kuweka maji, ingawa utoaji katika mishipa kutakiwa kama kunangazi ilipungua fahamu kama maji mwilini ni kali.[39][40] Mdomo badala tiba bidhaa kufanywa na wanga tata(i.e. yaani wale alifanya kutoka ngano au mchele)inaweza kuwa ni bora kuliko wale makao juu ya sukari.[41] Vinywaji hasa yulu katika sukari, kama vile vinywaji baridi na juisi matunda, si ilipendekeza kwa watoto chini ya miaka umri 5 kama wanaweza kuongeza kuharisha.[10] Maji wazi inaweza kutumika kama maalum zaidi na ufanisi ORT maandalizi ni hapayo au si mazuri.[10] A tube nasogastric inaweza kutumika kwa watoto wadogo kusimamia maji maji kama ya kuhalalisha.[16]

Malazi

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Inapendekezwa kwamba kunyonyesha watoto wachanga kuendelea kuwa ku muuguzi katika mtindo wa kawaida, na kwamba watoto wachanga fomyula-kulishwa kuendelea fomyula yao mara baada ya kuweka maji na ORT.[42] Laktosi-free au laktosi- ya kushuka fomyula kawaida si muhimu.[42]Watoto wanapashwa kuendelea mlo wao wa kawaida wakati wa matukio ya kuharisha na ubaguzi vyakula yulu saana katika ni Rahisi sukariziepukwe.<refname=MMWR2003/> mlo BRAT (ndizi, mchele, sosi ya tufaha, mkati ya kuchoma na chai) ni tena ilipendekeza, kama ina virutubisho haitoshi na haina faida juu ya kulisha kawaida.[42] Probiotics Baadhi wamekuwa umeonyesha kuwa na manufaa katika kupunguza muda wote wa ugonjwa na marudio ya stuli[43]Wanaweza pia kuwa na manufaa katika kuzuia na kutibu kiuvijasumu kuhusishwa kuharisha. [44] Maziwa bidhaa mchachuko (kama vile mtindi) ni vile vile manufaa .[45] Zinkinyongeza inaonekana kuwa na ufanisi katika wawili kutibu na kuzuia kuharisha miongoni mwa watoto katika nchi zinazoendelea.[46]

Antiemetics

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Dawa Antiemetic inaweza kuwa na manufaa kwa ajili ya kutibu kutapika katika watoto.Ondansetron ina baadhi ya shirika, na dozi moja isihusishwe na haja kidogo kwa ajili ya maji katika mishipa, hospitalini wachache, na kutapika inapungua. [47][48][49] Metoclopramideili pia kuwa na manufaa.[49] Hata hivyo, matumizi ya ondansetron pengine kuhusishwa na kiwango cha ongezeko la kurudi katika hospitali ya watoto.[50] Maandalizi katika mishipa ondansetron inaweza kutolewa kwa mdomo ikiwa vibali kliniki hukumu.[51]Dimenhydrinate,wakati kupunguza kutapika, haionekani kuwa muhimu kliniki faida.[1]

Vijasumu

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Vijasumu si kawaida kutumika kwa ajili ya gastroenteritis, ingawa wakati mwingine ilipendekeza hasa kama dalili ni kali.[52] au kama wanahusika sababu bakteria pekee au watuhumiwa.[53] Kama kiuvijasumu ni kwa kuajiriwa, macrolide ( kama vile azithromycin) ni ku penda zaidi ya fluoroquinolone kutokana na viwango vya juu vya upinzani na karibuni.[7] Pseudomembranous colitis, kawaida husababishwa na matumizi ya antibiotiki, inasimamiwa na kutoendelea na wakala visababishi na kutibu kwa aidha metronidazole au vancomycin.<refname="Mandell"/>Bakteria na protozoans kwamba ni amenable kwa matibabu pamoja na Shigella[54] Salmonellatyphi,[55] na‘Giardia spishi.<refname=Giar2010/> Katika wale wenye na Giardia spishi au Entamoeba histolytica, matibabu tinidazole inapendekeza na kushinda metronidazole.[56]<refname=Giar2010/> Shirika la afya Duniani (WHO) inapendekeza matumizi ya antibiotics kwa watoto wadogo ambao wana wawili wa damu na kuharisha na homa. [1]

Antimotility mawakala

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Antimotility dawa ina hatari ya kusababisha matatizo ya kinadharia, na ingawa uzoefu kliniki umeonyesha kuwa huu ni uwezekano, name="Oxford"/> dawa hizi ni tamaa katika watu na umwagaji damu kuhara au kuhara kwamba ni ngumu kwa homa. Loperamide, opioidi mfano wa afyuni , ni kawaida hutumiwa kwa ajili ya matibabu ya dalili kuharisha.[57] Loperamide haifai kwa watoto, hata hivyo, kama inaweza kuvuka machanga damu-ubongo kizuizi na kusababisha kusumisha. Bismuth subsalicylate, tata hakuna wa bismuth na salicylate, inaweza kutumika katika kesi kali kwa wastani,[27] lakinisalicylate sumu ni kinadharia iwezekanavyo.[1]

Epidemiolojia

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Uenezi wa kuharisha kati ya wakazi 100,000 mwaka 2004.
     no data      ≤less 500      500–1000      1000–1500      1500–2000      2000–2500      2500–3000
     3000–3500      3500–4000      4000–4500      4500–5000      5000–6000      ≥6000

Inakadiriwa kuwa kesi 3-5000000000 ya gastroenteritis kutokea duniani kila mwaka, [58] kimsingi unaathiri watoto nayanayoendelea duniani.[6] ni ulisababisha vifo vya watu milioni 1.3 kwa watoto chini ya miaka mitano kama ya 2008,[59] na zaidi ya hayo yanayotokea katika mataifa maskini zaidi duniani.[12]Zaidi ya 450,000 ya vifo haya ni kutokana na rotavirus kwa watoto chini ya miaka umri 5.[60][61]Cholera Kipindupindu husababisha kesi kuhusu 3-5,000,000 ya ugonjwa na unaua takriban watu 100,000 kila mwaka.[19] Katika watoto kuendeleza dunia chini ya miaka miwili ya umri mara nyingi kupata maambukizi sita au zaidi mwaka kwamba matokeo katika gastroenteritis hospitalini muhimu.[12] Ni chini ya kawaida kwa watu wazima, kutokana na maendeleo ya kinga.[5]

Mwaka 1980, kutokana na sababu zote gastroenteritis yaliyosababisha vifo milioni 4.6 kwa watoto, na wengi kutokea katika nchi zinazoendelea.[62] Viwango vya kifo walikuwa kupunguzwa kwa kiasi kikubwa (kwa takriban milioni 1.5 vifo kila mwaka) kwa mwaka 2000, kwa kiasi kikubwa kutokana na kuanzishwa na kuenea kwa matumizi yatiba ya ndomo ya kuweka maji.[63] Nchini Marekani, maambukizi kusababisha uvimbe wa tumbo ni maambukizi ya pili ya kawaida ( baada ya kawaida ya baridi), na wao kusababisha kesi kati ya 200 na 375 milioni ya kuharisha papo [5][12] na takriban elfu kumi vifo kila mwaka,[12] na 150-300 ya vifo hivi kwa watoto chini ya miaka mitano.[1]

Historia

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matumizi ya kwanza ya "gastroenteritis" ilikuwa katika 1825.[64] Kabla ya wakati huu ni zaidi hasa inayojulikana kamahoma ya matumbo au "kipindupindu morbus", miongoni mwa wengine, au chini hasa kama "kushisha ya matumbo", "wingi", "Flux", "mchango", "malalamiko ya tumbo", au moja ya idadi ya majina mengine ya kizamani kwa kuharisha papo hapo.[65]

Jamii na utamadumi

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Gastroenteritis ni kuhusishwa na majina mengi ya simo, ikiwa ni pamoja na "Montezuma wa kisasi", "Delhi tumbo", "la turista", na "sprint nyuma mlango", miongoni mwengine.[12] Ni imekuwa na jukumu katika kampeni nyingi za kijeshi na ni kuamini kuwa asili ya neno "matumbo hakuna hakuna utukufu".[12].

Gastroenteritis ni sababu kuu ya ziara milioni 3.7 kwa madaktari mwaka nchini Marekani[1] na 3,000,000 ya ziara nchini Ufaransa.[66] In the United States gastroenteritis as a whole is believed to result in costs of 23 billion USD per year[67] Uvimbe wa tumbo na Marekani kwa ujumla inaaminika kusababisha gharama ya bilioni 23 mwaka USD kwa mwaka. Na kwamba kutokana na rotavirus peke kusababisha Makadirio ya gharama za dola bilioni 1 mwaka huu[1]

Utafiti

hariri

Kuna idadi ya chanjo dhidi ya gastroenteritis katika maendeleo. Kwa mfano, chanjo dhidi ya Shigella na enterotoxigenic Escherichia coli (ETEC), mbili ya sababu ya kuongoza bakteria wa gastroenteritis duniani kote.[68][69]

Katika wanyama

hariri

Gastroenteritisi katika paka na mbwa inasababishwa na wengi wa mawakala sawa kwa binadamu: wa kawaida ni:Kampilobakteria, Clostridium difficile, Clostridium perfringens na Salmonella.[70] idadi kubwa ya mimea sumu huweza pia kusababisha dalili. [71] Baadhi ya mawakala ni maalumu zaidi ya aina fulani.Magonjwa gastroenteritis coronavirus(TGEV) hutokea katika nguruwe kusababisha kutapika, kuishiwa maji kuhara.[72] Inaaminika kuwa vishawishi kwa nguruwe na ndege wa pori na hakuna tiba maalumu inapatikana.[73] Ni si uambukizaji kwa binadamu. [74].

Tanbihi

hariri
  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 Singh, Amandeep (2010). "Pediatric Emergency Medicine Practice Acute Gastroenteritis — An Update". Emergency Medicine Practice. 7 (7). {{cite journal}}: Unknown parameter |month= ignored (help)
  2. ↑ Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD (2012). "2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis". The Lancet Infectious Diseases. 12 (2): 136–41. doi:10.1016/S1473-3099(11)70253-5. PMID 22030330. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  3. ↑ Marshall JA, Bruggink LD (2011). "The dynamics of norovirus outbreak epidemics: recent insights". International Journal of Environmental Research and Public Health. 8 (4): 1141–9. doi:10.3390/ijerph8041141. PMC 3118882. PMID 21695033. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: unflagged free DOI (link)
  4. ↑ Man SM (2011). "The clinical importance of emerging Campylobacter species". Nature Reviews. Gastroenterology & Hepatology. 8 (12): 669–85. doi:10.1038/nrgastro.2011.191. PMID 22025030. {{cite journal}}: Unknown parameter |month= ignored (help)
  5. ↑ 5.00 5.01 5.02 5.03 5.04 5.05 5.06 5.07 5.08 5.09 5.10 5.11 5.12 Eckardt AJ, Baumgart DC (2011). "Viral gastroenteritis in adults". Recent Patents on Anti-infective Drug Discovery. 6 (1): 54–63. PMID 21210762. {{cite journal}}: Unknown parameter |month= ignored (help)
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 Kigezo:Citebook
  7. ↑ 7.0 7.1 7.2 7.3 7.4 Galanis, E (2007Sep 11). "Campylobacter and bacterial gastroenteritis. journal=CMAJ : Canadian Medical Association". 177 (6): 5701. doi:10.1503/cmaj.070660. PMC 1963361. PMID 17846438. {{cite journal}}: Check date values in: |date= (help); Cite journal requires |journal= (help); Missing pipe in: |title= (help)
  8. ↑ 8.0 8.1 Meloni, A (2011 Oct). "Epidemiology and prevention of rotavirus infection: an underestimated issue?". The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 24 Suppl 2: 48–51. doi:10.3109/14767058.2011.601920. PMID 21749188. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  9. ↑ Toolkit. DefeatDD. Retrieved on 3 May 2012.
  10. ↑ 10.0 10.1 10.2 10.3 "Management of acute diarrhoea and vomiting due to gastoenteritis in children under 5". National Institute of Clinical Excellence. 2009. {{cite web}}: Unknown parameter |month= ignored (help)
  11. ↑ 11.0 11.1 11.2 11.3 11.4 11.5 Tintinalli, Judith E. (2010). Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)). New York: McGraw-Hill Companies. ku. 830–839. ISBN 0-07-1484809.
  12. ↑ 12.00 12.01 12.02 12.03 12.04 12.05 12.06 12.07 12.08 12.09 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 Mandell 2010 Chp. 93
  13. ↑ 13.0 13.1 13.2 Elliott, EJ (2007 Jan 6). "Acute gastroenteritis in children". BMJ (Clinical research ed.). 334 (7583): 35–40. doi:10.1136/bmj.39036.406169.80. PMC 1764079. PMID 17204802. {{cite journal}}: Check date values in: |date= (help)
  14. ↑ 14.0 14.1 14.2 14.3 Szajewska, H (2010 Jan). "Gastrointestinal infections in the pediatric population". Currentopinion in gastroenterology. 26 (1): 3644. doi:10.1097/MOG.0b013e328333d799. PMID 19887936. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  15. ↑ Dennehy PH (2011). "Viral gastroenteritis in children". The Pediatric Infectious Disease Journal. 30 (1): 63–4. doi:10.1097/INF.0b013e3182059102. PMID 21173676. {{cite journal}}: Unknown parameter |month= ignored (help)
  16. ↑ 16.0 16.1 16.2 16.3 16.4 16.5 16.6 Webb, A (2005 Apr). "Acute gastroenteritis in children". Australian family physician. 34 (4): 227–31. PMID 15861741. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  17. ↑ Desselberger U, Huppertz HI (2011). "Immune responses to rotavirus infection and vaccination and associated correlates of protection". The Journal of Infectious Diseases. 203 (2): 188–95. doi:10.1093/infdis/jiq031. PMC 3071058. PMID 21288818. {{cite journal}}: Unknown parameter |month= ignored (help)
  18. ↑ Nyachuba, DG (2010 May). "Foodborne illness: is it on the rise?". Nutrition Reviews. 68 (5): 25769. doi:10.1111/j.1753-4887.2010.00286.x. PMID 20500787. {{cite journal}}: Check date values in: |date= (help)
  19. ↑ 19.0 19.1 Charles, RC (2011Oct). "Cholera in the 21st century". Current opinion in infectious diseases. 24 (5): 4727. doi:10.1097/QCO.0b013e32834a88af. PMID 21799407. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  20. ↑ Moudgal, V (2012 Feb). "Clostridium difficile colitis: a review". Hospital practice (1995). 40 (1): 139–48. doi:10.3810/hp.2012.02.954. PMID 22406889. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  21. ↑ Lin, Z (2010 May). "Staphylococcal enterocolitis: forgotten but not gone?". Digestive diseases and sciences. 55 (5): 1200–7. PMID 19609675. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  22. ↑ 22.0 22.1 Leonard, J (2007 Sep). "Systematic review of the risk of enteric infection in patients taking acid suppression". The American journal of gastroenterology. 102 (9): 2047–56, quiz 2057. doi:10.1111/j.1572-0241.2007.01275.x. PMID 17509031. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  23. ↑ 23.0 23.1 Escobedo, AA. "Giardiasis: the ever-present threat of a neglected disease". Infectious disorders drug targets date=2010Oct. 10 (5): 32948. PMID 20701575. {{cite journal}}: Missing pipe in: |journal= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  24. ↑ Kigezo:Cite journal last=Grimwood
  25. ↑ Lawrence, DT (2007 May). "Food poisoning". Emergency medicine clinics of North America. 25 (2): 357–73, abstract ix. doi:10.1016/j.emc.2007.02.014. PMID 17482025. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  26. ↑ Steiner, MJ (2004 Jun 9). "Is this child dehydrated?". JAMA : the Journal of the American Medical Association. 291 (22): 2746–54. doi:10.1001/jama.291.22.2746. PMID 15187057. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  27. ↑ 27.0 27.1 Warrell D.A., Cox T.M., Firth J.D., Benz E.J., mhr. (2003). The Oxford Textbook of Medicine (tol. la 4th). Oxford University Press. ISBN 0-19-262922-0. Ilihifadhiwa kwenye nyaraka kutoka chanzo mnamo 2012-03-21. Iliwekwa mnamo 2013-03-06. {{cite book}}: Unknown parameter |= ignored (help); Unknown parameter |dead-url= ignored (|url-status= suggested) (help)CS1 maint: multiple names: editors list (link)
  28. ↑ Kigezo:Cite web title=Viral Gastroenteritis
  29. ↑ 29.0 29.1 29.2 World Health Organization (2009). "Rotavirus vaccines: an update" (PDF). Weekly epidemiological record. 51–52 (84): 533–540. Iliwekwa mnamo 10 Mei 2012. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: date auto-translated (link)
  30. ↑ Giaquinto, C (July). "Summary of effectiveness and impact of rotavirus vaccination with the oral pentavalent rotavirus vaccine: a systematic review of the experience in industrialized countries". Human Vaccines. 7. 7: 734–748. doi:10.4161/hv.7.7.15511. PMID 21734466. Iliwekwa mnamo 10 May 2012. {{cite journal}}: Check date values in: |year= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  31. ↑ Jiang, V (2010). "Performance of rotavirus vaccines in developed and developing countries". Human Vaccines. 6 (7): 532–542. PMID 20622508. Iliwekwa mnamo 10 Mei 2012. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)CS1 maint: date auto-translated (link)
  32. ↑ Patel, MM (2011 Jan). "Real-world impact of rotavirus vaccination". The Pediatric Infectious Disease Journal. 30 (1 Suppl): S1-5. doi:10.1097/INF.0b013e3181fefa1f. PMID 21183833. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  33. ↑ US Center for Disease Control and Prevention (2008). "Delayed onset and diminished magnitude of rotavirus activity—United States, November 2007 – May 2008". Morbidity and Mortality Weekly Report. 57 (25): 697–700. Iliwekwa mnamo 3 Mei 2012.{{cite journal}}: CS1 maint: date auto-translated (link)
  34. ↑ "Reduction in rotavirus after vaccine introduction—United States, 2000–2009". MMWR Morb. Mortal. Wkly. Rep. 58 (41): 1146–9. 2009. PMID 19847149. {{cite journal}}: Unknown parameter |month= ignored (help)
  35. ↑ Tate, JE (2011 Jan). "Uptake, impact, and effectiveness of rotavirus vaccination in the United States: review of the first 3 years of postlicensure data". The Pediatric Infectious Disease Journal. 30 (1Suppl): S5660. doi:10.1097/INF.0b013e3181fefdc0. PMID 21183842. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  36. ↑ Sinclair, D (2011Mar16). "Oral vaccines for preventing cholera". Cochrane database of systematic reviews (Online) (3): CD008603. doi:10.1002/14651858.CD008603.pub2. PMID 21412922. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  37. ↑ Alhashimi D, Al-Hashimi H, Fedorowicz Z (2009). Alhashimi, Dunia (mhr.). "Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents". Cochrane Database Syst Rev (2): CD005506. doi:10.1002/14651858.CD005506.pub4. PMID 19370620.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  38. ↑ Tytgat GN (2007). "Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain". Drugs. 67 (9): 1343–57. PMID 17547475.
  39. ↑ "BestBets: Fluid Treatment of Gastroenteritis in Adults". Ilihifadhiwa kwenye nyaraka kutoka chanzo mnamo 2009-02-12. Iliwekwa mnamo 2013-03-06.
  40. ↑ Canavan A, Arant BS (2009). "Diagnosis and management of dehydration in children". AmFam Physician. 80 (7): 692–6. PMID 19817339. {{cite journal}}: Unknown parameter |month= ignored (help)
  41. ↑ Gregorio GV, Gonzales ML, Dans LF, Martinez EG (2009). Gregorio, Germana V (mhr.). "Polymer-based oral rehydration solution for treating acute watery diarrhoea". Cochrane Database Syst Rev (2): CD006519. doi:10.1002/14651858.CD006519.pub2. PMID 19370638.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  42. ↑ 42.0 42.1 42.2 King CK, Glass R, Bresee JS, Duggan C (2003). "Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy". MMWR Recomm Rep. 52 (RR-16): 1–16. PMID 14627948. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  43. ↑ Allen SJ, Martinez EG, Gregorio GV, Dans LF (2010). Allen, StephenJ (mhr.). "Probiotics for treating acute infectious diarrhoea". Cochrane DatabaseSystRev. 11 (11): CD003048. doi:10.1002/14651858.CD003048.pub3. PMID 21069673.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  44. ↑ Hempel, S (2012May9). "Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis". JAMA : the journal of the American MedicalAssociation. 307 (18): 1959–69. PMID 22570464. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  45. ↑ Mackway-Jones, Kevin (2007). "Does yogurt decrease acute diarrhoeal symptoms in children with acute gastroenteritis?". BestBets. Ilihifadhiwa kwenye nyaraka kutoka chanzo mnamo 2013-05-17. Iliwekwa mnamo 2013-03-06. {{cite web}}: Unknown parameter |month= ignored (help)
  46. ↑ Telmesani, AM (2010 May). "Oral rehydration salts, zinc supplement and rota virus vaccine in the management of childhood acute diarrhea". Journal of family and community medicine. 17 (2): 7982. doi:10.4103/1319-1683.71988. PMC 3045093. PMID 21359029. {{cite journal}}: Check date values in: |date= (help)CS1 maint: unflagged free DOI (link)
  47. ↑ DeCamp LR, Byerley JS, Doshi N, Steiner MJ (2008). "Use of antiemetic agents in acute gastroenteritis: a systematic review and meta-analysis". ArchPediatrAdolescMed. 162 (9): 85865. doi:10.1001/archpedi.162.9.858. PMID 18762604. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  48. ↑ Mehta S, Goldman RD (2006). "Ondansetron for acute gastroenteritis in children". Can Fam Physician. 52 (11): 1397–8. PMC 1783696. {{cite journal}}: Text "pmid17279195" ignored (help)
  49. ↑ 49.0 49.1 Fedorowicz, Z (2011Sep7). "Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents". Cochrane database of systematic reviews (Online). 9 (9): CD005506. doi:10.1002/14651858.CD005506.pub5. PMID 21901699. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  50. ↑ Sturm JJ, Hirsh DA, Schweickert A, Massey R, Simon HK (2010). "Ondansetron use in the pediatric emergency department and effects on hospitalization and return rates: are we masking alternative diagnoses?". AnnEmerg Med. 55 (5): 41522. doi:10.1016/j.annemergmed.2009.11.011. PMID 20031265. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  51. ↑ Ondansetron. Lexi-Comp (May 2011).
  52. ↑ Traa BS, Walker CL, Munos M, Black RE (2010). "Antibiotics for the treatment of dysentery in children". Int J Epidemiol. 39 (Suppl 1): i704. doi:10.1093/ije/dyq024. PMC 2845863. PMID 20348130. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  53. ↑ Grimwood K, Forbes DA (2009). "Acute and persistent diarrhea". Pediatr. Clin. North Am. 56 (6): 134361. doi:10.1016/j.pcl.2009.09.004. PMID 19962025. {{cite journal}}: Unknown parameter |month= ignored (help)
  54. ↑ Christopher, PR (2010Aug4). "Antibiotic therapy for Shigella dysentery". Cochrane database of systematic reviews (Online) (8): CD006784. doi:10.1002/14651858.CD006784.pub4. PMID 20687081. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  55. ↑ Effa, EE (2011 Oct 5). "Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever)". Cochrane database of systematic reviews (Online) (10): CD004530. doi:10.1002/14651858.CD004530.pub4. PMID 21975746. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  56. ↑ Gonzales, ML (2009Apr15). "Antiamoebic drugs for treating amoebic colitis". Cochrane database of systematic reviews (Online) (2): CD006085. doi:10.1002/14651858.CD006085.pub2. PMID 19370624. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  57. ↑ Kigezo:Citebook
  58. ↑ Elliott, EJ (2007Jan6). "Acutegastroenteritis in children". BMJ (Clinical researched.). 334 (7583): 3540. doi:10.1136/bmj.39036.406169.80. PMC 1764079. PMID 17204802. {{cite journal}}: Check date values in: |date= (help)
  59. ↑ Black, RE (2010Jun5). "Global, regional, and national causes of child mortality in 2008: a systematic analysis". Lancet. 375 (9730): 196987. doi:10.1016/S01406736(10)605491. PMID 20466419. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  60. ↑ Tate, JE (2012 Feb). "2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis". The Lancet infectious diseases. 12 (2): 13641. doi:10.1016/S14733099(11)702535. PMID 22030330. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  61. ↑ World Health Organization (2008). "Global networks for surveillance of rotavirus gastroenteritis, 2001–2008" (PDF). Weekly Epidemiological Record. 47 (83): 421–428. Iliwekwa mnamo 10 Mei 2012. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: date auto-translated (link)
  62. ↑ Mandell, Gerald L.; Bennett, John E.; Dolin, Raphael (2004). Mandell's Principles and Practices of Infection Diseases (tol. la 6th). Churchill Livingstone. ISBN 0-443-06643-4. Ilihifadhiwa kwenye nyaraka kutoka chanzo mnamo 2013-10-18. Iliwekwa mnamo 2013-03-06. {{cite book}}: Unknown parameter |dead-url= ignored (|url-status= suggested) (help)
  63. ↑ Victora CG, Bryce J, Fontaine O, Monasch R (2000). "Reducing deaths from diarrhoea through oral rehydration therapy". Bull. World Health Organ. 78 (10): 124655. PMC 2560623. PMID 11100619.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  64. ↑ Gastroenteritis. Oxford English Dictionary 2011. Retrieved on January 15, 2012.
  65. ↑ "Rudy's List of Archaic Medical Terms". Ilihifadhiwa kwenye nyaraka kutoka chanzo mnamo 2007-07-09. Iliwekwa mnamo 2013-03-06. {{cite web}}: Unknown parameter |= ignored (help)
  66. ↑ Flahault, A (2010Nov). "[Epidemiology of viral gastroenteritis in France and Europe]". Bulletin de l'Academie nationale de medecine. 194 (8): 141524, discussion 1424-5. PMID 22046706. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  67. ↑ Albert, edited by Neil S. Skolnik ; associate editor, Ross H. (2008). Essential infectious disease topics for primary care. Totowa, NJ: Humana Press. uk. 66. ISBN 9781588295200. {{cite book}}: |first= has generic name (help)CS1 maint: multiple names: authors list (link)
  68. ↑ World Health Organization. "Enterotoxigenic Escherichia coli (ETEC)". Diarrhoeal Diseases. Ilihifadhiwa kwenye nyaraka kutoka chanzo mnamo 2012-05-15. Iliwekwa mnamo 3 Mei 2012.{{cite web}}: CS1 maint: date auto-translated (link)
  69. ↑ World Health Organization. "Shigellosis". Diarrhoeal Diseases. Iliwekwa mnamo 3 Mei 2012.{{cite web}}: CS1 maint: date auto-translated (link)
  70. ↑ Weese, JS (2011 Mar). "Bacterial enteritis in dogs and cats: diagnosis, therapy, and zoonotic potential". The Veterinary clinics of North America. Small animal practice. 41 (2): 287–309. doi:10.1016/j.cvsm.2010.12.005. PMID 21486637. {{cite journal}}: Check date values in: |date= (help)
  71. ↑ Rousseaux, Wanda Haschek, Matthew Wallig, Colin (2009). Fundamentals of toxicologic pathology (tol. la 2nd ed.). London: Academic. uk. 182. ISBN 9780123704696. {{cite book}}: |edition= has extra text (help)CS1 maint: multiple names: authors list (link)
  72. ↑ MacLachlan, edited na N. James (2009). Fenner's veterinary virology (tol. la 4th ed.). Amsterdam: Elsevier Academic Press. uk. 399. ISBN 9780123751584. {{cite book}}: |edition= has extra text (help); |first= has generic name (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  73. ↑ al.], edited by James G. Fox ... [et (2002). Laboratoryanimal medicine (tol. la 2nd ed.). Amsterdam: Academic Press. uk. 649. ISBN 9780122639517. {{cite book}}: |edition= has extra text (help); |first= has generic name (help)
  74. ↑ al.], edited by Jeffrey J. Zimmerman ... [et. Diseases of swine (tol. la 10thed.). Chichester,WestSussex: Wiley-Blackwell. uk. 504. ISBN 9780813822679. {{cite book}}: |first= has generic name (help)

Marejeo

hariri
  • Dolin, [edited by] Gerald L. Mandell, John E. Bennett, Raphael (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases (tol. la 7th ed.). Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0-443-06839-9. {{cite book}}: |edition= has extra text (help); |first= has generic name (help)CS1 maint: multiple names: authors list (link)
Rudishwa kutoka "https://sw.wikipedia.org/w/index.php?title=Gastroenteritisi&oldid=1351409"