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Sample records for acute infectious diarrhea

  1. The Efficacy of Probiotic in Adults with Acute Infectious Diarrhea

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    Mawin Mahen

    2017-04-01

    Full Text Available Diarrhea is a global health problem with high morbidity and mortality. In developing countries, acute diarrhea is most commonly caused by infectious pathogens. Regardless of the cause, diarrhea is primarily treated by fluid replacement therapy to decrease the risk of dehydration and death, although it does not affect the duration of diarrhea. Probiotics are able to shorten the duration of diarrhea in children, but its efficacy in adults is unclear. This study aimed to evaluate the benefit of probiotic in reducing the duration of acute diarrhea in adults as compared to placebo. Systematic search was done using four databases: PubMed, Scopus, ProQuest, and Embase, without limit on the year of publication. Randomized clinical trials were selected as the appropriate study design to answer the clinical question and two studies were considered relevant for appraisal. In conclusion, probiotics could improve the recovery of acute infectious diarrhea in adults (level of evidence 1b however more studies should be carried out since only very few strains of probiotics have been investigated. Keywords: probiotics, treatment efficacy, acute diarrhea, adults.     Efektivitas Probiotik pada Orang Dewasa dengan Diare:  Sebuah Laporan Kasus Berbasis Bukti   Abstrak Diare merupakan masalah kesehatan global dengan angka morbiditas dan mortalitas yang tinggi. Di negara berkembang, diare akut biasanya disebabkan oleh infeksi. Terlepas dari penyebabnya, tata laksana utama diare adalah terapi rehidrasi untuk mengurangi dehidrasi dan kematian walaupun hal tersebut tidak memengaruhi durasi diare. Probiotik dapat memperpendek durasi diare pada anak-anak, namun efektivitasnya pada orang dewasa masih belum jelas. Tujuan penelitian ini adalah untuk mengevaluasi efek probiotik dalam mengurangi durasi diare akut pada orang dewasa dibandingkan plasebo. Pencarian sistematik dilakukan pada empat database: PubMed, Scopus, ProQuest, dan Embase, tanpa membatasi tahun publikasi

  2. Metabolic disorders in acute infectious diarrhea in children

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    S. V. Khaliullina

    2017-01-01

    Full Text Available The purpose of the study: estimate the frequency of registration of different types of acid-base state disorders in children with acute infectious diarrhea; to determine the clinical features of acute intestinal infections that occur with metabolic acidosis (MA and without it to choose the tactics of effective correction.Мaterials and methods: retrospective cohort study was conducted of 246 patients hospitalized in a hospital with clinic of acute infectious diarrhea.Results of the study: laboratory-confirmed acidosis, were recorded in 40.7% (95% CI 34.6–46.8, 100/246 children, incl. With a pH below 7.25 in 9.3% (95% CI 5–7–12.9, 23/246. The condition of alkalosis revealed in 4.9% (95% CI 2.2–7.6 of 12/246 examined. Hyperchloremic acidosis had a place in 81% (95% CI 73.3–88.7, 81/100 patients, with a high anionic deficiency in 19% (95% CI 11.3–26.7, 19/100, P <0.001. Decompensated MA with pH <7.25 was recorded in 6.2% (95% CI 0.9–11.5, 5/81 examined with hyperchloremic acidosis and in 94.7% (95% CI 84.6–104, 8, 18/19 – with keto- and lactate-acidosis. Subcompensated MA was more often detected with rotavirus infection, RVI (50.6% (95% CI (39.4–61.8, 39/77, p <0.001. Metabolic disorders with RVI were more likely to correspond to acidosis with a high anion gap (52, 6% (95% CI 30.1–75.1 10/19, p=0.02. Bacterial diarrheas were more often observed in children without disturbances of the KHS (22.4% (95% CI 15.3–29, 5, 30/134, p=0.014. In assessing the characteristics of different types of MA we identified that the presence of tachypnea increases the probability of detecting acidosis with a high anion gap of 3.5 times (OR 3.5 CI 1.3–9.3.Conclusion: Our studies didn’t reveal pathognomonic clinical symptoms of various variants of metabolic acidosis.

  3. Lactobacillus reuteri DSM 17938 shortens acute infectious diarrhea in a pediatric outpatient setting

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    Ener Cagri Dinleyici

    2015-08-01

    Full Text Available OBJECTIVE: Two randomized controlled clinical trials have shown thatLactobacillus (L reuteri DSM 17938 reduces the duration of diarrhea in children hospitalized due to acute infectious diarrhea. This was the first trial evaluating the efficacy of L. reuteri DSM 17938 in outpatient children with acute infectious diarrhea.METHODS: This was a multicenter, randomized, single-blinded, case control clinical trial in children with acute watery diarrhea. A total of 64 children who presented at outpatient clinics were enrolled. The probiotic group received 1 × 108 CFU L. reuteri DSM 17938 for five days in addition to oral rehydration solution (ORS and the second group was treated with ORS only. The primary endpoint was the duration of diarrhea (in hours. The secondary endpoint was the number of children with diarrhea at each day of the five days of intervention. Adverse events were also recorded.RESULTS: The mean duration of diarrhea was significantly reduced in the L. reuteri group compared to the control group (approximately 15 h, 60.4 ± 24.5 h [95% CI: 51.0-69.7 h] vs. 74.3 ± 15.3 h [95% CI: 68.7-79.9 h], p < 0.05. The percentage of children with diarrhea was lower in the L. reuteri group (13/29; 44.8% after 48 h than the control group (27/31; 87%; RR: 0.51; 95% CI: 0.34-0.79,p < 0.01. From the 72nd hour of intervention onwards, there was no difference between the two groups in the percentage of children with diarrhea. No adverse effects related to L. reuteri were noted.CONCLUSION:L. reuteri DSM 17938 is effective, safe, and well-tolerated in outpatient children with acute infectious diarrhea.

  4. Lactobacillus reuteri DSM 17938 shortens acute infectious diarrhea in a pediatric outpatient setting.

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    Dinleyici, Ener Cagri; Dalgic, Nazan; Guven, Sirin; Metin, Ozge; Yasa, Olcay; Kurugol, Zafer; Turel, Ozden; Tanir, Gonul; Yazar, Ahmet Sami; Arica, Vefik; Sancar, Mesut; Karbuz, Adem; Eren, Makbule; Ozen, Metehan; Kara, Ates; Vandenplas, Yvan

    2015-01-01

    Two randomized controlled clinical trials have shown that Lactobacillus (L) reuteri DSM 17938 reduces the duration of diarrhea in children hospitalized due to acute infectious diarrhea. This was the first trial evaluating the efficacy of L. reuteri DSM 17938 in outpatient children with acute infectious diarrhea. This was a multicenter, randomized, single-blinded, case control clinical trial in children with acute watery diarrhea. A total of 64 children who presented at outpatient clinics were enrolled. The probiotic group received 1×10(8)CFU L. reuteri DSM 17938 for five days in addition to oral rehydration solution (ORS) and the second group was treated with ORS only. The primary endpoint was the duration of diarrhea (in hours). The secondary endpoint was the number of children with diarrhea at each day of the five days of intervention. Adverse events were also recorded. The mean duration of diarrhea was significantly reduced in the L. reuteri group compared to the control group (approximately 15h, 60.4±24.5h [95% CI: 51.0-69.7h] vs. 74.3±15.3h [95% CI: 68.7-79.9h], pL. reuteri group (13/29; 44.8%) after 48h than the control group (27/31; 87%; RR: 0.51; 95% CI: 0.34-0.79, pL. reuteri were noted. L. reuteri DSM 17938 is effective, safe, and well-tolerated in outpatient children with acute infectious diarrhea. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. Evaluation of a multiplex panel for the diagnosis of acute infectious diarrhea in immunocompromised hematologic patients.

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    Izaskun Alejo-Cancho

    Full Text Available Diarrhea is a frequent complication in hematologic patients, being an infectious cause frequently suspected. Rapid and accurate detection of gastrointestinal pathogens is vital in immunocompromised hosts. The aim of this study was to compare routine diagnostic methods versus a multiplex polymerase chain reaction (PCR assay for the diagnosis of infectious diarrhea in immunocompromised hematologic patients.We conducted a prospective observational study from March 2015 to January 2016 to compare conventional methods for the diagnosis of infectious diarrhea with FIlmArray GI Panel (BioFire-bioMérieux, France. Samples from adult immunocompromised hematologic patients with acute diarrhea were collected. In cases with discordant results, a second multiplex assay was performed (Allplex, Seegene, Korea. The result was considered positive or negative when the same result was obtained by at least two of the methods.A total of 95 samples were obtained from 95 patients (median age of 52 years (46-64. Sixty-one (64% episodes were hospital-acquired and 34 (36% were community-acquired diarrhea. Twenty-five (26% patients had a positive microbiological result, being Clostridium difficile the most frequent pathogen, followed by Campylobacter spp and norovirus. The concordance between FilmArray methods was good (k = 0.79. The FilmArray GI panel showed a sensitivity of 95%, a specificity of 100% for positive results. The time required to obtain results was markedly reduced with the use of multiplex PCR methods.Multiplex molecular panels provide a rapid and sensitive tool for the diagnosis of infectious diarrhea, thereby allowing more timely clinical decisions in immunocompromised hematologic patients.

  6. The nineteen gastrointestinal pathogens spectrum of acute infectious diarrhea in a sentinel hospital, Shenzhen, China

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    Hongwei Shen

    2016-11-01

    Full Text Available Acute infectious gastroenteritis is one of the most common diseases among all ages, particularly in developing countries. The pathogen spectrum may differ among different regions and seasons. To investigate the etiology of acute diarrhea in Shenzhen, a prospective study was conducted from August 2014 to September 2015. Stools from 412 patients with diarrhea (286 of whom were adults including the general epidemiological information of the patients were collected. The 19 pathogens were detected by conventional culture method or multiplex PCR assay, which included five viruses (rotavirus, adenovirus, sapovirus, norovirus, and astrovirus,11 bacterial pathogens (Salmonella, Campylobacter jejuni, Shigella, Listeria monocytogenes, Vibrio parahaemolyticus, Vibrio cholera, Enterohemorrhagic (EHEC, enteropathogenic (EPEC, enteroinvasive (EIEC, enterotoxigenic (ETEC; and enteroaggregative Escherichia coli (EAEC and three parasites (Entamoeba histolytica, Giardia lamblia, and Cryptosporidium parvum. A potential pathogen and coinfection was found in 41.5% and 7.0% of cases, respectively. The bacterial infection was the dominant cause of diarrhea (32.3%, and the three most frequently identified organisms were Salmonella (12.1%, ETEC (8.0%, and Campylobacter jejuni (4.9%. Salmonella enteritidis was the leading serotype of Salmonella spp.. Norovirus (8.3% and sapovirus (2.2% were the most common viral pathogens, followed by adenovirus (1.5% and rotavirus (1.2%. The single most important causes of diarrhea were Salmonella spp. and Campylobacter jejuni, which points toward the need for testing and surveillance for these pathogens in this region.

  7. Diagnostic approach to acute infectious diarrhea: the state of the art

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    1995-01-01

    ás relevantes identificados tienen que ver con los diseños de estudio, el efecto de la variación en la validez de los estudios sobre la exactitud diagnóstica, y la factibilidad de generalizar los resultados. Igualmente, se enfatiza sobre las fuentes potenciales de confusión y sesgo (tales como manifestaciones clínicas y epidemiológicas diferentes, y el hallazgo frecuente de diarreas mixtas, particularmente para estudios realizados en países en desarrollo. La lactoferrina fecal parece ser una prueba prometedora para distinguir las diarreas inflamatorias, si bien su utilidad final en diferentes contextos clínicos y de campo requiere de estudios adicionales. Finalmente, se puntualiza sobre la necesidad de llevar a cabo un estudio cuantitativo (meta-analítico de los estudios primarios realizados sobre el tema, como una estrategia potencialmente útil para resolver las preguntas que todavía quedan sin respuesta definitiva. A continuously increasing number of enteric microorganisms is being recognized as responsible for acute infectious diarrhea. Accordingly, the need of a low cost and effective approach to diagnosis and management of diarrhea is at present a pressing problem for both policy makers and physicians. This paper reviews the available information on the issue, attempting to answer whether fecal leukocytes, occult blood, fecal lactoferrin or any combination of these screening tests with clinical data allow the identification of a majority of cases of inflammatory, invasive diarrhea. After a preliminary section dealing with pathophysiological considerations on the inflammatory response of intestinal mucosa to infection by pathogenic agents and a summarized revision of the pioneering studies on the value of fecal leukocytes in the discrimination between bacillary and amebic dysentery, a critical analysis is made of later studies which addresses to the reliability of different approaches in the discrimination between invasive and noninvasive diarrhea. Several

  8. [Management of infectious diarrhea in nursing homes].

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    Ferahta, Nabila; Héquet, Delphine; Bizzozzero, Tosca; Major, Kristof; Petignat, Christiane

    2018-04-11

    Infectious diarrheas are of great concern in nursing homes and can engender outbreaks. Their importance in terms of morbidity, mortality and health economics justify the implementation of prevention and control measures. Although past studies emphasize the importance of infectious diarrheas occurring during hospitalization, data on nursing homes epidemiology remain scarce. This article is founded on recent data of the literature, on recommendations for the management of infectious diarrheas and for prevention and control of outbreaks in nursing homes.

  9. [Diarrhea].

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    Müllhaupt, B

    2002-10-16

    Diarrhea is not a single disease, but only a symptom of different diseases. Diarrhea is characterized by an increase in bowel movements (more than three per day) and an increased liquidity of stools. Acute diarrheas are defined as those that last less than four weeks, whereas chronic diarrheas persist for more than four weeks. The pathophysiological basis of diarrhea is a disturbed enteral water- and electrolyte balance, which can be caused by an increased secretion of osmotically active electrolytes (secretory diarrhea) or the increased ingestion of osmotically active substances (osmotic diarrhea). The stool characteristics allows to distinguish watery, bloody and fatty diarrhea. Acute diarrheas are mostly caused by an infectious agent (viruses, bacteria and parasites), whereas the differential diagnosis of chronic diarrhea is considerably larger and therefore the diagnostic work-up is more complex.

  10. Probiotics for Infectious Diarrhea and Traveler's Diarrhea - What Do We Really Know?

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    Hibberd, Patricia L.

    Worldwide, diarrhea is the sixth leading cause of premature death (Lopez et al., 2006), accounting for more than two million deaths each year. The majority of the burden is borne in lower and middle income countries, and in children under age 5 (Kosek et al., 2003). Even in the United States where there is easy access to “safe” food and water, there are an estimated 211-375 million episodes of acute diarrhea each year, resulting in 900,000 hospitalizations and 6,000 deaths (Herikstad et al., 2002; Mead et al., 1999). While mortality from diarrhea has decreased over the last 30 years, the incidence and morbidity associated with diarrhea has not improved (Kosek et al., 2003). During the same time period an ever increasing number of enteric pathogens as well as non-infectious conditions have been recognized as causes of acute diarrhea (Guerrant et al., 2001).

  11. [The treatment of acute diarrhea].

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    Leemans, L

    2013-09-01

    Racecadotril has sufficient proven efficacy in the treatment of acute diarrhea in children. Treatment outcomes in adults are less convincing. The place of gelatin tannate is unclear. Some sources point to potential hepatotoxicity and diminished iron absorption, with a concomitant risk of anemia, at least in case of excessive or prolonged use. Loperamide still has a prominent place in the treatment of acute and chronic diarrhea. Attention should be payed to correct dosing and some well-known contra-indications. Probiotics are indicated in children, as well as in the prevention of antibiotics-induced diarrhea. There is no evidence to support their use in the treatment of acute diarrhea in adults. Up till now publications disagree on the efficacy in the prevention of travelers' diarrhea. Astringents and absorbents are no longer supported in guidelines. Oral rehydration systems have a part to play in pediatric treatment.

  12. [Chronic, non-infectious diarrhea: diagnostics and therapy].

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    Ulbricht, Korinna; Layer, Peter; Andresen, Viola

    2016-09-01

    Chronic, non-infectious diarrhea can be caused by a variety of gastrointestinal diseases. In anamnesis, it is important to take accompanying warning symptoms and specific triggers into account. The fecal inflammatory marker calprotectin may help differentiating between organic and functional gastrointestinal disorders, but it is not specific. Among other options, gelling fibres, Loperamide and Cholestyramine as well as probiotics are available for the symptomatic treatment of chronic diarrhea. For long-term treatment of chronic diarrhea with the enkephalinase inhibitor racecadotril, which is approved for acute diarrhea, only limited data are available. Eluxadolin presents a new therapeutic option. It can alleviate abdominal pain and diarrhea by modulation of opioid receptors in the enteric nervous system. Additional approaches in intractable irritable bowel syndrome with diarrhea (IBS-D) include 5-HT3 receptor antagonists, the antibiotic Rifaximin as well as low-dose tricyclic antidepressants. Specific diets such as the low-FODMAP diet can also relieve symptoms in IBS. © Georg Thieme Verlag KG Stuttgart · New York.

  13. [Lactose intolerance in neonates with non-infectious diarrhea].

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    Su, Hui-Min; Jiang, Yi; Hu, Yu-Lian; Yang, Hui; Dong, Tian-Jin

    2016-04-01

    To 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. Seventy 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. Fecal 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 (Pintolerance tends to occur. Determination of fecal pH value has no significance in the diagnosis of lactose intolerance in neonates with diarrhea.

  14. The role of probiotics in the prevention and treatment of childhood infectious diarrhea

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    Maria Maragkoudaki

    2013-10-01

    Full Text Available Probiotics are beneficial bacteria that colonize and replicate in the human intestinal tract providing a positive benefit to the host. Several clinical trials support the efficacy of certain probiotics in the prevention and treatment of various diarrheal illnesses. This paper reviews published clinical trials assessing the efficacy of various probiotic species and strains in preventing and treating acute diarrhea in children. The available evidence shows that few probiotic species (mostly Lactobacillus GG and Saccharomyces boulardii are efficacious in decreasing the duration and the severity of acute gastroenteritis, with the most prominent of the reported benefits, the reduction of the duration of diarrhea by approximately 1 day. With regard to the prevention of acute diarrhea in the community and the hospital, there is modest evidence that some probiotic species may be efficacious in preventing community acquired diarrhea (Bifidobacterium lactis, Lactobacillus reuteri, Lactobacillus GG, nosocomial acquired diarrhea (Lactobacillus GG and Clostridium difficile diarrhea (Lactobacillus GG and Saccharomyces boulardii. In conclusion, the available evidence suggests that probiotics are safe when used in healthy children and effective in reducing the duration of acute infectious diarrhea. Further studies are required to assess the efficacy of selected probiotic species and strains at different dosages for different clinical indications and patient groups.

  15. Acute Infectious Disease,

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    1984-03-23

    intracelLular proteins such as metallothionine, hemosiderin , and ferritin.3 𔃻 6𔃼 1𔃽 5 A large variety of proteins must be produced during infection for...acute infections.50 On the other hand, iron is sequestered through its incorporation into hemosiderin .6,7,16 and ferritin in various tissue storage... hemosiderin and ferritin during infectious or inflammatory states. Concomitantly, plas1a ir. • - concentrations decline, sometimes to almost nondectable

  16. Probiotics, calcium and acute diarrhea : a randomized trial in Indonesian children

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    Agustina, R.

    2012-01-01

    Background
    Acute diarrhea and acute respiratory tract infections (ARTIs) continue to lead the infectious cause of morbidity and mortality among children <5 years of age in developing countries, including Indonesia. Efforts to prevent diarrheal disease by probiotics and milk calcium

  17. Human rotavirus genotypes causing acute watery diarrhea among ...

    African Journals Online (AJOL)

    Background: Diarrhea is a major cause of childhood morbidity and mortality in the developing countries. Rotavirus is a major cause of acute watery diarrhea. Aim: This study aims at characterizing the prevalent rotavirus G-genotypes among under.five children presenting with acute watery diarrhea in Benin City, Nigeria.

  18. An overview of calf diarrhea - infectious etiology, diagnosis, and intervention

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    Cho, Yong-il

    2014-01-01

    Calf diarrhea is a commonly reported disease in young animals, and still a major cause of productivity and economic loss to cattle producers worldwide. In the report of the 2007 National Animal Health Monitoring System for U.S. dairy, half of the deaths among unweaned calves was attributed to diarrhea. Multiple pathogens are known or postulated to cause or contribute to calf diarrhea development. Other factors including both the environment and management practices influence disease severity or outcomes. The multifactorial nature of calf diarrhea makes this disease hard to control effectively in modern cow-calf operations. The purpose of this review is to provide a better understanding of a) the ecology and pathogenesis of well-known and potential bovine enteric pathogens implicated in calf diarrhea, b) describe diagnostic tests used to detect various enteric pathogens along with their pros and cons, and c) propose improved intervention strategies for treating calf diarrhea. PMID:24378583

  19. Burden of acute, persistent and chronic diarrhea, Thailand, 2010.

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    Sutra, Sumitr; Kosuwon, Pensri; Chirawatkul, Aroon; Thepsuthammarat, Kaewjai

    2012-07-01

    The incidence of diarrhea in Thai children under five years of age increased over the last decade while mortality dramatically decreased. To evaluate the effectiveness of MCH services under Universal Coverage Schemes, health outcomes should be performed. To assess the burden and pattern of childhood diarrheal diseases in Thai children under five. The information on Intestinal Infectious Diseases ICD10: A00-A09 was divided into two groups: 1. Infectious diarrhea: A04, A05, A08, A09 and 2. Dysentery: A02, A03. The authors investigated the number of OPD visits, IPD, mortality, length of hospital stay and co-morbidity of severe cases. The burden of diarrhea was: 3.7 million (1:1) episodes, 756,552 OPD visits (1:5), 124, 403 IPD admissions (1:30), 202 (1:18,460) persistent diarrhea and 48 (1:77, 685) deaths. Diarrheal incidence had two peaks: cool season and early rainy season. Admissions lasted a collective 309,398 days. Diarrhea was persistent in 202 episodes (1.6 per 1,000 admissions) and the associated factors included: age, sepsis, anemia, chronic diseases, malnutrition and HIV. The risks for diarrhea-related mortality included: infant, septicemia and dehydration. The incidence of diarrhea was higher than expected albeit mortality was low. The mortality rate was associated with age under one year persistent diarrhea, septicemia, chronic and underlying diseases.

  20. Acute tonsillitis at infectious patients

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    Y. P. Finogeev

    2011-01-01

    Full Text Available We examined 1824 patients with diphtheria treated in Clinical Infectious Diseases Hospital Botkin (St. Petersburg in 1993 – 1994, and more than 500 patients referred to the clinic with a diagnosis of «angina». Based on published data and our own research observations investigated the etiology of acute tonsillitis. Bacterial tonsillitis should be treated with antibiotics, and this is important aetiological interpretation of these diseases. Streptococcal tonsillitis should always be a sore throat syndrome as a diagnostic sign of support. For other forms of lymphoma lesion of the tonsils should not be defined as «angina», and called «tonsillitis». Аngina as β-hemolytic streptococcus group A infection is recognized as the leader in the development of rheumatic fever. On the basis of a large clinical material briefly analyzed the clinical manifestations of various forms of diphtheria with membranous tonsillitis. Also presented with a syndrome of infectious diseases as tonsillitis, therapeutic and surgical «mask» of infectious diseases.

  1. [Hypokalemia-induced paraplegia secondary to acute diarrhea].

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    Ortuño Andériz, F; Cabello Clotet, N; de Diego Gamarra, R; Salaverría Garzón, I; Vázquez Rizaldos, S

    2002-02-01

    Hypokalemia can give a variety of syntomatology but more often courses without it or with inespecific clinical manifestations. In our enviroment the etiology of hypokalemia is wide but one of the most common causes in third world countries are diarrheas. We describe a case of severe hypokalemia due to acute diarrhea which was manifested with severe neurologic symtoms but improves with conventional treatment.

  2. Enteropathogens Associated with Acute Diarrhea in Children from Households with High Socioeconomic Level in Uruguay

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    Gustavo Varela

    2015-01-01

    Full Text Available Infectious diarrhea, a common disease of children, deserves permanent monitoring in all social groups. To know the etiology and clinical manifestations of acute diarrhea in children up to 5 years of age from high socioeconomic level households, we conducted a descriptive, microbiological, and clinical study. Stools from 59 children with acute community-acquired diarrhea were examined, and their parents were interviewed concerning symptoms and signs. Rotavirus, adenovirus, and norovirus were detected by commercially available qualitative immunochromatographic lateral flow rapid tests. Salmonella, Campylobacter, Yersinia, and Shigella were investigated by standard bacteriological methods and diarrheagenic E. coli by PCR assays. We identified a potential enteric pathogen in 30 children. The most frequent causes of diarrhea were enteropathogenic E. coli (EPEC, viruses, Campylobacter, Salmonella, and Shiga-toxin-producing E. coli (STEC. Only 2 patients showed mixed infections. Our data suggest that children with viral or Campylobacter diarrhea were taken to the hospital earlier than those infected with EPEC. One child infected with STEC O26 developed “complete” HUS. The microbiological results highlight the importance of zoonotic bacteria such as atypical EPEC, Campylobacter, STEC, and Salmonella as pathogens associated with acute diarrhea in these children. The findings also reinforce our previous communications about the regional importance of non-O157 STEC strains in severe infant food-borne diseases.

  3. Oral Administration of Astrovirus Capsid Protein Is Sufficient To Induce Acute Diarrhea In Vivo

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    Victoria A. Meliopoulos

    2016-11-01

    Full Text Available The disease mechanisms associated with the onset of astrovirus diarrhea are unknown. Unlike other enteric virus infections, astrovirus infection is not associated with an inflammatory response or cellular damage. In vitro studies in differentiated Caco-2 cells demonstrated that human astrovirus serotype 1 (HAstV-1 capsid protein alone disrupts the actin cytoskeleton and tight junction complex, leading to increased epithelial barrier permeability. In this study, we show that oral administration of purified recombinant turkey astrovirus 2 (TAstV-2 capsid protein results in acute diarrhea in a dose- and time-dependent manner in turkey poults. Similarly to that induced by infectious virus, TAstV-2 capsid-induced diarrhea was independent of inflammation or histological changes but was associated with increased intestinal barrier permeability, as well as redistribution of sodium hydrogen exchanger 3 (NHE3 from the membrane to the cytoplasm of the intestinal epithelium. Unlike other viral enterotoxins that have been identified, astrovirus capsid induces diarrhea after oral administration, reproducing the natural route of infection and demonstrating that ingestion of intact noninfectious capsid protein may be sufficient to provoke acute diarrhea. Based on these data, we hypothesize that the astrovirus capsid acts like an enterotoxin and induces intestinal epithelial barrier dysfunction.

  4. An unexpectedly high incidence of acute childhood diarrhea in Koot-Abdollah, Ahwaz, Iran.

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    Kolahi, Ali-Asghar; Rastegarpour, Ali; Abadi, Alireza; Gachkar, Latif

    2010-07-01

    Koot-Abdollah is a neighborhood in Ahwaz, in the southeast of Iran, susceptible to public health hazards due to a number of factors, including a low level of personal hygiene, inappropriate community sanitation, and a high level of environmental and water pollution. This study was designed to measure the incidence of acute childhood diarrhea in this neighborhood. This was a descriptive population-based study. Via multistage sampling, data were collected by interviewing the mothers in their homes. Reported 95% confidence intervals included a finite population correction factor and accounted for the cluster sampling design. The study included 2016 children aged 6 to 60 months. Overall, 725 (36.0%) of the children studied had experienced an episode of acute diarrhea during the previous two weeks. In other words, the children demonstrated a rate of diarrhea per 100 person-years of 936 for the studied period, which was a time period expected to reveal the lowest possible incidence of diarrhea. The incidence of diarrhea per two weeks in Koot-Abdollah is exceptionally high. The limitation of available drinking water, warm weather, illiteracy, poverty, and low incomes, in addition to the low level of sanitation and personal hygiene and extreme environmental pollution contribute to this high incidence. Copyright 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  5. Association between floods and infectious diarrhea and their effect modifiers in Hunan province, China: A two-stage model.

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    Liu, Zhidong; Zhang, Feifei; Zhang, Ying; Li, Jing; Liu, Xuena; Ding, Guoyong; Zhang, Caixia; Liu, Qiyong; Jiang, Baofa

    2018-06-01

    Understanding the potential links between floods and infectious diarrhea is important under the context of climate change. However, little is known about the risk of infectious diarrhea after floods and what factors could modify these effects in China. This study aims to quantitatively examine the relationship between floods and infectious diarrhea and their effect modifiers. Weekly number of infectious diarrhea cases from 2004 to 2011 during flood season in Hunan province were supplied by the National Notifiable Disease Surveillance System. Flood and meteorological data over the same period were obtained. A two-stage model was used to estimate a provincial average association and their effect modifiers between floods and infectious diarrhea, accounting for other confounders. A total of 134,571 cases of infectious diarrhea were notified from 2004 to 2011. After controlling for seasonality, long-term trends, and meteorological factors, floods were significantly associated with infectious diarrhea in the provincial level with a cumulative RR of 1.22 (95% CI: 1.05, 1.43) with a lagged effect of 0-1 week. Geographic locations and economic levels were identified as effect modifiers, with a higher impact of floods on infectious diarrhea in the western and regions with a low economic level of Hunan. Our study provides strong evidence of a positive association between floods and infectious diarrhea in the study area. Local control strategies for public health should be taken in time to prevent and reduce the risk of infectious diarrhea after floods, especially for the vulnerable regions identified. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Prolonged episodes of acute diarrhea reduce growth and increase risk of persistent diarrhea in children

    Science.gov (United States)

    Moore, Sean R.; Lima, Noélia L.; Soares, Alberto M.; Oriá, Reinaldo B.; Pinkerton, Relana C.; Barrett, Leah J.; Guerrant, Richard L.; Lima, Aldo A.M.

    2010-01-01

    Background & Aims Prolonged episodes of acute diarrhea (ProD, duration 7–13 days) or persistent diarrhea (PD, duration ≥14 days) are important causes of undernutrition, yet the epidemiology and nutritional impact of ProD are poorly understood. Methods We conducted a 10-year cohort study of 414 children from a Brazilian shantytown who were followed from birth; data were collected on diarrhea, enteric pathogens, and anthropometry. Results During 1,276 child-years of observation, we recorded 3,257 diarrheal episodes. ProD was twice as common as PD (12% and 5% of episodes, respectively); ProD and PD together accounted for 50% of all days with diarrhea. ProD was more common in infants whose mothers had not completed primary school (relative risk [RR]=2.1; 95% confidence interval=1.02–2.78). Early weaning was associated with earlier onset of ProD (Spearman's ρ, 0.309; P=0.005). Infants with ProD were twice as likely to develop PD in later childhood (log rank P=0.002) compared to infants with only acute diarrhea (AD, duration Children's growth was more severely stunted before their first episode of ProD, compared with AD (mean height-for-age Z score (HAZ) -0.81 vs. -0.51, Pchildren at risk of a vicious cycle of diarrhea and malnutrition. Further studies are needed to address the recognition and control of ProD and its consequences in resource-limited settings and assess its role in PD pathogenesis. PMID:20638937

  7. Campylobacter spp among Children with acute diarrhea attending ...

    African Journals Online (AJOL)

    Isolation rate in developing countries is between 5-35%. This study aimed at finding prevalence of children with campylobacter infection among children with acute diarrhea attending Mulago hospital. Objective: The objective was to establish the proportion of children infected with Campylobacter spp among children with ...

  8. Quantitative analysis of burden of infectious diarrhea associated with floods in northwest of anhui province, china: a mixed method evaluation.

    Science.gov (United States)

    Ding, Guoyong; Zhang, Ying; Gao, Lu; Ma, Wei; Li, Xiujun; Liu, Jing; Liu, Qiyong; Jiang, Baofa

    2013-01-01

    Persistent and heavy rainfall in the upper and middle Huaihe River of China brought about severe floods during the end of June and July 2007. However, there has been no assessment on the association between the floods and infectious diarrhea. This study aimed to quantify the impact of the floods in 2007 on the burden of disease due to infectious diarrhea in northwest of Anhui Province. A time-stratified case-crossover analysis was firstly conducted to examine the relationship between daily cases of infectious diarrhea and the 2007 floods in Fuyang and Bozhou of Anhui Province. Odds ratios (ORs) of the flood risk were quantified by conditional logistic regression. The years lived with disability (YLDs) of infectious diarrhea attributable to floods were then estimated based on the WHO framework of the calculating potential impact fraction in the Burden of Disease study. A total of 197 infectious diarrheas were notified during the exposure and control periods in the two study areas. The strongest effect was shown with a 2-day lag in Fuyang and a 5-day lag in Bozhou. Multivariable analysis showed that floods were significantly associated with an increased risk of the number cases of infectious diarrhea (OR = 3.175, 95%CI: 1.126-8.954 in Fuyang; OR = 6.754, 95%CI: 1.954-23.344 in Bozhou). Attributable YLD per 1000 of infectious diarrhea resulting from the floods was 0.0081 in Fuyang and 0.0209 in Bozhou. Our findings confirm that floods have significantly increased the risks of infectious diarrhea in the study areas. In addition, prolonged moderate flood may cause more burdens of infectious diarrheas than severe flood with a shorter duration. More attention should be paid to particular vulnerable groups, including younger children and elderly, in developing public health preparation and intervention programs. Findings have significant implications for developing strategies to prevent and reduce health impact of floods.

  9. Impacts of different grades of tropical cyclones on infectious diarrhea in Guangdong, 2005-2011.

    Science.gov (United States)

    Kang, Ruihua; Xun, Huanmiao; Zhang, Ying; Wang, Wei; Wang, Xin; Jiang, Baofa; Ma, Wei

    2015-01-01

    Guangdong province is one of the most vulnerable provinces to tropical cyclones in China. Most prior studies concentrated on the relationship between tropical cyclones and injuries and mortality. This study aimed to explore the impacts of different grades of tropical cyclones on infectious diarrhea incidence in Guangdong province, from 2005 to 2011. Mann-Whitney U test was firstly used to examine if infectious diarrhea were sensitive to tropical cyclone. Then unidirectional 1:1 case-crossover design was performed to quantitatively evaluate the relationship between daily number of infectious diarrhea and tropical cyclone from 2005 to 2011 in Guangdong, China. Principal component analysis (PCA) was applied to eliminate multicollinearity. Multivariate logistic regression model was used to estimate the hazard ratios (HRs) and the 95% confidence intervals (CI). There were no significant relationships between tropical cyclone and bacillary dysentery, amebic dysentery, typhoid, and paratyphoid cases. Infectious diarrhea other than cholera, dysentery, typhoid and paratyphoid significantly increased after tropical cyclones. The strongest effect were shown on lag 1 day (HRs = 1.95, 95%CI = 1.22, 3.12) and no lagged effect was detected for tropical depression, tropical storm, severe tropical storm and typhoon, with the largest HRs (95%CI) of 2.16 (95%CI = 1.69, 2.76), 2.43 (95%CI = 1.65, 3.58) and 2.21 (95%CI = 1.65, 2.69), respectively. Among children below 5 years old, the impacts of all grades of tropical cyclones were strongest at lag 0 day. And HRs were 2.67 (95%CI = 1.10, 6.48), 2.49 (95%CI = 1.80, 3.44), 4.89 (95%CI = 2.37, 7.37) and 3.18 (95%CI = 2.10, 4.81), respectively. All grades of tropical cyclones could increase risk of other infectious diarrhea. Severe tropical storm has the strongest influence on other infectious diarrhea. The impacts of tropical cyclones on children under 5 years old were higher than total population.

  10. Impacts of different grades of tropical cyclones on infectious diarrhea in Guangdong, 2005-2011.

    Directory of Open Access Journals (Sweden)

    Ruihua Kang

    Full Text Available Guangdong province is one of the most vulnerable provinces to tropical cyclones in China. Most prior studies concentrated on the relationship between tropical cyclones and injuries and mortality. This study aimed to explore the impacts of different grades of tropical cyclones on infectious diarrhea incidence in Guangdong province, from 2005 to 2011.Mann-Whitney U test was firstly used to examine if infectious diarrhea were sensitive to tropical cyclone. Then unidirectional 1:1 case-crossover design was performed to quantitatively evaluate the relationship between daily number of infectious diarrhea and tropical cyclone from 2005 to 2011 in Guangdong, China. Principal component analysis (PCA was applied to eliminate multicollinearity. Multivariate logistic regression model was used to estimate the hazard ratios (HRs and the 95% confidence intervals (CI.There were no significant relationships between tropical cyclone and bacillary dysentery, amebic dysentery, typhoid, and paratyphoid cases. Infectious diarrhea other than cholera, dysentery, typhoid and paratyphoid significantly increased after tropical cyclones. The strongest effect were shown on lag 1 day (HRs = 1.95, 95%CI = 1.22, 3.12 and no lagged effect was detected for tropical depression, tropical storm, severe tropical storm and typhoon, with the largest HRs (95%CI of 2.16 (95%CI = 1.69, 2.76, 2.43 (95%CI = 1.65, 3.58 and 2.21 (95%CI = 1.65, 2.69, respectively. Among children below 5 years old, the impacts of all grades of tropical cyclones were strongest at lag 0 day. And HRs were 2.67 (95%CI = 1.10, 6.48, 2.49 (95%CI = 1.80, 3.44, 4.89 (95%CI = 2.37, 7.37 and 3.18 (95%CI = 2.10, 4.81, respectively.All grades of tropical cyclones could increase risk of other infectious diarrhea. Severe tropical storm has the strongest influence on other infectious diarrhea. The impacts of tropical cyclones on children under 5 years old were higher than total population.

  11. DIARRHEA IN CHILDREN: MAIN CAUSES AND WAYS OF TREATMENT

    OpenAIRE

    S.V. Bel’mer; T.V. Gasilina

    2010-01-01

    The article discusses main questions of diagnostics of diarrhea in children. Main cause of acute diarrhea is infection, mainly viral (rotavirus, etc.). Chronic diarrhea frequently has non-infectious origin. The need of multi-aspect diagnostics of diarrhea cause in children is related to the significance of treatment of main disease. Besides, treatment of chronic and acute diarrhea include major component: adsorbents based on smectite. In total treatment of diarrhea has to be complex with the ...

  12. Anti-diarrheal effects of diosmectite in the treatment of acute diarrhea in children: a review.

    Science.gov (United States)

    Dupont, Christophe; Vernisse, Bernard

    2009-01-01

    Acute diarrhea caused by an infectious organism is highly prevalent, particularly in developing countries, and is usually self-limiting. The condition is a major contributor to the global disease burden and is associated with a significant economic cost. The disease is common in children aged Diarrhea almost always occurs by one or more of four mechanisms: disruption of osmotic forces in the intestine; disruption of normal secretory processes; disruption of epithelial cells or the epithelial tight junctions; or motility disorders. Oral rehydration therapy (ORT) is central to the management of acute diarrhea, and is sufficient to prevent complications due to dehydration in most patients while the disease runs its course. However, ORT has no effect on the duration of the disease or frequency of bowel motions, and any agent that could meet these needs would therefore be a useful addition to ORT. Diosmectite is a natural aluminomagnesium silicate clay with a lamellar, non-fibrous crystalline structure that gives it strong adsorbent properties. Its mechanisms of action are not yet fully understood, but are probably multiple. Diosmectite reduces inflammation, modifies mucus rheologic properties, inhibits mucolysis, and adsorbs bacteria, bacterial enterotoxins, viruses and other potentially diarrheogenic substances. A number of studies have shown that diosmectite reduces the duration of diarrhea and decreases the frequency of bowel motions after 2 days of treatment in children with mild-to-moderate acute diarrhea. Two recent trials have indicated a reduction in stool output with diosmectite. Because of its very favorable safety profile, with no serious adverse effects, diosmectite is frequently used, mainly in European countries but also in Asia and Africa. Diosmectite should be used as an adjunct, not an alternative, to ORT and, when needed, to antibacterial therapy.

  13. DEHYDRATION IN CHILDREN WITH ACUTE DIARRHEA

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    S. V. Khaliullina

    2014-01-01

    Full Text Available The article is focused on the main issues of the regulation of water-electrolyte metabolism in children, possible variants of its disorder in acute diarrhoeal diseases. The clinical features of dehydration depending on the severity and qualitative component of losses are described, recommendations on laboratory diagnosis and treatment are provided. 

  14. Diarrhea and Swimming

    Science.gov (United States)

    ... Pool What to Do if You Have Diarrhea Diarrhea and Swimming Diarrhea and swimming don’t mix! ... small amount of pool water to become infected. Diarrhea and Spreading Illness at the Pool Infectious diarrhea ...

  15. Acute Infectious Morbidity in Multiple Gestation

    Directory of Open Access Journals (Sweden)

    Sarah K. Dotters-Katz

    2015-01-01

    Full Text Available Objectives. Physiologic and immunologic changes in pregnancy result in increased susceptibility to infection. These shifts are more pronounced in pregnancies complicated by multiple gestation. The objective of this study was to determine the association between multiple gestation and risk of infectious morbidity. Study Design. The Nationwide Inpatient Sample for the years 2008–2010 was used to identify pregnant women during admission for delivery with International Classification of Diseases codes. Logistic regression was used to compute odds ratios and 95% confidence intervals for demographic data, preexisting medical conditions, and acute medical and infectious complications for women with multiple versus singleton gestations. Results. Among women with multiple gestation, 38.4 per 1,000 women had an infectious complication compared to 12.8 per 1,000 women with singletons. The most significant infectious morbidity associated with multiple gestation was intestinal infections, pyelonephritis, influenza, and pneumonia. After controlling for confounding variables, infectious complications at delivery persisted for women with multiples, though the association was dependent on mode of delivery. Conclusions. Women with multiple gestations are at increased risk for infectious morbidity identified at the time of delivery. This association was diminished among women who had a cesarean suggesting that operative delivery is not responsible for this association.

  16. Strategic control of acute diarrhea of newborn calves

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    Siti Chotiah

    2012-10-01

    Full Text Available Economic performance of beef cattle operations can be severely hampered by acute calfhood diarrhea. Accordingly, a study was conducted at Bbalitvet to identify the causal agents, reduce clinical incidence, and increase body weight gain of newborn calves. One potential control is application of suitable vaccines to pregnant cows. The study was begun by identifying cases of diarrhea followed by isolation and identification of the causal agents in 12 beef cattle farms in West Java. A field trial was then designed for controlling calf diarrhea in such farms. Inactive vaccines Ecoli-Closvak polivalen were administered to pregnant cows to increase specific resistance of the newborn calves. At 2 months prepartum, 12 pregnant cows were assigned either to a vaccination or a placebo group, with a booster vaccination 3 weeks prior to parturition. Strict hygenic management was provided to both groups, and all calves were provided adequately with colostrum. Subjects were observed for 5 months, starting from the time of initial vaccination until the calves were 3 months of age. In the initial farm surveys, entero-pathogenic bacteria such as Escherichia coli serotype K99 and Clostridium perfringens type A and C were isolated and identified in fecal samples from 4 beef cattle farms in 3 districts (Garut, Tasikmalaya, Ciamis and 2 beef cattle farms in 2 districts (Tasikmalaya and Ciamis of West Java. In the vaccination trial, good immune responses to E. coli and C. perfringens alpha toxin measured by ELISA were observed. Application of effective control of calf diarrhea including vaccination and good livestock management showed good results. No death or signs of diarrhea were found in the new born calves up to 3 months of age. The rate of body weight gain was significantly higher in calves of vaccinated dams than in calves of non-vaccinated dams.

  17. [Preliminary application of Back-Propagation artificial neural network model on the prediction of infectious diarrhea incidence in Shanghai].

    Science.gov (United States)

    Li, Jian; Gu, Jun-zhong; Mao, Sheng-hua; Xiao, Wen-jia; Jin, Hui-ming; Zheng, Ya-xu; Wang, Yong-ming; Hu, Jia-yu

    2013-12-01

    To establish BP artificial neural network predicting model regarding the daily cases of infectious diarrhea in Shanghai. Data regarding both the incidence of infectious diarrhea from 2005 to 2008 in Shanghai and meteorological factors including temperature, relative humidity, rainfall, atmospheric pressure, duration of sunshine and wind speed within the same periods were collected and analyzed with the MatLab R2012b software. Meteorological factors that were correlated with infectious diarrhea were screened by Spearman correlation analysis. Principal component analysis (PCA) was used to remove the multi-colinearities between meteorological factors. Back-Propagation (BP) neural network was employed to establish related prediction models regarding the daily infectious diarrhea incidence, using artificial neural networks toolbox. The established models were evaluated through the fitting, predicting and forecasting processes. Data from Spearman correlation analysis indicated that the incidence of infectious diarrhea had a highly positive correlation with factors as daily maximum temperature, minimum temperature, average temperature, minimum relative humidity and average relative humidity in the previous two days (P neural network model were established under the input of 4 meteorological principal components, extracted by PCA and used for training and prediction. Then appeared to be 4.7811, 6.8921,0.7918,0.8418 and 5.8163, 7.8062,0.7202,0.8180, respectively. The rate on mean error regarding the predictive value to actual incidence in 2008 was 5.30% and the forecasting precision reached 95.63% . Temperature and air pressure showed important impact on the incidence of infectious diarrhea. The BP neural network model had the advantages of low simulation forecasting errors and high forecasting hit rate that could ideally predict and forecast the effects on the incidence of infectious diarrhea.

  18. FilmArray™ GI panel performance for the diagnosis of acute gastroenteritis or hemorragic diarrhea.

    Science.gov (United States)

    Piralla, Antonio; Lunghi, Giovanna; Ardissino, Gianluigi; Girello, Alessia; Premoli, Marta; Bava, Erika; Arghittu, Milena; Colombo, Maria Rosaria; Cognetto, Alessandra; Bono, Patrizia; Campanini, Giulia; Marone, Piero; Baldanti, Fausto

    2017-05-12

    Acute gastroenteritis is a common cause of morbidity and mortality in humans worldwide. The rapid and specific identification of infectious agents is crucial for correct patient management. However, diagnosis of acute gastroenteritis is usually performed with diagnostic panels that include only a few pathogens. In the present bicentric study, the diagnostic value of FilmArray™ GI panels was assessed in unformed stool samples of patients with acute gastroenteritis and in a series of samples collected from pediatric patients with heamorragic diarrhea. The clinical performance of the FilmArray™ gastrointestinal (GI) panel was assessed in 168 stool samples collected from patients with either acute gastroenteritis or hemorragic diarrhea. Samples showing discordant results between FilmArray and routine methods were further analyzed with an additional assay. Overall, the FilmArray™ GI panel detected at least one potential pathogen in 92/168 (54.8%) specimens. In 66/92 (71.8%) samples, only one pathogen was detected, while in 26/92 (28.2%) multiple pathogens were detected. The most frequent pathogens were rotavirus 13.9% (22/168), Campylobacter 10.7% (18/168), Clostridium difficile 9.5% (16/168), and norovirus 8.9% (15/168). Clostridium difficile was identified only in patients with acute gastroenteritis (p Campylobacter spp., Salmonella spp., EPEC and E. coli producing Shiga-like toxin were more frequently detected in patients with hemorragic diarrhea (p < 0.05). The overall percent agreement calculated in samples was 73.8% and 65.5%, while 34.5% were discordant. After additional confirmatory analyses, the proportion of discordant samples decreased to 7.7%. Rotavirus and astrovirus were the most frequently unconfirmed pathogens. In conclusion, the FilmArray™ GI panel has proved to be a valuable new diagnostic tool for improving the diagnostic efficiency of GI pathogens.

  19. Predominant enteropathogens in acute diarrhea and associated variables in children at the Lambayeque Regional Hospital, Peru

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    Heber Silva-Díaz

    2017-01-01

    Full Text Available Objective: To determine the type and frequency of predominant enteropathogens in acute diarrhea and their associated characteristics in children treated at Hospital Regional Lambayeque (HRL - Peru. Materials and methods: A cross-sectional analytical study was carried out in 70 fecal samples between March and May 2015. These samples were studied by coproculture and immunochromatography for the detection of enteropathogenic bacteria and viruses, respectively, while enteroparasites were sought by direct microscopic examination, Kinyoun staining method and ELISA for the detection of coproantigens (Entamoeba histolytica, Giardia lamblia and Cryptosporidium spp. Leukocyte count and chemical tests (Benedict, Thevenon and Sudan III were also performed for the functional study of the diarrheal disease. Results: In 48.6% of the samples, the infectious etiology of diarrhea was detected, prevailing the parasitic cause (25.8%, followed by the bacterial (17.1% and viral (5.8% ones. The most common enteropathogens were G. lamblia (18.6% and Salmonella enteritidis (10.0%. An association between greater than 100 fecal leukocytes per field and the bacterial etiology (p=0.027 was observed, while less than 10 fecal leukocytes per field (p=0.002 and a positive Sudam III test (p=0.003 were associated with the parasitic etiology. Conclusions: In more than half of the samples (51.4% the infectious etiology of diarrhea could not be proven, whereas Giardia lamblia was the most frequent cause of diarrhea in the studied population. However, it is necessary to implement more sensitive and specific techniques for the detection of a greater range of enteropathogens with which to improve the diagnosis and treatment of the disease

  20. Diarrhea, pneumonia, and infectious disease mortality in children aged 5 to 14 years in India.

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    Shaun K Morris

    Full Text Available Little is known about the causes of death in children in India after age five years. The objective of this study is to provide the first ever direct national and sub-national estimates of infectious disease mortality in Indian children aged 5 to 14 years.A verbal autopsy based assessment of 3 855 deaths is children aged 5 to 14 years from a nationally representative survey of deaths occurring in 2001-03 in 1.1 million homes in India.Infectious diseases accounted for 58% of all deaths among children aged 5 to 14 years. About 18% of deaths were due to diarrheal diseases, 10% due to pneumonia, 8% due to central nervous system infections, 4% due to measles, and 12% due to other infectious diseases. Nationally, in 2005 about 59 000 and 34 000 children aged 5 to 14 years died from diarrheal diseases and pneumonia, corresponding to mortality of 24.1 and 13.9 per 100 000 respectively. Mortality was nearly 50% higher in girls than in boys for both diarrheal diseases and pneumonia.Approximately 60% of all deaths in this age group are due to infectious diseases and nearly half of these deaths are due to diarrheal diseases and pneumonia. Mortality in this age group from infectious diseases, and diarrhea in particular, is much higher than previously estimated.

  1. Diarrhea

    Science.gov (United States)

    ... lactose intolerance. Diseases that affect the stomach, small intestine, or colon, such as Crohn's disease Problems with how the colon functions, such as irritable bowel syndrome Some people also get diarrhea after stomach surgery, ...

  2. Diarrhea

    OpenAIRE

    Warren, Ralph E.

    1983-01-01

    The four major mechanisms of diarrhea are osmotic forces, secretory forces, exudation from a disrupted intestinal mucosa, and disturbed intestinal motility. In many illnesses, more than one mechanism produces diarrhea. The rotaviruses and the Norwalk viruses have recently been recognized as common causes of viral gastroenteritis. Also, the major cause of antibiotic-associated colitis is now known to be an overgrowth of Clostridium difficile. Campylobacter has also been identified as a common ...

  3. Acute Rotavirus-Induced Diarrhea in Children: Clinical Picture, Diagnosis, Treatment

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    S.L. Niankovskyi

    2015-09-01

    Full Text Available The paper considers the current aspects of epidemiology, diagnosis, clinical picture and treatment of acute rotavirus-induced diarrhea in children. There are presented the basic thesis of ESPGHAN consensus (2014 about acute diarrheas. There was analyzed the effectiveness of probiotic Subalin producing interferon for the treatment of acute rotavirus-induced diarrhea. It was demonstrated its effectiveness according to the literature review and own data.

  4. Identification of a novel picornavirus related to cosaviruses in a child with acute diarrhea

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    Kirkwood Carl D

    2008-12-01

    Full Text Available Abstract Diarrhea, the third leading infectious cause of death worldwide, causes approximately 2 million deaths a year. Approximately 40% of these cases are of unknown etiology. We previously developed a metagenomic strategy for identification of novel viruses from diarrhea samples. By applying mass sequencing to a stool sample collected in Melbourne, Australia from a child with acute diarrhea, one 395 bp sequence read was identified that possessed only limited identity to known picornaviruses. This initial fragment shared only 55% amino acid identity to its top BLAST hit, the VP3 protein of Theiler's-like virus, suggesting that a novel picornavirus might be present in this sample. By using a combination of mass sequencing, RT-PCR, 5' RACE and 3' RACE, 6562 bp of the viral genome was sequenced, which includes the entire putative polyprotein. The overall genomic organization of this virus was similar to known picornaviruses. Phylogenetic analysis of the polyprotein demonstrated that the virus was divergent from previously described picornaviruses and appears to belong to the newly proposed picornavirus genus, Cosavirus. Based on the analysis discussed here, we propose that this virus represents a new species in the Cosavirus genus, and it has tentatively been named Human Cosavirus E1 (HCoSV-E1.

  5. Clinical approach to diarrhea.

    Science.gov (United States)

    Corinaldesi, Roberto; Stanghellini, Vincenzo; Barbara, Giovanni; Tomassetti, Paola; De Giorgio, Roberto

    2012-10-01

    Diarrhea is defined as reduced stool consistency, increased water content and number of evacuations per day. A wide array of causes and pathophysiological mechanisms underlie acute and chronic forms of diarrhea. This review focuses on the major clinical aspects which should aid clinicians to diagnose chronic diarrhea. Clinical history, physical examination and stool evaluation and the predominant stool characteristic, i.e., bloody, watery, and fatty diarrhea, may narrow the differential diagnosis. Although mainly involved in acute diarrhea, many different infectious agents, including bacteria, viruses and protozoa, can be identified in chronic bloody/inflammatory diarrhea by appropriate microbiological tests and colonoscopic biopsy analysis. Osmotic diarrhea can be the result of malabsorption or maldigestion, with a subsequent passage of fat in the stool leading to steatorrhea. Secretory diarrhea is due to an increase of fluid secretion in the small bowel lumen, a mechanism often identified in gastroenteropancreatic neuroendocrine tumors. The evaluation of the fecal osmotic gap may help to characterize whether a chronic diarrhea is osmotic or secretory. Fatty diarrhea (steatorrhea) occurs if fecal fat output exceeds the absorptive/digestive capacity of the intestine. Steatorrhea results from malabsorption or maldigestion states and tests should differentiate between these two conditions. Individualized diagnostic work ups tailored on pathophysiological and clinical features are expected to reduce costs for patients with chronic diarrhea.

  6. Lactose-Free Compared with Lactose-Containing Formula in Dietary Management of Acute Childhood Diarrhea

    OpenAIRE

    Saneian, Hossein; Yaghini, Omid; Modaresi, Mohammadreza; Razmkhah, Narges

    2012-01-01

    Objective Few reports are available on some benefits, such as shortened duration of diarrhea and better weight gain, for lactose-free over lactose-containing formula in acute childhood diarrhea. We evaluated the effects of lactose-free formula in dietary management of acute diarrhea in formula-fed children. Methods This controlled-clinical trial was conducted on formula-fed children, aged 1 to 24 months, referring with acute non-bloody diarrhea (≤2 weeks). Those who had major systemic illness...

  7. DIARRHEA IN CHILDREN: MAIN CAUSES AND WAYS OF TREATMENT

    Directory of Open Access Journals (Sweden)

    S.V. Bel’mer

    2010-01-01

    Full Text Available The article discusses main questions of diagnostics of diarrhea in children. Main cause of acute diarrhea is infection, mainly viral (rotavirus, etc.. Chronic diarrhea frequently has non-infectious origin. The need of multi-aspect diagnostics of diarrhea cause in children is related to the significance of treatment of main disease. Besides, treatment of chronic and acute diarrhea include major component: adsorbents based on smectite. In total treatment of diarrhea has to be complex with the use of dietotherapy and medications: mucocytoprotectors, regulators of motoric, pre- and probiotics.Key words: children, diarrhea, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(6:135-138

  8. Impacts of tropical cyclones and accompanying precipitation on infectious diarrhea in cyclone landing areas of Zhejiang Province, China.

    Science.gov (United States)

    Deng, Zhengyi; Xun, Huanmiao; Zhou, Maigeng; Jiang, Baofa; Wang, Songwang; Guo, Qing; Wang, Wei; Kang, Ruihua; Wang, Xin; Marley, Gifty; Ma, Wei

    2015-01-22

    Zhejiang Province, located in southeastern China, is frequently hit by tropical cyclones. This study quantified the associations between infectious diarrhea and the seven tropical cyclones that landed in Zhejiang from 2005-2011 to assess the impacts of the accompanying precipitation on the studied diseases. A unidirectional case-crossover study design was used to evaluate the impacts of tropical storms and typhoons on infectious diarrhea. Principal component analysis (PCA) was applied to eliminate multicollinearity. A multivariate logistic regression model was used to estimate the odds ratios (ORs) and the 95% confidence intervals (CIs). For all typhoons studied, the greatest impacts on bacillary dysentery and other infectious diarrhea were identified on lag 6 days (OR = 2.30, 95% CI: 1.81-2.93) and lag 5 days (OR = 3.56, 95% CI: 2.98-4.25), respectively. For all tropical storms, impacts on these diseases were highest on lag 2 days (OR = 2.47, 95% CI: 1.41-4.33) and lag 6 days (OR = 2.46, 95% CI: 1.69-3.56), respectively. The tropical cyclone precipitation was a risk factor for both bacillary dysentery and other infectious diarrhea when daily precipitation reached 25 mm and 50 mm with the largest OR = 3.25 (95% CI: 1.45-7.27) and OR = 3.05 (95% CI: 2.20-4.23), respectively. Both typhoons and tropical storms could contribute to an increase in risk of bacillary dysentery and other infectious diarrhea in Zhejiang. Tropical cyclone precipitation may also be a risk factor for these diseases when it reaches or is above 25 mm and 50 mm, respectively. Public health preventive and intervention measures should consider the adverse health impacts from tropical cyclones.

  9. Impacts of Tropical Cyclones and Accompanying Precipitation on Infectious Diarrhea in Cyclone Landing Areas of Zhejiang Province, China

    Directory of Open Access Journals (Sweden)

    Zhengyi Deng

    2015-01-01

    Full Text Available Background: Zhejiang Province, located in southeastern China, is frequently hit by tropical cyclones. This study quantified the associations between infectious diarrhea and the seven tropical cyclones that landed in Zhejiang from 2005–2011 to assess the impacts of the accompanying precipitation on the studied diseases. Method: A unidirectional case-crossover study design was used to evaluate the impacts of tropical storms and typhoons on infectious diarrhea. Principal component analysis (PCA was applied to eliminate multicollinearity. A multivariate logistic regression model was used to estimate the odds ratios (ORs and the 95% confidence intervals (CIs. Results: For all typhoons studied, the greatest impacts on bacillary dysentery and other infectious diarrhea were identified on lag 6 days (OR = 2.30, 95% CI: 1.81–2.93 and lag 5 days (OR = 3.56, 95% CI: 2.98–4.25, respectively. For all tropical storms, impacts on these diseases were highest on lag 2 days (OR = 2.47, 95% CI: 1.41–4.33 and lag 6 days (OR = 2.46, 95% CI: 1.69–3.56, respectively. The tropical cyclone precipitation was a risk factor for both bacillary dysentery and other infectious diarrhea when daily precipitation reached 25 mm and 50 mm with the largest OR = 3.25 (95% CI: 1.45–7.27 and OR = 3.05 (95% CI: 2.20–4.23, respectively. Conclusions: Both typhoons and tropical storms could contribute to an increase in risk of bacillary dysentery and other infectious diarrhea in Zhejiang. Tropical cyclone precipitation may also be a risk factor for these diseases when it reaches or is above 25 mm and 50 mm, respectively. Public health preventive and intervention measures should consider the adverse health impacts from tropical cyclones.

  10. Nutritional Management of Acute Diarrhea in Infants and Children.

    Science.gov (United States)

    National Academy of Sciences-National Research Council, Washington, DC. Food and Nutrition Board.

    Written primarily for health professionals advising on programs and policy related to nutrition and diarrhea therapy, this report is aimed at management of diarrhea in less-developed countries, but its information and technical insights are relevant to an understanding of diarrhea and its management throughout the world. Technical in orientation…

  11. Detection of Infectious Bovine Rhinotracheitis and Bovine Viral Diarrhea Viruses in the Nasal Epithelial Cells by the Direct Immunofluorescence Technique

    Science.gov (United States)

    Silim, A.; Elazhary, M.A.S.Y.

    1983-01-01

    Nasal epithelial cells were collected by cotton swabs for the diagnosis in experimental and field cases of infectious bovine rhinotracheitis and field cases of bovine viral diarrhea in calves. A portion of the cells was washed twice in phosphate buffered saline and a 25 µL drop was placed on microscope slides. The cells were dried, fixed and stained according to the direct fluorescent antibody technique. Another portion of the same specimen was inoculated onto primary bovine skin cell cultures for virus isolation. In the experimental studies for infectious bovine rhinotracheitis, 29/35 specimens were positive by fluorescent antibody technique and 32/35 by cell culture and in the field cases, 22/119 were positive by fluorescent antibody technique and 19/119 by cell culture. In the field cases of bovine viral diarrhea, 28/69 samples were positive by fluorescent antibody technique and 14/69 by cell culture. When fluorescent antibody technique was performed on inoculated cell cultures a total of 24/69 specimens were positive for bovine viral diarrhea. The sensitivity of fluorescent antibody technique was thus comparable to that of cell culture method for infectious bovine rhinotracheitis and bovine viral diarrhea. ImagesFig. 1.Fig. 2.Fig. 3. PMID:6299484

  12. Efficacy of dioctahedral smectite in acute watery diarrhea in Indian children: a randomized clinical trial.

    Science.gov (United States)

    Mujawar, Quais Mohammad; Naganoor, Ravi; Ali, Mir Dilshad; Malagi, Naushad; Thobbi, Achyut Narayan

    2012-02-01

    To determine the effects and safety of dioctahedral smectite (DS) on the duration of acute watery diarrhea in children. A Randomized, open labeled, clinical controlled trial in a tertiary care hospital outpatient department (OPD) and emergency department. Participants were one hundred and seventeen children without any chronic illness between 2 and 5 years presenting to OPD, having acute watery diarrhea for diarrhea in children aged 2-5 years. There were no adverse effects on the use of DS. DS was acceptable to the children, and its administration was not accompanied with any side effects. DS reduces the duration of diarrhea in Indian children and prevents a prolonged course, and therefore, may consistently reduce the costs in treatment of acute watery diarrhea.

  13. Clinical approach and management of chronic diarrhea.

    Science.gov (United States)

    Abdullah, Murdani; Firmansyah, M Adi

    2013-04-01

    Chronic diarrhea is defined as the passage of loose stools that last for more than 4 weeks. Although generally it is estimated that the prevalence of chronic diarrhea only ranges 3-5% of population, but it poses some specific equally essential challenges compared to acute diarrhea because there are many differential diagnosis that should be considered as the cause of chronic diarrhea. One of them includes colorectal cancer and the small intestinal bacterial overgrowth, known as SIBO. In general, chronic diarrhea can be categorized into watery, malabsorption, and inflammatory diarrhea. A proper history taking, physical examination and laboratory investigation is therefore necessary for clinician in managing chronic diarrhea. Overall, the management of chronic diarrhea includes two types, i.e. supportive and pharmacological management both for infectious and non-infectious etiologies. Pharmacological treatment can also be classified into two kinds of treatment including symptomatic and causal treatment, which can be achieved through empirical therapy.

  14. The spray-drying process is sufficient to inactivate infectious porcine epidemic diarrhea virus in plasma.

    Science.gov (United States)

    Gerber, Priscilla F; Xiao, Chao-Ting; Chen, Qi; Zhang, Jianqiang; Halbur, Patrick G; Opriessnig, Tanja

    2014-11-07

    Porcine epidemic diarrhea virus (PEDV) is considered an emergent pathogen associated with high economic losses in many pig rearing areas. Recently it has been suggested that PEDV could be transmitted to naïve pig populations through inclusion of spray-dried porcine plasma (SDPP) into the nursery diet which led to a ban of SDPP in several areas in North America and Europe. To determine the effect of spray-drying on PEDV infectivity, 3-week-old pigs were intragastrically inoculated with (1) raw porcine plasma spiked with PEDV (RAW-PEDV-CONTROL), (2) porcine plasma spiked with PEDV and then spray dried (SD-PEDV-CONTROL), (3) raw plasma from PEDV infected pigs (RAW-SICK), (4) spray-dried plasma from PEDV infected pigs (SD-SICK), or (5) spray-dried plasma from PEDV negative pigs (SD-NEG-CONTROL). For the spray-drying process, a tabletop spray-dryer with industry-like settings for inlet and outlet temperatures was used. In the RAW-PEDV-CONTROL group, PEDV RNA was present in feces at day post infection (dpi) 3 and the pigs seroconverted by dpi 14. In contrast, PEDV RNA in feces was not detected in any of the pigs in the other groups including the SD-PEDV-CONTROL group and none of the pigs had seroconverted by termination of the project at dpi 28. This work provides direct evidence that the experimental spray-drying process used in this study was effective in inactivating infectious PEDV in the plasma. Additionally, plasma collected from PEDV infected pigs at peak disease did not contain infectious PEDV. These findings suggest that the risk for PEDV transmission through commercially produced SDPP is minimal. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Acute neurological involvement in diarrhea-associated hemolytic uremic syndrome.

    Science.gov (United States)

    Nathanson, Sylvie; Kwon, Thérésa; Elmaleh, Monique; Charbit, Marina; Launay, Emma Allain; Harambat, Jérôme; Brun, Muriel; Ranchin, Bruno; Bandin, Flavio; Cloarec, Sylvie; Bourdat-Michel, Guylhene; Piètrement, Christine; Champion, Gérard; Ulinski, Tim; Deschênes, Georges

    2010-07-01

    Neurologic involvement is the most threatening complication of diarrhea-associated hemolytic uremic syndrome (D+HUS). We report a retrospective multicenter series of 52 patients with severe initial neurologic involvement that occurred in the course of D+HUS. Verotoxigenic Escherichia coli infection was documented in 24. All except two patients had acute renal failure that required peritoneal dialysis, hemodialysis, or both techniques. A first group of eight patients remained with normal consciousness; five of them had protracted seizures. A second group of 23 patients had stuporous coma; five of these had protracted severe seizures, and 18 had a neurologic defect including pyramidal syndrome, hemiplegia or hemiparesia, and extrapyramidal syndrome. A third group of 21 patients had severe coma. Plasma exchanges were undertaken in 25 patients, 11 of whom were treated within 24 hours after the first neurologic sign; four died, two survived with severe sequelae, and five were alive without neurologic defect. Magnetic resonance imaging (MRI) for 29 patients showed that (1) every structure of the central nervous system was susceptible to involvement; (2) no correlation seemed to exist between special profile of localization on early MRI and the final prognosis; and (3) MRI did not exhibit any focal lesions in three patients. The overall prognosis of the series was marked by the death of nine patients and severe sequelae in 13. Neurologic involvement is associated with a severe renal disease but does not lead systematically to death or severe disability.

  16. Effectiveness and safety of Lactobacillus LB in the treatment of mild acute diarrhea in children.

    Science.gov (United States)

    Salazar-Lindo, Eduardo; Figueroa-Quintanilla, Dante; Caciano, Maria Isabel; Reto-Valiente, Victoria; Chauviere, Gilles; Colin, Patrick

    2007-05-01

    Acute diarrhea is an important cause of morbidity and mortality in children. Oral rehydration salts (ORS) have lowered mortality without having an effect on the duration or severity of diarrhea. Some studies have reported that heat-killed Lactobacillus bacteria have a beneficial effect in the treatment of acute diarrhea. In this placebo-controlled study the duration of diarrhea was compared for 2 types of treatment: Lactobacillus LB (Lacteol) in association with oral rehydration and oral rehydration alone. A total of 80 nondehydrated children between the ages of 3 months and 4 years with acute watery diarrhea were randomly assigned to be treated with Lactobacillus LB or placebo plus ORS. The primary endpoint was the duration of diarrhea; intake of ORS and change in body weight between the time of randomization and the last assessment were also measured. In 71 of the 80 patients, diarrhea was resolved: 36 in the Lactobacillus LB group and 35 in the placebo group. Several clinical characteristics of the 2 treatment groups were comparable at baseline. Median duration of diarrhea was 16.6 hours in the placebo group compared with 10.0 hours in the Lactobacillus LB group (P = 0.275). In the subgroup with a duration of diarrhea of more than 24 hours at inclusion, duration of diarrhea measured from that point was shorter for the Lactobacillus LB group (30.4 h vs 8.2 h; P = 0.044). ORS intake was similar for both groups. Lactobacillus LB was well tolerated, with only one patient experiencing an adverse effect. Lactobacillus LB is an effective and safe treatment for children with well-established diarrhea (>24 h).

  17. Lactose-free compared with lactose-containing formula in dietary management of acute childhood diarrhea.

    Science.gov (United States)

    Saneian, Hossein; Yaghini, Omid; Modaresi, Mohammadreza; Razmkhah, Narges

    2012-03-01

    Few reports are available on some benefits, such as shortened duration of diarrhea and better weight gain, for lactose-free over lactose-containing formula in acute childhood diarrhea. We evaluated the effects of lactose-free formula in dietary management of acute diarrhea in formula-fed children. This controlled-clinical trial was conducted on formula-fed children, aged 1 to 24 months, referring with acute non-bloody diarrhea (≤2 weeks). Those who had major systemic illness, severe malnutrition, severe dehydration, severe vomiting, or history of antibiotic therapy were not included. Children were allocated to receive lactose-free formula (intervention, n=37) or lactose-containing formula (control, n=34). Time to diarrhea relief and weight change were compared between the two groups after one week. During the study, 32 male and 39 female children (7.1±3.7 months) were included. Those who received lactose-free formula had a significantly shorter time to diarrhea relief compared with the controls (1.7±0.7 vs. 2.6±0.7 days, Pfree formula significantly predicted time to diarrhea relief (95% CI: 1.5 to 3.9, Pfree formula for formula-fed children presenting with acute diarrhea can result in a more rapid relief of acute diarrhea and thus perhaps less mortality and morbidity. Trials with longer follow-ups are warranted to better evaluate long-term results such as weight change and feeding problems in this regard.

  18. Role of zinc supplementation in acute diarrhea in pre-school children

    International Nuclear Information System (INIS)

    Rao, M.Y.; Malik, B.; Raza, A.

    2017-01-01

    Objective: To monitor the therapeutic impact of zinc supplementation on clinical course of acute diarrhea i.e. frequency of stool, on stool amount and duration of acute diarrhea. Study Design: Randomized controlled trial. Place and Duration of Study: Family medicine department, PAF Hospital, Islamabad Pakistan from Jul to Dec 2009. Material and Methods: One hundred and twenty eight children aged 6 months to 60 months in an Outpatient pediatric department of PAF Hospital, E-9 Sector Islamabad with acute diarrhea of less than 14 days were included in this randomized controlled trial. They were further divided into two groups zinc supplemented group (n=65) and non-zinc supplemented group (n=65). Results: Baseline characteristics were similar in both the groups. Mean age in zinc supplemented group was 33.67 +- 16.45 months and in non-zinc supplemented group 33.63 +- 16.44 months. Reduction in stool frequency per day was found 62 percent in zinc supplemented group and 26 percent reduction was found in non-zinc supplemented group with obvious difference of 36 percent between these two groups from day 3 to day 5, which was found statistically significant (p=0.01). Similarly, significant difference (p=0.01) was observed for reduction in amount of stool per day from day 3 and day 5 with obvious difference of 45 percent between the study groups. Conclusions: Oral zinc administration in acute diarrhea reduces the frequency of diarrhea, output of stool and decreases total duration of diarrhea. (author)

  19. Relationship of Renal Function Tests and Electrolyte Levels with Severity of Dehydration in Acute Diarrhea.

    Science.gov (United States)

    Gauchan, E; Malla, K K

    2015-01-01

    Acute diarrheal illness constitutes a major cause of morbidity and mortality in children in developing countries. Most of the complications of diarrhea occur due to excessive fluid and electrolyte loss; adverse complications are seen more with increasing severity of dehydration. This study was conducted to identify the relation of renal function and electrolyte abnormalities in children with varying severity of dehydration. This study was carried out in Manipal Teaching Hospital, Pokhara, Nepal over duration of one year. The aims were to find out the association of renal function and electrolyte disturbances with type of diarrhea, severity of dehydration and their relation to outcome. All children more than one month and less than 15 years with acute diarrhea were included in the study. Data were entered and analyzed by SPSS version 19. Statistical analysis applied was Chi-square test. A p-value of Dehydration was associated more with Acute Watery Diarrhea than with Invasive Diarrhea. Renal function and electrolyte abnormalities were seen more in Acute Watery Diarrhea with increasing levels of blood urea, serum creatinine and abnormal levels of serum sodium seen with increased severity of dehydration. Abnormalities in renal function and electrolytes correlated significantly with severity of dehydration. The outcome of patients correlated with severity of dehydration with mortality occurring in 18.1% of patients with Severe dehydration, 0.8% of Some dehydration with no mortality in the No dehydration group.

  20. Efficacy and safety of Saccharomyces boulardii in acute childhood diarrhea: a double blind randomised controlled trial.

    Science.gov (United States)

    Riaz, Musheer; Alam, Seema; Malik, Abida; Ali, S Manazir

    2012-04-01

    To see the efficacy and safety of 250 mg of Saccharomyces boulardii twice daily for 5 d in acute childhood diarrhea. Children aged between 3 mo and 59 mo with acute onset diarrhea (of less than 48 h) admitted in DTTU (diarrhea treatment and training unit) were included and those with clinical evidence of severe malnutrition, systemic infection, encephalopathy and/or convulsion, electrolyte imbalance, invasive diarrhea or previous use of any probiotics were excluded from the study. Those included randomly were given either a placebo or Saccharomyces boullardi (SB) in identical packets mixed with puffed rice powder. Mean post intervention duration of diarrhea was significantly (95% CI = -28.13 to -5.43) shorter in SB group (52.08 ± 24.57 h) as compared to placebo group (64.04 ± 30.43 h). The time of appearance of first semi formed stool in SB group (39.48 ± 23.09 h) was significantly (95% CI -25.4 to -3.87) shorter than the placebo group (54.13 ± 28.21 h). No statistically significant difference was found in rest of the parameters. There is initial evidence available that SB may have a therapeutic role in the management of acute childhood diarrhea.

  1. Influence of Zinc Supplementation in Acute Diarrhea Differs by the Isolated Organism

    Directory of Open Access Journals (Sweden)

    Archana B. Patel

    2010-01-01

    Full Text Available Zinc supplementation is recommended in all acute diarrheas in children from developing countries. We aimed to assess whether zinc supplementation would be equally effective against all the common organisms associated with acute diarrheas. We used data on 801 children with acute diarrhea recruited in a randomized, double blind controlled trial (ISRCTN85071383 of zinc and copper supplementation. Using prespecified subgroup analyses, multidimensionality reduction analyses, tests of heterogeneity, and stepwise logistic regression for tests of interactions, we found that the influence of zinc on the risk of diarrhea for more than 3 days depended on the isolated organism—beneficial in Klebsiella, neutral in Esherichia coli and parasitic infections, and detrimental in rotavirus coinfections. Although we found similar results for the outcome of high stool volume, the results did not reach statistical significance. Our findings suggest that the current strategy of zinc supplementation in all cases of acute diarrheas in children may need appropriate fine tuning to optimize the therapeutic benefit based on the causative organism, but further studies need to confirm and extend our findings.

  2. Risk factors for extended duration of acute diarrhea in young children.

    Directory of Open Access Journals (Sweden)

    Tor A Strand

    Full Text Available OBJECTIVE AND BACKGROUND: We sought to identify predictors of extended duration of diarrhea in young children, which contributes substantially to the nearly 1 1/2 million annual diarrheal deaths globally. METHODS: We followed 6-35 month old Nepalese children enrolled in the placebo-arm of a randomized controlled trial with 391 episodes of acute diarrhea from the day they were diagnosed until cessation of the episode. Using multiple logistic regression analysis, we identified independent risk factors for having diarrhea for more than 7 days after diagnosis. RESULTS: Infants had a 17 (95% CI 3.5, 83-fold and toddlers (12 to 23 month olds a 9.9 (95% CI 2.1, 47-fold higher odds of having such illness duration compared to the older children. Not being breastfed was associated with a 9.3 (95% CI 2.4, 35.7-fold increase in the odds for this outcome. The odds also increased with increasing stool frequency. Furthermore, having diarrhea in the monsoon season also increased the risk of prolonged illness. CONCLUSION: We found that high stool frequency, not being breastfed, young age and acquiring diarrhea in the rainy season were risk factors for prolonged diarrhea. In populations such as ours, breastfeeding may be the most important modifiable risk factor for extended duration of diarrhea.

  3. Acute treatment-related diarrhea during postoperative adjuvant therapy for high-risk rectal carcinoma

    International Nuclear Information System (INIS)

    Miller, Robert C.; Martenson, James A.; Sargent, Daniel J.; Kahn, Michael J.; Krook, James E.

    1998-01-01

    Purpose: The combination of pelvic radiotherapy and 5-fluorouracil-based chemotherapy is associated with an increase in acute gastrointestinal toxicity during rectal adjuvant therapy, most notably an increased incidence of diarrhea. Previous randomized, prospective studies have limited their analysis to presenting rates of severe and life-threatening diarrhea (Grade 3 or greater), and few data are available detailing the extent of mild to moderate diarrhea. To provide baseline data for future studies, we conducted a detailed analysis of diarrhea from a prior clinical trial of adjuvant therapy for rectal cancer. Methods and Materials: In a multiinstitutional clinical trial, 204 eligible patients with rectal carcinoma that either was deeply invasive (T3-T4) or involved regional lymph nodes were randomized to receive either postoperative pelvic radiotherapy alone (45 to 50.4 Gy) or pelvic radiotherapy and bolus 5-fluorouracil-based chemotherapy. Toxicity was assessed prospectively. Results: For the 99 eligible patients who received pelvic radiotherapy alone, rates of Grades 0, 1, 2, 3, and 4 diarrhea during treatment were 59, 20, 17, 4, and 0%, respectively. For the 96 eligible patients who received radiotherapy and 5-fluorouracil, the overall rates of grades 0, 1, 2, 3, and 4 diarrhea were 21, 34, 23, 20, and 2%, respectively. The increased rates of diarrhea during adjuvant rectal therapy were manifested across all toxicity levels for patients receiving chemotherapy and pelvic radiotherapy. Of primary clinical importance is the substantial increase in severe or life-threatening diarrhea (Grade 3 or more) (22 vs. 4%, p = 0.001) Additionally, increased rates of any diarrhea and also severe or life-threatening diarrhea were observed in patients who had a low anterior resection compared with those who had an abdominoperineal resection (p < 0.001 and p = 0.006, respectively). Conclusion: These results will be of value as a baseline for investigators who want to use

  4. Effect of probiotics on diarrhea in children with severe acute malnutrition

    DEFF Research Database (Denmark)

    Grenov, Benedikte; Namusoke, Hanifa; Lanyero, Betty

    2017-01-01

    OBJECTIVES: To assess the effect of probiotics on diarrhea during in- and outpatient treatment of children with severe acute malnutrition (SAM). METHODS: A randomized, double-blind, placebo-controlled study was conducted involving 400 children admitted with SAM. Patients received one daily dose...

  5. Diarrheagenic Escherichia coli and acute and persistent diarrhea in returned travelers

    NARCIS (Netherlands)

    Schultsz, C.; van den Ende, J.; Cobelens, F.; Vervoort, T.; van Gompel, A.; Wetsteyn, J. C.; Dankert, J.

    2000-01-01

    To determine the role of diarrheagenic Escherichia coli in acute and persistent diarrhea in returned travelers, a case control study was performed. Enterotoxigenic E. coli (ETEC) was detected in stool samples from 18 (10.7%) of 169 patients and 4 (3.7%) of 108 controls. Enteroaggregative E. coli

  6. Association between child-care and acute diarrhea: a study in Portuguese children

    Directory of Open Access Journals (Sweden)

    Barros Henrique

    2003-01-01

    Full Text Available OBJECTIVE: To quantify the influence of the type of child-care on the occurrence of acute diarrhea with special emphasis on the effect of children grouping during care. METHODS: From October 1998 to January 1999 292 children, aged 24 to 36 months, recruited using a previously assembled cohort of newborns, were evaluated. Information on the type of care and occurrence of diarrhea in the previous year was obtained from parents by telephone interview. The X² and Kruskal-Wallis tests were used to compare proportions and quantitative variables, respectively. The risk of diarrhea was estimated through the calculation of incident odds ratios (OR and their respective 95% confidence intervals (95% CI, crude and adjusted by unconditional logistic regression. RESULTS: Using as reference category children cared individually at home, the adjusted ORs for diarrhea occurrence were 3.18, 95% CI [1.49, 6.77] for children cared in group at home, 2.28, 95% CI [0.92, 5.67] for children cared in group in day-care homes and 2.54, 95% CI [1.21, 5.33] for children cared in day-care centers. Children that changed from any other type of child-care setting to child-care centers in the year preceding the study showed a risk even higher (OR 7.65, 95% CI [3.25, 18.02]. CONCLUSIONS: Group care increases the risk of acute diarrhea whatsoever the specific setting.

  7. An Acute Hemorrhagic Infectious Disease: Ebola Virus Disease

    Directory of Open Access Journals (Sweden)

    JIAO Lei

    2014-09-01

    Full Text Available Ebola virus disease (EVD is an acute hemorrhagic infectious disease caused by ebola virus, with high infectivity and fatality rate. At present, it mainly occurs in areas of Central Africa and West Africa and no effective vaccine and antiviral drugs are available for the clinical treatment.

  8. SWAB guidelines for antimicrobial therapy of acute infectious diarrhoea

    NARCIS (Netherlands)

    Bos, J. C.; Schultsz, C.; Vandenbroucke-Graulsz, C. M. J.; Speelman, P.; Prins, J. M.

    2006-01-01

    The Dutch Working Party on Antibiotic Policy (SWAB: Stichting Werkgroep Antibioticabeleid) develops evidence-based guidelines for the use of antibiotics in hospitalised adults. In this article we discuss the guideline on antibiotic treatment of acute infectious diarrhoea (AID). AID can be subdivided

  9. Isolated gut relapse presenting as chronic diarrhea during maintenance therapy for acute lymphoblastic leukemia.

    Science.gov (United States)

    Bhatti, Anuj; Bansal, Deepak; Vashishta, Rakesh K; Lal, Sadhna B

    2010-08-01

    Ten-year-old boy with acute lymphoblastic leukemia (ALL)-T cell subtype was on MRC UKALL 2003-based chemotherapy. Bone marrow attained remission after induction. After 8 months into maintenance, he presented with chronic diarrhea and weight loss. Search for infective and malabsorptive etiology was unrewarding. Infiltration with leukemic cells was seen in the lamina propria on mucosal biopsies of duodenum and colon. Marrow was in remission. Isolated gut relapse is exceedingly rare. It should be considered in the etiology of chronic diarrhea in patients with ALL, after common causes are excluded.

  10. Teaching treatment of mild, acute diarrhea and secondary dehydration to homeless parents.

    Science.gov (United States)

    Smith, L G

    1987-01-01

    Homeless people in America are at risk for numerous health hazards. Diarrhea and consequent dehydration commonly affect homeless infants and children. Dehydration, if not treated, can quickly become a medical emergency. If, however, signs of diarrhea and dehydration are recognized and treated early, medical complications may be avoided. Fortunately, some homeless people now have access to shelter facilities that provide health education and services. Education is a fundamental tool in the prevention of disease. For homeless children sick with diarrhea, an educated parent may mean the difference between life and death. Therefore, an educational program was developed to help homeless parents recognize and treat mild, acute diarrhea and secondary dehydration. Participants were urged to treat mild diarrhea at home with oral rehydration therapy, thus preventing expensive medical treatment and hospitalization. The project was based on a format used in workshops designed for battered women's shelters. The program's philosophy reflects the belief that people possess many answers to problems, but often lack the opportunity or encouragement to make use of their knowledge.

  11. Prevalence of microsporidia in healthy individuals and immunocompetent patients with acute and chronic diarrhea.

    Science.gov (United States)

    Mumcuoglu, Ipek; Cetin, Feyza; Dogruman Al, Funda; Oguz, Ilkiz; Aksu, Neriman

    2016-02-01

    Previously published studies of microsporidial infections have primarily focused on immunodeficient or immunocompromised patients. Data regarding infections caused by this microorganism in immunocompetent subjects are lacking. In the present study, we investigated the prevalence of microsporidia in healthy individuals and immunocompetent patients with acute and chronic diarrhea. The study included stool samples from 74 patients with acute diarrhea, 41 patients with chronic diarrhea, and 88 healthy volunteers. Slides were prepared after concentration with a formalin-ethyl acetate technique and were stained with modified trichrome, calcofluor white, and Uvitex 2B stains. The number of spores observed in each magnification field (×1000) was scored as follows: 1+, 1-10; 2+, 11-20; 3+, > 20. The prevalence of microsporidia was 27.0% in patients with acute diarrhea, 34.1% in patients with chronic diarrhea, and 45.5% in healthy volunteers. The parasite score was 1 + in all positive samples. The rate of microsporidia positivity was higher in solid stools (51.4%), and the rate of positivity increased with advancing age. Unexpectedly, a high prevalence of microsporidia was found in immunocompetent individuals in our region. There was no relationship between positivity for microsporidia and the presence of symptoms, due to higher rates both in solid stools and in healthy subjects. The parasite score was the same in all groups. Our results indicate that there is high exposure to microsporidia in immunocompetent subjects in our region. Natural reservoirs and environmental sources of microsporidia should be determined to design strategies for effective prevention of transmission.

  12. The fecal microbiome in dogs with acute diarrhea and idiopathic inflammatory bowel disease.

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    Jan S Suchodolski

    Full Text Available BACKGROUND: Recent molecular studies have revealed a highly complex bacterial assembly in the canine intestinal tract. There is mounting evidence that microbes play an important role in the pathogenesis of acute and chronic enteropathies of dogs, including idiopathic inflammatory bowel disease (IBD. The aim of this study was to characterize the bacterial microbiota in dogs with various gastrointestinal disorders. METHODOLOGY/PRINCIPAL FINDINGS: Fecal samples from healthy dogs (n = 32, dogs with acute non-hemorrhagic diarrhea (NHD; n = 12, dogs with acute hemorrhagic diarrhea (AHD; n = 13, and dogs with active (n = 9 and therapeutically controlled idiopathic IBD (n = 10 were analyzed by 454-pyrosequencing of the 16S rRNA gene and qPCR assays. Dogs with acute diarrhea, especially those with AHD, had the most profound alterations in their microbiome, as significant separations were observed on PCoA plots of unweighted Unifrac distances. Dogs with AHD had significant decreases in Blautia, Ruminococcaceae including Faecalibacterium, and Turicibacter spp., and significant increases in genus Sutterella and Clostridium perfringens when compared to healthy dogs. No significant separation on PCoA plots was observed for the dogs with IBD. Faecalibacterium spp. and Fusobacteria were, however, decreased in the dogs with clinically active IBD, but increased during time periods of clinically insignificant IBD, as defined by a clinical IBD activity index (CIBDAI. CONCLUSIONS: Results of this study revealed a bacterial dysbiosis in fecal samples of dogs with various GI disorders. The observed changes in the microbiome differed between acute and chronic disease states. The bacterial groups that were commonly decreased during diarrhea are considered to be important short-chain fatty acid producers and may be important for canine intestinal health. Future studies should correlate these observed phylogenetic differences with functional changes in the intestinal

  13. [Antiviral activity of different drugs in vitro against viruses of bovine infectious rhinotracheitis and bovine diarrhea].

    Science.gov (United States)

    Glotov, A G; Glotova, T I; Sergeev, A A; Belkina, T V; Sergeev, A N

    2004-01-01

    In vitro experiments studied the antiviral activity of 11 different drugs against viruses of bovine infective rhinotracheitis (BIRT) and bovine viral diarrhea (BVD). The 50% inhibiting concentrations of the test agents were determined in the monolayers of MDBK and KCT cell cultures. Only did phosprenyl show a virucidal activity against BIRT virus. All the tested drugs significantly inhibited the reproduction of BIRT virus in the sensitive MDBK cell cultures. Thus, bromuridin, acyclovir, ribavirin and methisazonum inhibited the virus by > or = 100,000 times; liposomal ribavirin, gossypolum, anandinum, polyprenolum, phosprenyl, by 1000-10,000 times; eracond and argovit, by 100 times. In experiments on BVD virus, the cultured KCT cells displayed the antiviral activity of bromuridin, phosprenil, polyprenolum, methisazonum, acyclovir, gossypolum, argovit, and ribavirin (in two variants), which caused a statistically significant (100-10,000-fold) decrease in the productive activity of this virus. Eracond and anandid proved to be ineffective.

  14. Risk factors for predicting diarrheal duration and morbidity in children with acute diarrhea.

    Science.gov (United States)

    Patel, Archana B; Ovung, Ronithung; Badhoniya, Neetu B; Dibley, Michael J

    2012-04-01

    To identify baseline risk factors for prolonged diarrheal duration and subsequent complications in children aged 6 to 59 mo with acute diarrhea who participated in a micronutrient clinical trial in a tertiary care hospital. The adjusted odds ratio or incidence risk ratios (IRR) of the baseline variables for prolongation of diarrheal duration (cox proportional hazard model), diarrhea >7 d (multiple logistic regressions), severe dehydration experienced after hospitalization (poisson regression models) was estimated. Fever (OR 1.10, 95% CI 1.02-1.19, p = 0.02), dehydration (OR 1.32, 95% CI 1.10-1.59, p = 0.003), dysentery (OR 1.41 95% CI 1.09-1.82, p = 0.008), those who received medications (OR 1.19, 95% CI 1.03-1.39, p = 0.02), and weight for age Z-score ≤2 (OR 1.25, 95% CI 1.07-1.46, p = 0.004) were at a greater risk of prolonged diarrhea. Diarrhea >7 d was associated with younger age (OR 1.08, 95% CI 1.03-1.14, p = 0.003), female child (OR 2.33, 95% CI 1.19-4.55, p = 0.013), diarrheal duration before enrolment (OR 1.06, 95% CI 1.04-1.09, p associated with dehydration at baseline (OR 6.7, 95% CI 2-3.0, p risk factors for diarrheal morbidity prospectively. The present study showed that children of acute diarrhea with above risk factors need stricter monitoring for complications to reduce diarrheal mortality.

  15. [Death caused by acute diarrhea in children: a study of prognostic factors].

    Science.gov (United States)

    Tomé, P; Reyes, H; Rodríguez, L; Guiscafré, H; Gutiérrez, G

    1996-01-01

    To identify prognostic factors of death due to acute diarrhea related to the process disease-health care-death in the State of Tlaxcala, Mexico. A case-control design was used. Cases were defined as children who died between the ages of seventy-two hours and five years between 1992 and 1994. An event of acute diarrhea was the main cause of death stated in the death certificate. Case ascertainment was done through the verbal autopsy method. Controls were children who had suffered acute diarrhea with at least one sign of dehydration or alarm and had overcome the diarrheal episode. Controls were randomly selected from the population at large and were matched by age with cases. One hundred and six cases and the same number of controls were taken. Using a logistic regression procedure in which severity of illness and days of evolution were controlled for, the prognosis-worsening predictors were: visit provided by private physician (OR 8.9); inappropriate treatment (OR 10.4); a working mother (OR 8.7); mother's lack of knowledge to identify dehydration signs (OR 8.1); siblings' malnutrition (OR 28.2); and malnutrition prior to the diarrheal event (OR 7.5). These findings suggest that factors worsening the outcome of the diarrheal episode are: malnutrition, the inappropriate treatment provided by private physicians, and the deficient household care of the diarrheal episode.

  16. Secretory diarrhea.

    Science.gov (United States)

    Schiller, L R

    1999-10-01

    Diarrhea, defined as loose stools, occurs when the intestine does not complete absorption of electrolytes and water from luminal contents. This can happen when a nonabsorbable, osmotically active substance is ingested ("osmotic diarrhea") or when electrolyte absorption is impaired ("secretory diarrhea"). Most cases of acute and chronic diarrhea are due to the latter mechanism. Secretory diarrhea can result from bacterial toxins, reduced absorptive surface area caused by disease or resection, luminal secretagogues (such as bile acids or laxatives), circulating secretagogues (such as various hormones, drugs, and poisons), and medical problems that compromise regulation of intestinal function. Evaluation of patients with secretory diarrhea must be tailored to find the likely causes of this problem. Specific and nonspecific treatment can be valuable.

  17. Comparison of Three Oral Rehydration Strategies in the Treatment of Acute Diarrhea in a Tropical Country

    Science.gov (United States)

    Pignatelli, Salvatore; Musumeci, Salvatore

    2003-01-01

    Background: The administration of hydrating solutions and early refeeding improve recovery for infants and children with diarrhea. Objective: The aim of this study was to assess the efficacy of a low-osmolarity (30 mEq/L Na+) solution administered after the standard, high-osmolarity (90 mEq/L Na+) solution via a nasogastric tube (NGT) and followed by early refeeding to achieve more rapid body weight recovery in infants and children with acute diarrhea. Methods: Infants and children aged 6 hours) with the low-osmolarity solution, versus 10% and 12% in groups B and C, respectively. A total of 3% of patients treated with combined rehydration required hospitalization, compared with 10% and 9% in groups B and C, respectively. At the end of infusion, 25% of the patients rehydrated only with a low-osmolarity solution showed poor body weight recovery and appeared lethargic, versus 10% in group A and 15% in group C. Patients who were rehydrated with a high-osmolarity solution showed symptoms of hypernatremia (serum Na+ concentration >140 mEq/L). At the end of rehydration (≥6 hours), all patients recovered their previous body weight, partially or totally, and refeeding was begun. Rehydration and diet were continued at home, or in neighboring areas for those living far away. Conclusions: In this study population, the administration of a high-osmolarity solution followed by a low-osmolarity solution and early refeeding was effective in the treatment of acute diarrhea and was well tolerated. PMID:24944365

  18. Probiotics for prevention and treatment of diarrhea.

    Science.gov (United States)

    Guandalini, Stefano

    2011-11-01

    Probiotics have been extensively studied over the past several years in the prevention and, to a larger extent, in the treatment of diarrheal diseases, especially in pediatric populations. Diarrhea is a symptom, and not a disease. This review will not address chronic disorders associated with diarrhea, or Clostridium difficile-induced diarrhea. Rather it will focus on published clinical trials performed on acute-onset, likely infectious diarrhea occurring in the settings of day-care centers, in the community, acquired in the hospital, antibiotic-associated diarrhea, and treatment of acute infectious diarrhea. For prevention of diarrhea acquired in day-care centers, 9 randomized and placebo-controlled trials have been published, conducted in different parts of the world. Probiotics tested were Lactobacillus GG, Bifidobacterium lactis (alone or in combination with Streptococcus thermophilus, and Lactobacillus reuteri, Lactobacillus rhamnosus (not GG), and Lactobacillus acidophilus, in various trials either alone or in comparison with each other. The evidence of their efficacy in these settings is only modest for the prevention of diarrhea, although somewhat better for prevention of upper respiratory infections. In the community, new trails conducted in underprivileged areas of India, again with modest efficacy. Previous trials that examined the potential role of probiotics in preventing the spreading of diarrhea in hospitalized children had yielded conflicting results. More recently, a large trial in Poland showed, however, rather good evidence of efficacy for Lactobacillus GG. The prevention of antibiotic-associated diarrhea has been the subject of many investigations, both in children and in adults. Most commonly used probiotics were Lactobacillus GG, Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium ssp, Streptococcus ssp, and the yeast Saccharomyces boulardii. In general, most of these trials do show clear evidence of efficacy, with the 2 most

  19. Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums.

    Science.gov (United States)

    Arifeen, S; Black, R E; Antelman, G; Baqui, A; Caulfield, L; Becker, S

    2001-10-01

    To describe breastfeeding practices and investigate the influence of exclusive breastfeeding in early infancy on the risk of infant deaths, especially those attributable to respiratory infections (ARI) and diarrhea. A prospective observational study was conducted on a birth cohort of 1677 infants who were born in slum areas of Dhaka in Bangladesh and followed from birth to 12 months of age. After enrollment at birth, the infants were visited 5 more times by 12 months of age. Verbal autopsy, based on a structured questionnaire, was used to assign a cause to the 180 reported deaths. Proportional hazards regression models were used to estimate the effect of breastfeeding practices, introduced as a time-varying variable, after accounting for other variables, including birth weight. Overall neonatal, postneonatal and infant mortality, and mortality attributable to ARI and diarrhea were measured. The proportion of infants who were breastfed exclusively was only 6% at enrollment, increasing to 53% at 1 month and then gradually declining to 5% at 6 months of age. Predominant breastfeeding declined from 66% at enrollment to 4% at 12 months of age. Very few infants were not breastfed, whereas the proportion of partially breastfed infants increased with age. Breastfeeding practices did not differ between low and normal birth weight infants at any age. The overall infant mortality rate was 114 deaths per 1000 live births. Compared with exclusive breastfeeding in the first few months of life, partial or no breastfeeding was associated with a 2.23-fold higher risk of infant deaths resulting from all causes and 2.40- and 3.94-fold higher risk of deaths attributable to ARI and diarrhea, respectively. The important role of appropriate breastfeeding practices in the survival of infants is clear from this analysis. The reduction of ARI deaths underscores the broad-based beneficial effect of exclusive breastfeeding in prevention of infectious diseases beyond its role in reducing

  20. Spiramycin vs. placebo for treatment of acute diarrhea caused by Cryptosporidium.

    Science.gov (United States)

    Sáez-Llorens, X; Odio, C M; Umaña, M A; Morales, M V

    1989-03-01

    The efficacy of spiramycin was evaluated in a double blind, placebo-controlled study of 44 immunocompetent infants ages 2 to 13 months who had acute diarrhea caused by Cryptosporidium. Twenty-one patients received spiramycin (100 mg/kg/day) for 10 days and 23 received placebo. On admission the patients in both groups were comparable regarding demographic and clinical characteristics. The infants who were treated with spiramycin had a shorter duration of diarrhea (mean, 5.2 vs. 7.3 days; P = 0.002) and a shorter duration of excretion of oocysts in the stools (7.1 vs. 8.5 days; P = 0.032) compared with those treated with placebo. No clinical or parasitologic relapses were seen in patients of both groups. Mild adverse effects to spiramycin were observed in 2 patients (10%). Spiramycin appeared to hasten clinical recovery and decrease the duration of oocyst excretion in immunocompetent children with diarrheal illness caused by Cryptosporidium.

  1. Dembo-PCR technique for the detection of bovine abortion, diarrhea, and respiratory disease complex infectious agents in potential vectors and reservoirs.

    Science.gov (United States)

    Rahpaya, Sayed Samim; Tsuchiaka, Shinobu; Kishimoto, Mai; Oba, Mami; Katayama, Yukie; Nunomura, Yuki; Kokawa, Saki; Kimura, Takashi; Kobayashi, Atsushi; Kirino, Yumi; Okabayashi, Tamaki; Nonaka, Nariaki; Mekata, Hirohisa; Aoki, Hiroshi; Shiokawa, Mai; Umetsu, Moeko; Morita, Tatsushi; Hasebe, Ayako; Otsu, Keiko; Asai, Tetsuo; Yamaguchi, Tomohiro; Makino, Shinji; Murata, Yoshiteru; Abi, Ahmad Jan; Omatsu, Tsutomu; Mizutani, Tetsuya

    2017-12-28

    The bovine abortion, diarrhea, and respiratory disease complexes, caused by infectious agents, result in high and significant economic losses for the cattle industry. These pathogens are likely transmitted by various vectors and reservoirs including insects, birds and rodents. However, experimental data that supports this possibility are scarce. We collected total 117 samples and screened for 44 bovine abortive, diarrheal and respiratory disease complex pathogens by using Dembo-PCR, based on TaqMan real-time PCR. Fifty-seven samples showed positive for at least one pathogen, including bovine viral diarrhea virus, bovine enterovirus, Salmonella enterica ser. Dublin, salmonella enterica ser. Typhimurium, and Neospora caninum ; some samples contained multiple pathogens. Bovine viral diarrhea virus and bovine enterovirus represented the most frequently detected pathogens, especially in flies, suggesting the important role of flies in the transmission of these viruses. Additionally, we detected the N. caninum genome from a cockroach sample for the first time. Our data suggests that insects (particularly flies), birds, and rodents are potential vectors and reservoirs of the abortion, diarrhea, and respiratory infectious agents and that they may transmit more than one pathogen at the same time.

  2. Impact of Childhood Nutritional Status on Pathogen Prevalence and Severity of Acute Diarrhea.

    Science.gov (United States)

    Tickell, Kirkby D; Pavlinac, Patricia B; John-Stewart, Grace C; Denno, Donna M; Richardson, Barbra A; Naulikha, Jaqueline M; Kirera, Ronald K; Swierczewski, Brett E; Singa, Benson O; Walson, Judd L

    2017-11-01

    Children with acute and chronic malnutrition are at increased risk of morbidity and mortality following a diarrheal episode. To compare diarrheal disease severity and pathogen prevalence among children with and without acute and chronic malnutrition, we conducted a cross-sectional study of human immunodeficiency virus-uninfected Kenyan children aged 6-59 months, who presented with acute diarrhea. Children underwent clinical and anthropometric assessments and provided stool for bacterial and protozoal pathogen detection. Clinical and microbiological features were compared using log binomial regression among children with and without wasting (mid-upper arm circumference ≤ 125 mm) or stunting (height-for-age z score ≤ -2). Among 1,363 children, 7.0% were wasted and 16.9% were stunted. After adjustment for potential confounders, children with wasting were more likely than nonwasted children to present with at least one Integrated Management of Childhood Illness danger sign (adjusted prevalence ratio [aPR]: 1.3, 95% confidence interval [CI]: 1.0 to 1.5, P = 0.05), severe dehydration (aPR: 2.4, 95% CI: 1.5 to 3.8, P < 0.01), and enteroaggregative Escherichia coli recovered from their stool (aPR: 1.8, 1.1-2.8, P = 0.02). There were no differences in the prevalence of other pathogens by wasting status after confounder adjustment. Stunting was not associated with clinical severity or the presence of specific pathogens. Wasted children with diarrhea presented with more severe disease than children without malnutrition which may be explained by a delay in care-seeking or diminished immune response to infection. Combating social determinants and host risk factors associated with severe disease, rather than specific pathogens, may reduce the disparities in poor diarrhea-associated outcomes experienced by malnourished children.

  3. OPEN ENDED RESULTS OF ACUTE DIARRHEA AGENT DETECTION TO VERIFY DIAGNOSIS IN ADULT CASES

    Directory of Open Access Journals (Sweden)

    E. A. Kozhukhova

    2016-01-01

    Full Text Available In 264 adult acute diarrhea cases with moderate course it was analyzed both symptoms and agents detected by different methods: in 91 cases (examined in the period of shigellosis high incidence level — by culture and serologic (specific antibodies detection methods to detect Shigella spp. and Salmonella spp. plus ELISA method to detect rotavirus antigen in feces; in 173 cases (examined in the period of shigellosis low incidence level — by above mentioned methods plus PCR based method. Data obtained in the period of shigellosis high incidence level have shown that there has been no significant difference in clinical scores (including colitis frequency between cases positive only for rotavirus antigen and those positive both for rotavirus antigen and Shigella spp. culture. That let suspect that acute diarrhea had been likely to be caused by association of rotavirus with any bacterial agent undetected by the methods used. PCR-based diagnostic method additionally used (in the period of shigellosis low incidence level resulted in detection of Campylobacter spp. accounted for campilobacteriosis as mono infection in 20,8% cases and as mixed infection (in association with other enteropatho-gens — in 4% cases. In cases with colitis the additional usage of PCR-based diagnostic method resulted in Salmonella spp. and Campylobacter spp. detection in every third case, Shigella spp. and agent association detection — in every fifth case. The target analysis of enteropathogens detected in 15 cases positive for rotavirus (examined in the period of shigellosis low incidence level has shown that in 6 of them there has been detected association of rotavirus with other agents predominantly bacterial ones (in 5 of 6 cases. So, the PCR method might be quite useful to broaden the spectrum of detected enteropathogens in adult acute diarrhea cases especially in those with colitis syndrome available.

  4. The Relation between Helicobacter pylori Infection and Acute Bacterial Diarrhea in Children

    Directory of Open Access Journals (Sweden)

    Maryam Monajemzadeh

    2014-01-01

    Full Text Available Background. H. pylori infection leads to chronic gastritis in both children and adults. But recently, there are arising theories of its protective effect in diarrheal diseases. Aim. To explore the prevalence of H. pylori infection in children with bacterial diarrhea and compare it with healthy controls. Patients and Methods. Two matched groups consisted of 122 consecutive children, aged 24–72 months old, with acute bacterial diarrhea, who had Shigellosis (N=68 and Salmonellosis (N=54 as patients group and 204 healthy asymptomatic children as control group enrolled in this study. Results. The prevalence of H. pylori infection in healthy control children was significantly higher than in patients group, (odds ratio = 3.6, 95% CI: 1.33–9.5, P=0.007. In our study, only 2/54 Salmonella infected patients and 3/68 of Shigellosis had evidence of H. pylori infection, while normal control children had 27/204 infected individuals. Conclusion. H. pylori infection may play a protective role against bacterial diarrhea in children. So it is important to consider all of the positive and negative aspects of H. pylori infection before its eradication.

  5. Occurrence of acute respiratory infection, diarrhea and jaundice among Afghan pilgrims, 2010.

    Science.gov (United States)

    Saeed, Khwaja Mir Islam; Mofleh, Jawad; Rasooly, M Hafiz; Aman, M Iabal

    2012-12-01

    Annually 30,000 Afghans attend the Hajj in Saudi Arabia that is one of the largest mass gathering events in the world. We aimed to determine the prevalence of three syndromes of interest diarrhea, acute respiratory infections (ARI) and jaundice-among Hajjis gathering at the four transit sites in Afghanistan before, during, and after their voyage. A total of 1659 Hajjis at four transit sites were selected and included a cross-sectional study. Information was collected prior Hajjis departure and upon their return from Saudi Arabia regarding demographics and experience of diarrhea, ARI and jaundice. Standardized case definitions were used for the three health outcomes of interest. The occurrence of diarrhea and jaundice remained constant over time. However, ARI increased from 1.4% at pre-transit to 4% at transit area and 37% during the Hajj. ARI rates among residents from the Central and Northern regions of Afghanistan were significantly higher at the post-Hajj stage, at 50% and 69%, respectively. There was no difference in ARI by sex among Hajjis. There is a need to review the quality and effectiveness of the flu vaccine. Authorities should come up with the sound strategies to overcome ARI problems during Hajj. Copyright © 2012 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  6. Occurrence of acute respiratory infection, diarrhea and jaundice among Afghan pilgrims, 2010

    Directory of Open Access Journals (Sweden)

    Khwaja Mir Islam Saeed

    2012-12-01

    Background: Annually 30,000 Afghans attend the Hajj in Saudi Arabia that is one of the largest mass gathering events in the world. We aimed to determine the prevalence of three syndromes of interest diarrhea, acute respiratory infections (ARI and jaundice-among Hajjis gathering at the four transit sites in Afghanistan before, during, and after their voyage. Methods: A total of 1659 Hajjis at four transit sites were selected and included a cross-sectional study. Information was collected prior Hajjis departure and upon their return from Saudi Arabia regarding demographics and experience of diarrhea, ARI and jaundice. Standardized case definitions were used for the three health outcomes of interest. Results: The occurrence of diarrhea and jaundice remained constant over time. However, ARI increased from 1.4% at pre-transit to 4% at transit area and 37% during the Hajj. ARI rates among residents from the Central and Northern regions of Afghanistan were significantly higher at the post-Hajj stage, at 50% and 69%, respectively. There was no difference in ARI by sex among Hajjis. Conclusions: There is a need to review the quality and effectiveness of the flu vaccine. Authorities should come up with the sound strategies to overcome ARI problems during Hajj.

  7. Pharmacologic Comparison of Clinical Neutral Endopeptidase Inhibitors in a Rat Model of Acute Secretory Diarrhea

    Science.gov (United States)

    Prinsen, Michael J.; Oliva, Jonathan; Campbell, Mary A.; Arnett, Stacy D.; Tajfirouz, Deena; Ruminski, Peter G.; Yu, Ying; Bond, Brian R.; Ji, Yuhua; Neckermann, Georg; Choy, Robert K. M.; de Hostos, Eugenio; Meyers, Marvin J.

    2016-01-01

    Racecadotril (acetorphan) is a neutral endopeptidase (NEP) inhibitor with known antidiarrheal activity in animals and humans; however, in humans, it suffers from shortcomings that might be improved with newer drugs in this class that have progressed to the clinic for nonenteric disease indications. To identify potentially superior NEP inhibitors with immediate clinical utility for diarrhea treatment, we compared their efficacy and pharmacologic properties in a rat intestinal hypersecretion model. Racecadotril and seven other clinical-stage inhibitors of NEP were obtained or synthesized. Enzyme potency and specificity were compared using purified peptidases. Compounds were orally administered to rats before administration of castor oil to induce diarrhea. Stool weight was recorded over 4 hours. To assess other pharmacologic properties, select compounds were orally administered to normal or castor oil–treated rats, blood and tissue samples collected at multiple time points, and active compound concentrations determined by mass spectroscopy. NEP enzyme activity was measured in tissue homogenates. Three previously untested clinical NEP inhibitors delayed diarrhea onset and reduced total stool output, with little or no effect on intestinal motility assessed by the charcoal meal test. Each was shown to be a potent, highly specific inhibitor of NEP. Each exhibited greater suppression of NEP activity in intestinal and nonintestinal tissues than did racecadotril and sustained this inhibition longer. These results suggest that newer clinical-stage NEP inhibitors originally developed for other indications may be directly repositioned for treatment of acute secretory diarrhea and offer advantages over racecadotril, such as less frequent dosing and potentially improved efficacy. PMID:26907621

  8. Genetic Virulence Profile of Enteroaggregative Escherichia coli Strains Isolated from Danish Children with Either Acute or Persistent Diarrhea

    DEFF Research Database (Denmark)

    Hebbelstrup Jensen, Betina; Poulsen, Anja; Hebbelstrup Rye Rasmussen, Stig

    2017-01-01

    Enteroaggregative Escherichia coli (EAEC) is frequently found in diarrheal stools worldwide. It has been associated with persistent diarrhea, weight loss, and failure to thrive in children living in developing countries. A number of important EAEC virulence genes are identified; however, their ro......Enteroaggregative Escherichia coli (EAEC) is frequently found in diarrheal stools worldwide. It has been associated with persistent diarrhea, weight loss, and failure to thrive in children living in developing countries. A number of important EAEC virulence genes are identified; however......, their roles in acute and persistent diarrhea have not been previously investigated. The aim of this study was to identify specific EAEC virulence genes associated with duration and type of diarrhea in Danish children. We aimed to improve the current diagnostics of EAEC and enable targeting of strains...... with an expected severe disease course. Questionnaires answered by parents provided information regarding duration of diarrhea and presence of blood or mucus. A total of 295 EAEC strains were collected from children with acute (≤7 days) and persistent diarrhea (≥14 days) and were compared by using multiplex PCR...

  9. Anti-infectious treatment in acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Min GAO

    2013-02-01

    Full Text Available Acute respiratory distress syndrome (ARDS is closely correlated with infection. Severe infection, e.g., sepsis and septic shock, can result in ARDS. Ventilator associated pneumonia (VAP is one of the common complications in ARDS related infection. As regards ARDS related infection, community acquired infection (CAI is different from hospital acquired infection (HAI in bacterial spectrum. The former is mainly caused by Streptococcus pneumonia, Hemophilus influenzae, Moraxelle catarrhalis, atypical pathogens and Klebsiella pneumoniae. However, HAI is mainly caused by Pseudomonas aeruginosa, Acinetobacter baumanii, methicillin-resistant Staphylococcus aureus(MRSA, and other drug-resistant bacteria. The drug-resistant bacterial infection not only makes treatment difficult, but also leads to an increase in mechanical ventilation time, length of ICU stay, mortality rate, and medical costs. The present paper has reviewed the relationship between ARDS and infection, therapeutic principles and measures of ARDS related infection, and introduced the optimal strategy of anti-infectious treatment of ARDS.

  10. Association Between Acute Infectious Mononucleosis and Vitamin D Deficiency.

    Science.gov (United States)

    Maghzi, Helia; Ataei, Behrooz; Khorvash, Farzin; Yaran, Majid; Maghzi, Amir-Hadi

    2016-09-01

    Epstein-Barr virus and vitamin D both have been implicated in the pathogenesis of autoimmune diseases, especially multiple sclerosis (MS). Vitamin D influences both innate and adaptive immune responses and has been linked to increased susceptibility to other viral infections such as influenza. Here we aimed to examine the association between vitamin D and acute infectious mononucleosis (IM).This study is a case-control study that was conducted on IM patients and a control group of healthy individuals at infectious disease clinics of Isfahan University of Medical Sciences. Patients were recruited from January to December 2014. The viral capsid antigen (VCA) IgM titer and vitamin D levels were measured at the time of acute infection in IM patients. We also measured vitamin D levels in healthy controls recruited during the same period of time. A total number of 60 IM patients with the mean age of 23.26 ± 7.59 and a healthy control group with the mean age of 25.13 ± 6.72 were enrolled. In the IM patients, there was no significant association between 25(OH) D3 levels and VCA IgM titers (r = 0.190, p = 0.146). Mean 25(OH) D3 levels in IM patients were significantly lower than in the control group (15.61 ± 9.72 vs. 21.41 ± 12.64, p = 0.006). Our findings showed significantly lower vitamin D levels in IM patients at the time of infection than in the control group, providing some evidence that the two major risk factors for autoimmune diseases (e.g., MS) might not be independent risk factors.

  11. Sociocultural determinants of anticipated vaccine acceptance for acute watery diarrhea in early childhood in Katanga Province, Democratic Republic of Congo.

    Science.gov (United States)

    Merten, Sonja; Schaetti, Christian; Manianga, Cele; Lapika, Bruno; Hutubessy, Raymond; Chaignat, Claire-Lise; Weiss, Mitchell

    2013-09-01

    Rotavirus and oral cholera vaccines have the potential to reduce diarrhea-related child mortality in low-income settings and are recommended by the World Health Organization. Uptake of vaccination depends on community support, and is based on local priorities. This study investigates local perceptions of acute watery diarrhea in childhood and anticipated vaccine acceptance in two sites in the Democratic Republic of Congo. In 2010, 360 randomly selected non-affected adults were interviewed by using a semi-structured questionnaire. Witchcraft and breastfeeding were perceived as potential cause of acute watery diarrhea by 51% and 48% of respondents. Despite misperceptions, anticipated vaccine acceptance at no cost was 99%. The strongest predictor of anticipated vaccine acceptance if costs were assumed was the educational level of the respondents. Results suggest that the introduction of vaccines is a local priority and local (mis)perceptions of illness do not compromise vaccine acceptability if the vaccine is affordable.

  12. Genetic Virulence Profile of EnteroaggregativeEscherichia coliStrains Isolated from Danish Children with Either Acute or Persistent Diarrhea.

    Science.gov (United States)

    Hebbelstrup Jensen, Betina; Poulsen, Anja; Hebbelstrup Rye Rasmussen, Stig; Struve, Carsten; Engberg, Jørgen H; Friis-Møller, Alice; Boisen, Nadia; Jønsson, Rie; Petersen, Randi F; Petersen, Andreas M; Krogfelt, Karen A

    2017-01-01

    Enteroaggregative Escherichia coli (EAEC) is frequently found in diarrheal stools worldwide. It has been associated with persistent diarrhea, weight loss, and failure to thrive in children living in developing countries. A number of important EAEC virulence genes are identified; however, their roles in acute and persistent diarrhea have not been previously investigated. The aim of this study was to identify specific EAEC virulence genes associated with duration and type of diarrhea in Danish children. We aimed to improve the current diagnostics of EAEC and enable targeting of strains with an expected severe disease course. Questionnaires answered by parents provided information regarding duration of diarrhea and presence of blood or mucus. A total of 295 EAEC strains were collected from children with acute (≤7 days) and persistent diarrhea (≥14 days) and were compared by using multiplex PCR targeting the genes sat, sepA, pic, sigA, pet, astA, aatA, aggR, aaiC, aap, agg3/4C, ORF3, aafA, aggA, agg3A, agg4A , and agg5A . Furthermore, the distribution of EAEC genes in strains collected from cases of bloody, mucoid, and watery diarrhea was investigated. The classification and regression tree analysis (CART) was applied to investigate the relationship between EAEC virulence genes and diarrheal duration and type. Persistent diarrhea was associated with strains lacking the pic gene ( p = 0.002) and with the combination of the genes pic, sat , and absence of the aggA gene ( p = 0.05). Prolonged diarrhea was associated with the combination of the genes aatA and astA ( p = 0.03). Non-mucoid diarrhea was associated with strains lacking the aatA gene ( p = 0.004). Acute diarrhea was associated with the genes aggR, aap , and aggA by individual odds ratios. Resistance toward gentamicin and ciprofloxacin was observed in 7.5 and 3% of strains, respectively. Multi-drug resistance was observed in 38% of strains. Genetic host factors have been associated with an increased risk of

  13. Genetic Virulence Profile of Enteroaggregative Escherichia coli Strains Isolated from Danish Children with Either Acute or Persistent Diarrhea

    Directory of Open Access Journals (Sweden)

    Betina Hebbelstrup Jensen

    2017-05-01

    Full Text Available Enteroaggregative Escherichia coli (EAEC is frequently found in diarrheal stools worldwide. It has been associated with persistent diarrhea, weight loss, and failure to thrive in children living in developing countries. A number of important EAEC virulence genes are identified; however, their roles in acute and persistent diarrhea have not been previously investigated. The aim of this study was to identify specific EAEC virulence genes associated with duration and type of diarrhea in Danish children. We aimed to improve the current diagnostics of EAEC and enable targeting of strains with an expected severe disease course. Questionnaires answered by parents provided information regarding duration of diarrhea and presence of blood or mucus. A total of 295 EAEC strains were collected from children with acute (≤7 days and persistent diarrhea (≥14 days and were compared by using multiplex PCR targeting the genes sat, sepA, pic, sigA, pet, astA, aatA, aggR, aaiC, aap, agg3/4C, ORF3, aafA, aggA, agg3A, agg4A, and agg5A. Furthermore, the distribution of EAEC genes in strains collected from cases of bloody, mucoid, and watery diarrhea was investigated. The classification and regression tree analysis (CART was applied to investigate the relationship between EAEC virulence genes and diarrheal duration and type. Persistent diarrhea was associated with strains lacking the pic gene (p = 0.002 and with the combination of the genes pic, sat, and absence of the aggA gene (p = 0.05. Prolonged diarrhea was associated with the combination of the genes aatA and astA (p = 0.03. Non-mucoid diarrhea was associated with strains lacking the aatA gene (p = 0.004. Acute diarrhea was associated with the genes aggR, aap, and aggA by individual odds ratios. Resistance toward gentamicin and ciprofloxacin was observed in 7.5 and 3% of strains, respectively. Multi-drug resistance was observed in 38% of strains. Genetic host factors have been associated with an increased risk

  14. Genetic Virulence Profile of Enteroaggregative Escherichia coli Strains Isolated from Danish Children with Either Acute or Persistent Diarrhea

    Science.gov (United States)

    Hebbelstrup Jensen, Betina; Poulsen, Anja; Hebbelstrup Rye Rasmussen, Stig; Struve, Carsten; Engberg, Jørgen H.; Friis-Møller, Alice; Boisen, Nadia; Jønsson, Rie; Petersen, Randi F.; Petersen, Andreas M.; Krogfelt, Karen A.

    2017-01-01

    Enteroaggregative Escherichia coli (EAEC) is frequently found in diarrheal stools worldwide. It has been associated with persistent diarrhea, weight loss, and failure to thrive in children living in developing countries. A number of important EAEC virulence genes are identified; however, their roles in acute and persistent diarrhea have not been previously investigated. The aim of this study was to identify specific EAEC virulence genes associated with duration and type of diarrhea in Danish children. We aimed to improve the current diagnostics of EAEC and enable targeting of strains with an expected severe disease course. Questionnaires answered by parents provided information regarding duration of diarrhea and presence of blood or mucus. A total of 295 EAEC strains were collected from children with acute (≤7 days) and persistent diarrhea (≥14 days) and were compared by using multiplex PCR targeting the genes sat, sepA, pic, sigA, pet, astA, aatA, aggR, aaiC, aap, agg3/4C, ORF3, aafA, aggA, agg3A, agg4A, and agg5A. Furthermore, the distribution of EAEC genes in strains collected from cases of bloody, mucoid, and watery diarrhea was investigated. The classification and regression tree analysis (CART) was applied to investigate the relationship between EAEC virulence genes and diarrheal duration and type. Persistent diarrhea was associated with strains lacking the pic gene (p = 0.002) and with the combination of the genes pic, sat, and absence of the aggA gene (p = 0.05). Prolonged diarrhea was associated with the combination of the genes aatA and astA (p = 0.03). Non-mucoid diarrhea was associated with strains lacking the aatA gene (p = 0.004). Acute diarrhea was associated with the genes aggR, aap, and aggA by individual odds ratios. Resistance toward gentamicin and ciprofloxacin was observed in 7.5 and 3% of strains, respectively. Multi-drug resistance was observed in 38% of strains. Genetic host factors have been associated with an increased risk of EAEC

  15. Economic evaluation of zinc and copper use in treating acute diarrhea in children: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Dhande Leena A

    2003-08-01

    Full Text Available Abstract Background The therapeutic effects of zinc and copper in reducing diarrheal morbidity have important cost implications. This health services research study evaluated the cost of treating a child with acute diarrhea in the hospital, the impact of micronutrient supplementation on the mean predicted costs and its cost-effectiveness as compared to using only standard oral rehydration solution (ORS, from the patient's and government's (providers perspective. Methods Children aged 6 months to 59 months with acute diarrhea were randomly assigned to receive either the intervention or control. The intervention was a daily dose of 40 mg of zinc sulfate and 5 mg of copper sulfate powder dissolved in a liter of standard ORS (n = 102. The control was 50 mg of standard ORS powder dissolved in a liter of standard ORS (n = 98. The cost measures were the total mean cost of treating acute diarrhea, which included the direct medical, the direct non-medical and the indirect costs. The effectiveness measures were the probability of diarrhea lasting ≤ 4 days, the disability adjusted life years (DALYs and mortality. Results The mean total cost of treating a child with acute diarrhea was US $14 of which the government incurred an expenditure of 66%. The factors that increased the total were the number of stools before admission (p = 0.01, fever (p = 0.01, increasing grade of dehydration (p = 0.00, use of antibiotics (p = 0.00, use of intra-venous fluids (p = 0.00, hours taken to rehydrate a child (p = 0.00, the amount of oral rehydration fluid used (p = 0.00, presence of any complications (p = 0.00 and the hospital stay (p = 0.00. The supplemented group had a 8% lower cost of treating acute diarrhea, their cost per unit health (diarrhea lasting ≤ 4 days was 24% less and the incremental cost-effectiveness ratio indicated cost savings (in Rupees with the intervention [-452; 95%CI (-11306, 3410]. However these differences failed to reach conventional levels

  16. Complete genome sequence of a highly divergent astrovirus isolated from a child with acute diarrhea

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    Wang David

    2008-10-01

    Full Text Available Abstract Background Astroviruses infect a variety of mammals and birds and are causative agents of diarrhea in humans and other animal hosts. We have previously described the identification of several sequence fragments with limited sequence identity to known astroviruses in a stool specimen obtained from a child with acute diarrhea, suggesting that a novel virus was present. Results In this study, the complete genome of this novel virus isolate was sequenced and analyzed. The overall genome organization of this virus paralleled that of known astroviruses, with 3 open reading frames identified. Phylogenetic analysis of the ORFs indicated that this virus is highly divergent from all previously described animal and human astroviruses. Molecular features that are highly conserved in human serotypes 1–8, such as a 3'NTR stem-loop structure and conserved nucleotide motifs present in the 5'NTR and ORF1b/2 junction, were either absent or only partially conserved in this novel virus. Conclusion Based on the analyses described herein, we propose that this newly discovered virus represents a novel species in the family Astroviridae. It has tentatively been named Astrovirus MLB1.

  17. [Persistent diarrhea

    Science.gov (United States)

    Andrade, J A; Moreira, C; Fagundes Neto, U

    2000-07-01

    INTRODUCTION: Persistent diarrhea has high impact on infantile morbidity and mortality rates in developing countries. Several studies have shown that 3 to 20% of acute diarrheal episodes in children under 5 years of age become persistent. DEFINITION: Persistent diarrhea is defined as an episode that lasts more than 14 days. ETIOLOGY: The most important agents isolated in persistent diarrhea are: Enteropathogenic E. coli (EPEC), Salmonella, Enteroaggregative E. coli (EAEC), Klebisiella and Cryptosporidium. CLINICAL ASPECTS: In general, the clinical characteristics of patients with persistent diarrhea do not change with the pathogenic agent. Persistent diarrhea seems to represent the final result of a several insults a infant suffers that predisposes to a more severe episode of diarrhea due to a combination of host factors and high rates of enviromental contamination. Therefore, efforts should be made to promptly treat all episodes of diarrhea with apropriate follow-up. THERAPY: The aim of the treatment is to restore hydroelectrolytic deficits and to replace losses until the diarrheal ceases. It is possible in the majority of the cases, using oral rehydration therapy and erly an appropriate type of diet. PREVENTION: It is imperative that management strategies also focus on preventive aspects. The most effective diarrheal prevention strategy in young infants worldwide is promotion of exclusive breast feeding.

  18. Chronic Diarrhea

    Science.gov (United States)

    ... infections that cause chronic diarrhea be prevented? Chronic Diarrhea What is chronic diarrhea? Diarrhea that lasts for more than 2-4 ... represent a life-threatening illness. What causes chronic diarrhea? Chronic diarrhea has many different causes; these causes ...

  19. Acute diarrhea in West African children: diverse enteric viruses and a novel parvovirus genus.

    Science.gov (United States)

    Phan, Tung G; Vo, Nguyen P; Bonkoungou, Isidore J O; Kapoor, Amit; Barro, Nicolas; O'Ryan, Miguel; Kapusinszky, Beatrix; Wang, Chunling; Delwart, Eric

    2012-10-01

    Parvoviruses cause a variety of mild to severe symptoms or asymptomatic infections in humans and animals. During a viral metagenomic analysis of feces from children with acute diarrhea in Burkina Faso, we identified in decreasing prevalence nucleic acids from anelloviruses, dependoviruses, sapoviruses, enteroviruses, bocaviruses, noroviruses, adenoviruses, parechoviruses, rotaviruses, cosavirus, astroviruses, and hepatitis B virus. Sequences from a highly divergent parvovirus, provisionally called bufavirus, were also detected whose NS1 and VP1 proteins showed parvoviruses. Four percent of the fecal samples were PCR positive for this new parvovirus, including a related bufavirus species showing only 72% identity in VP1. The high degree of genetic divergence of these related genomes from those of other parvoviruses indicates the presence of a proposed new Parvoviridae genus containing at least two species. Studies of the tropism and pathogenicity of these novel parvoviruses will be facilitated by the availability of their genome sequences.

  20. Does Measles Vaccination Reduce the Risk of Acute Respiratory Infection (ARI and Diarrhea in Children: A Multi-Country Study?

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    Rahul Bawankule

    Full Text Available Pneumonia and diarrhea occur either as complications or secondary infections in measles affected children. So, the integrated Global Action Plan for Pneumonia and Diarrhea (GAPPD by WHO and UNICEF includes measles vaccination as preventive measure in children. The objective of the study is to examine the effect of measles vaccination on Acute Respiratory Infection (ARI and diarrhea in children in the Democratic Republic of Congo, Ethiopia, India, Nigeria, and Pakistan.We analyzed data from the most recent rounds of Demographic and Health Surveys (DHS in the selected countries. We included children age 12-59 months in the analysis. We used multivariable binary logistic regression to examine the effect of measles vaccination on ARI and diarrhea in children. We also estimated Vaccination Effectiveness (VE.More than 60 percent of the children age 12-59 months were given measles vaccine before the survey in the Democratic Republic of Congo, Ethiopia, India and Pakistan. Children who were given the measles vaccine were less likely to suffer from ARI than unvaccinated children in India and Pakistan. Children who were given the measles vaccine had a lower risk of diarrhea than those who did not receive it in all the selected countries except Ethiopia. Measles vaccination was associated with reduction in ARI cases by 15-30 percent in India and Pakistan, and diarrhea cases by 12-22 percent in the Democratic Republic of Congo, India, Nigeria and Pakistan.The receipt of the measles vaccine was associated with decrease in ARI and diarrhea in children. The immunization program must ensure that each child gets the recommended doses of measles vaccine at the appropriate age. The measles vaccination should be given more attention as a preventive intervention under the Global Action Plan for Pneumonia and Diarrhea (GAPPD in all low and middle-income countries.

  1. Characteristics of diarrheagenic Escherichia coli among children under 5 years of age with acute diarrhea: a hospital based study.

    Science.gov (United States)

    Zhou, Yu; Zhu, Xuhui; Hou, Hongyan; Lu, Yanfang; Yu, Jing; Mao, Lie; Mao, Liyan; Sun, Ziyong

    2018-02-01

    Diarrhea is the leading infectious cause of childhood morbidity and mortality. Among bacterial agents, diarrheagenic Escherichia coli (DEC) is the major causal agent of childhood diarrhea in developing countries, particularly in children under the age of 5 years. Here, we performed a hospital-based prospective study to explore the pathotype distribution, epidemiological characteristics and antibiotic resistance patterns of DEC from coli (EPEC) isolates were identified simultaneously with serology. Furthermore, antimicrobial sensitivity tests and sequencing of antibiotic resistance-related genes were conducted. DEC strains were identified in 7.9% of the 684 stool samples. Among them, the most commonly detected pathotype was EPEC (50.0% of DEC), of which 77.8% were classified as atypical EPEC (aEPEC). Age and seasonal distribution revealed that DEC tended to infect younger children and to occur in summer/autumn periods. Multidrug-resistant DEC isolates were 66.7%; resistance rates to ampicillin, co-trimoxazole, cefazolin, cefuroxime, cefotaxime, and ciprofloxacin were ≥ 50%. Among 5 carbapenem-resistant DEC, 60.0% were positive for carbapenemase genes (2 blaNDM-1 and 1 blaKPC-2). Among 30 cephalosporin-resistant DEC, 93.3% were positive for extended-spectrum β-lactamase (ESBL) genes, with blaTEM-1 and blaCTX-M-55 being the most common types. However, no gyrA or gyrB genes were detected in 16 quinolone-resistant isolates. Notably, aEPEC, which has not received much attention before, also exhibited high rates of drug resistance (81.0%, 66.7%, and 14.3% for ampicillin, co-trimoxazole , and carbapenem resistance, respectively). EPEC was the most frequent DEC pathotype in acute diarrheal children, with aEPEC emerging as a dominant diarrheal agent in central China. Most DEC strains were multidrug-resistant, making even ciprofloxacin unsuitable for empiric treatment against DEC infection. Among carbapenem-resistant DEC strains, those harboring blaNDM-1 and blaKPC-2

  2. Using oral rehydration solution (oral rehydration salt with the addition of probiotic strain for the treatment of children with acute infectious pathology

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    S.O. Kramarov

    2018-02-01

    Full Text Available Background. Dehydration may be present in children with acute infectious pathology, for elimination of which we can use oral rehydration solutions (oral rehydration salts. When antibiotic therapy is prescribed, about 11–40 % of children have antibiotic-associated diarrhea (AAD. To prevent the development of AAD, it is recommended to use probiotic drugs. Purpose of the study: to examine the efficacy and tolerability of the oral rehydration solution (Rehydron Bio to maintain the water-electrolyte balance and prevent dysbiotic disorders in children with acute infectious diseases. Materials and methods. The study involved 60 children aged 3 to 14 years old with acute infectious diseases, who underwent in-patient treatment at the clinical basis of the department of children’s infectious diseases of Bogomolets NMU and received antibacterial therapy. The main group consisted of 30 children, who received Rehydron Bio as a part of comprehensive therapy. The comparison group included 30 children, who received standard therapy and were compensated for fluid loss by traditional means (tea, drinking water, etc.. Results. Among dehydration symptoms, the most often ones were the thirst and dryness of the mucous membranes, which were detected in 40–63 % of patients during the first day after hospitalization. The restoration of water-electrolyte balance due to the introduction of water and basic mineral substances ensures the rapid disappearance of dehydration symptoms. The AAD was detected in 10.0 % of patients in comparison group, the additional introduction of the probiotic strain Lactobacillus rhamnosus GG prevented the development of this complication. Conclusions. Oral rehydration with Rehydron Bio is an effective therapy of water-electrolyte disturbances in children with acute infectious diseases. The presence in Rehydron Bio of probiotic strain Lactobacillus rhamnosus GG allows it to be used to prevent AAD in children with acute infectious diseases.

  3. Acute Infectious Gastroenteritis Potentiates a Crohn's Disease Pathobiont to Fuel Ongoing Inflammation in the Post-Infectious Period.

    Science.gov (United States)

    Small, Cherrie L; Xing, Lydia; McPhee, Joseph B; Law, Hong T; Coombes, Brian K

    2016-10-01

    Crohn's disease (CD) is a chronic inflammatory condition of diverse etiology. Exposure to foodborne pathogens causing acute gastroenteritis produces a long-term risk of CD well into the post-infectious period but the mechanistic basis for this ongoing relationship to disease onset is unknown. We developed two novel models to study the comorbidity of acute gastroenteritis caused by Salmonella Typhimurium or Citrobacter rodentium in mice colonized with adherent-invasive Escherichia coli (AIEC), a bacterial pathobiont linked to CD. Here, we show that disease activity in the post-infectious period after gastroenteritis is driven by the tissue-associated expansion of the resident AIEC pathobiont, with an attendant increase in immunopathology, barrier defects, and delays in mucosal restitution following pathogen clearance. These features required AIEC resistance to host defense peptides and a fulminant inflammatory response to the enteric pathogen. Our results suggest that individuals colonized by AIEC at the time of acute infectious gastroenteritis may be at greater risk for CD onset. Importantly, our data identify AIEC as a tractable disease modifier, a finding that could be exploited in the development of therapeutic interventions following infectious gastroenteritis in at-risk individuals.

  4. Surveillance of acute infectious gastroenteritis (1992-2009) and food-borne disease outbreaks (1996-2009) in Italy, with a focus on the Piedmont and Lombardy regions.

    Science.gov (United States)

    Mughini-Gras, L; Graziani, C; Biorci, F; Pavan, A; Magliola, R; Ricci, A; Gilli, G; Carraro, E; Busani, L

    2012-02-23

    We describe trends in the occurrence of acute infectious gastroenteritis (1992 to 2009) and food-borne disease outbreaks (1996 to 2009) in Italy. In 2002, the Piedmont region implemented a surveillance system for early detection and control of food-borne disease outbreaks; in 2004, the Lombardy region implemented a system for surveillance of all notifiable human infectious diseases. Both systems are internet based. We compared the regional figures with the national mean using official notification data provided by the National Infectious Diseases Notification System (SIMI) and the National Institute of Statistics (ISTAT), in order to provide additional information about the epidemiology of these diseases in Italy. When compared with the national mean, data from the two regional systems showed a significant increase in notification rates of non-typhoid salmonellosis and infectious diarrhea other than non-typhoid salmonellosis, but for foodborne disease outbreaks, the increase was not statistically significant. Although the two regional systems have different objectives and structures, they showed improved sensitivity regarding notification of cases of acute infectious gastroenteritis and, to a lesser extent, food-borne disease outbreaks, and thus provide a more complete picture of the epidemiology of these diseases in Italy.

  5. Diarrhea is a Major killer of Children with Severe Acute Malnutrition Admitted to Inpatient Set-up in Lusaka, Zambia

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    Mwambazi Mwate

    2011-10-01

    Full Text Available Abstract Introduction Mortality of children with Severe Acute Malnutrition (SAM in inpatient set-ups in sub-Saharan Africa still remains unacceptably high. We investigated the prevalence and effect of diarrhea and HIV infection on inpatient treatment outcome of children with complicated SAM receiving treatment in inpatient units. Method A cohort of 430 children aged 6-59 months old with complicated SAM admitted to Zambia University Teaching Hospital's stabilization centre from August to December 2009 were followed. Data on nutritional status, socio-demographic factors, and admission medical conditions were collected up on enrollment. T-test and chi-square tests were used to compare difference in mean or percentage values. Logistic regression was used to assess risk of mortality by admission characteristics. Results Majority, 55.3% (238/430 were boys. The median age of the cohort was 17 months (inter-quartile range, IQR 12-22. Among the children, 68.9% (295/428 had edema at admission. The majority of the children, 67.3% (261/388, presented with diarrhea; 38.9% (162/420 tested HIV positive; and 40.5% (174/430 of the children died. The median Length of stay of the cohort was 9 days (IQR, 5-14 days; 30.6% (53/173 of the death occurred within 48 hours of admission. Children with diarrhea on admission had two and half times higher odds of mortality than those without diarrhea; Adjusted OR = 2.5 (95% CI 1.50-4.09, P Conclusion Diarrhea is a major cause of complication in children with severe acute malnutrition. Under the current standard management approach, diarrhea in children with SAM was found to increase their odds of death substantially irrespective of other factors.

  6. Management of children’s acute diarrhea by community pharmacies in five towns of Ethiopia: simulated client case study

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    Abegaz TM

    2016-04-01

    Full Text Available Tadesse Melaku Abegaz,1 Sewunet Admasu Belachew,1 Tamrat Befekadu Abebe,1 Begashaw Melaku Gebresilassie,1 Fitsum Sebsibe Teni,2 Habtamu Gebremeskel Woldie3 1Department of Clinical Pharmacy, School of Pharmacy, Gondar University, Gondar, 2Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, 3Department of Hospital Pharmacy, Debremarkos Teaching and Referral Hospital, Debremarkos, Ethiopia Background: Acute diarrhea is the major cause of child morbidity and mortality in low-income nations. It is the second most common cause of death among children <5 years of age globally. The indispensable role of community pharmacists is clearly observed in the prevention and treatment of diarrhea. However, there is a paucity of data on how community pharmacies manage acute childhood diarrhea cases in Ethiopia. This study aimed to evaluate the experience of community pharmacies in the management of acute diarrhea in northern Ethiopia.Methods: A simulated case-based cross-sectional study was conducted in community pharmacies from five towns of northern Ethiopia between April 2015 and September 2015. Convenience sampling technique was used to select sample towns. A structured questionnaire was organized to collect the information. Descriptive statistics, chi-squared test, one-way analysis of variance, and binary logistic regression were performed to describe, infer, and test for association between the variables. SPSS for Windows Version 21 was used to enter and analyze the data. A 95% confidence interval and P-value of 0.05 were set to test the level of significance.Results: Approximately 113 community pharmacies were visited to collect the required data from five towns. Majority (78, 69% of them were located away from hospitals and health care areas. Nine components of history taking were presented for dispensers. Regarding the patient history, “age” was frequently taken, (90

  7. The prophylactic effect of Lactobacillus rhamnosus GG on incidence of acute rotavirus diarrhea in children: a systematic review; randomized double-blind placebo-controlled trials

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    Elaheh Ahmadi

    2014-07-01

    Full Text Available otavirus is one of the most common etiologic agent of severe acute diarrhea in infants and children which results in high mortality and morbidity globally. Prophylactic strategies are required to prevent acute rotavirus diarrhea. Recently, the beneficial effect of probiotic therapy in control of rotavirus diarrhea was noted in many investigations. This systematic review investigated the prophylactic effect of Lactobacillus rhamnosus GG on the incidence of acute rotavirus diarrhea in infants and children. Databases including PubMed, Cochrane Controlled Trial Register (CCTR, Google Scholar, Science direct and Ovid (Wolters Kluwer health were searched for articles and reviews from 1980–2013. Reviewers selected randomized clinical trials that met the study inclusion criteria. The outcome measures included incidence of rotavirus diarrhea, duration of diarrhea, and hospital stay. The search results included three trials with 1043 eligible patients. The results indicated that the use of Lactobacillus rhamnosus GG compared with placebo significantly affected the incidence of rotavirus diarrhea without influencing the duration of hospital stay. Some studies signified the role of Lactobacillus rhamnosus GG in preventing acute rotavirus diarrhea; however we did not find sufficient trials with certain method to evaluate this influence.

  8. Detection and Molecular Characterization of Human Adenovirus Infections among Hospitalized Children with Acute Diarrhea in Shanghai, China, 2006–2011

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    Lijuan Lu

    2017-01-01

    Full Text Available Background: Human adenovirus (HAdV is considered a significant enteropathogen associated with sporadic diarrhea in children. However, limited data are available regarding the epidemiology of HAdV in hospitalized children with viral diarrhea in Shanghai. The aim of this study was to characterize the epidemiology of HAdVs and describe their association with acute diarrhea in hospitalized children. Methods: A total of 674 fecal samples were subjected to PCR or RT-PCR to detect RVA, HuCV, HAstV, and HAdV. Results: HAdV infections were detected in 4.7% (32/674 of specimens, with detection rates of 13.4% (11/82, 4.6% (8/174, 3.2% (4/124, 4.1% (3/74, 2.0% (2/100, and 3.3% (4/120 from 2006 to 2011, respectively. Comprehensive detection of the four viruses revealed the presence of a high percentage (90.6% of coinfections among HAdV-positive samples, where HAdV+RVA was the most prevalent coinfection. Of the 32 HAdV-positive samples, 50.0% (16/32 were classified as HAdV-41, and 18.8% (6/32 were classified as HAdV-3. Almost 94.0% of children infected with HAdV were less than 24 months of age. Conclusions: These results clearly indicated diversity across the HAdV genotypes detected in inpatient children with acute diarrhea in Shanghai and suggested that HAdVs play a role in children with acute diarrhea.

  9. Clinical benefits of probiotic canine-derived Bifidobacterium animalis strain AHC7 in dogs with acute idiopathic diarrhea.

    Science.gov (United States)

    Kelley, R L; Minikhiem, Debbie; Kiely, Barry; O'Mahony, Liam; O'Sullivan, David; Boileau, Tom; Park, Jean Soon

    2009-01-01

    This study evaluated the effect of supplementation with canine-derived probiotic Bifidobacterium animalis strain AHC7 (lams Prostora, Procter & Gamble Pet Care) on the resolution rate of acute idiopathic diarrhea in dogs randomly assigned to receive a placebo (n=18) or the probiotic (n=13). Nutritional management with the probiotic fed at 2 x 10(10) CFU/day significantly reduced the time to resolution (3.9 +/- 2.3 versus 6.6 +/- 2.7 days; P dogs that were administered metronidazole (38.5% versus 50.0%) compared with placebo. Probiotic B. animalis AHC7 may provide veterinarians another tool for management of acute diarrhea in dogs.

  10. Lactobacillus acidophilus, Lactobacillus reuteri and metabolites of intestinal bacteria as therapeutic agents in acute diarrhea in children

    Czech Academy of Sciences Publication Activity Database

    Tláskal, P.; Kokešová, A.; Schramlová, J.; Tlaskalová, Helena; Adamus, J.; Bubáková, D.; Kočnarová, N.; Kopecký, J.; Mucková, M.; Pacovská, J.; Sládková, J.

    2007-01-01

    Roč. 2, č. 1 (2007), s. 67-74 ISSN 1555-1431 Grant - others:CZ(CZ) 00000064203/6041; CZ(CZ) 00064203/6309 Institutional research plan: CEZ:AV0Z50200510 Source of funding: V - iné verejné zdroje ; V - iné verejné zdroje Keywords : acute diarrhea * metabolites of intestinal bacteria * probiotics Subject RIV: EE - Microbiology, Virology

  11. Case-Control Comparison of Enteric Viromes in Captive Rhesus Macaques with Acute or Idiopathic Chronic Diarrhea.

    Science.gov (United States)

    Kapusinszky, Beatrix; Ardeshir, Amir; Mulvaney, Usha; Deng, Xutao; Delwart, Eric

    2017-09-15

    Diarrhea is the major cause of non-research-associated morbidity and mortality affecting the supply of rhesus macaques and, potentially, their responses to experimental treatments. Idiopathic chronic diarrhea (ICD) in rhesus macaques also resembles ulcerative colitis, one form of human inflammatory bowel disease. To test for viral etiologies, we characterized and compared the fecal viromes from 32 healthy animals, 31 animals with acute diarrhea, and 29 animals with ICD. The overall fractions of eukaryotic viral reads were 0.063% for the healthy group, 0.131% for the acute-diarrhea group, and 0.297% for the chronic-diarrhea group. Eukaryotic viruses belonging to 6 viral families, as well as numerous circular Rep-encoding single-stranded DNA (CRESS DNA) viral genomes, were identified. The most commonly detected sequences were from picornaviruses, making up 59 to 88% of all viral reads, followed by 9 to 17% for CRESS DNA virus sequences. The remaining 5 virus families, Adenoviridae , Astroviridae , Anelloviridae , Picobirnaviridae , and Parvoviridae , collectively made up 1 to 3% of the viral reads, except for parvoviruses, which made up 23% of the viral reads in the healthy group. Detected members of the families Picornaviridae and Parvoviridae were highly diverse, consisting of multiple genera, species, and genotypes. Coinfections with members of up to six viral families were detected. Complete and partial viral genomes were assembled and used to measure the number of matching short sequence reads in feces from the 92 animals in the two clinical and the healthy control groups. Several enterovirus genotypes and CRESS DNA genomes were associated with ICD relative to healthy animals. Conversely, higher read numbers from different parvoviruses were associated with healthy animals. Our study reveals a high level of enteric coinfections with diverse viruses in a captive rhesus macaque colony and identifies several viruses positively or negatively associated with ICD

  12. Prevalence of Aeromonas Hydrophila and Yersinia Enterocolitica in Children with Acute Diarrhea Attending Health Centers in Hamadan

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    S. Kazemi

    2016-01-01

    Full Text Available Introduction & Objective: Diarrhea is the most common cause of morbidity and mortality in all age groups, especially children, the elderly and immunocompromised patients. Various studies have been reported regarding the relationship between the children acute diarrhea and Aeromonashydrophila and Yersinia enterocolitica. This study aimed to investigate the prevalence of the bacteria and their sensitivity to common antibiotics and the prevalence of virulence genes in the bacteria in Hamadan, Iran. Materials & Methods: In this study, 120 stool samples collected from children less than 10 years of age with acute diarrhea were examined for Aeromonashydrophila and Yersinia enterocolitica. Identification of the bacteria was performed by biochemical reactions and PCR using 16S rRNA genes. Moreover, the prevalence of virulence genes earA and hyl of Aeromonashydrophila and ail and ystB genes of Yersinia enterocolitica were investigated using PCR. Antibiotic susceptibility of isolated bacteria was performed by disk diffusion method. Results: Out of 120 stool samples, 2 (1.7 % Aeromonashydrophila and 3 (2.5% Yersinia enterocolitica were isolated. All isolates of Aeromonashydrophila were sensitive to the chloramphenicol, co-trimoxazole, gentamicin, meropenem, amikacin and 50% of isolates were sensitive to the ceftriaxone and azithromycin. All Aeromonashydrophila isolates were resistant to erythromycin. All isolates of Yersinia enterocolitica were sensitive to the chloramphenicol, co-trimoxazole and meropenem. The 33.3% of the isolates were sensitive to gentamicin and amikacin and 66.6% of them were susceptible to ceftriaxone. However, all of Yersinia enterocolitica isolates were resistant to erythromycin and azithromycin. The prevalence aerA and hyl genes in Aeromonashydrophila were reported 100% and 50%, respectively. The prevalence of ail and ystB genes in Yersinia enterocolitica was reported as 66.6%. Conclusions: Identification and analysis of

  13. Probiotics do not improve the benefits of a hospital treatment protocol for acute diarrhea in the breastfed child.

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    Sergio Santana Porbén

    2016-11-01

    Full Text Available Rationale: Probiotics have been used in the treatment of acute diarrhea occurring in pediatric ages with mixed results. Objective: To assess the impact of a probiotic (CFU per capsule: Lactobacillus rhamnosus G: 2 x 109, Lactobacillus cassei: 1 x 109, Bifidobacterium brevis: 2 x 109 upon the features and duration of acute diarrhea in breastfed children. Study location: Digestive Diseases and Nutrition Service, “Juan Manuel Márquez” Pediatric Teaching Hospital (Marianao, Havana City, Cuba. Study design: Open, quasi-experimental trial. Thirty children with ages 0.05; Improvement of the features of stools: Non-Treated: 93.3% vs. Treated: 96.1% (p > 0.05. Use of probiotics produced an increase of Hemoglobin ( = -0.44; p 0.05 values of indicators of systemic inflammatory response. Conclusions: Inclusion of probiotics within an institutional protocol for treatment of acute diarrhea does not significantly change the stool pattern of the breastfed child, but might reduce the systemic inflammatory tone which, in turn, would result in a better use of body iron.

  14. The Effect of Probiotics on Diarrhea in Children with Severe Acute Malnutrition

    DEFF Research Database (Denmark)

    Grenov, Benedikte

    with diarrhea and dehydration during hospitalization. In addition the association between days with diarrhea as well as dehydration and mortality during hospitalization were assessed. Results The study children had a mean age of 17.0 months, 58% were boys, 66% had edematous malnutrition and 14% were HIV...

  15. How to Do in Persistent Diarrhea of Children?: Concepts and Treatments of Chronic Diarrhea

    OpenAIRE

    Lee, Kun Song; Kang, Dong Soo; Yu, Jeesuk; Chang, Young Pyo; Park, Woo Sung

    2012-01-01

    Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the v...

  16. Accuracy of Inferior Vena Cava Ultrasound for Predicting Dehydration in Children with Acute Diarrhea in Resource-Limited Settings.

    Science.gov (United States)

    Modi, Payal; Glavis-Bloom, Justin; Nasrin, Sabiha; Guy, Allysia; Chowa, Erika P; Dvor, Nathan; Dworkis, Daniel A; Oh, Michael; Silvestri, David M; Strasberg, Stephen; Rege, Soham; Noble, Vicki E; Alam, Nur H; Levine, Adam C

    2016-01-01

    Although dehydration from diarrhea is a leading cause of morbidity and mortality in children under five, existing methods of assessing dehydration status in children have limited accuracy. To assess the accuracy of point-of-care ultrasound measurement of the aorta-to-IVC ratio as a predictor of dehydration in children. A prospective cohort study of children under five years with acute diarrhea was conducted in the rehydration unit of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Ultrasound measurements of aorta-to-IVC ratio and dehydrated weight were obtained on patient arrival. Percent weight change was monitored during rehydration to classify children as having "some dehydration" with weight change 3-9% or "severe dehydration" with weight change > 9%. Logistic regression analysis and Receiver-Operator Characteristic (ROC) curves were used to evaluate the accuracy of aorta-to-IVC ratio as a predictor of dehydration severity. 850 children were enrolled, of which 771 were included in the final analysis. Aorta to IVC ratio was a significant predictor of the percent dehydration in children with acute diarrhea, with each 1-point increase in the aorta to IVC ratio predicting a 1.1% increase in the percent dehydration of the child. However, the area under the ROC curve (0.60), sensitivity (67%), and specificity (49%), for predicting severe dehydration were all poor. Point-of-care ultrasound of the aorta-to-IVC ratio was statistically associated with volume status, but was not accurate enough to be used as an independent screening tool for dehydration in children under five years presenting with acute diarrhea in a resource-limited setting.

  17. Accuracy of Inferior Vena Cava Ultrasound for Predicting Dehydration in Children with Acute Diarrhea in Resource-Limited Settings.

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    Payal Modi

    Full Text Available Although dehydration from diarrhea is a leading cause of morbidity and mortality in children under five, existing methods of assessing dehydration status in children have limited accuracy.To assess the accuracy of point-of-care ultrasound measurement of the aorta-to-IVC ratio as a predictor of dehydration in children.A prospective cohort study of children under five years with acute diarrhea was conducted in the rehydration unit of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b. Ultrasound measurements of aorta-to-IVC ratio and dehydrated weight were obtained on patient arrival. Percent weight change was monitored during rehydration to classify children as having "some dehydration" with weight change 3-9% or "severe dehydration" with weight change > 9%. Logistic regression analysis and Receiver-Operator Characteristic (ROC curves were used to evaluate the accuracy of aorta-to-IVC ratio as a predictor of dehydration severity.850 children were enrolled, of which 771 were included in the final analysis. Aorta to IVC ratio was a significant predictor of the percent dehydration in children with acute diarrhea, with each 1-point increase in the aorta to IVC ratio predicting a 1.1% increase in the percent dehydration of the child. However, the area under the ROC curve (0.60, sensitivity (67%, and specificity (49%, for predicting severe dehydration were all poor.Point-of-care ultrasound of the aorta-to-IVC ratio was statistically associated with volume status, but was not accurate enough to be used as an independent screening tool for dehydration in children under five years presenting with acute diarrhea in a resource-limited setting.

  18. [First case report of Streptococcus equi subsp. zooepidemicus post-infectious acute glomerulonephritis in France].

    Science.gov (United States)

    Le-Berre, Nicolas; Filipozzi, Pierre; Martin, Laurent; Frimat, Luc; Girerd, Sophie

    2017-02-01

    Post-infectious glomerulonephritis has become exceptional in France because streptococcus infections are well-treated. When they appear, clinical and biological symptoms are mostly typical and associate acute nephritic syndrome, acute renal failure, proteinuria, hematuria and low complement. We are reporting the first French case of acute post-infectious glomerulonephritis related to Streptococcus equi subsp. zooepidemicus, which is commonly found in horses and rarely in human pathology, and of which contamination is by direct contact with sick horses or by ingestion of non-pasteurized milk. Copyright © 2016 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  19. A Two-Tube Multiplex Reverse Transcription PCR Assay for Simultaneous Detection of Viral and Bacterial Pathogens of Infectious Diarrhea

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    Ji Wang

    2014-01-01

    Full Text Available Diarrhea caused by viral and bacterial infections is a major health problem in developing countries. The purpose of this study is to develop a two-tube multiplex PCR assay using automatic electrophoresis for simultaneous detection of 13 diarrhea-causative viruses or bacteria, with an intended application in provincial Centers for Diseases Control and Prevention, China. The assay was designed to detect rotavirus A, norovirus genogroups GI and GII, human astrovirus, enteric adenoviruses, and human bocavirus (tube 1, and Salmonella, Vibrio parahaemolyticus, diarrheagenic Escherichia coli, Campylobacter jejuni, Shigella, Yersinia, and Vibrio cholera (tube 2. The analytical specificity was examined with positive controls for each pathogen. The analytical sensitivity was evaluated by performing the assay on serial tenfold dilutions of in vitro transcribed RNA, recombinant plasmids, or bacterial culture. A total of 122 stool samples were tested by this two-tube assay and the results were compared with those obtained from reference methods. The two-tube assay achieved a sensitivity of 20–200 copies for a single virus and 102-103 CFU/mL for bacteria. The clinical performance demonstrated that the two-tube assay had comparable sensitivity and specificity to those of reference methods. In conclusion, the two-tube assay is a rapid, cost-effective, sensitive, specific, and high throughput method for the simultaneous detection of enteric bacteria and virus.

  20. MANIFESTATION OF AIDS WITH DIARRHEA

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    Rahmat Zainuddin

    2014-09-01

    Full Text Available Infectious diseases HIV/AIDS is a global health problem. According to WHO (2000 reported that 58 million people in the world are infected with HIV, within the 22 million people died from AIDS or 7000 people die every day. HIV Infection caused decrease and disorder of humoral and cellular immunity. Intestinal mucosal normally shows a physiologic inflamation that account for intestinal mucosal integrity. Diarhhea in HIV infection due to immune deficiency can caused by pathogen and non pathogen. Acute and chronic diarrhea usually found in HIV infection patient, the latter is more frequent. HIV enteropathy cause chronic diarrhea without pathogen infection because intestinal mucous damage by HIV direct infection. Treatment is characterized as causative supportive and symptomatic treatment causal, supportive and Symptomatic. Immunonutrient is very important within management patient HIV/AIDS.

  1. How to do in persistent diarrhea of children?: concepts and treatments of chronic diarrhea.

    Science.gov (United States)

    Lee, Kun Song; Kang, Dong Soo; Yu, Jeesuk; Chang, Young Pyo; Park, Woo Sung

    2012-12-01

    Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the vicious cycle of chronic diarrhea and is one of the main one thing among treatments. We should know the exact concept of chronic diarrhea and provide appropriate treatments according to etiologies of chronic diarrhea.

  2. Acute diarrhea in hospitalized children of the municipality of juiz de fora, MG, Brazil: prevalence and risk factors associated with disease severity

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    Monica Couto Guedes Sejanes da Rocha

    2012-12-01

    Full Text Available CONTEXT: Acute diarrhea is a common cause of hospitalization among children under 5 years of age. Knowing the prevalence and risk factors associated with the severity of acute diarrhea is essential to control morbidity and mortality. OBJECTIVE: Describe the prevalence of demographic, epidemiologic and clinical features of children under 6 years of age hospitalized for acute diarrhea, and investigate the association between these determinants and the severity of the diarrheic episode. METHOD: Retrospective, cross-sectional study, during the period from January, 2005 through December, 2008, in the municipality of Juiz de Fora, MG, Brazil. Files from 6,201 children from 0 to 6 years of age, hospitalized in two public teaching institutions (which account for 84% of all the hospitalizations in the municipality, were assessed. Acute diarrhea was defined as the presence of at least three evacuations of liquid or loose stools, within 24 hours, for a maximum period of 14 days. The patients with acute diarrhea were divided in two groups, according to disease severity, severe diarrhea being considered whenever hospitalization lasted for at least 4 days. Epidemiologic and clinical data were assessed and compared through the application of the chi-squared test and the binomial logistic regression model. RESULTS: The prevalence rate for admission due to acute diarrhea was 8.4%. The factors significantly associated with the severity of the diarrheic episode were: age under 6 months (P = 0.01, OR = 2.762; disease onset during fall (P = 0.033, OR = 1.742, presence of fever (P = 0.017, OR = 1.715 and antibiotic use during hospitalization (P = 0.000, OR = 3.872. CONCLUSIONS: Diarrhea is the third most common cause of hospitalization among children under 6 years of age in Juiz de Fora. Young age (under or equal to 6 months, fever, antibiotic use during hospitalization and disease onset during fall are risk factors associated with longer hospital stay.

  3. Acute diarrhea in hospitalized children of the municipality of Juiz de Fora, MG, Brazil: prevalence and risk factors associated with disease severity.

    Science.gov (United States)

    Rocha, Monica Couto Guedes Sejanes da; Carminate, Delaine La Gatta; Tibiriçá, Sandra Helena Cerrato; Carvalho, Iná Pires de; Silva, Maria Luzia da Rosa E; Chebli, Júlio Maria Fonseca

    2012-12-01

    Acute diarrhea is a common cause of hospitalization among children under 5 years of age. Knowing the prevalence and risk factors associated with the severity of acute diarrhea is essential to control morbidity and mortality. Describe the prevalence of demographic, epidemiologic and clinical features of children under 6 years of age hospitalized for acute diarrhea, and investigate the association between these determinants and the severity of the diarrheic episode. Retrospective, cross-sectional study, during the period from January, 2005 through December, 2008, in the municipality of Juiz de Fora, MG, Brazil. Files from 6,201 children from 0 to 6 years of age, hospitalized in two public teaching institutions (which account for 84% of all the hospitalizations in the municipality), were assessed. Acute diarrhea was defined as the presence of at least three evacuations of liquid or loose stools, within 24 hours, for a maximum period of 14 days. The patients with acute diarrhea were divided in two groups, according to disease severity, severe diarrhea being considered whenever hospitalization lasted for at least 4 days. Epidemiologic and clinical data were assessed and compared through the application of the chi-squared test and the binomial logistic regression model. The prevalence rate for admission due to acute diarrhea was 8.4%. The factors significantly associated with the severity of the diarrheic episode were: age under 6 months (P = 0.01, OR = 2.762); disease onset during fall (P = 0.033, OR = 1.742), presence of fever (P = 0.017, OR = 1.715) and antibiotic use during hospitalization (P = 0.000, OR = 3.872). Diarrhea is the third most common cause of hospitalization among children under 6 years of age in Juiz de Fora. Young age (under or equal to 6 months), fever, antibiotic use during hospitalization and disease onset during fall are risk factors associated with longer hospital stay.

  4. Evaluation of chronic diarrhea.

    Science.gov (United States)

    Juckett, Gregory; Trivedi, Rupal

    2011-11-15

    Chronic diarrhea, defined as a decrease in stool consistency for more than four weeks, is a common but challenging clinical scenario. It can be divided into three basic categories: watery, fatty (malabsorption), and inflammatory. Watery diarrhea may be subdivided into osmotic, secretory, and functional types. Watery diarrhea includes irritable bowel syndrome, which is the most common cause of functional diarrhea. Another example of watery diarrhea is microscopic colitis, which is a secretory diarrhea affecting older persons. Laxative-induced diarrhea is often osmotic. Malabsorptive diarrhea is characterized by excess gas, steatorrhea, or weight loss; giardiasis is a classic infectious example. Celiac disease (gluten-sensitive enteropathy) is also malabsorptive, and typically results in weight loss and iron deficiency anemia. Inflammatory diarrhea, such as ulcerative colitis or Crohn disease, is characterized by blood and pus in the stool and an elevated fecal calprotectin level. Invasive bacteria and parasites also produce inflammation. Infections caused by Clostridium difficile subsequent to antibiotic use have become increasingly common and virulent. Not all chronic diarrhea is strictly watery, malabsorptive, or inflammatory, because some categories overlap. Still, the most practical diagnostic approach is to attempt to categorize the diarrhea by type before testing and treating. This narrows the list of diagnostic possibilities and reduces unnecessary testing. Empiric therapy is justified when a specific diagnosis is strongly suspected and follow-up is available.

  5. Campylobacter jejuni and Campylobacter coli in Children With Acute Diarrhea in Health Centers of Hamadan, Iran

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    Rastyani

    2015-11-01

    Full Text Available Background Enteritis caused by Campylobacter is considered as the most common acute bacterial diarrhea around the world. In most cases, infection occurs as a result of consuming contaminated water or food, especially raw meat of fowls. Objectives The purpose of the present study was to determine the prevalence and antibiotic resistance of campylobacter species among pediatrics of Hamadan city, Iran. Patients and Methods A total of 120 stool samples from children less than 10 years old were examined from January 2013 to December 2014 in Hamadan, Iran. The samples were incubated in Campy-Thio enrichment medium for 1 - 2 hours and then cultured on a specific medium; after that, the suspected colonies were analyzed for Campylobacter spp. identification by conventional tests. The identified species by biochemical methods were confirmed by polymerase chain reaction (PCR. Antimicrobial susceptibility testing was performed by disk agar diffusion (DAD method. Results Twelve (10% Campylobacter spp. from 120 stool samples were isolated including C. coli and C. jejuni. In the antibiotic susceptibility test, the most frequent resistance was observed to ciprofloxacin 8 (88.8%, followed by 7 (77.7% resistant strains to tetracycline, 7 (77.7% to erythromycin, 6 (66.6% to clindamycin, 5 (55.5% to meropenem, 4 (44.4% to gentamicin, 3 (33.3% to nalidixicacid and only 1 (11.1% to chloramphenicol. Conclusions Campylobacter is responsible for some important clinical problems such as enteritis and is also associated with meningitis and hemolytic-uremic syndrome. It is imperative to monitor the prevalence and antibiotic resistance of Campylobacter spp. as well as other the zoonotic bacteria.

  6. Acute myocardial infarction in infectious endocarditis. Report of one case

    International Nuclear Information System (INIS)

    Parietti, G; Artucio, C.; Fernandez, A; Areco, D.; Mallo, D; Lluberas, R.

    2012-01-01

    The acute myocardial infarction is a rare complication in the course of an acute endocarditis. It takes place in the first weeks infection. Although is not associated with any particular microorganism it has been associated with virulent microorganism and is common in aortic valve endocarditis insufficiency. This report is a case of a patient who suffered a myocardial infarction during a acute endocarditis of native valve

  7. Straight Poop on Kids and Diarrhea

    Science.gov (United States)

    ... Home For Consumers Consumer Updates How to Treat Diarrhea in Infants and Young Children Share Tweet Linkedin ... provide relief if that is occurring. Causes of Diarrhea Acute diarrhea (comes on rapidly, is severe, but ...

  8. Oral Phage Therapy of Acute Bacterial Diarrhea With Two Coliphage Preparations: A Randomized Trial in Children From Bangladesh

    Science.gov (United States)

    Sarker, Shafiqul Alam; Sultana, Shamima; Reuteler, Gloria; Moine, Deborah; Descombes, Patrick; Charton, Florence; Bourdin, Gilles; McCallin, Shawna; Ngom-Bru, Catherine; Neville, Tara; Akter, Mahmuda; Huq, Sayeeda; Qadri, Firdausi; Talukdar, Kaisar; Kassam, Mohamed; Delley, Michèle; Loiseau, Chloe; Deng, Ying; El Aidy, Sahar; Berger, Bernard; Brüssow, Harald

    2016-01-01

    Background Antibiotic resistance is rising in important bacterial pathogens. Phage therapy (PT), the use of bacterial viruses infecting the pathogen in a species-specific way, is a potential alternative. Method T4-like coliphages or a commercial Russian coliphage product or placebo was orally given over 4 days to Bangladeshi children hospitalized with acute bacterial diarrhea. Safety of oral phage was assessed clinically and by functional tests; coliphage and Escherichia coli titers and enteropathogens were determined in stool and quantitative diarrhea parameters (stool output, stool frequency) were measured. Stool microbiota was studied by 16S rRNA gene sequencing; the genomes of four fecal Streptococcus isolates were sequenced. Findings No adverse events attributable to oral phage application were observed (primary safety outcome). Fecal coliphage was increased in treated over control children, but the titers did not show substantial intestinal phage replication (secondary microbiology outcome). 60% of the children suffered from a microbiologically proven E. coli diarrhea; the most frequent diagnosis was ETEC infections. Bacterial co-pathogens were also detected. Half of the patients contained phage-susceptible E. coli colonies in the stool. E. coli represented less than 5% of fecal bacteria. Stool ETEC titers showed only a short-lived peak and were otherwise close to the replication threshold determined for T4 phage in vitro. An interim analysis after the enrollment of 120 patients showed no amelioration in quantitative diarrhea parameter by PT over standard care (tertiary clinical outcome). Stool microbiota was characterized by an overgrowth with Streptococcus belonging to the Streptococcus gallolyticus and Streptococcus salivarius species groups, their abundance correlated with quantitative diarrhea outcome, but genome sequencing did not identify virulence genes. Interpretation Oral coliphages showed a safe gut transit in children, but failed to achieve

  9. Acute diarrhea during adjuvant therapy for rectal cancer: a detailed analysis from a randomized intergroup trial

    International Nuclear Information System (INIS)

    Miller, Robert C.; Sargent, Daniel J.; Martenson, James A.; Macdonald, John S.; Haller, Daniel; Mayer, Robert J.; Gunderson, Leonard L.; Rich, Tyvin A.; Cha, Stephen S.; O'Connell, Michael J.

    2002-01-01

    Purpose: During adjuvant radiotherapy (RT) for rectal cancer, patients receiving 5-fluorouracil (5-FU) by protracted venous infusion have a higher risk of diarrhea than have patients receiving bolus 5-FU. Toxicity from a previously reported randomized clinical trial was analyzed to quantify the difference in this risk. Additionally, the persistence of diarrhea after RT was analyzed. Methods and Materials: A total of 656 patients were eligible. Patients with T3-4 N0-2 M0 or T1-2 N1-2 M0 resected, high-risk rectal cancer were randomly allocated to receive 5-FU by either protracted venous infusion or bolus during RT (50.4-54.0 Gy). Two cycles of bolus 5-FU were given before and after RT. One-half of the first 445 patients were also randomly allocated to receive lomustine in conjunction with the bolus 5-FU. The incidence and severity of diarrhea in relation to patient and treatment characteristics were evaluated. Results: The rate of diarrhea was significantly greater in patients receiving 5-FU by protracted venous infusion than in patients receiving bolus 5-FU; the difference was most pronounced for Grade 3 (severe) diarrhea (21% versus 13%, p=0.007). The incidence and magnitude of diarrhea before and after RT were similar. Patients treated with an anterior resection had a higher rate of severe or life-threatening diarrhea than did patients treated with an abdominoperineal resection (31% vs. 12%, p<0.001). Conclusions: During pelvic RT, patients who receive 5-FU by protracted venous infusion rather than by bolus have a higher risk of severe or life-threatening diarrhea during RT. This risk does not appear to persist during chemotherapy after completion of pelvic RT

  10. The Genetic Diversity and Phylogenetic Characteritics of Rotavirus VP4(P Genotypes in Children With Acute Diarrhea

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    Haghshenas Z

    2011-11-01

    Full Text Available Background: Acute gastroenteritis is a major cause of morbidity and mortality among children in developing countries. Rotaviruses are recognized as the most common etiologic factors of gastroenteritis. In this study, we determined the epidemiologic features, clinical symptoms and molecular structure of rotavirus VP4(P genotypes in children with acute diarrhea in Bahrami Hospital in Tehran Iran, during 2009 for justifying the routine use of rotavirus vaccines in children. Methods: One hundred fifty fecal samples from 150 children with acute diarrhea in Bahrami Pediatric Hospital in Tehran, Iran were collected from January to December 2009. The patients’ mean age was 20.90+18.19 years (ranging from 1 month to 14 years. Fecal samples were transported on ice to the laboratory of virology department of Pasture Institute of Iran. The demographic and clinical data for each case were entered in an author-devised questionnaire. Group A rotavirus was detected by dsRNA-PAGE. Subsequently, rotavirus genotyping (VP4 was performed by semi-nested multiple RT-PCR and the phylogenetic tree of the Rotavirus nucleotides was constructed. The data were analyzed by statistical tests including Wilcoxon signed and Mann-Whitney U. Results: Rotavirus was isolated in 19.3% of the samples, more than 90% of which had long RNA patterns. The predominant genotype (VP4 was P[8] (86% and other genotypes respectively were P[6] (6.9% and P[4] (6.9%. Conclusion: A high prevalence of the P[8] genotype was found to be the cause of acute diarrhea. The analysis of P[8] genotype sequence showed a high level of similarity of the virus in this study with those of other Asian countries.

  11. Infectious Thromboembolism related to prolonged reduced motility in ill acute patients

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    F. Dodi

    2011-01-01

    Full Text Available Update in new clinic complications related to infectious diseases reveals emergent, at present, the thromboembolic risk. Clinicians must examine carefully thromboembolism related to prolonged reduced motility during acute invalidating infectious diseases because it represents major risk during clinical conditions involving enzimatic procoagulant activity, fibronectine production, procoagulant autoimmunitary damage. Recent experimental data show that pathogenesis of thromboembolic lesions involves clinical risk factors, vascular anatomic features and bacterial genetic properties.

  12. Characterization of thymus-associated lymphoid depletion in bovine calves acutely or persistently infected with bovine viral diarrhea virus 1, bovine viral diarrhea 2 or HoBi-like pestivirus

    Science.gov (United States)

    Viruses from recognized pestivirus species bovine viral diarrhea 1 (BVDV-1) and BVDV-2 and the proposed pestivirus species HoBi-like virus infect primarily cattle. Exposure of cattle to these viruses can lead to either acute or persistent infections depending on the timing and status of the animal ...

  13. Acute kidney injury in symptomatic primary Epstein-Barr virus infectious mononucleosis: Systematic review.

    Science.gov (United States)

    Moretti, Milena; Lava, Sebastiano A G; Zgraggen, Lorenzo; Simonetti, Giacomo D; Kottanattu, Lisa; Bianchetti, Mario G; Milani, Gregorio P

    2017-06-01

    Textbooks and reviews do not mention the association of symptomatic primary Epstein-Barr virus infectious mononucleosis with acute kidney injury in subjects without immunodeficiency or autoimmunity. Stimulated by our experience with two cases, we performed a review of the literature. The literature documents 38 cases (26 male and 12 female individuals ranging in age from 0.3 to 51, median 18 years) of symptomatic primary Epstein-Barr virus infectious mononucleosis complicated by acute kidney injury: 27 acute interstitial nephritides, 1 jaundice-associated nephropathy, 7 myositides and 3 hemolytic uremic syndromes. Acute kidney injury requiring renal replacement therapy was observed in 18 (47%) cases. Acute kidney injury did not resolve in one patient with acute interstitial nephritis. Two patients died because of systemic complications. The remaining 35 cases fully recovered. In individuals with acute symptomatic Epstein-Barr virus infectious mononucleosis, a relevant kidney injury is rare but the outcome potentially fatal. It results from interstitial nephritis, myositis-associated acute kidney injury, hemolytic uremic syndrome or jaundice-associated nephropathy. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Importance of cholera and other etiologies of acute diarrhea in post-earthquake Port-au-Prince, Haiti.

    Science.gov (United States)

    Charles, Macarthur; Delva, Glavdia G; Boutin, Jethro; Severe, Karine; Peck, Mireille; Mabou, Marie Marcelle; Wright, Peter F; Pape, Jean W

    2014-03-01

    We estimated the proportion of diarrhea attributable to cholera and other pathogens during the rainy and dry seasons in patients seen in two urban health settings: a cholera treatment center (CTC) and oral rehydration points (ORPs). During April 1, 2011-November 30, 2012, stool samples were collected from 1,206 of 10,845 patients who came to the GHESKIO CTC or to the community ORPs with acute diarrhea, cultured for Vibrio cholerae, and tested by multiplex polymerase reaction. Vibrio cholerae was isolated from 409 (41.8%, 95% confidence interval [CI] = 38.7-44.9%) of the 979 specimens from the CTC and in 45 (19.8%, 95% CI = 14.8-25.6%) of the 227 specimens from the ORPs. Frequencies varied from 21.4% (95% CI = 16.6-26.7%) during the dry season to 46.8% (95% CI = 42.9-50.7%) in the rainy season. Shigella, enterotoxigenic Escherichia coli, rotavirus, and Cryptosporidium were frequent causes of diarrhea in children less than five years of age.

  15. The efficacy of octreotide in the therapy of acute radiation-induced diarrhea: a randomized controlled study

    International Nuclear Information System (INIS)

    Yavuz, Melek N.; Yavuz, A. Aydin; Aydin, Fazil; Can, Gamze; Kavgaci, Halil

    2002-01-01

    Purpose: Although the somatostatin analog octreotide is currently used in the treatment of chemotherapy-induced diarrhea and secretory diarrhea associated with various disorders, its role in the management of radiation enteritis is not well defined. We performed a randomized study that compared octreotide acetate with diphenoxylate hydrochloride plus atropine sulfate, the drug commonly used as therapy for acute radiation-induced diarrhea (ARID). Methods and Materials: Sixty-one patients with Grade 2 (four to six stools per day) or Grade 3 (≥ seven stools per day, National Cancer Institute Common Toxicity Criteria) diarrhea associated with pelvic radiotherapy were assigned randomly to receive octreotide s.c., 100 μg three times daily (n=33) or diphenoxylate and atropine orally, 2.5 mg four times daily (n = 28). Radiotherapy was delivered to all patients in a conventional manner, with high-energy photons in a total dose ≥45 Gy, which exceeds the tolerance of intestine. Overall, there was no significant difference in patient characteristics or radiotherapy applied between the two arms. Patients were evaluated daily for the primary study end point, resolution of diarrhea, as well as for interruption of pelvic radiotherapy. Results: Within 3 days, ARID completely resolved in 20 patients in the octreotide arm (2 within the first day, 11 within the second day, and 7 within the third day) vs. only 4 (all within the second day of therapy) in the diphenoxylate arm (p=0.002). On the diphenoxylate arm, 15/28 patients were required to discontinue pelvic radiotherapy; on the octreotide arm, 6/33 patients were required to discontinue pelvic radiotherapy for an average of 1.89±0.5 and 0.45±0.2 days, respectively (p=0.003). No side effects were observed in either arm. Three patients on the diphenoxylate arm and only 1 on the octreotide arm required further treatment for parenteral replenishment of fluids and electrolytes or other antidiarrheal treatments. Conclusion

  16. A Multicenter, Prospective, Randomized Controlled Trial to Evaluate the Additional Benefit of a Multistrain Synbiotic (Prodefen® in the Clinical Management of Acute Viral Diarrhea in Children

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    Emilia García-Menor MD

    2016-11-01

    Full Text Available This randomized, open-label study evaluated the additional benefits of the synbiotic Prodefen® in the clinical management of acute diarrhea of suspected viral origin in children between 6 months and 12 years of age. Study outcomes included the duration of diarrhea, the recovery from diarrhea, and the tolerability and acceptance of the treatment. The proportion of patients without diarrhea over the study period was greater in the synbiotic group than in the control group at all study time points, showing a statistically significant difference on the fifth day (95% vs 79%, p < 0.001. The duration of diarrhea (median and interquartile range was reduced by 1 day in the synbiotic-treated patients (3 [2-5] vs 4 [3-5], p = 0.377. The tolerability of the treatment regimen, as evaluated by the parents, was significantly better in those receiving the synbiotic than in the control group. Overall, 96% of the parents of children receiving the synbiotic reported being satisfied to very satisfied with the treatment regimen. The results of this study indicate that the addition of the synbiotic Prodefen® is a well-tolerated and well-accepted approach that provides an additional benefit to the standard supportive therapy in the management of acute viral diarrhea in children.

  17. The association between serological titers in infectious bovine rhinotracheitis virus, bovine virus diarrhea virus, parainfluenza-3 virus, respiratory syncytial virus and treatment for respiratory disease in Ontario feedlot calves.

    OpenAIRE

    Martin, S W; Bohac, J G

    1986-01-01

    A seroepidemiological study of the association between antibody titers to infectious bovine rhinotracheitis, parainfluenza-3, bovine virus diarrhea and bovine respiratory syncytial viruses, and treatment for bovine respiratory disease was conducted. A total of 322 calves from five different groups were bled on arrival, then one month later all cases (cattle treated for bovine respiratory disease) were rebled together with an equal number of controls (cattle not treated for any disease). Titer...

  18. The causes of acute Fever requiring hospitalization in geriatric patients: comparison of infectious and noninfectious etiology.

    Science.gov (United States)

    Cagatay, A Atahan; Tufan, Fatih; Hindilerden, Fehmi; Aydin, Sibel; Elcioglu, Omer Celal; Karadeniz, Asli; Alpay, Nilufer; Gokturk, Suut; Taranoglu, Ozer

    2010-08-12

    Introduction. Infectious diseases may present with atypical presentations in the geriatric patients. While fever is an important finding of infections, it may also be a sign of noninfectious etiology. Methods. Geriatric patients who were hospitalized for acute fever in our infectious diseases unit were included. Acute fever was defined as presentation within the first week of fever above 37.3°C. Results. 185 patients were included (82 males and 103 females). Mean age was 69.7 ± 7.5 years. The cause of fever was an infectious disease in 135 and noninfectious disease in 32 and unknown in 18 of the patients. The most common infectious etiologies were respiratory tract infections (n = 46), urinary tract infections (n = 26), and skin and soft tissue infections (n = 23). Noninfectious causes of fever were rheumatic diseases (n = 8), solid tumors (n = 7), hematological diseases (n = 10), and vasculitis (n = 7). A noninfectious cause of fever was present in one patient with no underlying diseases and in 31 of 130 patients with underlying diseases. Conclusion. Geriatric patients with no underlying diseases generally had infectious causes of fever while noninfectious causes were responsible from fever in an important proportion of patients with underlying diseases.

  19. Comparing the Accuracy of the Three Dehydration Scales in Children with Acute Diarrhea in a Developing Country of Kosovo

    Science.gov (United States)

    Hoxha, Teuta; Xhelili, Luan; Azemi, Mehmedali; Avdiu, Muharrem; Ismaili-Jaha, Vlora; Efendija-Beqa, Urata; Grajcevci-Uka, Violeta

    2015-01-01

    Background. Although diarrhea is a preventable disease, it remains the second leading cause of death (after pneumonia) among children aged under five years worldwide. The World Health Organization (WHO) scale, the Gorelick scale, and the Clinical Dehydration Scale (CDS) were created to estimate dehydration status using clinical signs. The purpose of this study is to determine whether these clinical scales can accurately assess dehydration status of children in a developing country of Kosovo. Methodology. Children aged 1 month to 5 years with a history of acute diarrhea were enrolled in the study. After recording the data about the patients historical features the treating physician recorded the physical examination findings consistent with each clinical score. Receiver operating characteristic (ROC) curves were constructed to evaluate the performance of the three scales, compared to the gold standard, percent weight change with rehydration. Sensitivity, specificity and likelihood ratios were calculated using the best cut-off points of the ROC curves. Results. We enrolled 230 children, and 200 children met eligibility criteria. The WHO scale for predicting significant dehydration (≥5 percent weight change) had an area under the curve (AUC) of 0.71 (95% : CI= 0.65-0.77). The Gorelick scales 4- and 10-point for predicting significant dehydration, had an area under the curve of 0.71 (95% : CI=0.63- 0.78) and 0.74 (95% : CI= 0.68-0.81) respectively. Only the CDS for predicting the significant dehydration above ≥6% percent weight change, did not have an area under the curve statistically different from the reference line with an AUC of 0.54 (95% CI = 0.45- 0.63). Conclusion. The WHO dehydration scale and Gorelick scales were fair predictors of dehydration in children with diarrhea. Only the Clinical Dehydration Scale was found not to be a helpful predictor of dehydration in our study cohort. PMID:26244042

  20. Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

    Directory of Open Access Journals (Sweden)

    Silviu Grisaru

    2011-01-01

    Full Text Available Acute kidney injury (AKI is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 58 (43% required ARRT over the past 16 years. In our cohort, all but one patient were started on peritoneal dialysis (PD. Most patients, 47 (81%, received acute PD on a pediatric inpatient ward. The most common recorded complications in our cohort were peritoneal fluid leaks 13 (22%, peritonitis 11 (20%, and catheter malfunction 5 (9%. Nine patients (16% needed surgical revision of their PD catheters. There were no bleeding events related to PD despite a mean platelets count of 40.9 (±23.5 × 103/mm3 and rare use of platelets infusions. Despite its methodological limitations, this paper adds to the limited body of evidence supporting the use of acute PD as the primary ARRT modality in children with D+HUS.

  1. [Beliefs and knowledge of a group of doctors about the nutritional management of the child with acute diarrhea].

    Science.gov (United States)

    Corral-Terrazas, Martha; Martínez, Homero; Flores-Huerta, Samuel; Duque-L, Ma Ximena; Turnbull, Bernardo; Levario-Carrillo, Margarita

    2002-01-01

    To identify the beliefs and knowledge of a group of rural physicians on the dietary management of children under five years of age, with acute diarrhea. Physicians' dietary management was compared with that recommended by the World Health Organization. A cognitive anthropology study was carried out from July to December 1998, on ten physicians that care for the infant population ascribed to Hospital Rural IMSS-Solidaridad of San Juanito Bocoyna, Chihuahua, Mexico. Data were collected through focus groups, case vignettes, free listing, pile sorting, and a semi-structured questionnaire, and then cross-referred. The physicians recognized the negative impact of diarrhea on the nutritional state of the child, but not all of them evaluated this state. Prevailing interventions were antibiotic therapy, fluid management, and feeding recommendations. Among the latter, the most consistent were breastfeeding, delayed feeding, and gradual feeding. The obtained information is in conflict with WHO's recommendations, specially with that of sustained feeding. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

  2. Non-infectious chemotherapy-associated acute toxicities during childhood acute lymphoblastic leukemia therapy [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Kjeld Schmiegelow

    2017-04-01

    Full Text Available During chemotherapy for childhood acute lymphoblastic leukemia, all organs can be affected by severe acute side effects, the most common being opportunistic infections, mucositis, central or peripheral neuropathy (or both, bone toxicities (including osteonecrosis, thromboembolism, sinusoidal obstruction syndrome, endocrinopathies (especially steroid-induced adrenal insufficiency and hyperglycemia, high-dose methotrexate-induced nephrotoxicity, asparaginase-associated hypersensitivity, pancreatitis, and hyperlipidemia. Few of the non-infectious acute toxicities are associated with clinically useful risk factors, and across study groups there has been wide diversity in toxicity definitions, capture strategies, and reporting, thus hampering meaningful comparisons of toxicity incidences for different leukemia protocols. Since treatment of acute lymphoblastic leukemia now yields 5-year overall survival rates above 90%, there is a need for strategies for assessing the burden of toxicities in the overall evaluation of anti-leukemic therapy programs.

  3. Lactobacillus casei strain GG in the treatment of infants with acute watery diarrhea: A randomized, double-blind, placebo controlled clinical trial [ISRCTN67363048

    Directory of Open Access Journals (Sweden)

    Chea-Woo Elsa

    2004-09-01

    Full Text Available Abstract Background Adjuvant therapy to ORT with probiotic bacteria for infants with acute watery diarrhea has been under active investigation. Most studies have been done in the developed world showing benefit only for viral mild gastroenteritis. We evaluated the effect of a milk formula containing one billion (109 cfu/ml of Lactobacillus casei strain GG (LGG upon duration and severity of diarrhea in infants in an environment with more severe acute diarrhea, where etiologic agents other than rotavirus are involved more frequently, and where mixed infections are more prevalent. Methods Male infants aged 3–36 months brought for treatment of acute watery diarrhea of less than 48 hours were eligible. After rehydration was completed with the WHO's oral rehydration solution, patients were randomly assigned to receive a milk formula either containing LGG or not. Stool volume was periodically measured using a devise suited to collect stools separate from urine. Duration of diarrhea was estimated based on stools physical characteristics. Results Eighty nine patients received the placebo milk formula and ninety received the LGG containing formula. Both groups were comparable in their baseline characteristics. Total stool output was significantly larger (p = 0.047 in the LGG group (247.8 ml/kg than in the placebo group (195.0 ml/kg. No significant differences were found in duration of diarrhea (58.5 hours with LGG vs. 50.4 hours with placebo, rate of treatment failure (21.1% with LGG vs. 18.0% with placebo, and proportion of patients with unresolved diarrhea after 120 hours (12.2% with LGG vs. 12.5% with placebo. The rate of stools with reducing substances after 24 hours of treatment increased significantly in both groups (from 41.4% to 72.2% with LGG and from 45.9% to 68.0% with placebo. Conclusion This study did not show a positive effect of LGG on the clinical course of acute watery diarrhea. Positive beneficial effects of LGG, as had been reported

  4. PFGE, Lior Serotype, and Antimicrobial Resistance Patterns Among Campylobacter jejuni Isolated from Travelers and US Military Personnel with Acute Diarrhea in Thailand, 1998-2003

    Science.gov (United States)

    2010-01-01

    gastroenteritis . Background Campylobacter jejuni is a major cause of gastroenteritis worldwide, especially in children, travelers, and military personnel...of gastroenteritis caused by Campylobacter jejuni. J Clin Microbial 2003, 41:4733-4739. 20. Beecham HJ, Lebron Cl. Echeverria P: Short report...and antimicrobial resistance patterns among Campylobacter jejuni isolated from travelers and US military personnel with acute diarrhea in Thailand

  5. Anti-NMDAR encephalitis, a mimicker of acute infectious encephalitis and a review of the literature

    Directory of Open Access Journals (Sweden)

    Darren Wong

    2014-01-01

    Full Text Available Anti-N-methyl-d-aspartate receptor encephalitis has become an increasingly recognized etiology of acute psychosis in young patients. The diverse constellation of symptoms allows for misdiagnosis as an infectious, psychological, or toxicological entity resulting in delays in treatment with increasing morbidity. We describe a case of anti-NMDAR encephalitis that was a particular challenge to diagnose. Practitioners should maintain a high index of suspicion for anti-NMDAR and related neuroautoimmune syndromes, especially in young patients that present with acute mental status decline or dyskinesia.

  6. Molecular Analysis of the Enteric Protozoa Associated with Acute Diarrhea in Hospitalized Children.

    Science.gov (United States)

    Boughattas, Sonia; Behnke, Jerzy M; Al-Ansari, Khalid; Sharma, Aarti; Abu-Alainin, Wafa; Al-Thani, Asma; Abu-Madi, Marawan A

    2017-01-01

    Pediatric diarrhea is a common cause of death among children under 5 years of age. In the current study, we investigated the frequency of intestinal parasites among 580 pediatric patients with chronic diarrhea. Parasitic protozoa (all species combined) were detected by molecular tools in 22.9% of the children and the most common parasite was Cryptosporidium spp. (15.1%). Blastocystis hominis was detected in 4.7%, Dientamoeba fragilis in 4%, Giardia duodenalis in 1.7%, and Entamoeba histolytica in 0.17%. Protozoan infections were observed among all regional groups, but prevalence was highest among Qatari subjects and during the winter season. Typing of Cryptosporidium spp. revealed a predominance of Cryptosporidium parvum in 92% of cases with mostly the IIdA20G1 subtype. Subtypes IIdA19G2, IIdA18G2, IIdA18G1, IIdA17G1, IIdA16G1, and IIdA14G1 were also detected. For Cryptosporidium hominis , IbA10G2 and IbA9G3 subtypes were identified. This study provides supplementary information for implementing prevention and control strategies to reduce the burden of these pediatric protozoan infections. Further analyses are required to better understand the local epidemiology and transmission of Cryptosporidium spp. in Qatar.

  7. Molecular Analysis of the Enteric Protozoa Associated with Acute Diarrhea in Hospitalized Children

    Directory of Open Access Journals (Sweden)

    Sonia Boughattas

    2017-08-01

    Full Text Available Pediatric diarrhea is a common cause of death among children under 5 years of age. In the current study, we investigated the frequency of intestinal parasites among 580 pediatric patients with chronic diarrhea. Parasitic protozoa (all species combined were detected by molecular tools in 22.9% of the children and the most common parasite was Cryptosporidium spp. (15.1%. Blastocystis hominis was detected in 4.7%, Dientamoeba fragilis in 4%, Giardia duodenalis in 1.7%, and Entamoeba histolytica in 0.17%. Protozoan infections were observed among all regional groups, but prevalence was highest among Qatari subjects and during the winter season. Typing of Cryptosporidium spp. revealed a predominance of Cryptosporidium parvum in 92% of cases with mostly the IIdA20G1 subtype. Subtypes IIdA19G2, IIdA18G2, IIdA18G1, IIdA17G1, IIdA16G1, and IIdA14G1 were also detected. For Cryptosporidium hominis, IbA10G2 and IbA9G3 subtypes were identified. This study provides supplementary information for implementing prevention and control strategies to reduce the burden of these pediatric protozoan infections. Further analyses are required to better understand the local epidemiology and transmission of Cryptosporidium spp. in Qatar.

  8. [Drug induced diarrhea].

    Science.gov (United States)

    Morard, Isabelle; Hadengue, Antoine

    2008-09-03

    Diarrhea is a frequent adverse event involving the most frequently antibiotics, laxatives and NSAI. Drug induced diarrhea may be acute or chronic. It may be due to expected, dose dependant properties of the drug, to immuno-allergic or bio-genomic mechanisms. Several pathophysiological mechanisms have been described resulting in osmotic, secretory or inflammatory diarrhea, shortened transit time, or malabsorption. Histopathological lesions sometimes associated with drug induced diarrhea are usually non specific and include ulcerations, inflammatory or ischemic lesions, fibrous diaphragms, microscopic colitis and apoptosis. The diagnosis of drug induced diarrhea, sometimes difficult to assess, relies on the absence of other obvious causes and on the rapid disappearance of the symptoms after withdrawal of the suspected drug.

  9. [Value of history and clinical and laboratory data for the diagnosis of dehydration due to acute diarrhea in children younger than 5 years].

    Science.gov (United States)

    Pruvost, Isabelle; Dubos, François; Aurel, Marie; Hue, Valérie; Martinot, Alain

    2008-04-01

    Acute diarrhea is frequent, costly because of the number of hospital admissions required, and sometimes serious, even fatal to children in France. The clinical diagnosis of dehydration is difficult, but essential to determine management. To summarize the published data on the value of clinical history, clinical signs and laboratory results for diagnosing dehydration during acute diarrhea in young (1 month-5 years) non-malnourished children. Four databases (Medline, INIST, Ovid, and Cochrane) were searched through November 2006, with the key words "dehydration" subcategories "diagnosis, or etiology, or history", "diarrhea" subcategory "diagnosis", and age limits "infant or preschool child". We selected the articles and reviews that included as an endpoint for dehydration "weight gain > 5% after recovery" (the gold standard). Thirteen studies were selected. No single clinical history item, clinical sign or laboratory value was sufficient to discriminate between children with and without dehydration. The reproducibility of clinical signs varied substantially between studies. Persistent skin folds and signs of vasoconstriction contributed the most information, with good specificity but sensitivity number of subjects. The diagnosis of dehydration due to acute diarrhea in young children depends on the number of signs present, since no individual element of clinical history, clinical picture or laboratory tests distinguished dehydration. Other studies are necessary.

  10. [Chronic diarrhea: etiologies and diagnostic evaluation].

    Science.gov (United States)

    Schoepfer, A

    2008-04-30

    Chronic diarrhea is defined as a decrease in fecal consistency lasting for four or more weeks. A myriad of disorders are associated with chronic diarrhea. In developed countries, chronic diarrhea is mostly caused by non-infectious diseases. There are four pathogenic mechanisms leading to chronic diarrhea: osmotic diarrhea, secretory diarrhea, inflammatory diarrhea, and dysmotility. Overlaps between these mechanisms are possible. A 72-hour fecal collection as well as the fasting test are important diagnostic tools to identify the underlying pathomechanism. The identification of the pathomechanism narrows down the possible etiologies of chronic diarrhea and allows therefore a cost-saving diagnostic workup. The endoscopy is well established in the workup of chronic diarrhea. This article gives an overview about the main causes and mechanisms leading to chronic diarrhea and proposes an algorithm for the diagnostic evalution.

  11. Sanitation facilities, hygienic conditions, and prevalence of acute diarrhea among under-five children in slums of Addis Ababa, Ethiopia: Baseline survey of a longitudinal study

    Science.gov (United States)

    Mengistie, Bezatu; Kloos, Helmut; Medhin, Girmay; Mulat, Worku

    2017-01-01

    Background In developing countries, children under the age of five years who live in slums are highly vulnerable to diarrhea. However, there is a paucity of information on the relationship between sanitation facilities and hygienic conditions to acute diarrhea among under-five children in slum areas of Addis Ababa, Ethiopia. Therefore, this study examines the sanitation facilities and hygienic conditions in the slums of Addis Ababa and identifies the main factors significantly associated with acute diarrhea among children aged 0–50 months in those slums. Methods A community-based cross-sectional household survey was carried out between September and November 2014, that then served as the baseline survey of a longitudinal study. For this survey, 697 children aged 0–50 months were recruited from two slum districts in Addis Ababa. A pre-tested structured questionnaire and an observational checklist were used for data collection. Multivariable logistic regression analysis was used to identify sanitation facilities and hygiene-related factors that were significantly associated with acute diarrhea by controlling potential confounding effects of selected socio-demographic factors. Adjusted odds ratio (AOR) with corresponding 95% confidence interval (CI) was used to quantify the strength of association. Main findings The prevalence of acute diarrhea among children aged 0–50 months in the study area was 11.9% and 94.6% of the sanitation facilities were unimproved. Sharing of a sanitation facility by six or more households (AOR = 4.7; 95% CI: 2.4–9.4), proximity of sanitation facilities within 15 meters of homes (AOR = 6.6; 95% CI: 2.5–17.0), presence of feces (AOR = 3.9; 95% CI: 1.5–10.3) and flies (AOR = 2.5; 95% CI: 1.3–5.0) on the floor of and/or around sanitation facilities, and presence of uncollected garbage inside house compounds (AOR = 3.2; 95% CI: 1.2–8.4) were significantly associated with acute diarrhea. Conclusion This study reveals the slum

  12. Serum Zinc Level and Its Correlation with Vesikari System Scoring in Acute Pediatric Diarrhea

    Directory of Open Access Journals (Sweden)

    Ayman E. Eskander

    2017-08-01

    CONCLUSION: Zinc level has an essential role in acute pediatric diarrhoea. Zinc therapy should be considered beside Oral rehydration salts (ORS to achieve maximum impact on diarrheal diseases; clinical trials are recommended to support the zinc supplementation in developing countries.

  13. Randomized, double-blind clinical trial of a lactose-free and a lactose-containing formula in dietary management of acute childhood diarrhea.

    Science.gov (United States)

    Simakachorn, Nipat; Tongpenyai, Yothi; Tongtan, Orapin; Varavithya, Wandee

    2004-06-01

    Refeeding of artificially fed infants with lactose-containing formula after oral rehydration therapy in the treatment of acute diarrhea was concluded to be indifferent to non-lactose formula by a meta-analysis. In Thai as well as Asian infants and children with low lactase level from genetically determinant and with rotavirus infection, lactose malabsorption is most likely to occur and cause delayed recovery. The aim of this study was to compare the effect of a lactose-free and a lactose-containing formula in dietary management of acute childhood diarrhea. A randomized, double-blind clinical trial of 80 male children, formula-fed, aged 3 to 24 months, admitted with acute watery diarrhea and mild or moderate dehydration, was carried out. All children received oral rehydration therapy for the first 4 hours. After appropriate rehydration, they were fed either a lactose-free formula (Dumex Lactose-Free Formula; treatment group, n = 40) or a lactose-containing formula (Dumex Infant Formula; control group, n = 40) in adjunction with oral rehydration solution. In addition, the infants were fed rice gruel as tolerated. Comparisons of duration of diarrhea, weight gain, vomiting, biochemical changes, stool frequency and weight and unscheduled intravenous fluid were made. Three children (2 treatment, and 1 control) dropped out from the study. The total number of unscheduled intravenous infusions were 6 of 80 children (7.5%), including 2 (5.0%) in the treatment group and 4 (10.0%) in the control group. Three children in the control group did not resolve from diarrhea within 7 days of treatment. Rotavirus was identified in approximately 50% of the children in each group. Using survival analysis, the median duration of diarrhea was significantly shortened by 20.5 hours in the treatment group compared to the control group (77.0 hours in the treatment group vs 97.5 hours in the control group; P = 0.002). Significantly decrease in stool frequency and increase in percent weight gain

  14. The effect of acute serotonergic modulation on rectal motor function in diarrhea-predominant irritable bowel syndrome and healthy controls.

    Science.gov (United States)

    van Nieuwenhoven, Michiel A; Kilkens, Tessa O C

    2012-11-01

    Irritable bowel syndrome (IBS) patients suffer from visceral hypersensitivity and show increased activity in the brain emotional arousal network following a rectal stimulus, compared with controls. Serotonergic activity can be decreased by acute tryptophan depletion (ATD), which increases visceral perception and also increases activity in the brain's emotional arousal network during rectal stimulation. Treatment with a serotonin reuptake inhibitor such as citalopram is effective in some IBS patients. Hence, serotonergic modulation alters visceral perception. However, it is not clear whether serotonergic modulation alters rectal motor function. The aims of the study were to evaluate the effect of the administration of ATD and citalopram on rectal motor function in diarrhea-predominant IBS (d-IBS) patients and controls using a barostat procedure. Following a randomized, double-blind placebo-controlled crossover design, an ATD and citalopram experiment was conducted. Fourteen d-IBS patients and 14 healthy, matched (age, sex, BMI) controls participated. Rectal volume (RV), adaptive relaxation (RAR), and compliance (RC) were determined using a barostat procedure. d-IBS patients showed significantly decreased RV (P0.1). d-IBS patients have disturbed rectal pressure-volume relations. Visceral perception in IBS is associated with both increased activity in the brain's emotional arousal network and decreased RC. Acutely decreasing or increasing serotonergic activity does not affect these characteristics in d-IBS patients or healthy controls. The pathophysiology in d-IBS contains both a rectal motor component and a central neuropsychologic component.

  15. Non-infectious chemotherapy-associated acute toxicities during childhood acute lymphoblastic leukemia therapy

    DEFF Research Database (Denmark)

    Schmiegelow, Kjeld; Müller, Klaus Gottlob; Mogensen, Signe Sloth

    2017-01-01

    During chemotherapy for childhood acute lymphoblastic leukemia, all organs can be affected by severe acute side effects, the most common being opportunistic infections, mucositis, central or peripheral neuropathy (or both), bone toxicities (including osteonecrosis), thromboembolism, sinusoidal...... useful risk factors, and across study groups there has been wide diversity in toxicity definitions, capture strategies, and reporting, thus hampering meaningful comparisons of toxicity incidences for different leukemia protocols. Since treatment of acute lymphoblastic leukemia now yields 5-year overall...

  16. Strategies to Improve Management of Acute Watery Diarrhea during a Military Deployment: A Cost Effectiveness Analysis.

    Science.gov (United States)

    Schrader, Andrew J; Tribble, David R; Riddle, Mark S

    2017-12-01

    To inform policy and decision makers, a cost-effectiveness model was developed to predict the cost-effectiveness of implementing two hypothetical management strategies separately and concurrently on the mitigation of deployment-associated travelers' diarrhea (TD) burden. The first management strategy aimed to increase the likelihood that a deployed service member with TD will seek medical care earlier in the disease course compared with current patterns; the second strategy aimed to optimize provider treatment practices through the implementation of a Department of Defense Clinical Practice Guideline. Outcome measures selected to compare management strategies were duty days lost averted (DDL-averted) and a cost effectiveness ratio (CER) of cost per DDL-averted (USD/DDL-averted). Increasing health care and by seeking it more often and earlier in the disease course as a stand-alone management strategy produced more DDL (worse) than the base case (up to 8,898 DDL-gained per year) at an increased cost to the Department of Defense (CER $193). Increasing provider use of an optimal evidence-based treatment algorithm through Clinical Practice Guidelines prevented 5,299 DDL per year with overall cost savings (CER -$74). A combination of both strategies produced the greatest gain in DDL-averted (6,887) with a modest cost increase (CER $118). The application of this model demonstrates that changes in TD management during deployment can be implemented to reduce DDL with likely favorable impacts on mission capability and individual health readiness. The hypothetical combination strategy evaluated prevents the most DDL compared with current practice and is associated with a modest cost increase.

  17. Ileus in children presenting with diarrhea and severe acute malnutrition: A chart review.

    Science.gov (United States)

    Chisti, Mohammod Jobayer; Shahid, Abu Smsb; Shahunja, K M; Bardhan, Pradip Kumar; Faruque, Abu Syeed Golam; Shahrin, Lubaba; Das, Sumon Kumar; Barua, Dipesh Kumar; Hossain, Md Iqbal; Ahmed, Tahmeed

    2017-05-01

    Severely malnourished children aged under five years requiring hospital admission for diarrheal illness frequently develop ileus during hospitalization with often fatal outcomes. However, there is no data on risk factors and outcome of ileus in such children. We intended to evaluate predictive factors for ileus during hospitalization and their outcomes. This was a retrospective chart review that enrolled severely malnourished children under five years old with diarrhea, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh between April 2011 and August 2012. We used electronic database to have our chart abstraction from previously admitted children in the hospital. The clinical and laboratory characteristics of children with (cases = 45), and without ileus (controls = 261) were compared. Cases were first identified by observation of abnormal bowel sounds on physical examination and confirmed with abdominal radiographs. For this comparison, Chi-square test was used to measure the difference in proportion, Student's t-test to calculate the difference in mean for normally distributed data and Mann-Whitney test for data that were not normally distributed. Finally, in identifying independent risk factors for ileus, logistical regression analysis was performed. Ileus was defined if a child developed abdominal distension and had hyperactive or sluggish or absent bowel sound and a radiologic evidence of abdominal gas-fluid level during hospitalization. Logistic regression analysis adjusting for potential confounders revealed that the independent risk factors for admission for ileus were reluctance to feed (odds ratio [OR] = 3.22, 95% confidence interval [CI] = 1.24-8.39, p = 0.02), septic shock (OR = 3.62, 95% CI = 1.247-8.95, pfeed, hypokalemia, hypocalcemia, and blood transfusion, septic shock (OR = 168.84, 95% CI = 19.27-1479.17, pchildren. This study suggests that the identification of simple independent admission risk

  18. Acute diarrhea in adults consulting a general practitioner in France during winter: incidence, clinical characteristics, management and risk factors.

    Science.gov (United States)

    Arena, Christophe; Amoros, Jean Pierre; Vaillant, Véronique; Ambert-Balay, Katia; Chikhi-Brachet, Roxane; Jourdan-Da Silva, Nathalie; Varesi, Laurent; Arrighi, Jean; Souty, Cécile; Blanchon, Thierry; Falchi, Alessandra; Hanslik, Thomas

    2014-10-30

    Data describing the epidemiology and management of viral acute diarrhea (AD) in adults are scant. The objective of this study was to identify the incidence, clinical characteristics, management and risk factors of winter viral AD in adults. The incidence of AD in adults during two consecutive winters (from December 2010 to April 2011 and from December 2011 to April 2012) was estimated from the French Sentinelles network. During these two winters, a subset of Sentinelles general practitioners (GPs) identified and included adult patients who presented with AD and who filled out a questionnaire and returned a stool specimen for virological examination. All stool specimens were tested for astrovirus, group A rotavirus, human enteric adenovirus, and norovirus of genogroup I and genogroup II. Age- and sex-matched controls were included to permit a case-control analysis with the aim of identifying risk factors for viral AD. During the studied winters, the average incidence of AD in adults was estimated to be 3,158 per 100,000 French adults (95% CI [2,321 - 3,997]). The most reported clinical signs were abdominal pain (91.1%), watery diarrhea (88.5%), and nausea (83.3%). GPs prescribed a treatment in 95% of the patients with AD, and 80% of the working patients with AD could not go to work. Stool examinations were positive for at least one enteric virus in 65% (95% CI [57 - 73]) of patients with AD with a predominance of noroviruses (49%). Having been in contact with a person who has suffered from AD in the last 7 days, whether within or outside the household, and having a job (or being a student) were risk factors significantly associated with acquiring viral AD. During the winter, AD of viral origin is a frequent disease in adults, and noroviruses are most often the cause. No preventable risk factor was identified other than contact with a person with AD. Thus, at the present time, reinforcement of education related to hand hygiene remains the only way to reduce the

  19. Ileus in children presenting with diarrhea and severe acute malnutrition: A chart review.

    Directory of Open Access Journals (Sweden)

    Mohammod Jobayer Chisti

    2017-05-01

    Full Text Available Severely malnourished children aged under five years requiring hospital admission for diarrheal illness frequently develop ileus during hospitalization with often fatal outcomes. However, there is no data on risk factors and outcome of ileus in such children. We intended to evaluate predictive factors for ileus during hospitalization and their outcomes.This was a retrospective chart review that enrolled severely malnourished children under five years old with diarrhea, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh between April 2011 and August 2012. We used electronic database to have our chart abstraction from previously admitted children in the hospital. The clinical and laboratory characteristics of children with (cases = 45, and without ileus (controls = 261 were compared. Cases were first identified by observation of abnormal bowel sounds on physical examination and confirmed with abdominal radiographs. For this comparison, Chi-square test was used to measure the difference in proportion, Student's t-test to calculate the difference in mean for normally distributed data and Mann-Whitney test for data that were not normally distributed. Finally, in identifying independent risk factors for ileus, logistical regression analysis was performed. Ileus was defined if a child developed abdominal distension and had hyperactive or sluggish or absent bowel sound and a radiologic evidence of abdominal gas-fluid level during hospitalization. Logistic regression analysis adjusting for potential confounders revealed that the independent risk factors for admission for ileus were reluctance to feed (odds ratio [OR] = 3.22, 95% confidence interval [CI] = 1.24-8.39, p = 0.02, septic shock (OR = 3.62, 95% CI = 1.247-8.95, p<0.01, and hypokalemia (OR = 1.99, 95% CI = 1.03-3.86, p = 0.04. Mortality was significantly higher in cases compared to controls (22% vs. 8%, p<0.01 in univariate analysis; however

  20. Epidemiologic and clinical characteristics of acute diarrhea with emphasis on Entamoeba histolytica infections in preschool children in an urban slum of Dhaka, Bangladesh.

    Science.gov (United States)

    Haque, Rashidul; Mondal, Dinesh; Kirkpatrick, Beth D; Akther, Selim; Farr, Barry M; Sack, R Bradley; Petri, William A

    2003-10-01

    . dispar, had half the chance of developing subsequent E. histolytica-associated diarrhea, consistent with the development of species-specific acquired immunity. In conclusion, the use of modern diagnostic tests demonstrated that E. histolytica contributed to overall morbidity from diarrheal illness. Understanding the etiology, frequency, and consequences of acute diarrhea in children from a developing country should aid in the design of interventions to improve child health.

  1. A canine-specific probiotic product in treating acute or intermittent diarrhea in dogs: A double-blind placebo-controlled efficacy study.

    Science.gov (United States)

    Gómez-Gallego, Carlos; Junnila, Jouni; Männikkö, Sofia; Hämeenoja, Pirkko; Valtonen, Elisa; Salminen, Seppo; Beasley, Shea

    2016-12-25

    A double-blind placebo-controlled intervention study on 60 dogs recruited from a pool of canine patients visiting a veterinary practice and diagnosed with acute diarrhea was conducted. The dogs received in randomized manner either a sour-milk product containing three canine-derived Lactobacillus sp. probiotics in combination of Lactobacillus fermentum VET 9A, L. rhamnosus VET 16A, and L. plantarum VET 14A (2×10 9 cfu/ml), or placebo. Stool consistency, general well-being, and the numbers of specific pathogens in stool samples were analyzed. Our results demonstrated that the treatment with the study sour-milk product had a normalizing effect on canine stool consistency. The treatment also enhanced the well-being of the pet by maintaining appetite and may reduce vomiting. In addition, the concentrations of Clostridium perfringens and Enterococcus faecium, which typically increase during diarrhea episodes in dogs, were decreased in probiotic group feces when compared with the placebo group. Taken together, the sour-milk with the specific probiotic combination had a normalizing effect on acute diarrhea in dogs which was associated with decreased numbers of potential pathogens in the feces of probiotic-treated dogs. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Genetic virulence profile of enteroaggregative Escherichia coli strains isolated from Danish children with either acute or persistent diarrhea

    DEFF Research Database (Denmark)

    Jensen, Betina Hebbelstrup; Poulsen, Anja; Rasmussen, Stig Hebbelstrup Rye

    2017-01-01

    Enteroaggregative Escherichia coli (EAEC) is frequently found in diarrheal stools worldwide. It has been associated with persistent diarrhea, weight loss, and failure to thrive in children living in developing countries. A number of important EAEC virulence genes are identified; however...

  3. [Blood cholesterol spectre in patients with acute and chronic inflammation of infectious origin].

    Science.gov (United States)

    Panchyshyn, Iu M; Srokopud, O O; Zhakun, I B; Komarytsia, O I; Huk-Leshnevs'ka, S O; Panchyshyn, M V

    2006-12-01

    Low level of blood cholesterol is often found in patients with diseases which pathogenesis is mainly associated with inflamation. To detect blood cholesterol spectre, 383 patients with acute and chronic infections have been observed, level of blood cholesterol of 1259 patients with different pathology was retrospectively analyzed. It was found that an increase in frequency of low cholesterol and decrease in frequency of high cholesterol in patients with diseases not associated with infections do not depend on the age of patients. Extremely low level of cholesterol (Cholesterol inflamation of infectious origion, oftener in patients with community-acquired pneumonia and chronic virus hepatitis. Patients with intestinal infections have extremely low level of cholesterol; two-fold oftener than healthy persons have.

  4. Infectious complications in children with acute lymphoblastic leukemia treated in low-middle-income countries.

    Science.gov (United States)

    Caniza, Miguela A; Odio, Carla; Mukkada, Sheena; Gonzalez, Miriam; Ceppi, Francesco; Chaisavaneeyakorn, Sujittra; Apiwattanakul, Nopporn; Howard, Scott C; Conter, Valentino; Bonilla, Miguel

    2015-10-01

    Infections are the most important cause of morbidity and mortality in children treated for acute lymphoblastic leukemia (ALL). The rates of infection-associated mortality are up to 10-times higher in low- and middle-income countries (LMIC) than in high-income countries. The prevention, early recognition and management of infectious complications is especially challenging in LMIC because of disease and poverty-related factors, as well as the shortage of trained personnel, supplies, diagnostic tools and adequate organizational infrastructure. Children in LMIC with ALL, who are frequently underweight, are at increased risk of community-acquired pathogens, nosocomial multidrug-resistant pathogens and opportunistic microorganisms. This review summarizes the challenges of managing the major categories of infections in children receiving treatment for ALL and provides updated practical recommendations for preventing and managing these infections in LMIC.

  5. Infectious dengue vesicles derived from CD61+ cells in acute patient plasma exhibited a diaphanous appearance

    Science.gov (United States)

    Hsu, Alan Yi-Hui; Wu, Shang-Rung; Tsai, Jih-Jin; Chen, Po-Lin; Chen, Ya-Ping; Chen, Tsai-Yun; Lo, Yu-Chih; Ho, Tzu-Chuan; Lee, Meed; Chen, Min-Ting; Chiu, Yen-Chi; Perng, Guey Chuen

    2015-01-01

    The levels of neutralizing antibody to a pathogen are an effective indicator to predict efficacy of a vaccine in trial. And yet not all the trial vaccines are in line with the theory. Using dengue virus (DENV) to investigate the viral morphology affecting the predictive value, we evaluated the viral morphology in acute dengue plasma compared to that of Vero cells derived DENV. The virions in plasma were infectious and heterogeneous in shape with a “sunny-side up egg” appearance, viral RNA was enclosed with CD61+ cell-derived membrane interspersed by the viral envelope protein, defined as dengue vesicles. The unique viral features were also observed from ex vivo infected human bone marrow. Dengue vesicles were less efficiently neutralized by convalescent patient serum, compared to virions produced from Vero cells. Our results exhibit a reason why potencies of protective immunity fail in vivo and significantly impact dengue vaccine and drug development. PMID:26657027

  6. Management of children with prolonged diarrhea [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Antonietta Giannattasio

    2016-02-01

    Full Text Available Prolonged diarrhea is usually defined as acute-onset diarrhea lasting 7 days or more, but less than 14 days. Its trend has been declining in recent years because of improvement in the management of acute diarrhea, which represents the ideal strategy to prevent prolonged diarrhea. The pathogenesis of prolonged diarrhea is multifactorial and essentially based on persistent mucosal damage due to specific infections or sequential infections with different pathogens, host-related factors including micronutrient and/or vitamin deficiency, undernutrition and immunodeficiency, high mucosal permeability due to previous infectious processes and nutrient deficiency with consequential malabsorption, and microbiota disruption. Infections seem to play a major role in causing prolonged diarrhea in both developing and developed areas. However, single etiologic pathogens have not been identified, and the pattern of agents varies according to settings, host risk factors, and previous use of antibiotics and other drugs. The management of prolonged diarrhea is complex. Because of the wide etiologic spectrum, diagnostic algorithms should take into consideration the age of the patient, clinical and epidemiological factors, and the nutritional status and should always include a search for enteric pathogens. Often, expensive laboratory evaluations are of little benefit in guiding therapy, and an empirical approach may be effective in the majority of cases. The presence or absence of weight loss is crucial for driving the initial management of prolonged diarrhea. If there is no weight loss, generally there is no need for further evaluation. If weight loss is present, empiric anti-infectious therapy or elimination diet may be considered once specific etiologies have been excluded.

  7. Risk factors associated with the introduction of acute clinical infectious bursal disease among Danish broiler chickens in 1998

    DEFF Research Database (Denmark)

    Flensburg, Mimi Folden; Ersbøll, Annette Kjær; Jørgensen, Poul Henrik

    2002-01-01

    The objective of the present study was to investigate risk factors associated with the introduction of acute clinical infectious bursal disease (IBD) among Danish broiler chickens in 1998. Data on 218 flocks were collected from hatcheries, abattoirs, farmers and veterinarians; 49 of the flocks had...

  8. Immunogenicity of a modified-live virus vaccine against bovine viral diarrhea virus types 1 and 2, infectious bovine rhinotracheitis virus, bovine parainfluenza-3 virus, and bovine respiratory syncytial virus when administered intranasally in young calves.

    Science.gov (United States)

    Xue, Wenzhi; Ellis, John; Mattick, Debra; Smith, Linda; Brady, Ryan; Trigo, Emilio

    2010-05-14

    The immunogenicity of an intranasally-administered modified-live virus (MLV) vaccine in 3-8 day old calves was evaluated against bovine viral diarrhea virus (BVDV) types 1 and 2, infectious bovine rhinotracheitis (IBR) virus, parainfluenza-3 (PI-3) virus and bovine respiratory syncytial virus (BRSV). Calves were intranasally vaccinated with a single dose of a multivalent MLV vaccine and were challenged with one of the respective viruses three to four weeks post-vaccination in five separate studies. There was significant sparing of diseases in calves intranasally vaccinated with the MLV vaccine, as indicated by significantly fewer clinical signs, lower rectal temperatures, reduced viral shedding, greater white blood cell and platelet counts, and less severe pulmonary lesions than control animals. This was the first MLV combination vaccine to demonstrate efficacy against BVDV types 1 and 2, IBR, PI-3 and BRSV in calves 3-8 days of age. Copyright 2010 Elsevier Ltd. All rights reserved.

  9. The association between mental health and acute infectious illness among a national sample of 18- to 24-year-old college students.

    Science.gov (United States)

    Adams, Troy B; Wharton, Christopher M; Quilter, Lyndsay; Hirsch, Tiffany

    2008-01-01

    Poor mental health is associated with physical illness, but this association is poorly characterized among college students. Using American College Health Association-National College Health Assessment data, the authors characterized poor mental health (depression, anxiety, negative affect) and examined the relationship between poor mental health and acute infectious illnesses (bronchitis, ear infection, sinusitis, strep throat) among 47,202 US college students. The authors used frequency and cross-tabulation analyses to characterize mental health and determine univariate associations among variables. They used binary logistic regression to determine the association between poor mental health and acute infectious illness, controlling for research-derived covariates. The prevalence of acute infectious illness ranged from 8% to 29%. The prevalence of anxiety and depression ranged from 12% to 20%, respectively. Depression, anxiety, and exhaustion were associated with acute infectious illness across all dependent measures, with odds ratios ranging from .56 to .91. Poor mental health is associated with acute infectious illness among college students.

  10. What would pediatric infectious disease consultants recommend for management of culture-negative acute hematogenous osteomyelitis?

    Science.gov (United States)

    Afghani, Behnoosh; Kong, Vivian; Wu, Fu L

    2007-01-01

    To assess the opinion of pediatric infectious disease (PID) specialists regarding the management of culture-negative acute hematogenous osteomyelitis. A questionnaire that included a hypothetical case scenario of a 4-year-old boy with culture-negative osteomyelitis was distributed via a Web-based system to PID specialists across the United States. Of 481 eligible participants surveyed, 147 (31%) responded. For initial therapy of osteomyelitis, 37% of respondents chose a beta-lactam, 24% chose clindamycin, 10% chose vancomycin as the sole therapy, and 29% chose a combination of these. The initial choice of antibiotics was correlated with the reported incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in the institution (P change from intravenous to oral therapy, approximately 70% of respondents would change to oral therapy sooner than 3 weeks depending on clinical, laboratory, and social factors. After significant clinical and laboratory (sedimentation rate and C-reactive protein) improvements, most respondents (69%) chose to treat for a total duration (intravenous and oral) of 3 to 4 weeks. This study illustrates that the empiric choice of antibiotics for treatment of acute hematogenous osteomyelitis was driven by the local prevalence of CA-MRSA. When the prevalence of CA-MRSA was intermediate, the recommendations for management of bone infections were more heterogeneous. Clinical trials are needed to compare the effect of different management strategies on outcome, side effects, and costs. Level V.

  11. Diarrhea - overview

    Science.gov (United States)

    ... is also a good source of these healthy bacteria. The following healthy steps can help you prevent illnesses that cause diarrhea: Wash your hands often, particularly after going to the bathroom and before eating. Use alcohol-based hand gel ...

  12. Vibrio isolates from cases of acute diarrhea and their antibiotic susceptibility pattern in a tertiary care hospital of Punjab

    Directory of Open Access Journals (Sweden)

    Atul Kumar

    2014-01-01

    Full Text Available Introduction: Vibrio cholerae, the cause of cholera, is one of the leading causes of morbidity and mortality in many developing countries. Especially during monsoon season, cholera outbreaks have been frequently reported from one or the other part of this country. However, occasional sporadic cases have also been reported, majorly due to lack of proper sanitation and impure water supply. Aim: To determine the prevalence of serotypes of Vibrio isolates from cases of acute diarrhea and their antibiotic susceptibility pattern in a tertiary care hospital, North India. Materials and Methods: A retrospective study was conducted over a period of 1 year from January 2013 to December 2013 in the department of microbiology, in a tertiary care hospital in Punjab. The diagnosis was suggested by the clinical picture and confirmed by stool culture. The stool samples received in the laboratory were processed by standard microbiological techniques for identification of V. cholerae. The suspected colonies of Vibrio were identified by standard biochemical tests and serotyping was done by group specific antisera. The susceptibility of all the isolated Vibrio species to different antibiotics were done by Kirby-Bauer′s disk diffusion technique as per the Clinical and Laboratory Standards Institute (CLSI guidelines. Results: V. cholerae were isolated from 41 (3.8% of total 1063 stool samples received during the study period. On serotyping, 100% (41 of these positive samples were identified as V. cholerae 01 ogawa serotype. 95% (39 cases were encountered during monsoon season. In the present study analysis of the antibiotic susceptibility data showed highest susceptibility to gentamicin, amikacin, tetracycline and chloramphenicol. There is gradual increase in resistance to ampicillin and high level of resistance was observed for furazolidone and trimethoprim-sulphamethoxazole during the same period. Conclusions: Our study reveals a significant increase in cases of

  13. Acute Corneal Hydrops Mimicking Infectious Keratitis as Initial Presentation of Keratoconus in a 10-Year-Old Child

    Directory of Open Access Journals (Sweden)

    Elise A. Slim

    2015-01-01

    Full Text Available Purpose. To report a case of acute hydrops in a 10-year-old child with advanced keratoconus. Case Presentation. A ten-year-old boy diagnosed as having right eye (RE infectious keratitis, not responding to antimicrobial therapy, was referred to our hospital. The diagnosis of infectious keratitis was established one month prior to his presentation following an episode of acute corneal whitening, pain, and drop in visual acuity. Topical fortified antibiotics followed by topical antiviral therapy were used with no improvement. Slit lamp examination showed significant corneal protrusion with edema surrounding a rupture in Descemet’s membrane in the RE. The diagnosis of acute corneal hydrops from advanced keratoconus was highly suspected and confirmed with corneal topography. Conclusion. Although a relatively rare disease at the age of 10 years, keratoconus can be rapidly progressive in the pediatric group. Keratoconus should always be considered in the differential diagnosis of progressive vision loss in this age group.

  14. diarrhea in children from 1 month to 24 months

    OpenAIRE

    Dahm Aziz, Taresh sadaan

    2014-01-01

    Diarrhea is loose, watery stools. Having diarrhea means passing loose stools three or more times a day. Acute diarrhea is a com-mon problem that usually lasts 1 or 2 days and goes away on its own. Chronic diarrhea—diarrhea that lasts at least 4 weeks, may be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual or they may come and go. There are many causes diarrhea, cute diarrhea is usually caused by a bacterial, viral, or parasitic infection. Chronic diarrhea is usua...

  15. Cost utility, budget impact, and scenario analysis of racecadotril in addition to oral rehydration for acute diarrhea in children in Malaysia

    Directory of Open Access Journals (Sweden)

    Rautenberg TA

    2018-03-01

    Full Text Available Tamlyn Anne Rautenberg,1,2 Ute Zerwes,3 Way Seah Lee4 1IGES Institut GmbH, Berlin, Germany; 2Health Economics and HIV/AIDS Research Division (HEARD, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; 3Assessment in Medicine GmbH, Lörrach, Germany; 4Department of Pediatrics, University Malaya, Kuala Lumpur, Malaysia Objective: To perform cost utility (CU and budget impact (BI analyses augmented by scenario analyses of critical model structure components to evaluate racecadotril as adjuvant to oral rehydration solution (ORS for children under 5 years with acute diarrhea in Malaysia.Methods: A CU model was adapted to evaluate racecadotril plus ORS vs ORS alone for acute diarrhea in children younger than 5 years from a Malaysian public payer’s perspective. A bespoke BI analysis was undertaken in addition to detailed scenario analyses with respect to critical model structure components.Results: According to the CU model, the intervention is less costly and more effective than comparator for the base case with a dominant incremental cost-effectiveness ratio of –RM 1,272,833/quality-adjusted life year (USD –312,726/quality-adjusted life year in favor of the intervention. According to the BI analysis (assuming an increase of 5% market share per year for racecadotril+ORS for 5 years, the total cumulative incremental percentage reduction in health care expenditure for diarrhea in children is 0.136578%, resulting in a total potential cumulative cost savings of –RM 73,193,603 (USD –17,983,595 over a 5-year period. Results hold true across a range of plausible scenarios focused on critical model components.Conclusion: Adjuvant racecadotril vs ORS alone is potentially cost-effective from a Malaysian public payer perspective subject to the assumptions and limitations of the model. BI analysis shows that this translates into potential cost savings for the Malaysian public health care system. Results hold true at evidence-based base

  16. Cost utility, budget impact, and scenario analysis of racecadotril in addition to oral rehydration for acute diarrhea in children in Malaysia.

    Science.gov (United States)

    Rautenberg, Tamlyn Anne; Zerwes, Ute; Lee, Way Seah

    2018-01-01

    To perform cost utility (CU) and budget impact (BI) analyses augmented by scenario analyses of critical model structure components to evaluate racecadotril as adjuvant to oral rehydration solution (ORS) for children under 5 years with acute diarrhea in Malaysia. A CU model was adapted to evaluate racecadotril plus ORS vs ORS alone for acute diarrhea in children younger than 5 years from a Malaysian public payer's perspective. A bespoke BI analysis was undertaken in addition to detailed scenario analyses with respect to critical model structure components. According to the CU model, the intervention is less costly and more effective than comparator for the base case with a dominant incremental cost-effectiveness ratio of -RM 1,272,833/quality-adjusted life year (USD -312,726/quality-adjusted life year) in favor of the intervention. According to the BI analysis (assuming an increase of 5% market share per year for racecadotril+ORS for 5 years), the total cumulative incremental percentage reduction in health care expenditure for diarrhea in children is 0.136578%, resulting in a total potential cumulative cost savings of -RM 73,193,603 (USD -17,983,595) over a 5-year period. Results hold true across a range of plausible scenarios focused on critical model components. Adjuvant racecadotril vs ORS alone is potentially cost-effective from a Malaysian public payer perspective subject to the assumptions and limitations of the model. BI analysis shows that this translates into potential cost savings for the Malaysian public health care system. Results hold true at evidence-based base case values and over a range of alternate scenarios.

  17. PFGE, Lior serotype, and antimicrobial resistance patterns among Campylobacter jejuni isolated from travelers and US military personnel with acute diarrhea in Thailand, 1998-2003

    Directory of Open Access Journals (Sweden)

    Serichantalergs Oralak

    2010-11-01

    Full Text Available Abstract Background Campylobacter jejuni is a major cause of gastroenteritis worldwide. In Thailand, several strains of C. jejuni have been isolated and identified as major diarrheal pathogens among adult travelers. To study the epidemiology of C. jejuni in adult travelers and U.S. military personnel with acute diarrhea in Thailand from 1998-2003, strains of C. jejuni were isolated and phenotypically identified, serotyped, tested for antimicrobial susceptibility, and characterized using pulsed-field gel electrophoresis (PFGE. Results A total of 312 C. jejuni isolates were obtained from travelers (n = 46 and U.S. military personnel (n = 266 in Thailand who were experiencing acute diarrhea. Nalidixic acid and ciprofloxacin resistance was observed in 94.9% and 93.0% of the isolates, respectively. From 2001-2003, resistance to tetracycline (81.9%, trimethoprim-sulfamethoxazole (57.9%, ampicillin (28.9%, kanamycin (5.9%, sulfisoxazole (3.9%, neomycin (2.0%, and streptomycin (0.7% was observed. Combined PFGE analysis showed considerable genetic diversity among the C. jejuni isolates; however, four PFGE clusters included isolates from the major Lior serotypes (HL: 36, HL: 11, HL: 5, and HL: 28. The PFGE analysis linked individual C. jejuni clones that were obtained at U.S. military exercises with specific antimicrobial resistance patterns. Conclusions In summary, most human C. jejuni isolates from Thailand were multi-resistant to quinolones and tetracycline. PFGE detected spatial and temporal C. jejuni clonality responsible for the common sources of Campylobacter gastroenteritis.

  18. Treatment of acute infectious endophthalmitis by vitrectomy surgery with silicon oil tamponade

    Directory of Open Access Journals (Sweden)

    Xiao-Dong Han

    2015-09-01

    Full Text Available AIM: To observe theclinical effect of acute infectious endophthalmitis by vitrectomy surgery with silicon oil tamponade.METHODS:The clinical data of 23 patients(23 eyesdiagnosed with acute endophthalmitis in our hospital from January, 2008 to February, 2013 were retrospectively analyzed, excluding the patients with intraocular foreign body. All the patients were undergone routine closed three-channel vitrectomy with silicon oil, including 6 eyes(complicated with traumatic cataractwith Ⅰ lensectomy and Ⅰ intraocular lens(IOLimplantation, 3 eyes(complicated with traumatic cataractwith Ⅰ lensectomy and Ⅱ IOL implantation, 4 eyes(complicated with cataract during silicon oil tamponadewith Ⅱ lensectomy and Ⅱ IOL implantation, 5 eyes(4 eyes with traumatic endophthalmitis and 1 eye with entophthalmia caused by glaucoma filtering bleb leakingreserved lens, 1 eye(post-cataract surgery entophthalmiawith Ⅰ IOL explantation and Ⅱ IOL implantation, and 4 eyes(post-cataract surgery entophthalmiareserved lens. RESULTS:Within follow-up 6~24mo, inflammation after vitrectomy surgery with silicon oil tamponade was controlled in all the 23 patients(23 eyes. Final visual acuity was improved in 21 eyes(91%. The intraocular pressure(IOPof 2 eyes were over 30mmHg. IOP of 1 eye was controlled after silicon oil removed, and IOP of the other eye after silcon oil extraction was still high and needed to be controlled by IOP lowering drugs. CONCLUSION: The patients of acuteinfectious endophthalmitis should undergo vitrectomy with silicon oil tamponade as early as possible, which can effectively controli endophthalmitis and improve visual acuity.

  19. Microbiologic surrogate end points in clinical trials of infectious diseases: example of acute otitis media trials.

    Science.gov (United States)

    Powers, John H

    2005-12-01

    Clinical outcomes that measure how patients feel, function, or survive are the most important and relevant outcomes of therapy in clinical trials and in clinical practice. Surrogate end points, which do not directly measure clinical benefit to the patient, may function as substitutes for clinical end points in clinical trials. Such surrogates are attractive as they may allow measurement of outcomes earlier in time or with a smaller sample size than with clinical outcomes. Microbiologic biomarkers, such as culture results at a specific time after start of therapy, or pharmacodynamic analyses of the effect of drugs on organisms often are proposed as surrogate end points in clinical trials of therapies for infectious diseases. However, evaluation of biomarkers as surrogate end points poses distinct challenges, and only a few biomarkers have been useful replacements for clinical end points. Evaluation of biomarkers as potential surrogate end points first requires an understanding of the differences among measurements of the cause of a disease, risk factors for outcome, and measurements of treatment effects. We will discuss the definitions of clinical and surrogate end points and the reasons why surrogate end points may not predict the true clinical benefit of therapies. We will use the example of the biomarker of microbiologic outcomes from tympanocenteses performed during therapy as the sole measure of clinical effectiveness in clinical trials of acute otitis media to illustrate the challenges in evaluating biomarkers as surrogate end points.

  20. [Chronic diarrhea].

    Science.gov (United States)

    Stelzer, Teresa; Heuss, Ludwig Theodor

    2014-09-01

    Defined by lasting more than four weeks - is a common but often challenging clinical scenario. It is important to be aware that diarrhoea means different things to different patients. The evaluation of chronic diarrhoea depends on taking an excellent history and careful physical examination as well as planning investigations thoughtfully. Functional diarrhea ist the most common cause of chronic diarrhea in the developed countries and motility disorders are more common than inflammatory, osmotic or secretory causes. In some cases categorizing patients by their stool characteristics can be helpful in directing further evaluation.

  1. Comparing the Accuracy of the Three Dehydration Scales in Children with Acute Diarrhea in a Developing Country of Kosovo

    OpenAIRE

    Hoxha, Teuta; Xhelili, Luan; Azemi, Mehmedali; Avdiu, Muharrem; Ismaili-Jaha, Vlora; Efendija-Beqa, Urata; Grajcevci-Uka, Violeta

    2015-01-01

    Background. Although diarrhea is a preventable disease, it remains the second leading cause of death (after pneumonia) among children aged under five years worldwide. The World Health Organization (WHO) scale, the Gorelick scale, and the Clinical Dehydration Scale (CDS) were created to estimate dehydration status using clinical signs. The purpose of this study is to determine whether these clinical scales can accurately assess dehydration status of children in a developing country of Kosovo. ...

  2. The Dose-Volume Relationship of Small Bowel Irradiation and Acute Grade 3 Diarrhea During Chemoradiotherapy for Rectal Cancer

    International Nuclear Information System (INIS)

    Robertson, John M.; Lockman, David; Yan Di; Wallace, Michelle

    2008-01-01

    Purpose: Previous work has found a highly significant relationship between the irradiated small-bowel volume and development of Grade 3 small-bowel toxicity in patients with rectal cancer. This study tested the previously defined parameters in a much larger group of patients. Methods and Materials: A total of 96 consecutive patients receiving pelvic radiation therapy for rectal cancer had treatment planning computed tomographic scans with small-bowel contrast that allowed the small bowel to be outlined with calculation of a small-bowel dose-volume histogram for the initial intended pelvic treatment to 45 Gy. Patients with at least one parameter above the previously determined dose-volume parameters were considered high risk, whereas those with all parameters below these levels were low risk. The grade of diarrhea and presence of liquid stool was determined prospectively. Results: There was a highly significant association with small-bowel dose-volume and Grade 3 diarrhea (p ≤ 0.008). The high-risk and low-risk parameters were predictive with Grade 3 diarrhea in 16 of 51 high-risk patients and in 4 of 45 low-risk patients (p = 0.01). Patients who had undergone irradiation preoperatively had a lower incidence of Grade 3 diarrhea than those treated postoperatively (18% vs. 28%; p = 0.31); however, the predictive ability of the high-risk/low-risk parameters was better for preoperatively (p = 0.03) than for postoperatively treated patients (p = 0.15). Revised risk parameters were derived that improved the overall predictive ability (p = 0.004). Conclusions: The highly significant dose-volume relationship and validity of the high-risk and low-risk parameters were confirmed in a large group of patients. The risk parameters provided better modeling for the preoperative patients than for the postoperative patients

  3. Risk factors associated with the introduction of acute clinical infectious bursal disease among Danish broiler chickens in 1998

    DEFF Research Database (Denmark)

    Flensburg, Mimi Folden; Ersbøll, Annette Kjær; Jørgensen, Poul Henrik

    2002-01-01

    The objective of the present study was to investigate risk factors associated with the introduction of acute clinical infectious bursal disease (IBD) among Danish broiler chickens in 1998. Data on 218 flocks were collected from hatcheries, abattoirs, farmers and veterinarians; 49 of the flocks had...... from each unaffected farm. The resulting numbers of cases and controls used for statistical analyses were 16 and 61, respectively. Statistically significant associations were seen between the initial 16 Danish cases of acute clinical IBD in 1998 and certain hatcheries, age of parent birds and a certain...

  4. Diarrhea in infants

    Science.gov (United States)

    When your infant has diarrhea; When your baby has diarrhea; BRAT diet; Diarrhea in children ... Children who have diarrhea may have less energy, dry eyes, or a dry, sticky mouth. They may also not wet their diaper as ...

  5. Drug-induced diarrhea

    Science.gov (United States)

    Diarrhea associated with medicines ... Nearly all medicines may cause diarrhea as a side effect. The drugs listed below, however, are more likely to cause diarrhea. Laxatives are meant to cause diarrhea. ...

  6. Acute and subacute non-infectious lung diseases. Usefulness of HRCT for evaluation of activity especially in follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Johkoh, Takeshi; Tomiyama, Noriyuki; Honda, Osamu [Osaka Univ., Suita (Japan). Medical School] (and others)

    2000-08-01

    The purpose of this study was to survey the usefulness of high-resolution CT (HRCT) for the evaluation of activity in acute and subacute non-infectious diffuse infiltrative lung diseases before and after corticosteroid treatment. Sequential HRCT images and chest radiographs obtained before and after treatment were retrospectively evaluated in 33 patients with acute or subacute non-infectious diffuse infiltrative lung diseases. All these patients were histologically confirmed to have pulmonary Inflammation and to have responded to treatment with corticosteroid. Radiographic and CT scores were correlated with the degree of dyspnea and the results of arterial blood gas analysis using Spearman's rank-correlation coefficient. On follow-up HRCT, the profusion score of areas with increased attenuation was significantly correlated with arterial oxygen tension (PaO{sub 2}) (p=.003, r=-.53) and the alveolar-arterial oxygen tension difference (AaDO{sub 2}) (p=.001, r=.57). No other correlation was found after treatment. Nodular and linear opacities were more commonly seen on follow-up chest radiographs and HRCT images than on initial ones. HRCT is useful for the evaluation of disease activity in acute and subacute non-infectious infiltrative lung diseases before and after treatment if paying special attention to the profusion of ground-glass attenuation. Even if pretreatment HRCT has not been performed, posttreatment HRCT should be examined. (author)

  7. Porcine epidemic diarrhea virus RNA present in commercial spray-dried porcine plasma is not infectious to naïve pigs.

    Directory of Open Access Journals (Sweden)

    Tanja Opriessnig

    Full Text Available Porcine epidemic diarrhea virus emerged in North America in April 2013 and has since been identified in 30 U.S. States, Canada and Mexico. The rapid spread of PEDV has raised concerns about the role of feed and particularly pork-by-product components such as spray-dried porcine plasma (SDPP in PEDV transmission. The aim of this study was to determine the infectivity of PEDV RNA present in commercial SDPP. Specifically, 40 3-week-old PEDV naïve pigs were randomly assigned to one of five treatment groups. At day post inoculation (dpi 0, NEG-CONTROL pigs were sham-inoculated, PEDV-CONTROL pigs received cell culture propagated PEDV, and SDPP-CONTROL pigs were switched to a diet with 5% SDPP containing 5.1±0.1 log10 PEDV RNA copies/g. To evaluate a potential positive effect of anti-PEDV antibodies in SDPP on PEDV challenge, four days prior to PEDV challenge the pigs in the SDPP-PEDV group were switched to and remained on a 5% SDPP diet through dpi 28. Another group, EGG-PEDV, was orally administered a commercial egg-derived liquid PEDV globulin product from dpi -4 through 6. All PEDV-CONTROL pigs began shedding PEDV in feces by dpi 3 and seroconverted between dpi 7 and 14, whereas pigs in NEG-CONTROL and SDPP-CONTROL groups remained PEDV RNA negative and did not seroconvert to PEDV for the study duration. This indicates no evidence of infectivity of the PEDV RNA in the SDPP lot utilized. Furthermore, under the study conditions SDPP or egg-derived liquid PEDV globulin addition did not significantly alter PEDV-shedding or overall disease course after experimental challenge.

  8. Surveillance for infectious complications in pediatric acute liver failure - a prospective study.

    Science.gov (United States)

    Mekala, Suresh; Jagadisan, Barath; Parija, Subhash Chandra; Lakshminarayanan, Subitha

    2015-03-01

    To prospectively evaluate infectious complications (IC) in pediatric acute liver failure (PALF) by employing surveillance cultures. From 2011 to 2013, children with PALF in a tertiary care centre received a standard protocolised management. Prophylactic parenteral antibiotics were used without antifungals. Surveillance cultures of blood, urine, ascites and tracheal aspirates were sent. Biochemical and clinical parameters and outcomes were compared between children with and without IC. Of the 29 children with PALF admitted during the study period (median age 36 mo, range 12-90 mo), 13.8 % had blood stream infections (BSI) at admission. Organisms were isolated in 8.8 % (12/136) of the blood cultures, 13.7 % (11/80) of the urine cultures, 30.8 % (8/26) of the tracheal aspirates and 7.1 % (1/14) of the ascitic fluid cultures. Gram negative bacteriae (n = 17) were the commonest, followed by fungi (n = 13) and gram positive bacteriae (n = 2). Klebsiella pneumoniae and Candida nonalbicans group were the commonest bacteria and fungi respectively. After admission, fungal BSI and urinary tract infections were diagnosed at a median time of 4 d (range 3-8 d) and 3.5 d (range 3-6 d) respectively. ICs were not associated with other complications and increased mortality but with longer hospital and pediatric intensive care unit (PICU) stay. In this study BSI was a common finding at admission in PALF. Inspite of prophylactic antibiotics, break through gram negative bacterial and fungal ICs were common. Empirical treatment of IC should include broad spectrum antibiotics. Fungal IC occurred beyond 48 h. Prophylactic antifungals at admission may be considered to decrease their frequency. IC prolongs PICU and hospital stay.

  9. Equine infectious anemia virus replication is upregulated during differentiation of blood monocytes from acutely infected horses.

    OpenAIRE

    Sellon, D C; Walker, K M; Russell, K E; Perry, S T; Covington, P; Fuller, F J

    1996-01-01

    Equine infectious anemia virus is a lentivirus that replicates in mature tissue macrophages of horses. Ponies were infected with equine infectious anemia virus. During febrile episodes, proviral DNA was detectable, but viral mRNA was not detectable. As cultured blood monocytes from these ponies differentiated into macrophages, viral expression was upregulated. In situ hybridization confirmed that viral transcription occurred in mature macrophages.

  10. Prevalence and determinants of acute diarrhea among children younger than five years old in Jabithennan District, Northwest Ethiopia, 2014

    Directory of Open Access Journals (Sweden)

    Zelalem Alamrew Anteneh

    2017-01-01

    Full Text Available Abstract Background Despite the global decline in death rates of children younger than five years old, the risk of a child dying before turning five years of age remains highest in the WHO African Region. The problem of child death in Ethiopia is worse, with an Ethiopian child being 30 times more likely to die by his/her fifth birthday than a child in Western Europe. Therefore, the aim of this study was to assess the prevalence and factors associated with diarrhea among children younger than five years old. Methods A community-based, cross-sectional study was conducted with mothers who had children younger than five years old from April to June 2014. A multistage sampling procedure was used to select eligible women. The data were coded, entered, cleaned and analyzed with the SPSS software package, version 16. Results he data of 775 mothers were included in the analysis, and 21.5% of the children had diarrhea in the two weeks before the survey. The main factors affecting the occurrence of diarrhea were residence (Odds ratio (AOR = 11.29, 95% Confidence interval (CI: 3.49-36.52, sex (AOR = 2.52, 95% CI:1.28-4.93, methods of complementary feeding (AOR = 50.88, 95% CI: 23.85- 108.54, types of water storage equipment (AOR = 19.50, 95% CI: 8.11-46.90, and cleansing materials used to wash hands (AOR = 5.53, 95% CI: 2.19-13.99. Conclusion Approximately one-fifth of the children included in the study reported diarrheal disease. Residence, sex of the child, type of water storage container, methods of complementary feeding, and cleansing materials to wash the hands were the most important variables that affected the occurrence of diarrhea in children. Therefore, families, the government and nongovernmental organizations working in the area must cooperate in interventions and prevention to minimize the risk of disease.

  11. Mesenchymal stem cells transplantation in hematological patients with acute graft-versus-host disease: characteristics and risk factors for infectious complications.

    Science.gov (United States)

    Stoma, Igor; Karpov, Igor; Krivenko, Svetlana; Iskrov, Igor; Milanovich, Natalia; Koritko, Alla; Uss, Anatoly

    2018-05-01

    The role of MSCs in infection prevention and treatment is still discussed in transplant and hematological patients. The spectrum and risk factors for infections after MSCs transplantation in patients with acute GVHD have not been studied before. To determine the risk factors and spectrum of infectious complications in patients received mesenchymal stem cell transplantation as a treatment for acute GVHD. A prospective observational study was performed to evaluate the risk factors and characteristics of infectious complications after MSCs transplantation in adult patients having acute GVHD. Thirty-four episodes of MSCs transplantation in patients with acute GVHD after allogeneic HSCT were enrolled in the study. MSCs were given at a median dose of 1.32 (interquartile range 0.87-2.16) mln cells/kg per infusion at 91 days (interquartile range 31-131 days) after HSCT. Data relating to age, gender, date, and type of transplantation, characteristics of MSCs, infectious agents, and antimicrobial therapy and prevention regimens were prospectively collected in all of the enrolled patients. The episode of proven infectious complication was set as a primary outcome. There were totally 68 patients with acute GVHD in the study; among them there were 34 cases of MSCs transplantation performed. Among the registered infectious episodes were viral infections (CMV-associated disease, EBV-associated disease), invasive pulmonary aspergillosis, bacterial bloodstream infections, and pneumonia. MSCs transplantation has shown no statistically significant association with risk of infectious complications in patients with acute GVHD in a performed multivariate analysis. Among the most frequent infections in acute GVHD, we have described CMV, invasive aspergillosis, and bacterial infections (bloodstream infections or pneumonia). Among risk factors for infectious complications in patients with acute GVHD with/without MSCs transplantation are progression of main disease and neutropenia below

  12. Transmission of acute infectious illness among cases of Kawasaki disease and their household members

    Directory of Open Access Journals (Sweden)

    Hsing-Chen Tsai

    2015-01-01

    Conclusion: A total of 66% KD cases had positive contact with ill household members prior to their disease onset and 92% of families had clusters of infectious illness, so KD is strongly associated with infections.

  13. Health related quality of life and impact of infectious comorbidity in outpatient management of patients with acute leukemia

    DEFF Research Database (Denmark)

    Møller, Tom; Adamsen, Lis; Appel, Charlotte

    2012-01-01

    a longitudinal HRQOL evaluation (European Organisation for Research and Treatment of Cancer core 30-item questionnaire; EORTC-QLQ C-30) and the impact of infectious comorbidity among 60 patients with leukemia (median age 47) treated in an outpatient management program at Copenhagen University Hospital......Although survival has improved among patients with acute leukemia, there is still a considerable risk of severe complications throughout the course of treatment. This contrast increases the interest in monitoring health related quality of life (HRQOL) in these patients. This study presents....... Significant improvement was seen on several HRQOL scores during follow-up. Explorative general linear models (GLMs) suggest that high cumulative severity of infectious comorbidity significantly reduces physical functioning and overall quality of life at treatment completion....

  14. Chronic Diarrhea: Diagnosis and Management.

    Science.gov (United States)

    Schiller, Lawrence R; Pardi, Darrell S; Sellin, Joseph H

    2017-02-01

    Chronic diarrhea is a common problem affecting up to 5% of the population at a given time. Patients vary in their definition of diarrhea, citing loose stool consistency, increased frequency, urgency of bowel movements, or incontinence as key symptoms. Physicians have used increased frequency of defecation or increased stool weight as major criteria and distinguish acute diarrhea, often due to self-limited, acute infections, from chronic diarrhea, which has a broader differential diagnosis, by duration of symptoms; 4 weeks is a frequently used cutoff. Symptom clusters and settings can be used to assess the likelihood of particular causes of diarrhea. Irritable bowel syndrome can be distinguished from some other causes of chronic diarrhea by the presence of pain that peaks before defecation, is relieved by defecation, and is associated with changes in stool form or frequency (Rome criteria). Patients with chronic diarrhea usually need some evaluation, but history and physical examination may be sufficient to direct therapy in some. For example, diet, medications, and surgery or radiation therapy can be important causes of chronic diarrhea that can be suspected on the basis of history alone. Testing is indicated when alarm features are present, when there is no obvious cause evident, or the differential diagnosis needs further delineation. Testing of blood and stool, endoscopy, imaging studies, histology, and physiological testing all have roles to play but are not all needed in every patient. Categorizing patients after limited testing may allow more directed testing and more rapid diagnosis. Empiric antidiarrheal therapy can be used to mitigate symptoms in most patients for whom a specific treatment is not available. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  15. Equine infectious anemia virus replication is upregulated during differentiation of blood monocytes from acutely infected horses.

    Science.gov (United States)

    Sellon, D C; Walker, K M; Russell, K E; Perry, S T; Covington, P; Fuller, F J

    1996-01-01

    Equine infectious anemia virus is a lentivirus that replicates in mature tissue macrophages of horses. Ponies were infected with equine infectious anemia virus. During febrile episodes, proviral DNA was detectable, but viral mRNA was not detectable. As cultured blood monocytes from these ponies differentiated into macrophages, viral expression was upregulated. In situ hybridization confirmed that viral transcription occurred in mature macrophages. PMID:8523576

  16. Infectious component of the pediatric acute-onset neuropsychiatric syndrome (PANS in terms of evidence-based medicine principles (review of literature

    Directory of Open Access Journals (Sweden)

    L.O. Bezrukov

    2017-04-01

    Full Text Available The first clinical cases of obsessive-compulsive di­sorder and/or tic disorder in children with acute sudden onset associated with infectious diseases have been named pediatric infection-triggered autoimmune neuropsychiatric disorders (PITANDS. The relationship of such neuropsychiatric manifestations with preceding infectious diseases caused by group A beta-hemolytic Streptococcus was the most important, and it has been called paediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS. Due to the low level of evidence of the research on the relationship of infectious agents with neurological and behavioral symptoms with an acute onset, since 2014 another syndrome is diagnosed in children — pediatric acute-onset neuropsychiatric syndrome (PANS. Currently, the question about infectious etiology, pathogenesis and autoimmune mechanisms of these paediatric neuropsychiatric syndromes are still debatable.

  17. Pathological studies on bovine viral diarrhea

    International Nuclear Information System (INIS)

    Elkady, A.A.M.A.

    2002-01-01

    Bovine viral diarrhea virus (BVDV) is classified as an RNA virus in the family flavin viride and is a member of the genus pest virus (Collet et al 1989). BVDV has a worldwide distribution and infections in cattle populations (Kahrs et al 1970). It was recognized since 50 years ago, the initial description of an acute enteric disease of cattle in North America, which was characterized by outbreaks of diarrhea and erosive of digestive tract (Olafsonp et al 1946). The disease and causative agent were named bovine viral diarrhea (B V D ) and (B V DV), respectively. This virus was subsequently associated with a sporadically occurring and highly fatal enteric disease that was termed mucosal disease (M D), (Ramsey and Chivers 1953). The initial isolate of BVDV did not produce cytopathic effect in cell culture, whereas an isolate from MD did produce cytopathic effects (Lee et al 1957). In vitro characteristic of non cytopathic or sytopathic effects of BVDV is referred to as the biotype of the virus. It has now been established that MD occurs only when xattle that are born immuno tolerant to and persistently infected with a noncyropathic BVDV become super infected with a cytopathic BVDV. The knowledge of the molecular biology. Pathogenesis and epidemiology of BVDV has greatly evolved in the past 10-15 years and has provided a better understanding of this complex infectious agent. Infection with BVDV can result in a wide spectrum of diseases ranging from subclinical infection s to a highly fatal from known as mucosal disease (ND). The clinical response to infection depends on multiple interactive factors. Host factors that influence the clinical outcome of BVDV infection include whether the host is immunocompetent or immuno tolerant to BVDV, pregnancy status, gestational age of the fetus, immune status (passively derived or actively derived from previous infection or vaccination) and concurrent level of environmental stress

  18. Respiratory infectious phenotypes in acute exacerbation of COPD: an aid to length of stay and COPD Assessment Test

    Directory of Open Access Journals (Sweden)

    Dai MY

    2015-10-01

    Full Text Available Meng-Yuan Dai,1 Jin-Ping Qiao,2 Yuan-Hong Xu,2 Guang-He Fei1 1Pulmonary Department, 2Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China Purpose: To investigate the respiratory infectious phenotypes and their impact on length of stay (LOS and the COPD Assessment Test (CAT Scale in acute exacerbation of COPD (AECOPD. Patients and methods: We categorized 81 eligible patients into bacterial infection, viral infection, coinfection, and non-infectious groups. The respiratory virus examination was determined by a liquid bead array xTAG Respiratory Virus Panel in pharyngeal swabs, while bacterial infection was studied by conventional sputum culture. LOS and CAT as well as demographic information were recorded. Results: Viruses were detected in 38 subjects, bacteria in 17, and of these, seven had both. Influenza virus was the most frequently isolated virus, followed by enterovirus/rhinovirus, coronavirus, bocavirus, metapneumovirus, parainfluenza virus types 1, 2, 3, and 4, and respiratory syncytial virus. Bacteriologic analyses of sputum showed that Pseudomonas aeruginosa was the most common bacteria, followed by Acinetobacter baumannii, Klebsiella, Escherichia coli, and Streptococcus pneumoniae. The longest LOS and the highest CAT score were detected in coinfection group. CAT score was positively correlated with LOS. Conclusion: Respiratory infection is a common causative agent of exacerbations in COPD. Respiratory coinfection is likely to be a determinant of more severe acute exacerbations with longer LOS. CAT score may be a predictor of longer LOS in AECOPD. Keywords: COPD, acute exacerbation, respiratory infectious, phenotypes, LOS, CAT

  19. Prescriber and dispenser perceptions about antibiotic use in acute uncomplicated childhood diarrhea and upper respiratory tract infection in New Delhi: Qualitative study

    Science.gov (United States)

    Kotwani, Anita; Joshi, P. C.; Jhamb, Urmila; Holloway, Kathleen

    2017-01-01

    OBJECTIVE: The objective of the study was to explore the prescribing practices, knowledge, and attitudes of primary care doctors and community pharmacists, regarding antibiotic use in acute upper respiratory tract infections (URTI) and diarrhea in children to better understand causes of misuse and identify provider suggestions to change such behavior. MATERIALS AND METHODS: Two focus group discussions (FGDs) each were conducted with primary care government doctors (GDs), private general practitioners (GPs), pediatricians, and community pharmacists in Delhi. Each FGD had 8–12 participants and lasted 2 h. Furthermore, 22 individual face-to-face semi-structured interviews were conducted with providers of varying type and experience at their workplaces. Thematic and summative qualitative content analysis was done. RESULTS: All groups admitted to overusing antibiotics, GPs appearing to use more antibiotics than GDs and pediatricians for URTI and diarrhea in children. Pharmacists copy the prescribing of neighborhood doctors. Antimicrobial resistance (AMR) knowledge was poor for all stakeholders except pediatricians. Causes for prescribing antibiotics were patient pressure, profit motive, lack of follow-up and in addition for GDs, workload, no diagnostic facility, and pressure to use near-expiry medicines. Knowledge was gained through self-experience, copying others, information from pharmaceutical companies, and for some, training, continuous medical education/conferences. All groups blamed other professional groups/quacks for antibiotic overuse. Interventions suggested were sensitizing and empowering prescribers through training of providers and the public about the appropriate antibiotic use and AMR and implementing stricter regulations. CONCLUSIONS: A package of interventions targeting providers and consumers is urgently needed for awareness and change in behavior to reduce inappropriate community antibiotic use.

  20. Candida lipolytica candidemia as a rare infectious complication of acute pancreatitis: a case report and literature review.

    Science.gov (United States)

    Liu, Wen-Cheng; Chan, Ming-Chin; Lin, Te-Yu; Hsu, Chin-Hui; Chiu, Sheng-Kang

    2013-10-01

    Candida lipolytica candidemia is a rare but an emerging pathogenic yeast infection in humans. It can gain access to the bloodstream through intravascular catheterization, especially through central venous catheters in immunocompromised or critically ill patients during hospitalization. In this report, we present a noncatheter-related C. lipolytica candidemia infection in an 84-year-old man who was admitted due to acute pancreatitis. The possible pathogenesis and management of C. lipolytica candidemia are highlighted. It was an unusual infectious complication of acute pancreatitis. Clinicians should be aware that such an opportunistic pathogen can lead to invasive candidemia infection. In clinical practice, systemic antifungal therapy and the removal of the potentially infected central venous catheter might be recommended for the treatment of C. lipolytica candidemia. Copyright © 2013. Published by Elsevier B.V.

  1. Side Effects: Diarrhea

    Science.gov (United States)

    Diarrhea, a side effect of cancer treatment, may cause symptoms such as loose, watery stools. Diarrhea can lead to dehydration and malnutrition in cancer patients. Learn about ways to treat and manage diarrhea during cancer treatment.

  2. Probiotic bacteria in prevention and treatment of diarrhea

    Directory of Open Access Journals (Sweden)

    Jasmina Havranek

    2009-03-01

    Full Text Available Probiotic bacteria have beneficial effects in prevention and treatment of different diseases. The results of preventive and therapeutic effect of probiotic bacteria on diarrhea during last ten years are shown in this paper. The greatest preventive and therapeutic effect of probiotic bacteria was identified for acute diarrhea in children caused by rotaviruses. Significant, but slightly lower effect of probiotic bacteria was proved for antibiotic associated diarrhea. Positive effect in prevention of traveller’s diarrhea and radiation-induced diarrhea is not significant. Preventive and therapeutic effect on diarrhea is not dependent on the way of probiotic bacteria consumption, by fermented milk, capsule or oral rehydration solution.

  3. [risk Factors For Persistent Diarrhea In Hospitalized Children].

    OpenAIRE

    Pinto, E A; Barros-Filho, A de A; Barros, M B

    2015-01-01

    A case control study was done among prospectively hospitalized children aged 1-24 months. The aim of the study was to identify the risk factors associated with persistent diarrhea in children. Sixty one children with diarrhea persisting for more than 14 days, observed at the hospital, were included in the investigation as cases and 133 hospitalized children with acute diarrhea was studied as controls. The risk factors studied for association with persistent diarrhea were mother's level of edu...

  4. Cryptosporidium, Enterocytozoon, and Cyclospora Infections in Pediatric and Adult Patients with Diarrhea in Tanzania.

    OpenAIRE

    Cegielski, J P; Ortega, Y R; McKee, S; Madden, J F; Gaido, L; Schwartz, D A; Manji, K; Jorgensen, A F; Miller, S E; Pulipaka, U P; Msengi, A E; Mwakyusa, D H; Sterling, C R; Reller, L B

    1999-01-01

    Cryptosporidiosis, microsporidiosis, and cyclosporiasis were studied in four groups of Tanzanian inpatients: adults with AIDS-associated diarrhea, children with chronic diarrhea (of whom 23 of 59 were positive [+] for human immunodeficiency virus [HIV]), children with acute diarrhea (of whom 15 of 55 were HIV+), and HIV control children without diarrhea. Cryptosporidium was identified in specimens from 6/86 adults, 5/59 children with chronic diarrhea (3/5, HIV+), 7/55 children with acute diar...

  5. Features of Acute Neuroinfections in Clinical Hospital of Pediatric Infectious of Kyiv

    Directory of Open Access Journals (Sweden)

    V.V. Yevtushenko

    2015-11-01

    Full Text Available We have analyzed the structure, course and clinical picture of 65 cases of acute neuroinfections in children, who were treated in the clinical hospital of pediatric infections of Kyiv in 2014.

  6. Molecular characterization of Salmonella strains in individuals with acute diarrhea syndrome in the State of Sucre, Venezuela.

    Science.gov (United States)

    Rodulfo, Hectorina; De Donato, Marcos; Luiggi, Jesús; Michelli, Elvia; Millán, Adriana; Michelli, Miriam

    2012-06-01

    In Venezuela, acute diarrheic syndrome (ADS) is a primary cause of morbi-mortality, often involving the Salmonella genus. Salmonella infections are associated with acute gastroenteritis, one of the most common alimentary intoxications, and caused by the consumption of contaminated water and food, especially meat. Conventional and molecular methods were used to detect Salmonella strains from 330 fecal samples from individuals of different ages and both sexes with ADS. Polymerase chain reaction (PCR) was used for the molecular characterization of Salmonella, using invA, sefA, and fliC genes for the identification of this genus and the serotypes Enteritidis and Typhimurium, respectively. The highest frequency of individuals with ADS was found in children 0-2 years old (39.4%), and the overall frequency of positive coprocultures was 76.9%. A total of 14 (4.2%) strains were biochemically and immunologically identified as Salmonella enterica subsp. enterica, of which 7 were classified as belonging to the Enteritidis serotype, 4 to the Typhimurium serotype, and 3 to other serotypes. The S. enterica strains were distributed more frequently in the age groups 3-4 and 9-10 years old. The molecular characterization method used proved to be highly specific for the typing of S. enterica strains using DNA extracted from both the isolated colonies and selective enrichment broths directly inoculated with fecal samples, thus representing a complementary tool for the detection and identification of ADS-causing bacteria.

  7. Hyperglycemia during induction therapy is associated with increased infectious complications in childhood acute lymphocytic leukemia

    Science.gov (United States)

    Children with acute lymphocytic leukemia (ALL) are at high risk for developing hyperglycemia. Hyperglycemic adult ALL patients have shorter remissions, more infections, and increased mortality. No corresponding data are available in children. We hypothesized that children with ALL who become hypergl...

  8. ARI-EL: een case-controle onderzoek naar Acute Respiratoire Infecties in de Eerste lijn. Tussenrapportage over okt. 2000 t/m sept. 2001

    NARCIS (Netherlands)

    van den Brandhof WE; Bartelds AIM; Peeters MF; Wilbrink B; Heijnen MLA; CIE; NIVEL; Streeklaboratorium voor de Volksgezondheid Tilburg; LIS

    2002-01-01

    Vanaf oktober 2000 is de Nederlandse influenza-surveillance tijdelijk uitgebreid tot een case-controle studie naar acute respiratoire infecties (ARI) bij huisartspatienten: de ARI-EL studie. Doel is inzicht verkrijgen in de incidentie en etiologie van ARI, risicofactoren voor ARI en in de zorgvraag

  9. A proposed emergency management program for acute care facilities in response to a highly virulent infectious disease.

    Science.gov (United States)

    Petinaux, Bruno; Ferguson, Brandy; Walker, Milena; Lee, Yeo-Jin; Little, Gary; Parenti, David; Simon, Gary

    2016-01-01

    To address the organizational complexities associated with a highly virulent infectious disease (HVID) hazard, such as Ebola Virus Disease (EVD), an acute care facility should institute an emergency management program rooted in the fundamentals of mitigation, preparedness, response, and recovery. This program must address all known facets of the care of a patient with HVID, from unannounced arrival to discharge. The implementation of such a program not only serves to mitigate the risks from an unrecognized exposure but also serves to prepare the organization and its staff to provide for a safe response, and ensure a full recovery. Much of this program is based on education, training, and infection control measures along with resourcing for appropriate personal protective equipment which is instrumental in ensuring an organized and safe response of the acute care facility in the service to the community. This emergency management program approach can serve as a model in the care of not only current HVIDs such as EVD but also future presentations in our healthcare setting.

  10. Assessment of the safety of hydrogenated resistant maltodextrin: reverse mutation assay, acute and 90-day subchronic repeated oral toxicity in rats, and acute no-effect level for diarrhea in humans.

    Science.gov (United States)

    Yoshikawa, Yuko; Kishimoto, Yuka; Tagami, Hiroyuki; Kanahori, Sumiko

    2013-01-01

    A series of safety assessments were performed on hydrogenated resistant maltodextrin prepared by converting the reducing terminal glucose of resistant maltodextrin into sorbitol. The reverse mutation assay did not show mutagenicity. Acute and 90-day subchronic oral toxicity studies in rats showed no death was observed in any groups, including the group receiving the highest single dose of 10 g/kg body weight or the highest dose of 5 g/kg body weight per day for 90 days. Mucous or watery stools were observed in the hydrogenated resistant maltodextrin treatment group on the acute study, which were transient and were associated with the osmotic pressure caused by intake of the high concentrations. Subchronic study showed dose-dependent increases in the weights of cecum alone, cecal contents alone, and cecum with cecal contents as well as hypertrophy of the cecal mucosal epithelium, which are considered to be common physiological responses after intake of indigestible carbohydrates. These results indicated that the no observed adverse effect level (NOAEL) of hydrogenated resistant maltodextrin was 10 g/kg body weight or more on the acute oral toxicity study and 5.0 g/kg body weight/day or more on the 90-day subchronic repeated oral toxicity study in rats. Further study performed in healthy adult humans showed that the acute no-effect level of hydrogenated resistant maltodextrin for diarrhea was 0.8 g/kg body weight for men and more than 1.0 g/kg body weight for women. The results of the current safety assessment studies suggest that hydrogenated resistant maltodextrin is safe for human consumption.

  11. Infectious etiologies of acute febrile illness among patients seeking health care in south-central Cambodia.

    Science.gov (United States)

    Kasper, Matthew R; Blair, Patrick J; Touch, Sok; Sokhal, Buth; Yasuda, Chadwick Y; Williams, Maya; Richards, Allen L; Burgess, Timothy H; Wierzba, Thomas F; Putnam, Shannon D

    2012-02-01

    The agents of human febrile illness can vary by region and country suggesting that diagnosis, treatment, and control programs need to be based on a methodical evaluation of area-specific etiologies. From December 2006 to December 2009, 9,997 individuals presenting with acute febrile illness at nine health care clinics in south-central Cambodia were enrolled in a study to elucidate the etiologies. Upon enrollment, respiratory specimens, whole blood, and serum were collected. Testing was performed for viral, bacterial, and parasitic pathogens. Etiologies were identified in 38.0% of patients. Influenza was the most frequent pathogen, followed by dengue, malaria, and bacterial pathogens isolated from blood culture. In addition, 3.5% of enrolled patients were infected with more than one pathogen. Our data provide the first systematic assessment of the etiologies of acute febrile illness in south-central Cambodia. Data from syndromic-based surveillance studies can help guide public health responses in developing nations.

  12. [Clinical demonstrations: Heart rupture in acute myocardial infarct. Infectious endocarditis. Wolff-Parkinson-White syndrome].

    Science.gov (United States)

    Nager, F

    1984-12-08

    This clinical demonstration includes three topics of clinical cardiology: myocardial rupture in acute myocardial infarction, infective endocarditis, and WPW-syndrome with paroxysmal supraventricular tachycardia. In the first part three cases with septal perforation or papillary muscle rupture are demonstrated. Our experience with myocardial rupture (free wall, septum, papillary muscle) during the last six years is summarized with special reference to the significance and the differential diagnosis of systolic regurgitant murmurs after myocardial infarction. Special features of acute mitral incompetence (papillary muscle dysfunction) in myocardial infarction are outlined and diagnostic guidelines for differentiation between septal perforation and papillary muscle rupture are discussed. In the second part two patients with aortic (e.g. mitral) valve rupture in the course of infective endocarditis are presented. The synoptic comparison of these two patients is related to the results of our own clinical studies on the changing pattern of infective endocarditis (epidemiologically, clinically) during the last three decades. The clinical picture of acute aortic valve rupture is outlined and the bedside signs indicating catastrophic complications of infective endocarditis are summarized. In the third part the odyssey of a patient with WPW-syndrome and consecutive paroxysmal supraventricular tachycardia is described. Progress in electrophysiological analysis of the re-entry circles in preexcitation syndromes is outlined.

  13. Rotavirus Genotypes in Sewage Treatment Plants and in Children Hospitalized with Acute Diarrhea in Italy in 2010 and 2011

    Science.gov (United States)

    Ruggeri, Franco M.; Bonomo, Paolo; Ianiro, Giovanni; Battistone, Andrea; Delogu, Roberto; Germinario, Cinzia; Chironna, Maria; Triassi, Maria; Campagnuolo, Rosalba; Cicala, Antonella; Giammanco, Giovanni M.; Castiglia, Paolo; Serra, Caterina; Gaggioli, Andrea

    2014-01-01

    Although the molecular surveillance network RotaNet-Italy provides useful nationwide data on rotaviruses causing severe acute gastroenteritis in children in Italy, scarce information is available on rotavirus circulation in the general Italian population, including adults with mild or asymptomatic infection. We investigated the genotypes of rotaviruses present in urban wastewaters and compared them with those of viral strains from clinical pediatric cases. During 2010 and 2011, 285 sewage samples from 4 Italian cities were tested by reverse transcription-PCRs (RT-PCRs) specific for rotavirus VP7 and VP4 genes. Rotavirus was detected in 172 (60.4%) samples, 26 of which contained multiple rotavirus G (VP7 gene) genotypes, for a total of 198 G types. Thirty-two samples also contained multiple P (VP4 gene) genotypes, yielding 204 P types in 172 samples. Genotype G1 accounted for 65.6% of rotaviruses typed, followed by genotypes G2 (20.2%), G9 (7.6%), G4 (4.6%), G6 (1.0%), G3 (0.5%), and G26 (0.5%). VP4 genotype P[8] accounted for 75.0% of strains, genotype P[4] accounted for 23.0% of strains, and the uncommon genotypes P[6], P[9], P[14], and P[19] accounted for 2.0% of strains altogether. These rotavirus genotypes were also found in pediatric patients hospitalized in the same areas and years but in different proportions. Specifically, genotypes G2, G9, and P[4] were more prevalent in sewage samples than among samples from patients, which suggests either a larger circulation of the latter strains through the general population not requiring medical care or their greater survival in wastewaters. A high level of nucleotide identity in the G1, G2, and G6 VP7 sequences was observed between strains from the environment and those from patients. PMID:25344240

  14. Species C Rotaviruses in Children with Diarrhea in India, 2010–2013: A Potentially Neglected Cause of Acute Gastroenteritis

    Directory of Open Access Journals (Sweden)

    Sudipta Bhat

    2018-02-01

    Full Text Available All over the world, children and adults are severely affected by acute gastroenteritis, caused by one of the emerging enteric pathogens, rotavirus C (RVC. At present, no extensive surveillance program is running for RVC in India, and its prevalence is largely unknown except cases of local outbreaks. Here, we intended to detect the presence of RVC in diarrheic children visiting or admitted to hospitals in Haldwani (state of Uttarakhand, India, a city located in the foothills of the Himalayas. During 2010–2013, we screened 119 samples for RVC by an RVC VP6 gene-specific RT-PCR. Of these, 38 (31.93% were found positive, which is higher than the incidence rates reported so far from India. The phylogenetic analysis of the derived nucleotide sequences from one of the human RVC (HuRVC isolates, designated as HuRVC/H28/2013/India, showed that the study isolate belongs to genotype I2, P2 and E2 for RVC structural genes 6 and 4 (VP6, and VP4 and non-structural gene 4 (NSP4, respectively. Furthermore, the VP6 gene of HuRVC/H28/2013/India shows the highest similarity to a recently-reported human-like porcine RVC (PoRVC/ASM140/2013/India, KT932963 from India suggesting zoonotic transmission. We also report a full-length NSP4 gene sequence of human RVC from India. Under the One-health platforms there is a need to launch combined human and animal RVC surveillance programs for a better understanding of the epidemiology of RVC infections and for implementing control strategies.Reoviridae, possess 11 double-stranded segments of RNA that encode six structural viral proteins (VP1, VP2, VP3, VP4, VP6, VP7 and five/six non-structural proteins (NSP1–NSP5/6 [7]. Based on the antigenic properties of the major inner capsid protein (VP6, RVs are subdivided into eight well-characterized species (A–H and two putative species viz. I and J [8–10]. Humans and other mammalian species are affected by species A, B, C and H rotaviruses and birds by species D, F and G, and

  15. A Prospective Study of Acute Diarrhea in a Cohort of United States Military Personnel on Deployment to the Multinational Force and Observers, Sinai, Egypt

    Science.gov (United States)

    2011-01-01

    Jiang ZD , Flores J , Belkind-Gerson J , Martinez-Sandoval FG , Okhuysen PC , 2008 . PCR -based assay using occult blood detection cards...enterotoxigenic Escherichia coli in 30 [42%] samples and Campylobacter jejuni in 7 [10%] samples) Despite modern preventive methods, diarrhea is still...30 [42%] samples and Campylobacter jejuni in 7 [10%] samples) Despite modern preventive methods, diarrhea is still a common problem for deployed US

  16. [The verbal autopsy on children with a respiratory infection and acute diarrhea. An analysis of the disease-care-death process].

    Science.gov (United States)

    Reyes, H; Tomé, P; Guiscafré, H; Martínez, H; Romero, G; Portillo, E; Rodríguez, R; Gutiérrez, G

    1993-01-01

    The study focuses on children between 72 hours and five years of age who died of acute respiratory infection (ARI) or acute diarrhea (AD) in the State of Tlaxcala. Peer Review Mortality Committee of the State contributed with the staff to the deaths analysis. Cases were included only when diagnosis was confirmed by verbal autopsy (VA). One hundred and thirty two cases were included (98 corresponding to ARI deaths and 34 to AD). The process related to medical care-seeking behaviors and prescribing practices by private and non-private physicians was analyzed through the VA. During the study period, 60% of children with ARI and 58.9% of children with AD died at home. More than 80% of these children had received medical care within three days preceding their death, and 50% of them had been seen by a physician within 12 hours prior to their death. Most of these visits were to a private doctor (71% for ARI and 86% for AD). Forty seven percent of treatments prescribed for ARI were judged to be wrong, either because of a bad choice of antibiotic or because the physician did not prescribe an antibiotic when the patient required it. Similarly, 65% of treatments for AD were considered erroneous, either due to the use of an antibiotic which was not justified or due to the lack of oral rehydration therapy when it was needed. Additionally, late referral to a hospital was considered as having direct influence at the death in half of the consultation. Families were too late in demanding medical care or demanded no care at all in 21.9% of cases of ARI and in 6.1% of cases of AD. We have found the VA to be useful in identifying problems related to the process of health-seeking behaviors and medical care. Our results suggest interventions that may lower the high mortality rates in Tlaxcala, such as training workshops directed to institutional and private physicians, and the implementation of top-of-line treatment centers where high-risk patients can be referred and also the health

  17. Implications of infectious diseases and the adrenal hypothesis for the etiology of childhood acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    F. Azevedo-Silva

    2010-03-01

    Full Text Available Acute leukemia is the most frequent cancer in children. Recently, a new hypothesis was proposed for the pathogenesis of childhood acute lymphoblastic leukemia (ALL. The so-called "adrenal hypothesis" emphasized the role of endogenous cortisol in the etiology of B-cell precursor ALL. The incidence peak of ALL in children between 3 to 5 years of age has been well documented and is consistent with this view. The adrenal hypothesis proposes that the risk of childhood B-cell precursor ALL is reduced when early childhood infections induce qualitative and quantitative changes in the hypothalamus-pituitary-adrenal axis. It suggests that the increased plasma cortisol levels would be sufficient to eliminate all clonal leukemic cells originating during fetal life. Because Brazil is a continental and tropical country, the exposure to infections is diversified with endemic viral and regionally non-viral infections, with some characteristics that support the recent adrenal hypothesis. Here we discuss this new hypothesis in terms of data from epidemiological studies and the possible implications of the diversity of infections occurring in Brazilian children.

  18. Hospital readmissions with acute infectious diseases in New Zealand children < 2 years of age.

    Science.gov (United States)

    Seibt, Silvia; Gilchrist, Catherine A; Reed, Peter W; Best, Emma J; Harnden, Anthony; Camargo, Carlos A; Grant, Cameron C

    2018-03-05

    Infectious diseases are the leading cause of hospital admissions in young children. Hospitalisation with an infectious disease is a recurrent event for some children. Our objective was to describe risk factors for infectious disease readmission following hospital admission with an infectious disease in the first two years of life. We performed a national cohort study of New Zealand children, born 2005-2009, with an infectious disease admission before age 24 months. Children readmitted with an infectious disease within 12 months of the first infectious disease admission were identified. Every infectious disease admission was categorised as a respiratory, enteric, skin and soft tissue, urinary or other infection. Independent associations of demographic and child health factors with infectious disease readmission were determined using multiple variable logistic regression. From 2005 to 2011, there were 69,902 infectious disease admissions for 46,657 children less than two years old. Of these 46,657 children, 10,205 (22%) had at least one infectious disease readmission within 12 months of their first admission. The first infectious disease admission was respiratory (54%), enteric (15%), skin or soft tissue (7%), urinary (4%) or other (20%). Risk of infectious disease readmission was increased if the first infectious disease admission was respiratory (OR = 1.87, 95% CI 1.78-1.95) but not if it was in any other infectious disease category. Risk factors for respiratory infectious disease readmission were male gender, Pacific or Māori ethnicity, greater household deprivation, presence of a complex chronic condition, or a first respiratory infectious disease admission during autumn or of ≥3 days duration. Fewer factors (younger age, male gender, presence of a complex chronic condition) were associated with enteric infection readmission. The presence of a complex chronic condition was the only factor associated with urinary tract infection readmission and none of

  19. Optimal combinations of acute phase proteins for detecting infectious disease in pigs

    DEFF Research Database (Denmark)

    Heegaard, Peter M. H.; Stockmarr, Anders; Piñeiro, Matilde

    2011-01-01

    The acute phase protein (APP) response is an early systemic sign of disease, detected as substantial changes in APP serum concentrations and most disease states involving inflammatory reactions give rise to APP responses. To obtain a detailed picture of the general utility of porcine APPs to detect...... any disease with an inflammatory component seven porcine APPs were analysed in serum sampled at regular intervals in six different experimental challenge groups of pigs, including three bacterial (Actinobacillus pleuropneumoniae, Streptococcus suis, Mycoplasma hyosynoviae), one parasitic (Toxoplasma...... for single APPs and for APP combinations. Combinations of APPs allowed the detection of disease more sensitively than any individual APP and the best three-protein combinations were CRP, apoA1, pigMAP and CRP, apoA1, Hp, respectively, closely followed by the two-protein combinations CRP, pigMAP and apoA1...

  20. Radiological Findings in Children with Acute Pneumonia: Age More Important Than Infectious Agent

    Energy Technology Data Exchange (ETDEWEB)

    Wahlgren, H.; Mortensson, W.; Eriksson, M.; Finkel, Y.; Forsgren, M.; Leinonen, M. [Astrid Lindgren' s Children' s Hospital, Karolinska Hospital, Stockholm (Sweden). Depts. of Pediatric Radiology and Pediatrics

    2005-07-01

    Purpose: To evaluate whether radiological findings and healing time in children with pneumonia are correlated to etiologic agent. Material and Methods: A total of 346 children with radiologically verified acute pneumonia, and with accomplished serological tests for bacteria and viruses, were included in the study. Five etiological groups were analysed: children with bacterial etiology only, with viral etiology only, with mixed bacterial and viral etiology, with Mycoplasma only, and children with no etiology. Results: The chest films of each etiological group were analysed and the findings were correlated to the children's age. The radiological findings did not differ between the etiological groups. Radiological findings correlated significantly with the patient's age. The radiological healing frequency at check-up X-ray was found to be significantly lower in children with mixed bacterial and viral etiology compared to children in each of the other groups and to the material as a whole. Conclusion: Conclusions about the etiology could not be drawn from the chest X-ray findings.

  1. Prevalência baixa de adenovírus em crianças com diarreia em Belo Horizonte-MG Low prevalence of adenoviruses in children with acute diarrhea in Belo Horizonte-MG

    Directory of Open Access Journals (Sweden)

    Ricardo Jenner Duarte

    2012-08-01

    Full Text Available INTRODUÇÃO: Diversos microrganismos são reconhecidos como agentes de diarreia aguda, entre eles, os adenovírus, cuja associação com a doença apresenta variações geográficas e é pouco conhecida no Brasil. OBJETIVOS: Investigar a presença de adenovírus em fezes de crianças com diarreia aguda e sem diarreia, em Belo Horizonte-MG, e estudar os fatores epidemiológicos associados à adenovirose intestinal. MATERIAL E MÉTODOS: O teste imunocromatográfico qualitativo (kit VIKIA® Rota-Adeno, bioMérieux foi utilizado para pesquisa de antígenos de adenovírus em amostras fecais obtidas de 268 crianças com diarreia aguda e 124 sem diarreia, em 2005 e 2006, no Hospital Infantil João Paulo II, Belo Horizonte-MG. Dados laboratoriais, clínicos e epidemiológicos foram registrados em banco de dados (SPSS Statistical package, IBM. RESULTADOS: Adenovírus foi detectado nas fezes de 16 crianças (4,1%: 12 (4,5% com diarreia e quatro (3,2% sem diarreia. A virose foi mais comum em meninas e a distribuição etária da infecção foi homogênea. Entre as 16 crianças com infecção pelo vírus, 11 (68,8% tinham até 12 meses de idade. Entretanto, diferença significativa não foi observada para os parâmetros analisados. Distribuição sazonal da infecção por adenovírus não foi detectada. CONCLUSÃO: Nossos dados demonstram que a prevalência da adenovirose é baixa na população pediátrica no nosso meio.INTRODUCTION: Several microorganisms, among them enteric adenovirus, are widely recognized as etiological agents of acute diarrhea. The association between adenovirus and the disease varies among geographical regions and is poorly known in Brazil. OBJECTIVES: To investigate the presence of adenovirus in stool samples from children with and without diarrhea in Belo Horizonte-MG. To study factors associated with enteric adenovirus infection. MATERIAL AND METHOD: A qualitative immunochromatographic assay (kit VIKIA® Rota-Adeno, bio

  2. [Diarrhea, from the gastroenterologist's point of view].

    Science.gov (United States)

    Bajor, Judit; Beró, Tamás

    2009-08-30

    Patients seeking help from gastroenterologist have frequent complaints of changes in the quality and quantity of stool as well in the frequency of bowel movements. Definition of diarrhea includes: more than three bowel movements daily, more than 200 grams of the stool daily, and its water content exceeding 75-85%. Diarrhea lowers the quality of life and can be a sign of organic disease. Its course can be acute and chronic. According to the pathomechanism, diarrheas can be divided into four different types: exudative (inflammatory), osmotic, dismotility and secretory. Acute diarrheas are usually infective, and sometimes they result in very serious conditions. Their course runs from a few days to a couple of weeks. If diarrhea persists more than four weeks, it is the chronic variant and it justifies gastroenterological examination. During the evaluation, we have to think of endocrine, autoimmune, allergic, postoperative states and the side effect of medications beside primer gastroenterological causes. To differentiate from a number of wide scale of clinical pictures and to reach the correct diagnosis, we are aided by the characteristics of diarrhea, the accompanying symptoms, laboratory values and invasive examinations. With the present summary, we would like to give a guide to the practicing physicians, mainly with a symptom-oriented approach.

  3. Lactancia materna y diarrea aguda en los primeros tres meses de vida Breast feeding and the incidence of acute diarrhea during the first three months of life

    Directory of Open Access Journals (Sweden)

    Claudia Macías-Carrillo

    2005-02-01

    ón como el aseguramiento de la provisión de agua potable para el recién nacido.OBJECTIVE: To assess the effect of exclusive breastfeeding and its interactions with selected socioeconomic factors, on the incidence of acute infantile diarrhea during the first three months of life. MATERIAL AND METHODS: A prospective cohort study with a follow up of three months was conducted in 327 mother and child pairs, living in the city of Durango, Mexico, between April and June 1994. Data analyses included simple univariate and bivariate cross-tabulations, as well as multivariate logistic regression models with random effects. RESULTS: Infants who were not exclusively breastfed were at a significantly increased risk of having acute diarrhea during early infancy (ORcombined breastfeeding= 3.23; 95% CI 1.84-5.68 and ORartificial breastfeeding=4.36; 95% CI 2.32-8.19. Moreover, the protective effect of breastfeeding was independent from the effects of the following factors: poor maternal education, lack of social support for baby care, and being an adolescent mother. However, lack of potable water and lack of sewerage were potential effect modifiers of type of lactation deltaG=9.26; p=0.09; ORno water/no sewerage= 2.58; 95% CI 1.10-6.03 in the final multivariate model, for simultaneous lack of potable water and sewerage, which is greater than the sum of the individual OR for each variable. CONCLUSIONS: Similar to previous studies, exclusive breastfeeding was found to have great importance, since this practice protects the child's health and allows for a better development, despite unfavorable social and economic conditions. In particular, it seems that the protection conferred by breastfeeding is stronger when home conditions are poor, but this same condition presents an intervention opportunity, particularly the assurance of potable water provision for the infant when breastfeeding is not an option.

  4. Environmental scan of infection prevention and control practices for containment of hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada.

    Science.gov (United States)

    Ocampo, Wrechelle; Geransar, Rose; Clayden, Nancy; Jones, Jessica; de Grood, Jill; Joffe, Mark; Taylor, Geoffrey; Missaghi, Bayan; Pearce, Craig; Ghali, William; Conly, John

    2017-10-01

    Ward closure is a method of controlling hospital-acquired infectious diseases outbreaks and is often coupled with other practices. However, the value and efficacy of ward closures remains uncertain. To understand the current practices and perceptions with respect to ward closure for hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada. A Web-based environmental scan survey was developed by a team of infection prevention and control (IPC) experts and distributed to 235 IPC professionals at acute care sites across Canada. Data were analyzed using a mixed-methods approach of descriptive statistics and thematic analysis. A total of 110 completed responses showed that 70% of sites reported at least 1 outbreak during 2013, 44% of these sites reported the use of ward closure. Ward closure was considered an "appropriate," "sometimes appropriate," or "not appropriate" strategy to control outbreaks by 50%, 45%, and 5% of participants, respectively. System capacity issues and overall risk assessment were main factors influencing the decision to close hospital wards following an outbreak. Results suggest the use of ward closure for containment of hospital-acquired infectious disease outbreaks in Canadian acute care health settings is mixed, with outbreak control methods varying. The successful implementation of ward closure was dependent on overall support for the IPC team within hospital administration. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Characterization of thymus-associated lymphoid depletion in bovine calves acutely or persistently infected with bovine viral diarrhea virus 1, bovine viral diarrhea virus 2 or HoBi-like pestivirus.

    Science.gov (United States)

    Falkenberg, Shollie M; Bauermann, Fernando V; Ridpath, Julia F

    2017-11-01

    Naïve pregnant cattle exposed to pestiviruses between 40-125 days of gestation can give birth to persistently infected (PI) calves. Clinical presentation and survivability, in PI cattle, is highly variable even with the same pestivirus strain whereas the clinical presentation in acute infections is more uniform with severity of symptoms being primarily a function of virulence of the infecting virus. The aim of this study was to compare thymic depletion, as measured by comparing the area of the thymic cortex to the medulla (corticomedullary ratio), in acute and persistent infections of the same pestivirus isolate. The same general trends were observed with each pestivirus isolate. Thymic depletion was observed in both acutely and persistently infected calves. The average thymic depletion observed in acutely infected calves was greater than that in age matched PI calves. PI calves, regardless of infecting virus, revealed a greater variability in amount of depletion compared to acutely infected calves. A trend was observed between survivability and depletion of the thymus, with PI calves surviving less than 5 weeks having lower corticomedullary ratios and greater depletion. This is the first study to compare PI and acutely infected calves with the same isolates as well as to evaluate PI calves based on survivability. Further, this study identified a quantifiable phenotype associated with potential survivability.

  6. The fecal microbiome in cats with diarrhea.

    Directory of Open Access Journals (Sweden)

    Jan S Suchodolski

    Full Text Available Recent studies have revealed that microbes play an important role in the pathogenesis of gastrointestinal (GI diseases in various animal species, but only limited data is available about the microbiome in cats with GI disease. The aim of this study was to evaluate the fecal microbiome in cats with diarrhea. Fecal samples were obtained from healthy cats (n = 21 and cats with acute (n = 19 or chronic diarrhea (n = 29 and analyzed by sequencing of 16S rRNA genes, and PICRUSt was used to predict the functional gene content of the microbiome. Linear discriminant analysis (LDA effect size (LEfSe revealed significant differences in bacterial groups between healthy cats and cats with diarrhea. The order Burkholderiales, the families Enterobacteriaceae, and the genera Streptococcus and Collinsella were significantly increased in diarrheic cats. In contrast the order Campylobacterales, the family Bacteroidaceae, and the genera Megamonas, Helicobacter, and Roseburia were significantly increased in healthy cats. Phylum Bacteroidetes was significantly decreased in cats with chronic diarrhea (>21 days duration, while the class Erysipelotrichi and the genus Lactobacillus were significantly decreased in cats with acute diarrhea. The observed changes in bacterial groups were accompanied by significant differences in functional gene contents: metabolism of fatty acids, biosynthesis of glycosphingolipids, metabolism of biotin, metabolism of tryptophan, and ascorbate and aldarate metabolism, were all significantly (p<0.001 altered in cats with diarrhea. In conclusion, significant differences in the fecal microbiomes between healthy cats and cats with diarrhea were identified. This dysbiosis was accompanied by changes in bacterial functional gene categories. Future studies are warranted to evaluate if these microbial changes correlate with changes in fecal concentrations of microbial metabolites in cats with diarrhea for the identification of potential diagnostic or

  7. Testing for Chronic Diarrhea.

    Science.gov (United States)

    Raman, M

    Chronic diarrhea is a frequently encountered symptom in clinical practice. The etiologies for chronic diarrhea are diverse and broad with varying clinical implications. A useful method of categorizing chronic diarrhea to guide a diagnostic work-up is a pathophysiology-based framework. Chronic diarrhea may be categorized as malabsorptive, secretory, osmotic, and inflammatory or motility related. Frequently, overlap between categories may exist for any given diarrhea etiology and diagnostic testing must occur with an understanding of the differential diagnosis. Investigations to achieve a diagnosis for chronic diarrhea range from screening blood and stool tests to more directed testing such as diagnostic imaging, and endoscopic and histological evaluation. The pathophysiology-based framework proposed in this chapter will allow the clinician to select screening tests followed by targeted tests to minimize cost and complications to the patient, while providing a highly effective method to achieve an accurate diagnosis. © 2017 Elsevier Inc. All rights reserved.

  8. Adaptive immunity is the primary force driving selection of equine infectious anemia virus envelope SU variants during acute infection.

    Science.gov (United States)

    Mealey, Robert H; Leib, Steven R; Pownder, Sarah L; McGuire, Travis C

    2004-09-01

    Equine infectious anemia virus (EIAV) is a lentivirus that causes persistent infection in horses. The appearance of antigenically distinct viral variants during recurrent viremic episodes is thought to be due to adaptive immune selection pressure. To test this hypothesis, we evaluated envelope SU cloned sequences from five severe combined immunodeficient (SCID) foals infected with EIAV. Within the SU hypervariable V3 region, 8.5% of the clones had amino acid changes, and 6.4% had amino acid changes within the known cytotoxic T lymphocyte (CTL) epitope Env-RW12. Of all the SU clones, only 3.1% had amino acid changes affecting potential N-linked glycosylation sites. In contrast, a much higher degree of variation was evident in SU sequences obtained from four EIAV-infected immunocompetent foals. Within V3, 68.8% of the clones contained amino acid changes, and 50% of the clones had amino acid changes within the Env-RW12 CTL epitope. Notably, 31.9% of the clones had amino acid changes affecting one or more glycosylation sites. Marked amino acid variation occurred in cloned SU sequences from an immune-reconstituted EIAV-infected SCID foal. Of these clones, 100% had amino acid changes within V3, 100% had amino acid changes within Env-RW12, and 97.5% had amino acid changes affecting glycosylation sites. Analysis of synonymous and nonsynonymous nucleotide substitutions revealed statistically significant differences between SCID and immunocompetent foals and between SCID foals and the reconstituted SCID foal. Interestingly, amino acid selection at one site occurred independently of adaptive immune status. Not only do these data indicate that adaptive immunity primarily drives the selection of EIAV SU variants, but also they demonstrate that other selective forces exist during acute infection.

  9. Is irritable bowel syndrome an infectious disease?

    Science.gov (United States)

    Thompson, John Richard

    2016-01-28

    Irritable bowel syndrome (IBS) is the most common of all gastroenterological diseases. While many mechanisms have been postulated to explain its etiology, no single mechanism entirely explains the heterogeneity of symptoms seen with the various phenotypes of the disease. Recent data from both basic and clinical sciences suggest that underlying infectious disease may provide a unifying hypothesis that better explains the overall symptomatology. The presence of small intestinal bowel overgrowth (SIBO) has been documented in patients with IBS and reductions in SIBO as determined by breath testing correlate with IBS symptom improvement in clinical trials. The incidence of new onset IBS symptoms following acute infectious gastroenteritis also suggests an infectious cause. Alterations in microbiota-host interactions may compromise epithelial barrier integrity, immune function, and the development and function of both central and enteric nervous systems explaining alterations in the brain-gut axis. Clinical evidence from treatment trials with both probiotics and antibiotics also support this etiology. Probiotics appear to restore the imbalance in the microflora and improve IBS-specific quality of life. Antibiotic trials with both neomycin and rifaximin show improvement in global IBS symptoms that correlates with breath test normalization in diarrhea-predominant patients. The treatment response to two weeks of rifaximin is sustained for up to ten weeks and comparable results are seen in symptom reduction with retreatment in patients who develop recurrent symptoms.

  10. Adenovirus Infection in Children with Diarrhea Disease in ...

    African Journals Online (AJOL)

    Ad40) and type 41(Ad41), can cause acute and severe diarrhea in young children worldwide. This study was conducted to delineate the epidemiological features of adenoviruses identified in children with gastroenteritis in Northwestern Nigeria.

  11. Enteropathogenic bacteria isolated from specimens of patients with diarrhea

    Directory of Open Access Journals (Sweden)

    Salary M

    1997-09-01

    Full Text Available Acute infectious gastroenteritis is one of the most common infectious diseases of humans in the world. Diarrheal disease still ranks very high as a major cause of illness and death especially in developing nations. This study has been carried out to investigate enteropathogenic bacteria isolated from 2517 specimens of patients with diarrhea. The results obtained are as follow: Salmonella typhimurium: 6 cases 3.1 percent, Salmonella havana: 5 cases 2.6 percent, Shigella dysenteriae: 12 cases 6.2 percent, Shigella flexneri: 26 cases 13.5 percent, Shigella boydii: 8 cases 4.1 percent, Shigella sonnei: 24 cases 12.4 percent, Enteropathogenic E.coli: 11 cases 5.7 percent, Enteroinvasive E.coli: 2 cases 1 percent, Yersinia enterocolitica: - cases - percent, Vibrio cholera: - cases - percent, Aeromonas hydrophila: 6 cases 3.1 percent, Plesiomonas shigelloides: 1 cases 0.5 percent, Toxigenic C.difficile: 36 cases 18.7 percent, Enterotogenic c.perfringens: 6 cases 3.1 percent, Campylobacter jejuni: 50 cases 25.9 percent.

  12. Intestinal coccidia in Cuban pediatric patients with diarrhea

    Directory of Open Access Journals (Sweden)

    Núñez FA

    2003-01-01

    Full Text Available From May to August 1999, we evaluated 401 patients from a pediatric hospital of Havana City. One group was composed of 113 patients with diarrhea admitted to the Gastroenterology ward and a second consisted of 288 patients without diarrhea, admitted for other reasons, and hospitalized within the same time period. Three stool samples were collected from each child and were examined using three parasitological techniques. When we compared the frequency of parasite species between both groups, we found Cryptosporidium spp. and Cyclospora cayetanensis, only in the group of children with diarrhea (P 0.05. In addition, in those children infected with Cryptosporidium, the diarrhea had a more prolonged duration (P < 0.01, while those infected with Cyclospora, the abdominal cramps or pain, and acute diarrhea were more frequently detected (P < 0.01. Our results showed that emerging intestinal coccidia are pathogens strongly associated in this group of children with diarrhea.

  13. Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea.

    Science.gov (United States)

    Camilleri, Michael; Sellin, Joseph H; Barrett, Kim E

    2017-02-01

    Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (>4 weeks in duration) are more elusive. We review the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties. We also describe the various extraepithelial factors that activate diarrheal mechanisms. Finally, clinical evaluation and tests used in the assessment of patients presenting with chronic diarrhea are reviewed, and an algorithm guiding therapeutic decisions and pharmacotherapy is presented. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  14. Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

    Science.gov (United States)

    Camilleri, Michael; Sellin, Joseph H.; Barrett, Kim E.

    2016-01-01

    Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (more than 4 weeks in duration) are more elusive. We review on the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties. We also describe the various extra-epithelial factors that activate diarrheal mechanisms. Finally, clinical evaluation and tests used in assessment of patients presenting with chronic diarrhea are reviewed, and an algorithm guiding therapeutic decisions and pharmacotherapy is presented. PMID:27773805

  15. Therapy of Acute Intestinal Infections in Children: Proven Efficiency

    Directory of Open Access Journals (Sweden)

    S. V. Khaliullina

    2014-01-01

    Full Text Available The paper focuses on questions of etiotropic, pathogenetic, and symptomatic treatment of acute infectious diarrhea in children. The recommendations are given with the basic principles of evidence-based medicine including summary data from randomized clinical trials and metaanalyses. The new lines of the treatment are discussed such as the possibility of application of antiemetic, antidiarrheal, antisecretory, probiotic drugs in pediatric practice.

  16. Characterization of thymus-associated lymphoid depletion in bovine calves acutely or persistently infected with bovine viral diarrhea virus 1, bovine viral diarrhea virus 2 or HoBi-like pestivirus

    OpenAIRE

    Falkenberg, Shollie M.; Bauermann, Fernando V.; Ridpath, Julia F.

    2017-01-01

    Naïve pregnant cattle exposed to pestiviruses between 40-125 days of gestation can give birth to persistently infected (PI) calves. Clinical presentation and survivability, in PI cattle, is highly variable even with the same pestivirus strain whereas the clinical presentation in acute infections is more uniform with severity of symptoms being primarily a function of virulence of the infecting virus. The aim of this study was to compare thymic depletion, as measured by comparing the area of th...

  17. Detection of 23 Gastrointestinal Pathogens Among Children Who Present With Diarrhea.

    Science.gov (United States)

    Stockmann, Chris; Pavia, Andrew T; Graham, Brad; Vaughn, Mike; Crisp, Rob; Poritz, Mark A; Thatcher, Stephanie; Korgenski, E Kent; Barney, Trenda; Daly, Judy; Rogatcheva, Margarita

    2017-09-01

    Diarrheal diseases are a major cause of ambulatory care visits and hospitalizations among children. Because of overlapping signs and symptoms and expensive and inefficient testing methods, the etiology of pediatric diarrhea is rarely established. We identified children diarrhea at Primary Children's Hospital in Salt Lake City, Utah, between October 2010 and September 2012. Stool specimens submitted for testing were evaluated by using the FilmArray gastrointestinal diagnostic system, which is a rapid multiplex polymerase chain reaction platform that can simultaneously detect 23 bacterial, viral, and protozoal agents. A pathogen was detected in 561 (52%) of 1089 diarrheal episodes. The most commonly detected pathogens included toxigenic Clostridium difficile (16%), diarrheagenic Escherichia coli (15%), norovirus GI/GII (11%), and adenovirus F 40/41 (7%). Shiga toxin-producing E coli were detected in 43 (4%) specimens. Multiple pathogens were identified in 160 (15%) specimens. Viral pathogens (norovirus, adenovirus, rotavirus, and sapovirus) were more common among children children 2 to 4 years of age. Children with 1 or more underlying chronic medical conditions were less likely to have a pathogen identified than those without a chronic medical condition (45% vs 60%, respectively; P children with diarrhea. Viral pathogens are identified frequently among young children with acute gastroenteritis. © The Author 2016. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  18. Long-term poor rapport, lack of spontaneity and passive social withdrawal related to acute post-infectious encephalitis: a case report.

    Science.gov (United States)

    Yamada, Atsurou; Miyachi, Nobuhiro; Miura, Toshiyasu; Suzuki, Masako; Watanabe, Norio; Akechi, Tatsuo

    2016-01-01

    Post-infectious encephalitis/encephalopathy is a neurological syndrome that sometimes develops following common viral or bacterial infections. The most common form is acute disseminated encephalomyelitis (ADEM). ADEM is a demyelinating disease of the central nervous system that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalitis. Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is another type of severe autoimmune disorder, characterized by seizures, movement disorders and psychiatric symptoms. In general, the prognosis and long-term outcomes of both ADEM and anti-NMDAR encephalitis are favorable. Most patients show complete, albeit slow recovery over a period of one to 2 years. There are few reports of patients with these disorders showing long-term residual psychiatric symptoms. We report the case of a 16-year-old Japanese male who suffered from acute post-infectious encephalitis. The patient followed an atypical recovery course, in that he showed poor rapport, lack of spontaneity and passive social withdrawal for more than 2 years after the initial symptoms. While treatment with small doses of antipsychotic drugs at the hospital had no effect on the symptoms, the patient recovered gradually over a prolonged period of five or so years. This case report suggests that a type of acute post-infectious encephalitis with demyelinating features, possibly ADEM or anti-NMDAR encephalitis, or an overlap between the two, can cause a prodrome of behavioral changes and long-term residual psychiatric symptoms for many months, although it is eventually associated with a good prognosis.

  19. N08C9 (Alliance): A Phase 3 Randomized Study of Sulfasalazine Versus Placebo in the Prevention of Acute Diarrhea in Patients Receiving Pelvic Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Robert C., E-mail: miller.robert@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Petereit, Daniel G. [Rapid City Regional Oncology Group, Rapid City, South Dakota (United States); Sloan, Jeff A.; Liu, Heshan [Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota (United States); Martenson, James A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Bearden, James D. [Upstate Carolina Community Clinical Oncology Program, Spartanburg, South Carolina (United States); Sapiente, Ronald [Carle Cancer Center CCOP, Urbana, Illinois (United States); Seeger, Grant R. [Altru Health Systems, Grand Forks, North Dakota (United States); Mowat, Rex B. [Toledo Community Hospital Oncology Program CCOP, Toledo, Ohio (United States); Liem, Ben [University of New Mexico, Albuquerque, New Mexico (United States); Iott, Matthew J. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Loprinzi, Charles L. [Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota (United States)

    2016-07-15

    Purpose: To provide confirmatory evidence on the use of sulfasalazine to reduce enteritis during pelvic radiation therapy (RT), following 2 prior single-institution trials suggestive that benefit existed. Methods and Materials: A multi-institution, randomized, double-blind, placebo-controlled phase 3 trial was designed to assess the efficacy of sulfasalazine versus placebo in the treatment of RT-related enteritis during RT including the posterior pelvis (45.0-53.5 Gy) and conducted through a multicenter national cooperative research alliance. Patients received 1000 mg of sulfasalazine or placebo orally twice daily during and for 4 weeks after RT. The primary endpoint was maximum severity of diarrhea (Common Terminology Criteria for Adverse Events version 4.0). Toxicity and bowel function were assessed by providers through a self-administered bowel function questionnaire taken weekly during RT and for 6 weeks afterward. Results: Eighty-seven patients were enrolled in the trial between April 29, 2011, and May 13, 2013, with evenly distributed baseline factors. At the time of a planned interim toxicity analysis, more patients with grade ≥3 diarrhea received sulfasalazine than received placebo (29% vs 11%, P=.04). A futility analysis showed that trial continuation would be unlikely to yield a positive result, and a research board recommended halting study treatment. Final analysis of the primary endpoint showed no significant difference in maximum diarrhea severity between the sulfasalazine and placebo arms (P=.41). Conclusions: Sulfasalazine does not reduce enteritis during pelvic RT and may be associated with a higher risk of adverse events than placebo. This trial illustrates the importance of confirmatory phase 3 trials in the evaluation of symptom-control agents.

  20. N08C9 (Alliance): A Phase 3 Randomized Study of Sulfasalazine Versus Placebo in the Prevention of Acute Diarrhea in Patients Receiving Pelvic Radiation Therapy

    International Nuclear Information System (INIS)

    Miller, Robert C.; Petereit, Daniel G.; Sloan, Jeff A.; Liu, Heshan; Martenson, James A.; Bearden, James D.; Sapiente, Ronald; Seeger, Grant R.; Mowat, Rex B.; Liem, Ben; Iott, Matthew J.; Loprinzi, Charles L.

    2016-01-01

    Purpose: To provide confirmatory evidence on the use of sulfasalazine to reduce enteritis during pelvic radiation therapy (RT), following 2 prior single-institution trials suggestive that benefit existed. Methods and Materials: A multi-institution, randomized, double-blind, placebo-controlled phase 3 trial was designed to assess the efficacy of sulfasalazine versus placebo in the treatment of RT-related enteritis during RT including the posterior pelvis (45.0-53.5 Gy) and conducted through a multicenter national cooperative research alliance. Patients received 1000 mg of sulfasalazine or placebo orally twice daily during and for 4 weeks after RT. The primary endpoint was maximum severity of diarrhea (Common Terminology Criteria for Adverse Events version 4.0). Toxicity and bowel function were assessed by providers through a self-administered bowel function questionnaire taken weekly during RT and for 6 weeks afterward. Results: Eighty-seven patients were enrolled in the trial between April 29, 2011, and May 13, 2013, with evenly distributed baseline factors. At the time of a planned interim toxicity analysis, more patients with grade ≥3 diarrhea received sulfasalazine than received placebo (29% vs 11%, P=.04). A futility analysis showed that trial continuation would be unlikely to yield a positive result, and a research board recommended halting study treatment. Final analysis of the primary endpoint showed no significant difference in maximum diarrhea severity between the sulfasalazine and placebo arms (P=.41). Conclusions: Sulfasalazine does not reduce enteritis during pelvic RT and may be associated with a higher risk of adverse events than placebo. This trial illustrates the importance of confirmatory phase 3 trials in the evaluation of symptom-control agents.

  1. Características etiológicas, clínicas y sociodemográficas de la diarrea aguda en Venezuela Etiological, clinical, and sociodemographic characteristics of acute diarrhea in Venezuela

    Directory of Open Access Journals (Sweden)

    María I. Urrestarazu

    1999-09-01

    Full Text Available En cuatro ciudades de Venezuela se llevó a cabo un estudio para evaluar las características epidemiológicas, clínicas y etiológicas de la diarrea aguda en niños menores de 5 años. Entre junio de 1993 y mayo de 1995 se estudiaron 2 552 niños con diarrea y 793 controles que fueron atendidos en el hospital. Para el análisis estadístico de los resultados se empleó la prueba exacta de Fisher. Los rotavirus fueron los agentes más importantes, tanto por su frecuencia (30% como por su asociación con la deshidratación (58%. Le siguieron en importancia Campylobacter spp. (13% y Escherichia coli serogrupos O clásicos (9%, pero su asociación con la diarrea solo fue estadísticamente significativa en los niños menores de 3 meses, hecho de particular importancia desde el punto de vista del tratamiento. Se confirmó la importancia de la edad como factor determinante de la prevalencia y gravedad de la diarrea.In four cities of Venezuela a study was carried out to evaluate the epidemiological, clinical, and etiological characteristics of acute diarrhea in children under 5 years of age. The study was done between June 1993 and May 1995 and involved children who were seen in a hospital, 2 552 with diarrhea and 793 controls. The Fisher exact test was used for the statistical analysis of the results. Rotaviruses were the most important agents, both in terms of their frequency (30% and their association with dehydration (58%. Following in importance were Campylobacter spp. (13% and Escherichia coli classical O serogroups (9%, but their association with diarrhea was only statistically significant among children less than 3 months old, a fact that is particularly important from the standpoint of treatment. The importance of age was confirmed as a determining factor in the prevalence and severity of diarrhea.

  2. Perfil etiológico das diarréias agudas de crianças atendidas em São Paulo Etiologic profile of acute diarrhea in children in the city of São Paulo

    Directory of Open Access Journals (Sweden)

    Eloisa C. Souza

    2002-02-01

    ção.Conclusões: as bactérias foram os enteropatógenos mais detectados nos casos de diarréia aguda, sendo a Escherichia coli a mais freqüente. Na maior parte, as cepas de Escherichia coli eram de biovariedade não-EPEC, habitualmente não investigadas nos laboratórios de patologia clínica. O rotavírus foi encontrado em grande parcela dos casos, muitas vezes em associação com as bactérias. Os protozoários tiveram importância reduzida.Objective: to evaluate the etiologic profile of acute diarrhea in socioeconomically deprived children assisted at a regional pediatric emergency care service. Methods: during two years all children with acute diarrhea assisted at a previously established day and week time schedule were included in the study. Other selective criteria were: a age less than 5 years; b nonuse of antibiotics in the previous month; and c no travel outside the city in the previous month. Stool examination was used for the detection of the following microorganisms: a rotavirus (immunofluorescence and counterimmunoelectrophoresis; b bacteria - culture in MacConkey agar, SS agar, Columbia agar, bright green, serotyping, detection of toxins - INV, LT,ST,SLT I, SLT II, Sereny test, detection of virulence factors - EAF, eae, BFP; and c protozoa (Hoffman and Faust. In the same period, a control group without diarrhea was also evaluated for the same fecal pathogens. Results: between March 1994 and June 1996, 154 children with acute diarrhea (AD and 42 control children (WAD, that is, without acute diarrhea, were selected. In the AD group, intestinal pathogens were detected in 112 (72.8% cases, and in 9 (21.5% cases in the WAD group. The association of two or more intestinal pathogens occurred in 47 (30.5% cases in the AD group, and in 3 (7.1% cases in the WAD group. The pathogens identified in the AD cases were: Rotavirus: 32 (20.8%, bacteria: 53 (34.4%, both: 25 (16.2%, and 2 (1.4% with Giardia lamblia (in one case associated with Rotavirus and in another one associated with

  3. The pathophysiology of diarrhea.

    Science.gov (United States)

    Sellin, J H

    2001-01-01

    Diarrhea is a very common event after transplantation, but its cause may be difficult to identify. The first step in determining the cause in any particular case is an understanding of the etiology of diarrhea in general. Although diarrhea often is categorized into such types as secretory versus osmotic, or electrolyte transport-related versus motility-related, a thorough understanding of the problem requires knowledge of how the paracrine, immune, nervous and endocrine systems react to each other as well as to infection, drugs or other stimuli.

  4. [Safety Evaluation of Rare Sugar Syrup: Single-dose Oral Toxicity in Rats, Reverse Mutation Assay, Chromosome Aberration Assay, and Acute Non-Effect Level for Diarrhea of a Single Dose in Humans].

    Science.gov (United States)

    Yamada, Takako; Iida, Tetsuo; Takamine, Satoshi; Hayashi, Noriko; Okuma, Kazuhiro

    2015-01-01

    The safety of rare sugar syrup obtained from high-fructose corn syrup under slightly alkaline conditions was studied. Mutagenicity of rare sugar syrup was assessed by a reverse mutation assay using Salmonella typhimurium and Escherichia coli, and an in vitro chromosomal aberration assay using Chinese hamster lung cell line (CHL/IU). No mutagenicity of rare sugar syrup was detected under these experimental conditions. Oral administration of single dose (15,000 mg/kg) of rare sugar syrup to rats caused no abnormalities, suggesting no adverse effect of rare sugar syrup. In humans, the acute non-effect level of rare sugar syrup for causing diarrhea was estimated as 0.9 g/kg body weight as dry solid base in both males and females.

  5. A case of acute diarrhea due to the emerging pathogen Campylobacter jejuni subsp. doylei in Southern Chile Um caso de diarréia aguda devido ao patógeno emergente Campylobacter jejuni subsp. doylei no sul do Chile

    Directory of Open Access Journals (Sweden)

    Heriberto Fernández

    2003-04-01

    Full Text Available The first documented case of acute diarrhea due to C. jejuni subsp. doylei in Chile is reported. The clinical findings, the absence of other enteropathogens, virus or parasites and the fact that C. jejuni subsp. doylei was the only bacteria isolated support the assumption that it was the etiological agent of this diarrheal case.O primeiro caso documentado de diarréia aguda por C. jejuni subsp. doylei no sul do Chile é apresentado. As características clínicas, a ausência de outros enteropatógenos, vírus ou parasitas, e o fato de C. jejuni subsp. doylei ter sido a única bactéria isolada, permitem assumir que este microrganismo é o agente etiológico neste caso de diarréia.

  6. ACUTE INTESTINAL INFECTIONS: THERAPEUTICAL TACTICS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    A.N. Surkov

    2011-01-01

    Full Text Available Acute intestinal infections are quite common among children. Their clinical presentations include intoxication syndrome (drowsiness, low appetite, fever etc, infectious toxic syndrome (toxicosis with exicosis, neurotoxicosi, hypovolemic or infectious-toxic shockand diarrhea syndrome. Sometimes intestinal infections can be quite severe and even lethal. However disease duration and outcome depend on timelines and adequacy of prescribed treatment. Main guidelines of intestinal infections treatment include probiotics. That is why the right choice of probiotics is important for a pediatrician. The article contains basic information upon etiopathogenesis, classification, diagnostic criteria and acute pediatric intestinal infections treatment guidelines.Key words: acute intestinal infections, etiopathogenesis, diagnostic criteria, treatment, probiotics, children. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6: 141–147

  7. Chronic Diarrhea in Children

    Science.gov (United States)

    ... stool tests, blood tests, hydrogen breath tests, and fasting tests. Treatment How doctors treat chronic diarrhea in ... The digestive system is made up of the gastrointestinal (GI) tract-also called the digestive tract-and ...

  8. Characteristics of Rotavirus Diarrhea in Hospitalized Children in Kosovo

    Science.gov (United States)

    Ismaili-Jaha, Vlora; Shala, Muje; Azemi, Mehmedali; Hoxha-Kamberi, Teuta; Avdiu, Muharrem; Spahiu, Shqipe; Jaha, Luan

    2014-01-01

    Background: Diarrhea is a leading cause of child mortality worldwide. Rotavirus is one of the most common causes of severe diarrhea and dehydration in children. Authors reviewed epidemiological and clinical data of the rotavirus diarrhea in Kosovo. Methods: This is a prospective study carried between January 1st and December 31st 2011. All data, comprising demographics, nutrition, clinical presentation, laboratory findings, management and outcome of the rotavirus diarrhea are collected on the specially designed form. Results: 116 children with rotavirus diarrhea are included in the study. The majority boys (74.4%) and children aged 0 – 12 months (82.75%). Mean age of children in the study was 16.38 months. Almost every third child in the study was hypotrophic (29.2%). More than half of the infants (55.2%) were on mixed food, somewhat more than every third was breast feeding (36.45%), and every twelfth (8.33%) was on artificial milk (animal or formula). Apart from diarrhea, present in all patients, vomiting (97.41%) and fever (43.96%) were characteristics of the clinical presentation of the diarrhea. Two thirds of the children had mild grade dehydration (70.7%). All patients recovered with no sequels. Conclusion: Rotavirus continues to be responsible for a significant portion of acute diarrhea in Kosovo. Clinical features, epidemiological data and the agglutination test are safe enough to establish the diagnosis. Treated correctly rotavirus diarrhea has a favorable outcome. PMID:25568634

  9. Acute extrahepatic infectious or inflammatory diseases are a cause of transient mosaic pattern on CT and MR imaging related to sinusoidal dilatation of the liver

    International Nuclear Information System (INIS)

    Ronot, Maxime; Vilgrain, Valerie; Kerbaol, Anne; Rautou, Pierre-Emmanuel; Valla, Dominique-Charles; Brancatelli, Giuseppe; Bedossa, Pierre; Cazals-Hatem, Dominique

    2016-01-01

    To report the association of a mosaic enhancement pattern on contrast-enhanced CT or MR imaging and hepatic sinusoidal dilatation (SD) with acute inflammatory conditions affecting extrahepatic organs. From 2007 to 2012, patients with acute inflammatory diseases who underwent contrast-enhanced CT and/or MRI of the liver with a mosaic enhancement pattern were selected. Clinico-biological and other imaging features were collected at diagnosis and during follow-up. Sixteen patients were included (15 women, median age 27 years; range 18-68). Five women (33 %) were receiving oral contraceptives. Acute inflammatory diseases included pyelonephritis (n = 10), pancreatitis (n = 2), pneumonia (n = 1), septicemia (n = 1), active Crohn's disease (n = 1), and infectious colitis (n = 1). Median white blood cell count was 13,250 cells/μL (range 11,500-18,000 cells/μL) and CRP level 94 mg/L (range 60-121 mg/L). Mosaic enhancement pattern was present in the whole liver and was prominent in the subcapsular areas. Four patients underwent liver biopsy confirming SD. Eleven patients underwent follow-up imaging showing normalized aspect in 9/11 patients after a median of 2 months. Acute diseases of extrahepatic organs, associated with a marked systemic inflammatory syndrome should be added to the list of conditions causing a reversible hepatic sinusoidal dilatation as manifested by a mosaic enhancement pattern on contrast-enhanced CT or MR imaging. (orig.)

  10. [Observation on clinical efficacy of Baoerkang san on spleen-deficiency and dampness-obstructing diarrhea in children].

    Science.gov (United States)

    Zhang, Li-xue

    2015-04-01

    The study aims to observe the clinical efficacy of Baoerkang san on spleen-deficiency and dampness-obstructing diarrhea in children. Children diarrhea divided into acute diarrhea (group I) and chronic persistent diarrhea (group II). A randomized, double-blind, positive control test was conducted for dose finding. The 340 cases with acute diarrhea in group I were divided into three groups: the high dose group (112 patients), the low dose group (113 patients) and the positive control group (115 patients), which were treated for 3 days. Their clinical efficacies were compared to evaluate the clinical safety of Baoerkang san. The 167 patients with chronic persistent diarrhea in group If were divided into the high dose group (56 patients), the low dose group (55 patients) and the control group (56 patients), which were treated for 5 days. Their clinical efficacy were compared to evaluate the clinical safety of Baoerkang san. According to the results, the cure rate and the effective rate of acute diarrhea and chronic persistent diarrhea in the high dose group and the low dose group were significantly higher than that of the positive control group (P diarrhea with traditional Chinese medicines, the cure rate and the effective rate of acute diarrhea and chronic persistent diarrhea in the high dose group and the low dose group were significantly higher than that of the positive control group (P diarrhea and chronic persistent diarrhea (spleen-deficiency and dampness-obstructing) and safe clinical application.

  11. Failure of Syndrome-Based Diarrhea Management Guidelines to Detect Shigella Infections in Kenyan Children.

    Science.gov (United States)

    Pavlinac, P B; Denno, D M; John-Stewart, G C; Onchiri, F M; Naulikha, J M; Odundo, E A; Hulseberg, C E; Singa, B O; Manhart, L E; Walson, J L

    2016-12-01

    Shigella is a leading cause of childhood diarrhea mortality in sub-Saharan Africa. Current World Health Organization guidelines recommend antibiotics for children in non cholera-endemic areas only in the presence of dysentery, a proxy for suspected Shigella infection. To assess the sensitivity and specificity of the syndromic diagnosis of Shigella-associated diarrhea, we enrolled children aged 6 months to 5 years presenting to 1 of 3 Western Kenya hospitals between November 2011 and July 2014 with acute diarrhea. Stool samples were tested using standard methods for bacterial culture and multiplex polymerase chain reaction for pathogenic Escherichia coli. Stepwise multivariable logit models identified factors to increase the sensitivity of syndromic diagnosis. Among 1360 enrolled children, median age was 21 months (interquartile range, 11-37), 3.4% were infected with human immunodeficiency virus, and 16.5% were stunted (height-for-age z-score less than -2). Shigella was identified in 63 children (4.6%), with the most common species being Shigella sonnei (53.8%) and Shigella flexneri (40.4%). Dysentery correctly classified 7 of 63 Shigella cases (sensitivity, 11.1%). Seventy-eight of 1297 children without Shigella had dysentery (specificity, 94.0%). The combination of fecal mucous, age over 23 months, and absence of excessive vomiting identified more children with Shigella-infection (sensitivity, 39.7%) but also indicated antibiotics in more children without microbiologically confirmed Shigella (specificity, 82.7%). Reliance on dysentery as a proxy for Shigella results in the majority of Shigella-infected children not being identified for antibiotics. Field-ready rapid diagnostics or updated evidence-based algorithms are urgently needed to identify children with diarrhea most likely to benefit from antibiotic therapy. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions

  12. Infectious Diseases

    Science.gov (United States)

    ... But some of them can make you sick. Infectious diseases are diseases that are caused by germs. There ... many different ways that you can get an infectious disease: Through direct contact with a person who is ...

  13. Control of radiation-induced diarrhea with cholestyramine

    International Nuclear Information System (INIS)

    Heusinkveld, R.S.; Manning, M.R.; Aristizabal, S.A.

    1978-01-01

    Cholestyramine is a non-absorbable ion-exchange resin which specifically binds bile salts. We have treated seven patients with acute or chronic radiation-induced diarrhea that was refractory to the usual methods of control with cholestyramine. In each case, the diarrhea was controlled with cholestyramine. This observation supports previous experimental work with animals which indicated that bile salts contribute to the genesis of radiation-induced diarrhea. Cholestyramine is well-tolerated, but should not be administered with certain oral medications. The results of this small series are preliminary, but point the way toward a more extensive clinical trial to define the usefulness of cholestyramine in the treatment of refractory acute or chronic radiation-induced diarrhea

  14. Comparison of acute infection of calves exposed to a high-virulence or low-virulence bovine viral diarrhea virus or a HoBi-like virus

    Science.gov (United States)

    The objective of this research was to compare clinical presentation following acute infection of cattle with either a high virulence (HV) BVDV or a low virulence (LV) BVDV to clinical presentation following infection with a viral strain that belongs to an emerging species of pestivirus. The viral st...

  15. Antibiotic-Associated Diarrhea

    Science.gov (United States)

    ... antibiotic-associated colitis, which can occur after the antibiotic therapy upsets the balance of good and bad bacteria in your intestinal tract. Besides loose stools, C. difficile infection can ... and symptoms of antibiotic-associated diarrhea. These signs and symptoms are common ...

  16. Incidence of Norovirus-Associated Diarrhea and Vomiting Disease Among Children and Adults in a Community Cohort in the Peruvian Amazon Basin.

    Science.gov (United States)

    Romero, Candice; Tinoco, Yeny O; Loli, Sebastian; Razuri, Hugo; Soto, Giselle; Silva, María; Galvan, Patricia; Kambhampati, Anita; Parashar, Umesh D; Kasper, Matthew R; Bausch, Daniel G; Simons, Mark P; Lopman, Benjamin

    2017-09-01

    Data on norovirus epidemiology among all ages in community settings are scarce, especially from tropical settings. We implemented active surveillance in 297 households in Peru from October 2012 to August 2015 to assess the burden of diarrhea and acute gastroenteritis (AGE) due to norovirus in a lower-middle-income community. During period 1 (October 2012-May 2013), we used a "traditional" diarrhea case definition (≥3 loose/liquid stools within 24 hours). During period 2 (June 2013-August 2015), we used an expanded case definition of AGE (by adding ≥2 vomiting episodes without diarrhea or 1-2 vomiting episodes plus 1-2 loose/liquid stools within 24 hours). Stool samples were tested for norovirus by reverse-transcription polymerase chain reaction. During period 1, overall diarrhea and norovirus-associated diarrhea incidence was 37.2/100 person-years (PY) (95% confidence interval [CI], 33.2-41.7) and 5.7/100 PY (95% CI, 3.9-8.1), respectively. During period 2, overall AGE and norovirus-associated AGE incidence was 51.8/100 PY (95% CI, 48.8-54.9) and 6.5/100 PY (95% CI, 5.4-7.8), respectively. In both periods, children aged <2 years had the highest incidence of norovirus. Vomiting without diarrhea occurred among norovirus cases in participants <15 years old, but with a higher proportion among children <2 years, accounting for 35% (7/20) of all cases in this age group. Noroviruses were identified in 7% (23/335) of controls free of gastroenteric symptoms. Norovirus was a significant cause of AGE in this community, especially among children <2 years of age. Inclusion of vomiting in the case definition resulted in a 20% improvement for detection of norovirus cases. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  17. Estimating the Incidence of Acute Infectious Intestinal Disease in the Community in the UK: A Retrospective Telephone Survey.

    Directory of Open Access Journals (Sweden)

    Laura Viviani

    Full Text Available To estimate the burden of intestinal infectious disease (IID in the UK and determine whether disease burden estimations using a retrospective study design differ from those using a prospective study design.A retrospective telephone survey undertaken in each of the four countries comprising the United Kingdom. Participants were randomly asked about illness either in the past 7 or 28 days.14,813 individuals for all of whom we had a legible recording of their agreement to participate.Self-reported IID, defined as loose stools or clinically significant vomiting lasting less than two weeks, in the absence of a known non-infectious cause.The rate of self-reported IID varied substantially depending on whether asked for illness in the previous 7 or 28 days. After standardising for age and sex, and adjusting for the number of interviews completed each month and the relative size of each UK country, the estimated rate of IID in the 7-day recall group was 1,530 cases per 1,000 person-years (95% CI: 1135-2113, while in the 28-day recall group it was 533 cases per 1,000 person-years (95% CI: 377-778. There was no significant variation in rates between the four countries. Rates in this study were also higher than in a related prospective study undertaken at the same time.The estimated burden of disease from IID varied dramatically depending on study design. Retrospective studies of IID give higher estimates of disease burden than prospective studies. Of retrospective studies longer recall periods give lower estimated rates than studies with short recall periods. Caution needs to be exercised when comparing studies of self-reported IID as small changes in study design or case definition can markedly affect estimated rates.

  18. Infectious disease

    Science.gov (United States)

    Pierson, Duane L.

    1990-01-01

    This is a collection of viewgraphs on the Johnson Space Center's work on infectious disease. It addresses their major concern over outbreaks of infectious disease that could jeopardize the health, safety and/or performance of crew members engaged in long duration space missions. The Antarctic environment is seen as an analogous location on Earth and a good place to carry out such infectious disease studies and methods for proposed studies as suggested.

  19. Risk Factor Analysis May Provide Clues to Diarrhea Prevention in Outdoor-Housed Rhesus Macaques (Macaca mulatta)

    OpenAIRE

    PRONGAY, KAMM; PARK, BYUNG; MURPHY, STEPHANIE J.

    2013-01-01

    Seventy-five percent of rhesus macaques at national primate research centers are housed outside. Annually, 15–39% of these animals experience diarrhea and require veterinary treatment for dehydration, electrolyte imbalance, or weight loss. An estimated 21–33% of these patients will die or be euthanized. Many studies have explored the various infectious etiologies of non-human primate diarrhea. However, there is little published information on diarrhea incidence rates and risk factors in outdo...

  20. Alimentación sostenida durante diarrea aguda en niños menores de cinco años Sustained feeding during acute diarrhea in children younger than five years of age

    Directory of Open Access Journals (Sweden)

    HOMERO MARTÍNEZ-SALGADO

    1998-03-01

    Full Text Available Objetivo. Identificar alimentos locales con aceptabilidad cultural para nutrir a niños con diarrea aguda y probar su aceptación e impacto sobre el peso corporal en niños enfermos. Material y métodos. Se entrevistó a 142 madres de niños menores de cinco años en comunidades rurales, para conformar dietas culturalmente aceptables mediante sorteo de grupos, desplegado en un diagrama multidimensional. Se hizo un ensayo sobre el curso clíniño de 54 niños de 4-50 meses de edad cursando las primeras 48 horas de un episodio diarreico, quienes recibieron las dietas desarrolladas. Resultados. Se diseñaron dietas de acuerdo con la edad del niño y con el tiempo de evolución de la enfermedad. En las 47.6 ± 22.2 horas que permanecieron hospitalizados, los niños consumieron 44.8 ± 28.6 kcal/kg/día (además de la leche materna y ganaron 70.6 ± 179.7 g. Hubo una relación directa entre mayor edad y mayor consumo calórico, y entre éste y mayor ganancia de peso. Conclusiones. Los niños mostraron buena aceptabilidad a las dietas ofrecidas, de tal manera que se evitó la pérdida de peso.Objective. To identify locally available and culturally acceptable foods for children with acute diarrhea, and test their acceptance and effect on the childís weight. Material and methods. 142 mothers of children younger than five years of age living in rural communities were interviewed to indentify culturally accepted diets by means of group sorting. These were displayed in a multidimensional scale. A descriptive study was performed of the clinical course of 54 children, ages 4 to 50 months who received the designed diets during the first 48 hours of diarrhea. Results. The designed diets considered age of the child, and stage of the disease. Children spent 47.6 ± 22.2 h in the hospital during which they consumed 44.8 ± 28.6 kcal/kg/day (additional to breast milk and they gained 70.6 ± 179.7 g. A direct relationship was observed between increasing age and

  1. Creencias y conocimientos de un grupo de médicos sobre el manejo de la alimentación del niño con diarrea aguda Physicians' beliefs and knowledge on dietary management of children with acute diarrhea

    Directory of Open Access Journals (Sweden)

    Martha Corral-Terrazas

    2002-07-01

    Full Text Available Objetivo. Identificar las creencias y conocimientos de un grupo de médicos rurales sobre el manejo de alimentación en los casos de diarrea aguda de los menores de cinco años y compararlos con la recomendación de la Organización Mundial de la Salud (OMS. Material y métodos. Se realizó un estudio de antropología cognitiva con los 10 médicos que brindan atención a la población infantil en el Hospital Rural del IMSS-Solidaridad de San Juanito, Bocoyna, Chihuahua, México, de julio a diciembre de 1998. Se trianguló la información obtenida por las técnicas de grupos focales, viñetas, listado libre, sorteo de montones y cuestionario semiestructurado. Resultados. Los médicos reconocieron el impacto negativo de la diarrea sobre el estado nutricio del niño, pero no todos evaluaron su estado de nutrición. Como tratamientos predominaron los antimicrobianos, el manejo con líquidos y las recomendaciones sobre alimentación. De éstas, las más consistentes fueron la lactancia materna, la alimentación tardía y la dieta "escalonada". Conclusiones. La información obtenida contrasta con la recomendación de la OMS, en especial con la de alimentación sostenida.Objective. To identify the beliefs and knowledge of a group of rural physicians on the dietary management of children under five years of age, with acute diarrhea. Physicians' dietary management was compared with that recommended by the World Health Organization. Material and Methods. A cognitive anthropology study was carried out from July to December 1998, on ten physicians that care for the infant population ascribed to Hospital Rural IMSS-Solidaridad of San Juanito Bocoyna, Chihuahua, Mexico. Data were collected through focus groups, case vignettes, free listing, pile sorting, and a semi-structured questionnaire, and then cross-referred. Results. The physicians recognized the negative impact of diarrhea on the nutritional state of the child, but not all of them evaluated this state

  2. Post-irradiation diarrhea

    International Nuclear Information System (INIS)

    Meerwaldt, J.H.

    1984-01-01

    In radiotherapy of pelvic cancers, the X-ray dose to be delivered to the tumour is limited by the tolerance of healthy surrounding tissue. In recent years, a number of serious complications of irradiation of pelvic organs were encountered. Modern radiotherapy necessitates the acceptance of a calculated risk of complications in order to achieve a better cure rate. To calculate these risks, one has to know the radiation dose-effect relationship of normal tissues. Of the normal tissues most at risk when treating pelvic tumours only the bowel is studied. In the literature regarding post-irradiation bowel complications, severe and mild complications are often mixed. In the present investigation the author concentrated on the group of patients with relatively mild symptoms. He studied the incidence and course of post-irradiation diarrhea in 196 patients treated for carcinoma of the uterine cervix or endometrium. The aims of the present study were: 1) to determine the incidence, course and prognostic significance of post-irradiation diarrhea; 2) to assess the influence of radiotherapy factors; 3) to study the relation of bile acid metabolism to post-irradiation diarrhea; 4) to investigate whether local factors (reservoir function) were primarily responsible. (Auth.)

  3. Infectious Diseases

    International Development Research Centre (IDRC) Digital Library (Canada)

    While recent infectious disease events have helped mobilize large amounts of funding and expertise to address pandemic preparedness and vaccine research, many infectious diseases, particularly those affecting the poor, have been neglected. The complexity of environmental diseases like Chagas and dengue defy ...

  4. Comparison of Culture, Cytotoxin Assay and Two Eia Tests with Clinical Diagnosis of Clostridium difficile-Associated Diarrhea

    Directory of Open Access Journals (Sweden)

    Marilyn Binning

    1994-01-01

    Full Text Available Objective: The most common etiology of infectious diarrhea in hospitalized patients is Clostridium difficile. No single laboratory test yields a definitive diagnosis. Four methods were evaluated for their sensitivity and specificity in patients who had clinically defined C difficile-associated diarrhea.

  5. Detection of toxin genes in Escherichia coli isolated from normal dogs and dogs with diarrhea.

    OpenAIRE

    Hammermueller, J; Kruth, S; Prescott, J; Gyles, C

    1995-01-01

    The etiology of acute, nonviral diarrhea in dogs is poorly understood. Enterotoxigenic and verotoxigenic Escherichia coli are causal agents of diarrhea in humans, pigs, and cattle, but the association of these toxigenic E. coli with diarrhea in dogs has not been explored to a significant extent. In this study, DNA hybridization and PCR amplification were used to identify the frequency with which the genes for E. coli enterotoxins (STap, STb, and LTI) and verotoxins (VT1 and VT2) occur in asso...

  6. Fatores de risco para internamento por diarréia aguda em menores de dois anos: estudo de caso-controle Risk factors for hospitalization due to acute diarrhea in children under two years old: a case-control study

    Directory of Open Access Journals (Sweden)

    Lygia Carmen de Moraes Vanderlei

    2003-04-01

    Full Text Available O objetivo deste estudo foi investigar a associação entre determinantes sócio-econômico-demográficos e biológicos e hospitalização por diarréia aguda (DA em menores de dois anos. Utilizou-se estudo tipo caso-controle de base hospitalar no período de maio a outubro de 1997, em hospital pediátrico de nível terciário em Recife, Pernambuco. Os casos (n = 185 foram crianças internadas por DA e os controles (n = 185 foram crianças com doenças ambulatoriais, exceto diarréia, que tinham apresentado a doença nos últimos 15 dias, atendidas no mesmo local e período. Utilizaram-se os programas Epi Info e Stata para a análise dos dados. Foram calculados o odds ratio e os intervalos de confiança de 95% por meio da técnica de regressão logística múltipla, para o controle dos fatores de confusão, considerando um modelo hierarquizado dos fatores de risco. A investigação mediante o modelo proposto mostrou existência de associação entre internamento por DA e piso de terra ou tábua, paridade das mães igual a cinco ou mais filhos, criança menor de seis meses e gravidade dos episódios, que depende da interação entre condições sócio-econômicas desfavoráveis, baixa idade das crianças e episódio diarréico grave.The aim of this study was to investigate the socioeconomic, demographic, and biological determinants of hospitalization due to acute diarrhea (AD in children under two years old. The hospital-based, case-control study was conducted from May to October 1997 in a pediatric hospital in Recife, Pernambuco, Brazil. Cases (n = 185 were children hospitalized due to AD, and controls (n = 185 were children with various diseases (except AD presenting in the previous 15 days in the same area and time period. Data analysis used the Epi Info and Stata software. Odds ratios and 95% confidence intervals were calculated by multiple logistic regression to control confounding factors, considering a hierarchical risk factor model

  7. Role of octreotide in chemo and radiotherapy induced diarrhea

    International Nuclear Information System (INIS)

    Farooqi, J.I.; Farooqi, R. J.

    2000-01-01

    An international, quasi-experimental, clinical trial of 'before-and-after type' was conducted to find out the role of octreotide in chemo and radiotherapy-induced diarrhea on thirty patients. Among these 19 patients had advanced cancer and 11 with acute leukemia. All patients were given IV fluids and Loperamide for 5 days. The patients who did not respond during this period were administered with octreotide subcutaneously for another 5 days and response against diarrhea was noted. We found that only 10% patients responded to loperamide therapy whereas in the remaining 90% patients an excellent response was noted as 96.29% of these patients responded to octreotide therapy which stopped their diarrhea (P<0.005) leading us to the conclusion that, octreotide is a safe and effective drug in the management of chemo and radiotherapy-induced diarrhea. (author)

  8. [Chronic diarrhea with uncommon etiology].

    Science.gov (United States)

    Gil Borrás, R; Juan Vidal, O; Talavera Encinas, M I; Bixquert Jiménez, M

    2005-03-01

    Chronic diarrhea is a common syndrome. An etiological diagnosis is often reached through clinical history, physical examination and simple tests. In some cases, when the etiology is not found, the syndrome is called functional diarrhea, even though established criteria are often not fulfilled. We present the case of a patient with diarrhea for several months. The most common causes were ruled out through clinical history, physical examination, radiographic studies and laboratory tests, and the patient was diagnosed with functional diarrhea. Three months later, the patient presented a neck mass, and biopsy revealed medullary carcinoma of the thyroid. A review of recommendations for the systematic evaluation of chronic diarrhea is presented. A general approach should include careful history taking characteristics of diarrhea (onset, associated symptoms, epidemiological factors, iatrogenic causes such as laxative ingestion), a thorough physical examination with special attention to the anorectal region, and routine laboratory tests (complete blood count and serum chemistry). In addition, stool analysis including electrolytes (fecal osmotic gap), leukocytes, fecal occult blood, excess stool fat and laxative screening can yield important objective information to classify the diarrhea as: osmotic (osmotic gaps > 125 mOsm/Kg), secretory (osmotic gaps diarrhea described above. A systematic approach to the evaluation of chronic diarrhea is warranted. Medullary thyroid carcinoma and other endocrine syndromes causing chronic diarrhea are very rare. Measurement of serum peptide concentrations should only be performed when clinical presentation and findings in stool or radiographic studies suggest this etiology.

  9. High Frequency of Enteric Protozoan, Viral, and Bacterial Potential Pathogens in Community-Acquired Acute Diarrheal Episodes: Evidence Based on Results of Luminex Gastrointestinal Pathogen Panel Assay

    OpenAIRE

    Hawash, Yousry A.; Ismail, Khadiga A.; Almehmadi, Mazen

    2017-01-01

    Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses...

  10. A comprehensive systematic review of healthcare workers' perceptions of risk from exposure to emerging acute respiratory infectious diseases and the perceived effectiveness of strategies used to facilitate healthy coping in acute hospital and community healthcare settings.

    Science.gov (United States)

    Yiwen, Koh; Hegney, Desley; Drury, Vicki

    2010-01-01

    Emerging acute respiratory infectious diseases, such as Severe Acute Respiratory Syndrome (SARS) and the Avian Influenza A/H5N1 virus are contagious with high morbidity and mortality rates. Hence, health care workers, who are in close contact with affected patients, face many risks. There need to be a greater understanding of: individual HCWs' risk perceptions; adopted risk-mitigating strategies; and factors influencing both. This review aimed to establish the best evidence regarding health care worker's risk perceptions and workplace strategies towards emerging acute respiratory infectious diseases in acute hospital and community healthcare settings; and to make recommendations for practice and future research. Participants Studies that included male and female health care workers practising in acute and community health care settings were considered.Types of intervention (s)/Phenomena of interest This review considered studies that investigated: health care workers' risk perceptions; perceived meaning/effectiveness of the individual and workplace strategies implemented; and the factors influencing both.Types of outcomes This review focused on factors affecting: health care worker' risk perceptions; use of risk-mitigating strategies; and their perceived meaning and effectiveness.Types of studies Both qualitative and quantitative study designs published in the English language were including in the study. Using a three-step search strategy, the following databases from 1997-2009 were accessed: CINAHL, PubMed, SCOPUS, ScienceDirect, Sociological Abstracts, PsycINFO, and Web of Science. Two independent reviewers assessed each paper for methodological validity prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute. Disagreements were resolved through discussion, or with a third reviewer. Information was extracted by two independent reviewers from each paper using the standardised data extraction tools from

  11. [The input of graduates of Russian military medical academies into fight against acute infectious diseases in pre-revolutionary Dagestan].

    Science.gov (United States)

    2011-01-01

    The population study permitted to establish the role of Russian military physicians in organization of medical business in Dagestan. The prevalence of acute epidemiologic diseases in pre-revolutionary Dagestan is examined. It is derived that mass propagation of infections was supported by cultural and economic backwardness, non-sanitary conditions in cities, lifestyle of mountain dwellers. The tradition to visit ill fellow villager resulted into mass morbidity and even in death collapse of entire population of mountain settlements (auls). The positive conditions to develop medical business developed after Dagestan joined Russia. The activities of Russian military physicians in the Caucasus coincided with the full swing of various infection epidemics among soldiers and residents. The measures undertaken by Russian military physicians permitted to liquidate the epidemics.

  12. Tissue Sites of Persistent Infection and Active Replication of Equine Infectious Anemia Virus during Acute Disease and Asymptomatic Infection in Experimentally Infected Equids

    Science.gov (United States)

    Harrold, Sharon M.; Cook, Sheila J.; Cook, R. Frank; Rushlow, Keith E.; Issel, Charles J.; Montelaro, Ronald C.

    2000-01-01

    Equine infectious anemia virus (EIAV) infection of horses is characterized by recurring cycles of disease and viremia that typically progress to an inapparent infection in which clinical symptoms are absent as host immune responses maintain control of virus replication indefinitely. The dynamics of EIAV viremia and its association with disease cycles have been well characterized, but there has been to date no comprehensive quantitative analyses of the specific tissue sites of EIAV infection and replication in experimentally infected equids during acute disease episodes and during asymptomatic infections in long-term inapparent carriers. To characterize the in vivo site(s) of viral infection and replication, we developed a quantitative competitive PCR assay capable of detecting 10 copies of viral DNA and a quantitative competitive reverse transcription-PCR assay with a sensitivity of about 30 copies of viral singly spliced mRNA. Animals were experimentally infected with one of two reference viruses: the animal-passaged field isolate designated EIAVWyo and the virulent cell-adapted strain designated EIAVPV. Tissues and blood cells were isolated during the initial acute disease or from asymptomatic animals and analyzed for viral DNA and RNA levels by the respective quantitative assays. The results of these experiments demonstrated that the appearance of clinical symptoms in experimentally infected equids coincided with rapid widespread seeding of viral infection and replication in a variety of tissues. During acute disease, the predominant cellular site of viral infection and replication was the spleen, which typically accounted for over 90% of the cellular viral burden. In asymptomatic animals, viral DNA and RNA persisted in virtually all tissues tested, but at extremely low levels, a finding indicative of tight but incomplete immune control of EIAV replication. During all disease states, peripheral blood mononuclear cells (PBMC) were found to harbor less than 1% of

  13. Vibrio parahaemolyticus: A Rare Cause of Chronic Diarrhea in a Heart Transplant Patient

    OpenAIRE

    Shuja, Asim; Dickstein, Aaron; Lee, Hannah M.

    2014-01-01

    Vibrio parahaemolyticus usually causes a self-limiting acute diarrheal illness, and is rarely tested for in cases of chronic diarrhea. We present a rare case of chronic diarrhea caused by V. parahaemolyticus in a heart transplant patient requiring antibiotic treatment.

  14. Hidratación oral continua o a dosis fraccionadas en niños deshidratados por diarrea aguda Oral rehydration in continuous administration or in fractionated doses in dehydrated children with acute diarrhea

    Directory of Open Access Journals (Sweden)

    Felipe Mota-Hernández

    2002-01-01

    Full Text Available Objetivo. Evaluar la seguridad y efectividad de dos técnicas de hidratación oral. Material y métodos. Ensayo clínico aleatorio, hecho en el Servicio de Hidratación Oral del Hospital Infantil de México, Federico Gómez, entre septiembre de 1998 y junio de 1999. Cuarenta pacientes deshidratados por diarrea aguda, menores de cinco años, recibieron suero oral ad libitum (grupo AL y otros cuarenta lo recibieron en dosis fraccionada (grupo DF. Las características clínicas fueron similares en ambos grupos. Los resultados se presentan como promedio y desviación estándar o mediana, según la distribución de frecuencias simples y relativas. Resultados. El promedio de gasto fecal en el grupo AL fue 11.0±7.5 g/kg/h y en el grupo DF 7.1±7.4 (p=0.03. La ingesta de suero, el tiempo de hidratación y la diuresis promedio, fueron similares entre ambos grupos (p>0.05. Seis pacientes del grupo AL y cinco del DF tuvieron gasto fecal alto (>10 g/kg/hora, mejorando con la administración de atole de arroz. Un paciente del grupo AL y dos pacientes del DF tuvieron vómitos persistentes, mejorando con gastroclisis. Ningún paciente requirió rehidratación intravenosa. Conclusiones. Estos resultados sugieren que la administración de suero oral ad libitum, bajo supervisión, es tan segura y efectiva como la técnica de dosis fraccionada para el tratamiento de niños deshidratados por diarrea aguda.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

  15. Diarrhea caused by circulating agents.

    Science.gov (United States)

    Fabian, Elisabeth; Kump, Patrizia; Krejs, Guenter J

    2012-09-01

    Circulating agents cause intestinal secretion or changes in motility with decreased intestinal transit time, resulting in secretory-type diarrhea. Secretory diarrhea as opposed to osmotic diarrhea is characterized by large-volume, watery stools, often more than 1 L per day; by persistence of diarrhea when patients fast; and by the fact that on analysis of stool-water, measured osmolarity is identical to that calculated from the electrolytes present. Although sodium plays the main role in water and electrolyte absorption, chloride is the major ion involved in secretion. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Prevention of infectious complications after laparoscopic appendectomy for complicated acute appendicitis--the role of routine abdominal drainage.

    Science.gov (United States)

    Allemann, Pierre; Probst, Herve; Demartines, Nicolas; Schäfer, Markus

    2011-01-01

    Complicated acute appendicitis is still associated with an increased morbidity. If laparoscopy has been accepted as a valid approach, some questions remain concerning intra-abdominal abscess formation. Routine prophylactic drainage of the abdomen has been proposed. However, this practice remains a matter of debate, poorly validated in the literature. With the present study, we investigated the impact of drainage in laparoscopic appendectomy for complicated appendicitis. This is a case match study of consecutive patients operated on by laparoscopy in a single institution. One hundred and thirty patients operated for complicated appendicitis (local peritonitis without perforation, with perforation, or with periappendicular abscess) with prophylactic intraperitoneal drainage were matched one by one to 130 patients operated without drainage. Uncomplicated appendicitis and generalized peritonitis were excluded. Primary endpoint was surgical complications and secondary endpoints were transit recovery time and length of hospital stay. Patients without drain had significantly less overall complications (7.7% vs. 18.5%, p = 0.01). Moreover, the absence of drainage was of significant benefit for transit recovery time (2.5 vs. 3.5 days, p = 0.0068) and length of hospital stay (4.2 vs. 7.3 days, p drainage of the abdominal cavity during emergency laparoscopic treatment of complicated appendicitis. For this reason, this practice may be abandoned.

  17. Bovine Virus Diarrhea (BVD)

    OpenAIRE

    Hoar, Bruce R.

    2004-01-01

    Bovine virus diarrhea (BVD) is a complicated disease to discuss as it can result in a wide variety of disease problems from very mild to very severe. BVD can be one of the most devastating diseases cattle encounter and one of the hardest to get rid of when it attacks a herd. The viruses that cause BVD have been grouped into two genotypes, Type I and Type II. The disease syndrome caused by the two genotypes is basically the same, however disease caused by Type II infection is often more severe...

  18. Infectious neuropathies.

    Science.gov (United States)

    Robinson-Papp, Jessica

    2012-02-01

    The purpose of this review is to address bacterial, viral, and other infectious causes of neuropathy or neuronopathy, with an emphasis on clinical manifestations and treatment. Most infectious neuropathies have been well described for some time and treatments are well established. An exception is HIV-associated distal symmetric polyneuropathy, which is an area of active research. Current work in this area focuses on epidemiology, risk factors, and underlying mechanisms. Infectious diseases are an important part of the differential diagnosis of peripheral nerve disorders because they are among the most amenable to treatment. However, diagnosis of infectious peripheral neuropathy may be challenging because of variability in a number of factors, including the pattern of deficits, geographic distribution of pathogens, length of time from the onset of infection to the development of neuropathy, and mechanism of nerve injury.

  19. Infectious Diseases

    Science.gov (United States)

    ... such as undercooked hamburger or unpasteurized fruit juice. Risk factors While anyone can catch infectious diseases, you may ... only minor complications. But some infections — such as pneumonia, AIDS and ... increased risk of cancer: Human papillomavirus is linked to cervical ...

  20. Infectious Arthritis

    Science.gov (United States)

    Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Infectious arthritis is an infection in the joint. The infection ...

  1. Dietary management of childhood diarrhea in low- and middle-income countries: a systematic review

    Science.gov (United States)

    2013-01-01

    Background Current WHO guidelines on the management and treatment of diarrhea in children strongly recommend continued feeding alongside the administration of oral rehydration solution and zinc therapy, but there remains some debate regarding the optimal diet or dietary ingredients for feeding children with diarrhea. Methods We conducted a systematic search for all published randomized controlled trials evaluating food-based interventions among children under five years old with diarrhea in low- and middle-income countries. We classified 29 eligible studies into one or more comparisons: reduced versus regular lactose liquid feeds, lactose-free versus lactose-containing liquid feeds, lactose-free liquid feeds versus lactose-containing mixed diets, and commercial/specialized ingredients versus home-available ingredients. We used all available outcome data to conduct random-effects meta-analyses to estimate the average effect of each intervention on diarrhea duration, stool output, weight gain and treatment failure risk for studies on acute and persistent diarrhea separately. Results Evidence of low-to-moderate quality suggests that among children with acute diarrhea, diluting or fermenting lactose-containing liquid feeds does not affect any outcome when compared with an ordinary lactose-containing liquid feeds. In contrast, moderate quality evidence suggests that lactose-free liquid feeds reduce duration and the risk of treatment failure compared to lactose-containing liquid feeds in acute diarrhea. Only limited evidence of low quality was available to assess either of these two approaches in persistent diarrhea, or to assess lactose-free liquid feeds compared to lactose-containing mixed diets in either acute or persistent diarrhea. For commercially prepared or specialized ingredients compared to home-available ingredients, we found low-to-moderate quality evidence of no effect on any outcome in either acute or persistent diarrhea, though when we restricted these

  2. A Systematic Review and Meta-analysis of the Association Between Giardia lamblia and Endemic Pediatric Diarrhea in Developing Countries

    Science.gov (United States)

    Muhsen, Khitam; Levine, Myron M.

    2012-01-01

    We performed a systematic literature review and meta-analysis examining the association between diarrhea in young children in nonindustrialized settings and Giardia lamblia infection. Eligible were case/control and longitudinal studies that defined the outcome as acute or persistent (>14 days) diarrhea, adjusted for confounders and lasting for at least 1 year. Data on G. lamblia detection (mainly in stools) from diarrhea patients and controls without diarrhea were abstracted. Random effects model meta-analysis obtained pooled odds ratios (ORs) and 95% confidence intervals (CIs). Twelve nonindustrialized-setting acute pediatric diarrhea studies met the meta-analysis inclusion criteria. Random-effects model meta-analysis of combined results (9774 acute diarrhea cases and 8766 controls) yielded a pooled OR of 0.60 (95% CI, .38–.94; P = .03), indicating that G. lamblia was not associated with acute diarrhea. However, limited data suggest that initial Giardia infections in early infancy may be positively associated with diarrhea. Meta-analysis of 5 persistent diarrhea studies showed a pooled OR of 3.18 (95% CI, 1.50–6.76; P diarrhea in children in developing countries. PMID:23169940

  3. Infectious abdominal emergencies

    International Nuclear Information System (INIS)

    Porcel, A.; Arrive, L.; Mehdi, M.; Monnier-Cholley, L.; Ayadi, K.; Tubiana, J.M.

    1996-01-01

    Infectious disease is a common cause of acute abdomen. The diagnosis is based on clinical examination and basic laboratory tests. However, medical imaging routinely performed according to the clinical findings is frequently useful. Hepatic and splenic abscesses are correctly demonstrated by ultrasonography and computed tomography. Ultrasonography is the reference standard for the diagnosis of acute cholecystitis. The US examination is also performed for the diagnosis of appendicitis and its complications. Ultrasonography and barium enema are commonly performed for the evaluation of sigmoid diverticulitis. Computed tomography is the reference standard to determine medical or surgical procedures. (authors). 20 refs., 15 figs

  4. Antibiotic Resistance in Children with Bloody Diarrhea

    Directory of Open Access Journals (Sweden)

    Hamedi Abdolkarim

    2009-05-01

    Full Text Available Shigellosis is an important public health problem, especially in developing countries. Antibiotic treatment of bacterial dysentery, aimed at resolving diarrhea or reducing its duration is especially indicated whenever malnutrition is present. First-line drugs include ampicillin and trimethoprim sulfamethoxazole(TMP-SMX; however multidrug-resistance has occurred and careful antibiotic selection must be considered in prescribing .When epidemiologic data indicate a rise in resistancy, fluoroquinolones may be used in adults and oral third-generation cephalosporins and nalidixic acid in children. All children (n=2400 with acute diarrhea who were admitted to the Pediatric department of Dr.sheykh Hospital Mashhad, Iran from March 2004 to March 2005 were selected and their stool culture were obtained, then positive cultures (312 cases,13% were evaluated by antibiogram. This study showed that in heavily populated areas of IRAN like Mashhad, 97% shigella strain isolated from children with bloody diarrhea were sensitive to nalidixic acid, ciprofloxacin and cefixime and rarely susceptible to ampicillin and cotrimoxazole. There is increasing resistance of Shigella to most of the antibiotics in use, and for this reason, careful selection of antibiotics must use considered in each area. Development and use of new drugs are expensive and have severe limitations in the third world. Simple prophylactic alternatives are therefore, required, such as awareness of hygienic child care practices and early promotion of breast feeding. For treatment of shigellosis in infants Ceftriaxon, and in children Nalidixic Acid is recommended.

  5. Diarrhea associated with typhoid fever

    NARCIS (Netherlands)

    Roy, S. K.; Speelman, P.; Butler, T.; Nath, S.; Rahman, H.; Stoll, B. J.

    1985-01-01

    To study the pathogenesis of diarrhea occurring with typhoid fever, we selected 42 patients with diarrhea and blood cultures positive for Salmonella typhi or Salmonella paratyphi A, but without diarrheal copathogens, for measurement of stool output and examination of fecal composition. The mean

  6. Investigation of Diarrhea in AIDS

    Directory of Open Access Journals (Sweden)

    Klaus E Mönkemüller

    2000-01-01

    Full Text Available Chronic diarrhea is a common problem in patients with acquired immune deficiency syndrome (AIDS, resulting in significant morbidity and potential mortality. In the early stages of immunodeficiency, human immunodeficiency virus (HIV-infected patients are susceptible to infection with the same enteric pathogens that cause diarrhea in immunocompetent hosts, but with progressive immunodeficiency, these patients become susceptible to numerous opportunistic disorders. The main factor to consider when tailoring the work-up of diarrhea in the HIV-infected patient is the immune status, which is reflected by the total CD4 lymphocyte cell count. A CD4 count of less than 100 cells/µL is significantly correlated with opportunistic disorders. For the HIV-infected patient with diarrhea, repeated stool studies to investigate for bacteria, ova and parasites should be the first step. When either upper or lower gastrointestinal tract symptoms are present and stool studies are negative, endoscopy directed to the probable organ of involvement is appropriate. If localizing symptoms are absent, the most appropriate next test is sigmoidoscopy with biopsies. Not infrequently, despite extensive evaluation, the cause of diarrhea in patients with AIDS remains unexplained. Recently, the widespread use of highly active antiretroviral therapy, including protease inhibitors, has led to a change in the epidemiology of diarrhea in AIDS patients. As their immune status improves, HIV-infected patients treated with combination therapy become less prone to opportunistic disorders. However, diarrhea appears to be frequent because several antiretroviral agents can themselves cause diarrhea.

  7. Characterization of norovirus-associated traveler's diarrhea.

    Science.gov (United States)

    Ajami, N; Koo, H; Darkoh, C; Atmar, R L; Okhuysen, P C; Jiang, Z-D; Flores, J; Dupont, H L

    2010-07-15

    Traveler's diarrhea is the most common medical complaint of international visitors to developing regions. Previous findings suggested that noroviruses (NoVs) are an underappreciated cause of traveler's diarrhea. METHODS. In the present study, we sought to define the presence of NoVs in 320 acute diarrheic stool samples collected from 299 US students who traveled to Guadalajara, Cuernavaca, or Puerto Vallarta, Mexico, during the period from 2007 through 2008. Conventional and quantitative real-time polymerase chain reaction assays were used to detect and determine NoV loads in stool samples. NoV strains were characterized by purification of viral RNA followed by sequencing of the viral capsid protein 1 gene. Sequences were compared using multiple sequence alignment, and phylogenetic trees were generated to evaluate the evolutionary relatedness of the viral strains associated with cases of traveler's diarrhea. NoV RNA was detected in 30 (9.4%) of 320 samples. Twelve strains belonged to genogroup I, and 18 strains belonged to genogroup II. NoV prevalence was higher in the winter season than in the summer season (23% vs 7%, respectively; P = .001). The cDNA viral loads of genogroup I viruses were found to be 500-fold higher than those of genogroup II strains. Phylogenetic analysis revealed a diverse population of NoV strains over different locations and years. NoV strains are important causes of traveler's diarrhea in Mexico, especially during the wintertime, and US students in Mexico may represent a suitable group for future NoV vaccine efficacy trials.

  8. Epidemiology and vaccine of porcine epidemic diarrhea virus in China: a mini-review.

    Science.gov (United States)

    Sun, Dongbo; Wang, Xinyu; Wei, Shan; Chen, Jianfei; Feng, Li

    2016-03-01

    Porcine epidemic diarrhea (PED) is an intestinal infectious disease caused by porcine epidemic diarrhea virus (PEDV); manifestations of the disease are diarrhea, vomiting and dehydration. Starting from the end of 2010, a PED outbreak occurred in several pig-producing provinces in southern China. Subsequently, the disease spread throughout the country and caused enormous economic losses to the pork industry. Accumulating studies demonstrated that new PEDV variants that appeared in China were responsible for the PED outbreak. In the current mini-review, we summarize PEDV epidemiology and vaccination in China.

  9. Digestive Disorders in Children with Antibiotic-Associated Diarrhea

    Directory of Open Access Journals (Sweden)

    O.A. Radutna

    2016-08-01

    Full Text Available Introduction. The most notable problem of the widespread use of antibiotics is the changes in microbial ecology, imbalance of intestinal biocenosis, the appearance of antibiotic-resistant strains of microorganisms with pathogenic properties and due to this the pathological changes in the intestine that cause symptoms of digestive disorders in patients with antibiotic-associated diarrhea. Objective. To identify the symptoms of malabsorption in order to improve early diagnosis of antibiotic-associated diarrhea in children. Materials and methods. The object of the study were 116 patients treated with antibiotics, aged 6 months to 18 years. The examination of children included clinical, biochemical, bacteriological, immunoenzyme, immunochromatographic, instrumental, mathematical methods. Results. In the development of diarrhea in patients with negative test on clostridial toxins, such cases were qualified as idiopathic antibiotic-associated diarrhea, with positive — like intestinal Clostridium difficile infection. The study revealed significant differences in scatological indices between the children with acute idiopathic and antibiotic-associated diarrhea caused by clostridial infection. During microscopic and biochemical studies of feces, we have revealed symptomatic signs of impaired digestion and absorption of fats and carbohydrates, which manifested by clinical symptoms of malabsorption. All children with antibiotic-associated diarrhea are characterized by increased concentrations of carbohydrates in feces. Signs of digestive disorders with the development of malabsorption of lipids were detected n children with antibiotic-associated diarrhea, primarily caused by Clostridium difficile infection. Conclusions. Maldigestion and lipid and carbohydrate absorption, as well as symptoms of inflammation in the intestines (leukocytes, occult blood, mucus are the markers of antibiotic-associated diarrhea and can be used for its early diagnosis

  10. A reliable, practical, and economical protocol for inducing diarrhea and severe dehydration in the neonatal calf.

    Science.gov (United States)

    Walker, P G; Constable, P D; Morin, D E; Drackley, J K; Foreman, J H; Thurmon, J C

    1998-07-01

    Fifteen healthy, colostrum-fed, male dairy calves, aged 2 to 7 d were used in a study to develop a diarrhea protocol for neonatal calves that is reliable, practical, and economical. After instrumentation and recording baseline data, diarrhea and dehydration were induced by administering milk replacer [16.5 mL/kg of body weight (BW), PO], sucrose (2 g/kg in a 20% aqueous solution, p.o.), spironolactone and hydrochlorothiazide (1 mg/kg, PO) every 8 h, and furosemide (2 mg/kg, i.m., q6h). Calves were administered sucrose and diuretic agents for 48 h to induce diarrhea and severe dehydration. Clinical changes after 48 h were severe watery diarrhea, severe depression, and marked dehydration (mean, 14% BW loss). Cardiac output, stroke volume, mean central venous pressure, plasma volume, thiocyanate space, blood pH and bicarbonate concentration, base excess, serum chloride concentration, and fetlock temperature were decreased. Plasma lactate concentration, hematocrit, and serum potassium, creatinine, phosphorus, total protein and albumin concentrations were increased. This non-infectious calf diarrhea protocol has a 100% response rate, while providing a consistent and predictable hypovolemic state with diarrhea that reflects most of the clinicopathologic changes observed in osmotic/maldigestive diarrhea caused by infection with rotavirus, coronavirus or cryptosporidia. Limitations of the protocol, when compared to infectious diarrhea models, include failure to induce a severe metabolic acidosis, absence of hyponatremia, renal instead of enteric loss of chloride, renal as well as enteric loss of free water, absence of profound clinical depression and suspected differences in the morphologic and functional effect on intestinal epithelium. Despite these differences, the sucrose/diuretic protocol should be useful in the initial screening of new treatment modalities for calf diarrhea. To confirm their efficacy, the most effective treatment methods should then be examined in

  11. Executive summary of imported infectious diseases after returning from foreign travel: Consensus document of the Spanish Society for Infectious Diseases and Clinical Microbiology (SEIMC).

    Science.gov (United States)

    Pérez-Arellano, José Luis; Górgolas-Hernández-Mora, Miguel; Salvador, Fernando; Carranza-Rodríguez, Cristina; Ramírez-Olivencia, Germán; Martín-Echeverría, Esteban; Rodríguez-Guardado, Azucena; Norman, Francesca; Velasco-Tirado, Virginia; Zubero-Sulibarría, Zuriñe; Rojo-Marcos, Gerardo; Muñoz-Gutierrez, José; Ramos-Rincón, José Manuel; Sánchez-Seco-Fariñas, M Paz; Velasco-Arribas, María; Belhassen-García, Moncef; Lago-Nuñez, Mar; Cañas García-Otero, Elías; López-Vélez, Rogelio

    2018-03-01

    In a global world, knowledge of imported infectious diseases is essential in daily practice, both for the microbiologist-parasitologist and the clinician who diagnoses and treats infectious diseases in returned travelers. Tropical and subtropical countries where there is a greater risk of contracting an infectious disease are among the most frequently visited tourist destinations. The SEIMC considers it appropriate to produce a consensus document that will be useful to primary care physicians as well as specialists in internal medicine, infectious diseases and tropical medicine who help treat travelers returning from tropical and sub-tropical areas with infections. Preventive aspects of infectious diseases and infections imported by immigrants are explicitly excluded here, since they have been dealt with in other SEIMC documents. Various types of professionals (clinicians, microbiologists, and parasitologists) have helped produce this consensus document by evaluating the available evidence-based data in order to propose a series of key facts about individual aspects of the topic. The first section of the document is a summary of some of the general aspects concerning the general assessment of travelers who return home with potential infections. The main second section contains the key facts (causative agents, diagnostic procedures and therapeutic measures) associated with the major infectious syndromes affecting returned travelers [gastrointestinal syndrome (acute or persistent diarrhea); febrile syndrome with no obvious source of infection; localized cutaneous lesions; and respiratory infections]. Finally, the characteristics of special traveler subtypes, such as pregnant women and immunocompromised travelers, are described. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  12. Sensitivity and Specificity of Procalcitonin to Determine Etiology of Diarrhea in Children Younger Than 5 Years

    Science.gov (United States)

    Ismaili-Jaha, Vlora; Shala, Mujë; Azemi, Mehmedali; Spahiu, Shqipe; Hoxha, Teuta; Avdiu, Muharrem; Spahiu, Lidvana

    2014-01-01

    Aim: The aim of this study is to assess the sensitivity and specificity of procalcitonin to determine bacterial etiology of diarrhea. The examinees and methods: For this purpose we conducted the study comprising 115 children aged 1 to 60 months admitted at the Department of Pediatric Gastroenterology, Pediatric Clinic, divided in three groups based on etiology of the diarrhea that has been confirmed with respective tests during the hospitalization. Each group has equal number of patients – 35. The first group was confirmed to have bacterial diarrhea, the second viral diarrhea and the third extra intestinal diarrhea. The determination of procalcitonin has been established with the ELFA methods of producer B.R.A.H.M.S Diagnostica GmbH, Berlin, (Germany). Results: From the total number of 1130 patient with acute diarrhea procalcitonin was assessed in 105. 67 (63.8%) of these patient were male. More than one third (38.14%) of the children in our study were younger then 12 months. Approximately the same was the number of children 13-24 months (33 patients or 31.43%) and 25-60 months (32 patients or 30.43%). The mean value of PRC in children with viral diarrhea was 0.13±0.5 ng/mL in children with bacterial diarrhea was 5.3±4.9 ng/m Land in children with extra intestinal diarrhea was 1.7±2.8 ng/mL. When measured using ANOVA and Turkey HSD tests, results have shown the statistical significance when comparing viral with bacterial and extra intestinal diarrhea but were statistically insignificant when comparing bacterial and extra intestinal diarrhea. Conclusion: Procalcitonin is an important but not conclusive marker of bacterial etiology of acute diarrhea in children younger than 5 years. PMID:24944526

  13. The effect of high-dose vitamin A supplementation given with bacille Calmette-Guérin vaccine at birth on infant rotavirus infection and diarrhea: a randomized prospective study from Guinea-Bissau

    DEFF Research Database (Denmark)

    Diness, Birgitte Rode; Christoffersen, Dorthe; Pedersen, Ulla Britt

    2010-01-01

    Prophylactic vitamin A supplementation (VAS) reduces mortality and may reduce morbidity associated with diarrhea in children >6 months of age. Rotavirus is the most common cause of acute dehydrating diarrhea among children worldwide.......Prophylactic vitamin A supplementation (VAS) reduces mortality and may reduce morbidity associated with diarrhea in children >6 months of age. Rotavirus is the most common cause of acute dehydrating diarrhea among children worldwide....

  14. Diarrhea incidence and intestinal infections among rotavirus vaccinated infants from a poor area in Brazil: a spatial analysis

    Science.gov (United States)

    2014-01-01

    Background Acute diarrhea is the second leading cause of mortality among children under 5 years of age in developing countries. The pathogen most strongly associated with diarrhea is rotavirus followed by enteric pathogens such as bacteria, helminthes and protozoan. Adequate sanitation and water supply contribute to decrease acute diarrhea incidence of most etiologic agents, although vaccination remains the most important intervention to control rotavirus acute diarrhea. This study aimed to describe environmental conditions and analyze spatially the acute diarrhea and intestinal infection among rotavirus vaccinated infants from Laranjeiras-Sergipe, Brazil. Methods Children were enrolled between 2 and 11 months of age and followed through 12 months. Demographic, socioeconomic and environmental data were obtained from a questionnaire, and immunization data were obtained from children vaccination card. Children stool samples were collected each month in order to run laboratory analyses. The household spatial localization was obtained by using a Global Positioning System (GPS). Spatial analysis was performed using the TerraView computer program and Kernel intensity estimation. Results A total of 1,113 stool samples were collected with 80 being diarrhea associated. Diarrhea incidence rate was 0.5 ± 1.0 episodes/child/year. The overall infection rates by Ascaris lumbricoides, Endolimax nana, Giardia lamblia and rotavirus were 5.1%, 3.0%, 0.9% and 2.6%, respectively. 3.8% of diarrhea-associated stool samples were positive for rotavirus and 11.3% were positive for helminths and protozoans. There were some changes on spatial distribution of intestinal infections and diarrhea episodes along the four trimesters evaluated. Conclusions The studied infants live equally in precarious conditions of sanitation which probably explain the significant rates of parasitic infections appearing in early life. The low acute diarrhea incidence in the studied rotavirus vaccinated

  15. Nutritional Status and Infectious Disease of Undernourished Children under five in Desa Cipacing, Jatinangor Subdistrict, West Java, from April to December 2012

    Directory of Open Access Journals (Sweden)

    Palomina Caesarea Nurhasanah

    2015-09-01

    Full Text Available Background: Undernutrition frequently occurs in children under five. If not treated, it will cause acute health effects and affect on cognitive development, social, physical work capacity and productivity. Undernutrition can be accompanied by the presence of infectious disease that can worsen the children’s nutritional status. This study aimed to describe the nutritional status and infectious disease of undernutrition children under five in Jatinangor Subdistrict. Methods: A qualitative study was carried out to 7 parents and undernourished children under five, in Desa Cipacing, Jatinangor. It was conducted from April to December 2012. The inclusion criterias were undernourished children under five with a history of infectious disease in the previous year, and the parents were willing to participate in this study. Exclusion criteria were parents and/or the children who were not at home when the collection of the data was conducted.. Data collection was conducted using measurement of nutritional status, in depth interview and environmental observation. The data were presented in tables, figures and narration. Results: Three subjects with undernutrition (-3SD to -2SD and four subjects with severe undernutrition (<-3SD. Factors affecting poor nutritional status were weight loss, no significant weight gain, diet and eating habit, and onset of disease. Commonly occurred infectious diseases were common cold, diarrhea, fever and cough. Some factors affecting infectious diseases were family member transmission, immunization, and treatment behavior. Conclusions: Poor nutritional status and infectious diseases contribute to undernutrition in children under five.

  16. Congenital chloride diarrhea: late presentation

    OpenAIRE

    Al Bishi, Laila; Mustafa,

    2011-01-01

    Laila Al Bishi1, Mustafa Al Toonisi2Pediatric Department, North West Armed Forces Hospital, Tabuk, Kingdom of Saudi ArabiaAbstract: We report the case of a male infant who presented with diarrhea at 6 months of age. He was failing to thrive, and biochemical investigation revealed hypokalemic hypochloremic metabolic alkalosis. Diagnosis of congenital chloride diarrhea was suspected and confirmed by the stool chloride result. He was started on high-dose sodium chloride and potassium chloride to...

  17. Metagenomic analysis of human diarrhea: viral detection and discovery.

    Directory of Open Access Journals (Sweden)

    Stacy R Finkbeiner

    2008-02-01

    Full Text Available Worldwide, approximately 1.8 million children die from diarrhea annually, and millions more suffer multiple episodes of nonfatal diarrhea. On average, in up to 40% of cases, no etiologic agent can be identified. The advent of metagenomic sequencing has enabled systematic and unbiased characterization of microbial populations; thus, metagenomic approaches have the potential to define the spectrum of viruses, including novel viruses, present in stool during episodes of acute diarrhea. The detection of novel or unexpected viruses would then enable investigations to assess whether these agents play a causal role in human diarrhea. In this study, we characterized the eukaryotic viral communities present in diarrhea specimens from 12 children by employing a strategy of "micro-mass sequencing" that entails minimal starting sample quantity (<100 mg stool, minimal sample purification, and limited sequencing (384 reads per sample. Using this methodology we detected known enteric viruses as well as multiple sequences from putatively novel viruses with only limited sequence similarity to viruses in GenBank.

  18. Particularly acute intestinal infections in children with atopic dermatitis. Case-control study

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    S. V. Khaliullina

    2016-01-01

    Full Text Available Aim — determine the clinical and laboratory features of acute intestinal infection in children, occurring in conjunction with atopic dermatitis (AD.Material and methods. We conducted a study of «case-control», which included observation of 144 children hospitalized in the infectious hospital with a clinic of acute infectious diarrhea in the period from January to December 2012. In the study group were selected 72 children with atopic dermatitis clinic and acute infectious diarrhea in a couple of which, from the group of patients without burdened premorbid background were selected 72 «controls» matched by sex, age and etiology developed acute intestinal infection. The observation time was 5±2 days, which corresponds to the average length of stay of the child, patients with moderate forms of acute intestinal infection in the hospital.Results and discussion. About 2 times more often than in the control, acute intestinal infections in children with atopic dermatitis lesions were characterized by clinic middle and lower gastrointestinal — 31.9% (CI 21,1–42,7 vs. 15.3% (CI 7–23 6, p=0.03. A number of bowel movements 6 or more times per day significantly more frequently observed in children with a combination of acute intestinal infections and atopic dermatitis — 54.1% (CI 42,6–65,6 vs. 33.3% (CI 22,4–43.9 in the control, p=0.011. The duration of diarrhea was higher in the study group (Med 6 IQR 4–7 days and Med 5 IQR 3–6 days, respectively, p=0.046. The proportion of patients with high fever was also higher in the study group than in the controls –15.3% (CI 7–23,6 vs. 2,8% (CI 1–6,6, p=0.016.Conclusion. Acute intestinal infections in children with atopic dermatitis have a more pronounced clinical symptoms, which is characterized by clinic enterocolitis, severity and duration of diarrhea syndrome, usually accompanied by a high fever. 

  19. Infectious uveitis in Virginia

    Directory of Open Access Journals (Sweden)

    Engelhard SB

    2015-08-01

    Full Text Available Stephanie B Engelhard,1 Zeina Haddad,1 Asima Bajwa,1 James Patrie,2 Wenjun Xin,2 Ashvini K Reddy1 1Department of Ophthalmology, 2Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA Purpose: To report the causes, clinical features, and outcomes of infectious uveitis in patients managed in a mid-Atlantic tertiary care center.Methods: Retrospective, observational study of infectious uveitis patients seen at the University of Virginia from 1984 to 2014.Results: Seventy-seven of 491 patients (15.7% were diagnosed with infectious uveitis (mean age 58 years, 71.4% female, 76.6% Caucasian. The mean follow-up was 5 years. Anterior uveitis was the most common anatomic classification (39 patients, 50.6% followed by panuveitis (20 patients, 26.0% and posterior uveitis (18 patients, 23.4%. The most common infectious etiology was herpetic anterior uveitis (37 patients, 48.1% followed by toxoplasma uveitis (14 patients, 18.2%. The most prevalent viral pathogen was varicella-zoster virus (21 patients, 27.3% followed by herpes simplex virus (20 patients, 26.0%. Acute retinal necrosis (ARN was diagnosed in 14 patients (18.2%. Aqueous humor yielded an etiologic diagnosis in seven (50% of ARN patients, four of whom tested positive for cytomegalovirus and three for varicella-zoster virus. On presentation, 43 patients (55.8% had a visual acuity (VA better than 20/40 and 17 (22.1% had a VA worse than 20/200. VA at the final follow-up was better than 20/40 in 39 patients (50.6% and worse than 20/200 in 22 patients (28.6%. In all, 16 (20.8% and 10 (13.0% patients required cataract and vitrectomy surgery, respectively. A total of 14 patients (18.2% were on glaucoma topical treatment and four (5.2% required glaucoma surgery.Conclusion: The most common type of infectious uveitis seen over the study period was herpetic anterior uveitis secondary to varicella-zoster virus or herpes simplex virus, found to be most prevalent in patients

  20. Diseases of the small bowel in chronic diarrhea: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    M. Simadibrata

    2002-09-01

    Full Text Available The incidence of chronic diarrhea in Asia is between 0.8-1.0%. The diseases and abnormalities according to the location, which can cause chronic diarrhea, are divided into three locations: the small bowel, the large bowel and extraintestinal. The small bowel diseases include infectious and non-infectious diseases. The infectious diseases are bacterial infections, parasitic infections etc. The non-infectious diseases include of Crohn’s disease, Celiac sprue, NSAID enteropathy, lactose intolerance, benign tumor, carcinoid tumor, carcinoma, post surgery complications, laxative etc. The approaches to diagnosis include good anamnesis, careful physical examination, supporting laboratory tests, more specialized supporting examinations including X-ray of the colon, esophagogastroduodenum follow-through, enteroclysis, ileo-colonoscopy and endoscopy on the upper portion of the digestive tract including the small intestine with biopsy for histopathology examinations. The treatment for chronic diarrhea is divided into supportive and causal therapy. (Med J Indones 2002; 11: 179-89 Keywords: small bowel, chronic diarrhea, approaches to diagnosis, treatment

  1. Intestinal infection at onset of mycophenolic acid-associated chronic diarrhea in kidney transplant recipients.

    Science.gov (United States)

    von Moos, S; Cippà, P E; Wüthrich, R P; Mueller, T F

    2016-10-01

    Chronic diarrhea after kidney transplantation is often attributed to mycophenolic acid (MPA) toxicity. We hypothesize that intestinal infections contribute to the pathogenesis of chronic MPA-associated diarrhea. In this retrospective study, all patients (n = 726) receiving a kidney transplant between 2000 and 2010 at the University Hospital Zurich were followed until July 2014 for occurrence of chronic diarrhea (≥4 weeks). Infectious triggers at diarrhea onset were assessed by reviewing medical history, stool microbiology, and histology of colon biopsies. In 46 patients (6.3% of the cohort), a total of 51 episodes of chronic diarrhea during MPA treatment were documented. The diarrhea episodes were often severe, as confirmed by significant weight loss. The cumulative incidence of chronic diarrhea was uniformly distributed throughout the post-transplant period, with 2.0%, 5.1%, and 9.6% at 1, 5, and 10 years, respectively. Evidence was found for intestinal infection at diarrhea onset in 38 episodes (74.5%). Occurrence of diarrhea onset showed a seasonal distribution with peaks in April and October/November. Specific antimicrobial treatment alone was associated with a 19% resolution rate only, whereas combination with dose reduction of MPA or switch from mycophenolate mofetil to enteric-coated mycophenolate sodium resulted in a 22.7% and 76.5% resolution rate, respectively. Change to an MPA-free regimen was associated with a 100% resolution rate. These results provide first evidence for a contribution of intestinal infections in chronic post-transplant diarrhea associated with MPA treatment. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Impact of antibiotics on necrotizing enterocolitis and antibiotic-associated diarrhea

    Science.gov (United States)

    Silverman, Michael A.; Konnikova, Liza; Gerber, Jeffrey S.

    2017-01-01

    Summary Antibiotics induce changes or dysbiosis of the intestinal microbiome. These antibiotic-induce changes may contribute to the pathogenesis of necrotizing enterocolitis (NEC) and antibiotic-associated diarrhea (AAD). Studies are beginning to unravel the contribution of specific groups of microbes to these diseases—most notably Gammaproteobacteria for NEC and bile acid- and carbohydrate-metabolizing microbes for AAD. Antibiotic-associated diarrhea occurs when antibiotic treatment induces diarrhea by altering the metabolic function of the patient’s intestinal microbiota leading to either an osmotic or infectious diarrhea, most notably Clostridium difficile infection (CDI). Antibiotic therapy impairs the host microbiota’s ability to resist colonization or expansion of pathogenic bacteria. In the case of CDI, there is growing evidence that microbiota-mediated bile acid metabolism is critical in the pathogenesis of this infection. Probiotics or other microbiota-targeted therapies may provide effective strategies to prevent and treat NEC and AAD. PMID:28164853

  3. Infectious Tolerance

    Science.gov (United States)

    Jonuleit, Helmut; Schmitt, Edgar; Kakirman, Hacer; Stassen, Michael; Knop, Jürgen; Enk, Alexander H.

    2002-01-01

    Regulatory CD4+CD25+ T cells (Treg) are mandatory for maintaining immunologic self-tolerance. We demonstrate that the cell-cell contact–mediated suppression of conventional CD4+ T cells by human CD25+ Treg cells is fixation resistant, independent from membrane-bound TGF-β but requires activation and protein synthesis of CD25+ Treg cells. Coactivation of CD25+ Treg cells with Treg cell–depleted CD4+ T cells results in anergized CD4+ T cells that in turn inhibit the activation of conventional, freshly isolated CD4+ T helper (Th) cells. This infectious suppressive activity, transferred from CD25+ Treg cells via cell contact, is cell contact–independent and partially mediated by soluble transforming growth factor (TGF)-β. The induction of suppressive properties in conventional CD4+ Th cells represents a mechanism underlying the phenomenon of infectious tolerance. This explains previously published conflicting data on the role of TGF-β in CD25+ Treg cell–induced immunosuppression. PMID:12119350

  4. Acute diarrhea in hospitalized children of the municipality of juiz de fora, MG, Brazil: prevalence and risk factors associated with disease severity Diarreia aguda em crianças hospitalizadas no município de Juiz de Fora, MG: prevalência e fatores de risco associados à gravidade da doença

    Directory of Open Access Journals (Sweden)

    Monica Couto Guedes Sejanes da Rocha

    2012-12-01

    Full Text Available CONTEXT: Acute diarrhea is a common cause of hospitalization among children under 5 years of age. Knowing the prevalence and risk factors associated with the severity of acute diarrhea is essential to control morbidity and mortality. OBJECTIVE: Describe the prevalence of demographic, epidemiologic and clinical features of children under 6 years of age hospitalized for acute diarrhea, and investigate the association between these determinants and the severity of the diarrheic episode. METHOD: Retrospective, cross-sectional study, during the period from January, 2005 through December, 2008, in the municipality of Juiz de Fora, MG, Brazil. Files from 6,201 children from 0 to 6 years of age, hospitalized in two public teaching institutions (which account for 84% of all the hospitalizations in the municipality, were assessed. Acute diarrhea was defined as the presence of at least three evacuations of liquid or loose stools, within 24 hours, for a maximum period of 14 days. The patients with acute diarrhea were divided in two groups, according to disease severity, severe diarrhea being considered whenever hospitalization lasted for at least 4 days. Epidemiologic and clinical data were assessed and compared through the application of the chi-squared test and the binomial logistic regression model. RESULTS: The prevalence rate for admission due to acute diarrhea was 8.4%. The factors significantly associated with the severity of the diarrheic episode were: age under 6 months (P = 0.01, OR = 2.762; disease onset during fall (P = 0.033, OR = 1.742, presence of fever (P = 0.017, OR = 1.715 and antibiotic use during hospitalization (P = 0.000, OR = 3.872. CONCLUSIONS: Diarrhea is the third most common cause of hospitalization among children under 6 years of age in Juiz de Fora. Young age (under or equal to 6 months, fever, antibiotic use during hospitalization and disease onset during fall are risk factors associated with longer hospital stay

  5. Congenital chloride diarrhea: late presentation

    Directory of Open Access Journals (Sweden)

    Al Bishi L

    2011-04-01

    Full Text Available Laila Al Bishi1, Mustafa Al Toonisi2Pediatric Department, North West Armed Forces Hospital, Tabuk, Kingdom of Saudi ArabiaAbstract: We report the case of a male infant who presented with diarrhea at 6 months of age. He was failing to thrive, and biochemical investigation revealed hypokalemic hypochloremic metabolic alkalosis. Diagnosis of congenital chloride diarrhea was suspected and confirmed by the stool chloride result. He was started on high-dose sodium chloride and potassium chloride to control the electrolyte imbalance. The disease was difficult to control for a year after diagnosis. Late presentation is associated with severe chronic electrolyte disturbances and high-dose replacement therapy.Keywords: congenital chloride diarrhea, hypokalemic hypochloremic metabolic alkalosis, high stool chloride

  6. Diarrhea in severely burned children.

    Science.gov (United States)

    Thakkar, Kalpesh; Kien, C Lawrence; Rosenblatt, Judah I; Herndon, David N

    2005-01-01

    Diarrhea is a common problem in critically ill patients. Our patients are fed a high-carbohydrate enteral formula. We hypothesized that diarrhea in our patients may be related to the osmotic effects of unabsorbed carbohydrate in the small intestine and colon. We studied 19 patients, 3 months to 17 years, with burns >40% total body surface area. Each subject was studied weekly for up to 4 weeks postburn. Breath H2 concentration was measured. For the 24-hour period before the breath H2 measurement, the enteral carbohydrate intake, stool volume, and total enteral fluid volume were recorded. At each of several weekly intervals for each subject, the times when stool volume and enteral carbohydrate intake were each maximal were noted. Maximal stool volume ranged from 12 to 69 mL/kg/d. At the time point of maximal carbohydrate intake, diarrhea (stool volume >10 mL/kg/d) occurred in 18 of 19 patients, and maximal stool volume occurred in 10 of 19. Breath H2 concentration (ppm/5% CO2; mean +/- SEM) was 5.5 +/- 3.5 at the time of maximal carbohydrate intake, and was 25 +/- 20 at maximal stool volume. There were no correlations among breath H2 concentration, stool volume, enteral fluid intake, and enteral carbohydrate intake. Almost all the subjects had diarrhea over several weeks postburn. The lack of correlation of either carbohydrate intake or breath H2 with stool volume suggests that diarrhea in these patients may be caused by factors other than carbohydrate malabsorption. These data do not support altering nutrition support because of watery diarrhea.

  7. CT evaluation of infectious colitis

    International Nuclear Information System (INIS)

    Horiki, Noriyuki; Maruyama, Masataka; Fujita, Yoshiyuki; Suzuki, Yuko; Tanaka, Tsuyoshi; Imoto, Ichiro; Adachi, Yukihiko

    2002-01-01

    Computed tomography (CT) is useful for evaluating the diagnosis of gastrointestinal disease, such as infectious colitis, in patients with severe pain and bloody diarrhea. During the 7 years between November 1993 and October 2000, 34 patients with infectious colitis (18 male, 16 female; mean age 42±19 yrs), received emergency CT and colonoscopy because of severe abdominal pain and dysentery. The following organisms were isolated: pathogenic Escherichia coli (12), 6 of which were O157: H7 (O-157), Salmonella species (11), Campylobacter species (5), Vibrio parahaemolyticus (3), Yersinia enterocolotica (2) and Shigella species (1). Thickening of the intestinal wall greater than 10 mm was seen in the ascending colon in the 6 cases with E. coli O157, in 5/11 cases with Salmonella, 4/5 with Campylobacter and 1/6 with non-O157 pathogenic E. Coli. marked intestinal wall thickening, greater than 20 mm, was seen in the ascending colon of the 4 of the patients with an O-157 infection. In all patients with O-157 colitis, slight ascites was noted in the pelvic space. In additions, ascites was also seen in 3/13 patients with Salmonella and 1/5 patients with Campylobacter colitis. The CT findings, in the patients with infectious colitis, are non-specific but knowledge and recognition of the findings will help in patient evaluation and proper treatment. (author)

  8. CT evaluation of infectious colitis

    Energy Technology Data Exchange (ETDEWEB)

    Horiki, Noriyuki; Maruyama, Masataka; Fujita, Yoshiyuki; Suzuki, Yuko [Saint Luke' s International Hospital, Tokyo (Japan); Tanaka, Tsuyoshi; Imoto, Ichiro [National Mie Chuo Hospital, Hisai (Japan); Adachi, Yukihiko [Mie Univ., Tsu (Japan). School of Medicine

    2002-08-01

    Computed tomography (CT) is useful for evaluating the diagnosis of gastrointestinal disease, such as infectious colitis, in patients with severe pain and bloody diarrhea. During the 7 years between November 1993 and October 2000, 34 patients with infectious colitis (18 male, 16 female; mean age 42{+-}19 yrs), received emergency CT and colonoscopy because of severe abdominal pain and dysentery. The following organisms were isolated: pathogenic Escherichia coli (12), 6 of which were O157: H7 (O-157), Salmonella species (11), Campylobacter species (5), Vibrio parahaemolyticus (3), Yersinia enterocolotica (2) and Shigella species (1). Thickening of the intestinal wall greater than 10 mm was seen in the ascending colon in the 6 cases with E. coli O157, in 5/11 cases with Salmonella, 4/5 with Campylobacter and 1/6 with non-O157 pathogenic E. Coli. marked intestinal wall thickening, greater than 20 mm, was seen in the ascending colon of the 4 of the patients with an O-157 infection. In all patients with O-157 colitis, slight ascites was noted in the pelvic space. In additions, ascites was also seen in 3/13 patients with Salmonella and 1/5 patients with Campylobacter colitis. The CT findings, in the patients with infectious colitis, are non-specific but knowledge and recognition of the findings will help in patient evaluation and proper treatment. (author)

  9. Risk Factor Analysis May Provide Clues to Diarrhea Prevention in Outdoor-Housed Rhesus Macaques (Macaca mulatta)

    Science.gov (United States)

    PRONGAY, KAMM; PARK, BYUNG; MURPHY, STEPHANIE J.

    2014-01-01

    Seventy-five percent of rhesus macaques at national primate research centers are housed outside. Annually, 15–39% of these animals experience diarrhea and require veterinary treatment for dehydration, electrolyte imbalance, or weight loss. An estimated 21–33% of these patients will die or be euthanized. Many studies have explored the various infectious etiologies of non-human primate diarrhea. However, there is little published information on diarrhea incidence rates and risk factors in outdoor-housed rhesus macaques. Without this information, it is challenging to determine endemic and epidemic diarrhea levels, or to develop and evaluate mitigation strategies. Using electronic medical records, we conducted a retrospective cohort study to calculate diarrhea incidence rates for rhesus macaques (N = 3,181) housed in three different outdoor housing types (corrals, shelters, and temporary housing) at the Oregon National Primate Research Center between November 1, 2009 and October 31, 2010. With multiple logistic regression analysis, we determined the relative risk of housing type, sex, and age on development of diarrhea. Diarrhea incidence and mortality in our population was lower than many published ranges. Type of outdoor housing, age, and previous diarrhea episode were positively correlated with diarrhea risk. Younger animals in smaller shelters and temporary housing had a greater risk of acquiring diarrhea, with juvenile animals (0.7–3.9 years) having the highest mortality rate. Sex was not a risk factor, but adult females with diarrhea were more likely to develop life-threatening complications than adult males. We also constructed a predictive model for diarrhea-associated mortality using Classification and Regression Tree. Findings from this study will be used to develop and evaluate mitigation strategies in our outdoor-housed population and to provide a foundation for genetic susceptibility and immune function testing. PMID:23568382

  10. Chronic Diarrhea: A Concern After Gallbladder Removal?

    Science.gov (United States)

    ... six months ago, and I'm still having diarrhea. Is this normal? Answers from Michael F. Picco, ... develop the frequent loose, watery stools that characterize diarrhea after surgery to remove their gallbladders (cholecystectomy). Studies ...

  11. Gelatin tannate and tyndallized probiotics: a novel approach for treatment of diarrhea.

    Science.gov (United States)

    Lopetuso, L; Graziani, C; Guarino, A; Lamborghini, A; Masi, S; Stanghellini, V

    2017-02-01

    Intestinal permeability impairment is implicated in many gastrointestinal (GI) diseases. Chronic diarrhea, defined as the presence of diarrhea for more than 3 weeks in adults and 2 weeks in children, requires a different diagnostic and therapeutic work-up than acute diarrhea. Gelatin tannate, by reducing the clinical activity of acute colitis and the proinflammatory effects of lipopolysaccharide (LPS), is emerging as a mucosal barrier protector. New therapeutic strategies focusing on the physiological function of the intestinal barrier, may offer an innovative approach for the clinical improvement of highly debilitating chronic GI diseases. We review the available data on the role of gelatin tannate and tyndallized probiotics in the treatment of diarrhea. Gelatin tannate and tyndallized probiotics can be used to re-establish the physiological functions of the gut barrier, as well as for preventing dysbiosis. There is evidence that due to their particular properties, gelatin tannate and tyndallized probiotics are highly effective in the treatment of acute gastroenteritis and may be especially indicated in the management of moderate and prolonged diarrhea. Gelatin tannate and tyndallized probiotics may be effective in the management of chronic diarrhea. Further clinical trials are necessary to further explore their effects in clinical practice.

  12. Diseases in Chronic Non-infective Diarrhea

    OpenAIRE

    Simadibrata, Marcellus; Rani, Aziz; Daldiyono, Daldiyono; Syam, Ari Fahrial; Tytgat, GNJ; Yuwono, Vera; Lesmana, L A; Ariawan, Iwan

    2004-01-01

    Background: Chronic diarrhea is common in Indonesia. The chronic non-infective diarrhea cases seem to be increasing recently. The aim of this study is to reveal the pattern of diseases that can cause chronic non-infective diarrhea. Methods: We examined all patients suffering from chronic non-infective diarrhea over a six years period. The patients underwent physical examination and performed laboratory tests, colon enema X-ray, colonoscopy, ileoscopy, upper gastrointestnal endoscopy and smal...

  13. Changes in causes of acute gastroenteritis in the United Kingdom over 15 years: microbiologic findings from 2 prospective, population-based studies of infectious intestinal disease.

    Science.gov (United States)

    Tam, Clarence C; O'Brien, Sarah J; Tompkins, David S; Bolton, Frederick J; Berry, Lisa; Dodds, Julie; Choudhury, Dalia; Halstead, Fenella; Iturriza-Gómara, Miren; Mather, Katherine; Rait, Greta; Ridge, Alan; Rodrigues, Laura C; Wain, John; Wood, Bernard; Gray, James J

    2012-05-01

    Large-scale, prospective studies of infectious intestinal disease (IID) in developed countries are uncommon. Two studies of IID incidence and etiology have been conducted in the United Kingdom: the Infectious Intestinal Disease Study in England (IID1) in 1993-1996 and the Second Study of Infectious Intestinal Disease in the Community (IID2) in 2008-2009. We examined changes in etiology and diagnostic yield of IID cases over 15 years. Fecal samples submitted by IID cases were examined for a range of bacterial, viral, and protozoal pathogens using traditional and molecular microbiological methods. We calculated the percentage of specimens positive for each organism based on traditional methods and on traditional and molecular methods combined. We compared the distributions of organisms in the 2 studies. For pathogens investigated in both studies, 40% of fecal samples submitted by cases in IID2 were positive compared with 28% in IID1. Viruses were most frequent among community cases in IID2. Campylobacter was the most common bacterial pathogen among cases presenting to healthcare. Major differences between the 2 studies were increases in the detection of norovirus and sapovirus and a decline Salmonella. Most fecal specimens were negative for the pathogens tested in both studies, so new strategies are needed to close the diagnostic gap. Among known pathogens, effective control of norovirus, rotavirus, and Campylobacter remain high priorities. The reduction in nontyphoidal salmonellosis demonstrates the success of Europe-wide control strategies, notably an industry-led Salmonella control program in poultry in the United Kingdom.

  14. Application of qPCR assays for diagnosing causes of viral mink diarrhea. Preliminary results

    DEFF Research Database (Denmark)

    Hartby, Christina Marie; Kvisgaard, Lise Kirstine; Larsen, Lars Erik

    ). Diarrhea in mink can be caused by infectious agents (virus, bacteria and parasites) and food-related/multifactorial conditions. Known enteric viral infections are mink enteritis virus (MEV) and mink astrovirus. Coronaviruses and caliciviruses have also been implicated as potential causes or contributors...... for a quantitative diagnostic approach. We have developed new or adapted previously published real-time PCR/RT-PCR assays for MEV, astrovirus, rota- and coronavirus diagnostics. The technical test validation was initially carried out on archived diarrhea samples from diagnosed positive animals and on normal...

  15. Effective prophylaxis against rotavirus diarrhea using a combination of Lactobacillus rhamnosus GG and antibodies

    Directory of Open Access Journals (Sweden)

    Hammarström Lennart

    2007-09-01

    Full Text Available Abstract Background Rotavirus is a worldwide cause of infectious infantile diarrhea that claims over 600,000 lives annually. Recently, two new vaccine candidates have been developed but their efficacy in developing countries, still remains to be proven. Oral delivery of specific immunoglobulins provides passive immunity and is a fast acting treatment for rotavirus diarrhea. Probiotic bacteria have also gained considerable attention lately as treatment for rotavirus diarrhea. Here we report an evaluation of the therapeutic potential of different probiotics and their combination with anti – rotavirus antibodies in a mouse model of rotavirus diarrhea. Results Of the six probiotic bacteria tested, Lactobacillus rhamnosus strain GG had the strongest influence in reducing prevalence, duration and severity of diarrhea and was therefore chosen for combination treatment with immunoglobulins. The combination treatment reduced the diarrhea outcome measures significantly, prevented histopathological changes and reduced the virus load in the intestines. Conclusion The advantages associated with immunoglobulins and probiotics based therapy is that the treatment provides a rapid therapeutic effect and is cost efficient. These components do not require special storage conditions and could potentially complement the rehydration therapy that is currently used.

  16. Effect of Probiotics and Zinc Combination to the Frequency and Duration of Diarrhea in Pediatrics Patients at PKU Muhammadiyah Hospital Yogyakarta

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    Nurul Huda

    2017-03-01

    Full Text Available Based on the survey of household health and basic medical research over the years, diarrhea is a major cause of infant mortality in Indonesia. Probiotics have been used extensively in acute diarrhea in children, although are not recommended yet by Word Health Organization (WHO. Research on comparative of increasing probiotic research to standard therapy of diarrhea is still very limited. Therefore this study was conducted to determine the effect of probiotics given concomitantly with standard therapy of diarrhea to the frequency and duration of acute diarrhea in children. This study was conducted by cohort design with data collection was performed prospectively in children patients with acute diarrhea in the pediatric ward of PKU Muhammadiyah Hospital in Yogyakarta from September until December 2015. Subjects were receiving standard therapy of diarrhea (rehydration solution and zinc as group I, and who received standard therapy diarrhea (rehydration solution and zinc combined with probiotics as group II. The main observation variables were frequency and duration of diarrhea. Differences of diarrhea frequency and diarrhea duration between groups normally distributed were analyzed by parametric unpaired t-test, while not normally distributed were analyzed by non-parametric Mann-Whitney test. During the study period we recruited 44 subjects who met the inclusion criteria, which consisted of 38 subjects who received fluid rehydration therapy, zinc and probiotics and as much as 6 subjects who received therapy rehydration liquid and zinc. The results show the frequency of diarrhea in group I is less than group II, the average value of group I is 1 time and the average value of group II is 3 times (p=0.024. Duration of diarrhea was shorter in group I with the average value of 46 hours 30 minutes than in group II 53 hours 10 minutes (p=0.515. This study suggests that the administration of probiotics in the standard therapy of diarrhea did not

  17. Dosimetric predictors of diarrhea during radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Sanguineti, Giuseppe; Endres, Eugene J.; Parker, Brent C.; Sormani, Maria Pia

    2009-01-01

    Purpose: to investigate dosimetric predictors of diarrhea during radiotherapy (RT) for prostate cancer. Patients and methods: all patients who underwent external-beam radiotherapy as part of treatment for localized prostate cancer at the University of Texas Medical Branch, Galveston, TX, USA, from May 2002 to November 2006 were extracted from the own database. From the cumulative dose-volume histogram (DVH), the absolute volumes (V-value) of intestinal cavity (IC) receiving 15, 30, and 45 Gy were extracted for each patient. Acute gastrointestinal toxicity was prospectively scored at each weekly treatment visit according to CTC (common toxicity criteria) v2.0. The endpoint was the development of peak grade ≥ 2 diarrhea during RT. Various patient, tumor, and treatment characteristics were evaluated using logistic regression. Results: 149 patients were included in the analysis, 112 (75.2%) treated with whole-pelvis intensity-modulated radiotherapy (WP-IMRT) and 37 (24.8%) with prostate-only RT, including or not including, the seminal vesicles (PORT ± SV). 45 patients (30.2%) developed peak grade ≥ 2 diarrhea during treatment. At univariate analysis, IC-V 15 and IC-V 30 , but not IC-V 45 , were correlated to the endpoint; at multivariate analysis, only IC-V 15 (p = 0.047) along with peak acute proctitis (p = 0.041) was independently correlated with the endpoint. Conclusion: these data provide a novel and prostate treatment-specific ''upper limit'' DVH for IC. (orig.)

  18. Diarrhea caused by carbohydrate malabsorption.

    Science.gov (United States)

    Hammer, Heinz F; Hammer, Johann

    2012-09-01

    This article will focus on the role of the colon in the pathogenesis of diarrhea in carbohydrate malabsorption or physiologically incomplete absorption of carbohydrates, and on the most common manifestation of carbohydrate malabsorption, lactose malabsorption. In addition, incomplete fructose absorption, the role of carbohydrate malabsorption in other malabsorptive diseases, and congenital defects that lead to malabsorption will be covered. The article concludes with a section on diagnostic tools to evaluate carbohydrate malabsorption. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Stir-fried white pepper can treat diarrhea in infants and children efficiently: a randomized controlled trial.

    Science.gov (United States)

    Jin, Cheng-Qiang; Jia, Yan-Xia; Dong, Hai-Xin; Zhou, Jian-Wei; Sun, Guang-Fei; Zhang, Yu-Yan; Zhao, Qing; Zheng, Bi-Ying

    2013-01-01

    We evaluated the efficacy and safety of stir-fried white pepper in the treatment of infant and children diarrhea. This was a randomized trial conducted in the pediatric emergency department of the hospital affiliated to Jining Medical College. One hundred seventy four patients were selected from outpatients from 2011 to 2012. Participants were randomly assigned to treatment with stir-fried white pepper (n = 88) or montmorillonite powder (n = 86). The proportions of chronic diarrhea patients (n = 52) showing success of treatment were similar for both groups. There were great differences between the two groups in acute diarrhea (n = 62) and persistent diarrhea (n = 60), and the cure rate of stir-fried white pepper was higher than montmorillonite powder in both groups. The prescription of stir-fried white pepper significantly decreased the frequency of diarrhea in infants and children under 2.5 years with diarrhea compared to treatment with montmorillonite powder, especially for the patients with acute diarrhea or persistent diarrhea.

  20. Zinc supplementation for the treatment of diarrhea in infants in Pakistan, India and Ethiopia.

    Science.gov (United States)

    Fischer Walker, Christa L; Bhutta, Zulfiqar A; Bhandari, Nita; Teka, Telahun; Shahid, Farhana; Taneja, Sunita; Black, Robert E

    2006-09-01

    This randomized, placebo controlled trial was designed to assess the safety and efficacy of 10-mg zinc supplementation for the treatment of acute diarrhea in infants. A total of 1110 infants aged 28 days to 5 months with acute diarrhea were enrolled and randomized to receive either zinc (n = 554) or placebo (n = 556) for 14 days. Diarrhea history, anthropometric status, breast-feeding status and socioeconomic indicators were assessed at baseline. The homes of all infants were visited every 3 days until the diarrhea episode was over. The number of stools, presence of blood and additional illnesses were recorded daily. The geometric mean duration of the diarrhea episode was 0.21 days longer among infants receiving zinc versus those receiving placebo, but this was not statistically significant and no difference was observed after controlling for sex, exclusive breast-feeding and length for age Z score. There were no differences in any subgroup (ie, sex, baseline length for age Z score, exclusive breast-feeding or site after controlling for the remaining subgroup variables). There were no differences in reported stool frequency or among the proportion of episodes lasting longer than 7 days. Rates of vomiting were similar in the zinc and placebo groups. Young infants do not appear to benefit from zinc supplementation for the treatment of diarrhea.

  1. Development and validation of a biomarker for diarrhea-predominant irritable bowel syndrome in human subjects.

    Directory of Open Access Journals (Sweden)

    Mark Pimentel

    Full Text Available Diarrhea-predominant irritable bowel syndrome (IBS is diagnosed through clinical criteria after excluding "organic" conditions, and can be precipitated by acute gastroenteritis. Cytolethal distending toxin B (CdtB is produced by bacteria that cause acute gastroenteritis, and a post-infectious animal model demonstrates that host antibodies to CdtB cross-react with vinculin in the host gut, producing an IBS-like phenotype. Therefore, we assessed circulating anti-CdtB and anti-vinculin antibodies as biomarkers for D-IBS in human subjects. Subjects with D-IBS based on Rome criteria (n=2375 were recruited from a large-scale multicenter clinical trial for D-IBS (TARGET 3. Subjects with inflammatory bowel disease (IBD (n=142, subjects with celiac disease (n=121, and healthy controls (n=43 were obtained for comparison. Subjects with IBD and celiac disease were recruited based on the presence of intestinal complaints and histologic confirmation of chronic inflammatory changes in the colon or small intestine. Subjects with celiac disease were also required to have an elevated tTG and biopsy. All subjects were aged between 18 and 65 years. Plasma levels of anti-CdtB and anti-vinculin antibodies were determined by ELISA, and compared between groups. Anti-CdtB titers were significantly higher in D-IBS subjects compared to IBD, healthy controls and celiac disease (P<0.001. Anti-vinculin titers were also significantly higher in IBS (P<0.001 compared to the other groups. The area-under-the-receiver operating curves (AUCs were 0.81 and 0.62 for diagnosis of D-IBS against IBD for anti-CdtB and anti-vinculin, respectively. Both tests were less specific in differentiating IBS from celiac disease. Optimization demonstrated that for anti-CdtB (optical density≥2.80 the specificity, sensitivity and likelihood ratio were 91.6%, 43.7 and 5.2, respectively, and for anti-vinculin (OD≥1.68 were 83.8%, 32.6 and 2.0, respectively. These results confirm that anti-CdtB and

  2. Infectious Risks of Traveling Abroad.

    Science.gov (United States)

    Chen, Lin H; Blair, Barbra M

    2015-08-01

    A popular leisure activity, international travel can be associated with some infections. The most common travel-related illnesses appear to be gastrointestinal, dermatologic, respiratory, and systemic febrile syndromes. The pretravel medical consultation includes immunizations, malaria chemoprophylaxis, self-treatment for traveler's diarrhea, and advice on the prevention of a myriad of other infectious causes including dengue, chikungunya, rickettsiosis, leptospirosis, schistosomiasis, and strongyloidiasis. Travel to locations experiencing outbreaks such as Ebola virus disease, Middle East respiratory syndrome, avian influenza, and chikungunya call for specific alerts on preventive strategies. After travel, evaluation of an ill traveler must explore details of exposure, including destinations visited; activities; ingestion of contaminated food or drinks; contact with vectors, animals, fresh water, or blood and body fluids; and other potential exposures. Knowledge of the geographic distribution of infectious diseases is important in generating the differential diagnoses and testing accordingly. Empiric treatment is sometimes necessary when suspicion of a certain diagnosis is strong and confirmatory tests are delayed or lacking, particularly for infections that are rapidly progressive (for example, malaria) or for which timing of testing is prolonged (such as leptospirosis).

  3. Observational Study of Travelers' Diarrhea.

    Science.gov (United States)

    Meuris

    1995-03-01

    Background: European air travelers returning from Algeria, Egypt, Mexico, Morocco, and Tunisia were interviewed about their experience of travelers' diseases upon arrival in Brussels. Diarrhea was mentioned by 37% of the adults and 27% of the children. These subjects were questioned about the types of measures taken, type and duration of drug treatment (if any), and about duration of diarrhea and side effects experienced. Methods: Final analysis was performed based on 2160 interviews. The largest proportion of diarrhea was reported in the age group 15-24 years (46%). Results: The majority of the 2160 subjects had opted for drug treatment (81%): 927 subjects for loperamide alone, 235 for loperamide in combination with nifuroxazide, and 178 for nifuroxazide alone. Other drugs had been used less frequently. The median time to recovery was 2.4 days with loperamide compared to 3.2 days with nifuroxazide and to 3.4 days for the no-treatment group. Conclusions: A stratification of the results by severity of the diarrhea suggests a rank of antidiarrheal potency as follows: loperamide > nifuroxazide > no-drug treatment. The side effect with the highest incidence was constipation (2.4% with loperamide). (J Travel Med 2:11-15, 1995) Travelers' diarrhea is usually defined as the passage of at least three unformed stools per day or any number of such stools when accompanied by fever, abdominal cramping, or vomiting. The definition may be broadened to include more trivial bowel disturbance.1,2 The duration of this self-limited disease generally is 3 to 5 days. Medical intervention aims at shortening the duration of disease, thus allowing the sufferer to resume his or her usual activities at an early stage. A shortened period of recovery to physical well-being has obvious favorable economic implications if the traveler is on business and may help the maintenance of a desired level of quality of life while a traveler is on holiday. An observational study of various medical

  4. Immunoglobulin M indirect-fluorescent antibody test for the diagnosis of acute toxoplasmosis during pregnancy in the avidity era: A 14-year experience at the Tuscany Reference Center for Infectious Diseases in Pregnancy, Florence, Italy.

    Science.gov (United States)

    Trotta, Michele; Borchi, Beatrice; Zammarchi, Lorenzo; Sterrantino, Gaetana; Brogi, Michela; Kiros, Seble Tekle; Lorini, Chiara; Bonaccorsi, Guglielmo; Colao, Maria Grazia; Bartoloni, Alessandro

    2016-12-01

    The aim of this study was to evaluate immunoglobulin M indirect-fluorescent antibody test (IgM IFAT) for the diagnosis of acute or chronic Toxoplasma infection in pregnancy. Pregnant women with suspected acute toxoplasmosis referred to the Tuscany Reference Center for Infectious Diseases in Pregnancy during the period 1998-2012 were retrospectively enrolled. All women were tested with a panel of serological tests, including enzyme-linked immunosorbent assay for IgG avidity and IgM IFAT. On the basis of anamnestic, clinical, and serological criteria, pregnant women were classified into three groups: recently infected (RI), latently infected (LI), and doubtful latently infected (DLI). Patients classified as DLI were excluded from the analysis. The association between IgM IFAT (positive or negative) and the diagnosis of infection (acute or chronic) was assessed. Positive predictive value and negative predictive value of the IgM IFAT were calculated. A total of 810 pregnant women were enrolled in the study: 302 in the RI group and 508 in the LI group. Fifty-two women classified as DLI were excluded. IgM IFAT was positive in 172 out of 302 (56.9%) pregnant women in the RI group and in 29 out of 508 (5.7%) in the LI group. The positive predictive value and negative predictive value of IgM IFAT in predicting RI was 85.6% and 78.6%, respectively. IgM IFAT has reasonable sensitivity and specificity in diagnosing recent infection and, mostly in case of borderline avidity test, could be considered as a further aid for an accurate diagnosis of acute toxoplasmosis in pregnancy. © 2016 Japan Society of Obstetrics and Gynecology.

  5. Infectious Urethritis in Men and Women

    Science.gov (United States)

    Meares, Edwin M.

    1975-01-01

    Acute and recurrent infectious urethritis in men and women is commonly seen by physicians. Since specific therapy varies widely with the type of urethritis present, the proper diagnosis must be clearly established if curative drug therapy is to be selected. It is valuable, therefore, to review the diagnosis and therapy of the various forms of infectious urethritis that are recognized today in both men and women. PMID:1199099

  6. Analysis of the Salmonella typhimurium Proteome through Environmental Response toward Infectious Conditions

    Energy Technology Data Exchange (ETDEWEB)

    Adkins, Joshua N.; Mottaz, Heather M.; Norbeck, Angela D.; Gustin, Jean K.; Rue, Joanne; Clauss, Therese RW; Purvine, Samuel O.; Rodland, Karin D.; Heffron, Fred; Smith, Richard D.

    2006-08-01

    Salmonella enterica serovar Typhimurium (aka, S. typhimurium) is a facultative intracellular pathogen that causes ~40,000 reported cases of acute gastroenteritis and diarrhea a year in the United States. To develop a deeper understanding of the infectious state of S. typhimurium, liquid chromatography-mass spectrometry-based “bottom-up” proteomics was used to globally analyze the proteins present under specific growth conditions. Salmonella typhimurium LT2 strain cells were grown in contrasting culture conditions that mimicked both natural free-living conditions and an infectious state, i.e., logarithm phase, stationary phase and Mg-depleted medium growth. Initial comparisons of the LT2 strain protein abundances among cell culture conditions indicate that the majority of proteins do not change significantly. Not unexpectedly, cells grown in Mg-depleted medium conditions had a higher abundance of Mg2+ transport proteins than found in other growth conditions. A second more virulent Salmonella typhimurium strain (14028) was also studied with these growth conditions and used to directly compare to the LT2 strain. The strain comparison offers a unique opportunity to compare and contrast observations in these closely related bacteria. One particular protein family, propanediol utilization proteins, was drastically more abundant in the 14028 strain than in the LT2 strain, and may be a contributor to increased pathogenicity in the 14028 strain.

  7. Tutorials for Africa - Diarrhea: MedlinePlus

    Science.gov (United States)

    ... includes information about how diarrhea is contracted, the importance of treatment and techniques for prevention. Select the tutorial to play: Japadhola Japadhola (Self Playing Tutorial) Luganda ...

  8. Diarrhea

    Science.gov (United States)

    ... Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Diverticular Disease Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Dumping Syndrome ...

  9. Diarrhea

    Science.gov (United States)

    ... Possible Causes DiagnosisYour symptoms may be caused by LACTOSE INTOLERANCE. People who have this condition have trouble digesting ... dairy products. Self CareIf you think you have lactose intolerance, talk to your doctor. He or she may ...

  10. Etiology of Diarrhea in Young Children in Denmark: a Case-Control Study

    Science.gov (United States)

    Olesen, Bente; Neimann, Jacob; Böttiger, Blenda; Ethelberg, Steen; Schiellerup, Peter; Jensen, Charlotte; Helms, Morten; Scheutz, Flemming; Olsen, Katharina E. P.; Krogfelt, Karen; Petersen, Eskild; Mølbak, Kåre; Gerner-Smidt, Peter

    2005-01-01

    Infectious gastroenteritis is one of the most common diseases in young children. To clarify the infectious etiology of diarrhea in Danish children less than 5 years of age, we conducted a 2-year prospective case-control study. Stools from 424 children with diarrhea and 870 asymptomatic age-matched controls were examined, and their parents were interviewed concerning symptoms. Rotavirus, adenovirus, and astrovirus were detected by enzyme-linked immunosorbent assay, and norovirus and sapovirus were detected by PCR. Salmonella, thermotolerant Campylobacter, Yersinia, Shigella, and Vibrio spp. were detected by standard methods. Shiga toxin-producing (STEC), attaching-and-effacing (A/EEC), enteropathogenic (EPEC), enterotoxigenic, enteroinvasive, and enteroaggregative Escherichia coli were detected by using colony hybridization with virulence gene probes and serotyping. Parasites were detected by microscopy. Overall, a potential pathogen was found in 54% of cases. More cases than controls were infected with rotavirus, Salmonella, norovirus, adenovirus, Campylobacter, sapovirus, STEC, classical EPEC, Yersinia, and Cryptosporidium strains, whereas A/EEC, although common, was not associated with illness. The single most important cause of diarrhea was rotavirus, which points toward the need for a childhood vaccine for this pathogen, but norovirus, adenovirus, and sapovirus were also major etiologies. Salmonella sp. was the most common bacterial pathogen, followed by Campylobacter, STEC, Yersinia, and classical EPEC strains. A/EEC not belonging to the classical EPEC serotypes was not associated with diarrhea, underscoring the importance of serotyping for the definition of EPEC. PMID:16081890

  11. Neighborhood Urban Environmental Quality Conditions Are Likely to Drive Malaria and Diarrhea Mortality in Accra, Ghana

    Directory of Open Access Journals (Sweden)

    Julius N. Fobil

    2011-01-01

    Full Text Available Background. Urbanization is a process which alters the structure and function of urban environments. The alteration in the quality of urban environmental conditions has significant implications for health. This applies both to the ecology of insect vectors that may transmit diseases and the burden of disease. Study Objectives. To investigate the relationship between malaria and infectious diarrhea mortality and spatially varied neighborhood environmental quality conditions in a low-income economy. Design. A one time point spatial analysis of cluster-level environmental conditions and mortality data using principal component analysis (PCA, one-way analysis of variance (ANOVA and generalized linear models (GLMs. Methods. Environmental variables were extracted from the Ghana Census 2000 database while mortality data were obtained from the Ghana Births and Deaths Registry in Accra over the period 1998–2002. Results. Whereas there was a strong evidence of a difference in relative mortality of malaria across urban environmental zones of differing neighborhood environmental conditions, no such evidence of mortality differentials was observed for diarrhea. In addition, whereas bivariate analyses showed a weak to strong evidence of association between the environmental variables and malaria mortality, no evidence of association was found between diarrhea mortality and environmental variables. Conclusion. We conclude that environmental management initiatives intended for infectious disease control might substantially reduce the risk of urban malaria mortality and to a less extent that for urban diarrhea mortality in rapidly urbanizing areas in a low-income setting.

  12. Visual diagnosis: Chronic diarrhea and failure to thrive in a 5-year-old girl.

    Science.gov (United States)

    Hasosah, Mohammed; Satti, Mohamed; Hayat, Amirshazad

    2014-06-01

    Chronic GVHD usually develops 100 days after BMT and is a serious and potentially life-threatening long-term complication. Chronic GVHD can occur after previous or ongoing acute GVHD or in patients without a history of acute GVHD (eg, de novo disease) as illustrated by this case. In evaluating a patient presenting with chronic diarrhea more than 100 days after BMT, one must consider a serious underlying illness such as chronic GVHD because it is a major cause of morbidity and mortality of allogeneic stem cell transplantation. As indicated by this case, chronic GVHD can cause diarrhea. Complete evaluation of the diarrhea state should be part of the initial investigation. In many cases, however, the diagnosis of GVHD is not straightforward, and gastrointestinal biopsy and histologic confirmation is often necessary to corroborate a clinical impression of chronic GVHD.

  13. A Study on the Epidemiology and Aetiology of Acute Gastroenteritis in Adult Patients Presenting at the Infectious Diseases Hospital in Tirana, Albania

    Directory of Open Access Journals (Sweden)

    Gentian P. Stroni

    2014-09-01

    Full Text Available Background: Acute gastroenteritis remains a common cause of hospital emergency room visits in Albania. However, the aetiology of severe gastroenteritis leading to hospitalization in adults frequently remains unclear. Aims: Our objective was to study the epidemiology and causes of community-acquired, acute gastroenteritis in adult patients presenting to hospital. Study Design: Cross sectional study. Methods: A prospective study was conducted from January 2010 to January 2012, among patients ≥15 years old with community-acquired gastroenteritis presenting to the emergency room of the University Hospital “Mother Theresa” in Tirana, Albania. Stool samples and rectal swabs were collected from the patients for microbiological testing. Results: The median age of the study patients was 33 (15-88 years and 577 (58% were females. The median age of males was 35 (15-87 years. The vast majority of cases occurred in urban area (849, 85%, p<0.01. Patients were admitted throughout the year with peak admissions for patients infected by bacterial pathogens in summer and those affected by viral pathogens in autumn. A total of 917 (91.7% patients underwent a laboratory examination. The overall isolation rate was 51%. Bacterial pathogens were found in 29%, viral pathogens in 19% and protozoal pathogens in 2.5% of patients. No aetiological agent or other cause of acute diarrhoea was found in 449 (49% patients. Twenty-nine (3.2% patients were hospitalized. Conclusion: Despite extensive laboratory investigations, enteropathogens were detected in only 51% of adult patients who presented to the hospital ER with acute gastroenteritis. Viral infections ranked as the second most common cause of gastroenteritis in adults.

  14. The roles of ADAM33, ADAM28, IL-13 and IL-4 in the development of lung injuries in children with lethal non-pandemic acute infectious pneumonia.

    Science.gov (United States)

    Baurakiades, Emanuele; Costa, Victor Horácio; Raboni, Sonia Mara; de Almeida, Vivian Rafaela Telli; Larsen, Kelly Susana Kunze; Kohler, Juliana Nemetz; Gozzo, Priscilla do Carmo; Klassen, Giseli; Manica, Graciele C M; de Noronha, Lucia

    2014-12-01

    ADAM28, ADAM33, IL-13, IL-4 and other cytokines (IL-6 and IL-10) seem to play important roles in the persistence and maintenance of acute inflammatory processes that ultimately lead to lung remodeling and pulmonary fibrosis, which may be responsible for the high morbidity and mortality rates associated with non-pandemic acute viral pneumonias in childhood. The aim of this study was to evaluate the roles of ADAM33, ADAM28, IL4, IL6, IL10 and IL13 in the development of inflammation and alveolar fibrosis due to lethal acute respiratory infections of the lower airway in a pediatric population, especially in those with viral etiology. For this study, 193 cases were selected, and samples from the cases were processed for viral antigen detection by immunohistochemistry and then separated into two groups: virus-positive (n=68) and virus-negative (n=125). Immunohistochemistry was performed to assess the presence of metalloproteinases (ADAM33 and ADAM28) and inflammatory cytokines (IL-4, IL-13, IL-6, IL-10) in the alveolar septa. The virus-positive group showed stronger immunolabeling for ADAM33, ADAM28, IL-4 and IL-13 (pplay important roles in pulmonary inflammatory reactions elicited against etiological viral agents. In addition, these mediators may affect the process of lung remodeling and the development of pulmonary fibrosis. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Risk factors associated with Bovine Viral Diarrhea Virus (BVDV) infection in the semiarid of the state of Paraíba, in the northeast region of Brazil

    OpenAIRE

    Ana Luisa Alves Marques; Adriana Cunha de Oliveira Assis; Sara Vilar Dantas Simões; Mikael Leandro Duarte de Lima Tolentino; Sérgio Santos de Azevedo

    2016-01-01

    Bovine viral diarrhea virus (BVDV) has become an important viral infectious agent in cows and is considered endemic in many regions. This study aimed to determine the epidemiological status of BVDV in bovine herds in the semiarid state of Paraíba, in northeastern Brazil, by determining the frequency of anti-BVDV antibodies and risk factors associated with the infection. We tested 359 cows from 20 farms. Three had a history of clinically suspected bovine viral diarrhea (BVD) or mucosal disease...

  16. Development of one-step real-time reverse transcriptase-PCR-based assays for the rapid and simultaneous detection of four viruses causing porcine diarrhea

    OpenAIRE

    Masuda, Tsuneyuki; Tsuchiaka, Shinobu; Ashiba, Tomoko; Yamasato, Hiroshi; Fukunari, Kazuhiro; Omatsu, Tsutomu; Furuya, Tetsuya; Shirai, Junsuke; Mizutani, Tetsuya; Nagai, Makoto

    2016-01-01

    Porcine diarrhea caused by viruses is a major problem of the pig farming industry and can result in substantial losses of revenue. Thus, diagnosing the infectious agents is important to prevent and control diseases in pigs. We developed novel one-step real-time quantitative RT-PCR (qPCR) assays that can detect four porcine diarrheal viruses simultaneously: porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine deltacoronavirus (PDCoV), and porcine group A ...

  17. Acute Motor Axonal Neuropathy in Association with Hepatitis E

    Directory of Open Access Journals (Sweden)

    Araz Al-Saffar

    2018-02-01

    Full Text Available Guillain–Barré syndrome (GBS is an acute peripheral neuropathy that develops as a result of post-infectious immune-mediated nerve injury. It can be classified into classic and variant GBS. Acute motor axonal neuropathy (AMAN is a subtype of GBS with the key clinical features of pure motor weakness, areflexia, absence of sensory symptoms, and lack of neurophysiologic evidence of demyelination. We reported a case of acute motor axonal neuropathy in association with hepatitis E infection. A young woman was referred to us after a period of nausea, fever, and diarrhea. She had unexplained muscle weakness at admission and has been diagnosed with acute hepatitis E infection. A rigorous clinical neurological assessment revealed bilateral symmetrical weakness, which affects the lower limbs more than the upper limbs, with no evidence of sensory involvement. Neurophysiological measurements indicated acute axonal injury without clues to demyelination. A diagnosis of acute motor axonal neuropathy subtype has been made, to which she only received supportive therapy. The symptoms resolved spontaneously and full recovery of motor function was attained after 35 days of weakness onset with complete normalization of neurophysiologic parameters.

  18. Role of the Gut Microbiota of Children in Diarrhea Due to the Protozoan Parasite Entamoeba histolytica.

    Science.gov (United States)

    Gilchrist, Carol A; Petri, Sarah E; Schneider, Brittany N; Reichman, Daniel J; Jiang, Nona; Begum, Sharmin; Watanabe, Koji; Jansen, Caroline S; Elliott, K Pamela; Burgess, Stacey L; Ma, Jennie Z; Alam, Masud; Kabir, Mamun; Haque, Rashidul; Petri, William A

    2016-05-15

    An estimated 1 million children die each year before their fifth birthday from diarrhea. Previous population-based surveys of pediatric diarrheal diseases have identified the protozoan parasite Entamoeba histolytica, the etiological agent of amebiasis, as one of the causes of moderate-to-severe diarrhea in sub-Saharan Africa and South Asia. We prospectively studied the natural history of E. histolytica colonization and diarrhea among infants in an urban slum of Dhaka, Bangladesh. Approximately 80% of children were infected with E. histolytica by the age of 2 years. Fecal anti-galactose/N-acetylgalactosamine lectin immunoglobulin A was associated with protection from reinfection, while a high parasite burden and expansion of the Prevotella copri level was associated with diarrhea. E. histolytica infection was prevalent in this population, with most infections asymptomatic and diarrhea associated with both the amount of parasite and the composition of the microbiota. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.

  19. Celiac Disease Presenting as Profound Diarrhea and Weight Loss - A Celiac Crisis.

    Science.gov (United States)

    Bul, Vadim; Sleesman, Brett; Boulay, Brian

    2016-08-05

    BACKGROUND Celiac disease is a hypersensitivity enteropathy that can have various presentations in adults. Rarely, patients can present with severe lab abnormalities, dehydration and weight loss caused by celiac disease - a celiac crisis. CASE REPORT A 46-year-old male with a past medical history significant for diabetes mellitus, type 2 (DM2) and recently treated Bell's Palsy presented to the emergency room complaining of weakness, diarrhea and lightheadedness. On presentation, the patient had a systolic blood pressure (SBP) of 60 mm Hg and a lactic acidosis with pH of 7.28. Infectious etiologies of diarrhea were ruled out. The patient had an EGD which showed erythema of the duodenal bulb. Serum anti-gliadin and anti-TTG IgA were both elevated suggesting Celiac disease. Biopsies showed histopathology consistent with celiac disease. The patient's diarrhea resolved after initiation of a gluten free diet. He gained 25 kilograms after discharge and did not require further hospitalizations for diarrhea. CONCLUSIONS Celiac crisis is a very rare presentation of celiac disease in adults but nonetheless should be considered in patients with marked metabolic derangements in the setting of osmotic diarrhea. Treatment consists of a gluten free diet and may require management with steroids and total parenteral nutrition (TPN).

  20. Endoscopy in acquired immunodeficiency syndrome patients with diarrhea and negative stool studies.

    Science.gov (United States)

    Wei, S C; Hung, C C; Chen, M Y; Wang, C Y; Chuang, C Y; Wong, J M

    2000-04-01

    Diarrhea is a frequent gastrointestinal symptom in patients with acquired immuno-deficiency syndrome (AIDS) and is a major source of morbidity and mortality. A stepwise diagnostic approach is often recommended to search for treatable causes. However, whether the stepwise diagnostic approach is adequate for planning treatment and whether specific treatment for infectious etiologies will affect the survival of patients with AIDS remain unknown. From March 1996 to September 1997, endoscopy was performed in AIDS patients with diarrhea, the etiology of which was not identified by noninvasive methods. Specific treatment was given according to the identified etiologies and symptomatic treatment was given for those without definite diagnosis. The clinical symptoms, signs, and duration of follow-up were recorded and survival patterns were analyzed. Etiologic diagnoses were made in 26 of 40 patients (65%) who underwent endoscopic studies. Amebic colitis and cytomegalovirus colitis were the 2 leading causes of prolonged diarrhea in patients with AIDS. Thirty-five patients (87.5%) recovered after treatment. The difference in survival time after diarrhea between patients whose symptoms resolved after treatment and those who continued to have diarrhea was statistically significant (p AIDS patients who had negative stool studies and did not respond to 2 weeks of empiric treatment. Specific treatment according to the results of endoscopy may improve survival in these patients.

  1. Is there a relationship between low vitamin D and rotaviral diarrhea?

    Science.gov (United States)

    Bucak, Ibrahim Hakan; Ozturk, Agah Bahadır; Almis, Habip; Cevik, Muhammer Özgür; Tekin, Mehmet; Konca, Çapan; Turgut, Mehmet; Bulbul, Mehmet

    2016-04-01

    For children under 5 years of age, 1700 000 000 episodes of diarrhea are seen worldwide, and death occurs in 700 000 of these cases due to diarrhea. Rotavirus is an important cause of diarrhea in this age group, and many studies have shown that vitamin D plays a pivotal role in the immune system, as well as in antimicrobial peptide gene expression. In addition, lower vitamin D has been correlated with higher rates of infectious diseases such as respiratory tract infection, tuberculosis, and viral infection. Seventy patients with rotaviral diarrhea and 67 healthy patients were enrolled in this study. Serum 25-hydroxy vitamin D(3) (25(OH)D(3)), parathormone, calcium, phosphate, alkaline phosphatase, complete blood count parameters, and C-reactive protein were compared between pre-school children hospitalized due to rotaviral diarrhea and healthy children. Additionally, birthweight, feeding habits in the first 6 months of life, vitamin D and multivitamin supplements, and rotaviral vaccinations were also evaluated in each group. There were no differences between the groups with regard to gender and age, but 25(OH)D(3) was significantly different: 14.6 ± 8.7 ng/mL in the rotaviral diarrhea patients versus 29.06 ± 6.51 ng/mL in the health controls (P vitamin D is associated with rotaviral diarrhea. This is the first study in the literature to show this, and this result needs to be repeated in larger controlled clinical studies. © 2015 Japan Pediatric Society.

  2. Acute Infectious and Haematological Toxicity in patients with ALL after Consolidation Phase with Methotrexate in the Oncology Center of Javeriana University (2012-2014)

    OpenAIRE

    Córdoba Núñez, María Adelaida; Pontificia Universidad Javeriana; Guzmán Cruz, Paula Carolina; Pontificia Universidad Javeriana; Acero Azuero, Silvia; Pontificia Universidad Javeriana

    2014-01-01

    Introduction: Acute lymphocytic leukemia (ALL) is the most common childhood malignancy. Treatment includes 3 phases. During the cosolidation phase the use of methrotexate in different doses, depending on the risk classification, is the treatments main pilar.Objective: To Estimate the presence of febrile neutropenia, anemia and thrombocytopenia in patients with ALL receiving methotrexate during the consolidation phase at a dose of 5 g/m2 compared to patients who received doses of 2 g/m2.Method...

  3. Diarrhea: Cancer-Related Causes and How to Cope

    Science.gov (United States)

    Diarrhea: Cancer-related causes and how to cope Knowing which diarrhea signs and symptoms are routine and which are ... stomach cramps. The frequent trips to the bathroom. Diarrhea is an unpleasant but common side effect in ...

  4. Equine Infectious Anemia

    OpenAIRE

    Hoopes, Karl H.

    2017-01-01

    This fact sheet gives information on equine infectious anemia, a blood-borne infectious viral disease of horses, donkeys, and mules. It describes transmission, clinical disease, diagnosis and control.

  5. Diarrhea due to Cryptosporidium parvum in immunocompromised ...

    African Journals Online (AJOL)

    Objective: The objective of this study is to search for Cryptosporidium parvum in Sudanese immunocompromised and immunocompetent patients presenting with diarrhea. Methods: Two hundred and thirteen stool specimens were collected from different groups of patients presenting with diarrhea and healthy control ...

  6. Effect of mild diarrhea on tacrolimus exposure

    NARCIS (Netherlands)

    Boekel, G.A.J van; Aarnoutse, R.E.; van der Heijden, J.J.; Hoogtanders, K.E.; Hilbrands, L.B.

    2012-01-01

    BACKGROUND: Diarrhea is a frequent adverse event in patients treated with the combination of tacrolimus and mycophenolate mofetil (MMF). In case of severe diarrhea, the total exposure to tacrolimus can substantially increase, which is reflected in a rise of the predose trough level (C0). In mild

  7. Diarrhea - what to ask your doctor - child

    Science.gov (United States)

    What to ask your doctor about diarrhea - child; Loose stools - what to ask your doctor - child ... FOODS What foods can make my child's diarrhea worse? How should I prepare the foods for my child? If my child is still breastfeeding or bottle feeding, do I need to ...

  8. Campylobacter jejuni diarrhea model in infant chickens

    NARCIS (Netherlands)

    Sanyal, S. C.; Islam, K. M.; Neogy, P. K.; Islam, M.; Speelman, P.; Huq, M. I.

    1984-01-01

    To study the pathogenic mechanisms of Campylobacter jejuni infection, 36- to 72-h-old chickens were fed 10(3) to 10(6) live cells, using strains isolated from 40 patients with watery diarrhea and 6 with bloody mucoid diarrhea from whom no other known enteropathogen was detected. Chickens of Starbro

  9. Infectious diseases in the 21st century.

    Science.gov (United States)

    Kumate, J

    1997-01-01

    Infecto-contagious diseases in the twenty-first century with respect to precedent will see themselves deprived of smallpox, dracunculiasis and very probably of paralyzing poliomyelitis. Vaccination-preventable diseases, such as measles, whooping cough, diphtheria, tetanus, rabies, some forms of meningitis, yellow fever and episodes of disseminated tuberculosis will greatly diminish in their rates of morbi-lethality; the elimination of some, and the eradication of measles, are expected. Other diseases such as diarrhea (including cholera), geo-helminthiasis, some severe respiratory tract infections and the majority of vector-transmitted infectious diseases will decrease due to improvements in potable water services, drainage, sanitary food control, living quarters, and individual and community anti-vector action. Leprosy, onchocerciasis and several parasitoses will be controlled by the available antimicrobial drugs. Infectious diseases will continue to be an important health problem due to: Reduction in the immunocompetence resulting from the aging of the population, chemotherapies necessary for neoplasms, and autoimmune pathology and the survival of persons with primary immunodeficiencies; lifestyles prone to infectious pathology, such as mega-city urbanization, children in day care centers, industrialized foods, intravenous drug addiction, sexual liberation, global commerce, and tourism; antibiotic-multiresistant microbial flora; environmental disturbances as a result of global warming, deforestation, the settling of virgin areas, dams, the large-scale use of pesticides, fertilizers and antimicrobials, and natural/social disasters generators of poverty, violence and deprivation will result in emergence or re-emergence of infectious diseases already controlled in the past.

  10. Occurrence of gastrointestinal parasites in dogs (Canis familiaris with acute diarrhea from metropolitan region of Londrina, Parana State, Brazil/ Ocorrência de parasitos gastrintestinais em cães (Canis familiaris com diarréia aguda oriundos da região metropolitana de Londrina, Estado do Paraná, Brasil

    Directory of Open Access Journals (Sweden)

    Pedro Luiz de Camargo

    2007-10-01

    Full Text Available One hundred and fifty fecal samples from dogs with acute diarrhea (Group 1 and from 50 dogs without diarrhea (Group 2 were collected and analyzed at the Veterinary Teaching Hospital of the State University of Londrina, between October, 2004 and October 2005. From the positive samples (29.3% of Group 1, 72.7% were infected by only one agent, while 27.3% had mixed infection. The following genera wereobserved by coproparasitologic evaluation: Giardia sp. (9.3%, Ancylostoma sp. (7.3%, Cystoisospora (7.3%, Entamoeba sp. (6.7%, Toxocara sp.(4%, Pentatrichomanas hominis (3.3%, and Trichurisvulpis (1.3%. From the 50 animals without diarrhea, six (12% were positive by coproparasitologic evaluation: two (4% for Ancylostoma sp., three (6% with Giardia sp., and one (2% for both Ancylostoma sp. and Cystoisospora sp. There was a significant relationship between infection and diarrhea (P=0,005, age and infection (PForam examinadas 150 amostras de fezes colhidas de cães com diarréia aguda (Grupo 1, e outras 50 de animais sem diarréia (Grupo 2, atendidos entre outubro de 2004 e outubro 2005, no Hospital Veterinário Escola da Universidade Estadual de Londrina. Dos 150 animais do G1, 44 (29,3% estavam infectados por helmintos e/ou protozoários, sendo que destes, 32 (72,7% apresentavam infecção simples e 12 (27,3% infecções múltiplas. Os gêneros identificados nestes animais foram: Giardia sp. (9,3%, Cystoisospora sp. (7,3%, Ancylostoma sp. (7,3%, Entamoeba sp. (6,7%, Toxocara sp. (4%, Pentatrichomonas hominis (3,3% e Trichuris vulpis (1,3%. Dos 50 animais sem diarréia, seis (12% eram positivos, dois (4% para Ancylostoma sp., três (6% para Giardia sp. e um (2% para Ancylostoma sp. e Cystoisospora simultaneamente. Houve relação estatisticamente significativa (P=0,005 entre o parasitismo e a ocorrência de diarréia, assim como entre a faixa etária e a proporção de infecções (P<0,001, porém, machos e fêmeas foram igualmente acometidos (P=0,08. O

  11. Mortality in children with complicated severe acute malnutrition is related to intestinal and systemic inflammation: an observational cohort study

    NARCIS (Netherlands)

    Attia, Suzanna; Versloot, Christian J.; Voskuijl, Wieger; van Vliet, Sara J.; Di Giovanni, Valeria; Zhang, Ling; Richardson, Susan; Bourdon, Céline; Netea, Mihai G.; Berkley, James A.; van Rheenen, Patrick F.; Bandsma, Robert Hj

    2016-01-01

    Diarrhea affects a large proportion of children with severe acute malnutrition (SAM). However, its etiology and clinical consequences remain unclear. We investigated diarrhea, enteropathogens, and systemic and intestinal inflammation for their interrelation and their associations with mortality in

  12. Mortality in children with complicated severe acute malnutrition is related to intestinal and systemic inflammation : an observational cohort study

    NARCIS (Netherlands)

    Attia, Suzanna; Versloot, Christian J.; Voskuijl, Wieger; van Vliet, Sara J.; Di Giovanni, Valeria; Zhang, Ling; Richardson, Susan; Bourdon, Celine; Netea, Mihai G.; Berkley, James A.; van Rheenen, Patrick F.; Bandsma, Robert H. J.

    2016-01-01

    Background: Diarrhea affects a large proportion of children with severe acute malnutrition (SAM). However, its etiology and clinical consequences remain unclear. Objective: We investigated diarrhea, enteropathogens, and systemic and intestinal inflammation for their interrelation and their

  13. Mortality in children with complicated severe acute malnutrition is related to intestinal and systemic inflammation: an observational cohort study

    NARCIS (Netherlands)

    Attia, S.; Versloot, C.J.; Voskuijl, W.; Vliet, S.J. van; Giovanni, V. Di; Zhang, L.; Richardson, S.; Bourdon, C.; Netea, M.G.; Berkley, J.A.; Rheenen, P.F. van; Bandsma, R.H.

    2016-01-01

    BACKGROUND: Diarrhea affects a large proportion of children with severe acute malnutrition (SAM). However, its etiology and clinical consequences remain unclear. OBJECTIVE: We investigated diarrhea, enteropathogens, and systemic and intestinal inflammation for their interrelation and their

  14. Evaluating the Patient With Diarrhea: A Case-Based Approach

    OpenAIRE

    Sweetser, Seth

    2012-01-01

    The evaluation of the patient with diarrhea can be complex and the treatment challenging. In this article, the definition of diarrhea and the pathophysiologic mechanisms that lead to diarrhea are reviewed. A simplified 5-step approach to the patient with diarrhea is provided and applied in a case-oriented manner applicable to everyday clinical practice. On completion of this article, you should be able to (1) define diarrhea, (2) outline various pathophysiologic mechanisms of diarrhea, and (3...

  15. [Surveillance on other infectious diarrheal diseases in China from 2014 to 2015].

    Science.gov (United States)

    Zhang, P; Zhang, J

    2017-04-10

    Objective: To analyze the current situation on infectious diarrhea other than cholera, dysentery, typhoid and paratyphoid (hereinafter referred to as Other Infectious Diarrheal Diseases) under the current monitoring program in China from 2014 to 2015, to provide evidence for developing strategies related to the control of these diseases. Methods: All the reported infectious diarrhea cases and information on public health emergencies relevant to infectious diarrhea were collected from the "Chinese Information System for Disease Control and Prevention" . Analytic method was carried out to describe the etiological and epidemiological characteristics of all the infectious diarrhea cases. Results: In 2014, a total of 867 545 infectious diarrhea cases were reported, with the incidence rate as 64.0/100 000. While in 2015, a total of 937 616 infectious diarrhea cases were reported, and the incidence rate was 68.8/100 000. Cases distributed in all provinces of the country, with incidence rates between 3.8/100 000 and 506.7/100 000. Cases involved in all the age groups, with 53.7 % (968 984/1 805 161) of the total reported cases below 5 years of age. Reported cases showed two peaks of incidence, in summer (from June to August) and winter (from November to next January). Laboratory-confirmed cases accounted for 9.5 % (82 285/867 545) of the total and 9.3 % (86 975/937 616) of the cases reported in 2014 and 2015 respectively. Among cases reported in the two years, viral infection accounted for 92.4 % (76 045/82 285) and 91.0 % (79 176/86 975) while bacterial infection accounted for 7.4 % (6 062/82 285) and 8.8 % (7 614/86 975), respectively. Among the death cases, only three were laboratory confirmed, with two of them caused by rotavirus. Conclusions: Children under 5 years old appeared both higher incidence and mortalities for infectious diarrhea. Most laboratory-confirmed cases were viral-born, with pathogenic spectrums varied in different provinces. Capabilities related to

  16. Nosocomial diarrhea in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Ana Paula Marcon

    Full Text Available We made an epidemiological case-control study to examine risk factors for the development of diarrhea in the intensive care unit (ICU of a public hospital in Santo André, SP, from January to October 2002. Forty-nine patients with diarrhea (cases and 49 patients without diarrhea (controls, matched for age and gender, were included in the study. A stool culture and enzyme immunoassays for Clostridium difficile toxins A and B were performed on fecal specimens from diarrhea patients. Fourteen of them presented positive cultures for Pseudomonas aeruginosa and 22 patients presented positive ELISA for Clostridium diffícile. Nosocomial diarrhea was associated with several factors, including use of antibiotics (P=0.001, use of ceftriaxone (P=0.001, presence of infection (P=0.010 and length of hospital stay (P=0.0001.

  17. Diarréia aguda grave associada à Escherichia coli enteropatogênica clássica (EPEC: características clínicas e perdas fecais em lactentes hospitalizados Severe acute diarrhea associated to classic enteropathogenic by clinical features and fecal losses in hospitalized infants

    Directory of Open Access Journals (Sweden)

    C.A.G. Oliva

    1997-12-01

    estudados. A duração da diarréia mostrou curso agudo (menor ou igual a 14 dias na maioria das crianças estudadas, reafirmando a evolução potencialmente autolimitada da diarréia aguda. Sete (18,4% pacientes, entretanto, desenvolveram quadro de diarréia persistente, indicando que tal evolução é esperada em uma parcela razoável de lactentes jovens hospitalizados com tal enfermidade. Os volumes médios de ingestão das fórmulas alimentares encontrados mostram o impacto da diarréia aguda na diminuição da ingestão alimentar. As médias observadas nas três diferentes fórmulas alimentares ficaram abaixo da ingestão calórica sugerida como padrão pela FAO/WHO (100cal/kg/dia. Não houve diferenças entre os volumes de aceitação segundo os tipos de fórmulas alimentares utilizadas.Enteropathogenic Escherichia coli (EPEC strains are the most prevalent enteropathogenic agents isolated in the stools of hospitalized infants with severe acute diarrhea in São Paulo. These microorganisms induce a severe intestinal secretion of fluids and electrolytes that can cause dehydration leading to hospital admission in the majority of the cases. OBJECTIVES. This investigation aims at the following objectives: 1 to study the clinical features of acute diarrhea in male infants who were hospitalized owing to EPEC infection; 2 to determine the fecal fluid losses, formula intake and variation of the body weight during the evolution of the disease. PATIENTS AND METHODS. Thirty eight male infants with acute diarrhea due to EPEC strains were studied. The clinical and epidemiological features of the patients were recorded and the different EPEC serogroups were identified. The infants were kept in a metabolic bed in order to allow the collection of stools and urine separately during the whole period of the disease, and daily metabolic balances were also obtained. The mean duration of the metabolic study was 5.8 days, and during this period of time 220 daily metabolic balances were

  18. Incidence of diarrhea in children living in urban slums in Salvador, Brazil

    Directory of Open Access Journals (Sweden)

    Maria Clotildes N. de Melo

    Full Text Available Diarrhea remains a major health issue in developing countries, with high morbidity and mortality rates. Determining the incidence of acute diarrhea in children and its associated factors is crucial to the planning of preventive approaches. The objective of this study was to determine the incidence of diarrhea and to assess some relevant associated factors to it in children younger than 40 months living in two slums of Salvador, Brazil. This is the first prospective cohort, community-based study that was performed in two periurban slums of Salvador, Brazil. Eighty-four children younger than 40 months were randomly selected and visited every other day for one year. The chi-square test was used to evaluate the occurrence of diarrhea and its associated factors. During the surveillance period, 232 diarrhea episodes were identified, resulting in an incidence rate of 2.8 episodes/child/year. In average (mean value of 84 children,each child suffered 11.1 days of diarrhea per year, yielding an average duration of 3.9 days per episode. The highest incidence rates were found among children under one year old. Early weaning, male sex, malnutrition, having a mother younger than 25 years or who considered her child malnourished, missed immunizations and previous pneumonia were associated factors for suffering diarrheal episodes. The rates of incidence and duration of diarrhea that we found are in accordance to those reported by others. Additionally, our results reinforce the importance of environmental and health-related associated factors to the onset of diarrhea.

  19. 1,2-Fucosyllactose Does Not Improve Intestinal Function or Prevent Escherichia coli F18 Diarrhea in Newborn Pigs

    DEFF Research Database (Denmark)

    Cilieborg, Malene Skovsted; Sangild, Per Torp; Jensen, Michael Ladegaard

    2017-01-01

    Objectives: Infectious diarrhea, a leading cause of morbidity and deaths, is less prevalent in breastfed infants compared with infants fed infant formula. The dominant human milk oligosaccharide (HMO), α-1,2-fucosyllactose (2′-FL), has structural homology to bacterial adhesion sites in the intest......Objectives: Infectious diarrhea, a leading cause of morbidity and deaths, is less prevalent in breastfed infants compared with infants fed infant formula. The dominant human milk oligosaccharide (HMO), α-1,2-fucosyllactose (2′-FL), has structural homology to bacterial adhesion sites...... in the intestine and may in part explain the protective effects of human milk. We hypothesized that 2′-FL prevents diarrhea via competitive inhibition of pathogen adhesion in a pig model for sensitive newborn infants. Methods: Intestinal cell studies were coupled with studies on cesarean-delivered newborn pigs (n...... more diarrhea than control pigs (P diarrhea, although the relative weight loss tended to be reduced (−19 vs −124 g/kg, P = 0.12), higher villi were observed in the distal small intestine (P 

  20. Gastro 2013 APDW/WCOG Shanghai working party report: chronic diarrhea: definition, classification, diagnosis.

    Science.gov (United States)

    Schiller, Lawrence R; Pardi, Darrell S; Spiller, Robin; Semrad, Carol E; Surawicz, Christina M; Giannella, Ralph A; Krejs, Guenter J; Farthing, Michael J G; Sellin, Joseph H

    2014-01-01

    Diarrhea is best defined as passage of loose stools often with more frequent bowel movements. For clinical purposes, the Bristol Stool Form Scale works well to distinguish stool form and to identify loose stools. Laboratory testing of stool consistency has lagged behind. Acute diarrhea is likely to be due to infection and to be self-limited. As diarrhea becomes chronic, it is less likely to be due to infection; duration of 1 month seems to work well as a cut-off for chronic diarrhea, but detailed scientific knowledge is missing about the utility of this definition. In addition to duration of diarrhea, classifications by presenting scenario, by pathophysiology, and by stool characteristics (e.g. watery, fatty, or inflammatory) may help the canny clinician refine the differential diagnosis of chronic diarrhea. In this regard, a careful history remains the essential part of the evaluation of a patient with diarrhea. Imaging the intestine with endoscopy and radiographic techniques is useful, and biopsy of the small intestine and colon for histological assessment provides key diagnostic information. Endomicroscopy and molecular pathology are only now being explored for the diagnosis of chronic diarrhea. Interest in the microbiome of the gut is increasing; aside from a handful of well-described infections because of pathogens, little is known about alterations in the microbiome in chronic diarrhea. Serological tests have well-defined roles in the diagnosis of celiac disease but have less clearly defined application in autoimmune enteropathies and inflammatory bowel disease. Measurement of peptide hormones is of value in the diagnosis and management of endocrine tumors causing diarrhea, but these are so rare that these tests are of little value in screening because there will be many more false-positives than true-positive results. Chemical analysis of stools is of use in classifying chronic diarrhea and may limit the differential diagnosis that must be considered, but

  1. Anti-diarrhea activity of the aqueous root bark extract of Byrsocarpus coccineus on castor oil-induced diarrhea in Wistar rats.

    Science.gov (United States)

    Ejeh, Sunday A; Onyeyili, Patrick; Abalaka, Samson E

    2017-07-01

    The use of traditional medicine as an alternative source of cure for many ailments has played an important role in health care delivery in both developing and developed countries. Byrsocarpus coccineus Schum and Thonn ( Connaraceae ) is used in traditional medicine for treatment of various disease conditions, including diarrhea. The anti-diarrhea activity of the root bark aqueous extract of B. coccineus was investigated in this study. Acute toxicity evaluation of the aqueous extract of B. coccineus root bark was performed in exposed rats. Diarrhea was induced in exposed rats with castor oil, and the effect of the extract on castor oil-induced gastrointestinal motility and enteropooling was consequently investigated. In the acute toxicity study, the extract caused no death in treated rats nor produced signs of delayed toxicity, even at 5000 mg/kg. The aqueous root bark extract of B. coccineus also decreased the distance travelled by activated charcoal in the gastrointestinal tract of treated rats when compared to control rats. Results of castor oil-induced enteropooling revealed slight reduction in the weight of intestinal contents of treated rats compared to control rats. There was significant (pcastor oil-induced diarrhea at 100 mg/kg dose with 74.96% inhibition of defecation. The study demonstrated the anti-diarrheic property of the aqueous extract of B. coccineus root bark as currently exploited in our traditional herbal therapy.

  2. Infectious diseases in Greenlanders of Upernavik

    DEFF Research Database (Denmark)

    Bjerregaard, P

    1985-01-01

    During one year, 1979-80, all the contacts between the 836 inhabitants of Upernavik town and the local medical officers were recorded. In the 737 native Greenlanders 1006 contacts (41%) were caused by infectious diseases, representing 705 episodes of disease. The number of contacts per episode...... infections during winter was noted. The contact rate for all infectious diseases together was slightly higher than in Danish general practice, and infectious diseases also accounted for a larger proportion of all registered contacts. Contacts due to chronic respiratory infections, skin infections...... of disease was similar in all age groups. Of these contacts 26% were caused by acute upper respiratory tract infections, 8% by other acute respiratory infections, 10% by chronic respiratory infections, 24% by non-traumatic skin infections, 7% by post-traumatic skin infections, 8% by sexually transmitted...

  3. Neutropenic enterocolitis (typhlitis) associated with infectious mononucleosis

    Energy Technology Data Exchange (ETDEWEB)

    Sigirci, Ahmet [Inonu University School of Medicine, Department of Radiology, Turgut Ozal Medical Centre, Malatya (Turkey); Akinci, Aysehan; Oezgen, Uensal; Oezen, Metehan [Inonu University School of Medicine, Department of Paediatrics, Turgut Ozal Medical Centre, Malatya (Turkey)

    2006-02-01

    Neutropenic enterocolitis (typhlitis) is an unusual acute complication of neutropenia, most often associated with leukaemia and lymphoma and characterized by segmental caecal and ascending colonic ulceration that may progress to necrosis, perforation, and septicaemia. We present a unique case of an 8-year-old girl with recently diagnosed infectious mononucleosis having findings consistent with typhlitis on abdominal CT. (orig.)

  4. [Diarrhea in a patient with Down syndrome and endemic sprue].

    Science.gov (United States)

    Micklefield, G; Wenzel, I U

    2000-02-01

    Down syndrome is associated with disorders such as celiac disease, hypothyroidism, and insulin-dependent diabetes mellitus. In patients with mono- or oligosymptomatic celiac disease the time interval between the onset of symptoms and diagnosis often is unacceptably long. A female patient with Down syndrome is presented who had acute watery diarrhea, which spontaneously ceased but recurred after a few days. After endoscopic and histologic evaluation and measurement of gliadin, endomysium, and reticulin antibodies celiac sprue was diagnosed. Further investigation showed findings of autoimmune hypothyroidism and secondary hyperparathyreoidism. After the patient was put on a gluten-free diet her state quickly improved. Associations between Down syndrome and autoimmune diseases exist. Patients with acute gastrointestinal symptoms should be evaluated as to celiac disease. The time interval between the onset of symptoms and diagnosis of celiac disease can be shortened, if all diagnostic tools are used at the appropriate time.

  5. Characterization of Norovirus-associated Travelers’ Diarrhea

    Science.gov (United States)

    Ajami, NJ; Koo, HL; Darkoh, C; Atmar, RL; Jiang, ZD; DuPont, HL

    2011-01-01

    Background Travelers’ diarrhea (TD) is the most common medical complaint of international visitors to developing regions. Previous findings suggested that noroviruses (NoVs) are an underappreciated cause of TD. Methods In the present study we sought to define the presence of NoVs in 320 acute diarrheic stool samples collected from 299 U.S. students who travelled to Guadalajara, Cuernavaca or Puerto Vallarta, Mexico during 2007 and 2008. Conventional and quantitative real time PCR (qPCR) were employed to detect and determine NoV loads in stool samples. NoV strains were characterized by purification of viral RNA followed by sequencing of the viral capsid protein (VP1) gene. Sequences were compared using multiple sequence alignment and phylogenetic trees were generated to evaluate the evolutionary relatedness of the viral strains associated with TD cases. Results NoV RNA was detected in 9.4% (30 of 320) of the samples. Twelve strains belonged to Genogroup I (GI) and 18 to GII. NoV prevalence was higher in the winter season compared to the summer season (23% vs. 7%, respectively, P=.001). cDNA viral loads of GI viruses were found to be ~500-fold higher than those of GII strains. Phylogenetic analysis revealed a diverse population of NoV strains over different locations and years. Conclusions NoV strains are important causes of TD in Mexico, especially during the wintertime, and U.S. students in Mexico may represent a suitable group for future NoV vaccine efficacy trials. PMID:20540620

  6. Bile acids in radiation-induced diarrhea

    International Nuclear Information System (INIS)

    Arlow, F.L.; Dekovich, A.A.; Priest, R.J.; Beher, W.T.

    1987-01-01

    Radiation-induced bowel disease manifested by debilitating diarrhea is an unfortunate consequence of therapeutic irradiation for pelvic malignancies. Although the mechanism for this diarrhea is not well understood, many believe it is the result of damage to small bowel mucosa and subsequent bile acid malabsorption. Excess amounts of bile acids, especially the dihydroxy components, are known to induce water and electrolyte secretion and increase bowel motility. We have directly measured individual and total bile acids in the stool samples of 11 patients with radiation-induced diarrhea and have found bile acids elevated two to six times normal in eight of them. Our patients with diarrhea and increased bile acids in their stools had prompt improvement when given cholestyramine. They had fewer stools and returned to a more normal life-style

  7. Norovirus-related chronic diarrhea in a patient treated with alemtuzumab for chronic lymphocytic leukemia.

    Science.gov (United States)

    Ronchetti, Anne-Marie; Henry, Benoit; Ambert-Balay, Katia; Pothier, Pierre; Decroocq, Justine; Leblond, Véronique; Roos-Weil, Damien

    2014-05-06

    Norovirus infection is increasingly recognized as an important cause of persistent gastroenteritis in immunocompromised hosts and can be a potential cause of morbidity in these populations. Here, we report a case of norovirus-related chronic diarrhea occurring in a 62-year-old immunocompromised patient treated with alemtuzumab for chronic lymphocytic leukemia. Despite different therapeutic strategies including tapering of immunosuppressive therapy and immunoglobulin administration, diarrhea unfortunately did not resolve and lasted for a total of more than twelve weeks with prolonged norovirus fecal excretion. Norovirus infection can occur in the setting of alemtuzumab treatment, even as a single agent, and should be included in the differential diagnoses of acute and chronic diarrhea in these immunocompromised patients. Although the administration of oral immunoglobulin has been described as a promising efficient therapy, this was not the case in our patient. Clinical trials are thus clearly warranted to better define risk factors and efficient therapies for norovirus infection in immunocompromised populations.

  8. The Dangerous Decline in the United States Military’s Infectious Disease Vaccine Program

    Science.gov (United States)

    2010-02-17

    is focused on drug therapies to attenuate lethal disease in children and pregnant women in under-developed countries. The goal of the DOD’s...HIV/AIDS, pneumonia, diarrhea, malaria and tuberculosis . (WHO). 9 core funding for infectious disease vaccine R&D declined.44,x Since the post-ŝ

  9. Evaluating the Patient With Diarrhea: A Case-Based Approach

    Science.gov (United States)

    Sweetser, Seth

    2012-01-01

    The evaluation of the patient with diarrhea can be complex and the treatment challenging. In this article, the definition of diarrhea and the pathophysiologic mechanisms that lead to diarrhea are reviewed. A simplified 5-step approach to the patient with diarrhea is provided and applied in a case-oriented manner applicable to everyday clinical practice. On completion of this article, you should be able to (1) define diarrhea, (2) outline various pathophysiologic mechanisms of diarrhea, and (3) describe a simplified 5-step approach to facilitate the evaluation of diarrhea. PMID:22677080

  10. Probiotics and Antibiotic-Associated Diarrhea and Clostridium difficile Infection

    Science.gov (United States)

    Surawicz, Christina M.

    Diarrhea is a common side effect of antibiotics. Antibiotics can cause diarrhea in 5-25% of individuals who take them but its occurrence is unpredictable. Diarrhea due to antibiotics is called antibiotic-associated diarrhea (AAD). Diarrhea may be mild and resolve when antibiotics are discontinued, or it may be more severe. The most severe form of AAD is caused by overgrowth of Clostridium difficile which can cause severe diarrhea, colitis, pseudomembranous colitis, or even fatal toxic megacolon. Rates of diarrhea vary with the specific antibiotic as well as with the individual susceptibility.

  11. Renal abnormalities in congenital chloride diarrhea

    International Nuclear Information System (INIS)

    Al-Hamad, Nadia M.; Al-Eisa, Amal A.

    2004-01-01

    Congenital chloride diarrhea CLD is a rare autosomal recessive disorder caused by a defect in the chloride/ bicarbonate exchange in the ileum and colon. It is characterized by watery diarrhea, abdominal distension, hypochloremic hypokalemic metabolic alkalosis with high fecal content of chloride >90 mmol/l. We report 3 patients with CLD associated with various renal abnormalities including chronic renal failure secondary to renal hypoplasia, nephrocalcinosis and congenital nephrotic syndrome. (author)

  12. Clinical trial evaluating cholestyramine to prevent diarrhea in patients maintained on low-fat diets during pelvic radiation therapy

    International Nuclear Information System (INIS)

    Chary, S.; Thomson, D.H.

    1984-01-01

    A prospective randomized trial to determine the value of a low fat diet with or without cholestyramine in the treatment of acute intestinal complications of pelvic irradiation is presented. A total of 35 patients receiving pelvic irradiation were entered in the study and all patients had received a 40 gm fat diet. The group was then randomized to receive either placebo (17 patients) or cholestyramine (18 patients). Diarrhea occurred in six out of 16 evaluable patients in the control group and only one of the 17 evaluable patients in the cholestyramine group. The frequency of diarrhea and the diarrhea scale remained high in the placebo group in the entire observation period. Statistical analysis had revealed better diarrhea control in the cholestyramine group. In this report mechanism by which diarrhea occurs following pelvic irradiation is discussed. The adverse effects associated with the use of cholestyramine have been presented. It was concluded that cholestyramine is effective in preventing acute diarrhea induced by pelvic irradiation in patients receiving a low fat diet but is associated with side effects

  13. Infectious Bursal Disease Virus

    Science.gov (United States)

    Gimenez, María Cecilia; Zanetti, Flavia Adriana; Terebiznik, Mauricio R; Colombo, María Isabel; Delgui, Laura Ruth

    2018-03-14

    Birnaviruses are unconventional members of the double-stranded RNA (dsRNA) viruses group that are characterized by the lack of a transcriptionally active inner core. Instead, the birnaviral particles organize their genome in ribonucleoprotein complexes (RNPs) composed by dsRNA segments, the dsRNA-binding VP3 protein, and the viral encoded RNA-dependent RNA-polymerase (RdRp). This and other structural features suggests that birnaviruses may follow a completely different replication program from that followed by members of the Reoviridae family, supporting the hypothesis that birnaviruses are the evolutionary link between single-stranded positive RNA (+ssRNA) and dsRNA viruses. Here, we demonstrated that the Infectious Bursal Disease Virus (IBDV), a prototypical member of the Birnaviridae family, hijacks endosomal membranes of infected cells through the interaction of viral protein, VP3, with the phospholipids on the cytosolic leaflet of these compartments for replication. Employing a mutagenesis approach, we demonstrated that VP3 domain PATCH 2 (P2) mediates the association of VP3 with the endosomal membranes. To determine the role of VP3 P2 in the context of virus replication cycle, we used avian cells stably overexpressing VP3 P2 for IBDV infection. Importantly, the intra- and extra-cellular virus yields, as well as the intracellular levels of VP2 viral capsid protein, significantly diminished in VP3 P2 stably overexpressing cells. Altogether, our results indicate that the association of VP3 with endosomes has a relevant role in IBDV replication cycle. This report provides direct experimental evidence for membranous compartments such as endosomes being required by a dsRNA virus for its replication. The results also support the previously proposed role of birnaviruses as an evolutionary link between +ssRNA and dsRNA viruses. IMPORTANCE Infectious Bursal Disease (IBD, also called Gumboro disease) is an acute, highly contagious immunosuppressive disease that affects

  14. Spectrum of Drug-induced Chronic Diarrhea.

    Science.gov (United States)

    Philip, Nissy A; Ahmed, Nazir; Pitchumoni, Capecomorin S

    2017-02-01

    The evaluation of a patient with chronic diarrhea can be quite frustrating, as it is expensive and involves multiple diagnostic studies. Moreover, identification of a drug as a cause of chronic diarrhea is a challenge in patients taking multiple medications. The disease may either be associated with intestinal mucosal changes, mimicking diseases such as celiac disease, or purely functional, with no histopathologic change. Drug-induced diarrhea may or may not be associated with malabsorption of nutrients, and a clinical improvement may occur within days of discontinuation of the drug, or may take longer when associated with mucosal injury. Diarrhea in diabetics, often attributed to poor management and lack of control, may be due to oral hypoglycaemic agents. Chemotherapy can result in diffuse or segmental colitis, whereas olmesartan and a few other medications infrequently induce a disease that mimics celiac disease, but is not associated with gluten intolerance. In short, increased awareness of a drug, as a cause for diarrhea and a clear understanding of the clinical manifestations will help clinicians to solve this challenging problem. This article aims to review drug-induced diarrhea to (a) understand known pathophysiological mechanisms; (b) assess the risk associated with frequently prescribed medications, and discuss the pathogenesis; and (c) provide easily retrievable data in tables to help identify known offending medication/s and a list of top 100 prescribed medications in the United States as a useful comprehensive reference.

  15. Emerging Infectious Diseases in Pregnancy.

    Science.gov (United States)

    Beigi, Richard H

    2017-05-01

    It has been recognized for centuries that pregnant women have unique susceptibilities to many infectious diseases that predispose them to untoward outcomes compared with the general adult population. It is thought a combination of adaptive alterations in immunity to allow for the fetal allograft combined with changes in anatomy and physiology accompanying pregnancy underlie these susceptibilities. Emerging infectious diseases are defined as those whose incidence in humans has increased in the past two decades or threaten to increase in the near future. The past decade alone has witnessed many such outbreaks, each with its own unique implications for pregnant women and their unborn fetuses as well as lessons for the health care community regarding response and mitigation. Examples of such outbreaks include, but are not limited to, severe acute respiratory syndrome, the 2009 H1N1 pandemic influenza, Ebola virus, and, most recently, the Zika virus. Although each emerging pathogen has unique features requiring specific considerations, there are many underlying principles that are shared in the recognition, communication, and mitigation of such infectious outbreaks. Some of these key principles include disease-specific delineation of transmission dynamics, understanding of pathogen-specific effects on both mothers and fetuses, and advance planning and contemporaneous management that prioritize communication among public health experts, clinicians, and patients. The productive and effective working collaboration among the Centers for Disease Control and Prevention, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine has been a key partnership in the successful communication and management of such outbreaks for women's health care providers and patients alike. Going forward, the knowledge gained over the past decade will undoubtedly continue to inform future responses and will serve to optimize the education and care given

  16. [Infectious diseases research].

    Science.gov (United States)

    Carratalà, Jordi; Alcamí, José; Cordero, Elisa; Miró, José M; Ramos, José Manuel

    2008-12-01

    There has been a significant increase in research activity into infectious diseases in Spain in the last few years. The Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) currently has ten study groups, with the cooperation of infectious diseases specialists and microbiologists from different centres, with significant research activity. The program of Redes Temáticas de Investigación Cooperativa en Salud (Special Topics Cooperative Health Research Networks) is an appropriate framework for the strategic coordination of research groups from the Spanish autonomous communities. The Spanish Network for Research in Infectious Diseases (REIPI) and the Network for Research in AIDS (RIS) integrate investigators in Infectious Diseases from multiple groups, which continuously perform important research projects. Research using different experimental models in infectious diseases, in numerous institutions, is an important activity in our country. The analysis of the recent scientific production in Infectious Diseases shows that Spain has a good position in the context of the European Union. The research activity in Infectious Diseases carried out in our country is a great opportunity for the training of specialists in this area of knowledge.

  17. Overview of Infectious Diseases

    Science.gov (United States)

    ... Español Text Size Email Print Share Overview of Infectious Diseases Page Content Article Body I nfectious diseases are ... worms Last Updated 11/21/2015 Source Immunizations & Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy ...

  18. Spontaneous cecal perforation secondary to acute fulminant ...

    African Journals Online (AJOL)

    Acute gastroenteritis and food poisoning are suspected when two or more family members present with vomiting, diarrhea, and abdominal pain. Acute gastroenteritis com- monly occurs because of viral, bacterial, and protozoan organisms. Acute gastroenteritis runs a fulminant course in the immunocompromised patients ...

  19. Efficacy of four commercially available multivalent modified-live virus vaccines against clinical disease, viremia, and viral shedding in early-weaned beef calves exposed simultaneously to cattle persistently infected with bovine viral diarrhea virus and cattle acutely infected with bovine herpesvirus 1.

    Science.gov (United States)

    Chamorro, Manuel F; Walz, Paul H; Passler, Thomas; Palomares, Roberto; Newcomer, Benjamin W; Riddell, Kay P; Gard, Julie; Zhang, Yijing; Galik, Patricia

    2016-01-01

    To evaluate the efficacy of 4 commercially available multivalent modified-live virus vaccines against clinical disease, viremia, and viral shedding caused by bovine viral diarrhea virus (BVDV) and bovine herpesvirus 1 (BHV1) in early-weaned beef calves. 54 early-weaned beef steers (median age, 95 days). Calves were randomly assigned to 1 of 5 groups and administered PBSS (group A [control]; n = 11) or 1 of 4 commercially available modified-live virus vaccines that contained antigens against BHV1, BVDV types 1 (BVDV1) and 2 (BVDV2), parainfluenza type 3 virus, and bovine respiratory syncytial virus (groups B [11], C [10], D [11], and E [11]). Forty-five days after vaccination, calves were exposed simultaneously to 6 cattle persistently infected with BVDV and 8 calves acutely infected with BHV1 for 28 days (challenge exposure). For each calf, serum antibody titers against BVDV and BHV1 were determined before vaccination and before and after challenge exposure. Virus isolation was performed on nasal secretions, serum, and WBCs at predetermined times during the 28-day challenge exposure. None of the calves developed severe clinical disease or died. Mean serum anti-BHV1 antibody titers did not differ significantly among the treatment groups at any time and gradually declined during the study. Mean serum anti-BVDV antibody titers appeared to be negatively associated with the incidence of viremia and BVDV shedding. The unvaccinated group (A) had the lowest mean serum anti-BVDV antibody titers. The mean serum anti-BVDV antibody titers for group D were generally lower than those for groups B, C, and E. Results indicated differences in vaccine efficacy for the prevention of BVDV viremia and shedding in early-weaned beef calves.

  20. Etiology of acute diarrhea among children in Ribeirão Preto-SP, Brazil Principais enteropatógenos causadores de diarréia em crianças, na região de Ribeirão Preto-SP, Brasil

    Directory of Open Access Journals (Sweden)

    Marta Inês Cazentini MEDEIROS

    2001-02-01

    Full Text Available To study the main enteropathogens causing diarrhea in the region of Ribeirão Preto regarding serogroups and serotypes, the feces of 1836 children under 10 years old, from both sexes, attack of acute gastroenteritis, were analysed during a period of 4 years in Adolfo Lutz Institute - Ribeirão Preto, SP. The pathogens identified by standard methods were the following: Escherichia coli, Salmonella spp., Shigella spp., Campylobacter spp., Yersinia spp., and Cryptosporidium spp. Positive samples were 22.8% (419 with 1.7% association of pathogens. Larger isolates were mainly from children 0 to 11 months old. Enteropathogenic E. coli (EPEC was most frequent (8.7% with predominance of serogroup O119 (40.2%, followed by Shigella (6.2%, 63.6% of which S. sonnei.Com o objetivo de caracterizar os principais enteropatógenos causadores de diarréia na região de Ribeirão Preto, quanto aos sorogrupos e sorotipos, por um período de 4 anos foram estudadas fezes de 1836 crianças, menores de 10 anos de idade, de ambos os sexos, portadoras de gastrenterite aguda no IAL de Ribeirão Preto, SP. Foram pesquisados os seguintes enteropatógenos: Escherichia coli, Salmonella sp., Shigella sp., Campylobacter sp., Yersinia sp., e Cryptosporidium sp., identificados através de metodologia tradicional. Foram positivas 419 (22,8% amostras, com 1,7% de associação entre enteropatógenos. Houve predomínio na faixa etária de 0 a 11 meses. Destacou-se a E.coli enteropatogênica (EPEC (8,7%, sendo mais frequente o sorogrupo O119 (40,2%, seguida do gênero Shigella (6,2%, dos quais 63,2% corresponderam à S. sonnei.

  1. Clostridium difficile-associated diarrhea in the Clinical Center of Vojvodina, Serbia, in the period 2008 to 2012

    Directory of Open Access Journals (Sweden)

    Stefan-Mikić Sandra

    2014-01-01

    Full Text Available Clostridium difficile-associated diarrhea (CDAD has been recognized as the leading cause of diarrhea worldwide. In the last five years, it has become the leading cause of diarrhea in the Clinical Center of Vojvodina (CCV as well. The aim of this study was to determine the epidemiology and total cost of treatment for all patients with Clostridium difficile-associated diarrhea hospitalized at the Infectious Disease Clinic of the CCV; to analyze the costs of treatment with regard to therapeutic approach; to compare the costs of treatment in each year of the investigated period related to the number of patients, and to analyze the outcome of treatment. The study was retrospective, and the data were collected from the medical records of 472 patients with Clostridium difficile diarrhea treated from 2008 to 2012 and analyzed. Of the total 472 patients with CDAD, 54.23% were female and the average age was 65.84. A statistically significant majority of them had been previously treated in other hospitals and a minority in ambulatory settings (395 inpatients vs. 77 outpatients, p=0.000, p<0.05. Of the 395 previously hospitalized patients, most were from the Clinic of Urology of the CCV (58, 14.68%. When comparing therapeutic options, oral vancomycin was significantly more frequently used than other protocols. The average mortality rate during the study period was 6.51%. In this period, total hospital costs related to Clostridium difficile diarrhea in the Infectious Disease Clinic were $636,679.92. Implementation of infection-control measures and a restricted use of antibiotics would result in a great reduction in material costs.

  2. Syndromic (phenotypic diarrhea in early infancy

    Directory of Open Access Journals (Sweden)

    Bodemer Christine

    2008-02-01

    Full Text Available Abstract Syndromic diarrhea (SD, also known as phenotypic diarrhea (PD or tricho-hepato-enteric syndrome (THE, is a congenital enteropathy presenting with early-onset of severe diarrhea requiring parenteral nutrition (PN. To date, no epidemiological data are available. The estimated prevalence is approximately 1/300,000–400,000 live births in Western Europe. Ethnic origin does not appear to be associated with SD. Infants are born small for gestational age and present with facial dysmorphism including prominent forehead and cheeks, broad nasal root and hypertelorism. Hairs are woolly, easily removed and poorly pigmented. Severe and persistent diarrhea starts within the first 6 months of life (≤ 1 month in most cases and is accompanied by severe malabsorption leading to early and relentless protein energy malnutrition with failure to thrive. Liver disease affects about half of patients with extensive fibrosis or cirrhosis. There is currently no specific biochemical profile, though a functional T-cell immune deficiency with defective antibody production was reported. Microscopic analysis of the hair show twisted hair (pili torti, aniso- and poilkilotrichosis, and trichorrhexis nodosa. Histopathological analysis of small intestine biopsy shows non-specific villous atrophy with low or no mononuclear cell infiltration of the lamina propria, and no specific histological abnormalities involving the epithelium. The etiology remains unknown. The frequent association of the disorder with parental consanguinity and/or affected siblings suggests a genetic origin with an autosomal recessive mode of transmission. Early management consists of total PN. Some infants have a rather milder phenotype with partial PN dependency or require only enteral feeding. Prognosis of this syndrome is poor, but most patients now survive, and about half of the patients may be weaned from PN at adolescence, but experience failure to thrive and final short stature. Disease name

  3. Molecular Survey of Viral and Bacterial Causes of Childhood Diarrhea in Khartoum State, Sudan

    Directory of Open Access Journals (Sweden)

    Mosab A. Adam

    2018-02-01

    Full Text Available Diarrheal disease is a major public health problem for children in developing countries. Knowledge of etiology that causes diarrheal illness is essential to implement public health measures to prevent and control this disease. Published studies regarding the situation of childhood diarrhea in Sudan is scanty. This study aims to investigate viral and bacterial etiology and related clinical and epidemiological factors in children with acute diarrhea in Khartoum State, Sudan. A total of 437 fecal samples were collected from hospitalized children <5 years old with acute diarrhea, viral and bacterial pathogens were investigated by using two-tube multiplex RT-PCR. The genotypes of adenovirus and bocavirus were determined by sequencing. Viral diarrhea was identified in 79 cases (62 single and 17 co-infections (18%, and bacterial diarrhea in 49 cases (37 single and 12 co-infections (11.2%. Mixed infections in both groups totaled 19 samples (4.3% with more than one pathogen, they were viral co-infections (n = 7, 36.8% bacterial co-infections (n = 2, 10.5% and viral bacterial co-infection (n = 10, 52.6%. Rotavirus (10.2% was predominantly detected, followed by norovirus G2 (4.0%, adenovirus (1.6%, bocavirus (1%, and norovirus G1 (0.9%. Infection with astrovirus was not detected in this study. The Shigella –Enteroinvasive E.coli (EIEC (8.9% was the predominantly found bacterial pathogen, followed by Vibrio parahaemolyticus (0.9%, enterohaemorrhagic E.coli (EHEC –Enteropathogenic E. coli (EPEC (0.6% and Salmonella enteritidis (0.6%. V. cholerae, Yersinia enterocolitica and Campylobacter jejuni were not detected in this study. The phylogenetic tree identified adenovirus belonged to genotype 41 and bocavirus belonged to two different clades within human bocavirus 1. Our findings represent the first report that adenovirus 41 is a cause of diarrhea in Sudan and that human bocavirus 1 is the principal bocavirus strain circulating in Sudan. In conclusion

  4. Infectious keratitis after keratoplasty.

    Science.gov (United States)

    Davila, Jose R; Mian, Shahzad I

    2016-07-01

    Infectious keratitis is an uncommon but serious complication after corneal transplantation that threatens the visual potential of corneal grafts. Several large retrospective studies from sites worldwide have documented the experiences of corneal surgeons with this sight-threatening complication. The present review synthesizes and compares incidence rates, risk factors, common microorganisms, treatments, and visual prognoses of patients with postkeratoplasty infectious keratitis. In 2012, endothelial keratoplasty replaced penetrating keratoplasty as the most commonly performed corneal transplantation procedure in the United States. Although reported rates of infectious keratitis after endothelial keratoplasty appear to be less than after penetrating keratoplasty, there are still too few publications documenting infectious keratitis after endothelial keratoplasty or anterior lamellar keratoplasty to adequately assess outcomes. Infectious keratitis continues to be a serious complication among all types of keratoplasty, threatening the viability of the grafted tissues and visual outcomes of patients. Reports from various sites worldwide indicate differences in incidence rates and common infecting microorganisms between high- and middle-income countries. Most reports agree that suture-related problems and factors contributing to a suboptimal ocular surface are the primary risk factors for developing infectious keratitis. In general, patients with infectious keratitis following keratoplasty have a poor visual prognosis because of the difficulty of successful treatment without residual scarring.

  5. Scoring system to distinguish between rotavirus and non-rotavirus diarrhea in children

    Directory of Open Access Journals (Sweden)

    Atika Akbari

    2017-01-01

    Full Text Available Background Distinguishing rotavirus from non-rotavirus diarrhea is helpful for managing the illness. However, definitively diagnosing rotavirus diarrhea from serology is difficult and expensive. Objectives To distinguish between the clinical manifestations of rotavirus and non-rotavirus diarrhea, and to assess the accuracy of using such clinical manifestations to predict the type of diarrhea in children. Methods A cross-sectional study was performed from April to October 2015 in all children less than five years of age who presented with acute diarrhea at the Pediatric Outpatient Clinic of the Department of Child Health and Emergency Department, Dr. Mohammad Hoesin and Bari Hospitals, Palembang, South Sumatera. Clinical manifestations were collected from history and physical examinations; stool specimens were examined by immunochromatography. Clinical parameters were analyzed by multivariate analysis, and scores given to each significant parameter. The accuracy of the scoring system based in these parameters was analyzed by means of receiver-operating characteristic (ROC area under the curve (AUC. Results Of 184 children, 92 had rotavirus and 92 had non-rotavirus diarrhea. Multivariate analysis showed 3 clinical parameters commonly seen in the rotavirus diarrhea cases: male sex (OR 2.718; 95%CI 1.373 to 5.382, cough (OR 3.500; 95%CI 1.788 to 6.582, and yellow-greenish stool (OR 4.009; 95%CI 2.061 to 7.797. A scoring system was constructed based on the parameters: male (score of 1, cough (score of 2, and yellow-greenish stool (score of 3. From ROC analysis, the AUC was 0.755. Using a cut-off score of > 3, the sensitivity was 81.5%, specificity 51.1%, and PPV 62.5%. Conclusion Cough, yellow-greenish stool, and male are significant parameters for differentiating rotavirus from non-rotavirus diarrhea. A scoring system from these parameters is sensitive for predicting rotavirus vs. non-rotavirus diarrhea in children less than five years of age.

  6. Non-Infectious Meningitis

    Science.gov (United States)

    ... Links Vaccine Schedules Preteen & Teen Vaccines Meningococcal Disease Sepsis Non-Infectious Meningitis Recommend on Facebook Tweet Share Compartir On This Page Causes and How it Spreads Signs and Symptoms Causes ...

  7. [Protozoan infection causes diarrhea in calves].

    Science.gov (United States)

    Geurden, T; Claerebout, E; Vercruysse, J

    2005-12-01

    The role of protozoan parasites in the etiology of diarrhea in calves is highlighted with emphasis on correct diagnosis. In neonatal calves, Cryptosporidium parvum is isolated in more than 44% of the faeces of diarrhetic calves. In calves older than one month, both Eimeria bovis and E. zuernii, and Giardia duodenalis are associated with diarrhea and poor growth. Clinical diagnosis has to be confirmed by examination of host faecal material. Both for C. parvum and G. duodenalis immunological assays are available. Control measures must aim to reduce or prevent oocyst or cyst transmission, by combining management measures, desinfection and chemotherapeutic treatment.

  8. Diarrhea in enterally fed patients: blame the diet?

    Science.gov (United States)

    Chang, Sue-Joan; Huang, Hsiu-Hua

    2013-09-01

    Diarrhea has great impact on enteral nutrition. The purpose of this review is to identify the factors leading to diarrhea during enteral nutrition and to provide the published updates on diarrhea prevention through nutritional intervention. Diarrhea in enteral fed patients is attributed to multiple factors, including medications (major contributor), infections, bacterial contamination, underlying disease, and enteral feeding. Diet management can alleviate diarrhea in enteral feeding. High content of fermentable oligosaccharides, disaccharides, and monosaccharides and polyols (FODMAPs) in enteral formula is postulated to induce diarrhea and lower FODMAPs formula may reduce the likelihood of diarrhea in enterally fed patients. Fiber-enriched formula can reduce the incidence of diarrhea and produce short-chain fatty acids for colonocytes. Ingesting prebiotics, nonviable probiotics or probiotic derivatives, and human lactoferrin may provide alternatives for reducing/preventing diarrhea. Enteral feeding is not generally considered the primary cause of diarrhea, which is frequently linked to prescribed medications. When diarrhea is apparent, healthcare members should evaluate the possible risk factors and systematically attempt to eliminate the underlying causes of diarrhea before reducing or suspending enteral feeding. Lower FODMAPs formula, prebiotics, probiotic derivatives, and lactoferrin may be used to manage enteral feeding-related diarrhea.

  9. The role of enterosorbtion in treatment of bacterial diarrhea in children

    Directory of Open Access Journals (Sweden)

    O.I. Nyrkova

    2011-01-01

    Full Text Available Authors studied clinical and laboratory efficacy of natural enterosorbate Filtrum-STI in treatment of acute bacterial diarrhea in patients 1–14 years old. The drug has significant detoxication effect resulting in the dynamics of infection syndrome and terms of endotoxicosis laboratory markers normalization. This sorbate has protective effect on obligatory micro flora of intestinum.Key words: children, bacterial intestinal infections, endotoxicosis, enterosorption.

  10. Improved detection of Bovine Viral Diarrhea Virus in Bovine lymphoid cell lines using PrimeFlow RNA assay

    Science.gov (United States)

    Bovine viral diarrhea virus (BVDV) infections, whether as acute, persistent or contributing to co-infections, result in significant losses for cattle producers. BVDV can be identified by real-time PCR and ELISA, detection and quantification of viral infection at the single cell level is extremely di...

  11. Diarréia aguda em crianças menores de um ano: subsídios para o delineamento do cuidar Diarrea aguda en niños menores de un año: subsidios para el delineamiento del cuidado Acute diarrhea in lesser Children of one year: subsidies for the delineation of taking care

    Directory of Open Access Journals (Sweden)

    Ivonete Vieira Pereira

    2008-06-01

    incluir cuestiones culturales en las actividades educativas como parte de una política pública de cuidado.Observational descriptive study with a quantitive approach which data is based on an epidemiological survey aims to determine the reasons of the high prevalence of acute diarrheas illnesses in minors of one year in Ananindeua, Pará. The sample was constituted by the families registered in the cadaster of the Family Health Program. It was evidenced that the social-economic-cultural aspects had influenced in the diarrhea occurrence, therefore how the lesser mother’s age and the scholarship, bigger the illness prevalence. This population lives in an occupation area, without basic sanitation, with garbage and dejections in opened sky, being below of the poverty boundary. About precocious weaning, water and tea were introduced in the first fifteen days and ar tificial milk during the first month, there was a resistance to use oral rehydrating therapy. They used domestic treatment. It concludes that reversion of structural factors, is necessary and cultural matters should be included in educational activities of a public care policy.

  12. Clostridium Difficile-Associated Diarrhea in 200 Canadian Children

    Directory of Open Access Journals (Sweden)

    Véronique Morinville

    2005-01-01

    Full Text Available OBJECTIVE: Clostridium difficile-associated diarrhea is a major problem in adults. The present study was conducted to assess risk factors and outcomes in children with C difficile-associated diarrhea.

  13. Diarrhea - what to ask your health care provider - adult

    Science.gov (United States)

    What to ask your health care provider about diarrhea - adult; Loose stools - what to ask your health ... medicines, vitamins, herbs, or supplements I take cause diarrhea? Should I stop taking any of them? What ...

  14. Diarrhea of travelers to Mexico. Relative susceptibility of United States and Latin American students attending a Mexican University.

    Science.gov (United States)

    Dupont, H L; Haynes, G A; Pickering, L K; Tjoa, W; Sullivan, P; Olarte, J

    1977-01-01

    A clinic was established at Universidad de las Americas, Cholula, Puebla, Mexico for the study of acute diarrhea rates in newly-arrived students and full-time students. Diarrhea occurred in 22 of 55 newlly-arrived U.S. summer students (40%), compared to 28 of 142 U.S. full-time students (20%), 4 of 29 Venezuelan summer and full-time students (14%) and 7 of 66 Mexican full-time students (11%) (the differences were significant, p less than 0.005). Recurrent episodes of diarrhea during the month of study occurred in 15% of U.S. summer students, 4% of U.S. full-time students, and were non-existent in students from Latin America. As well as the 61 students with diarrhea enrolled in the incidence study, all students who developed diarrhea at the univeristy were encouraged to visit the clinic. This gave a total population of 130 cases of diarrhea. The illness that developed in students form the U.S. varied widely, but it typically consisted of seven to 13 unformed stools during the first 48 hours of illness, with illness persiting three to five days. Illness tended to be more severe in the U.S. students. Fifty per cent of the U.S. students with diarrhea had "severe" illness (greater than or equal to 10 unformed stools in first 48 hours) compared to 23% of the Latin Americans. This study indicates that the agents responsible for diarrhea in Latin America are widespread and that resistance to infection develops after prolonged or repeated exposure.

  15. Characteristics of Rotavirus Diarrhea in Hospitalized Children in Kosovo

    OpenAIRE

    Ismaili-Jaha, Vlora; Shala, Muje; Azemi, Mehmedali; Hoxha-Kamberi, Teuta; Avdiu, Muharrem; Spahiu, Shqipe; Jaha, Luan

    2014-01-01

    Background: Diarrhea is a leading cause of child mortality worldwide. Rotavirus is one of the most common causes of severe diarrhea and dehydration in children. Authors reviewed epidemiological and clinical data of the rotavirus diarrhea in Kosovo. Methods: This is a prospective study carried between January 1st and December 31st 2011. All data, comprising demographics, nutrition, clinical presentation, laboratory findings, management and outcome of the rotavirus diarrhea are collected on the...

  16. Anti-diarrhea activity of the aqueous root bark extract of Byrsocarpus coccineus on castor oil-induced diarrhea in Wistar rats

    Directory of Open Access Journals (Sweden)

    Sunday A. Ejeh

    2017-07-01

    Full Text Available Aim: The use of traditional medicine as an alternative source of cure for many ailments has played an important role in health care delivery in both developing and developed countries. Byrsocarpus coccineus Schum and Thonn (Connaraceae is used in traditional medicine for treatment of various disease conditions, including diarrhea. The anti-diarrhea activity of the root bark aqueous extract of B. coccineus was investigated in this study. Materials and Methods: Acute toxicity evaluation of the aqueous extract of B. coccineus root bark was performed in exposed rats. Diarrhea was induced in exposed rats with castor oil, and the effect of the extract on castor oil-induced gastrointestinal motility and enteropooling was consequently investigated. Results: In the acute toxicity study, the extract caused no death in treated rats nor produced signs of delayed toxicity, even at 5000 mg/kg. The aqueous root bark extract of B. coccineus also decreased the distance travelled by activated charcoal in the gastrointestinal tract of treated rats when compared to control rats. Results of castor oil-induced enteropooling revealed slight reduction in the weight of intestinal contents of treated rats compared to control rats. There was significant (p<0.05 decrease in the frequency of defecation as well as in the number of unformed feces produced by castor oil-induced diarrhea at 100 mg/kg dose with 74.96% inhibition of defecation. Conclusion: The study demonstrated the anti-diarrheic property of the aqueous extract of B. coccineus root bark as currently exploited in our traditional herbal therapy.

  17. Refractory diarrhea: A paraneoplastic syndrome of neuroblastoma.

    Science.gov (United States)

    Han, Wei; Wang, Huan-Min

    2015-07-07

    Neuroblastoma (NB) is the most common extracranial solid tumor in children. Diarrheal NB is quite rare and is not easy to diagnose in the early stage. Six cases of diarrheal NB in our hospital treated from 1996 to 2006 were retrospectively analyzed, including characteristics such as electrolyte imbalance, pathologic features, vasoactive intestinal peptide (VIP) immunohistochemical staining results, treatment, and prognosis. All patients were boys with 3-8 loose or watery stools each day and routine fecal tests were normal. Abdominal tumors were identified by B-ultrasound. Drugs were ineffective. Three patients underwent surgery, and the remaining three patients received surgery and chemotherapy. Diarrhea stopped after treatment in five patients. Two patients died due to intractable hypokalemia. The tumor was located in the adrenal gland in four patients, in the upper retroperitoneum in one patient, and in the presacral area in one patient. Pathologic findings were NB and ganglioneuroblastoma. Five patients were at clinical stage I-II, and one was at stage III. Four patients survived (followed-up for 6 mo to 4 years). Immunohistochemical staining for VIP was positive. Refractory diarrhea is a paraneoplastic syndrome of NB and is rare. Patients aged 1-3 years who present with chronic intractable diarrhea should be followed closely. Intractable diarrhea, hypokalemia, and dysplasia are the initial clinical manifestations. Increased VIP is characteristic of this disease. Potassium supplementation plays a vital role in the treatment procedure, especially preoperatively. The prognosis of diarrheal NB is good following appropriate treatment.

  18. Bovine viral diarrhea virus: biosecurity and control

    Science.gov (United States)

    This paper discusses the recommended procedures involved in setting up biosecurity and control programs designed to limit bovine viral diarrhea virus infections in beef cattle operations. For the purpose of these discussions, a working definition of a biosecurity plan was considered to be an organiz...

  19. Rota virus Diarrhea in Hospitalized Children

    International Nuclear Information System (INIS)

    Habib, M. I.; Khan, K. M. A.; Zia, N.; Kazi, S. G.

    2014-01-01

    Objective: To determine the frequency and clinical features of Rota virus diarrhea in children presenting in a tertiary care hospital. Study Design: A cross-sectional, observational study. Place and Duration of Study: National Institute of Child Health, Karachi, from January to June 2007. Methodology: A total of three hundred children of either gender aged 1 month to 5 years, who presented with diarrhea of < 7 days as a primary illness were enrolled. Children with bloody diarrhea or nosocomial gastroenteritis acquired during hospitalization for other disease were not included. Detection of Rota virus in stool was done by enzyme linked immunoassay. Results: Out of 300 children, 188 (63%) tested positive and 112 (37%) tested negative for Rota virus. Positive Rota virus cases in 7 - 12 months of age was (n = 34, 18.08%). Overall, 151 (80.3%) children with Rota virus were less than 3 years old. 182 (60.7%) had fever, 118 (39.3%) had vomiting and 156 (82.9%) children had both fever and vomiting. Conclusion: This study shows that Rota virus is a common organism causing diarrhea in children less than 3 years of age. There is a need to incorporate Rota virus vaccine in the national EPI program to decrease the disease burden as highlighted in this study. (author)

  20. Mechanism of diarrhea in microscopic colitis.

    Science.gov (United States)

    Protic, Marijana; Jojic, Njegica; Bojic, Daniela; Milutinovic, Svetlana; Necic, Dusanka; Bojic, Bozidar; Svorcan, Petar; Krstic, Miodrag; Popovic, Obren

    2005-09-21

    To search the pathophysiological mechanism of diarrhea based on daily stool weights, fecal electrolytes, osmotic gap and pH. Seventy-six patients were included: 51 with microscopic colitis (MC) (40 with lymphocytic colitis (LC); 11 with collagenous colitis (CC)); 7 with MC without diarrhea and 18 as a control group (CG). They collected stool for 3 d. Sodium and potassium concentration were determined by flame photometry and chloride concentration by titration method of Schales. Fecal osmotic gap was calculated from the difference of osmolarity of fecal fluid and double sum of sodium and potassium concentration. Fecal fluid sodium concentration was significantly increased in LC 58.11+/-5.38 mmol/L (Pdiarrhea compared to fecal osmotic gap. Seven (13.3%) patients had osmotic diarrhea. Diarrhea in MC mostly belongs to the secretory type. The major pathophysiological mechanism in LC could be explained by a decrease of active sodium absorption. In CC, decreased Cl/HCO3 exchange rate and increased chloride secretion are coexistent pathways.

  1. Diarrhea Management Training in Early Childhood Settings.

    Science.gov (United States)

    Winnail, Scott D.; Artz, Lynn M.; Geiger, Brian F.; Petri, Cynthia J.; Bailey, Rebecca; Mason, J.W.

    2001-01-01

    Addresses the health of young children and how to safely and effectively care for children with diarrhea in the home and in early child care settings. Discusses specific intervention and program activities, including specially designed materials for mixing homemade oral rehydration usage. (Author/SD)

  2. Constipation, diarrhea, and symptomatic hemorrhoids during pregnancy.

    Science.gov (United States)

    Wald, Arnold

    2003-03-01

    Constipation, diarrhea, and symptomatic hemorrhoids are disorders common in the general population, particularly in women. These conditions, if mild, often are self-treated with various home remedies or nonprescription preparations. Few of these patients, moreover, are referred to gastroenterologists, as primary care providers generally are confident managing these conditions, unless they are severe, refractory to conventional management, or require additional diagnostic studies.

  3. Predictors of under-five childhood diarrhea: Mecha District, West ...

    African Journals Online (AJOL)

    admin

    Bivariate and multivariate logistic regression analyses were undertaken to identify predictors of childhood diarrhea. Results: The prevalence of diarrhea among mothers and under-five children was 8.2% and 18.0%, respectively. Maternal education (AOR=5.6, 95% CI: 1.5 - 19.4), maternal history of recent diarrhea (AOR, 5.5 ...

  4. Microscopic colitis in children with chronic diarrhea.

    Science.gov (United States)

    Singh, Prashant; Das, Prasenjit; Jain, A K; Mathan, Minnie; Mathur, Meera; Bhat, Abdus Sami; Varma, Sharat; Chaturvedi, Mona K; Gupta, Siddhartha Datta; Bhatnagar, Shinjini

    2013-08-01

    The aim of the present study was to study microscopic colitis (MC) in children with special reference to its role in chronic diarrhea and changes in mucosal biopsies. A total of 100 consecutive children ages 3 to 12 years, with nonbloody diarrhea (passage of ≥3 loose stools per day) of >12 weeks' duration were screened and 26 were enrolled in the study in which no specific etiology could be found and colonoscopy did not reveal any mucosal abnormality. Colonic biopsies were evaluated for the presence of lymphocytic colitis or collagenous colitis and those with the characteristic changes were defined to have MC (group A). Colonic biopsies from patients with MC were compared with biopsies from patients with chronic diarrhea but no evidence of MC (group B). One hundred children ages 3 to 12 years with bleeding per rectum were screened and colonic biopsies from 45 patients (group C) who had colonic mucosal changes but no vascular or polyp lesion were compared with patients with MC. Of the 26 patients with chronic diarrhea, MC was found in 5 (3 lymphocytic colitis and 2 collagenous colitis). Significantly higher polymorphonuclear infiltration was seen in group A as compared with group B (13.8 [5.4-20.6] vs 7.2 [0-19.6]; P = 0.03) or group C (13.8 [5.4-20.6] vs 4 [0-13.4]; P = 0.007). Intraepithelial lymphocytes (12 [4-32] vs 4 [0-24]; P = 0.008) and basement membrane thickening (3.5 [2.9-10.6] vs 2.5 [1.6-5.86]; P = 0.008) were also significantly higher in group A as compared with group C. MC was found to be present in children with nonbloody chronic diarrhea in children. Further multicentric studies may provide adequate data on its prevalence.

  5. Emergent infectious uveitis.

    Science.gov (United States)

    Khairallah, Moncef; Jelliti, Bechir; Jenzeri, Salah

    2009-10-01

    Infectious causes should always be considered in all patients with uveitis and it should be ruled out first. The differential diagnosis includes multiple well-known diseases including herpes, syphilis, toxoplasmosis, tuberculosis, bartonellosis, Lyme disease, and others. However, clinicians should be aware of emerging infectious agents as potential causes of systemic illness and also intraocular inflammation. Air travel, immigration, and globalization of business have overturned traditional pattern of geographic distribution of infectious diseases, and therefore one should work locally but think globally, though it is not possible always. This review recapitulates the systemic and ocular mainfestations of several emergent infectious diseases relevant to the ophthalmologist including Rickettsioses, West Nile virus infection, Rift valley fever, dengue fever, and chikungunya. Retinitis, chorioretinitis, retinal vasculitis, and optic nerve involvement have been associated with these emergent infectious diseases. The diagnosis of any of these infections is usually based on pattern of uveitis, systemic symptoms and signs, and specific epidemiological data and confirmed by detection of specific antibody in serum. A systematic ocular examination, showing fairly typical fundus findings, may help in establishing an early clinical diagnosis, which allows prompt, appropriate management.

  6. Entamoeba moshkovskii is associated with diarrhea in infants and causes diarrhea and colitis in mice.

    Science.gov (United States)

    Shimokawa, Chikako; Kabir, Mamun; Taniuchi, Mami; Mondal, Dinesh; Kobayashi, Seiki; Ali, Ibne Karim M; Sobuz, Shihab U; Senba, Masachika; Houpt, Eric; Haque, Rashidul; Petri, William A; Hamano, Shinjiro

    2012-09-01

    Entamoeba moshkovskii is prevalent in developing countries and morphologically indistinguishable from pathogenic Entamoeba histolytica and nonpathogenic Entamoeba dispar. It is not known if E. moshkovskii is pathogenic. Mice were intracecally challenged with the trophozoites of each Entamoeba spp. to test the ability to cause diarrhea, and infants in Bangladesh were prospectively observed to see if newly acquired E. moshkovskii infection was associated with diarrhea. E. moshkovskii and E. histolytica caused diarrhea and weight loss in susceptible mice. E. dispar infected none of the mouse strains tested. In Mirpur, Dhaka, Bangladesh, E. moshkovskii, E. histolytica, and E. dispar were identified in 42 (2.95%), 66 (4.63%), and 5 (0.35%), respectively, of 1426 diarrheal episodes in 385 children followed prospectively from birth to one year of age. Diarrhea occurred temporally with acquisition of a new E. moshkovskii infection: in the 2 months preceding E. moshkvskii-associated diarrhea, 86% (36 of 42) of monthly surveillance stool samples were negative for E. moshkovskii. E. moshkovskii was found to be pathogenic in mice. In children, the acquisition of E. moshkovskii infection was associated with diarrhea. These data are consistent with E. moshkovskii causing disease, indicating that it is important to reexamine its pathogenicity.

  7. Gastrointestinal symptoms in children with acute neuroinfections

    Directory of Open Access Journals (Sweden)

    A.I. Markov

    2018-02-01

    Full Text Available Background. In cases of severe forms of infectious di­seases, in addition to local inflammation, secondary lesions of the gastrointestinal organs may occur. We aimed to study the semiotics and epidemiology of gastrointestinal symptoms in children with acute neuroinfection. Materials and methods. This observational, retrospective, case-control study. We analyzed cases of in-patient treatment of children aged 1 month to 18 years with acute neuroinfections (meningitis, encephalitis and encephalomyelopolyneuropathy. Results. The study included 117 patients with acute central nervous system infections. Clinical symptoms of gastrointestinal infection were observed in 83 (70.9 % children. Among revealed symptoms, disorders of intestinal moti­lity, such as constipation and diarrhea, were prevalent. Manifestations of hepatobiliary system dysfunction included increased transaminase level (alanine aminotransferase (ALT, alkaline phosphatase, gamma-glutamyltransferase (GGTF and/or ultrasound changes (enlargement, diffuse structural changes and were observed in 39.1 % of patients. Among the laboratory parameters, elevated ALT level was observed in 8.3 % of patients, bilirubin was elevated in only one child, alkaline phosphatase was above the age norm in 11.8 %, an increased GGTF above the age norm was observed in 31.3 % of patients. The level of intestinal fatty acid binding protein (I-FABP was elevated in 86.4 %, and L-type fatty acid binding protein (L-FABP — in all (100 % children. Clinical manifestations of gastrointestinal dysfunction (the presence of at least one of the gastrointestinal symptoms had an inverse relationship with the child’s age (rpb = –0.19, p = 0.033, correlated with staying in intensive care unit (odds ratio (OR = +5.25; 95% confidence interval (CI 1.62–16.97, artificial ventilation (OR = +4.5; 95% CI 1.00–21.69 and level of I-FABP (rpb = 0.34, p = 0.019. Conclusions. Among gastrointestinal symptoms in children with

  8. Detection of diarrheagenic Escherichia coli from children with and without diarrhea in Salvador, Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Vanessa Bueris

    2007-11-01

    Full Text Available We identified different diarrheagenic (DEC Escherichia coli pathotypes isolated from 1,207 children with and without acute endemic diarrhea in Salvador, Bahia, Brazil collected as part of a case-control study. Since the identification of DEC cannot be based on only biochemical and culture criteria, we used a multiplex polymerase chain reaction developed by combining five specific primer pairs for Enteropathogenic Escherichia coli (EPEC, Shiga toxin-producing E. coli/ Enterohaemorrhagic E. coli (STEC/EHEC, Enterotoxigenic E. coli (ETEC and Enteroaggregative E. coli (EAEC to detect these pathotypes simultaneously in a single-step reaction. In order to distinguish typical and atypical EPEC strains, these were tested for the presence of EAF plasmid. The prevalence of diarrheagenic E. coli in this sample of a global case-control study was 25.4% (259 patients and 18.7% (35 patients in the diarrhea group (1,020 patients and the control group (187 patients, respectively. The most frequently isolated pathotype was EAEC (10.7%, followed by atypical EPEC (9.4%, ETEC (3.7%, and STEC (0.6%. Typical EPEC was detected only in one sample. The prevalence of the pathotypes studied in children with diarrhea was not significantly different from that in children without diarrhea.

  9. Is racecadotril effective for acute diarrhea in children? -First update

    Directory of Open Access Journals (Sweden)

    Josefina Sáez

    2016-06-01

    Full Text Available Este resumen Epistemonikos (Living FRISBEE: Living FRIendly Summary of the Body of Evidence using Epistemonikos es una actualización del resumen publicado en Diciembre de 2015, basado en la detección de dos nuevas revisiones sistemáticas que no habían sido identificadas en la versión anterior. La gastroenteritis o diarrea aguda es una enfermedad habitualmente autolimitada, pero que consume recursos sanitarios y constituye un motivo de consulta frecuente en pediatría. El racecadotrilo, un inhibidor de la encefalinasa intestinal, se ha usado como tratamiento porque disminuiría la duración de la diarrea y la pérdida de líquidos, pero no hay evidencia que justifique su uso rutinario. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos cinco revisiones sistemáticas que en conjunto incluyen nueve estudios aleatorizados relevantes para nuestra pregunta. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que el uso de racecadotrilo probablemente disminuye la duración del cuadro de diarrea aguda en población pediátrica y que no se asociaría a mayor tasa de eventos adversos.

  10. Is racecadotril effective for acute diarrhea in children?

    Directory of Open Access Journals (Sweden)

    Josefina Sáez

    2016-12-01

    Full Text Available La gastroenteritis o diarrea aguda es una enfermedad habitualmente autolimitada, pero consume recursos sanitarios y constituye un motivo de consulta frecuente en pediatría. El racecadotrilo, un inhibidor de la encefalinasa intestinal, se ha usado como tratamiento porque disminuiría la duración de la diarrea y la pérdida de líquidos, pero no hay evidencia que justifique su uso rutinario. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos tres revisiones sistemáticas que en conjunto incluyen nueve estudios aleatorizados que evalúan la eficacia de esta terapia. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que el uso de racecadotrilo probablemente disminuye la duración del cuadro de diarrea aguda en población pediátrica.

  11. Concomitant Rotavirus and Salmonella Infections in Children with Acute Diarrhea

    Directory of Open Access Journals (Sweden)

    Wen-Tzong Lan

    2009-02-01

    Conclusion: Concomitant rotavirus and Salmonella infections accounted for 3.7% of cases in this study. Patients in group C (30.0% had a significantly higher incidence of hypokalemia than group R (7.3% or S (8.8%. Group C consisted of 33 cases of the 895 reviewed cases (3.7%. In a child with rotavirus gastroenteritis, concomitant infection with Salmonella should be considered if the child has sustained a high fever (≥ 39°C for over 4 days and a green stool with mucus and blood.

  12. Human rotavirus genotypes causing acute watery diarrhea among ...

    African Journals Online (AJOL)

    2014-06-17

    Jun 17, 2014 ... Americas and Europe[14,15] and have been introduced into routine immunization programs .... asymptomatic rotavirus infection of the malnourished infant ... the malnutrition. However, this study was unable to relate the multiple genotype infection with nutritional status and could be an area for further study.

  13. Forecasting Infectious Disease Outbreaks

    Science.gov (United States)

    Shaman, J. L.

    2015-12-01

    Dynamic models of infectious disease systems abound and are used to study the epidemiological characteristics of disease outbreaks, the ecological mechanisms affecting transmission, and the suitability of various control and intervention strategies. The dynamics of disease transmission are non-linear and consequently difficult to forecast. Here, we describe combined model-inference frameworks developed for the prediction of infectious diseases. We show that accurate and reliable predictions of seasonal influenza outbreaks can be made using a mathematical model representing population-level influenza transmission dynamics that has been recursively optimized using ensemble data assimilation techniques and real-time estimates of influenza incidence. Operational real-time forecasts of influenza and other infectious diseases have been and are currently being generated.

  14. Infectious Chronic Rhinosinusitis

    Science.gov (United States)

    Bose, Sumit; Grammer, Leslie C.; Peters, Anju T.

    2016-01-01

    Chronic rhinosinusitis (CRS) is a persistent inflammatory disease that affects a multitude of people worldwide. The pathogenesis of CRS involves many factors including genetics, status of the sinonasal microbiome, infections and environmental influences. Comorbidities associated with CRS include asthma, allergic rhinitis, bronchiectasis and certain kinds of immunodeficiency. CRS can be divided into different subtypes based on endotypes and phenotypes. Infectious CRS is one such category. The etiology of infectious CRS is usually secondary to chronic bacterial infection which commonly begins with a viral upper respiratory tract infection. Humoral antibody deficiencies can underlie difficult-to-treat or recurrent CRS. Infectious CRS can be treated with antimicrobials, topical or oral corticosteroids and nasal saline irrigations. Patients with CRS and humoral immunodeficiency may require an aggressive treatment approach including immunoglobulin replacement therapy. Despite advancements in the field of CRS, targeted therapies and reliable biomarkers are still lacking. PMID:27393772

  15. Enteric Pathogens and Coinfections in Foals with and without Diarrhea

    Directory of Open Access Journals (Sweden)

    Giovane Olivo

    2016-01-01

    Full Text Available Diarrhea is a major clinical problem affecting foals up to 3 months of age. The aim of this study was to identify enteric microorganisms involved in monoinfections and coinfections and the associated virulence factors in healthy and diarrheic foals. Diarrheic (D (n=56 and nondiarrheic (ND foals (n=60 up to three months of age were studied. Fecal samples were analyzed for identification of infectious agents (microbiological culturing, molecular techniques, and microscopic analyses. Escherichia coli fimH (30% versus 25%, Salmonella spp. (25% versus 7%, Strongyloides westeri (25% versus 25%, Clostridium perfringens type A (21% versus 10%, E. coli ag43 (20% versus 35%, Strongylus (11% versus 18%, and vapA-positive Rhodococcus equi (5% versus 2% were the most frequent enteric pathogens detected in D and ND foals, respectively. The frequency of toxin A-positive C. perfringens was significantly increased in the D (p=0.033 compared with the ND animals. R. equi strains harboring virulent plasmids were also identified (VapA 85-kb type I and VapA 87-kb type I in D and ND foals. Coinfections were observed in 46% of the D and 33% of the ND foals. Our results demonstrate the great diversity of enteric pathogens, virulence factors, and coinfections involved in enteric infections of foals.

  16. Knowledge, attitudes, and practice of travelers' diarrhea management among frontline providers.

    Science.gov (United States)

    Hayat, Aatif M; Tribble, David R; Sanders, John W; Faix, Dennis J; Shiau, Danny; Armstrong, Adam W; Riddle, Mark S

    2011-01-01

    Many studies have found acute gastrointestinal infections to be among the most likely reason for clinic visits among forward deployed soldiers and are considered a significant contributor to morbidity in this population. This occurs despite the controlled food and water distribution systems under which military populations operate. Furthermore, recent studies have indicated that providers often fail to appropriately identify and treat the typical causes of these infections. To adequately address this issue, an assessment of gaps in knowledge, practice, and management of acute diarrhea in deployed troops was conducted. A multiple-choice survey was developed by clinical researchers with expertise in travelers' diarrhea (TD) and provided to a convenience sample of clinical providers with a broad range of training and operational experience. The survey evaluated provider's knowledge of TD along with their ability to identify etiologies of various syndromic categories of acute gastrointestinal infections. Providers were also queried on selection of treatment approaches to a variety of clinical-based scenarios. A total of 117 respondents completed the survey. Most were aware of the standard definition of TD (77%); however, their knowledge about the epidemiology was lower, with less than 24% correctly answering questions on etiology of diarrhea, and 31% believing that a viral pathogen was the primary cause of watery diarrhea during deployment. Evaluation of scenario-based responses showed that 64% of providers chose not to use antibiotics to treat moderate TD. Furthermore, 19% of providers felt that severe inflammatory diarrhea was best treated with hydration only while 25% felt hydration was the therapy of choice for dysentery. Across all provider types, three practitioner characteristics appeared to be related to better scores on responses to the nine management scenarios: having a Doctor of Medicine or Doctor of Osteopathy degree, greater knowledge of TD epidemiology

  17. Infectious waste feed system

    Science.gov (United States)

    Coulthard, E. James

    1994-01-01

    An infectious waste feed system for comminuting infectious waste and feeding the comminuted waste to a combustor automatically without the need for human intervention. The system includes a receptacle for accepting waste materials. Preferably, the receptacle includes a first and second compartment and a means for sealing the first and second compartments from the atmosphere. A shredder is disposed to comminute waste materials accepted in the receptacle to a predetermined size. A trough is disposed to receive the comminuted waste materials from the shredder. A feeding means is disposed within the trough and is movable in a first and second direction for feeding the comminuted waste materials to a combustor.

  18. The effect of Lactobacillus GG on acute diarrheal illness in the pediatric emergency department.

    Science.gov (United States)

    Nixon, Abigail F; Cunningham, Sandra J; Cohen, Hillel W; Crain, Ellen F

    2012-10-01

    The purpose of this study was to evaluate the effectiveness of the probiotic Lactobacillus GG (LGG) in reducing the duration of acute infectious diarrhea in the pediatric emergency department. We conducted a double-blind, randomized controlled trial of children 6 months to 6 years presenting to the pediatric emergency department with a complaint of diarrhea. Patients were randomized to receive either placebo or LGG powder twice daily for 5 days. With each dose, parents recorded the stool history in a home diary and were followed up daily by a blinded researcher. Groups were compared in terms of time to normal stool and number of diarrheal stools. Of 155 patients enrolled, 129 completed the study: 63 in the LGG group and 66 in the placebo group. There was no significant difference in the median (interquartile range) time to normal stool (LGG: 60 hours [37-111] vs placebo: 74 hours [43-120]; P = 0.37) or the number of diarrheal stools (LGG: 5.0 [1-10] vs placebo: 6.5 [2-14]; P = 0.19). Among children who presented with more than 2 days of diarrhea, the LGG group returned to normal stool earlier (LGG: 51 hours [32-78] vs placebo: 74 hours [45-120]; P = 0.02), had fewer episodes of diarrheal stools (LGG: 3.5 [1.0-7.5] vs placebo: 7 [3.0-16.3]; P = 0.02), and were 2.2 times more likely to return to normal stool (95% confidence interval, 1.3-3.9; P = 0.01) compared with children in the placebo group. Lactobacillus GG may reduce the duration of acute diarrheal illness among children presenting with more than 2 days of symptoms.

  19. Human intestinal microbiota gene risk factors for antibiotic-associated diarrhea: perspectives for prevention. Risk factors for antibiotic-associated diarrhea. : Diarrhea risk prediction from microbiota genes

    OpenAIRE

    De La Cochetière, Marie France; Montassier, Emmanuel; Hardouin, Jean-Benoît; Carton, Thomas; Le Vacon, Françoise; Durand, Tony; Lalande, Valérie; Petit, Jean-Claude; Potel, Gilles; Beaugerie, Laurent

    2010-01-01

    8 pages, 4 figures; International audience; Antibiotic-associated diarrhea (AAD) is associated with altered intestinal microflora and other symptoms that may lead to possibly death. In critically ill patients, diarrhea increases rates of morbimortality. Assessing diarrhea risks is thus important for clinicians. For this reason, we conducted a hypothesis-generating study focused on AAD to provide insight into methods of prevention. We evaluated the hypothesis of predisposing factors within the...

  20. A comparative analysis of response to ORS (oral rehydration solution vs. ORS + gelatin tannate in two cohorts of pediatric patients with acute diarrhea Análisis comparativo de dos cohortes de pacientes pediátricos con diarrea aguda y respuesta a la solución de rehidratación oral (SRO frente a SRO + tanato de gelatina

    Directory of Open Access Journals (Sweden)

    J. Esteban Carretero

    2009-01-01

    Full Text Available Aim: the study aims to observe the response to treatment with ORS only or ORS + gelatin tannate in two cohorts of pediatric patients with acute diarrhea, with the primary efficacy endpoint being the number of stools at 12 hours from baseline. Methods: children aged 3 months to 12 years were included in the study. Only children with acute diarrhea, more than 3 liquid stools, and duration inferior to 72 h were included. Number of stools was recorded as absolute number, categorized as ≤ 3 and ≥ 4 stools over 12 hours, and as a stool decrease index (SDI. Other clinical variables were recorded, including weight, fever, vomiting, stool characteristics, and signs of peritonitis/sepsis. Results: baseline characteristics for the two populations included a mean age of 2.3 years in the ORS group and 2.6 years in the ORS + gelatin tannate group. Children younger than 2 years represented 59.8 and 54.3% in the ORS and ORS + gelatin tannate groups, respectively. Clinical variables such as vomiting, dehydration, weigth, and stool decrease index were used to compare the two groups. We found a statistical significant difference between the two groups (p Objetivo: el estudio tiene como objetivo observar la respuesta al tratamiento con SRO o SRO + tanato de gelatina en dos cohortes de pacientes pediátricos que presentan diarrea aguda, siendo el número de deposiciones a las 12 horas desde el tratamiento inicial el criterio principal de valoración de la eficacia. Métodos: en el estudio se incluyeron niños de entre 3 meses y 12 años de edad. Únicamente se incluyeron niños con diarrea aguda, con más de 3 deposiciones líquidas y menos de 72 horas de evolución. Se registró la variable principal del número de deposiciones y de análisis como número absoluto, categorizado como ≤ 3 y ≥ 4 deposiciones en 12 horas y como un índice de disminución de deposiciones (IDD. Se registraron otras variables clínicas como peso, fiebre, vómitos, caracter

  1. Infectious disease-specific health literacy in Tibet, China.

    Science.gov (United States)

    Yang, Peng; Dunzhu, Ciren; Widdowson, Marc-Alain; Wu, Shuangsheng; Ciren, Pengcuo; Duoji, Dunzhu; Pingcuo, Wangqing; Dun, Bian; Ma, Chunna; Li, Jie; Pang, Xinghuo; Wang, Quanyi

    2018-02-01

    This study was aimed to develop an instrument to assess infectious disease-specific health literacy (IDSHL) in the general population of Tibet, China and identify the association between IDSHL and reported infectious disease-related symptoms. A survey using a standardized questionnaire, which included 25 questions on knowledge, behaviors and skills regarding infectious diseases, was conducted in the general population of Tibet, China between September 2011 and November 2011. The 25 questions formed the index system of the instrument assessing IDSHL (total scores: 25 scores). Factors associated with index scores of IDSHL were identified by general linear model. The association between the index score of IDSHL and the occurrence of the five selected infectious disease symptoms (fever, diarrhea, rash, jaundice or conjunctivitis) were investigated using multivariate unconditional logistic regression. Among 5717 eligible participants in the survey, 4631 participants completed all of the 25 questions in the instrument. The instrument was reliable and valid as measured by the Cronbach's alpha coefficient and split-half coefficient, and the confirmatory factor analysis. Only 1.0% (48/4631) answered ≥80% of the 25 questions correctly (score ≥ 20). Significant factors associated with lower health literacy score included female gender, older age, Tibetan group, lower education level, underlying diseases and more undeveloped area. For each increasing score of IDSHL, reports of fever, diarrhea or jaundice in the prior year were significantly decreased by 3% (p = 0.015), 4% (p = 0.004) and 16% (p < 0.001), respectively. Accurately measuring IDSHL could help identify those individuals with poor IDSHL, who could be targeted with specific interventions to improve health. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Infectious disease-specific health literacy in Tibet, China

    Science.gov (United States)

    Yang, Peng; Dunzhu, Ciren; Widdowson, Marc-Alain; Wu, Shuangsheng; Ciren, Pengcuo; Duoji, Dunzhu; Pingcuo, Wangqing; Dun, Bian; Ma, Chunna; Li, Jie; Pang, Xinghuo; Wang, Quanyi

    2018-01-01

    Summary This study was aimed to develop an instrument to assess infectious disease-specific health literacy (IDSHL) in the general population of Tibet, China and identify the association between IDSHL and reported infectious disease-related symptoms. A survey using a standardized questionnaire, which included 25 questions on knowledge, behaviors and skills regarding infectious diseases, was conducted in the general population of Tibet, China between September 2011 and November 2011. The 25 questions formed the index system of the instrument assessing IDSHL (total scores: 25 scores). Factors associated with index scores of IDSHL were identified by general linear model. The association between the index score of IDSHL and the occurrence of the five selected infectious disease symptoms (fever, diarrhea, rash, jaundice or conjunctivitis) were investigated using multivariate unconditional logistic regression. Among 5717 eligible participants in the survey, 4631 participants completed all of the 25 questions in the instrument. The instrument was reliable and valid as measured by the Cronbach’s alpha coefficient and split-half coefficient, and the confirmatory factor analysis. Only 1.0% (48/4631) answered ≥80% of the 25 questions correctly (score ≥20). Significant factors associated with lower health literacy score included female gender, older age, Tibetan group, lower education level, underlying diseases and more undeveloped area. For each increasing score of IDSHL, reports of fever, diarrhea or jaundice in the prior year were significantly decreased by 3% (p = 0.015), 4% (p = 0.004) and 16% (p < 0.001), respectively. Accurately measuring IDSHL could help identify those individuals with poor IDSHL, who could be targeted with specific interventions to improve health. PMID:27476868

  3. Dynamics of infectious diseases

    International Nuclear Information System (INIS)

    Rock, Kat; Brand, Sam; Moir, Jo; Keeling, Matt J

    2014-01-01

    Modern infectious disease epidemiology has a strong history of using mathematics both for prediction and to gain a deeper understanding. However the study of infectious diseases is a highly interdisciplinary subject requiring insights from multiple disciplines, in particular a biological knowledge of the pathogen, a statistical description of the available data and a mathematical framework for prediction. Here we begin with the basic building blocks of infectious disease epidemiology—the SIS and SIR type models—before considering the progress that has been made over the recent decades and the challenges that lie ahead. Throughout we focus on the understanding that can be developed from relatively simple models, although accurate prediction will inevitably require far greater complexity beyond the scope of this review. In particular, we focus on three critical aspects of infectious disease models that we feel fundamentally shape their dynamics: heterogeneously structured populations, stochasticity and spatial structure. Throughout we relate the mathematical models and their results to a variety of real-world problems. (review article)

  4. Vasculitis and infectious diseases.

    Science.gov (United States)

    Satta, R; Biondi, G

    2015-04-01

    Vasculitis usually presents without a well-known underline cause (idiopathic vasculitis), nevertheless, it is sometimes possible to find out one or more causative agents (secondary vasculitis). Nowadays, thanks to the increasing amount of precise diagnostic tools, a piece of idiopathic vasculitis is reclassified as associated with probable etiology, which can be set off by several factors, such as infections. Infections are considered to be the most common cause of secondary vasculitis. Virtually, every infectious agent can trigger a vasculitis by different mechanisms which can be divided in two main categories: direct and indirect. In the former, infectious agents destroy directly the vascular wall leading, eventually, to a subsequent inflammatory response. In the latter, indirect form, they stimulate an immune response against blood vessels. Different infectious agents are able to directly damage the vascular wall. Among these, it is possible to recognize Staphylococcus spp, Streptococcus spp, Salmonella spp, Treponema spp, Rickettsia spp, Cytomegalovirus, Herpes Simplex Virus 1 and 2, and many others which have a peculiar tropism for endothelial cells. Conversely, another group of microbial agents, such as Mycobacterium tuberculosis, Mycobacterium leprae, Hepatits B Virus, Human Immunodeficiency Virus and others, trigger vasculitis in the indirect way. This is due to the fact that they can share epitopes with the host or modify self-antigens, thus leading to a cross-self reaction of the immune system. These mechanism, in turn, leads to immunological responses classified as type I-IV by Gell-Coombs. Nevertheless, it is difficult to strictly separate the direct and indirect forms, because most infectious agents can cause vasculitis in both ways (mixed forms). This paper will analyze the link between infectious agents and vasculitis, focusing on direct and indirect secondary vasculitis, and on a group of probable infection-related idiopathic vasculitis, and finally

  5. Diarrhea after bariatric procedures: Diagnosis and therapy.

    OpenAIRE

    Borbély, Yves Michael; Osterwalder, Alice; Kröll, Dino; Nett, Philipp C.; Inglin, Roman

    2017-01-01

    Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually...

  6. Diarrhea after bariatric procedures: Diagnosis and therapy

    OpenAIRE

    Borb?ly, Yves M; Osterwalder, Alice; Kr?ll, Dino; Nett, Philipp C; Inglin, Roman A

    2017-01-01

    Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually...

  7. Diarrhea and parasitosis in Salta, Argentina.

    Science.gov (United States)

    Aramayo, Cristian F; Gil, José F; Cruz, Mercedes C; Poma, Hugo R; Last, Michael S; Rajal, Verónica B

    2009-03-01

    Salta city is the capital of the province with the same name located in the northwest of Argentina. Its great growth over the last decade was not organized and the population expanded to occupy places where water and sanitation were not yet available. Although the Arenales River, crossing the city, receives the impact of point and non-point source pollution, the water is used for many purposes, including domestic in the poorest areas, industrial, and recreational with children as the main users. According to the World Health Organization, an estimated 24% of the global disease burden and 23% of all deaths can be attributed to environmental factors. In particular, an estimated 94% of the diarrheal burden of disease is attributable to environment, and is associated with risk factors such as unsafe drinking water and poor sanitation and hygiene. Chronic diarrhea can be caused by an infection or other etiologies; however, most of the times the etiological agent is not identified. All the cases of diarrhea and parasitosis reported during 2005 in four public health centers of the city of Salta were classified by gender and age, analyzed, and represented geographically to show areas of higher morbidity rates, which were probably related to environmental factors. Water, poor sanitation, and pollution are candidate risk factors. Diarrhea cases showed seasonality, with the highest incidence during late spring and summer, while parasitosis was persistent throughout the year. Our spatial analysis permitted us to detect the regions of higher incidence of diarrhea and parasitosis during 2005 in the area of study.

  8. Diarrhea after bariatric procedures: Diagnosis and therapy.

    Science.gov (United States)

    Borbély, Yves M; Osterwalder, Alice; Kröll, Dino; Nett, Philipp C; Inglin, Roman A

    2017-07-14

    Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future. A multitude of factors exert their influence on bowel habits; preoperative comorbidities and procedure-related aspects are intertwined with postoperative nutritional habits. Diagnosis may be challenging owing to the characteristics of post-bariatric surgery anatomy with hindered accessibility of excluded segments of the small bowel and restriction at the gastric level. Conventional testing measures, if available, generally yield low accuracy and are usually not validated in this specific population. Limited trials of empiric treatment are a practical alternative and oftentimes an indispensable part of the diagnostic process. This review provides an overview of causes for chronic post-bariatric surgery diarrhea and details the particularities of its diagnosis and treatment in this specific patient population. Topics of current interest such as the impact of gut microbiota and the influence of bile acids on morbid obesity and especially their role in diarrhea are highlighted in order to provide a better understanding of the specific problems and chances of future treatment in post-bariatric surgery patients.

  9. Diarrhea after bariatric procedures: Diagnosis and therapy

    Science.gov (United States)

    Borbély, Yves M; Osterwalder, Alice; Kröll, Dino; Nett, Philipp C; Inglin, Roman A

    2017-01-01

    Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future. A multitude of factors exert their influence on bowel habits; preoperative comorbidities and procedure-related aspects are intertwined with postoperative nutritional habits. Diagnosis may be challenging owing to the characteristics of post-bariatric surgery anatomy with hindered accessibility of excluded segments of the small bowel and restriction at the gastric level. Conventional testing measures, if available, generally yield low accuracy and are usually not validated in this specific population. Limited trials of empiric treatment are a practical alternative and oftentimes an indispensable part of the diagnostic process. This review provides an overview of causes for chronic post-bariatric surgery diarrhea and details the particularities of its diagnosis and treatment in this specific patient population. Topics of current interest such as the impact of gut microbiota and the influence of bile acids on morbid obesity and especially their role in diarrhea are highlighted in order to provide a better understanding of the specific problems and chances of future treatment in post-bariatric surgery patients. PMID:28765690

  10. Management of chemotherapy induced diarrhea (abstract)

    International Nuclear Information System (INIS)

    Qureshi, A.M.

    1998-01-01

    Diarrhoea is seen with many tumors and following several chemotherapy regimen esp. those containing 5-fluorouracil and high dose folinic acid it causes debility even death, delays cancer treatment, reduces compliance increases cost. It causes dehydration, renal failure volume depletion. Quality of life is worsened and hospitalization may be needed in multifactorial, with secretion; absorption imbalance due to mucosal damage, necrosis or inflammation. Local infection is set up by opportunistic organism and cell necrosis. The large volume of fluid and electrolytes overwhelms colonic absorptive capacity. Agent usually used for treatment is opioids (such as Diphenoxylate / Loperamide]. Bismuth (for inflammatory diarrhea). NSAIDs or alpha 2-agonists. For optimal management, the cause and severity should be assessed and treatment planned. Advice is given about certain dietary restraints and avoidance of some drugs. Fever, infection, dehydration and electrolyte losses are treated, pain relieved. Diphenoxylate / Loperamide (later is more effective; 4 mg, STAT, then 2mg every 4 hours or even 2 hourly) may be used. It is moderately effective in CID. Octreotide is useful in carcinoid. VIPoma, AIDS idiopathic secretary diarrhea, ileostomy, dumping syndrome. It acts directly on epithelial cells to reduce secretin, motilin pancreatic polypeptide. It slows transit time, reduces fluid and electrolyte secretin, increases absorption of electrolytes. It is effective in 5 FU and high dose chemotherapy with a 90% response rates seen after 3 days treatment. High Dose Chemotherapy and total body irradiation - induced diarrhea usually resolves within 72 hours. (author)

  11. Chronic diarrhea. Diagnosis and clinical evaluation

    International Nuclear Information System (INIS)

    Pineda O, Luis F; Otero R, William; Arbelaez M, Victor

    2004-01-01

    Chronic diarrhea is a syndrome of great clinical complexity, which is frequently encountered by general physicians, internists and gastroenterologists. Differential diagnosis is very broad and sometime finding the precise cause can be difficult, expensive and frustration. Literature published about this topic lack, in general, adequate controlled studies and for this reason recommendations for diagnostic evaluation and treatment are based upon series of cases, experience of the institutions or expert opinion and not on reasonable evidence. On the other hand, many of the classical diagnostic tests that have survived until now were designed over physiologic foundations and have not been validated extensively with the precision of a clinical test. This limits its acceptance, application and standardization in the daily practice. There is not a general agreement about diagnosis and treatment of chronic diarrhea and many of the experts divert recommendation about their recommendations. The purpose of this paper is to define some general guidelines about the clinical evaluation of patients with chronic diarrhea that lead us to a rational approach based upon clinical trials and the appropriate use of the many different tests

  12. International adoption: issues in infectious diseases.

    Science.gov (United States)

    Staat, Dana D; Klepser, Michael E

    2006-09-01

    International adoptions have become increasingly common in the United States. Children awaiting international adoption and families traveling to adopt these children can be exposed to a variety of infectious diseases. Compared with the United States, foreign countries often have different immunization practices and methods of diagnosing, treating, and monitoring disease. Reporting of medical conditions can also differ from that of the United States. The prevalence of infectious diseases varies from country to country and may or may not be common among adopted children. The transmission of tuberculosis, hepatitis B, and measles from adopted children to family members has been documented. Furthermore, infectious organisms (e.g., intestinal parasites), bacterial pathogens (e.g., Bordetella pertussis and Treponema pallidum), and viruses (e.g., human immunodeficiency virus and hepatitis viruses) may cause clinically significant morbidity and mortality among infected children. Diseases such as severe acute respiratory syndrome or avian influenza have not been reported among international adoptees, but transmission is possible if infection is present. Family members may be infected by others during travel or by their adopted child after returning home. Families preparing to adopt a child from abroad should pay special attention to the infectious diseases they may encounter and to the precautions they should take on returning home.

  13. A survey on relationships between thyroid hormone levels and clinical findings in dairy calf diarrhea

    Directory of Open Access Journals (Sweden)

    Ali Hajimohammadi

    2015-03-01

    Full Text Available Calf diarrhea is an important disease that occurs in association with the interaction of various infectious agents and calf susceptibility. The economic losses is associated with death loss and treatment costs, reduction of live weight gain, and reduction of productive life span, which may be considerable. Thyroid hormones previously thought mainly in thermoregulation and energy metabolism. Recently, several studies have challenged on their roles in the metabolic response of animals to certain conditions such as nutritional, environmental, or disease state. The aim of the present study was to survey relationships between thyroid hormones in calves with diarrhea in the different clinical features. Holstein calves (50 within 1 day to 2 months old with signs of diarrhea and healthy calves (40 with similar age and sex were selected. Standard clinical examinations and also dehydration degree assessment were carried out on each calf and recorded accordingly. Calves with clinical signs of diarrhea were divided in different groups based on the severity of the clinical findings, fever and degree of dehydration. Blood samples were taken from the jugular vein from all calves into vacutainer tubes for serum collection.T4, fT4, T3 and fT3 concentrations were measured by validated methods. A significant increase in T4, T3 and fT3 in diarrheic calves was observed (P<0.05. Thyroid hormones in calves with severe clinical signs decreased significantly (P<0.001 compared to calves with moderate or mild systemic clinical signs. Thyroid hormones between febrile diarrheic calves compared to afebrile diarrheic calves had no significant changes. Diarrheic calves with severe dehydration compared to diarrheic calves with mild and moderate dehydration had significant decreases in their thyroid hormones (P<0.001.

  14. [Estimation of small intestinal bacterial overgrowth in patients with constipation and diarrhea irritable bowel syndrome].

    Science.gov (United States)

    Łokieć, Katarzyna; Klupińska, Grazyna; Walecka-Kapica, Ewa; Błońska, Aleksandra

    2014-05-01

    Irritable bowel syndrome (IBS) is one of the most common reason for gastroenterology consultations. The diverse in symptomatology of the disease comes from its rich etiopathogenesis. Recently studies talk about infectious etiology of IBS and because of that it is necessary to expand its diagnostics by small intestinal bacterial overgrowth (SIBO) test. The aim of this study was to evaluate the prevalence of small intestinal bacterial overgrowth in patients with constipation (IBS-C) and diarrhea (IBS-D) irritable bowel syndrome with regard to nutrition. The study involved 46 subjects (33 women and 13 men) in average age of 44 years, which were divided into two groups: diarrhea and constipation IBS. All patients underwent hydrogen breath test studying bacterial overgrowth in the small intestine. In addition, each person had fulfilled a feeding questionnaire. Student's t-test, Pearson test. It has been shown that there is no statistical significances between the prevalence of SIBO in form of diarrheal IBS and constipation IBS and gender. Average value of increments of hydrogen in breath during the test was higher in IBS-C in comparison with IBS-D, which was the highest in the intestine bacterial overgrowth in patients with IBS-C. STATISTICAL ANALYSIS showed that there is no relationship between the type and frequency of consumption of milk, meat, fruit and vegetables, sweets and coffee and the prevalence of SIBO in form of diarrhea and constipation IBS. The occurrence of constipation or diarrhea irritable bowel syndrome is not related to gender. SIBO is more common in patients with IBS-C than in IBS-D group. There is no relationship between the type of food consumed and the amount of SIBO in people with IBS. Type of food intake do not affect the status of the intestinal flora of people with IBS.

  15. Effectiveness of aqueous and hydroalcoholic extracts of Acanthospermum australe (Loefl. Kuntze against diarrhea-inducing bacteria

    Directory of Open Access Journals (Sweden)

    R. Mallmann

    2018-01-01

    Full Text Available Abstract Leaves and roots of Acanthospermum australe (Asteraceae have been used in Brazilian folk medicine for the treatment of various ailments including diarrhea, skin diseases, blennorrhagia, dyspepsia, parasitic worms and malaria. The aim of study was to characterize the chemical profiles of the aqueous and hydroalcoholic extracts of leaves and roots of A. australe, and to evaluate their antimicrobial activities against diarrhea-inducing bacteria (Enterococcus faecalis, Shigella dysenteriae and Yersinia enterocolitica, as well as their cytotoxic properties. Aqueous leaf extracts were obtained by infusion, while aqueous root extracts were obtained by decoction. The hydroalcoholic leaf and root extracts were prepared by maceration in 90% ethanol for 3 days. Antimicrobial activity was assessed using standard techniques and cytotoxicity was evaluated using Chinese hamster ovary cells CHO-K1. Chemical analysis revealed the presence of tannins, flavonoids, saponins and phenolic compounds in the extracts. Although root extracts were not effective against E. faecalis, leaf extracts at concentrations of 20 mg/mL exhibited bactericidal activities against this microorganism. The hydroalcoholic root extract was unique in presenting a bactericidal effect against S. dysenteriae. None of the extracts showed bacteriostatic or bactericidal activities against Y. enterocolitica. The results presented herein demonstrate that the Gram-positive E. faecalis and the Gram-negative S. dysenteriae were susceptible to A. australe extracts, although bacteriostatic/bactericidal activities were only observed at concentrations considered too high for clinical application. Our results support the ethnopharmacological use of A. australe in the treatment of gastrointestinal disorders, particularly diarrhea caused by infectious bacteria, although further studies are required to determine the anti-diarrhea effects and the toxicities of the extracts in vivo.

  16. High protective efficacy of probiotics and rice bran against human norovirus infection and diarrhea in gnotobiotic pigs

    Directory of Open Access Journals (Sweden)

    Shaohua Lei

    2016-11-01

    Full Text Available Probiotics have been recognized as vaccine adjuvants and therapeutic agents to treat acute gastroenteritis in children. We previously showed that rice bran reduced human rotavirus diarrhea in gnotobiotic pigs. Human noroviruses (HuNoVs are the major pathogens causing nonbacterial acute gastroenteritis worldwide. In this study, Lactobacillus rhamnosus GG (LGG and Escherichia coli Nissle 1917 (EcN were first screened for their ability to bind HuNoV P particles and virions derived from clinical samples containing HuNoV genotype GII.3 and GII.4, then the effects of LGG+EcN and rice bran on HuNoV infection and diarrhea were investigated using the gnotobiotic pig model. While LGG+EcN colonization inhibited HuNoV shedding, probiotic cocktail regimens in which rice bran feeding started 7 days prior to or 1 day after viral inoculation in the LGG+EcN colonized gnotobiotic pigs exhibited high protection against HuNoV diarrhea and shedding, characterized by significantly reduced incidence (89% versus 20% and shorter mean duration of diarrhea (2.2 versus 0.2 days, as well as shorter mean duration of virus shedding (3.2 versus 1.0 days. In both probiotic cocktail groups, the diarrhea reduction rates were 78% compared with the control group, and diarrhea severity was reduced as demonstrated by the significantly lower cumulative fecal scores. The high protective efficacy of the probiotic cocktail regimens was attributed to stimulation of IFN-γ+ T cell responses, increased production of intestinal IgA and IgG, and maintenance of healthy intestinal morphology (manifested as longer villi compared with the control group. Therefore, probiotic cocktail regimens containing LGG+EcN and rice bran may represent highly efficacious strategies to prevent and treat HuNoV gastroenteritis, and potentially other human enteric pathogens.

  17. Colon in acute intestinal infection.

    Science.gov (United States)

    Guarino, Alfredo; Buccigrossi, Vittoria; Armellino, Carla

    2009-04-01

    The colon is actively implicated in intestinal infections not only as a target of enteric pathogens and their products but also as a target organ for treatment. In the presence of diarrhea, both of osmotic and secretory nature, the colon reacts with homeostatic mechanisms to increase ion absorption. These mechanisms can be effectively exploited to decrease fluid discharge. A model of intestinal infections using rotavirus (RV) in colonic cells was set up and used to define a dual model of secretory and osmotic diarrhea in sequence. Using this model, antidiarrheal drugs were tested, namely zinc and the enkephalinase inhibitor racecadotril. Zinc was able to decrease the enterotoxic activity responsible for secretory diarrhea. It also inhibited the cytotoxic effect of RV. The mechanism of zinc was related at least in part to the activation of MAPK activity, but also a direct antiviral effect was observed. Racecadotril showed a potent and selective inhibition of active secretion, being particularly effective in the first phase of RV diarrhea. The use of drugs active at the colonic level, therefore, offers effective options to treat intestinal infections in childhood. In addition, the colon is the natural site of colonic microflora, a target of probiotic therapy, which is the first line of approach recommended by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition to treat infectious diarrhea.

  18. Low cost extraction and isothermal amplification of DNA for infectious diarrhea diagnosis.

    Directory of Open Access Journals (Sweden)

    Shichu Huang

    Full Text Available In order to counter the common perception that molecular diagnostics are too complicated to work in low resource settings, we have performed a difficult sample preparation and DNA amplification protocol using instrumentation designed to be operated without wall or battery power. In this work we have combined a nearly electricity-free nucleic acid extraction process with an electricity-free isothermal amplification assay to detect the presence of Clostridium difficile (C. difficile DNA in the stool of infected patients. We used helicase-dependent isothermal amplification (HDA to amplify the DNA in a low-cost, thermoplastic reaction chip heated with a pair of commercially available toe warmers, while using a simple Styrofoam insulator. DNA was extracted from known positive and negative stool samples. The DNA extraction protocol utilized an air pressure driven solid phase extraction device run using a standard bicycle pump. The simple heater setup required no electricity or battery and was capable of maintaining the temperature at 65°C±2°C for 55 min, suitable for repeatable HDA amplification. Experiments were performed to explore the adaptability of the system for use in a range of ambient conditions. When compared to a traditional centrifuge extraction protocol and a laboratory thermocycler, this disposable, no power platform achieved approximately the same lower limit of detection (1.25×10(-2 pg of C. difficile DNA while requiring much less raw material and a fraction of the lab infrastructure and cost. This proof of concept study could greatly impact the accessibility of molecular assays for applications in global health.

  19. New active natural phytocompounds for the treatment and prevention of infectious diarrhea

    OpenAIRE

    Mohamed Salem, Reda Mohamed

    2016-01-01

    Las infecciones entéricas siguen siendo uno de los problemas más importantes de salud pública. La diarrea infecciosa es a nivel mundial la segunda causa de morbilidad y mortalidad infantil, con 4,6 millones de muertes de los aproximadamente un billón de episodios de diarrea al año reportados en niños. Según informes recientes de la OMS, 1,9 millones de niños menores de cinco años siguen muriendo de estas enfermedades cada año. Los principales síntomas clínicos de las infecciones entéricas inc...

  20. Molecular Survey of Viral and Bacterial Causes of Childhood Diarrhea in Khartoum State, Sudan.

    Science.gov (United States)

    Adam, Mosab A; Wang, Ji; Enan, Khalid-A; Shen, Hongwei; Wang, Hao; El Hussein, Abdel R; Musa, Azza B; Khidir, Isam M; Ma, Xuejun

    2018-01-01

    Diarrheal disease is a major public health problem for children in developing countries. Knowledge of etiology that causes diarrheal illness is essential to implement public health measures to prevent and control this disease. Published studies regarding the situation of childhood diarrhea in Sudan is scanty. This study aims to investigate viral and bacterial etiology and related clinical and epidemiological factors in children with acute diarrhea in Khartoum State, Sudan. A total of 437 fecal samples were collected from hospitalized children PCR. The genotypes of adenovirus and bocavirus were determined by sequencing. Viral diarrhea was identified in 79 cases (62 single and 17 co-infections) (18%), and bacterial diarrhea in 49 cases (37 single and 12 co-infections) (11.2%). Mixed infections in both groups totaled 19 samples (4.3%) with more than one pathogen, they were viral co-infections ( n = 7, 36.8%) bacterial co-infections ( n = 2, 10.5%) and viral bacterial co-infection ( n = 10, 52.6%). Rotavirus (10.2%) was predominantly detected, followed by norovirus G2 (4.0%), adenovirus (1.6%), bocavirus (1%), and norovirus G1 (0.9%). Infection with astrovirus was not detected in this study. The Shigella -Enteroinvasive E.coli (EIEC) (8.9%) was the predominantly found bacterial pathogen, followed by Vibrio parahaemolyticus (0.9%), enterohaemorrhagic E.coli (EHEC) -Enteropathogenic E. coli (EPEC) (0.6%) and Salmonella enteritidis (0.6%). V. cholerae, Yersinia enterocolitica and Campylobacter jejuni were not detected in this study. The phylogenetic tree identified adenovirus belonged to genotype 41 and bocavirus belonged to two different clades within human bocavirus 1. Our findings represent the first report that adenovirus 41 is a cause of diarrhea in Sudan and that human bocavirus 1 is the principal bocavirus strain circulating in Sudan. In conclusion, this is the first comprehensive report to elaborate the pathogen spectrum associated with childhood diarrhea in

  1. Fecal calprotectin concentrations in adult dogs with chronic diarrhea.

    Science.gov (United States)

    Grellet, Aurélien; Heilmann, Romy M; Lecoindre, Patrick; Feugier, Alexandre; Day, Michael J; Peeters, Dominique; Freiche, Valérie; Hernandez, Juan; Grandjean, Dominique; Suchodolski, Jan S; Steiner, Jorg M

    2013-05-01

    To evaluate fecal calprotectin concentrations in healthy dogs and dogs with chronic diarrhea, to identify cutoff values for fecal calprotectin concentrations for use in differentiating dogs with chronic diarrhea and a canine chronic enteropathy clinical activity index (CCECAI) chronic diarrhea and a CCECAI ≥ 12, and to evaluate the association between histologic evidence of intestinal mucosal changes and fecal calprotectin concentrations in dogs with chronic diarrhea. Fecal samples from 96 adult dogs (27 dogs with chronic diarrhea and 69 healthy control dogs). Severity of clinical signs was evaluated on the basis of the CCECAI scoring system. Endoscopy was performed in all dogs with chronic diarrhea, and mucosal biopsy specimens were evaluated histologically. Fecal calprotectin concentration was quantified via radioimmunoassay. Fecal calprotectin concentrations were significantly higher in dogs with chronic diarrhea than in healthy control dogs. Fecal calprotectin concentrations were also significantly higher in dogs with a CCECAI ≥ 12, compared with concentrations for dogs with a CCECAI between 4 and 11. Fecal calprotectin concentrations were significantly higher in dogs with chronic diarrhea associated with histologic lesions, compared with concentrations in control dogs, and were significantly correlated with the severity of histologic intestinal lesions. Among dogs with chronic diarrhea, the best cutoff fecal calprotectin concentration for predicting a CCECAI ≥ 12 was 48.9 μg/g (sensitivity, 53.3%; specificity, 91.7%). Fecal calprotectin may be a useful biomarker in dogs with chronic diarrhea, especially dogs with histologic lesions.

  2. Coinfection with Giardia lamblia and Enterocytozoon bieneusi in a patient with acquired immunodeficiency syndrome and chronic diarrhea.

    Science.gov (United States)

    Hewan-Lowe, K; Furlong, B; Sims, M; Schwartz, D A

    1997-04-01

    Diarrhea is an important clinical problem in immunosuppressed patients with acquired immunodeficiency syndrome (AIDS). There are numerous classical as well as emerging enteric pathogens that can produce diarrhea; however, these agents can be missed when only one method, such as microbiological examination of stool, is used for diagnosis. The endoscopic biopsy is a sensitive method for diagnosis of many viral, fungal, and parasitic infections of the gastrointestinal tract. Although only one agent is often identified in mucosal biopsies from these immunosuppressed patients, coinfection with multiple microbial agents is being increasingly recognized. Giardia infection is not as prevalent as other pathogens in patients with AIDS, but it remains an important diarrheal agent that is potentially curable. However, there have been only rare reports of coinfections with giardiasis and other infectious agents. This report describes a patient with AIDS and chronic diarrhea who had repeated negative stool examinations for ova and parasites. Light and electron microscopic examination of subsequent endoscopically obtained small intestinal biopsies revealed coinfection with two parasites, Enterocytozoon bieneusi and Giardia lamblia. Following treatment with metronidazole for giardiasis, the diarrhea persisted, but was less severe. This report also describes the diagnostic features of Giardia and Enterocytozoon infections in biopsy tissues and emphasizes the importance of identifying enteric coinfections in patients with AIDS to ensure timely and specific modes of therapy.

  3. The Global Infectious Disease Threat and Its Implications for the United States

    Science.gov (United States)

    2000-01-01

    including tuberculosis (TB), malaria, and cholera––have reemerged or spread geographically since 1973, often in more virulent and drug-resistant forms...controlling or eradicating a growing number of infectious diseases—such as tuberculosis (TB), malaria, and smallpox–– in the decades after the Second...of Pathogenic Microbes and the Diseases They Cause, Identified Since 1973 Year Microbe Type Disease 1973 Rotavirus Virus Infantile diarrhea 1977 Ebola

  4. Two cases of Kawasaki disease presented with acute febrile jaundice.

    Science.gov (United States)

    Kaman, Ayşe; Aydın-Teke, Türkan; Gayretli-Aydın, Zeynep Gökçe; Öz, Fatma Nur; Metin-Akcan, Özge; Eriş, Deniz; Tanır, Gönül

    2017-01-01

    Kawasaki disease is an acute, systemic vasculitis of unknown etiology. Although gastrointestinal involvement does not belong to the classic diagnostic criteria; diarrhea, abdominal pain, hepatic dysfunction, hydrops of gallbladder, and acute febrile cholestatic jaundice are reported in patients with Kawasaki disease. We describe here two cases presented with fever, and acute jaundice as initial features of Kawasaki disease.

  5. Marine infectious disease ecology

    Science.gov (United States)

    Lafferty, Kevin D.

    2017-01-01

    To put marine disease impacts in context requires a broad perspective on the roles infectious agents have in the ocean. Parasites infect most marine vertebrate and invertebrate species, and parasites and predators can have comparable biomass density, suggesting they play comparable parts as consumers in marine food webs. Although some parasites might increase with disturbance, most probably decline as food webs unravel. There are several ways to adapt epidemiological theory to the marine environment. In particular, because the ocean represents a three-dimensional moving habitat for hosts and parasites, models should open up the spatial scales at which infective stages and host larvae travel. In addition to open recruitment and dimensionality, marine parasites are subject to fishing, filter feeders, dosedependent infection, environmental forcing, and death-based transmission. Adding such considerations to marine disease models will make it easier to predict which infectious diseases will increase or decrease in a changing ocean.

  6. African Journal of Infectious Diseases

    African Journals Online (AJOL)

    The African Journal of Infectious Diseases accepts original research papers on the pathogenesis, diagnosis, epidemiology and treatment of infectious diseases, impact of infectious agents on the environment and related disciplines. Reports of research related to any aspect of the fields of microbiology, parasitology, ...

  7. Post-Infectious IBS (IBS-PI)

    Science.gov (United States)

    ... for IBS Signs and Symptoms Overview Recognizing Symptoms Diagnosis of IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS ... for IBS Signs and Symptoms Overview Recognizing Symptoms Diagnosis of IBS Pain in IBS IBS with Constipation Constipated Diarrhea IBS ...

  8. Pasteurella multocida infectious arthritis.

    Science.gov (United States)

    Spagnuolo, P J

    1978-01-01

    Pasteurella multocida, a small gram-negative rod, is a domestic animal saprophyte that occasionally causes disease in humans. Infectious arthritis may develop from a superficial animal bite or scratch. Nine previous cases of infectious arthritis due to this organism have been documented in the literature, and a tenth case is reported here. Most patients had recent animal exposure, and half the patients had underlying chronic rheumatoid arthritis. Clinical signs of inflammation were consistently present; however, systemic infection was infrequent. The lack of positive synovial fluid gram-stain smears may make differentiation from other forms of infectious arthritis difficult. Penicillin in moderate doses is effective therapy, with osteomyelitis developing in only two patients. The tendency for this syndrome to affect patients with rheumatoid arthritis may reflect deficient local defense mechanisms, chronic steroid therapy, or increased ownership of pets. The mechanism of spread of infection to the joint space appears to be through contiguous spread from a skin site rather than by the hematogenous route in most cases.

  9. Fatores de risco para diárreia persistente em lactentes Risk factors to persistent diarrhea in infants

    Directory of Open Access Journals (Sweden)

    Maria das Graças Moura Lins

    2003-12-01

    Full Text Available RACIONAL: A diarréia persistente é uma doença multicausal. A análise do risco para o prolongamento do quadro diarréico envolve variáveis ambientais, biológicas e do manejo clínico. OBJETIVO: Identificar fatores de risco para a diarréia persistente em crianças hospitalizadas na fase aguda do quadro diarréico. PACIENTES E MÉTODOS: O estudo foi do tipo caso-controle. A amostra consistiu de 216 crianças menores de 24 meses hospitalizadas por diarréia de início abrupto, no Instituto Materno-Infantil de Pernambuco, Recife, PE. O grupo de casos incluiu as crianças com diarréia persistente e o de controles aquelas com diarréia aguda. Foram analisadas variáveis socioeconômicas, biológicas, de morbidade anterior, clínicas e do manejo terapêutico prévio à admissão. Utilizou-se o odds ratio não ajustado e ajustado, com seus respectivos intervalos de confiança de 95%, observando-se o nível de significância de 5%. A análise multivariada foi feita através de regressão logística. RESULTADOS: O risco de persistência da diarréia foi maior nas crianças com: disenteria, febre no início do quadro, dieta suspensa e uso de antibiótico à admissão hospitalar. O risco de diarréia persistente foi cerca de três vezes maior para crianças sem geladeira no domicílio e que apresentavam hiperemia perianal ao exame físico na admissão hospitalar, sendo estas as variáveis que apresentaram significância estatística após o ajuste para fatores de confusão. CONCLUSÕES: A melhoria das condições ambientais e o manejo adequado e individualizado da criança hospitalizada por diarréia pode contribuir para a redução da morbidade da doença.BACKGROUND: Persistent diarrhea is a multicausal disease. The analysis of risk factors for persistent diarrhea includes environmental and biological variables as well as therapeutical management. AIM: To identify risk factors for persistent diarrhea among children hospitalized with acute diarrhea

  10. Syndromic diarrhea/Tricho-hepato-enteric syndrome

    Directory of Open Access Journals (Sweden)

    Fabre Alexandre

    2013-01-01

    Full Text Available Abstract Syndromic diarrhea/Tricho-hepato-enteric syndrome (SD/THE is a rare and severe bowel disorder caused by mutation in SKIV2L or in TTC37, 2 genes encoding subunits of the putative human SKI complex. The estimated prevalence is 1/1,000,000 births and the transmission is autosomal recessive. The classical form is characterized by 5 clinical signs: intractable diarrhea of infancy beginning in the first month of life, usually leading to failure to thrive and requiring parenteral nutrition; facial dysmorphism characterised by prominent forehead and cheeks, broad nasal root and hypertelorism; hair abnormalities described as woolly and easily removable; immune disorders resulting from defective antibody production; intrauterine growth restriction. The aetiology is a defect in TTC37, a TPR containing protein, or in the RNA helicase SKIV2L, both constituting the putative human ski complex. The ski complex is a heterotetrameric cofactor of the cytoplasmic RNA exosome which ensures aberrants mRNAs decay. The diagnosis SD/THE is initially based on clinical findings and confirmed by direct sequencing of TTC37 and SKIV2L. Differential diagnosis with the other causes of intractable diarrhea is easily performed by pathologic investigations. During their clinical course, most of the children require parenteral nutrition and often immunoglobulin supplementation. With time, some of them can be weaned off parenteral nutrition and immunoglobulin supplementation. The prognosis depends on the management and is largely related to the occurrence of parenteral nutrition complications or infections. Even with optimal management, most of the children seem to experience failure to thrive and final short stature. Mild mental retardation is observed in half of the cases. Abstract in French Les diarrhées syndromiques ou syndrome tricho-hepato-enterique (SD/THE sont un syndrome rare et sévère dont l’incidence est estimée à 1 cas pour 1 million de naissances et la

  11. Frequência de Escherichia coli e sua sensibilidade aos antimicrobianos em menores de cinco anos hospitalizados por diarreia aguda The frequency of Escherichia coli and its sensitivity to antimicrobials in children aged under five years admitted to hospital for treatment of acute diarrhea

    Directory of Open Access Journals (Sweden)

    Maria do Rosário S. de Almeida Lélis de Moura

    2012-06-01

    Full Text Available OBJETIVOS: determinar a frequência de Escherichia coli diarreiogênica e sua sensibilidade aos antimicrobianos em menores de cinco anos hospitalizados por diarreia aguda. MÉTODOS: estudo prospectivo tipo corte transversal realizado no Instituto de Medicina Integral Prof. Fernando Figueira, entre janeiro de 2010 e fevereiro de 2011. Foram excluídas as crianças com diagnóstico de imunodeficiência ou usando antimicrobianos. Para cada paciente foi feito uma única coleta de swab retal nas primeiras 24 horas de internação. Os patógenos foram identificados na coprocultura e sorotipagem. Os antibiogramas foram obtidos por disco-difusão. RESULTADOS: 140 crianças foram arroladas, em sua maioria provinham de famílias de baixa renda da Região Metropolitana do Recife. Foram isolados 99 microorganismos: 9 (6,4% E. coli enteropatogênica (EPEC e 4 (2,9% E. coli enteroinvasora (EIEC e 80 (57,1% outras E.coli não EPEC, não EIEC, 3 (2,1% Shigella spp e 3 (2,1% Salmonella spp. O perfil de sensibilidade aos antimicrobianos demonstrou níveis elevados de resistência à ampicilina e sulfametoxazol-trimetoprima. CONCLUSÕES: a baixa frequência de EPEC observada pode estar associada às condições de saneamento básico favoráveis apresentadas pelos pacientes do estudo. A análise local do perfil da sensibilidade da E. coli aos antimicrobianos reforça a recomendação da Organização Mundial de Saúde para o uso racional dessas drogas visando prevenção da resistência bacteriana.OBJECTIVES: to determine the frequency of diarrheic Escherichia coli and its sensitivity to antimicrobials in children aged under five years admitted to hospital for treatment of acute diarrhea. METHODS: a prospective cross-sectional study was carried out at the Instituto de Medicina Integral Prof. Fernando Figueira, between January 2010 and February 2011. Children were excluded if they had been diagnosed as immunodeficient or were using antimicrobials. A single rectal

  12. Optimaliseren van het antibioticabeleid in Nederland. IX. SWAB-richtlijn voor antimicrobiële therapie bij acute infectieuze diarree

    NARCIS (Netherlands)

    Bos, J. C.; Schultsz, C.; Vandenbroucke-Grauls, C. M. J.; Speelman, P.; Prins, J. M.

    2006-01-01

    The 'Stichting Werkgroep Antibioticabeleid' (SWAB; Dutch Working Party on Antibiotic Policy) develops evidence-based guidelines for the use of antibiotics in hospitalised adults. This guideline on acute infectious diarrhoea (AID) concerns the antibiotic treatment of acute infectious inflammation of

  13. Cow’s milk allergy in patients with diarrhea

    OpenAIRE

    Nanis S Marzuki; Arwin AP Akib; I Boediman

    2016-01-01

    Background Cow’s milk allergy (CMA) might be one of the causes of diarrhea in children. Previous prospective studies found the prevalence of CMA in children aged 0-3 years between 1.1-5.2%, but data about the prevalence of CMA in children with diarrhea was very limited. Objective This study intended to estimate the prevalence of CMA in children with diarrhea. Methods Children aged 0-3 years, who came with diarrhea and consumed milk formula were selected for further eva...

  14. Clinical results of galantase for diarrhea due to gynecological radiotherapy

    International Nuclear Information System (INIS)

    Tokunaga, Akiteru; Higuchi, Akira.

    1977-01-01

    Galantase, a preparation of lactose-decomposing enzyme, was used for 20 radiotherapeutic patients for prevention and treatment of diarrhea. The results were compared with those of 58 control cases without administration. In the 58 cases, the timing of onset of diarrhea during irradiation was examined, and the mechanism of onset of radioinjury in the digestive tract was discussed. Galantase 6 g/day was administered to 13 of the 20 patients simultaneously with institution of irradiation and to 7 patients simultaneously with the onset of diarrhea during irradiation. As radiotherapy, the patients were given remote cobalt irradiation 5 times a week, each consisting of 200 rad, a total dose of 5,000 rad, in a field of 14 - 16 x 14 - 16 cm by way of 2 ports (anterior and posterior). Diarrhea and soft stool both appeared by irradiation of less than 300 rad, and diarrhea was observed in 84%. Temporal diarrhea occurred in 3 of the 13 patients given galantase simultaneously with irradiation. Diarrhea continued for 6 days in one of the 6 cases in which galantase was administered simultaneously with the onset of diarrhea or watery stool. In the other 5, the stool recovered to be soft or normal 2-3 days after administration. Diarrhea during irradiaion appeared in 21.4% of the cases given galantase and 42.1% of those without it. The clinical value of galantase was recognized. (Chiba, N.)

  15. Diarrhea & Child Care: Controlling Diarrhea in Out-of-Home Child Care. NCEDL Spotlights, No. 4.

    Science.gov (United States)

    Churchill, Robin B.; Pickering, Larry K.

    This report, the fourth in the National Center for Early Development and Learning's (NCEDL) "Spotlights" series, is based on excerpts from a paper presented during a "Research into Practice in Infant/Toddler Care" synthesis conference in fall 1997. The report addresses controlling diarrhea in out-of-home child care. The report…

  16. Infectious bursal disease outbreak in 19-week old commercial ...

    African Journals Online (AJOL)

    Necropsy revealed a markedly enlarged, oedematous and haemorrhagic bursa. Histopathologic findings including lympho-cytolysis and oedema were characteristic of an acute bursitis and a positive agar-gel precipitation test were used to confirm the diagnosis of Infectious bursal disease. Keywords: Agar gel precipitation, ...

  17. Assay for Serum Antibodies to Infectious Bursal Disease Virus in ...

    African Journals Online (AJOL)

    Infectious bursal disease (IBD) is an acute, lymphocidal disease that has been a threat to poultry production in Nigeria and a major disease problem of poultry producing areas of the world. A serological detection of antibodies to the virus was conducted on 300 sera samples derived from local chickens slaughtered at Sheik ...

  18. [Equine Infectious Anemia (EIA)].

    Science.gov (United States)

    Kaiser, A; Meier, H P; Straub, R; Gerber, V

    2009-04-01

    Equine Infectious Anemia (EIA) is a reportable, eradicable epizootic disease caused by the equine lentivirus of the retrovirus family which affects equids only and occurs worldwide. The virus is transmitted by blood, mainly by sanguivorous insects. The main symptoms of the disease are pyrexia, apathy, loss of body condition and weight, anemia, edema and petechia. However, infected horses can also be inapparent carriers without any overt signs. The disease is diagnosed by serological tests like the Coggins test and ELISA tests. Presently, Switzerland is offi cially free from EIA. However, Switzerland is permanently at risk of introducing the virus as cases of EIA have recently been reported in different European countries.

  19. [Keratitis - Infectious or Autoimmune?].

    Science.gov (United States)

    Messmer, E M

    2016-07-01

    Histopathological evaluation of ocular tissues is important in differentiating between infectious and autoimmune disease. Inflammation, necrosis and keratolysis are common to most forms of keratitis. Histopathology can be of great help in identifying the causative organism, establishing a final diagnosis and/or managing the patient with herpes simplex virus keratitis, mycotic keratitis, acanthamoeba keratitis or microsporidia keratoconjunctivitis. Important pathogenetic knowledge with therapeutic relevance has been gained from histopathological studies in nummular keratitis after epidemic keratoconjunctivitis and atopic keratoconjunctivitis. Georg Thieme Verlag KG Stuttgart · New York.

  20. Globalization and infectious diseases.

    Science.gov (United States)

    Frenk, Julio; Gómez-Dantés, Octavio; Knaul, Felicia M

    2011-09-01

    This article discusses the nature of the health challenges created by globalization and proposes new forms of international cooperation to confront them. The discussion of global health challenges includes both the transfer of health risks, with an emphasis on infectious diseases, and the international dissemination of health opportunities, including the transfer of knowledge and technology. The authors argue that the health-related challenges and opportunities of an increasingly interdependent world demand new forms of international cooperation. The authors suggest the promotion of 3 elements that, in their essence, contain the idea of collaboration: exchange, evidence, and empathy. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Enteropathogenic Escherichia coli Associated with Diarrhea in Children in Cairo, Egypt

    Directory of Open Access Journals (Sweden)

    Iman K. Behiry

    2011-01-01

    Full Text Available In this study we isolate and identify the Enteropathogenic Escherichia coli (EPEC causing diarrhea in children less than five years in Cairo, Egypt, during different seasons. Children younger than five years with diarrhea, attending the Pediatric Gastroenterology Intensive Care Unit of the Cairo University Pediatric Hospital in one year period were our group of study. Our control group was age and sex matched concurrent healthy children. The identified E. coli isolates were subjected to antimicrobial disc diffusion susceptibility test and further identified for EPEC serotype by slide agglutination test, using antiserum E. coli somatic trivalent I (O111, O55, O26 according to the instructions of the manufacturer. Out of 134 patients 5.2% of them revealed EPEC in the fecal sample, while the 20 children control group showed no EPEC isolates in their samples. Our EPEC frequency showed variations from the compared results of other studies. Higher rate of EPEC (18.7% was found in patients between 2 to 3 years, while EPEC rate was (7.5% in patients less than 6 months old, with <0.05. EPEC was identified from fecal specimens as a unique pathogen or associated with other pathogens in acute and chronic diarrhea in children. EPEC were detected in all seasons except in winter, and was predominant in summer season. Four (57% EPEC isolates were resistant to ampicillin, ticarcillin, and cotrimoxazole, and (14.3% to the third generation cephalosporins.

  2. Role of colonic short-chain fatty acid transport in diarrhea.

    Science.gov (United States)

    Binder, Henry J

    2010-01-01

    Short-chain fatty acids (SCFA) are the major anion in stool and are synthesized from nonabsorbed carbohydrate by the colonic microbiota. Nonabsorbed carbohydrate are not absorbed in the colon and induce an osmotically mediated diarrhea; in contrast, SCFA are absorbed by colonic epithelial cells and stimulate Na-dependent fluid absorption via a cyclic AMP-independent process involving apical membrane Na-H, SCFA-HCO(3), and Cl-SCFA exchanges. SCFA production represents an adaptive process to conserve calories, fluid, and electrolytes. Inhibition of SCFA synthesis by antibiotics and administration of PEG, a substance that is not metabolized by colonic microbiota, both result in diarrhea. In contrast, increased production of SCFA as a result of providing starch that is relatively resistant to amylase digestion [so-called resistant starch (RS)] to oral rehydration solution (RS-ORS) improves the efficacy of ORS and represents an important approach to improve the effectiveness of ORS in the treatment of acute diarrhea in children under five years of age.

  3. AIDS-associated diarrhea and wasting in northeast Brazil is associated with subtherapeutic plasma levels of antiretroviral medications and with both bovine and human subtypes of Cryptosporidium parvum

    Directory of Open Access Journals (Sweden)

    Richard K. Brantley

    Full Text Available Advanced HIV infection is frequently complicated by diarrhea, disruption of bowel structure and function, and malnutrition. Resulting malabsorption of or pharmacokinetic changes in antiretroviral agents might lead to subtherapeutic drug dosing and treatment failure in individual patients, and could require dose adjustment and/or dietary supplements during periods of diarrheal illness. We determined the plasma levels of antiretroviral medications in patients that had already been started on medication by their physicians in an urban infectious diseases hospital in northeast Brazil. We also obtained blood samples from patients hospitalized for diarrhea or AIDS-associated wasting, and we found reduced stavudine and didanosine levels in comparison with outpatients without diarrhea or wasting who had been treated at the same hospital clinic. There was a predominance of the protozoal pathogens Cryptosporidium and Isospora belli, typical opportunistic pathogens of AIDS-infected humans, in the stool samples of inpatients with diarrhea. We conclude that severe diarrhea and wasting in this population is associated with both protozoal pathogens and subtherapeutic levels of antiretroviral medications.

  4. AIDS-associated diarrhea and wasting in Northeast Brazil is associated with subtherapeutic plasma levels of antiretroviral medications and with both bovine and human subtypes of Cryptosporidium parvum.

    Science.gov (United States)

    Brantley, Richard K; Williams, K Robert; Silva, Terezinha M J; Sistrom, Maria; Thielman, Nathan M; Ward, Honorine; Lima, Aldo A M; Guerrant, Richard L

    2003-02-01

    Advanced HIV infection is frequently complicated by diarrhea, disruption of bowel structure and function, and malnutrition. Resulting malabsorption of or pharmacokinetic changes in antiretroviral agents might lead to subtherapeutic drug dosing and treatment failure in individual patients, and could require dose adjustment and/or dietary supplements during periods of diarrheal illness. We determined the plasma levels of antiretroviral medications in patients that had already been started on medication by their physicians, in an urban infectious diseases hospital in northeast Brazil. We also obtained blood samples from patients hospitalized for diarrhea or AIDS-associated wasting, and we found reduced stavudine and didanosine levels in comparison with outpatients without diarrhea or wasting who had been treated at the same hospital clinic. There was a predominance of the protozoal pathogens Cryptosporidium and Isospora belli, typical opportunistic pathogens of AIDS-infected humans, in the stool samples of inpatients with diarrhea. We conclude that severe diarrhea and wasting in this population is associated with both protozoal pathogens and subtherapeutic levels of antiretroviral medications.

  5. [Globalization and infectious diseases].

    Science.gov (United States)

    Mirski, Tomasz; Bartoszcze, Michał; Bielawska-Drózd, Agata

    2011-01-01

    Globalization is a phenomenon characteristic of present times. It can be considered in various aspects: economic, environmental changes, demographic changes, as well as the development of new technologies. All these aspects of globalization have a definite influence on the emergence and spread of infectious diseases. Economic aspects ofglobalization are mainly the trade development, including food trade, which has an impact on the spread of food-borne diseases. The environmental changes caused by intensive development of industry, as a result of globalization, which in turn affects human health. The demographic changes are mainly people migration between countries and rural and urban areas, which essentially favors the global spread of many infectious diseases. While technological advances prevents the spread of infections, for example through better access to information, it may also increase the risk, for example through to create opportunities to travel into more world regions, including the endemic regions for various diseases. The phenomenon ofglobalization is also closely associated with the threat of terrorism, including bioterrorism. It forces the governments of many countries to develop effective programs to protect and fight against this threat.

  6. Surveillance of Food- and Smear-Transmitted Pathogens in European Soldiers with Diarrhea on Deployment in the Tropics: Experience from the European Union Training Mission (EUTM Mali

    Directory of Open Access Journals (Sweden)

    Hagen Frickmann

    2015-01-01

    Full Text Available Introduction. Since 2013, European soldiers have been deployed on the European Union Training Mission (EUTM in Mali. From the beginning, diarrhea has been among the most “urgent” concerns. Diarrhea surveillance based on deployable real-time PCR equipment was conducted between December 2013 and August 2014. Material and Methods. In total, 53 stool samples were obtained from 51 soldiers with acute diarrhea. Multiplex PCR panels comprised enteroinvasive bacteria, diarrhea-associated Escherichia coli (EPEC, ETEC, EAEC, and EIEC, enteropathogenic viruses, and protozoa. Noroviruses were characterized by sequencing. Cultural screening for Enterobacteriaceae with extended-spectrum beta-lactamases (ESBL with subsequent repetitive sequence-based PCR (rep-PCR typing was performed. Clinical information was assessed. Results. Positive PCR results for diarrhea-associated pathogens were detected in 43/53 samples, comprising EPEC (n=21, ETEC (n=19, EAEC (n=15, Norovirus (n=10, Shigella spp./EIEC (n=6, Cryptosporidium parvum (n=3, Giardia duodenalis (n=2, Salmonella spp. (n=1, Astrovirus (n=1, Rotavirus (n=1, and Sapovirus (n=1. ESBL-positive Enterobacteriaceae were grown from 13 out of 48 samples. Simultaneous infections with several enteropathogenic agents were observed in 23 instances. Symptoms were mild to moderate. There were hints of autochthonous transmission. Conclusions. Multiplex real-time PCR proved to be suitable for diarrhea surveillance on deployment. Etiological attribution is challenging in cases of detection of multiple pathogens.

  7. International adoption: infectious diseases issues.

    Science.gov (United States)

    Miller, Laurie C

    2005-01-15

    Nearly 220,000 children have been adopted from other countries by American parents since 1986. Approximately 65,000 children have arrived from China and Russia, mostly in the past 6 years. Most of these children reside in orphanages before adoption, where they may experience malnutrition, environmental deprivation, neglect, and exposure to infectious diseases. After arrival to the United States, international adoptees should undergo specialized screening evaluation for infectious diseases and other conditions. Infectious conditions of special concern include hepatitis B and C, syphilis, human immunodeficiency virus infection, tuberculosis, and presence of intestinal parasites. Before the adoption occurs, the infectious disease consultant may be asked to assist the primary care provider and the adoptive family with advice about travel and review of preadoptive medical records. After the adoption, the infectious diseases consultant may be asked to assess the adequacy of the child's vaccination record from the birth country and to assist in screening, evaluation, and management of infectious diseases.

  8. current approach in the management of diarrhea in children

    African Journals Online (AJOL)

    Diarrhea is the second leading cause of deaths in children under five - after pneumonia- with 1.5 million deaths per year. Several studies and meta-analysis, show that low osmolarity oral rehydration salts and zinc, significantly reduce morbidity and mortality in children with diarrhea. Since 2004, the World Health ...

  9. Overview of the causes of chronic diarrhea in children

    Science.gov (United States)

    The major causes and the prevalence of chronic diarrhea differ between developed and developing countries. In the developing world, chronic diarrhea is typically associated with serial enteric infections and malnutrition; it is manifested by a chronic enteropathy, with impaired mucosal healing, and ...

  10. [Chronic diarrhea in the diabetic. A review of the literature].

    Science.gov (United States)

    Frías Ordoñez, Juan Sebastián; Otero Regino, William

    2016-01-01

    The association of diarrhea with diabetes mellitus has been known for more than 70 years. In diabetic patients its prevalence is around 20%.Its clinical manifestations are diverse, and represents a diagnostic and therapeutic challenge.There are certain diagnoses of higher prevalence in diabetic patients than in the general population.The different related etiologies can be adequately diagnosed through the clinical history and complementary diagnostic tests.The medications used by the diabetic patient to manage their disease often cause chronic diarrhea, so the pharmacological background should be studied at the time of the study of diarrhea.Diabetic patients can present other associated pathological conditions, such as celiac disease or microscopic colitis, which only discomfort is diarrhea.Exocrine pancreatic function may be decreased in the diabetic patient, frequently leading to exocrine pancreatic insufficiency. Dietary factors, such as sugar-free sweeteners and other agents, can cause diarrhea in the diabetic patient.The presence of conditions such as autonomic neuropathy and peripheral neuropathy secondary to diabetes mellitus may explain disorders such as anorectal dysfunction and faecal incontinence. Finally, diabetic enteropathy alone or with associated bacterial overgrowth can cause diarrhea.Achieving adequate glycemic control is the pillar of the treatment of diarrhea in the diabetic, after which there are additional measures that are applied according to the specific context of the patient.This article reviews the causes of higher diarrhea incidence in the diabetic patient and the pathophysiological mechanisms involved.

  11. Epidemiology of rotavirus diarrhea in children under 5 years in ...

    African Journals Online (AJOL)

    Background: Rotavirus still remains the major cause of diarrhea in children below 5 years. No data on rotavirus epidemiology is available in the Northern regions of Cameroon. We aimed to determine the prevalence of group A rotavirus (RVA) in children below 5 years with diarrhea in two regions of Northern Cameroon ...

  12. Myths, experiences and home management of childhood diarrhea ...

    African Journals Online (AJOL)

    Background: Diarrhea is a major threat to child survival due to its devastating complication of dehydration. Several home remedies inclusive of oral rehydration therapy have benefited many people. This study assessed nursing mothers' knowledge and experiences of home management of childhood diarrhea. Methodology: ...

  13. The Anti-Diarrhea Properties Of Zingibier Offcinale | Nwoko ...

    African Journals Online (AJOL)

    Introduction: The crude extract of the plant Zingiber officinale has a high folkloric reputation for anti-diarrhea activity. This study investigated the scientific basis of this folkloric claim. Materials and Methods: Diarrhea was induced in albino mice and albino wistar rats using Castor-oil. The animals (mice) were offered the ...

  14. Alterations in the colonic microbiota in response to osmotic diarrhea.

    Science.gov (United States)

    Gorkiewicz, Gregor; Thallinger, Gerhard G; Trajanoski, Slave; Lackner, Stefan; Stocker, Gernot; Hinterleitner, Thomas; Gülly, Christian; Högenauer, Christoph

    2013-01-01

    Diseases of the human gastrointestinal (GI) tract are often accompanied by diarrhea with profound alterations in the GI microbiota termed dysbiosis. Whether dysbiosis is due to the disease itself or to the accompanying diarrhea remains elusive. With this study we characterized the net effects of osmotic diarrhea on the composition of the GI microbiota in the absence of disease. We induced osmotic diarrhea in four healthy adults by oral administration of polyethylene glycol 4000 (PEG). Stool as well as mucosa specimens were collected before, during and after diarrhea and 16S rDNA-based microbial community profiling was used to assess the microbial community structure. Stool and mucosal microbiotas were strikingly different, with Firmicutes dominating the mucosa and Bacteroidetes the stools. Osmotic diarrhea decreased phylotype richness and showed a strong tendency to equalize the otherwise individualized microbiotas on the mucosa. Moreover, diarrhea led to significant relative shifts in the phyla Bacteroidetes and Firmicutes and to a relative increase in the abundance of Proteobacteria on the mucosa, a phenomenon also noted in several inflammatory and diarrheal GI diseases. Changes in microbial community structure induced by osmotic diarrhea are profound and show similarities to changes observed in other GI diseases including IBD. These effects so must be considered when specimens from diarrheal diseases (i.e. obtained by stratification of samples according to diarrheal status) or conditions wherein bowel preparations like PEG (i.e. specimens obtained during endoscopy) are used.

  15. Zinc treatment ameliorates diarrhea and intestinal inflammation in undernourished rats.

    Science.gov (United States)

    de Queiroz, Camila A A; Fonseca, Said Gonçalves C; Frota, Priscila B; Figueiredo, Italo L; Aragão, Karoline S; Magalhães, Carlos Emanuel C; de Carvalho, Cibele B M; Lima, Aldo Ângelo M; Ribeiro, Ronaldo A; Guerrant, Richard L; Moore, Sean R; Oriá, Reinaldo B

    2014-08-05

    WHO guidelines recommend zinc supplementation as a key adjunct therapy for childhood diarrhea in developing countries, however zinc's anti-diarrheal effects remain only partially understood. Recently, it has been recognized that low-grade inflammation may influence stunting. In this study, we examined whether oral zinc supplementation could improve weight, intestinal inflammation, and diarrhea in undernourished weanling rats. Rats were undernourished using a northeastern Brazil regional diet (RBD) for two weeks, followed by oral gavage with a saturated lactose solution (30 g/kg) in the last 7 days to induce osmotic diarrhea. Animals were checked for diarrhea daily after lactose intake. Blood was drawn in order to measure serum zinc levels by atomic absorption spectroscopy. Rats were euthanized to harvest jejunal tissue for histology and cytokine profiles by ELISA. In a subset of animals, spleen samples were harvested under aseptic conditions to quantify bacterial translocation. Oral zinc supplementation increased serum zinc levels following lactose-induced osmotic diarrhea. In undernourished rats, zinc improved weight gain following osmotic diarrhea and significantly reduced diarrheal scores by the third day of lactose intake (p diarrhea and undernutrition and support the use of zinc to prevent the vicious cycle of malnutrition and diarrhea.

  16. Alterations in the colonic microbiota in response to osmotic diarrhea.

    Directory of Open Access Journals (Sweden)

    Gregor Gorkiewicz

    Full Text Available BACKGROUND & AIMS: Diseases of the human gastrointestinal (GI tract are often accompanied by diarrhea with profound alterations in the GI microbiota termed dysbiosis. Whether dysbiosis is due to the disease itself or to the accompanying diarrhea remains elusive. With this study we characterized the net effects of osmotic diarrhea on the composition of the GI microbiota in the absence of disease. METHODS: We induced osmotic diarrhea in four healthy adults by oral administration of polyethylene glycol 4000 (PEG. Stool as well as mucosa specimens were collected before, during and after diarrhea and 16S rDNA-based microbial community profiling was used to assess the microbial community structure. RESULTS: Stool and mucosal microbiotas were strikingly different, with Firmicutes dominating the mucosa and Bacteroidetes the stools. Osmotic diarrhea decreased phylotype richness and showed a strong tendency to equalize the otherwise individualized microbiotas on the mucosa. Moreover, diarrhea led to significant relative shifts in the phyla Bacteroidetes and Firmicutes and to a relative increase in the abundance of Proteobacteria on the mucosa, a phenomenon also noted in several inflammatory and diarrheal GI diseases. CONCLUSIONS: Changes in microbial community structure induced by osmotic diarrhea are profound and show similarities to changes observed in other GI diseases including IBD. These effects so must be considered when specimens from diarrheal diseases (i.e. obtained by stratification of samples according to diarrheal status or conditions wherein bowel preparations like PEG (i.e. specimens obtained during endoscopy are used.

  17. Diarrhea associated with myenteric ganglionitis in a dog

    International Nuclear Information System (INIS)

    Willard, M.D.; Mullaney, T.; Karasek, S.; Yamini, B.

    1988-01-01

    Diarrhea in a Border Terrier was associated with inflammatory lesions of the myenteric plexus. This lesion has been documented rarely in dogs. It is speculated that the myenteric plexus lesions were responsible for an autonomic nervous system dysfunction, which resulted in extreme intestinal hypermotility and subsequent diarrhea. Suggested tests for dogs suspected to have autonomic dysfunction are given

  18. Genetics Home Reference: acute necrotizing encephalopathy type 1

    Science.gov (United States)

    ... induced acute encephalopathy 3 Related Information How are genetic conditions and genes named? ... National Institute of Allergy and Infectious Diseases: Flu (Influenza) National Institute of Neurological Disorders ...

  19. Management of VIP Associated Diarrhea in a Case with Neuroblastoma

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    Begul Yagci-Kupeli

    2013-06-01

    Full Text Available Watery diarrhea associated with hypokalemia and achlorhydria (WDHA syndrome is commonly caused by vasoactive intestinal peptide (VIP secreting tumors in adults and generally associated with neural crest tumors in pediatric population. VIP secretion is associated with neuroblastic cell differentiation. Octreotide treatment can be a choice for diarrhea in such cases. However, its benefit is controversial and surgery is usually needed. A 14-month-old female with diagnosis of inoperable undifferantiated intraabdominal neuroblastoma who developed chronic diarrhea at first year of chemotherapy is reported. Octreotide treatment was used to control diarrhea. Because of the failure of octreotide treatment, debulking surgery was performed and diarrhea subsided after the surgery. [Cukurova Med J 2013; 38(3.000: 528-530

  20. Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila in elderly patients with stroke (C-PEPS, M-PEPS, L-PEPS): a case-control study on the infectious burden of atypical respiratory pathogens in elderly patients with acute cerebrovascular disease.

    Science.gov (United States)

    Ngeh, Joseph; Goodbourn, Colin

    2005-02-01

    Multiple studies have suggested an association between Chlamydia pneumoniae and Mycoplasma pneumoniae infection and cardiovascular disease. We investigated whether the risk of cerebrovascular disease is associated with Legionella pneumophila infection and the aggregate number/infectious burden of these atypical respiratory pathogens. One hundred patients aged >65 years admitted with acute stroke or transient ischemic attack (TIA) and 87 control patients admitted concurrently with acute noncardiopulmonary, noninfective conditions were recruited prospectively. Using enzyme-linked immunosorbent assay (ELISA) kits, we previously reported the seroprevalences of C pneumoniae and M pneumoniae in these patients. We have now determined the seroprevalences of L pneumophila IgG and IgM in this cohort of patients using ELISA. The seroprevalences of L pneumophila IgG and IgM were 29% (n=91) and 12% (n=81) in the stroke/TIA group and 22% (n=86) and 10% (n=72) in the controls, respectively. Using logistic regression to adjust for age, sex, hypertension, smoking, diabetes, ischemic heart disease, and ischemic ECG, the odds ratios for stroke/TIA in relation to L pneumophila IgG and IgM were 1.52 (95% CI, 0.70 to 3.28; P=0.29) and 1.49 (95% CI, 0.45 to 4.90; P=0.51), respectively. The odds ratios in relation to IgG seropositivity for 1, 2, or 3 atypical respiratory pathogens after adjustment were 3.89 (95% CI, 1.13 to 13.33), 2.00 (95% CI, 0.64 to 6.21), and 6.67 (95% CI, 1.22 to 37.04), respectively (P=0.06). L pneumophila seropositivity is not significantly associated with stroke/TIA. However, the risk of stroke/TIA appears to be associated with the aggregate number of chronic infectious burden of atypical respiratory pathogens such as C pneumoniae, M pneumoniae, and L pneumophila.

  1. Breastfeeding and the risk for diarrhea morbidity and mortality

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    Victora Cesar

    2011-04-01

    Full Text Available Abstract Background Lack of exclusive breastfeeding among infants 0-5 months of age and no breastfeeding among children 6-23 months of age are associated with increased diarrhea morbidity and mortality in developing countries. We estimate the protective effects conferred by varying levels of breastfeeding exposure against diarrhea incidence, diarrhea prevalence, diarrhea mortality, all-cause mortality, and hospitalization for diarrhea illness. Methods We systematically reviewed all literature published from 1980 to 2009 assessing levels of suboptimal breastfeeding as a risk factor for selected diarrhea morbidity and mortality outcomes. We conducted random effects meta-analyses to generate pooled relative risks by outcome and age category. Results We found a large body of evidence for the protective effects of breastfeeding against diarrhea incidence, prevalence, hospitalizations, diarrhea mortality, and all-cause mortality. The results of random effects meta-analyses of eighteen included studies indicated varying degrees of protection across levels of breastfeeding exposure with the greatest protection conferred by exclusive breastfeeding among infants 0-5 months of age and by any breastfeeding among infants and young children 6-23 months of age. Specifically, not breastfeeding resulted in an excess risk of diarrhea mortality in comparison to exclusive breastfeeding among infants 0-5 months of age (RR: 10.52 and to any breastfeeding among children aged 6-23 months (RR: 2.18. Conclusions Our findings support the current WHO recommendation for exclusive breastfeeding during the first 6 months of life as a key child survival intervention. Our findings also highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and mortality throughout the first 2 years of life.

  2. Sports: The Infectious Hazards.

    Science.gov (United States)

    Minooee, Arezou; Wang, Jeff; Gupta, Geeta K

    2015-10-01

    Although the medical complications of sports are usually traumatic in nature, infectious hazards also arise. While blood-borne pathogens such as HIV, hepatitis B, and hepatitis C, cause significant illness, the risk of acquiring these agents during sporting activities is minimal. Skin infections are more commonplace, arising from a variety of microbial agents including bacterial, fungal, and viral pathogens. Sports involving water contact can lead to enteric infections, eye infections, or disseminated infections such as leptospirosis. Mumps, measles, and influenza are vaccine-preventable diseases that have been transmitted during sporting events, both in players and in spectators. Prevention is the key to many of these infections. Players should be vaccinated and should not participate in sports if their infection can be spread by contact, airborne, or droplet transmission.

  3. Wetlands and infectious diseases

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    Robert H. Zimmerman

    2001-01-01

    Full Text Available There is a historical association between wetlands and infectious disease that has led to the modification of wetlands to prevent disease. At the same time there has been the development of water resources projects that increase the risk of disease. The demand for more water development projects and the increased pressure to make natural wetlands economically beneficial creates the need for an ecological approach to wetland management and health assessment. The environmental and health interactions are many. There is a need to take into account the landscape, spatial boundaries, and cross-boundary interactions in water development projects as well as alternative methods to provide water for human needs. The research challenges that need to be addressed are discussed.

  4. Virulence determinants of equine infectious anemia virus.

    Science.gov (United States)

    Payne, Susan L; Fuller, Frederick J

    2010-01-01

    Equine infectious anemia virus (EIAV) is a macrophage-tropic lentivirus that rapidly Induces disease in experimentally infected horses. Because EIAV infection and replication is centered on the monocyte/macrophage and has a pronounced acute disease stage, it is a useful model system for understanding the contribution of monocyte/macrophages to other lentivirus-induced diseases. Genetic mapping studies utilizing chimeric proviruses in which parental viruses are acutely virulent or avirulent have allowed the identification of important regions that influence acute virulence. U3 regions in the viral LTR, surface envelope (SU) protein and the accessory S2 gene strongly influence acute disease expression. While the chimeric proviruses provide insight into genes or genome regions that affect viral pathogenesis, it is then necessary to further dissect those regions to focus on specific virus-host mechanisms that lead to disease expression. The V6 region of the viral env protein is an example of one identified region that may interact with the ELR-1 receptor in an important way and we are currently identifying S2 protein motifs required for disease expression.

  5. Efficacy of intravenous ondansetron to prevent vomiting episodes in acute gastroenteritis: a randomized, double blind, and controlled trial

    Directory of Open Access Journals (Sweden)

    Sanguansak Rerksuppaphol

    2010-09-01

    Full Text Available Acute gastroenteritis is one of the most common infectious diseases of childhood. Its symptoms are vomiting, diarrhea, and dehydration. In the emergency ward, intravenous rather than oral rehydration is usually preferred because of the high likelihood of emesis. Treatments to reduce emesis are of value in improving the rehydration procedure. Our study is a double-blind randomized trial and proposes the use of ondansetron as an anti-emetic drug to treat children with acute gastroenteritis. Seventy-four in-patients, aged 3 months to 15 years, were enrolled and randomly assigned to an ondansetron or placebo group. Inclusion criteria were the diagnosis of acute gastroenteritis and the absence of other diseases or allergies to drugs. A single bolus (0.15 mg/kg of ondansetron was injected intravenously; normal 0.9% saline solution was used as a placebo. This treatment induced vomiting cessation in the ondansetron group significantly in comparison to the placebo group. The length of the hospital stay and the oral rehydration fluid volume were similar in the two groups and no adverse effects were noticed. Thus, safety, low cost, and overall bene­fit of ondansetron treatment suggests that this drug can be administered successfully to children with acute gastroenteritis.

  6. Village-randomized clinical trial of home distribution of zinc for treatment of childhood diarrhea in rural Western kenya.

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    Daniel R Feikin

    Full Text Available BACKGROUND: Zinc treatment shortens diarrhea episodes and can prevent future episodes. In rural Africa, most children with diarrhea are not brought to health facilities. In a village-randomized trial in rural Kenya, we assessed if zinc treatment might have a community-level preventive effect on diarrhea incidence if available at home versus only at health facilities. METHODS: We randomized 16 Kenyan villages (1,903 eligible children to receive a 10-day course of zinc and two oral rehydration solution (ORS sachets every two months at home and 17 villages (2,241 eligible children to receive ORS at home, but zinc at the health-facility only. Children's caretakers were educated in zinc/ORS use by village workers, both unblinded to intervention arm. We evaluated whether incidence of diarrhea and acute lower respiratory illness (ALRI reported at biweekly home visits and presenting to clinic were lower in zinc villages, using poisson regression adjusting for baseline disease rates, distance to clinic, and children's age. RESULTS: There were no differences between village groups in diarrhea incidence either reported at the home or presenting to clinic. In zinc villages (1,440 children analyzed, 61.2% of diarrheal episodes were treated with zinc, compared to 5.4% in comparison villages (1,584 children analyzed, p<0.0001. There were no differences in ORS use between zinc (59.6% and comparison villages (58.8%. Among children with fever or cough without diarrhea, zinc use was low (<0.5%. There was a lower incidence of reported ALRI in zinc villages (adjusted RR 0.68, 95% CI 0.46-0.99, but not presenting at clinic. CONCLUSIONS: In this study, home zinc use to treat diarrhea did not decrease disease rates in the community. However, with proper training, availability of zinc at home could lead to more episodes of pediatric diarrhea being treated with zinc in parts of rural Africa where healthcare utilization is low. TRIAL REGISTRATION: ClinicalTrials.gov NCT

  7. Utilidad del estudio de las heces para el diagnóstico y manejo de lactantes y prescolares con diarrea aguda Stool work-up protocol in infants and preschool children with acute diarrhea: is it useful for diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Alfredo Larrosa-Haro

    2002-07-01

    analyze the results of a stool work-up protocol in a series of infants and preschoolers with acute diarrhea. Material and Methods. A cross-sectional descriptive study was conducted between April 1999 and March 2000, among 288 children seen at a pediatric office in Guadalajara, Mexico. The mean age (±1SD was 23.1±13.9 months; 43% were females. Data were collected on demographic and clinical characteristics. The stool work-up consisted of fresh smear and methylene blue and Kinyoun smears, as well as determination of pH and reducing substances. Stool culture was performed in samples with ³ 3 leukocytes/microscopic field and rotavirus antigen detection only in selected cases. Data were analyzed using descriptive statistics, chi², odds ratios, and 95% confidence intervals. Results. Enterophatogens (% identified were: rotavirus 47.1, Campylobacter jejuni 27.4, Salmonella spp. 5.1, Shigella spp. 4.3, Cryptosporidium parvum 2.8, Giardia lamblia 2.4, Blastocystis hominis 1.4, Entamoeba histolytica 0.7. An OR of 5.7 was obtained for isolation of enteroinvasive bacteria in the presence of fecal leukocytes. Lactose intolerance was detected in 19.1%. The frequencies of rotavirus antigen identification and lactose intolerance were significantly higher in infants; the OR for lactose intolerance in infants with rotavirus was 21. Mucus and blood in the stools were associated to enteroinvasive bacteria and Cryptosporidium parvum. Conclusions. The current stool work-up protocol allowed the identification of enteropathogenic parasites, rotavirus and lactose intolerance in a short period of time. Leukocytes in stools were associated to the isolation of enteroinvasive bacteria. The frequency of agents associated to diarrheal disease was similar to that from other national studies. This stool work-up protocol could be useful as a tool to limit the unnecessary prescription of drugs and to follow universal recommendations for dietary management of these patients.

  8. Infectious Diseases in Day Care.

    Science.gov (United States)

    Sleator, Esther K.

    Discussed in this publication are infectious illnesses for which children attending day care appear to be at special risk. Also covered are the common cold, some infectious disease problems receiving media attention, and some other annoying but not serious diseases, such as head lice, pinworms, and contagious skin conditions. Causes,…

  9. Infectious Disease (ID) Learning Unit:

    Science.gov (United States)

    Westlake, Amanda A; Eisenberg, Mark P

    2017-01-01

    In the context of an escalating opioid epidemic, infectious disease clinicians increasingly treat the infectious complications of injection drug use. In this learning unit, we review the history, pharmacology, and clinical use of buprenorphine as maintenance therapy for opioid use disorder, and we describe the process by which clinicians can obtain a buprenorphine waiver.

  10. Reducing Non-Infectious Risks of Blood Transfusion

    Science.gov (United States)

    Gilliss, Brian M.; Looney, Mark R.; Gropper, Michael A.

    2011-01-01

    Summary As screening for transfusion-associated infections has improved, non-infectious complications of transfusion now cause the majority of morbidity and mortality associated with transfusion in the United States. For example, transfusion-related acute lung injury, transfusion-associated circulatory overload, and hemolytic transfusion-reactions are the first, second, and third leading causes of death from transfusion respectively. These complications and others are reviewed here and several controversial methods for prevention of non-infectious complications of transfusion are discussed; universal leukoreduction of red cell units, use of male-only plasma, and restriction of red cell storage age. PMID:21792054

  11. Infectious Diseases and Tropical Cyclones in Southeast China.

    Science.gov (United States)

    Zheng, Jietao; Han, Weixiao; Jiang, Baofa; Ma, Wei; Zhang, Ying

    2017-05-07

    Southeast China is frequently hit by tropical cyclones (TCs) with significant economic and health burdens each year. However, there is a lack of understanding of what infectious diseases could be affected by tropical cyclones. This study aimed to examine the impacts of tropical cyclones on notifiable infectious diseases in southeast China. Disease data between 2005 and 2011 from four coastal provinces in southeast China, including Guangdong, Hainan, Zhejiang, and Fujian province, were collected. Numbers of cases of 14 infectious diseases were compared between risk periods and reference periods for each tropical cyclone. Risk ratios (RR s ) were calculated to estimate the risks. TCs were more likely to increase the risk of bacillary dysentery, paratyphoid fever, dengue fever and acute hemorrhagic conjunctivitis ( ps infectious diseases. TCs are more likely to increase the risk of intestinal and contact transmitted infectious diseases than to decrease the risk, and more likely to decrease the risk of respiratory infectious diseases than to increase the risk. Findings of this study would assist in developing public health strategies and interventions for the reduction of the adverse health impacts from tropical cyclones.

  12. Infectious Diseases and Tropical Cyclones in Southeast China

    Directory of Open Access Journals (Sweden)

    Jietao Zheng

    2017-05-01

    Full Text Available Southeast China is frequently hit by tropical cyclones (TCs with significant economic and health burdens each year. However, there is a lack of understanding of what infectious diseases could be affected by tropical cyclones. This study aimed to examine the impacts of tropical cyclones on notifiable infectious diseases in southeast China. Disease data between 2005 and 2011 from four coastal provinces in southeast China, including Guangdong, Hainan, Zhejiang, and Fujian province, were collected. Numbers of cases of 14 infectious diseases were compared between risk periods and reference periods for each tropical cyclone. Risk ratios (RRs were calculated to estimate the risks. TCs were more likely to increase the risk of bacillary dysentery, paratyphoid fever, dengue fever and acute hemorrhagic conjunctivitis (ps < 0.05 than to decrease the risk, more likely to decrease the risk of measles, mumps, varicella and vivax malaria (ps < 0.05 than to increase the risk. In conclusion, TCs have mixed effects on the risk of infectious diseases. TCs are more likely to increase the risk of intestinal and contact transmitted infectious diseases than to decrease the risk, and more likely to decrease the risk of respiratory infectious diseases than to increase the risk. Findings of this study would assist in developing public health strategies and interventions for the reduction of the adverse health impacts from tropical cyclones.

  13. Optimal control of diarrhea transmission in a flood evacuation zone

    Science.gov (United States)

    Erwina, N.; Aldila, D.; Soewono, E.

    2014-03-01

    Evacuation of residents and diarrhea disease outbreak in evacuation zone have become serious problem that frequently happened during flood periods. Limited clean water supply and infrastructure in evacuation zone contribute to a critical spread of diarrhea. Transmission of diarrhea disease can be reduced by controlling clean water supply and treating diarrhea patients properly. These treatments require significant amount of budget, which may not be fulfilled in the fields. In his paper, transmission of diarrhea disease in evacuation zone using SIRS model is presented as control optimum problem with clean water supply and rate of treated patients as input controls. Existence and stability of equilibrium points and sensitivity analysis are investigated analytically for constant input controls. Optimum clean water supply and rate of treatment are found using optimum control technique. Optimal results for transmission of diarrhea and the corresponding controls during the period of observation are simulated numerically. The optimum result shows that transmission of diarrhea disease can be controlled with proper combination of water supply and rate of treatment within allowable budget.

  14. Early management of acute pancreatitis

    NARCIS (Netherlands)

    Schepers, Nicolien J.; Besselink, Marc G. H.; van Santvoort, Hjalmar C.; Bakker, Olaf J.; Bruno, Marco J.

    2013-01-01

    Acute pancreatitis is the most common gastro-intestinal indication for acute hospitalization and its incidence continues to rise. In severe pancreatitis, morbidity and mortality remains high and is mainly driven by organ failure and infectious complications. Early management strategies should aim to

  15. Early management of acute pancreatitis.

    Science.gov (United States)

    Schepers, Nicolien J; Besselink, Marc G H; van Santvoort, Hjalmar C; Bakker, Olaf J; Bruno, Marco J

    2013-10-01

    Acute pancreatitis is the most common gastro-intestinal indication for acute hospitalization and its incidence continues to rise. In severe pancreatitis, morbidity and mortality remains high and is mainly driven by organ failure and infectious complications. Early management strategies should aim to prevent or treat organ failure and to reduce infectious complications. This review addresses the management of acute pancreatitis in the first hours to days after onset of symptoms, including fluid therapy, nutrition and endoscopic retrograde cholangiography. This review also discusses the recently revised Atlanta classification which provides new uniform terminology, thereby facilitating communication regarding severity and complications of pancreatitis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. QUALITY OF LIFE IN CHILDREN WITH CHRONIC DIARRHEA

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    F.F. Zhvaniya

    2009-01-01

    Full Text Available The results of evaluation of quality of life in children from 1 to 3 years old with chronic diarrhea in exacerbation or remission with QUALIN questionnaire is presented in this article. Authors used two types of questionnaire: doctors' and parents'. Obtained data was compared to indices of healthy children. Proved, that children in early age with chronic diarrhea, as in exacerbation, as in remission, have significantly lower rates of quality of life compared to healthy coevals.Key words: children, quality of life, QUALIN questionnaire, chronic diarrhea.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:16-19