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Sample records for causing acute diarrhea

  1. [Clinical study of acute diarrhea caused by rotavirus].

    Science.gov (United States)

    Mihalache, Doina; Fîntînaru, Rodica; Iacob, Monica; Simonca, Cornelia

    2005-01-01

    To establish the implication of Rotavirus in acute diarrhea of babies and children. Prospective study on 164 patients aged between 1 month and 3 years with acute diarrhea, admitted in the Clinical Hospital of Infectious Diseases Iaşi between 01.01.2005 - 31.03.2005. Rotavirus cause the illness in 30 patients (18.29%). The disease was more prevalent among children with dystrophy or with other comorbidities like: iron-deficiency anemia, intestinal parasitosis, rhinopharyngitis, pneumococcal meningitidis. In seven cases the infectious was considered to be nosocomial. During the illness patients also accused other symptoms, while in order of frequency were: common respiratory infection (13.3%), nausea and vomiting (40%), maculopapular eruption and intestinal pneumonia (16.6%), acute pharyngitis (10%). In this study latex agglutination confirmed the diagnosis. Vomiting and diarrhea led in all cases to moderate or severe dehydration. Appropriate rehydration was necessary but only in 12 cases was made through intravenous access with: Ringer lactate, isotonic sodium chloride solutions. Most children recovered with in 5 days.

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

    African Journals Online (AJOL)

    2014-06-17

    Jun 17, 2014 ... Nigerian Journal of Clinical Practice • Jan-Feb 2015 • Vol 18 • Issue 1. Abstract. Background: Diarrhea is a major cause of childhood morbidity and mortality in the .... Pennap et al. from Zaria, northern Nigeria, a case‑controlled.

  3. Acute diarrhea.

    Science.gov (United States)

    Tobillo, E T; Schwartz, S M

    1998-10-01

    Diarrhea can result from damage to the intestinal lining caused by viruses or bacteria, malabsorption, inflammatory processes, bile salt and pancreatic enzyme deficiency, abnormal motility, or the presence of osmotically active solutes in the gut. While it is important to elicit information to determine the possible cause of diarrhea, be sure to check circulatory status first. Some patients may need rehydration therapy more urgently than they need a diagnosis. The main goals of treatment are to prevent dehydration and correct electrolyte imbalance, to provide supportive and symptomatic therapy, and to treat underlying disease. In most cases, a specific diagnosis is not necessary to guide initial treatment.

  4. Viral causes of diarrhea.

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    Goodgame, R W

    2001-09-01

    Viruses are important causes of diarrhea. In healthy adults, the main clinical manifestation is acute, self-limited gastroenteritis. Advances in molecular diagnostics have shown that epidemics of acute gastroenteritis most frequently are due to caliciviruses spread through contaminated food or through person-to-person contact. Application of similar technology is needed to make a definitive statement about the role of such candidate viruses as rotavirus, astrovirus, and adenovirus as the cause of nonepidemic acute gastroenteritis in adults. Rarely a previously healthy adult gets acute CMV colitis. CMV and EBV mainly cause diarrhea in immunocompromised patients, however. Advances in prophylaxis and treatment have reduced the frequency and severity of these diseases. Acute infantile gastroenteritis is caused by rotavirus, calcivirus, astrovirus, and adenovirus. These viral diseases of the gut are seen by the physician as routine and rare clinical problems.

  5. OPPORTUNICTIC ENTEROBACTERIACAE AS THE CAUSE OF THE ACUTE DIARRHEA AND GUT DISBIOSIS

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    S. A. Egorova

    2011-01-01

    Full Text Available Abstract. Strains of Klebsiella pneumonia isolated from faces were studied to detect virulence factors of “classical” enteric pathogens causing acute diarrhea (Shigella, Salmonella, diarreagenic Escherichia coli. We haven’t detect in Klebsiella the genes encode different virulence factors: the abilities to adherence (sfa, afa, aaf/1, eae, invasion (ipaH, ial, production of heat-lable toxins (elt, LT II, heat-stable toxins (st1, st2 and Shiga toxins (stx1, stx2. Klebsiella spp. is well-known pathogen of the opportunistic infections of urinary tract, blood, wound, respiratory tract. But this bacteria hasn’t virulence factors of diarreagenic Enterobacteriaceae and can’t cause acute diarrhea and other gut pathology.

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

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    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.

  7. Acute diarrhea in children

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    Radlović Nedeljko

    2015-01-01

    Full Text Available Acute diarrhea (AD is the most frequent gastroenterological disorder, and the main cause of dehydration in childhood. It is manifested by a sudden occurrence of three or more watery or loose stools per day lasting for seven to 10 days, 14 days at most. It mainly occurs in children until five years of age and particularly in neonates in the second half-year and children until the age of three years. Its primary causes are gastrointestinal infections, viral and bacterial, and more rarely alimentary intoxications and other factors. As dehydration and negative nutritive balance are the main complications of AD, it is clear that the compensation of lost body fluids and adequate diet form the basis of the child’s treatment. Other therapeutic measures, except antipyretics in high febrility, antiparasitic drugs for intestinal lambliasis, anti-amebiasis and probiotics are rarely necessary. This primarily regards uncritical use of antibiotics and intestinal antiseptics in the therapy of bacterial diarrhea. The use of antiemetics, antidiarrhetics and spasmolytics is unnecessary and potentially risky, so that it is not recommended for children with AD.

  8. Global challenges in acute diarrhea.

    Science.gov (United States)

    Das, Jai K; Bhutta, Zulfiqar A

    2016-01-01

    Childhood diarrhea is the most common cause of morbidity and mortality, especially in the low and middle-income countries. The burden of child mortality because of diarrhea has declined, but still a lot is desired not only to reduce diarrhea-specific mortality but reduce the overall incidence, and hence the morbidity associated with childhood diarrhea. A recent Lancet series on diarrhea suggests that amplification of the current interventions can eliminate virtually all preventable diarrhea deaths. A refocused attention and strategy and collective effort from the multilateral entities to promote water sanitation and hygiene, rotavirus vaccination, nutrition, and improved case management can bridge gaps and tackle the existing undue burden of deaths because of diarrhea. Investment toward preventing and controlling childhood diarrhea should be a priority, especially when the existing solution is plausible for implementation at scale and in underprivileged settings.

  9. Efficacy of synbiotic treatment in children with acute rotavirus diarrhea

    OpenAIRE

    Made Ratna Dewi; Yati Soenarto; I Putu Gede Karyana

    2015-01-01

    Background Diarrhea is one of the major causes of morbidity and mortality in children throughout the world, mostly due to rotavirus infection. In daily practice, we routinely use the World Health Organization Five steps for managing acute diarrhea.This practice has shown great success in diarrhea management, but concerns remain on reducing the duration of diarrhea to prevent complications. Synbiotics can reduce the severity of diarrhea. However, there has been limited data on synbiotic therap...

  10. Efficacy of synbiotic treatment in children with acute rotavirus diarrhea

    OpenAIRE

    Made Ratna Dewi; Yati Soenarto; I Putu Gede Karyana

    2016-01-01

    Background Diarrhea is one of the major causes of morbidityand mortality in children throughout the world, mostly due torotavirus infection. In daily practice, we routinely use the WorldHealth Organization Five steps for managing acute diarrhea.Thispractice has shown great success in diarrhea management, butconcerns remain on reducing the duration of diarrhea to preventcomplications. Synbiotics can reduce the severity of diarrhea.However, there has been limited data on synbiotic therapy fortr...

  11. Zinc therapy for different causes of diarrhea

    OpenAIRE

    Hafaz Zakky Abdillah; Supriatmo Supriatmo; Melda Deliana; Selvi Nafianti; Atan Baas Sinuhaji

    2013-01-01

    Background The incidence of diarrhea in Indonesia has declined in the past five years. In spite of the increasing number of studies on the treatment for acute diarrhea, especially the use of zinc, it is not known if bacterial vs. non-bacterial etiology makes a difference in the reduction of severity of acute diarrhea in children on zinc therapy. Objective To assess the effect of zinc therapy in reducing the severity of acute bacterial and non-bacterial diarrhea. Method...

  12. [Medication in infectious acute diarrhea in children].

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    Cézard, J-P; Bellaiche, M; Viala, J; Hugot, J-P

    2007-10-01

    Acute infectious diarrhea in children remain still a frequent cause of morbidity. 50 % of them are due to rotavirus. Oral rehydration therapy and early realimentation have drastically reduced their mortality and morbidity. Beside oral or eventually IV rehydration therapy no medication has proven its efficacy based on the main HMO criteria (reduction of over 30 % of the stool output) except racecadotril and loperamide which is contre-indicated for the last one in children less than 2 years old. Other medications such as silicates or some probiotics have shown efficacy on diarrhea duration or stool consistency but not on stool output. They have so no formal indication in infectious diarrhea and should be considered as "comfort" treatment. Antibiotics, beside their indication in shigella, cholera and amibiasis could be used in invasive diarrhea in some debilating conditions or infants less than 3 months.

  13. Zinc therapy for different causes of diarrhea

    OpenAIRE

    Hafaz Zakky Abdillah; Supriatmo; Melda Deliana; Selvi Nafianti; Atan Baas Sinuhaji

    2013-01-01

    Background The incidence of diarrhea in Indonesia has declined in the past five years. In spite of the increasing number of studies on the treatment for acute diarrhea, especially the use of zinc, it is not known if bacterial vs. non-bacterial etiology makes a difference in the reduction of severity of acute diarrhea in children on zinc therapy. Objective To assess the effect of zinc therapy in reducing the severity of acute bacterial and non-bacterial diarrhea. Methods We performed a...

  14. Efficacy of synbiotic treatment in children with acute rotavirus diarrhea

    Directory of Open Access Journals (Sweden)

    Made Ratna Dewi

    2015-03-01

    Full Text Available Background Diarrhea is one of the major causes of morbidity and mortality in children throughout the world, mostly due to rotavirus infection. In daily practice, we routinely use the World Health Organization Five steps for managing acute diarrhea.This practice has shown great success in diarrhea management, but concerns remain on reducing the duration of diarrhea to prevent complications. Synbiotics can reduce the severity of diarrhea. However, there has been limited data on synbiotic therapy for treating acute rotavirus diarrhea in children. Objective To compare the durations of acute rotavirus diarrhea treated with synbiotics vs. placebo. Methods This study was a randomized, double-blind, clinical trial, performed at the Pediatric Gastrohepatology Division, Sanglah and Wangaya Hospitals in Denpasar. Subjects were children aged 6 to 59 months with acute rotavirus diarrhea. Rotavirus was diagnosed by immune chromatography assay. The synbiotic group received probiotic comprised of Lactobacillus sp., Streptococcus sp., Bifidobacterium sp. (total viable count 1.00x109 CFU per dose, and prebiotic consisted of 990.00 mg fructooligosacharide (FOS. The placebo consisted of lactose monohydrate packaged similarly as the synbiotics. Subjects orally ingested 1 pack per day for 5 days. Results Seventy children with acute rotavirus diarrhea was involved in this study. The median duration of diarrhea in the synbiotic group was 50.0 (SE 1.1; 95%CI 47.9 to 52.1 hours, while that of the placebo group was 63.0 (SE 5.9; 95%CI 51.4 to 74.6 hours. Based on Kaplan-Meier survival analysis, the duration of diarrhea in the synbiotic group was significantly shorter than that of the placebo group (log-rank test P <0.0001. Conclusion In children with acute rotaviral diarrhea, synbiotic reduces the duration of diarrhea compared to placebo. [Paediatr Indones. 2015;55:74-8.].

  15. [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.

  16. Zinc therapy for different causes of diarrhea

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    Hafaz Zakky Abdillah

    2013-11-01

    Full Text Available Background The incidence of diarrhea in Indonesia has declined in the past five years. In spite of the increasing number of studies on the treatment for acute diarrhea, especially the use of zinc, it is not known if bacterial vs. non-bacterial etiology makes a difference in the reduction of severity of acute diarrhea in children on zinc therapy. Objective To assess the effect of zinc therapy in reducing the severity of acute bacterial and non-bacterial diarrhea. Methods We performed a cross-sectional study in the Secanggang District, Langkat Regency of North Sumatera, from August to November 2009 in children aged 2 months to 14 years. Microscopic stool examinations were undertaken to separate subjects into the acute bacterial or non-bacterial diarrhea groups. Both groups received 10 mg/day of zinc sulphate for subjects aged <6 months or 20 mg/day for those aged ≥6 months for 10 days. Measurement of disease severity was based on the frequency of diarrhea (times/day and the duration of diarrhea (hours after initial drug consumption. We performed independent T-test for statistical analysis. Results Sixty-two children participated in this study, with 31 children in the acute bacterial group, and the remainder in the non-bacterial group. There were no significant differences between the two groups in frequency of diarrhea (2.61 vs 2.70 times/day, respectively, P=0.27 or in duration of diarrhea (63.39 vs 66.68 hours, respectively, P=0.06. Conclusion Zinc is not more effective in reducing the severity of acute bacterial diarrhea compared to non-bacterial diarrhea in children. [Paediatr Indones. 2013;53:334-8.].

  17. The nutritional management of acute diarrhea

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    MacLean William

    1996-01-01

    Full Text Available Acute diarrhea may have a profound effect on nutritional status worldwide. After rehvdra-tion, proper nutritional management can mitigate these effects. This paper discusses the advantages and disadvantages of continued feeding, emphasizing that breastfeeding should not be stopped during episodes of acute diarrhea.

  18. The nutritional management of acute diarrhea

    OpenAIRE

    MacLean William

    1996-01-01

    Acute diarrhea may have a profound effect on nutritional status worldwide. After rehvdra-tion, proper nutritional management can mitigate these effects. This paper discusses the advantages and disadvantages of continued feeding, emphasizing that breastfeeding should not be stopped during episodes of acute diarrhea.

  19. Efficacy of synbiotic treatment in children with acute rotavirus diarrhea

    Directory of Open Access Journals (Sweden)

    Made Ratna Dewi

    2016-06-01

    Full Text Available Background Diarrhea is one of the major causes of morbidityand mortality in children throughout the world, mostly due torotavirus infection. In daily practice, we routinely use the WorldHealth Organization Five steps for managing acute diarrhea.Thispractice has shown great success in diarrhea management, butconcerns remain on reducing the duration of diarrhea to preventcomplications. Synbiotics can reduce the severity of diarrhea.However, there has been limited data on synbiotic therapy fortreating acute rotavirus diarrhea in children.Objective To compare the durations of acute rotavirus diarrheatreated with synbiotics vs. placebo.Methods This study was a randomized, double-blind, clinical trial,performed at the Pediatric Gastrohepatology Division, Sanglahand Wangaya Hospitals in Denpasar. Subjects were children aged6 to 59 months with acute rotavirus diarrhea. Rotavirus wasdiagnosed by immune chromatography assay. The synbiotic groupreceived probiotic comprised of Lactobacillus sp., Streptococcus sp.,Bifidobacterium sp. (total viable count 1.00x109 CFU per dose, andprebiotic consisted of 990.00 mg fructooligosacharide (FOS. Theplacebo consisted of lactose monohydrate packaged similarly as thesynbiotics. Subjects orally ingested 1 pack per day for 5 days.Results Seventy children with acute rotavirus diarrhea wasinvolved in this study. The median duration of diarrhea in thesynbiotic group was 50.0 (SE 1.1; 95%CI 47.9 to 52.1 hours, whilethat of the placebo group was 63.0 (SE 5.9; 95%CI 51.4 to 74.6hours. Based on Kaplan-Meier survival analysis, the duration ofdiarrhea in the synbiotic group was significantly shorter than thatof the placebo group (log-rank test P <0.0001.Conclusion In children with acute rotaviral diarrhea, synbioticreduces the duration of diarrhea compared to placebo.

  20. Rifaximin for the treatment of acute infectious diarrhea

    OpenAIRE

    Hong, Kyoung Sup; Kim, Joo Sung

    2011-01-01

    Rifaximin is a nonabsorbable rifamycin derivative with an excellent safety profile and a broad spectrum of antimicrobial activity against a variety of enteropathogens causing acute infectious diarrhea. After oral ingestion, its bioavailability is known to be less than 0.4%, and it has a low potential for significant drug interactions. In the treatment of travelers’ diarrhea caused by noninvasive diarrheagenic Escherichia coli, it has been demonstrated that rifaximin significantly shortens the...

  1. RACECADOTRIL IN ACUTE WATERY DIARRHEA IN CHILDREN

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    Maha

    2016-01-01

    Full Text Available BACKGROUND Hypersecretory state of gut epithelium induced by toxins secreted by microorganisms is the main mechanism of fluid loss in diarrheal illness. Enkephalins (Endogenous Opioids secreted by gut epithelium have marked pro-absorptive activity and are inactivated by enzyme enkephalinase. Racecadotril, the study drug act by augmenting the levels of enkephalins by inactivating enzyme enkephalinase thus leading to increased intestinal absorption. AIMS AND OBJECTIVES To study the efficacy of racecadotril in acute watery diarrhea in children. PARTICIPANTS Total of 100 patients who met inclusion criteria in the age group of 6 months to 5 years admitted with acute watery diarrhea and some dehydration were enrolment in the study. Cases were randomly divided into racecadotril and placebo group study outcomes in form of number of stools during first 48 hours of admission, mean daily stool number, total duration of diarrheal illness and recovery time, weight on discharge, volume of oral rehydration solution intake during hospital stay and requirement for unscheduled intravenous infusion were observed. RESULTS There was a significant decrease (43.9% in mean number of stools passed per day in racecadotril group when compared to placebo group. Secondary outcome variables, i.e. mean daily stool number, duration of diarrhea and recovery time, total volume of oral rehydration solution during study period, requirement for unscheduled intravenous infusion also showed a statically significant difference in two groups. Complications rates were not different in the two groups. CONCLUSION Racecadotril can be used as an adjunctive therapy in acute watery diarrhea

  2. 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

  3. Oral Zinc Supplementation for the Treatment of Acute Diarrhea

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    Sh Gheibi

    2014-04-01

    Full Text Available Introduction: Diarrheal diseases are a serious health problem and important causes of growth retardation and death in the developing world, especially those of prolonged duration. Since diarrhea is constantly found in children with zinc deficiency, very studies supported zinc supplements beneficial on the duration and severity of diarrhea among children. We review the impact of zinc effects on diarrhea in South-West Asia to update the evidences and to assess its effect on the global burden of diarrhea.   Materials and Methods: We conduct a systematic review through January 2014, for randomized controlled trials relevant to effect of zinc on diarrhea in children. We searched the MeSH terms zinc, acute gastroenteritis and children from various databases of Cochrane Library and PubMed, then clinical trials done in South-West Asia, selected for making written. Results: In recent years, several studies have reported the therapeutic effect of zinc supplementation on diarrheal diseases that was beneficial on decreased episode duration, stool output, stool frequency, hospitalization duration. In some countries in West Asia such as Lebanon, Israel, Saudi Arabia and Iran in clinical trials showed a faster improvement in acute gastroenteritis in children less than five years. But in some countries, such as Turkey, this effect was not significant.   Conclusions: Oral zinc supplementation significantly decreases diarrhea duration and has a greater effect on malnourished children. Zinc supplementation seems to be an appropriate public health strategy, mainly in areas of endemic deficiencies. Global attempts should is increased to support recommended regimen of therapeutic zinc by WHO in all areas. Keywords: Acute Gastroenteritis, Children, Zinc, South-West Asia.  

  4. Acute diarrhea: evidence-based management.

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    Brandt, Kátia Galeão; Castro Antunes, Margarida Maria de; Silva, Gisélia Alves Pontes da

    2015-01-01

    To describe the current recommendations on the best management of pediatric patients with acute diarrheal disease. PubMed, Scopus, Google Scholar. There has been little progress in the use of oral rehydration salts (ORS) in recent decades, despite being widely reported by international guidelines. Several studies have been performed to improve the effectiveness of ORS. Intravenous hydration with isotonic saline solution, quickly infused, should be given in cases of severe dehydration. Nutrition should be ensured after the dehydration resolution, and is essential for intestinal and immune health. Dietary restrictions are usually not beneficial and may be harmful. Symptomatic medications have limited indication and antibiotics are indicated in specific cases, such as cholera and moderate to severe shigellosis. Hydration and nutrition are the interventions with the greatest impact on the course of acute diarrhea. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. Zinc and copper supplementation in acute diarrhea in children: a double-blind randomized controlled trial

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    Mamtani Manju

    2009-05-01

    Full Text Available Abstract Background Diarrhea causes an estimated 2.5 million child deaths in developing countries each year, 35% of which are due to acute diarrhea. Zinc and copper stores in the body are known to be depleted during acute diarrhea. Our objectives were to evaluate the efficacy of zinc and copper supplementation when given with standard treatment to children with acute watery or bloody diarrhea. Methods We conducted a double-blind randomized controlled clinical trial in the Department of Pediatrics at Indira Gandhi Government Medical College Nagpur, India. Eight hundred and eight children aged 6 months to 59 months with acute diarrhea were individually randomized to placebo (Pl, zinc (Zn only, and zinc and copper (Zn+Cu together with standard treatment for acute diarrhea. Results The mean duration of diarrhea from enrolment and the mean stool weight during hospital stay were 63.7 hours and 940 grams, respectively, and there were no significant differences in the adjusted means across treatment groups. Similarly, the adjusted means of the amount of oral rehydration solution or intravenous fluids used, the proportion of participants with diarrhea more than 7 days from onset, and the severity of diarrhea indicated by more than three episodes of some dehydration or any episode of severe dehydration after enrolment, did not differ across the three groups. Conclusion The expected beneficial effects of zinc supplementation for acute diarrhea were not observed. Therapeutic Zn or Zn and Cu supplementation may not have a universal beneficial impact on the duration of acute diarrhea in children. Trial registration The study was registered as an International Standard Randomized Controlled Trial (ISRCTN85071383.

  6. Enteroendocrine and neuronal mechanisms in pathophysiology of acute infectious diarrhea.

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    Camilleri, Michael; Nullens, Sara; Nelsen, Tyler

    2012-01-01

    While enterocyte secretion is the predominant mechanism considered responsible for secretory diarrhea in response to acute enteric infections, there are several lines of evidence that support alternative mechanisms controlling fluid and electrolyte secretion in diarrhea. To review enteroendocrine and neuronal mechanisms that participate in the development of acute infectious diarrhea. Acute infectious diarrheas due to bacterial toxins (e.g., cholera, E. coli heat-stable enterotoxin, C. difficile) and rotavirus are all associated with secretion of transmitters from enteroendocrine cells (e.g., 5-HT) and activation of afferent neurons that stimulate submucosal secretomotor neurons. The latter secrete acetylcholine (which binds to muscarinic receptors on epithelial cells) and VIP. Involvement of nerves was demonstrated by inhibition of bacterial toxin-induced secretion by hexamethonium (nicotinic), tetrodotoxin (Na(+) channel blocker), and lidocaine (visceral/mucosal afferents). Nicotinic receptors are present on secretomotoneurons and these are activated by release of acetylcholine from enteric interneurons or extrinsic efferent fibers. Specific organisms also modify other mechanisms that may contribute to development of acute diarrhea. Thus, mucin secretion, activation of motor mechanisms, increased mucosal permeability and inhibition of bile acid absorption have been reported in specific types of acute infectious diarrhea. New therapies targeting neural and transmitter mediation including 5-HT, VIP, NPY, as well as toxin receptors and channels activated during acute infectious diarrhea could usher in a novel approach to enhancing glucose-electrolyte solutions used in the treatment of acute diarrhea.

  7. Diffusely adherent Escherichia coli as a cause of acute diarrhea in young children in northeast Brazil: a case-control study

    OpenAIRE

    Scaletsky, Isabel CA; Fabbricotti, Sandra H. [UNIFESP; Carvalho, Rozane LB [UNIFESP; Nunes, Claudia R.; Maranhao, Helcio S.; Morais, Mauro B; FAGUNDES-NETO Ulysses

    2002-01-01

    In a prospective study carried out in two urban centers in northeastern Brazil, 195 HEp-2-adherent Escherichia coli strains were isolated; 110 were identified as the only pathogen in stools of children with diarrhea, and 85 were from controls. Enteropathogenic E. coli isolates were identified in 21 children with diarrhea (8.9%) and 7 children without diarrhea (3.0%), and they were significantly associated with diarrhea (P < 0.01). Enteroaggregative E. coli strains were isolated from 40 childr...

  8. [Probiotics for the treating acute diarrhea and preventing antibiotic-associated diarrhea in children].

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    Pérez, Carlos

    2015-02-07

    Probiotics are helpful in the treatment of acute diarrhea. Several systematic reviews show that the use of probiotics shortens the duration of diarrhea in one day and reduces by 59% the risk of diarrhea lasting longer than 4 days. Hospital stay is 24 hours shorter in children treated with probiotics. The benefitial effect of probiotics is species-specific; Lactobacillus rhamnosus GG and Saccharomyces boulardii are the two species with proven efficacy in the treatment of acute diarrhea. The use of probiotics reduces by 50% the risk of antibiotic-associated diarrhea. No significant side effects were found in the clinical trials but rare cases of invasive infections have been reported in immunosuppressed children or those with indwelling central venous catheters.

  9. Nitazoxanide in Acute Rotavirus Diarrhea: A Randomized Control Trial from a Developing Country

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    Mahapatro, Samarendra; Mahilary, Nijwm; Satapathy, Amit Kumar

    2017-01-01

    Background. Acute diarrhea is one of the leading causes of childhood mortality, with rotavirus being an important pathogen. Nitazoxanide, an antiparasitic agent, has been shown to inhibit rotavirus. Objective. This double-blind, randomized trial was designed to study the role of nitazoxanide in acute rotavirus diarrhea. Methods. Of 174 children (12 months to 5 years) with acute diarrhea, 50 rotavirus positive cases were randomized. The intervention group received syrup nitazoxanide twice daily (100 mg in 12–47 months, 200 mg in ≥4 yr) for 3 days along with standard treatment of diarrhea. Duration of diarrhea was the primary outcome measure. Results. The median duration (hrs) of diarrhea (54 versus 80; 95% CI: –26 [–13.2 to –38.8]) and hospitalization (68 versus 90; 95% CI: –22 [–12.98 to –31.02]) was significantly shorter in the nitazoxanide group. No significant difference was seen in the median duration (hrs) of fever or vomiting or the proportion of children requiring parenteral rehydration. There was no report of any adverse events. Conclusions. Oral nitazoxanide is effective and safe in the management of acute rotavirus diarrhea in Indian children (CTRI REF/2016/10/012507). PMID:28331496

  10. Nitazoxanide in Acute Rotavirus Diarrhea: A Randomized Control Trial from a Developing Country

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    Samarendra Mahapatro

    2017-01-01

    Full Text Available Background. Acute diarrhea is one of the leading causes of childhood mortality, with rotavirus being an important pathogen. Nitazoxanide, an antiparasitic agent, has been shown to inhibit rotavirus. Objective. This double-blind, randomized trial was designed to study the role of nitazoxanide in acute rotavirus diarrhea. Methods. Of 174 children (12 months to 5 years with acute diarrhea, 50 rotavirus positive cases were randomized. The intervention group received syrup nitazoxanide twice daily (100 mg in 12–47 months, 200 mg in ≥4 yr for 3 days along with standard treatment of diarrhea. Duration of diarrhea was the primary outcome measure. Results. The median duration (hrs of diarrhea (54 versus 80; 95% CI: –26 [–13.2 to –38.8] and hospitalization (68 versus 90; 95% CI: –22 [–12.98 to –31.02] was significantly shorter in the nitazoxanide group. No significant difference was seen in the median duration (hrs of fever or vomiting or the proportion of children requiring parenteral rehydration. There was no report of any adverse events. Conclusions. Oral nitazoxanide is effective and safe in the management of acute rotavirus diarrhea in Indian children (CTRI REF/2016/10/012507.

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

    NARCIS (Netherlands)

    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 suppleme

  12. [Rotavirus in the feces of children with acute diarrhea in Cochabamba, Bolivia].

    Science.gov (United States)

    López, E; Barrera, F; Saavedra, J; Cona, E; Aguilera, G

    1989-01-01

    Eighty patients with acute diarrheal disease from Cochabamba, Bolivia, were investigated for rotavirus infection by rotapheresis. Rotavirus ARN was detected in 18 (22.5%) of the cases, thus suggesting that this agent is also a frequent cause of acute diarrhea in the studied population as reported from other places of the world.

  13. [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.

  14. Correlation between gut pathogens and fecal calprotectin levels in young children with acute diarrhea

    Directory of Open Access Journals (Sweden)

    Yanever Angela Lam

    2014-07-01

    Full Text Available Background In cases of acute diarrhea, it is difficult to distinguish between bacterial and non-bacterial causes. Increased fecal calprotectin (f-CP level is a marker of neutrophil migration in the intestinal lumen and is associated with intestinal inflammation. Previous studies reported an increase in f-CP levels in children with acute diarrhea, which is caused by bacteria, but only few have studied the relationship between intestinal pathogens with f-CP levels in acute diarrhea. Objective To assess for a correlation between gut pathogens and fecal calprotectin levels in children with acute diarrhea. Methods We conducted a cross-sectional study between July to November 2012 on children aged 1-5 years with acute diarrhea, and underwent routine blood tests, stool microscopy, f-CP tests, and stool cultures. We used a simple linear regression and correlation analysis with a significance level of P<0.05. Results Forty-two children enrolled in this study. The mean age of subjects was 2.27 (SD 1.34 years. Their mean f-CP level was 93.88 (SD 14.68 μg/g. On microscopic stool examination, 26 patients (61.9% had positive leukocytes, 1 had Ancylostoma duodenale, 1 had Ascaris lumbricoides, and 2 had Blastocystis hominis. Positive stool cultures were found in 14 children (33.3% with acute diarrhea. There was a significant positive correlation between gut pathogens and f-CP levels (r=0.605; P<0.0001. Conclusion In young children with acute diarrhea, the average f-CP levels are higher in those with positive intestinal pathogens. [Paediatr Indones. 2014;54:193-7.].

  15. 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

    2012-01-01

    Background.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. Methods.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. Results.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. Conclusions.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. PMID:22723640

  16. Acute diarrhea | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available ermina)Versus ORT Alone, Administered for 5 Days With the Treatment of Acute Diarrhea in Children A.3.1Title...on or disease under investigation E.1.1Medical condition(s) being investigated Acute...tigation E.1.2Version 17.1 E.1.2Level LLT E.1.2Classification code 10000706 E.1.2Term Acute

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Bacterial entropathogens and antimicrobial susceptibility in children with acute diarrhea in Babol, Iran

    OpenAIRE

    Esmaeili Dooki, Mohammad Reza; Rajabnia, Ramazan; Barari Sawadkohi, Rahim; Mosaiebnia Gatabi, Zahra; Poornasrollah, Mohammad; Mirzapour, Mohaddeseh

    2014-01-01

    Background: Infectious diarrhea is one of common cause of children diarrhea causing mortality and morbidity worldwide. This study was performed to identify the common bacteria and their antimicrobial susceptibility in children with diarrhea.

  19. Chronic diarrhea and pancolitis caused by paracoccidioidomycosis: a case report.

    Science.gov (United States)

    Bravo, Eduar A; Zegarra, Arturo J; Piscoya, Alejandro; Pinto, José L; de Los Rios, Raúl E; Prochazka, Ricardo A; Huerta-Mercado, Jorge L; Mayo, Nancy L; Tagle, Martin

    2010-01-01

    South American blastomycosis is a systemic micosis caused by infection with Paracoccidioides brasiliensis. The most frequently affected sites are the lower lip buccal mucous membrane, palate, tongue, sublingual region, lymph glands, and lungs. However, colonic involvement is not a common expression of Paracoccidioidomycosis. We report a case of chronic diarrhea and pancolitis caused by Paracoccidioidomycosis with fatal outcome.

  20. Chronic Diarrhea and Pancolitis Caused by Paracoccidioidomycosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Eduar A. Bravo

    2010-01-01

    Full Text Available South American blastomycosis is a systemic micosis caused by infection with Paracoccidioides brasiliensis. The most frequently affected sites are the lower lip buccal mucous membrane, palate, tongue, sublingual region, lymph glands, and lungs. However, colonic involvement is not a common expression of Paracoccidioidomycosis. We report a case of chronic diarrhea and pancolitis caused by Paracoccidioidomycosis with fatal outcome.

  1. Acute diarrhea during army field exercise in southern China

    Institute of Scientific and Technical Information of China (English)

    Yang Bai; Ying-Chun Dai; Jian-Dong Li; Jun Nie; Qing Chen; Hong Wang; Yong-Yu Rui; Ya-Li Zhang; Shou-Yi Yu

    2004-01-01

    AIM: During emergency period, infectious diseases can bea major threat to military forces. During field training insouthern China, diarrhea is the main cause of nonbattleinjury. To evaluate the causes of and risk factors for diarrheain emergency period, we collected clinical and epidemiologicaldata from the People′s Liberation Army (PLA) during fieldtraining in southern China.METHODS: From September 25 to October 2 1997, 2636military personnel were investigated. Fecal sample cultures for lapactic pathogens were obtained from 103 military personnel with diarrhea. In addition, a questionnaire was administered to 103 cases and 206 controls to evaluate the association between illness and potential risk factors. At the same time,another questionnaire of 1:4 case-case control was administered to 22 severe cases (each severe case paired 4 mild cases).RESULTS: The training troop′s diarrhea incidence rate was significantly higher than that of garrison. The diarrhea incidence rate of officers was significantly lower than that of soldiers. A lapactic pathogen was identified in 63.1% (65/103) of the troops with diarrhea. Enterotoxigenic Escherichia coli(35.0%) and plesiomona shigelloides (16.5%) were the most common bacterial pathogens. All bacterial isolates were sensitive to norfloxacin and ceftazidine. However, almost all of them were resistant to sulfamethoxazole, trimethoprim-sulfamethoxazole,oxytetracycline, doxycycline, furazolidone, ampicillin and cloromycetin to a different degree. Risk factors associated with diarrhea includediidrinking raw water, eating outside,contacting diarrhea patients, lacking sanitation, depression,lacking sleep, which were established by multiple-factor logistic regression analysis. In addition, the unit incidence rate was associated with the density of flies and the average daily boiled water available by regression and discriminate analysis.CONCLUSION: A series of risk factors are associated with the incidence rate of diarrhea. Our

  2. Effect of vitamin A on severity of acute diarrhea in children

    Directory of Open Access Journals (Sweden)

    Marlisye Marpaung

    2013-05-01

    Full Text Available Background Vitamin A deficiency may increase the risk or be a cause of diarrhea. Many studies have been conducted on the efficacy of vitamin A in the management of acute diarrhea, but the outcomes remain inconclusive. Objective To determine the effectiveness of vitamin A in reducing the severity of acute diarrhea in children. Methods We performed a single-blind-randomized controlled trial in the Secanggang District, Langkat Regency, North of Sumatera, from August 2009 to January 2010 in children aged 6 months to 5 years, who had diarrheas. Subjects were divided into two groups. Group 1 received a single dose of vitamin A (100,000 IU for subjects aged 6 to 11 month old or with body weights ≤ 10 kg, or 200,000 IU for subjects aged ≥ 12 month old or with body weights > 10 kg. Group 2 received a single dose of placebo. The establishment of severity was based on changes in diarrheal frequency, stool consistency, volume and duration of diarrhea after treatment. We performed independent T-test and Chi square tests for statistical analyses. The study was an intention-to-treat analysis. Results We enrolled 120 children who were randomized into two groups of 60 subjects each. Group 1, received vitamin A and group 2 received a placebo. The results showed significant differences between the two groups in stool volume starting on the first day (95%CI 192.30 to 3237.51; P=0.001, as well as diarrheal frequency (P=0.001 and stool consistency (P=0.001 on the second day observation and duration of diarrhea following treatment (95%CI - 40.60 to - 25.79; P=0.001;. Conclusions Vitamin A supplementation is effective in reducing the severity of acute diarrhea in children under five years of age. [Paediatr Indones. 2013;53:125-31.

  3. Effect of vitamin A on severity of acute diarrhea in children

    Directory of Open Access Journals (Sweden)

    Atan Baas Sinuhaji

    2013-01-01

    Full Text Available Background Vitamin A deficiency may increase the risk or be a cause of diarrhea. Many studies have been conducted on the efficacy of vitamin A in the management of acute diarrhea, but the outcomes remain inconclusive.Objective To determine the effectiveness of vitamin A in reducing the severity of acute diarrhea in children.Methods We performed a single-blind-randomized controlled trial in the Secanggang District, Langkat Regency, North of Sumatera, from August 2009 to January 2010 in children aged 6 months to 5 years, who had diarrheas. Subjects were divided into two groups. Group 1 received a single dose of vitamin A (100,000 IU for subjects aged 6 to 11 month old or with body weights ≤ 10 kg, or 200,000 IU for subjects aged ≥ 12 month old or with body weights > 10 kg. Group 2 received a single dose of placebo. The establishment of severity was based on changes in diarrheal frequency, stool consistency, volume and duration of diarrhea after treatment. We performed independent T-test and Chi square tests for statistical analyses. The study was an intention-to-treat analysis.Results We enrolled 120 children who were randomized into two groups of 60 subjects each. Group 1, received vitamin A and group 2 received a placebo. The results showed significant differences between the two groups in stool volume starting on the first day (95%CI 192.30 to 3237.51; P=0.001, as well as diarrheal frequency (P=0.001 and stool consistency (P=0.001 on the second day observation and duration of diarrhea following treatment (95%CI - 40.60 to - 25.79; P=0.001;.Conclusions Vitamin A supplementation is effective in reducing the severity of acute diarrhea in children under five years of age.

  4. DEHYDRATION IN CHILDREN WITH ACUTE DIARRHEA

    Directory of Open Access Journals (Sweden)

    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. 

  5. Gut Microbial Succession Follows Acute Secretory Diarrhea in Humans

    Science.gov (United States)

    David, Lawrence A.; Weil, Ana; Ryan, Edward T.; Calderwood, Stephen B.; Harris, Jason B.; Chowdhury, Fahima; Begum, Yasmin; Qadri, Firdausi

    2015-01-01

    ABSTRACT Disability after childhood diarrhea is an important burden on global productivity. Recent studies suggest that gut bacterial communities influence how humans recover from infectious diarrhea, but we still lack extensive data and mechanistic hypotheses for how these bacterial communities respond to diarrheal disease and its treatment. Here, we report that after Vibrio cholerae infection, the human gut microbiota undergoes an orderly and reproducible succession that features transient reversals in relative levels of enteric Bacteroides and Prevotella. Elements of this succession may be a common feature in microbiota recovery from acute secretory diarrhea, as we observed similar successional dynamics after enterotoxigenic Escherichia coli (ETEC) infection. Our metagenomic analyses suggest that multiple mechanisms drive microbial succession after cholera, including bacterial dispersal properties, changing enteric oxygen and carbohydrate levels, and phage dynamics. Thus, gut microbiota recovery after cholera may be predictable at the level of community structure but is driven by a complex set of temporally varying ecological processes. Our findings suggest opportunities for diagnostics and therapies targeting the gut microbiota in humans recovering from infectious diarrhea. PMID:25991682

  6. Therapeutic value of zinc supplementation in acute and persistent diarrhea: a systematic review.

    Directory of Open Access Journals (Sweden)

    Archana Patel

    Full Text Available BACKGROUND: For over a decade, the importance of zinc in the treatment of acute and persistent diarrhea has been recognized. In spite of recently published reviews, there remain several unanswered questions about the role of zinc supplementation in childhood diarrhea in the developing countries. Our study aimed to assess the therapeutic benefits of zinc supplementation in the treatment of acute or persistent diarrhea in children, and to examine the causes of any heterogeneity of response to zinc supplementation. METHODS AND FINDINGS: EMBASE, MEDLINE and CINAHL databases were searched for published reviews and meta-analyses on the use of zinc supplementation for the prevention and treatment of childhood diarrhea. Additional RCTs published following the meta-analyses were also sought. The reviews and published RCTs were qualitatively mapped followed by updated random-effects meta-analyses, subgroup meta-analyses and meta-regression to quantify and characterize the role of zinc supplementation with diarrhea-related outcomes. We found that although there was evidence to support the use of zinc to treat diarrhea in children, there was significant unexplained heterogeneity across the studies for the effect of zinc supplementation in reducing important diarrhea outcomes. Zinc supplementation reduced the mean duration of diarrhea by 19.7% but had no effect on stool frequency or stool output, and increased the risk of vomiting. Our subgroup meta-analyses and meta-regression showed that age, stunting, breast-feeding and baseline zinc levels could not explain the heterogeneity associated with differential reduction in the mean diarrheal duration. However, the baseline zinc levels may not be representative of the existing zinc deficiency state. CONCLUSIONS: Understanding the predictors of zinc efficacy including the role of diarrheal disease etiology on the response to zinc would help to identify the populations most likely to benefit from supplementation

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

    Directory of Open Access Journals (Sweden)

    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.

  8. The 12 Gastrointestinal Pathogens Spectrum of Acute Infectious Diarrhea in a Sentinel Hospital, Shenzhen, China

    Science.gov (United States)

    Shen, Hongwei; Zhang, Jinjin; Li, Yinghui; Xie, Sirou; Jiang, Yixiang; Wu, Yanjie; Ye, Yuhui; Yang, Hong; Mo, Haolian; Situ, Chaoman; Hu, Qinghua

    2016-01-01

    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 sp. Norovirus (8.3%) and sapovirus (2.2%) were the most common viral pathogens, followed by adenovirus (1.5%) and rotavirus (1.2%). No EHEC, L. monocytogenes, V. cholera, Shigella, and parasites were found. 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. PMID:27965649

  9. The 12 Gastrointestinal Pathogens Spectrum of Acute Infectious Diarrhea in a Sentinel Hospital, Shenzhen, China.

    Science.gov (United States)

    Shen, Hongwei; Zhang, Jinjin; Li, Yinghui; Xie, Sirou; Jiang, Yixiang; Wu, Yanjie; Ye, Yuhui; Yang, Hong; Mo, Haolian; Situ, Chaoman; Hu, Qinghua

    2016-01-01

    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 sp. Norovirus (8.3%) and sapovirus (2.2%) were the most common viral pathogens, followed by adenovirus (1.5%) and rotavirus (1.2%). No EHEC, L. monocytogenes, V. cholera, Shigella, and parasites were found. 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.

  10. Strategic control of acute diarrhea of newborn calves

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    S.L. Niankovskyi

    2015-11-01

    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.

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

    National Research Council Canada - National Science Library

    Heber Silva-Díaz; Olinda Bustamante-Canelo; Franklin-Rómulo Aguilar-Gamboa; Katya Mera-Villasis; Jhonatan Ipanaque-Chozo; Eberth Seclen-Bernabe; Martha Vergara-Espinoza

    2017-01-01

    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...

  13. [Feeding infants and young children with acute diarrhea].

    Science.gov (United States)

    Chouraqui, J-P; Michard-Lenoir, A-P

    2007-10-01

    Acute gastroenteritis remains a common and often severe illness among infants and children throughout the world. The management of a child with acute diarrhea includes rehydration and maintenance fluids with oral rehydration solutions (ORS), combined with continued age-appropriate nutrition. However, although substantial data support the role of continued nutrition in improving gastrointestinal function and anthropometric, biochemical, and clinical outcomes, the practice of continued feeding during diarrheal episodes has been difficult to establish as accepted standard of care. Recommendations for maintenance dietary therapy depend on the age and diet history of the patient. It has been clear for many years that, when affected by gastroenteritis, breastfed infants should be continued on breast milk without any need for interruption and, by that way, will get faster recovery and improved nutrition. Moreover, many well-conducted studies have provided evidence that in formula-fed children not severely dehydrated, a rapid return to full feeding is well tolerated. Lactose intolerance and/or secondary cow's milk allergy are not a clinical concern for the vast majority of patients. In fact early refeeding i.e resumption of normal diet, in amounts sufficient to satisfy energy and nutrient requirements, should be the rule. However, in children younger than 6 months of age, the lack of suitable studies must lead to caution and use of specific lactose-free or extensively hydrolysate formulae, especially in case of severe and/or prolonged diarrhea. Several studies support the use of zinc supplementation or probiotics for acute diarrhea but some doubts persist in infant in developed countries.

  14. 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.

  15. 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, ...

  16. Association of Diarrheagenic Escherichia coli Pathotypes with Infection and Diarrhea among Mexican Children and Association of Atypical Enteropathogenic E. coli with Acute Diarrhea

    Science.gov (United States)

    Estrada-Garcia, Teresa; Lopez-Saucedo, Catalina; Thompson-Bonilla, Rocio; Abonce, Maricela; Lopez-Hernandez, Daniel; Santos, Jose Ignacio; Rosado, Jorge L.; DuPont, Herbert L.; Long, Kurt Z.

    2009-01-01

    Seventy-six children ≤2 years old were prospectively followed for 1 year in a peri-urban community of Mexico City to determine asymptomatic infection and acute diarrhea associated with diarrheagenic Escherichia coli pathotypes (DEPs). By use of a pathogen-specific multiplex PCR, DEPs were sought in 795 stool samples, of which 125 (16%) were positive for DEP; of these, 4 represented shedding episodes and 4 parasite coinfections. Most single-DEP infections (85/117) were asymptomatic (P < 0.001), and of the 32 DEP diarrhea episodes, 41% were associated with atypical enteropathogenic E. coli (aEPEC), 37.5% with enterotoxigenic E. coli, 9% with typical EPEC, 9% with enteroinvasive E. coli, and 3% with Shiga toxin-producing E. coli strains. Among the 76 children, 54 had at least one stool positive for DEP, of which 23 experienced a DEP-associated diarrhea episode. In the last group of children, DEP infection was significantly associated with a diarrhea episode (relative risk [RR] = 2.5; 95% confidence interval [CI], 1.79 to 3.57; P < 0.001), with ETEC (RR = 2.30; 95% CI, 1.49 to 3.54; P = 0.003) and aEPEC (RR = 1.92; 95% CI, 1.23 to 3.0; P = 0.019) being the pathotypes associated with diarrhea. aEPEC-associated diarrhea episodes were frequently in the <12-month age group (RR = 2.57; 95% CI, 1.05 to 6.27; P = 0.04). aEPEC infections were distributed all year round, but associated diarrheal episodes were identified from April to October, with a May-June peak (rainy season). Most ETEC infections and diarrhea episodes characteristically occurred during the summer (rainy season), with a diarrhea peak in August. Of all DEPs, only aEPEC was associated with acute diarrhea episodes lasting 7 to 12 days (P = 0.019). DEPs are important causes of community-acquired enteric infection and diarrhea in Mexican children. PMID:19020055

  17. Predictors of plasma zinc concentrations in children with acute diarrhea.

    Science.gov (United States)

    Strand, Tor A; Adhikari, Ramesh K; Chandyo, Ram K; Sharma, Pushpa R; Sommerfelt, Halvor

    2004-03-01

    Plasma and serum zinc concentrations are the most widely used markers of zinc status in individual persons and populations. The objective was to identify factors that influence plasma zinc concentrations during acute childhood diarrhea. This was a cross-sectional study of 1757 cases of acute diarrhea in 6-35-mo-old Nepalese children. The association between plasma zinc concentration and several clinical, anthropometric, socioeconomic, and biochemical variables was estimated in simple and multiple linear regression analyses. We observed a reduction in the mean plasma zinc concentration of 0.59 (95% CI: 0.44, 0.74) micro mol/L per degree ( degrees C) increase in axillary temperature. Having dysentery and an elevated plasma C-reactive protein concentration was also independently associated with lower plasma zinc. Children with clinical features of dehydration had higher plasma zinc concentrations than did those who were not dehydrated. Furthermore, a decrease in plasma albumin of 1 g/L was associated with a decrease in plasma zinc of 0.25 (95% CI: 0.21, 0.29) micro mol/L. The plasma albumin concentration confounded the associations between some clinical variables and plasma zinc, but the association between axillary temperature and dehydration on one hand and plasma zinc on the other was not substantially influenced by the albumin concentration. Moreover, the plasma zinc concentration increased with an increase in observed hemolysis. Dehydration, clinical and biochemical indicators of inflammation and hemolysis, and, when possible, plasma albumin concentrations should be taken into account when the plasma zinc concentration is used to estimate zinc status during episodes of diarrhea in childhood.

  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 GI panel has proved to be a valuable new diagnostic tool for improving the diagnostic efficiency of GI pathogens.

  19. The effect of aqueous Elaeagnus angustifolia extract on acute non-inflammatory diarrhea in 1-5 year old children

    Directory of Open Access Journals (Sweden)

    Khoshdel Abofazl

    2014-01-01

    Full Text Available Introduction: Acute diarrhea is one of the most important causes of global childhood mortality and morbidity. The most common complication of acute diarrhea is dehydration. The aim of this study was to evaluate the use of aqueous Elaeagnus angustifolia extract in controlling non-inflammatory diarrhea in a hospital setting. Methods: In this case–controlled randomized double blind clinical trial 80 children in age range of 1-5 years were admitted in pediatric ward with diagnosis of non-inflammatory diarrhea. The patients were randomly divided into two equal groups of 40 cases. The subject in the first group received aqueous Elaeagnus angustifolia extract, 1.2 ml/Kg single dose for 4 days duration and the second group (control group 1.2 cm/Kg distilled water single dose for 4 days duration. Data analysis were performed by Chi-square and t-tests, using SPSS software. Results: The groups were similar regarding gender, mean age, and frequency, and consistency of defecation (p> 0.05. Although the children seemed better in regard to frequency and consistency of defecation, however the results showed that aqueous extract of Elaeagnus angustifolia was not significantly effective in the treatment of non-inflammatory diarrhea. Conclusion: The results of this study demonstrated that the use of aqueous extract of Elaeagnus angustifolia was not effective in the treatment of non-inflammatory diarrhea in children.

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

    OpenAIRE

    Silviu Grisaru; Morgunov, Melissa A.; Samuel, Susan M.; Julian P Midgley; Wade, Andrew W; Tee, James B.; Hamiwka, Lorraine A.

    2011-01-01

    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 5...

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

    Science.gov (United States)

    Abegaz, Tadesse Melaku; Belachew, Sewunet Admasu; Abebe, Tamrat Befekadu; Gebresilassie, Begashaw Melaku; Teni, Fitsum Sebsibe; Woldie, Habtamu Gebremeskel

    2016-01-01

    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 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, (90.3%), whereas “chief complaint” was the least to be taken (23%), for patients presenting with diarrhea. Approximately 96 (85.0%) cases were provided with one or more medications. The remaining 17 (15%) cases did not receive any medication. A total of six pharmacologic groups of medications were given to alleviate acute diarrheal symptoms. Majority (66, 29.6%) of the medications were oral rehydration salts with zinc. The mean number of medications was 1.99 per visit. Components of advice, such as dose, frequency, duration, drug action

  2. 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…

  3. Characterization of microbial dysbiosis and metabolomic changes in dogs with acute diarrhea.

    Science.gov (United States)

    Guard, Blake C; Barr, James W; Reddivari, Lavanya; Klemashevich, Cory; Jayaraman, Arul; Steiner, Jörg M; Vanamala, Jairam; Suchodolski, Jan S

    2015-01-01

    Limited information is available regarding the metabolic consequences of intestinal dysbiosis in dogs with acute onset of diarrhea. The aim of this study was to evaluate the fecal microbiome, fecal concentrations of short-chain fatty acids (SCFAs), as well as serum and urine metabolites in healthy dogs (n=13) and dogs with acute diarrhea (n=13). The fecal microbiome, SCFAs, and serum/urine metabolite profiles were characterized by 454-pyrosequencing of the 16S rRNA genes, GC/MS, and untargeted and targeted metabolomics approach using UPLC/MS and HPLC/MS, respectively. Significantly lower bacterial diversity was observed in dogs with acute diarrhea in regards to species richness, chao1, and Shannon index (p=0.0218, 0.0176, and 0.0033; respectively). Dogs with acute diarrhea had significantly different microbial communities compared to healthy dogs (unweighted Unifrac distances, ANOSIM p=0.0040). While Bacteroidetes, Faecalibacterium, and an unclassified genus within Ruminococcaceae were underrepresented, the genus Clostridium was overrepresented in dogs with acute diarrhea. Concentrations of fecal propionic acid were significantly decreased in acute diarrhea (p=0.0033), and were correlated to a decrease in Faecalibacterium (ρ=0.6725, p=0.0332). The predicted functional gene content of the microbiome (PICRUSt) revealed overrepresentations of genes for transposase enzymes as well as methyl accepting chemotaxis proteins in acute diarrhea. Serum concentrations of kynurenic acid and urine concentrations of 2-methyl-1H-indole and 5-Methoxy-1H-indole-3-carbaldehyde were significantly decreased in acute diarrhea (p=0.0048, 0.0185, and 0.0330, respectively). These results demonstrate that the fecal dysbiosis present in acute diarrhea is associated with altered systemic metabolic states.

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

    Directory of Open Access Journals (Sweden)

    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

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

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    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.

  6. The 12 Gastrointestinal Pathogens Spectrum of Acute Infectious Diarrhea in a Sentinel Hospital, Shenzhen, China

    OpenAIRE

    Shen, Hongwei; Zhang, Jinjin; Li, Yinghui; Xie, Sirou; Jiang, Yixiang; Wu, Yanjie; Ye, Yuhui; Yang, Hong; Mo, Haolian; Situ, Chaoman; Hu, Qinghua

    2016-01-01

    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 detecte...

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

    OpenAIRE

    Hongwei Shen; Jinjin Zhang; Yinghui Li; Sirou Xie; Yixiang Jiang; Yanjie Wu; Yuhui Ye; Hong Yang; Haolian Mo; Chaoman Situ; Qinghua Hu

    2016-01-01

    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 detecte...

  8. Can Giardia lamblia infection lower the risk of acute diarrhea among preschool children?

    Science.gov (United States)

    Muhsen, Khitam; Cohen, Dani; Levine, Myron M

    2014-04-01

    There are inconsistent findings concerning the role of Giardia lamblia in pediatric diarrhea. A prospective cohort study of the incidence of acute diarrhea among Israeli Arab preschool children offered the opportunity to examine the association between G. lamblia infection (at baseline) and subsequent diarrhea. Following baseline screening by light microscopy for the presence of Giardia in their stools, a cohort was assembled of 142 children who were followed between October 2003 and August 2004 for the incidence of diarrhea. Surveillance was performed through maternal interviews. At baseline, 21 children tested Giardia-positive. During the prospective surveillance, acute diarrhea occurred less often among Giardia-positive children (9.5%) than among children who were not infected with Giardia (26.5%). G. lamblia infection was associated with lower risk of acute diarrhea; adjusted odds ratio of 0.18 (95% confidence interval 0.04-0.93) (p = 0.041). This prospective study provides additional evidence that Giardia may lower the risk of subsequent acute diarrhea among preschool children.

  9. Incidence and clinical manifestations of rotavirus infection among children with acute diarrhea admitted at Buri Ram Hospital, Thailand.

    Science.gov (United States)

    Sungkapalee, Thrissawan; Puntukosit, Puntawee; Eunsuwan, Orapun; Theamboonlers, Apiradee; Chongsrisawat, Voranush; Poovorawan, Yong

    2006-11-01

    To study the incidence and clinical manifestations of rotavirus among children at Buri Ram Hospital, admitted with the diagnosis of acute diarrhea between November 2005 and February 2006. In the course of a cross sectional descriptive study, 103 stool samples obtained from inpatients below the age of 5 years were examined for rotavirus by RT- PCR. Data on clinical manifestations, complications, administration of antibiotics, length of admission and hospital cost were obtained by means of questionnaires distributed among physicians. The statistics used were presented as percentage, mean and 95% confidence interval, while chi-square and unpaired t-test were used to establish significant differences at p < 0.05. Rotavirus was detected in 45 of 103 stool samples (43.68%, 95%CI = 33.93, 53.81). No significant differences were found between clinical manifestations of children with rotavirus infection and non-rotavirus infection as both groups displayed acute watery diarrhea (p = 0.33), fever (p = 0.80), nausea or vomiting (p = 0.08), predominant lymphocytes (p = 0.54), absence of red blood cells (p = 0.63) or white blood cells (p = 0.57) in the stool examination, moderate or severe dehydration (p = 0.06), lactose intolerance (p = 0.41), hypokalemia (p = 0.55), metabolic acidosis (0.18) Administration of antibiotics was significantly reduced for treatment of rotavirus acute diarrhea (31.1% vs 63.8%, p = 0.001). Hospital cost and length of admission were significantly reduced in rotavirus acute diarrhea (1,845.04 baht vs 2,297.00 baht, p < 0.01) (2.09 days vs 2.81 days, p < 0.001). Compared to previous studies, no differences were found in the percentage of rotavirus acute diarrhea. Rotavirus infection is a major cause for hospitalization of children below the age of 5 years with acute diarrhea. Clinical characteristics of rotavirus acute diarrhea were not significantly different from those due to other etiologies. Diagnosis of rotavirus infection should be based on

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

    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.

  11. 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 ...

  12. Frequency of E.coli pathotypes in acute diarrhea of children and its related factorsat Beassat hospital,Sanandaj

    Institute of Scientific and Technical Information of China (English)

    Kalantar E; Solatni J; Khosravi B; Salehi A

    2009-01-01

    Objective:Diarrhea is a leading cause of morbidity and mortality among children in developing countries.The bacterial pathogen most commonly associated with childhood diarrhea is Escherichia coli.A one-year prospec-tive study was carried out in Sanandaj to determine the prevalence and roles of the different E.coli pathotypes in children less than five years of age with acute diarrhea.Methods:Rectal swab were collected prospectively from children with acute diarrhea and transported to the Department of Microbiology,School of Medicine, KUMS,Sanandaj during 2008.The study was approved by the institutional ethics committee.Results:During this study period,rectal swabs were investigated from a total of 466 children 1 to 144 months of age (mean, 29.97 months ±S.D)with diarrhea.Among the children,191 (41%,191 /466)were girls,and 275 (59%,275 /466)were boys.The age-specific incidence rates of acute diarrhea among children 13 -24 and 1-12 months of age were 37.37% (37 /99)and 26.26 % (26 /99),respectively,during the study period.A total of 99 strains of E.coli were detected.EPEC 59 (59.59%)and EIEC 22 (22.22%),were the most commonly found Escherichia coli strains detected in stools from children.Disk diffusion testing showed E.coli strains resistance to tetracycline (89.89 %),chloramphenicol (88.88%),Ampicillin (79.79%),Amoxi-cillin (75.75%)and Ceficime (75.75%).Among risk factors like age,sex,haemoglubin,father's and moth-er's education,food and weight of children only mother's education was significant (P =0.018).Conclusion:In most of the clinical laboratories in Iran,E.coli does not considered as an etiologic agent responsible for di-arrhea.Results in this study revealed that E.coli should be considered as an etiologic agent causing acute di-arrhea among children.We therefore,recommend the routine isolation and identification of E.coli strains in all the clinical laboratories in Sanandaj.Guidelines for appropriate use of antibiotics in Sanandaj need upda-ting.

  13. Lactobacillus acidophilus Mixture in Treatment of Children Hospitalized With Acute Diarrhea.

    Science.gov (United States)

    Pinto, Jamie M; Petrova, Anna

    2016-11-01

    Despite unproven effectiveness, Lactobacillus acidophilus is a widely used probiotic in the treatment of pediatric diarrhea. In this report, we evaluated the association between length of stay (LOS) for 290 young children hospitalized with acute diarrhea and adjuvant therapy with a probiotic mixture containing 80% L acidophilus that was included in treatment for 22.4% of them. Overall, no association between LOS and use of L acidophilus was recorded after controlling for age, length of diarrhea symptoms, duration of intravenous fluids, and prior exposure to antibiotic. However, LOS was directly associated with use of L acidophilus in children with negative stool studies, and no such association was recorded in children with positive stool for rotavirus or other infections. We concluded that adjuvant therapy with L acidophilus mixture is not beneficial for young children hospitalized with acute diarrhea.

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

    Directory of Open Access Journals (Sweden)

    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

  15. Risk Factors for Extended Duration of Acute Diarrhea in Young Children

    OpenAIRE

    Tor A. Strand; Sharma, Pushpa R.; Håkon K Gjessing; Manjeswori Ulak; Chandyo, Ram K; Adhikari, Ramesh K.; Halvor Sommerfelt

    2012-01-01

    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 ...

  16. Cytomegalovirus-associated colitis causing diarrhea in an immunocompetent patient

    Institute of Scientific and Technical Information of China (English)

    Dan Carter; David Olchovsky; Russell Pokroy; David Ezra

    2006-01-01

    Cytomegalovirus (CMV) colitis rarely occurs in immunocompetent patients. We report a case of disabling and life threatening diarrhea in an immunocompetent elderly woman due to CMV colitis. The diagnosis of CMV was based on histological examination of tissues biopsied at colonoscopy, positive CMV antigen and high CMV-IgM titer in peripheral blood samples and a good response to systemic gancyclovir treatment.We conclude that CMV should be considered in the differential diagnosis of colitis in elderly immunocompetent patients.

  17. Etiology of acute diarrhea in the elderly in China: A six-year observational study

    Science.gov (United States)

    Geng, Qibin; Yang, Wanqi; Chen, Yu; Wu, Jianguo; Jing, Huaiqi; Yang, Weizhong; Li, Zhongjie

    2017-01-01

    Acute diarrhea leads to a substantial disease burden among the elderly worldwide. However, in the context of increasingly aging trend in China, the prevalence of etiological agents among elderly diarrheal patients was undetermined. This study aimed to explore the major enteropathogens of acute diarrhea among outpatients older than 65 years in China, and also the epidemiological features of the pathogens. Demographic and clinical data for acute diarrhea among outpatients older than 65 years were collected from 213 participating hospitals from 2009 to 2014. Stool specimens were collected and tested for 13 enteric viruses and bacteria. The proportion of outpatients positive for targeted pathogens was analyzed by residential areas and seasonal patterns. Among the 7,725 patients enrolled, 1,617 (20.9%)were positive for any one of the 13 study pathogens. The predominant pathogen was norovirus (9.0%), followed by diarrheagenic Escherichia coli (DEC) (5.5%), rotavirus (3.9%), non-typhoidal Salmonella (NTS) (2.9%), and Shigella spp. (2.5%). The prevalence of Shigella spp. among rural patients (6.9%) was higher than that among urban patients (1.6%) (p spp. in summer. A wide variety of enteropathogens were detected among the elderly with acute diarrhea in China, with norovirus and DEC being the most commonly isolated pathogens. A strong seasonal pattern was observed for major pathogens of acute diarrhea among the elderly. PMID:28323855

  18. 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.

  19. Diarrea funcional como causa de diarrea crónica Functional diarrhea as cause of chronic diarrhea

    Directory of Open Access Journals (Sweden)

    Trini Fragoso Arbelo

    2010-12-01

    Full Text Available La diarrea funcional se presenta con frecuencia en la práctica pediátrica, y generalmente no se asocia a alteraciones nutricionales, pero sí a esquemas dietéticos incorrectos. Se actualiza su importancia clínica, se hace énfasis en la patogenia, diagnóstico y en los métodos de tratamiento. Consideramos que es la causa más frecuente de diarrea crónica inespecífica, y que el interrogatorio dirigido según los criterios de Roma es útil para su diagnóstico. La mayoría de los pacientes con esta enfermedad en la infancia deben ser tratados en la atención primaria.The functional diarrhea is frequent in the pediatric practice and in general it is not associated with nutritional alterations, but to incorrect dietary schemes. Its clinical significance is updated and its pathogenesis, diagnosis and treatment methods are emphasized. Authors considered that the functional diarrhea is the more frequent cause of unspecific chronic diarrhea and the questioning directed according the Rome criteria is very useful for its diagnosis. Most of patients presenting with this disease during childhood must to be treated in primary care services.

  20. Prevalence and genetic diversity of norovirus among patients with acute diarrhea in Guatemala.

    Science.gov (United States)

    Estévez, Alejandra; Arvelo, Wences; Hall, Aron J; López, María R; López, Beatriz; Reyes, Lissette; Moir, Juan Carlos; Gregoricus, Nicole; Vinjé, Jan; Parashar, Umesh D; Lindblade, Kim A

    2013-07-01

    Noroviruses (NoVs) are a leading cause of acute gastroenteritis outbreaks and sporadic cases of diarrhea in industrialized countries. To study the prevalence and genetic diversity of NoVs in Guatemala, stool specimens were collected from hospitalized and ambulatory patients presenting with diarrhea (≥3 loose or liquid stools in a 24-hr period) who were enrolled in a prospective surveillance system in the Departments of Santa Rosa (October 2007 to August 2010) and Quetzaltenango (August 2009 to August 2010), Guatemala. Specimens were tested for rotavirus, enteric bacteria, and parasites by routine methods and for genogroups I and II NoV by real-time reverse transcription-PCR. A total of 2,403 stool specimens were collected from hospitalized (n = 528) and ambulatory patients (n = 1,875). Overall, 341 (14%) samples tested positive for NoVs including 114 (22%) hospitalized and 227 (12%) ambulatory patients. NoVs disease peaked during the winter (November-January) months. Among the 341 NoVs-positive patients, 32 (9%) were also positive for rotavirus, 32 (9%) for bacteria, and 9 (3%) for protozoa. Nucleotide sequences were obtained from 84 samples collected from hospitalized children aged Guatemala. The findings highlight the need to implement laboratory diagnostics for NoVs to improve appropriate clinical management of diarrheal diseases and guide vaccine development.

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

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    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. Epidemiological analysis of acute diarrhea in children and inspection of pathogenic bacterium, viruses and other microorganisms

    Institute of Scientific and Technical Information of China (English)

    Li Hu; Yan Wang

    2016-01-01

    Objective:To investigate of epidemiological analysis of acute diarrhea in children, and to discuss the inspection of pathogenic bacterium, viruses and other microorganisms, in order to provide theoretical basis for the prevention and treatment of the disease.Methods: Five hundred and sixty-two cases of children with acute diarrhea treated in our center were selected as the research subjects, whose epidemiological data were analyzed. The fecal samples were collected for bacterial culture and identification, and the distribution characteristics of pathogenic bacteria were collected, then their relative characteristics were analyzed.Results:Children with acute diarrhea were more common in men aged 1-2 years old,and the incidence of time was more concentrated in June-August. There were four hundred and eighty-nine strains in the five hundred and sixty-two cases of children, among which the rate of viruses was the most, and the human rotavirus accounted for 30.67%, and the Shigella bacterium accounted for 20.65% in the total microorganisms, which was the highest detection rate of pathogenic bacterium. Rotavirus infection occured mainly in Winter, but the bacterial and goblet viral diarrhea was prevalent in summer.Conclusions:Children with acute diarrhea were more common in men aged 1-2 years old , and the rate of viruses in the detection of microorganisms is the highest, so targeted treatment should be taken according to the type of infection.

  3. Microscopic colitis as a missed cause of chronic diarrhea

    Institute of Scientific and Technical Information of China (English)

    Nooroudien Mohamed; Monique Marais; Juanita Bezuidenhout

    2011-01-01

    AIM: To determine the prevalence of increased in-traepithelial lymphocytes, using immunohistochemistry in patients with normal colonoscopy and near normal biopsy. METHODS: We retrospectively reviewed all non-malig-nant colon mucosal biopsies between 2005 and 2007, reported as normal, chronic inflammation or melanosis coli in patients who were undergoing routine colonos-copy. Immunohistochemistry using CD3 was performed on all mucosal biopsies and an intraepithelial lympho-cyte count (IEL) was determined. Cases with an IEL count of ≥ 20 IELs per 100 surface epithelial cells were correlated with demographic, clinical and follow-up data. A further subgroup was evaluated for lymphocytic colitis.RESULTS: Twenty (8.3%) of 241 cases revealed an IEL count ≥ 20. Six (2.5%) patients were identified as having lymphocytic colitis (P < 0.001), of whom, five were missed on initial evaluation (P = 0.01). Four of these five patients were labeled with diarrhea-predom-inant irritable bowel syndrome (IBS). On follow-up, three of the remaining 20 cases were diagnosed with malignancy (renal cell carcinoma and myelodysplastic syndrome) and one had an unknown primary tumor with multiple liver metastases. Two cases of collag-enous colitis with an IEL count < 10 were included in this study. Increased IELs were not confined to pa-tients with diarrhea as a primary presenting symptom, but were also present in patients with abdominal pain (n = 7), constipation (n = 3) and loss of weight (n = 1). CONCLUSION: Immunohistochemistry using CD3 is of value in identifying and quantifying IELs for the pres-ence of microscopic colitis in patients with diarrhea-predominant IBS.

  4. [Frequent causes of diarrhea: celiac disease and lactose intolerance].

    Science.gov (United States)

    Jankowiak, Carsten; Ludwig, Diether

    2008-06-15

    Celiac disease and lactose intolerance are both relatively frequent diseases with symptoms occurring after ingestion of certain food components. In celiac disease wheat gluten and related proteins of other cereals induce an inflammatory disease of the small intestine in predisposed individuals, leading to gastrointestinal and extraintestinal symptoms. Moreover, there is an association with many other diseases and besides classic symptoms (diarrhea, weight loss, malabsorption) atypical courses with less or lacking gastrointestinal symptoms exist. The prevalence is about 1 : 100 (Europe, USA) and higher than supposed earlier. Diagnostic criteria include serologic tests (tissue transglutaminase antibody, endomysial antibody) and characteristic small bowel histology (lymphocytic infiltration, villous atrophy). Therapy is a strict and lifelong gluten-free diet. Rarely, refractory disease or lack of compliance are associated with increased risk of malignancy and worse prognosis. Lactose intolerance is attributed to low intestinal lactase levels, due to reduced genetic expression or mucosal injury and consequent intolerance to dairy products. The frequency is varying in different ethnic groups, occurring in 10-15% of Northern European people. Intensity of clinical symptoms (diarrhea, abdominal pain, bloating) depends on the amount of ingested lactose and individual activity of intestinal lactase. The capacity of lactose malabsorption can be measured using the noninvasive lactose breath hydrogen test. The treatment is based on a reduced dietary lactose intake or in case of secondary form treatment of the underlying disease.

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

    Science.gov (United States)

    Strand, Tor A; Sharma, Pushpa R; Gjessing, Håkon K; Ulak, Manjeswori; Chandyo, Ram K; Adhikari, Ramesh K; Sommerfelt, Halvor

    2012-01-01

    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. 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. 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. 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.

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

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    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.

  7. 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

  8. Campylobacter enteritis in adult patients with acute diarrhea from 2005 to 2009 in Beijing, China

    Institute of Scientific and Technical Information of China (English)

    CHEN Jie; SUN Xin-ting; ZENG Zheng; YU Yan-yan

    2011-01-01

    Background There has been a marked global increase in the incidence of human Campylobacter enteritis in recent years. This study investigated the epidemiological and clinical features of Campylobacter enteritis in adult patients suffering from acute diarrhea.Methods This was a retrospective review of Campylobacter enteritis in adult patients with acute diarrhea presenting at Beijing University First Hospital, Beijing, China, in the summer and autumn (April to October) of 2005 to 2009. The data collected included the species of campylobacter identified, and the age, gender, clinical manifestations and results of laboratory test on stool samples collected from the patients. Campylobacter sensitivity tests to various antimicrobial agents were conducted on 80 specimens. Chi-square tests were applied using SPSS13.0 software and a two-sided P value of <0.05 was considered statistically significant.Results Campylobacter spp. isolated from the stool specimens of 142 patients with diarrhea represented 14.9% of all the cases examined. C. jejuni was identified in 127 patients (89.4%) and C. coli in 15 others (10.6%). The infection incidence was highest in the age range of 21-30 years which comprised 21.7% of the total cases examined. Most cases of diarrhea (46 patients) occurred in June. Watery diarrhea (97.2%), abdominal pain (72.5%) and fever (64.8%) were the most common manifestations of enteric campylobacteriosis. Only four patients (2.8%) had bloody diarrhea. The antimicrobial resistance rates were: cefoperazone (100%), levofloxacin (61.3%), gentamicin (12.5%), erythromycin (6.3%), and azithromycin (2.5%).Conclusions Campylobacter was prevalent among adults with acute diarrhea from 2005 to 2009 in Beijing, China. The large number of those afflicted by the disease warrants the commission of a large multicenter study to determine the extent of enteric campylobacteriosis in this region.

  9. Causes of childhood diarrhea as perceived by mothers in the Punjab, Pakistan

    DEFF Research Database (Denmark)

    Nielsen, Melanie; Hoogvorst, Anneke; Konradsen, Flemming

    2003-01-01

    This study was carried out in the southern Punjab, Pakistan, to outline the causes of childhood diarrhea as perceived by mothers. Two hundred households in ten villages were randomly selected. Information was obtained from mothers, through a questionnaire, in-depth interviews, and direct...... observations. The focus was on obtaining information from mothers of children who were below five years of age. Causes of diarrhea reported by mothers were categorized in seven different domains. Causes relating to the digestive system, especially consumption of too much food, were the most important, followed...... by causes pertaining to contamination and those pertaining to the humoral theory of 'hot' and 'cold'. The mothers' health status was perceived as determining the health of her child through her breast milk. Through in-depth interviews, diarrhea as a symptom of envy and malice was brought up. The study draws...

  10. Causes of childhood diarrhea as perceived by mothers in the Punjab, Pakistan

    DEFF Research Database (Denmark)

    Nielsen, Melanie; Hoogvorst, Anneke; Konradsen, Flemming

    2003-01-01

    This study was carried out in the southern Punjab, Pakistan, to outline the causes of childhood diarrhea as perceived by mothers. Two hundred households in ten villages were randomly selected. Information was obtained from mothers, through a questionnaire, in-depth interviews, and direct observat......This study was carried out in the southern Punjab, Pakistan, to outline the causes of childhood diarrhea as perceived by mothers. Two hundred households in ten villages were randomly selected. Information was obtained from mothers, through a questionnaire, in-depth interviews, and direct...... observations. The focus was on obtaining information from mothers of children who were below five years of age. Causes of diarrhea reported by mothers were categorized in seven different domains. Causes relating to the digestive system, especially consumption of too much food, were the most important, followed...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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...

  13. Incidence of Acute Diarrhea Among Children Aged 0 - 1 Year in Southern Brazil, 2012

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    Nascimento

    2015-09-01

    Full Text Available Background The incidence rate of acute diarrheal disease in children is a health indicator, and the estimation of these data can help guide public health policies. Objectives The aim of this study was to estimate the incidence and risk factors for acute diarrheal disease in children aged 0 - 1 year. Patients and Methods An observational prospective cohort study was conducted on 210 children recruited at Hospital Nossa Senhora da Conceicao, in Tubarao, state of Santa Catarina, Brazil. Children born between July and September 2012 were followed up for 12 months. The presence of three or more liquid or loose stools during a 24-hour period was considered acute diarrhea. The categories of variables evaluated were comprised of sociodemographic characteristics (per capita income, maternal education, maternal age, access to medical care [public or private], and housing and living conditions [sanitation and hygiene, water supply, daycare attendance, and domestic animal] and characteristics of the child (gender, birth weight, and breastfeeding. Results The incidence of acute diarrhea among the 0 - 1-year-old children was 26.7 cases per 1,000 children per month. Independent risk factors for the occurrence of diarrhea were maternal age under 20 years and health care services provided by the Brazilian National Health System (SUS. Conclusions The high incidence density of diarrhea among the children recruited in this study indicates the need for educational programs directed at people who are involved in this issue.

  14. Bacterial enteric pathogens and serum interleukin-6 levels in children with acute diarrhea

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    Herlina Herlina

    2016-07-01

    Conclusion Serum IL-6 levels are significantly more elevated in children with acute diarrhea and bacterial enteric pathogens. Therefore, serum IL-6 may be a useful marker for early identification of bacterial gastroenteritis in children aged 1-5 years. [Paediatr Indones. 2016;56:144-8.].

  15. Dimorphic Fungal Coinfection as a Cause of Chronic Diarrhea and Pancolitis

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    Eduar A. Bravo

    2011-01-01

    Full Text Available Histoplasma capsulatum and Paracoccidioides brasiliensis are dimorphic fungi that cause systemic mycosis mostly in tropical South America and some areas of North America. Gastrointestinal involvement is not uncommon among these fungal diseases, but coinfection has not previously been reported. We report a patient with chronic diarrhea and pancolitis caused by paracoccidioidomycosis and histoplasmosis.

  16. Dimorphic fungal coinfection as a cause of chronic diarrhea and pancolitis.

    Science.gov (United States)

    Bravo, Eduar A; Zegarra, Arturo J; Piscoya, Alejandro; Pinto, José L; de Los Rios, Raúl E; Prochazka, Ricardo A; Huerta-Mercado, Jorge L; Cok, Jaime; Tagle, Martin

    2011-01-01

    Histoplasma capsulatum and Paracoccidioides brasiliensis are dimorphic fungi that cause systemic mycosis mostly in tropical South America and some areas of North America. Gastrointestinal involvement is not uncommon among these fungal diseases, but coinfection has not previously been reported. We report a patient with chronic diarrhea and pancolitis caused by paracoccidioidomycosis and histoplasmosis.

  17. 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.

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

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    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.

  19. 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.

  20. 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...... to diarrhea in mink. Rotavirus is poorly described in mink, but has previously been demonstrated in feces from mink pups with and without clinical signs (Jorgensen et al. 1996). The pathogenicity of these viruses could be related to viral load, virulence and the age of the mink. Therefore, there is a need...... and diarrhea samples from a case-control study. In order to further validate the applicability of the assays, a testing scheme for normal and affected farms was set up and initiated in June 2015. This protocol will allow optimization of test characteristics (sensitivity, specificity and predictive value...

  1. The cause of infant diarrhea%婴幼儿腹泻原因的分析

    Institute of Scientific and Technical Information of China (English)

    张燕; 王伟红

    2016-01-01

    Objective to analysis the cause of infant diarrhea in our hospital .Methods 3 260 cases of inpatient and outpatient children with diarrhea were collected from January 2014 to February 2015 .The cases were divided into five groups according to the test result and clinical diagnosis :indigestion ,rotavirus infection group ,bacterial diarrhea group ,lactose intolerance groups and other reason groups .And ,there were divided into four groups according to the age ,too .Results (1)The incidence of diarrhea in boys (60 .73% ) was higher than that in girls(39 .26% ) .(2)The main causes for diarrhea in the fall is bacterial diarrhea (53 .36% );ro‐tavirus infection in the winter (45 .12% ) ,respectively .(3 ) The highest incidence of children with diarrhea is 1 -12 months (49 .85% ) ,the highest incidence with diarrhea in 1-12 months was lactose intolerance (79 .61% ) .Conclusion Infantile diarrhea is still a high incidence of disease in children and caused by rotavirus infection ,bacterial infection ,lactose intolerance .%目的:统计分析该院婴幼儿腹泻原因。方法收集住院及门诊儿科2014年1月至2015年2月腹泻患儿3260例,根据检测结果及临床诊断分为5组:消化不良组、轮状病毒感染组、细菌性腹泻组、乳糖不耐受组、其他原因组。同时根据患儿年龄分4组。结果男孩腹泻发病率(60.73%)高于女孩(39.26%);秋季细菌性腹泻占53.36%,为最主要致病原因;冬季轮状病毒感染占45.12%,为最主要致病原因;1~12个月患儿腹泻发病率高,占49.85%;乳糖不耐受致腹泻在1~12个月患儿中发病率最高(79.61%)。结论婴幼儿腹泻仍然是危害儿童健康的高发疾病,致病原因常见轮状病毒感染、细菌性感染、乳糖不耐受。

  2. Viral and Bacterial Etiology of Acute Diarrhea among Children under 5 Years of Age in Wuhan, China

    OpenAIRE

    Xu-Hui Zhu; Lei Tian; Zhong-Ju Cheng; Wei-Yong Liu; Song Li; Wei-Ting Yu; Wen-Qian Zhang; Xu Xiang; Zi-Yong Sun

    2016-01-01

    Background: Acute diarrhea remains the serious problem in developing countries, especially among children under 5 years of age. Currently, only two or three common diarrhea pathogens were screened at most hospitals in China. The aim of this study was to provide a wide variety of diarrhea pathogens and their antimicrobial resistance patterns in children under 5 years of age. Methods: Totally 381 stool samples collected from Tongji Hospital between July 1, 2014 and June 30, 2015 were tested by ...

  3. A single-tube multiplex PCR for rapid detection in feces of 10 viruses causing diarrhea.

    Science.gov (United States)

    Khamrin, Pattara; Okame, Makiko; Thongprachum, Aksara; Nantachit, Nattika; Nishimura, Shuichi; Okitsu, Shoko; Maneekarn, Niwat; Ushijima, Hiroshi

    2011-05-01

    A novel multiplex polymerase chain reaction assay was developed to identify 10 viruses in a single tube. The assay was targeted to detect group A and C rotaviruses, adenovirus, norovirus GI, norovirus GII, sapovirus, astrovirus, Aichi virus, parechovirus, and enterovirus. A total of 235 stool samples were collected from infants and children with acute gastroenteritis in Kyoto, Japan, from 2008 to 2009, then tested by this novel multiplex PCR and compared with a multiplex PCR described previously, which used 3 primer sets. The novel multiplex PCR could detect the targeted viruses in 111 of the 235 (47.2%) stool samples. Of these, 9 out of 10 types of viruses were identified, including group A rotavirus, norovirus GII, enterovirus, sapovirus, adenovirus, parechovirus, group C rotavirus, astrovirus, and norovirus GI. In contrast, the multiplex PCR that used 3 sets of primers could detect the targeted viruses in 109 of the 235 (46.4%) stool samples. Among these, 8 types of viruses were identified, including group A rotavirus, norovirus GII, enterovirus, adenovirus, parechovirus, group C rotavirus, sapovirus, and astrovirus. The results suggested that the new multiplex PCR is useful as a rapid and cost effective diagnostic tool for the detection of major pathogenic viruses causing diarrhea.

  4. An enzyme-linked immuno focus assay for rapid detection and enumeration, and a newborn mouse model for human non-polio enteroviruses associated with acute diarrhea.

    Science.gov (United States)

    Rao, C Durga; Reddy, Harikrishna; Naidu, Jagadish R; Raghavendra, A; Radhika, N S; Karande, Anjali

    2015-11-01

    We have recently reported significant association of non-polio enteroviruses (NPEVs) with acute and persistent diarrhea (18-21% of total diarrheal cases), and non-diarrheal Increased Frequency of Bowel Movements (IFoBM-ND) (about 29% of the NPEV infections) in children and that the NPEV-associated diarrhea was as significant as rotavirus diarrhea. However, their diarrhea-causing potential is yet to be demonstrated in an animal model system. Since the determination of virus titers by the traditional plaque assay takes 4-7 days, there is a need for development of a rapid method for virus titer determination to facilitate active clinical research on enterovirus-associated diarrhea. The goal of this study is to develop a cell-based rapid detection and enumeration method and to demonstrate the diarrhea-inducing potential of purified and characterized non-polio enteroviruses, which were isolated from diarrheic children. Here we describe generation of monoclonal and polyclonal antibodies against purified strains belonging to different serotypes, and development of an enzyme-linked immuno focus assay (ELIFA) for detection and enumeration of live NPEV particles in clinical and purified virus samples, and a newborn mouse model for NPEV diarrhea. Plaque-purified NPVEs, belonging to different serotypes, isolated from children with diarrhea, were grown in cell culture and purified by isopycnic CsCl density gradient centrifugation. By ELIFA, NPEVs could be detected and enumerated within 12h post-infection. Our results demonstrated that Coxsackievirus B1 (CVB1) and CVB5 strains, isolated from diarrheic children, induced severe diarrhea in orally-inoculated 9-12 day-old mouse pups, fulfilling Koch's postulates. The methods described here would facilitate studies on NPEV-associated gastrointestinal disease.

  5. DIARRHEA, UROSEPSIS AND HEMOLYTIC UREMIC SYNDROME CAUSED BY THE SAME HETEROPATHOGENIC ESCHERICHIA COLI STRAIN

    NARCIS (Netherlands)

    Ang, C. Wim; Bouts, Antonia H. M.; Rossen, John W. A.; Van der Kuip, Martijn; Van Heerde, Marc; Bokenkamp, Arend

    2016-01-01

    We describe an 8-month-old girl with diarrhea, urosepsis and hemolytic uremic syndrome caused by Escherichia coli. Typing of cultured E. coli strains from urine and blood revealed the presence of virulence factors from multiple pathotypes of E. coli. This case exemplifies the genome plasticity of E.

  6. Diarrhea, Urosepsis and Hemolytic Uremic Syndrome Caused by the Same Heteropathogenic Escherichia coli Strain.

    Science.gov (United States)

    Ang, C Wim; Bouts, Antonia H M; Rossen, John W A; Van der Kuip, Martijn; Van Heerde, Marc; Bökenkamp, Arend

    2016-09-01

    We describe an 8-month-old girl with diarrhea, urosepsis and hemolytic uremic syndrome caused by Escherichia coli. Typing of cultured E. coli strains from urine and blood revealed the presence of virulence factors from multiple pathotypes of E. coli. This case exemplifies the genome plasticity of E. coli and the resulting heteropathogenic strains.

  7. Maternal agency influences the prevalence of diarrhea and acute respiratory tract infections among young Indonesian children.

    Science.gov (United States)

    Agustina, Rina; Shankar, Anita V; Ayuningtyas, Azalea; Achadi, Endang L; Shankar, Anuraj H

    2015-05-01

    To examine the relationship between measures of mother's caretaking, practice and individual agency on acute diarrhea and respiratory tract infections (ARTIs) of Indonesian children. Using population-based household data from the Indonesian Demographic Health Surveys for 2002-2003 (n = 9,151 children) and 2007 (n = 9,714 children), we selected 28 indicators related to mother' caretaking, and applied principal component analysis to derive indices for access to care, practice and experience, and agency. The association between index quartiles (level 1-4) and the prevalence of diarrhea and ARTIs in the youngest child Children of mothers with higher levels (level 4) of agency were protected against both diarrhea (adjusted OR 0.68, 95 % CI 0.60-0.77) and ARTIs (adjusted OR 0.77, 95 % CI 0.66-0.91). Stratified analyses with child's age and mother's education, and tests of interaction, showed that agency had a stronger effect on diarrhea and ARTIs prevalence in children diarrhea and ARTIs in younger children. Interventions specifically designed to promote maternal autonomy and decision-making may lead to improved child health.

  8. The maximum single dose of resistant maltodextrin that does not cause diarrhea in humans.

    Science.gov (United States)

    Kishimoto, Yuka; Kanahori, Sumiko; Sakano, Katsuhisa; Ebihara, Shukuko

    2013-01-01

    The objective of the present study was to determine the maximum dose of resistant maltodextrin (Fibersol)-2, a non-viscous water-soluble dietary fiber), that does not induce transitory diarrhea. Ten healthy adult subjects (5 men and 5 women) ingested Fibersol-2 at increasing dose levels of 0.7, 0.8, 0.9, 1.0, and 1.1 g/kg body weight (bw). Each administration was separated from the previous dose by an interval of 1 wk. The highest dose level that did not cause diarrhea in any subject was regarded as the maximum non-effective level for a single dose. The results showed that no subject of either sex experienced diarrhea at dose levels of 0.7, 0.8, 0.9, or 1.0 g/kg bw. At the highest dose level of 1.1 g/kg bw, no female subject experienced diarrhea, whereas 1 male subject developed diarrhea with muddy stools 2 h after ingestion of the test substance. Consequently, the maximum non-effective level for a single dose of the resistant maltodextrin Fibersol-2 is 1.0 g/kg bw for men and >1.1 g/kg bw for women. Gastrointestinal symptoms were gurgling sounds in 4 subjects (7 events) and flatus in 5 subjects (9 events), although no association with dose level was observed. These symptoms were mild and transient and resolved without treatment.

  9. A blind, randomized comparison of racecadotril and loperamide for stopping acute diarrhea in adults

    Institute of Scientific and Technical Information of China (English)

    Hwang-Huei Wang; Ming-Jium Shieh; Kuan-Fu Liao

    2005-01-01

    AIM: Racecadotril is a specific enkephalinase inhibitor that exhibits intestinal antisecretory activity without affecting intestinal transit. Loperamide is an effective anti-diarrheal agent, but it usually induces constipation. This study is to compare the efficacy, safety, and tolerability of racecadotril versus Ioperamide in the outpatient treatment of acute diarrhea in adults.METHODS: A two-center, randomized, parallel-group,single-blind study was carried out to compare the efficacy,tolerability, and safety of racecadotril (100 mg thrics daily)and Ioperamide (2.0 mg 2 twics daily) in 62 adult patients suffering from acute diarrhea. The main efficacy criterion used was the duration of diarrhea after beginning the treatment (in hours). Other signs and symptoms were also evaluated.RESULTS: The clinical success rates for these antidiarrheal treatments were 95.7% and 92.0% for racecadotril and Ioperamide respectively. Patients on racecadotril had a median duration of diarrhea of 19.5 h compared with a median of 13 h for patients on Ioperamide.Rapid improvement in anal burn and nausea was found for each drug. However, more patients on Ioperamide suffered from reactive constipation (29.0% vs 12.9%).Itching, another adverse event was notably higher in the racecadotril group (28.6% vs 0%). With regard to other adverse events, the two medications showed similar occurrence rates and similar concomitant medication usage rates.CONCLUSION: Racecadotril and Ioperamide are rapid,equally effective treatments for acute diarrhea in adults,but Ioperamide treatment is associated with a higher incidence of treatment-related constipation.

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

    Directory of Open Access Journals (Sweden)

    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

  11. Prevalence of Iron Deficiency and Anemia among Young Children with Acute Diarrhea in Bhaktapur, Nepal

    Science.gov (United States)

    Chandyo, Ram K.; Ulak, Manjeswori; Adhikari, Ramesh K.; Sommerfelt, Halvor; Strand, Tor A.

    2015-01-01

    Iron deficiency anemia is still common in children under five years of age and may impair their growth and cognitive development. Diarrhea is the second most common reason for seeking medical care for young children in Nepal. However, neither screening programs nor effective preventive measures for anemia and iron deficiencies are in place among children with diarrhea in many developing countries. The aims of this study were to determine the prevalence of anemia and iron deficiency and explore their associations with clinical, socioeconomic, and anthropometric parameters in Nepalese children. This was a cross-sectional study based on 1232 children, six to 35 months old, with acute diarrhea participating in a zinc supplementation trial. The mean (SD) hemoglobin was 11.2 g/dL (1.2). Anemia was found in 493 children (40%); this estimate increased to 641 (52%) when we adjusted for the altitude of the study area (hemoglobin <11.3 g/dL). One in every three children had depleted iron stores and 198 (16%) of the children had both depleted iron stores and anemia, indicating iron deficiency anemia. The prevalence of anemia among children presenting with acute diarrhea was high but the degree of severity was mainly mild or moderate. Iron deficiency explained less than half of the total anemia, indicating other nutritional deficiencies inducing anemia might be common in this population. PMID:27417782

  12. [Prevention and treatment of acute diarrhea in infants].

    Science.gov (United States)

    Turck, D

    2007-11-01

    The prognosis of acute diarrhoea in infants is most often satisfactory in industrialized countries. However, it has been estimated that 10 to 15 children die every year in France from acute dehydration due to acute diarrhoea. In spite of an increasing use over the least few years, oral rehydration solutions (ORS) are used in only 70% of infants presenting with acute diarrhoea. The use of homemade ORS, plain water or fizzy drink should be strictly avoided. In case of acute diarrhoea there is no indication to stop breastfeeding or the use of infant formula for more than 4 hours. Lactose intolerance is observed in only 5-10% of infants. Lactose free formulae should only be used in infants with severe, persistent or recurrent diarrhoea. Under 3-4 months of age, infants with severe diarrhoea should receive for a period of 2-4 weeks lactose free protein hydrolysate formulae. Racecadotril is the only drug with anti-diarrheal properties, with a reduction of the stool output of 50%. Oral antibiotics should only be used in case of Shigella infection or in case of bacterial infection with severe sepsis or underlying debilitating disease. Oral Rotavirus vaccine, that is not reimbursed yet in France, has been shown to dramatically reduce the number of severe cases of diarrhoea with dehydration, and has been associated with a striking reduction of both morbidity and mortality, as well as of the number of hospitalisations during periods of epidemics.

  13. Loperamide therapy for acute diarrhea in children: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Su-Ting T Li

    2007-03-01

    Full Text Available BACKGROUND: Loperamide is widely used in adults for acute diarrhea. However, its use in children has been discouraged by the World Health Organization and the American Academy of Pediatrics owing to concerns over safety and efficacy in young children. METHODS AND FINDINGS: To assess the efficacy and adverse effects of loperamide compared with placebo for acute diarrhea in children, we reviewed Medline, EMBase, the Cochrane Central Register of Controlled Trials, and bibliographies of known clinical trials and of review articles, and we also interviewed key investigators in the field. We undertook a systematic review and meta-analysis of randomized controlled trials of children younger than 12 y of age with acute diarrhea, comparing loperamide with placebo. Included trials reported data on diarrhea duration or severity, or provided data on adverse effects. Compared with patients who received placebo, patients allocated to loperamide were less likely to continue to have diarrhea at 24 h (prevalence ratio 0.66, 95% confidence interval [CI]: 0.57 to 0.78, had a shorter duration of diarrhea by 0.8 d (95% CI: 0.7 to 0.9 d, and had a lower count of stools at 24 h (0.84, 95% CI: 0.77 to 0.92. Results were similar when random-effects summaries were estimated. Serious adverse events, defined as ileus, lethargy, or death, were reported in eight out of 927 children allocated to loperamide (0.9%, 95% CI: 0.4% to 1.7%. Serious adverse events were not reported in any of the 764 children allocated to placebo (0%, 95% CI: 0% to 0.5%. Among the children allocated to loperamide, serious adverse events were reported only among children younger than 3 y. CONCLUSIONS: In children who are younger than 3 y, malnourished, moderately or severely dehydrated, systemically ill, or have bloody diarrhea, adverse events outweigh benefits even at doses

  14. Spoiled breast milk and bad water; local understandings of diarrhea causes and prevention in rural Sierra Leone

    OpenAIRE

    McMahon, Shannon A; Asha S. George; Yumkella, Fatu; Diaz, Theresa

    2013-01-01

    Background Globally, diarrhea remains a leading killer of young children. In Sierra Leone, one in seven children die before their fifth birthday and diarrhea is a leading cause. Studies that emphasize the demand-side of health interventions -- how caregivers understand causation and prevention of diarrhea -- have been neglected in research and programming. Methods We undertook applied qualitative research including 68 in-depth interviews and 36 focus group discussions with mothers, fathers an...

  15. Microbiologic and Clinical Study of Acute Diarrhea in Children in Aswan, Egypt

    Science.gov (United States)

    1989-01-01

    other enteropathogens. Salmonella- and shigella-infected children tended to be cider (mean age 26.6 months) than other children with acute diarrhea...Aswan. Mothers of patients were not just aware of the benefits of ORT but were Lnowledgeable enough to request the-goveriment supplied-rehydration packets...and use them effectively. -others were, in fact, soc.knowledgeable about the benefits of ORT that many were unwilling to wait for their child to

  16. 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 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.

  17. Smectite in acute diarrhea in children: a double-blind placebo-controlled clinical trial.

    Science.gov (United States)

    Madkour, A A; Madina, E M; el-Azzouni, O E; Amer, M A; el-Walili, T M; Abbass, T

    1993-08-01

    Dioctahedral smectite (DS) a natural adsorbent clay capable of adsorbing viruses, bacteria, and other intestinal irritants in vitro, is claimed to possess beneficial "antidiarrheal" properties. This study tested the effect of DS on the duration of diarrhea and the frequency and amount of liquid stools. Ninety well-nourished boys, aged 3-24 months, with acute watery diarrhea and mild, moderate, or severe dehydration were included in a randomized double-blind, placebo-controlled trial. After initial rehydration, they received DS or placebo (1.5 g freshly dissolved in 50 ml of water, four times daily for 3 days) along with oral rehydration solution (ORS) and adequate feeding. The clinical characteristics of both groups were comparable on admission. Patients in the smectite group had a significantly shorter duration of diarrhea (mean +/- SD, 54 +/- 16 vs. 73 +/- 13 h) and significantly fewer stools (2.6 +/- 0.8 vs. 3 +/- 0.7 on second day; 1.9 +/- 0.7 vs. 2.4 +/- 0.7 on third day; and 11.3 +/- 3.2 vs. 13.8 +/- 3 overall). The amount of liquid stools was not significantly reduced. Weight gain at 24, 48, and 72 h and on recovery was significantly higher in the smectite group despite the comparable fluid and food intake in both groups. These results suggest a beneficial effect of DS in shortening the duration of diarrhea and reducing the frequency of liquid stools in children rehydrated with ORS.

  18. [Enterohemorrhagic Escherichia coli as the cause of diarrhea in the Czech Republic, 1965-2013].

    Science.gov (United States)

    Marejková, M; Petráš, P

    2014-09-01

    Enterohemorrhagic Escherichia coli (EHEC) is the cause of diarrhea, bloody diarrhea, and haemolytic uremic syndrome (HUS) worldwide. The role of EHEC in the etiology of HUS in the Czech Republic has recently been described, but the prevalence, characteristics, and epidemiology of EHEC causing diarrhea have not been fully known. Therefore, this study analyzed the serotypes, stx genotypes, and virulence factors in EHEC strains isolated in 1965-2013 from patients with diarrhea or bloody diarrhea and their family contacts. In addition, we characterized diagnostically relevant phenotypes of EHEC strains, their antimicrobial susceptibility, seasonal trends, and distribution by administrative region. Serogrouped E. coli isolates from patients were referred to the National Reference Laboratory (NRL) for E. coli and Shigella for the detection of Stx. Specimens of both human and non-human origin were referred to the NRL for epidemiological investigation. Serotyping was performed by conventional and molecular methods, PCR was applied to stx genotyping and identification of non-stx virulence factors, and standard methods were used for phenotypic analysis and antimicrobial susceptibility testing. The epidemiological link between the human and animal isolates was confirmed using pulsed-field gel electrophoresis (PFGE). Of 50 EHEC strains, 24 were recovered from patients with diarrhea without blood, 19 from patients with bloody diarrhea, six from family contacts, and one from an epidemiologically linked animal. EHEC cases were reported during the whole year, with peaks in May through October, most often in the Central Bohemian and Hradec Králové Regions. EHEC outbreaks occurred in three families: in one of them sheep-to-human transmission of EHEC was detected. The EHEC strains were assigned to five serotypes, with more than half of them being non-sorbitol fermenting (NSF) O157:H7/NM[fliCH7] and a third being strains O26:H11/NM[fliCH11]; serotypes O111:NM[fliCH8], O118:NM

  19. Diarrhea among children in developing countries.

    Science.gov (United States)

    Nataro, James P

    2013-01-01

    Diarrhea continues to stand among the most important causes of global morbidity and mortality in children under 5 years of age. Although the introduction of oral rehydration and other case-management strategies have reduced acute diarrhea fatalities, many of the survivors develop persistent diarrhea and/or deficiencies of growth and cognition. Thus understanding the true global burden of diarrhea requires attention to acute diarrhea as well is its sequelae. To understand the etiology of moderate to severe diarrhea among children in high mortality areas of sub-Saharan Africa and south Asia we performed a comprehensive case-control study of children under 5 years of age at seven sites. Each site employed an identical case-control study design and each utilized a uniform comprehensive set of microbiological assays to identify the likely bacterial, viral and protozoal etiologies. Results of the studies will inform diarrhea prevention and management efforts worldwide.

  20. Small Intestine Bacterial Overgrowth: An Underdiagnosed Cause of Diarrhea in Patients with Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Ivan Bustillo

    2009-09-01

    Full Text Available Dear Sir: Pancreatic cancer is currently the fourth leading cause of cancer related death in the United States, with an overall survival rate at five years of diagnosis of less than 5%. It affects more men than women, with slight preponderance for African Americans and 77% of patients are diagnosed after the age of 60 years [1]. The majority of patients with advanced pancreatic cancer report a poor quality of life, with special compromise in the areas of emotional and social functioning, presumably due to anxiety and depression [2]. Among the physical symptoms reported to affect quality of life, fatigue and pain were ranked the highest. However, we are yet to understand how other less commonly recognized symptoms such as diarrhea and weight loss affect the functioning and comfort level of these patients. Small intestine bacterial overgrowth is a frequent, yet unrecognized, cause of diarrhea in patients with advanced pancreatic cancer.

  1. Diarrhea (image)

    Science.gov (United States)

    ... drinking water contaminated with organisms like bacteria and parasites. Medications can also cause diarrhea, especially antibiotics, laxatives containing magnesium, and chemotherapy for cancer treatment.

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

    African Journals Online (AJOL)

    ANNALS

    41(Ad41), can cause acute and severe diarrhea in young children worldwide. This study was ... specimen in adenovirus infected patients showed watery diarrhea in 87% (55/63), diarrhea with mucus in ..... However, the impact of these viruses ...

  3. Clostridium difficile causing acute renal failure: Case presentation and review

    OpenAIRE

    Arrich, Jasmin; Sodeck, Gottfried H.; Sengölge, Gürkan; Konnaris, Christoforos; Müllner, Marcus; Anton N Laggner; Domanovits, Hans

    2005-01-01

    AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population. Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.

  4. The cost utility and budget impact of adjuvant racecadotril for acute diarrhea in children in Thailand.

    Science.gov (United States)

    Rautenberg, Tamlyn Anne; Zerwes, Ute

    2017-01-01

    To evaluate the cost utility and the budget impact of adjuvant racecadotril for the treatment of acute diarrhea in children in Thailand. A cost utility model has been adapted to the context of Thailand to evaluate racecadotril plus oral rehydration solution (R+ORS) versus oral rehydration solution (ORS) alone for acute diarrhea in children costs and effects (quality-adjusted life years) over a 6-day time horizon from a public health care payer's perspective in Thailand. Deterministic sensitivity analysis and budget impact analysis have been undertaken. According to the cost utility model, the intervention (R+ORS) is less costly and more effective than the comparator (ORS) for the base case with a dominant incremental cost-effectiveness ratio of -2,481,390฿ for the intervention. According to the budget impact analysis (assuming an increase of 5% market share for R+ORS over 5 years), the year-on-year reduction for diarrhea as a percentage of the total health care expenditure is -0.0027%, resulting in potential net cost savings of -35,632,482฿ over 5 years. Subject to the assumptions and limitations of the models, adjuvant racecadotril versus ORS alone is potentially cost-effective for children in Thailand and uptake could translate into savings for the Thailand public health care system.

  5. Post-prandial reactive hypoglycaemia and diarrhea caused by idiopathic accelerated gastric emptying: a case report

    Directory of Open Access Journals (Sweden)

    Balan Kottekkattu

    2011-05-01

    Full Text Available Abstract Introduction The majority of cases of post-prandial reactive hypoglycemia are considered idiopathic. Abnormalities of B-cell function and glucose regulation by insulin and glucagon have been postulated as causes but associated gastrointestinal dysfunction has not been reported. We report the first case of accelerated gastric emptying associated with post-prandial reactive hypoglycemia, abdominal bloating and diarrhea. We consider that gastric dysmotility is an important cause of this condition as treatment of the underlying abnormal gastric emptying allows effective control of symptoms. Case presentation A 20-year-old Caucasian woman presented with post-prandial fatigue, sweating, nausea, faintness and intermittent confusion, which had led to pre-syncope and syncope on occasions. She also experienced marked abdominal bloating and diarrhea over the same period. These episodes responded to oral administration of sweet drinks. Her symptoms were ameliorated by modification of her diet. Conclusion This is an original case report of the association of idiopathic accelerated gastric emptying with post-prandial reactive hypoglycemia and diarrhea. Family physicians, endocrinologists and gastroenterologists often consult patients with a constellation of post-prandial symptoms, which are considered to be idiopathic in most cases. This case indicates that gastric dysmotility might be the primary cause of these symptoms in some patients and, if found, offers a therapeutic target which in our case was successful.

  6. Comparison of zinc-probiotic combination theraphy to zinc theraphy alone in reducing the severity of acute diarrhea

    Directory of Open Access Journals (Sweden)

    Muhammad Hatta

    2011-01-01

    Full Text Available Background Although the incidence of diarrhea in Indonesia has declined in the last five years, the mortality rate in children under five years old is still high. Therefore, appropriate and comprehensive management of diarrhea is essential. There have been many studies on the role of zinc therapy and probiotic therapy in reducing the severity of acute diarrhea, but not many studies have compared the use of a combination of the two therapies to zinc therapy alone. Objective To compare the efficacy of zinc-probiotic combination therapy to zinc alone in reducing the severity of acute diarrhea. Methods We conducted a randomized, open-label, controlled trial from July 2009 to January 2010 in Adam Malik Hospital and Pirngadi Hospital , Medan. Children aged between 1 month and 5 years who met the criteria were divided into two groups. Group I recieved zinc sulphate (aged 6 months: 20mg/day combined with heat-killed Lactobacillus acidophilus (3x1010 CFU/day for 10 days. zinc sulphate at the same dosage as group I. Measurement of disease severity was based on the frequency of diarrhea (times/day and the duration of diarrhea (hours after initial drug consumption. Results Eighty subjects were enrolled, randomised, and divided equally into two groups. 40 children received zinc-probiotic in combination (group I and the remainder (group II received zinc alone. We observed significant differences in frequency of diarrhea (2.1 vs 3.1 times/day, P= 0.001, 95%CI-1.62 to -0.49, and duration of diarrhea (52.1 vs 72.6 hours, P=0.001, 95%CI-30.91 to -10.18 in the two groups. Conclusion Combination of zinc-probiotic therapy was more effective in reducing the severity of acute diarrhea than zinc therapy alone in children under five years of age. [Paediatr Indones. 2011;51:1-6].

  7. [Double-blind controlled study of the efficacy of nifuroxazide versus placebo in the treatment of acute diarrhea in adults].

    Science.gov (United States)

    Bourée, P; Chaput, J C; Krainik, F; Michel, H; Trépo, C

    1989-05-01

    In a double-blind, controlled randomized trial, 88 adult patients with acute diarrhea (more than three watery stools per day) received either 400 mg of nifuroxazide twice daily or placebo for 5 days. The mean duration of diarrhea in the nifuroxazide group was 2.09 days versus 3.26 days in the placebo group (p less than 0.004). The number of bowel movements per day diminished and mucus disappeared more quickly in patients treated by nifuroxazide than in patients of the placebo group. Nifuroxazide was well tolerated and no side effects were observed. Nifuroxazide is an effective therapy for acute diarrhea and can be prescribed from the onset of diarrhea without waiting for stool culture results which can be late or negative.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Localized, diffuse, and aggregative-adhering Escherichia coli from infants with acute diarrhea and matched-controls

    OpenAIRE

    Marcelo Magalhães; Amorim,Rosemary J. M.; Yoshifumi Takeda; Teizo Tsukamoto; Maria G. Antas; Seiki Tateno

    1992-01-01

    Of 126 infants under 2 years, enrolled in a study on the etiology of acute diarrhea in Recife, Brazil, we selected 37 from whom no recognized enteropathogens, except classic enteropathogenic Escherichia coli, were identified. For comparison, we also examined 37 matched-control infants without diarrhea seen at the same hospital setting. This paper had the purpose to determine the prevalence of localized, diffuse, and aggregative-adhering E. coli strains in both groups. Three to five fecal E. c...

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

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    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.

  11. Probiotic bacteria in prevention and treatment of diarrhea

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    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.

  12. Spoiled breast milk and bad water; local understandings of diarrhea causes and prevention in rural Sierra Leone.

    Science.gov (United States)

    McMahon, Shannon A; George, Asha S; Yumkella, Fatu; Diaz, Theresa

    2013-12-13

    Globally, diarrhea remains a leading killer of young children. In Sierra Leone, one in seven children die before their fifth birthday and diarrhea is a leading cause. Studies that emphasize the demand-side of health interventions -- how caregivers understand causation and prevention of diarrhea -- have been neglected in research and programming. We undertook applied qualitative research including 68 in-depth interviews and 36 focus group discussions with mothers, fathers and older female caretakers to examine the causes and prevention of childhood diarrhea in villages near and far from health facilities across four rural districts. Verbal consent was obtained. Respondents reported multiple, co-existing descriptions of causation including: contaminated water and difficulties accessing clean water; exposure to an unclean environment and poor food hygiene; contaminated breast milk due to sexual intercourse, overheated breast milk or bodily maternal conditions such as menstruation or pregnancy; and dietary imbalances and curses. Respondents rarely discussed the role of open defecation or the importance of handwashing with soap in preventing diarrhea. Categorizing behaviors as beneficial, harmful, non-existent or benign enables tailored programmatic recommendations. For example, respondents recognized the value of clean water and we correspondingly recommend interventions that reinforce consumption of and access to clean water. Second, respondents report denying "contaminated" breast milk to breastfeeding children. This is a harmful practice that merits attention. Third, the role of open defecation and poor hygiene in causing diarrhea is less understood and warrants introduction or clarification. Finally, the role of exposed feet or curses in causing diarrhea is relatively benign and does not necessitate programmatic attention. Further research supportive of communication and social mobilization strategies building on these findings is required to ensure that improved

  13. Acute diarrhea in HIV infected patient receiving antiretroviral therapy:is there any role of microscopic stool examination at present?

    Institute of Scientific and Technical Information of China (English)

    Beuy Joob; Viroj Wiwanitkit

    2014-01-01

    Objective:To reassess the usefulness of microscopic stool examination for theHIV infected patients with acute diarrhea.Methods:Overall100HIV-infected patients receiving standard antiretroviral therapy who visited to a primary care center(for privacy reason, the name is hereby blinded) with compliant of acute diarrhea were reviewed.In all patients, the standard microscopic stool examination was performed.Results:Of interest, from overall100 indexed cases, there is no case with determined parasite in stool samples.Conclusions:Based on our setting, it seems that there is diagnostic role of using microscopic stool examination for determining possible parasitic infestation inHIV infected patients receiving standard antiretroviral therapy who present with acute diarrhea.

  14. 浅谈小儿急性腹泻的治疗方法%Treatment of Children With Acute Diarrhea

    Institute of Scientific and Technical Information of China (English)

    王焱新

    2016-01-01

    Objective To investigate the treatment of children with acute diarrhea. Methods 35 cases of acute diarrhea in children treatedand analyzed clinical observation of treatment from June 2014 to November 2015 in our hospital. Results The group of children with acute diarrhea in 35 cases, 34 cases recovered after treatment, to chronic diarrhea in one case, the effective rate was 97.14%. Conclusion The onset timely ifnd out the reasons, effective control of infection, symptomatic treatment of acute diarrhea in children can help a speedy recovery.%目的:探讨小儿急性腹泻的治疗方法。方法选取我院2014年6月~2015年11月收治的35例急性腹泻患儿,对其治疗方法进行临床观察分析。结果本组急性腹泻患儿共35例,治疗后痊愈34例,转为慢性腹泻1例,治疗有效率为97.14%。结论及时找出患儿发病原因,对感染进行有效控制,对症治疗,有助于急性腹泻患儿尽快康复。

  15. Multiplex RT-PCR for rapid detection of viruses commonly causing diarrhea in pediatric patients.

    Science.gov (United States)

    Thongprachum, Aksara; Khamrin, Pattara; Pham, Ngan Thi Kim; Takanashi, Sayaka; Okitsu, Shoko; Shimizu, Hiroyuki; Maneekarn, Niwat; Hayakawa, Satoshi; Ushijima, Hiroshi

    2017-05-01

    Multiplex RT-PCR method using five sets of panel primers was developed for the detection of diarrheal viruses, including rotavirus A, B, and C, adenovirus, astrovirus, norovirus GI and GII, sapovirus, Aichi virus, parechovirus, enterovirus, cosavirus, bocavirus, and Saffold virus. The sensitivity of the method was evaluated and tested with 751 fecal specimens collected from Japanese children with acute diarrhea. Several kinds of viruses were detected in 528 out of 751 (70.3%) fecal specimens. Mixed-infection with different viruses in clinical specimens could also be effectively detected. The method proved to be reliable with highly sensitive and specific and useful for routine diagnosis. J. Med. Virol. 89:818-824, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. Prevalence of Clostridium spp. and Clostridium difficile in children with acute diarrhea in São Paulo city, Brazil

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    Claudia EA Ferreira

    2003-06-01

    Full Text Available Species of Clostridium are widely distributed in the environment, inhabiting both human and animal gastrointestinal tracts. Clostridium difficile is an important pathogen associated with outbreaks of pseudomembranous colitis and other intestinal disorders, such as diarrhea. In this study, the prevalence of Clostridium spp. and C. difficile, from hospitalized children with acute diarrhea, was examined. These children were admitted to 3 different hospitals for over 12 months. Eighteen (20% and 19 (21% stool specimens from children with (90 and without (91 diarrhea respectively, were positive to clostridia. Only 10 C. difficile strains were detected in 5.5% of the stool samples of children with diarrhea. None healthy children (without diarrhea harbored C. difficile. From these 10 C. difficile, 9 were considered as toxigenic and genotyped as tcdA+/tcdB+ or tcdA-/tcdB+, and 1 strain as nontoxigenic (tcdA-/tdcB-. They were detected by the citotoxicity on VERO cells and by the multiplex-polymerase chain reaction. Thirty clinical fecal extracts produced minor alterations on VERO cells. The presence of C. difficile as a probable agent of acute diarrhea is suggested in several countries, but in this study, the presence of these organisms was not significant. More studies will be necessary to evaluate the role of clostridia or C. difficile in diarrhoeal processes in children.

  17. Effect of Warming Moxibustion on Shenque Acupoint for the Treatment of Acute Diarrhea in Children with Infantile Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    张红运; 卢圣锋; 肖农

    2009-01-01

    Objective:To observe the effect of warming moxibustion on Shenque acupoint(RN8) for the treatment of acute diarrhea in children with infantile cerebral palsy(ICP).Methods:Clinical observation was performed on 60 ICP children suffering from acute diarrhea,who were randomly assigned to two groups equally.The Mox group was treated with warming moxibustion on Shenque acupoint(RN8) and the control group treated with Smecta.The efficacy was evaluated by markedly effective rate and total effective rate after a ...

  18. Clostridium difficile causing acute renal failure: Case presentation and review

    Institute of Scientific and Technical Information of China (English)

    Jasmin Arrich; Gottfried H. Sodeck; Gürkan Seng(o)lge; Christoforos Konnaris; Marcus Müllner; Anton N. Laggner; Hans Domanovits

    2005-01-01

    AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population.Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.METHODS: In this case report, we describe the course of Clostridium difficile-associated diarrhea in an 82-yearold patient developing acute renal failure. Stopping the offending agent and symptomatic therapy brought a rapid improvement of diarrhea and acute renal failure, full recovery was gained 18 d after admission. In a systematic review we looked for links between the two conditions.RESULTS: The link between Clostridium difficilr-associated diarrhea and acute renal failure in our patient was most likely volume depletion. However, in experimental studies a direct influence of Clostridium difficile toxins on renal duct cells could be shown.CONCLUSION: Rapid diagnosis, nonspecific supportive treatment and specific antibiotic treatment, especially in the elderly, may lower excess mortality Clostridium difficile-associated diarrhea and renal failure being possible complications.

  19. A cross-sectional study of acute diarrhea in Pudong, Shanghai, China: prevalence, risk factors, and healthcare-seeking practices.

    Science.gov (United States)

    Yu, J-X; Zhu, W-P; Ye, C-C; Xue, C-Y; Lai, S-J; Zhang, H-L; Zhang, Z-K; Geng, Q-B; Yang, W-Z; Sun, Q; Li, Z-J

    2017-10-01

    Diarrhea is a common cause of morbidity and mortality and the incidence of diarrhea in the world has changed little over the past four decades. To assess the prevalence of and healthcare practices for diarrhea, a cross-sectional study was conducted in Pudong, Shanghai, China. In October 2014, a total of 5324 community residents were interviewed. Respondents were asked if they had experienced diarrhea (defined as ⩾3 passages of watery, loose, bloody, or mucoid stools within a 24-h period) in the previous month prior to the interview. The monthly prevalence of diarrhea was 4·1% (95% CI: 3·3-4·8), corresponding to an incidence rate of 0·54 episodes per person-year. The proportion of individuals with diarrhea who sought healthcare was 21·2% (95% CI: 13·4-29·0). Diarrhea continues to impose a considerable burden on the community and healthcare system in Pudong. Young age and travel were identified as predictors of increased diarrhea occurrence.

  20. Diarrhea - overview

    Science.gov (United States)

    ... cause of diarrhea is the stomach flu ( viral gastroenteritis ). This mild viral infection goes away on its own within a few days. Eating or drinking food or water that contains certain types of bacteria or parasites can also lead to diarrhea. This ...

  1. Sorbitol-based osmotic diarrhea: Possible causes and mechanism of prevention investigated in rats

    Institute of Scientific and Technical Information of China (English)

    Md Shahidul Islam; Ei Sakaguchi

    2006-01-01

    AIM: To study the possible causes of sorbitol (S)-based diarrhea and its mechanism of reduction by rice gruel (RG)in cecectomized rats.METHODS: S was dissolved either in distilled water or in RG (50 g/L) and ingested as a single oral dose (1.2 g/kg body mass, containing 0.5 g/L phenol red as a recovery marker) by S (control) and S + RG groups (n = 7),respectively. This dose is over the laxative dose for humans. Animals were sacrificed exactly 1 h after dose ingestion, without any access to drinking water. The whole gastro-intestinal tract was divided into seven segments and sampled to analyze the S and marker remaining in its contents.RESULTS: Gastric-emptying and intestinal transit were comparatively slower in the S + RG group. Also, the S absorption index in the 3rd and last quarter of the small intestine (24.85 ± 18.88% vs 0.0 ± 0.0% and 39.09 ± 32.75% vs 0.0 ± 0.0%, respectively, P < 0.05) was significantly higher in the S + RG group than in the control group. The S absorption index and the intestinal fluid volume are inversely related to each other.CONCLUSION: The intestinal mai-absorption of S is the main reason for S-based osmotic diarrhea. Where RG enhanced the absorption of S through passive diffusion, the degree of diarrhea was reduced in cecectomized rats.

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

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    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

  3. [Lactose intolerance in hospitalized infants with acute diarrhea due to classic enteropathogenic Escherichia coil (EPEC)].

    Science.gov (United States)

    Moreira, C R; Fagundes-Neto, U

    1997-01-01

    Three hundred and eleven hospitalized weaned infants with acute diarrhea, all under 12 months of age, were studied in order to evaluate the development of lactose intolerance and its association with age, nutritional status, birth weight, dehydration and enteropathogenic agents identified in fecal samples. After been rehydrated the infants received whole cow' milk assuring the intake of 100 kcal/kg per day. Lactose intolerance was defined according t the following criteria: 1) persistence of diarrhea associated with weight loss during 48 hours, 2) development of vomiting and/or abdominal distention associated with excretion of carbohydrate in feces and/or acids tools, 3) metabolic acidosis associated with abdominal distention at anytime of refeeding period. Lactose intolerance was detected in 52.1% (162/311) of the patients and it was significantly associated with age under 6 months (P < 0.01), birth weight under 3000 grams (P < 0.01), development of dehydration (P < 0.01) and with enteropathogenic Escherichia coli (EPEC) serotypes infection (P < 0.01).

  4. Massive Trichuris trichiura infection as a cause of chronic bloody diarrhea in a child.

    Science.gov (United States)

    Diniz-Santos, Daniel R; Jambeiro, Jamile; Mascarenhas, Ramiro R; Silva, Luciana R

    2006-02-01

    The differential diagnosis of chronic diarrhea is extensive and requires the investigation of several diseases, such as celiac disease, inflammatory bowel disease and irritable bowel syndrome. A few patients infected by Trichuris trichiura may present a chronic dysentery-like syndrome in the context of a massive infestation of the colon leading to anemia and growth retardation, but the rarity of that finding demands a high level of suspicion. Herein we report the case of an 8-year-old boy from the rural zone who had suffered diarrhea without blood or mucus for 4 years and was taken to our Service because his mother had noticed the presence of blood on the feces on the 3 previous months. The diagnosis of a massive Trichuris trichiura infestation as the cause of the process was only reached by colonoscopy. We stress that Trichuris trichiura infection can mimic other forms of inflammatory bowel disease and lead to physical growth retardation and that prolonged regimens of albendazole may be required to the effective treatment of massive infestations.

  5. Intervention analysis of introduction of rotavirus vaccine on hospital admissions rates due to acute diarrhea

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    Maria de Lourdes Teixeira Masukawa

    2014-10-01

    Full Text Available The aim of this study is to investigate the impact of rotavirus vaccine on hospitalization rates for acute diarrhea in children younger than 5 years old after the introduction of the vaccine in 2006. A descriptive analytical observational study was carried out of the hospitalization rates occurred between 2000 and 2011 in 22 Regional Health Centers of Paraná State, Brazil. The effect of the vaccine was assessed by applying the SARIMA/Box-Jenkins time series methodology of intervention analysis, which allows verifying the slopes of the series are different after the introduction of the vaccine and estimating the magnitude of these effects for children younger than five years of age, by age group, for each region center. It was verified a statistically significant reduction by center/month on hospitalization rates for children 1 year old and younger, with averages of 47% and 58%, respectively, in December 2011.

  6. [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.

  7. Comparison of zinc-probiotic combination therapy to zinc therapy alone in reducing the severity of acute diarrhea

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    Muhammad Hatta

    2011-02-01

    Full Text Available Background Although the incidence of diarrhea in Indonesia has declined in the last five years, the mortality rate in children under five years old is still high. Therefore, appropriate and comprehensive management of diarrhea is essential. There have been many studies on the role of zinc therapy and probiotic therapy in reducing the severity of acute diarrhea, but not many studies have compared the use of a combination of the two therapies to zinc therapy alone. Objective To compare the efficacy of zinc-probiotic combination therapy to zinc alone in reducing the severity of acute diarrhea. Methods We conducted a randomized, open-label, controlled trial from July 2009 to January 2010 in Adam Malik Hospital and Pirngadi Hospital, Medan. Children aged between 1 month and 5 years who met the criteria were divided into two groups. Group I received zinc sulphate (aged <6 months: 10 mg/day; aged 2:6 months: 20 mg/day combined with heat-killed Lactobacillus acidophilus (3x101O CFU/day for 10 days. Group II received only zinc sulphate at the same dosage as group I. Measurement of disease severity was based on the frequency of diarrhea (times/day and the duration of diarrhea (hours after initial drug consumption. Results Eighty subjects were enrolled, randomised, and divided equally into two groups. 40 children received zinc-probiotic in combination (group I and the remainder (group II received zinc alone. We observed significant differences in frequency of diarrhea (2.1 vs 3.1 times/day, P=0.001, 95%CI -1.62 to -0.49, and duration of diarrhea (52.1 vs. 72.6 hours, P=0.00l, 95%CI -30.91 to -10.18 in the two groups. Conclusion Combination of zinc-probiotic therapy was more effective in reducing the severity of acute diarrhea than zinc therapy alone in children under five years of age.

  8. Acute compartment syndrome caused by uncontrolled hypothyroidism.

    Science.gov (United States)

    Modi, Anar; Amin, Hari; Salzman, Matthew; Morgan, Farah

    2017-06-01

    Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures. No precipitating causes were readily identified. Further laboratory testing revealed uncontrolled hypothyroidism. Management included emergent fasciotomy and initiating thyroid hormone replacement. This case represents a rare association between acute compartment syndrome and uncontrolled hypothyroidism. We also discuss the pathogenesis of compartment syndrome in hypothyroid patients and emphasize the importance of evaluating for less common causes, particularly in setting of non-traumatic compartment syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Translating Molecular Physiology of Intestinal Transport into Pharmacologic Treatment of Diarrhea: Stimulation of Na+ Absorption

    OpenAIRE

    Singh, Varsha; Yang, Jianbo; Chen, Tiane-e; Zachos, Nick; Kovbasnjuk, Olga; Verkman, Alan; Donowitz, Mark

    2013-01-01

    Diarrheal diseases remain a leading cause of morbidity and mortality for children in developing countries while representing an important cause of morbidity worldwide. The WHO recommended low osmolarity oral rehydration solutions plus zinc save lives in patients with acute diarrhea1, but there are no approved, safe drugs which have been shown to be effective against most causes of acute diarrhea. Identification of abnormalities in electrolyte handling by the intestine in diarrhea, including i...

  10. Acute esophageal necrosis caused by alcohol abuse

    Institute of Scientific and Technical Information of China (English)

    Tetsu Endo; Juichi Sakamoto; Ken Sato; Miyako Takimoto; Koji Shimaya; Tatsuya Mikami; Akihiro Munakata; Tadashi Shimoyama; Shinsaku Fukuda

    2005-01-01

    Acute esophageal necrosis (AEN) is extremely rare and the pathogenesis of this is still unknown. We report a case of AEN caused by alcohol abuse. In our case, the main pathogenesis could be accounted for low systemic perfusion caused by severe alcoholic lactic acidosis. After the healing of AEN, balloon dilatation was effective to manage the stricture.

  11. Genetic determinants of pathogenicity of Escherichia coli isolated from children with acute diarrhea in Maputo, Mozambique.

    Science.gov (United States)

    Sumbana, Jose; Taviani, Elisa; Manjate, Alice; Paglietti, Bianca; Santona, Antonella; Colombo, Mauro M

    2015-07-04

    Diarrheagenic Escherichia coli (DEC) represents one of the leading cause of diarrhoea in developing countries. In this study a molecular approach was applied for the detection of diarrheagenic Escherichia coli (DEC) circulating in Maputo, Mozambique. All isolates were PCR tested for species-specific genes and for 11 molecular markers: stx1, stx2, eae, bfpA, lt, st, ipaH, aap, aggR CVD432 and daaE. Of the 80 E. coli isolated, 74% were potential DEC: 21% EIEC, 19% EPEC, 15% EAEC, 13% ETEC, 5% DAEC and 1% hybrids. This study revealed the complexity of the etiology of diarrhea caused by pathogenic E. coli in Mozambique, and the risk of the emergence of new pathogenic variants due to the horizontal transmission of pathogenicity factors.

  12. Epidemiological and microbiological aspects of acute bacterial diarrhea in children from Salvador, Bahia, Brazil

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    Daniel R. Diniz-Santos

    2005-02-01

    Full Text Available In the few cases of acute childhood diarrhea that require antimicrobial therapy, the correct choice of the drug depends on detailed previous knowledge of local strains. In order to establish such parameters in our city, we reviewed the results of all 260 positive stool cultures of children between 0 and 15 years of age during two years at a pediatric tertiary care facility in Salvador, Brazil. Bacterial strains had been presumptively identified by culturing in selective media and by biochemical testing, and their antimicrobial susceptibility patterns were automatically detected by the MicroScan Walkaway System. Data about patients' sex and age, monthly distribution of the cases, pathogens isolated and their antimicrobial resistance patterns were recorded. Males corresponded to 55.4% of our sample, and most of our patients (42.7% were between one and four years of age. Shigella was the commonest pathogen, being found in 141 (54.3% cultures, while Salmonella was found in 100 (38.4% cultures and Enteropathogenic E. coli in 19 (7.3%. Salmonella was the main causal agent of diarrhea in children younger than five years old, whereas Shigella was the most frequent pathogen isolated from the stools of children between five and 15 years old. The peaks of incidence correspond to the periods of school vacations. Shigella specimens presented a very high resistance rate to trimethoprim-sulfamethoxazole (90.1% and to ampicillin (22.0%, while Salmonella presented very low resistance rates to all drugs tested. These data are useful for practitioners and they reinforce the need for continuous microbiological surveillance.

  13. Acute generalized exanthematous pustulosis caused by daptomycin.

    Science.gov (United States)

    Leng, Teoh Yee; Aan, Mark Koh Jean; Chan, Michelle; Tsien, Liu Tsun

    2011-12-01

    Daptomycin, a lipopeptide antibiotic with similar action as vancomycin, is used to treat complicated skin and soft tissue infections caused by resistant Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus, penicillin-resistant streptococci, and vancomycin-resistant enterococci. Acute generalized exanthematous pustulosis (AGEP), characterized by acute onset of numerous sterile, nonfollicular pinhead sized pustules, is common secondary to drugs, in particular, antibiotics. We present the first case of AGEP following the use of daptomycin.

  14. [Enterobius vermicularis causing symptoms of acute appendicitis].

    Science.gov (United States)

    Antal, András; Kocsis, Béla

    2008-08-01

    The authors present a case of enterobiasis of the appendix. Enterobius infection is an uncommon cause of acute appendicitis. Preoperative diagnosis of pinworm infestation is almost impossible unless there is a strong clinical suspicion. Parasites may produce symptoms which resemble acute appendicitis. Careful observation of the appendix stump may lead to intraoperative diagnosis of enterobiasis. A quick diagnosis and appropriate treatment may prevent future complications.

  15. Do alcohol-based hand rubs reduce the incidence of acute diarrhea during military deployments? A prospective randomized trial.

    Science.gov (United States)

    Succo, Tiphanie; De Laval, Franck; Sicard, Sébastien; Belleoud, Didier; Marimoutou, Catherine; Mayet, Aurélie; Sagaon-Teyssier, Luis; Michel, Rémy

    Acute diarrhea remains a public health concern in armed forces deployed in tropical areas where access to water and soap is limited. This study aims to assess the effectiveness of alcohol-based hand rubs (ABHR) on incidence of diarrhea in poor hygiene conditions. A prospective randomized trial was conducted between November 2014 and January 2015 among French military troops deployed in Africa to compare a group of soldiers receiving usual hand hygiene recommendations (control group), to a group of soldiers who received ABHR in addition to usual hand hygiene recommendations (intervention group). Data on diarrhea and hygiene behaviors were collected using self-questionnaires. The incidence rate of diarrhea episodes in groups was compared. Participation rate was 59% (236/400). The proportion of individuals who used ABHR was 97% in the intervention group and 62% in the control group. The overall incidence rate of diarrheal episodes was observed to be in the region of 60 per 100 persons-month without any significant difference between groups after adjustment on confounding factors (p = 0.93). Handwashing with soap was used on average 4 times a day in the control group and twice a day in the intervention group (p = 0.93). It was the only significant protective factor for diarrhea (p soap and good quality water should be a priority on the field. Copyright © 2016. Published by Elsevier Ltd.

  16. Mutations in SPINT2 Cause a Syndromic Form of Congenital Sodium Diarrhea

    NARCIS (Netherlands)

    Heinz-Erian, Peter; Mueller, Thomas; Krabichler, Birgit; Schranz, Melanie; Becker, Christian; Rueschendorf, Franz; Nuernberg, Peter; Rossier, Bernard; Vujic, Mihailo; Booth, Ian W.; Holmberg, Christer; Wijmenga, Cisca; Grigelioniene, Giedre; Kneepkens, C. M. Frank; Rosipal, Stefan; Mistrik, Martin; Kappler, Matthias; Michaud, Laurent; Doczy, Ludwig-Christoph; Siu, Victoria Mok; Krantz, Marie; Zoller, Heinz; Utermann, Gerd; Janecke, Andreas R.

    2009-01-01

    Autosomal-recessive congenital sodium diarrhea (CSD) is characterized by perinatal onset of a persistent watery diarrhea with nonproportionally high fecal sodium excretion. Defective jejunal brush-border Na(+)/H(+) exchange has been reported in three sporadic patients, but the molecular basis of the

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

    Science.gov (United States)

    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).

  18. Forecasting non-stationary diarrhea, acute respiratory infection, and malaria time-series in Niono, Mali.

    Directory of Open Access Journals (Sweden)

    Daniel C Medina

    Full Text Available BACKGROUND: Much of the developing world, particularly sub-Saharan Africa, exhibits high levels of morbidity and mortality associated with diarrhea, acute respiratory infection, and malaria. With the increasing awareness that the aforementioned infectious diseases impose an enormous burden on developing countries, public health programs therein could benefit from parsimonious general-purpose forecasting methods to enhance infectious disease intervention. Unfortunately, these disease time-series often i suffer from non-stationarity; ii exhibit large inter-annual plus seasonal fluctuations; and, iii require disease-specific tailoring of forecasting methods. METHODOLOGY/PRINCIPAL FINDINGS: In this longitudinal retrospective (01/1996-06/2004 investigation, diarrhea, acute respiratory infection of the lower tract, and malaria consultation time-series are fitted with a general-purpose econometric method, namely the multiplicative Holt-Winters, to produce contemporaneous on-line forecasts for the district of Niono, Mali. This method accommodates seasonal, as well as inter-annual, fluctuations and produces reasonably accurate median 2- and 3-month horizon forecasts for these non-stationary time-series, i.e., 92% of the 24 time-series forecasts generated (2 forecast horizons, 3 diseases, and 4 age categories = 24 time-series forecasts have mean absolute percentage errors circa 25%. CONCLUSIONS/SIGNIFICANCE: The multiplicative Holt-Winters forecasting method: i performs well across diseases with dramatically distinct transmission modes and hence it is a strong general-purpose forecasting method candidate for non-stationary epidemiological time-series; ii obliquely captures prior non-linear interactions between climate and the aforementioned disease dynamics thus, obviating the need for more complex disease-specific climate-based parametric forecasting methods in the district of Niono; furthermore, iii readily decomposes time-series into seasonal

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

    DEFF Research Database (Denmark)

    Grenov, Benedikte

    hospitalization. Secondary outcomes included number of days with diarrhea during outpatient treatment, diarrhea incidence, diarrhea severity according to the Vesikari scale, fever, vomit, pneumonia, weight gain and nutritional recovery. All outcomes were analyzed separately for in- and outpatient treatment......-seropositive. There was no effect of probiotics on days with diarrhea during inpatient treatment (adjusted difference +0.2 days [95% CI -0.8; 1.2], p=0.69). However a reduction in days with diarrhea was found in the probiotic group during outpatient treatment (adjusted difference -2.2 days [95% CI -3.5; -0.3], p=0.......025). There was no difference between the probiotic and placebo groups with regard to diarrhea incidence and severity, vomiting, fever, pneumonia, weight gain or nutritional recovery. Fortysix patients died, with 26 patients from the probiotic group and 20 patients from the placebo group (p=0.38). Caregivers understood...

  20. Probiotic bacteria in prevention and treatment of diarrhea

    OpenAIRE

    Jasmina Havranek; Šimun Zamberlin; Iva Dolenčić Špehar; Tamara Prtilo; Milna Tudor; Dubravka Samaržija

    2009-01-01

    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 preventi...

  1. Oral Zinc Supplementation for the Treatment of Acute Diarrhea in Children: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Laura M. Lamberti

    2013-11-01

    Full Text Available Evidence supporting the impact of therapeutic zinc supplementation on the duration and severity of diarrhea among children under five is largely derived from studies conducted in South Asia. China experiences a substantial portion of the global burden of diarrhea, but the impact of zinc treatment among children under five has not been well documented by previously published systematic reviews on the topic. We therefore conducted a systematic literature review, which included an exhaustive search of the Chinese literature, in an effort to update previously published estimates of the effect of therapeutic zinc. We conducted systematic literature searches in various databases, including the China National Knowledge Infrastructure (CNKI, and abstracted relevant data from studies meeting our inclusion and exclusion criteria. We used STATA 12.0 to pool select outcomes and to generate estimates of percentage difference and relative risk comparing outcomes between zinc and control groups. We identified 89 Chinese and 15 non-Chinese studies for the review, including studies in 10 countries from all WHO geographic regions, and analyzed a total of 18,822 diarrhea cases (9469 zinc and 9353 control. None of the included Chinese studies had previously been included in published pooled effect estimates. Chinese and non-Chinese studies reported the effect of therapeutic zinc supplementation on decreased episode duration, stool output, stool frequency, hospitalization duration and proportion of episodes lasting beyond three and seven days. Pooling Chinese and non-Chinese studies yielded an overall 26% (95% CI: 20%−32% reduction in the estimated relative risk of diarrhea lasting beyond three days among zinc-treated children. Studies conducted in and outside China report reductions in morbidity as a result of oral therapeutic zinc supplementation for acute diarrhea among children under five years of age. The WHO recommendation for zinc treatment of diarrhea

  2. [A case of sustained cholestasis caused by acute A viral hepatitis in Dubin-Johnson syndrome].

    Science.gov (United States)

    Ra, Sang Ho; Sung, Se Yong; Jung, Ho Yeon; Cha, Jae Hwang; Baik, Soon Koo; Cho, Mee Yon; Kim, Moon Young

    2012-04-01

    Dubin-Johnson syndrome is a rare clinical entity. It shows intermittent symptoms such as chronic or intermittent jaundice, abdominal pain, weakness, nausea, vomiting, anorexia and diarrhea. Symptoms are precipitated or aggravated by pregnancy, alcoholism, surgical procedures and intercurrent disease. Chronic idiopathic jaundice is typical of Dubin-Johnson syndrome and its prognosis is good. We describe a case of prolonged cholestasis for more than 10 months caused by acute A viral hepatitis in a patient with Dubin-Johnson syndrome. It is a first report of cholestasis complicated by acute A viral hepatitis in a patient with Dubin-Johnson syndrome.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Cobalamin and folate status in 6 to 35 months old children presenting with acute diarrhea in Bhaktapur, Nepal.

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    Manjeswori Ulak

    Full Text Available BACKGROUND: Cobalamin and folate are essential micronutrients and are important in DNA and RNA synthesis, cell proliferation, growth, hematopoiesis, and cognitive function. However, data on cobalamin and folate status are lacking particularly from young children residing in low and middle income countries. OBJECTIVE: To measure cobalamin and folate status and identifies their predictors among 6 to 35 months old children presenting with acute diarrhea. DESIGN: This was a cross-sectional study in 823 children presenting with acute diarrhea. We measured plasma cobalamin, folate, methylmalonic acid and total homocysteine who sought treatment for acute diarrhea between June 1998 and August 2000. RESULTS: The mean (SD plasma concentrations of cobalamin, folate, total homocysteine and methylmalonic acid were 206 (124 pmol/L, 55 (32 nmol/L, 11.4 (5.6 µmol/L and 0.79 (1.2 µmol/L, respectively. The prevalence of low plasma cobalamin (10 µmol/L and elevated methylmalonic acid (>0.28 µmol/L were 73% and 52%, respectively. In the regression analyses, the plasma cobalamin concentration was positively associated with age, and introduction of animal or formula milk. CONCLUSIONS: Our study indicated that poor cobalamin status was common particularly among breastfed children. Folate deficiency was virtually none existent. Possible consequences of cobalamin deficiency in young children need to be explored.

  5. Efficacy of probiotic use in acute rotavirus diarrhea in children: A systematic review and meta-analysis

    Science.gov (United States)

    Ahmadi, Elaheh; Alizadeh-Navaei, Reza; Rezai, Mohammad Sadegh

    2015-01-01

    Background: Probiotic therapies with different strains demonstrated some beneficial effects, although some studies did not show any significant effects. This study assessed systematically the current knowledge on the effect of probiotic bacteria on duration of acute rotavirus diarrhea in children compared with control. Methods: The PubMed, Cochrane Controlled Trial Register (CCTR) and Ovid (Wolters Kluwer Health) were searched between 1980 to June 15, 2013. Randomized controlled trials including the administration of probiotics for treatment of rotavirus diarrhea in infants and children were reviewed. Results: A total number of 1244 articles were found through the aforementioned search. 203 articles were selected after the first screening of title and abstract. The intervention group included subjects who received probiotic strains and dosage in any conditions. Placebo or any similar vehicle without probiotic was used in the controlled trials. Finally, 14 articles were selected. The outcomes from each study were considered in the duration of diarrhea. Statistical analyses were performed with Stata software. The pooled estimate of efficacy of probiotics in prevention or treatment of disease yielded in all studies a mean difference of 0.41 (CI 95%: -0.56 to –0.25; p<0.001). The pooled estimate of efficacy of lactobacillus rhamnosus GG and other probiotics significantly reduced the duration of diarrhea. Among trials, the overall reduction of LGG was 0.47 (CI 95%: -0.80 to -0.14; P= 0.020). Conclusion: In conclusion, probiotics exert positive effect in reducing the duration of acute rotavirus diarrhea compared with control. PMID:26644891

  6. Epidemiological characteristics of nosocomial diarrhea caused by Clostridium difficile in a tertiary level hospital in Serbia

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    Šuljagić Vesna

    2013-01-01

    Full Text Available Introduction. Among the most important causes of diarrhea in modern hospitals is Clostridium difficile (C. difficile. A wide spectrum of diseases caused by this bacterium is now known as C. difficile associated disease (CDAD. The development of CDAD is usually preceded by the administration of antimicrobial therapy and fecal-oral infections with C. difficile. Over the last years epidemiology of CDAD has significantly changed. Recently, a hypervirulent BI/NAP1/027 strain, the cause of severe epidemics in North America and Western Europe, has been identified. Objective. The aim of this study was to identify risk factors for CDAD in patients operated on at the Military Medical Academy (MMA. Methods. The study included all patients who underwent surgery at the MMA during 2010. Nested case-control study design was used. The subjects were divided into groups of operated patients with and without CDAD. The patients were under prospective follow-up, while their data were collected using a questionnaire during a routine epidemiological control. Results. During 2010 the incidence rate of CDAD was 3.3 per 10,000 hospital days. Univariate regression analysis showed that the length of administration of one or two antibiotics, as well as concurrent administration of two antibiotics, were far more frequently observed in the patients with than in the patients without CDAD. Independent risk factor for the development of CDAD was the length of the administration of one antibiotic. Conclusion Reduction in the incidence rate of CDAD can be achieved by using reliable measures of prevention and control; the rational use of antibiotics, early diagnosis and therapy of infected patients, contact isolation of infected persons, proper disinfection, and continued education of medical and non-medical personnel.

  7. 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...

  8. Antibiotic-associated diarrhea: a refresher on causes and possible prevention with probiotics--continuing education article.

    Science.gov (United States)

    Varughese, Christy A; Vakil, Niyati H; Phillips, Kristy M

    2013-10-01

    Antibiotic-associated diarrhea (AAD) describes any unexplained diarrhea associated with the use of an antibiotic. AAD also includes infection caused by Clostridium difficile, however this organism only accounts for a small percentage of diarrhea caused by antibiotics. AAD can be caused by multiple other organisms including C perfringens, S aureus, and Candida. Some antibiotics are more likely to cause non-C difficile AAD, such as erythromycin and the penicillin class. AAD develops through the loss of normal flora and reduced colonic bacterial carbohydrate metabolism during antibiotic administration. There is an increasing interest in the use of probiotics for the prevention of AAD. There are several meta-analyses that report a relative risk reduction of AAD with the use of probiotics during antibiotic administration. Interpretation of these studies has been challenging due to the heterogeneity and size of the patient populations, unclear probiotic regimen, and unclear safety profile. Since AAD can be a reason for a patient to become non-compliant or receive incomplete treatment, clinicians should monitor for this potential adverse effect caused by antibiotics.

  9. Diarrhea (For Parents)

    Science.gov (United States)

    ... hospitalization. Another group of viruses that can cause diarrhea in children, especially during the summer months, are enteroviruses, particularly ... water, this parasite often is the culprit behind diarrhea epidemics in child-care centers and other public places. Cryptosporidiosis often ...

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

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    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.

  11. 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

  12. Mycobacterium ulcerans infection as a cause of chronic diarrhea in an AIDS patient: A case report

    Institute of Scientific and Technical Information of China (English)

    Jin-Gook Huh; Myoung-Don Oh; You-Sun Kim; Jong-Sung Lee; Tae-Yeob Jeong; Soo-Hyung Ryu; Jung-Hwan Lee; Jeong-Seop Moon; Yun-Kyung Kang; Myung-Shup Shim

    2008-01-01

    Chronic diarrhea is one of the most frequent gastro-intestinal manifestations in acquired immunodeficiency syndrome (AIDS).Protozoa and nontuberculous mycobacteria (NTM) are opportunistic pathogens that can easily infect these patients.Among the NTM,Mycobacterium avium complex (MAC) is the most frequently observed pathogen in HIV-infected patients.However,NTMs other than MAC have not been reported as a gastrointestinal pathogen as yet.We present a case of chronic diarrhea in an AIDS patient in whom Mycobacterium ulcerans and cryptosporidium co-infection is evidenced from colonic tissue.

  13. Causes of rhabdomyolysis in acute poisonings

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    Janković Snežana R.

    2013-01-01

    Full Text Available Background/Aim. Rhabdomyolysis (RM is potentially lethal syndrome, but there are no enough published data on its frequency and characteristics in acute poisonings. The aim of this study was to determine the causes and severity of RM in acute poisonings. Methods. Patients hospital charts were retrospectively screened during a one-year period in order to identify patients with RM among 656 patients treated due to acute poisonings with different agents. All the patients with RM were selected. Entrance criterion was the value of creatine kinase (CK over 250 U/L. The severity of RM was assessed according to the Poison Severity Score. The patients were divided into three groups: the first one with mild RM (CK from 250 to 1,500 U/L, the second with moderate RM (CK from 1,500 to 10,000 U/L and the third with severe RM (CK greater than 10,000 U/L. Results. RM occurred in 125 (19% of the patients with acute poisonings. It was mainly mild (61%, or moderate (36%, and only in 3% of the patients was severe RM. The incidence of RM was the highest in poisonings with opiates (41%, pesticides (38%, neuroleptics (26%, anticonvulsants (26%, ethyl alcohol (20%, and gases (19%. Psychotropic agents were the most common causes of poisoning, and consequently of RM. Fatal outcomes were registered in 32 (25.60% of all RM patients. The incidence of fatal outcomes in poisonings with mild, moderate and severe RM was 19.73%, 31.11% and 75%, respectively. Conclusion. RM syndrome occurs at a relatively high rate in acute poisonings. Although agent’s toxicity is crucial for the outcome, severe RM and its complications may significantly influence the clinical course and prognosis of poisoning. Routine analysis of CK, as a relevant marker for RM may indicate the development of RM in acute poisoning and initiate prompt therapeutic measures in preventing acute renal failure as the most frequent consequence of extensive rhabdomyolysis.

  14. Pathophysiological mechanisms of diarrhea caused by the Vibrio cholerae O1 El Tor variant: an in vivo study in mice.

    Science.gov (United States)

    Satitsri, Saravut; Pongkorpsakol, Pawin; Srimanote, Potjanee; Chatsudthipong, Varanuj; Muanprasat, Chatchai

    2016-10-02

    Cholera is caused by infection with Vibrio cholerae. This study aimed to investigate the pathophysiology of diarrhea caused by the V. cholerae O1 El Tor variant (EL), a major epidemic strain causing severe diarrhea in several regions. In the ligated ileal loop model of EL-induced diarrhea in the ICR mice, a cystic fibrosis transmembrane conductance regulator (CFTR) inhibitor and a calcium-activated chloride channel (CaCC) inhibitor similarly inhibited intestinal fluid secretion. In addition, barrier disruption and NF-κB-mediated inflammatory responses, e.g., iNOS and COX-2 expression, were observed in the infected ileal loops. Interestingly, intestinal fluid secretion and barrier disruption were suppressed by NF-κB and COX-2 inhibitors, whereas an iNOS inhibitor suppressed barrier disruption without affecting fluid secretion. Furthermore, EP2 and EP4 PGE2 receptor antagonists ameliorated the fluid secretion in the infected ileal loops. The amount of cholera toxin (CT) produced in the ileal loops by the EL was ∼2.4-fold of the classical biotype. The CT transcription inhibitor virstatin, a toll-like receptor-4 (TLR-4) antibody and a CT antibody suppressed the EL-induced intestinal fluid secretion, barrier disruption and COX-2 expression. The CT at levels detected during EL infection induced mild intestinal barrier disruption without inducing inflammatory responses in mouse intestine. Collectively, this study indicates that CT-induced intestinal barrier disruption and subsequent TLR-4-NF-κB-mediated COX-2 expression are involved in the pathogenesis of EL-induced diarrhea and represent promising novel therapeutic targets of cholera.

  15. [Effects of nifuroxazide (Ercefuryl), trimethoprim-sulfamethoxazole and bactisubtil in acute diarrhea].

    Science.gov (United States)

    Bulbulović-Telalbasić, S

    1991-01-01

    The clinical effects of Nifuroxasid (N), Trimetoprim sulphametoxasol (TS) and Bactisubtil (B) on bacillar dysentery and alimentary toxicoinfections in the patients treated at the Clinic from January 1984 to the end of December 1989 have been analysed. According to the clinical signs, patients have been divided in ten categories of light, mild and heavy forms. In total, 329 cases of bacillar dysentery and 89 cases of alimentary toxicoinfections have been analysed. The following was established: A. Bacilar dysentery: the fastest normalization of the stool was achieved with N in every clinical form (averages 2.2, 3.5 and 4.05 days). With TS the effects were slower (3.0, 3.9 and 4.4 days), but the slowest normalization was recorded with B (3.4, 4.6 and 5.4 days). However, with TS, some Shigella strains showed resistance (in 23 out of 94 antibiograms), which diminished the effects. B. Alimentary toxicoinfections were treated only with N and B, since these forms of diarrhea caused by toxigenic factors were milder. Better results were achieved with N in this case as well.

  16. Appropriate Management of Acute Diarrhea in Children Among Public and Private Providers in Gujarat, India: A Cross-Sectional Survey.

    Science.gov (United States)

    Walker, Christa L Fischer; Taneja, Sunita; LeFevre, Amnesty; Black, Robert E; Mazumder, Sarmila

    2015-05-07

    Diarrhea remains a leading cause of morbidity and mortality among children under 5 years of age in low- and middle-income countries. In 2006, the Indian government formally endorsed the World Health Organization guidelines that introduced zinc supplementation and low-osmolarity oral rehydration salts (ORS) for the treatment of diarrhea. Despite this, zinc is rarely prescribed and has not been available in the public sector in India until very recently. The Diarrhea Alleviation Through Zinc and ORS Treatment (DAZT) project was implemented in Gujarat between 2011 and 2013 to accelerate the uptake of zinc and ORS among public and private providers in 6 rural districts. As part of an external evaluation of DAZT, we interviewed 619 randomly selected facility- and community-based public and private providers 2-3 months after a 1-day training event had been completed (or, in the case of private providers, after at least 1 drug-detailing visit by a pharmaceutical representative had occurred) and supplies were in place. The purpose of the interviews was to assess providers' knowledge of appropriate treatment for diarrhea in children, reported treatment practices, and availability of drugs in stock. More than 80% of all providers interviewed reported they had received training or a drug-detailing visit on diarrheal treatment in the past 6 months. Most providers in all cadres (range, 68% to 100%) correctly described how to prepare ORS and nearly all (range, 90% to 100%) reported routinely prescribing it to treat diarrhea in children. Reported routine prescription of zinc was lower, ranging from 62% among private providers to 96% among auxiliary nurse-midwives. Among providers who reported ever not recommending zinc (n = 242), the 2 most frequently reported reasons for not doing so were not completely understanding zinc for diarrhea treatment and not having zinc in stock at the time of contact with the patient. In a multiple logistic regression analysis, recent training or

  17. Molecular biology of bovine viral diarrhea virus

    Science.gov (United States)

    Bovine viral diarrhea viruses (BVDV) are arguably the most important viral pathogen of ruminants worldwide and can cause severe economic loss. Clinical symptoms of the disease caused by BVDV range from subclinical to severe acute hemorrhagic syndrome, with the severity of disease being strain depend...

  18. Diarrhea and loss of production on Dutch dairy farms caused by the Schmallenberg virus

    NARCIS (Netherlands)

    Muskens, J.; Smolenaars, A.J.; Poel, van der W.H.M.; Mars, M.H.; Wuijckhuise, van L.; Holzhauer, M.; Weering, van H.; Kock, P.

    2012-01-01

    At the end of August and the first two weeks of September 2011 dozens of veterinary practitioners reported to GD Veekijker (Animal Health Service) several dairy herds with cows with sudden decreased milk production, watery diarrhea and sometimes fever. In the beginning these reports came from the Ea

  19. [Tropical sprue as the cause of chronic diarrhea after travel to Southeast Asia].

    Science.gov (United States)

    Kirchgatterer, A; Allinger, S; Balon, R; Tuppy, H; Knoflach, P

    1998-10-01

    A 43-year-old woman developed abdominal pain and diarrhea following a travel to Malaysia. Examinations in another hospital proved no evidence of infection, an empirical antibiotic therapy with ciprofloxacin yielded no benefit. One and a half year later, the patient was admitted to our department because of persistent diarrhea and wasting. Laboratory tests showed megaloblastic anemia, folate deficiency and steatorrhea. Stool specimens for bacterial pathogens and parasites were negative. Endoscopy and biopsy from the distal portion of the duodenum revealed broadening and shortening of the villi and an increased infiltration of the lamina propria by chronic inflammatory cells (plasma cells and lymphocytes). In conclusion, diagnosis of tropical sprue was established. The therapy comprised of tetracycline for six weeks and folic acid for six months. Subsequently, the diarrhea disappeared, the patient continuously gained weight and was free of any complaints. The complete remission following this regimen proved the suspected diagnosis. Differential diagnosis in any patient who recently returned from the tropics may be a challenge. Tropical sprue predominantly occurs during or after a longer stay in endemic areas. However, if chronic diarrhea and signs of malabsorption develop after a short journey to India, South-East Asia and parts of the Caribbean, tropical sprue has to be considered, too.

  20. Controlled, double-blind, randomized clinical trial to evaluate the impact of fruit juice consumption on the evolution of infants with acute diarrhea

    Directory of Open Access Journals (Sweden)

    Mendes Carlos

    2005-08-01

    Full Text Available Abstract In order to assess the effects of juice feedings during acute diarrhea a double-blind, randomized study was performed in 90 children, mean age of 10 ± 4.28 months. Thirty patients with acute diarrhea were fed twice-daily 15 ml/kg of Apple Juice (AJ, 30 received White Grape Juice (WGJ, and 30 were given colored and flavored water (WA as part of their age appropriate dietary intake. The duration and severity of diarrhea were the main endpoint variables of the study performed in a metabolic unit. The patients were similar among the 3 groups, had diarrhea for 50–64 hours prior to admission, and were dehydrated when admitted to the unit for study. Half of the patients in each group were well nourished and the others had mild to moderate degrees of malnutrition. Rotavirus infection was the agent causing the illness in 63% of the patients. The infants fed juice ingested 14–17% more calories than those given WA, (those receiving AJ and WGJ ingested 95 and 98 Calories/Kg/d respectively whereas those receiving WA consumed 81 cal/kg/d. The increased energy intake was not at the expense of other foods or milk formula. The mean body weight gain was greater among patients receiving WGJ (+ 50.7 gm as compared with the patients in the AJ group (+ 18.3 gm or the patients fed WA (- 0.7 gm (p = 0.08. The duration of the illness was longer in the infants fed juice as compared with those given WA (p = 0.006, the mean +/- SD duration in hours was 49.4 ± 32.6, 47.5 ± 38.9 and 26.5 ± 27.4 in patients fed AJ, WGJ and WA respectively. All patients improved while ingesting juice and none of them developed persistent diarrhea; most recovered within 50 hours of the beginning of treatment and less than one fourth had diarrhea longer than 96 hours in the unit. The fecal losses were also increased among the juice fed patients (p = 0.001; the mean ± SD fecal excretion in g/kg/h was 3.94 ± 2.35, 3.59 ± 2.35, and 2.19 ± 1.63 in AJ, WGJ and WA respectively

  1. Acute kidney injury: A rare cause

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    Satish Mendonca

    2015-01-01

    Full Text Available We present a young lady who consumed hair dye, which contained paraphenylene diamine (PPD, as a means of deliberate self-harm. This resulted in severe angio-neurotic edema for which she had to be ventilated, and thereafter developed rhabdomyolysis leading to acute kidney injury (AKI. The unusual aspect was that the patient continued to have flaccid quadriparesis and inability to regain kidney function. Renal biopsy performed 10 weeks after the dye consumption revealed severe acute tubular necrosis with myoglobin pigment casts. This suggests that PPD has a long-term effect leading to ongoing myoglobinuria, causing flaccid paralysis to persist and preventing the recovery of AKI. In such instances, timely treatment to prevent AKI in the form alkalinization of urine should be initiated promptly. Secondly, because PPD is a nondialyzable toxin, and its long-term effect necessitates its speedy removal, hemoperfusion might be helpful and is worth considering

  2. Incidence, etiology, and determinants associated with acute diarrhea among French forces deployed to Chad.

    Science.gov (United States)

    Pommier de Santi, Vincent; Nicand, Elisabeth; Lagathu, Gisèle; Michel, Rémy; Rosenmayr, Georg; Raingeval, Jean-Baptiste; Samy, Julien; Boutin, Jean-Paul; Marimoutou, Catherine

    2011-01-01

    This study assesses, for the first time, the incidence, etiology, and determinants associated with traveler's diarrhea (TD) among French forces deployed to N'Djamena, Chad. A prospective study was conducted based on physician consultation for diarrhea during a 5-month French forces mandate. Diarrhea was defined as ≥3 loose stools in a 24-hour period or ≥2 loose stools within the last 8 hours. For each diarrheic episode, an anonymous physician-administered questionnaire was completed and a stool sample collected. Samples were tested for parasites, bacteria, and enteric viruses. Global incidence rate was calculated using the mean number of soldiers based in N'Djamena (n = 1,024) over the 5-month period, as denominator. Incidence rates were also estimated for each of the eleven 2-week periods of stay. A case-crossover analysis estimated determinants associated with diarrhea. A total of 240 cases of diarrhea were notified by military physicians, resulting in a global incidence rate of 49 cases per 1,000 person-months (PM). The cumulative individual risk of developing diarrhea during the study period was 0.23. The incidence per 2-week stay began at 8.8/1,000 PM, rose to 54.4/1,000 PM after 1 month, and decreased after 2 months. Of the 240 cases reported, stool samples were obtained for 196 cases. Pathogens were identified in 40% of samples; enteric viruses were predominant (28.1%). Three determinants were associated with diarrhea by multivariate analysis: diarrhea in the close circle [OR: 3.8 (2.0-7.0)]; always eating at the military mess [OR: 0.2 (0.1-0.5)]; or staying in a temporary encampment [OR: 0.3 (0.1-0.8)]. This study found a high frequency of enteric viruses and a high risk of person-to-person transmission associated with diarrhea. Eating at the military mess or staying in a temporary encampment conferred a protective effect. In addition to food-borne disease prevention, stringent hygiene measures are required to break transmission of diarrhea during

  3. 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....

  4. Acute abdomen caused by brucellar hepatic abscess.

    Science.gov (United States)

    Ibis, Cem; Sezer, Atakan; Batman, Ali K; Baydar, Serkan; Eker, Alper; Unlu, Ercument; Kuloglu, Figen; Cakir, Bilge; Coskun, Irfan

    2007-10-01

    Brucellosis is a zoonotic infection that is transmitted from animals to humans by ingestion of infected food products, direct contact with an infected animal, or aerosol inhalation. The disease is endemic in many countries, including the Mediterranean basin, the Middle East, India, Mexico, Central and South America and, central and southwest Asia. Human brucellosis is a systemic infection with a wide clinical spectrum. Although hepatic involvement is very common during the course of chronic brucellosis, hepatic abscess is a very rare complication of Brucella infection. We present a case of hepatic abscess caused by Brucella, which resembled the clinical presentation of surgical acute abdomen.

  5. [Acute axillary eczema caused by mercury compounds].

    Science.gov (United States)

    Ippen, H

    1979-01-01

    Not every axillary dermatitis is caused by an allergy against corresponding cosmetics (deodorants or anti-perspirants). This is shown in a 24-year-old man with an acute contact dermatitis in the left axilla. Sensitization probably developed against mercury salts due to the regular use of thermometers which were kept in a disinfecting solution containing phenylmercuric borate. The patient was in two hospitals for a check up before heart surgery and temperature was regularly measured in the left axilla. In both clincis phenylmercuric borate was used for desinfection of the thermometers. The sensitivity was proofed by positive patch tests.

  6. Diarrhea in the immunocompromised patient.

    Science.gov (United States)

    Krones, Elisabeth; Högenauer, Christoph

    2012-09-01

    Diarrhea is a common problem in patients with immunocompromising conditions. The etiologic spectrum differs from patients with diarrhea who have a normal immune system. This article reviews the most important causes of diarrhea in immunocompromised patients, ranging from infectious causes to noninfectious causes of diarrhea in the setting of HIV infection as a model for other conditions of immunosuppression. It also deals with diarrhea in specific situations, eg, after hematopoietic stem cell or solid organ transplantation, diarrhea induced by immunosuppressive drugs, and diarrhea in congenital immunodeficiency syndromes.

  7. Tamoxifen-induced hypertriglyceridemia causing acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Hemant Kumar Singh

    2016-01-01

    Full Text Available Tamoxifen has both antagonistic and agonistic tissue-specific actions. It can have a paradoxical estrogenic effect on lipid metabolism resulting in elevated triglyceride and chylomicron levels. This can cause life-threatening complications like acute pancreatitis. To our knowledge, very few cases of tamoxifen-induced pancreatitis have been reported in the literature. We report a case of severe hypertriglyceridemia and acute pancreatitis following tamoxifen use. A 50-year-old diabetic lady was on tamoxifen (20mg/day hormonal therapy for breast cancer. Within 3 months of starting therapy, she developed hypertriglyceridemia and acute pancreatitis. Laboratory values include: Serum amylase 778 IU/L, total cholesterol 785 mg/dL, triglycerides 4568 mg/dL and high-density lipoproteins (HDL 12 mg/dL. Tamoxifen was substituted with letrozole and atorvastatin started. There was a prompt reversal of the adverse effects. Effects on lipid profile must be considered while initiating tamoxifen in predisposed individuals as the consequences are life threatening.

  8. Fecal microbiota transplant by push enteroscopy to treat diarrhea caused by Clostridium difficile.

    Science.gov (United States)

    Ganc, Arnaldo José; Ganc, Ricardo Leite; Reimão, Sílvia Mansur; Frisoli Junior, Alberto; Pasternak, Jacyr

    2015-01-01

    Clostridium difficile is the major etiological agent of pseudomembranous colitis and is found in up to 20% of adult inpatients. The recommended treatment is antibiotic therapy with metronidazole and/or vancomycin. However, the recurrence rate may reach up to 25% and it increases in each episode. The newest alternative to treat diarrhea due to recurrent Clostridium difficile is fecal microbiota transplantation. The procedure was performed in 12 patients, with a 6-month follow-up on 10 of them. Of the ten cases, bacterial recurrence was diagnosed in only one patient, after a course of antibiotic to treat urinary tract infection, without presenting with diarrhea. The particularity of our study, besides being an unprecedented event in South America, is the way to perform the infusion of fecal microbiota by enteroscopy.

  9. Typical enteroaggregative Escherichia coli is the most prevalent pathotype among E. coli strains causing diarrhea in Mongolian children.

    Science.gov (United States)

    Sarantuya, Jav; Nishi, Junichiro; Wakimoto, Naoko; Erdene, Shirchin; Nataro, James P; Sheikh, Jalaluddin; Iwashita, Mayumi; Manago, Kunihiro; Tokuda, Koichi; Yoshinaga, Masao; Miyata, Koichiro; Kawano, Yoshifumi

    2004-01-01

    Diarrhea remains one of the main sources of morbidity and mortality in the world, and a large proportion is caused by diarrheagenic Escherichia coli. In Mongolia, the epidemiology of diarrheagenic E. coli has not been well studied. A total of 238 E. coli strains from children with sporadic diarrhea and 278 E. coli strains from healthy children were examined by PCR for 10 virulence genes: enteropathogenic E. coli (EPEC) eae, tir, and bfpA; enterotoxigenic E. coli (ETEC) lt and st; enteroinvasive E. coli (EIEC) ipaH; enterohemorragic E. coli stx1 and stx2; and enteroaggregative E. coli (EAEC) aggR and astA. EAEC strains without AggR were identified by the HEp-2 cell adherence test. The detection of EAEC, ETEC, EPEC, and EIEC was significantly associated with diarrhea. The incidence of EAEC (15.1%), defined by either a molecular or a phenotypic assay, was higher in the diarrheal group than any other category (0 to 6.0%). The incidence of AggR-positive EAEC in the diarrheal group was significantly higher than in the control group (8.0 versus 1.4%; P = 0.0004), while that of AggR-negative EAEC was not (7.1 versus 4.3%). Nineteen AggR-positive EAEC strains harbored other EAEC virulence genes-aggA, 2 (5.5%); aafA, 4 (11.1%); agg-3a, 5 (13.8%); aap, 8 (22.2%); aatA, 11 (30.5%); capU, 9 (25.0%); pet, 6 (16.6%); and set, 3 (8.3%)-and showed 15 genotypes. EAEC may be an important pathogen of sporadic diarrhea in Mongolian children. Genetic analysis showed the heterogeneity of EAEC but illustrated the importance of the AggR regulon (denoting typical EAEC) as a marker for virulent EAEC strains.

  10. Acute meningitis caused by Cladosporium sphaerospermum.

    Science.gov (United States)

    Chen, Chi-Yu; Lu, Po-Liang; Lee, Kun-Mu; Chang, Tsung Chain; Lai, Chung-Chih; Chang, Ko; Lin, Wei-Ru; Lin, Chun-Yu; Chen, Yen-Hsu

    2013-12-01

    Phaeohyphomycosis of the central nervous system is rare but typically associated with high mortality. Treatment has not been standardized, but the combination of antifungal chemotherapy with surgical debridement is recommended. We report a 73-year-old, retired, male timber merchant with acute meningitis caused by Cladosporium sphaerospermum. The patient, who had well-controlled type 2 diabetes mellitus, presented with fever and weakness of the lower limbs. No brain abscess was apparent by cranial computed tomography. C. sphaerospermum was isolated from the cerebral spinal fluid and identified based on both morphology and DNA sequencing. He was treated with combination antifungal chemotherapy with amphotericin B and voriconazole for 28 days, followed by voriconazole monotherapy for 46 days. To date, the patient has recovered without significant sequelae. This patient represents the first reported case of cerebral phaeohyphomycosis caused by C. sphaerospermum. Moreover, the therapy was successful for totally less than 3 months of treatment duration.

  11. Etiology of Acute Diarrhea in Tunisian Children with Emphasis on Diarrheagenic Escherichia coli: Prevalence and Identification of E. coli Virulence Markers.

    Directory of Open Access Journals (Sweden)

    Imen Ben Salem-Ben Nejma

    2014-07-01

    Full Text Available Diarrheal diseases can be caused by viral, bacterial and parasitic infections. This paper provides a preliminary image of diarrhea with regards to etiology and epidemiologic factors in Tunisian children less than five years of age.Overall, 124 diarrhoeal stools were collected from patients suffering from acute diarrhea and 54 stool samples from healthy children. All stools were examined for the presence of enteric pathogens.In diarrheagenic children, 107 pathogenic bacteria were isolated (12 Salmonella spp. (9.7% and 95 diarrheagenic Escherichia coli strains (76.6%: 29 enteroaggregative E.coli (EAEC (23.4%, 15 enteroinvasive E.coli (EIEC (12.1%, 17 enteropathogenic E.coli (EPEC (13.7%, 26 enterotoxigenic E.coli (ETEC (21% and 2 enterohemoragic E.coli (EHEC (1.6%. However, in the control group, 23 pathogenic E.coli strains were isolated (42.6%: 8 EAEC (14.8%, 12 EIEC (22.2% and 3 EPEC (5.5%. Among diarrheagenic E.coli (DEC, only ETEC strains were significantly recovered from diarrheagenic children than from healthy controls (P < 0.0003. Group A rotavirus was identified in 33.9% (n=42 of diarrheagenic children and in 11.1% among the control group (n=6. Concerning norovirus, 8.9% (n=11 of the samples collected from diarrheagenic children and 9.2% (n=5 from the control group were positive. The prevalence of rotaviruses and Salmonella spp were also significantly higher in patients with diarrhea than in controls (P = 0.002 and P < 0.019, respectively. Finally, enteropathogenic parasites (Entamoeba coli and cryptosporidium Oocystes were isolated from 4.8% and 9.2% of diarrheagenic and control children, respectively.These results provide baseline data about the relative importance of different enteropathogens in Tunisian children.

  12. Acute Pancreatitis Caused By Mushroom Poisoning

    Directory of Open Access Journals (Sweden)

    Samet Karahan Research Fellow

    2016-01-01

    Full Text Available Of the more than 5000 species of mushrooms known, 100 types are toxic and approximately 10% of these toxic types can cause fatal toxicity. A type of mushroom called Amanita phalloides is responsible for 95% of toxic mushroom poisonings. In this article, we report 2 cases of mushroom poisonings caused by Lactarius volemus, known as Tirmit by the local people. The patient and his wife were admitted to the emergency room with abdominal pain, nausea, and vomiting 20 hours after consuming Lactarius volemus, an edible type of mushroom. The patients reported that they had been collecting this mushroom from the mountains and eating them for several years but had never developed any clinicopathology to date. Further examination of the patients revealed a very rare case of acute pancreatitis due to mushroom intoxication. The male patient was admitted to the intensive care unit while his wife was followed in the internal medicine service, because of her relative mild clinical symptoms. Both patients recovered without sequelae and were discharged. In this article, we aimed to emphasize that gastrointestinal symptoms are often observed in mushroom intoxications and can be confused with acute pancreatitis, thus leading to misdiagnosis of patients. Early diagnosis and appropriate treatment can improve patients’ prognosis and prevent the development of complications.

  13. Simultaneous Detection of Six Diarrhea-Causing Bacterial Pathogens with an In-House PCR-Luminex Assay

    Science.gov (United States)

    Gratz, Jean; Maro, Athanasia; Kumburu, Happy; Kibiki, Gibson; Taniuchi, Mami; Howlader, Arif Mahmud; Sobuz, Shihab U.; Haque, Rashidul; Talukder, Kaisar A.; Qureshi, Shahida; Zaidi, Anita; Haverstick, Doris M.; Houpt, Eric R.

    2012-01-01

    Diarrhea can be caused by a range of pathogens, including several bacteria. Conventional diagnostic methods, such as culture, biochemical tests, and enzyme-linked immunosorbent assay (ELISA), are laborious. We developed a 7-plex PCR-Luminex assay to simultaneously screen for several of the major diarrhea-causing bacteria directly in fecal specimens, including pathogenic Aeromonas, Campylobacter jejuni, Campylobacter coli, Salmonella, Shigella, enteroinvasive Escherichia coli (EIEC), Vibrio, and Yersinia. We included an extrinsic control to verify extraction and amplification. The assay was first validated with reference strains or isolates and exhibited a limit of detection of 103 to 105 CFU/g of stool for each pathogen as well as quantitative detection up to 109 CFU/g. A total of 205 clinical fecal specimens from individuals with diarrhea, previously cultured for enteric pathogens and tested for Campylobacter by ELISA, were evaluated. Using these predicate methods as standards, sensitivities and specificities of the PCR-Luminex assay were 89% and 94% for Aeromonas, 89% and 93% for Campylobacter, 96% and 95% for Salmonella, 94% and 94% for Shigella, 92% and 97% for Vibrio, and 100% and 100% for Yersinia, respectively. All discrepant results were further examined by singleplex real-time PCR assays targeting different gene regions, which revealed 89% (55/62 results) concordance with the PCR-Luminex assay. The fluorescent signals obtained with this approach exhibited a statistically significant correlation with the cycle threshold (CT) values from the cognate real-time PCR assays (P < 0.05). This multiplex PCR-Luminex assay enables sensitive, specific, and quantitative detection of the major bacterial causes of gastroenteritis. PMID:22075596

  14. Loperamide-Induced Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Halla Vidarsdottir

    2013-01-01

    Full Text Available Acute pancreatitis is a common disease leading to hospitalizations, most often caused by gallstones or alcohol. We present a case of a patient diagnosed with acute pancreatitis considered to be due to loperamide treatment for diarrhea.

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

    Science.gov (United States)

    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.

  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

    Science.gov (United States)

    García-Menor, Emilia; García-Marín, Fátima; Vecino-López, Raquel; Horcajo-Martínez, Gloria; de Ibarrondo Guerrica-Echevarría, María-José; Gómez-González, Pedro; Velasco-Ortega, Syra; Suárez-Almarza, Javier; Nieto-Magro, Concepción

    2016-01-01

    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 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. PMID:28229091

  17. 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

    Directory of Open Access Journals (Sweden)

    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.

  18. Use of multiplex real-time PCR for detection of common diarrhea causing protozoan parasites in Egypt.

    Science.gov (United States)

    Nazeer, John T; El Sayed Khalifa, Khalifa; von Thien, Heidrun; El-Sibaei, Mahmoud Mohamed; Abdel-Hamid, Magda Youssef; Tawfik, Ranya Ayman Samir; Tannich, Egbert

    2013-02-01

    Diarrhea is an important cause of morbidity and mortality, worldwide. Giardia intestinalis, Cryptosporidium spp., and Entamoeba histolytica are the most common diarrhea-causing parasitic protozoa. Diagnosis of these parasites is usually performed by microscopy. However, microscopy lacks sensitivity and specificity. Replacing microscopy with more sensitive and specific nucleic acid based methods is hampered by the higher costs, in particular in developing countries. Multiplexing the detection of more than one parasite in a single test by real-time polymerase chain reaction (PCR) has been found to be very effective and would decrease the cost of the test. In the present study, stool samples collected from 396 Egyptian patients complaining of diarrhea along with 202 faecal samples from healthy controls were examined microscopically by direct smear method and after concentration using formol-ethyl acetate. Frozen portions of the same samples were tested by multiplex real-time for simultaneous detection of E. histolytica, G. intestinalis, and Cryptosporidium spp. The results indicate that among diarrheal patients in Egypt G. intestinalis is the most common protozoan parasite, with prevalence rates of 30.5 and 37.1 %, depending on the method used (microscopy vs. multiplex real-time PCR). Cryptosporidium spp. was detected in 1 % of the diarrheal patients by microscopy and in 3 % by real-time PCR. While E. histolytica/dispar was detected in 10.8 % by microscopy, less than one fifth of them (2 %) were found true positive for Entamoeba dispar by real-time PCR. E. histolytica DNA was not detected in any of the diarrheal patients. In comparison with multiplex real-time PCR, microscopy exhibited many false positive and negative cases with the three parasites giving sensitivities and specificities of 100 and 91 % for E. histolytica/dispar, 57.8 and 85.5 % for G. intestinalis, and 33.3 and 100 % for Cryptosporidium spp.

  19. Tritrichomonas foetus infection, a cause of chronic diarrhea in the domestic cat.

    Science.gov (United States)

    Yao, Chaoqun; Köster, Liza S

    2015-03-19

    Tritrichomonas foetus is a very intriguing trichomonad protozoan with respect to its varied choice of residence in the different host species. It is an obligate parasite of the reproductive and the gastrointestinal tract of bovine and feline host respectively, leading to trichomonosis. Bovine trichomonosis is a sexually transmitted disease whereas feline trichomonosis is a disease with a purported fecal-oral route of spread. Further, the trichomonad is a commensal in the nasal passages, stomach, cecum and colon of swine host. Advances have been exponential in understanding the trichomonad biology and specifically feline trichomonosis since late 1990s and early 2000s when T. foetus was soundly determined to be a causative agent of chronic diarrhea in the domestic cat. It is a challenging task, even for a skilled investigator not to mention the busy clinical veterinarian, to keep up with the vast volume of information. Here we comprehensively reviewed the trichomonad biology, clinical manifestations, pathogenesis, host immunity, world map of distribution, risk factors, diagnosis and treatment. Risk factors associated with T. foetus-positive status in the domestic cat include young age, purebred, history of diarrhea, co-infections with other enteral pathogens. In addition, molecular similarity of bovine and feline isolates of T. foetus in DNA sequence was concisely discussed. The data presented serve as an information source for veterinarians, and investigators who are interested in biology of T. foetus and feline trichomonosis.

  20. Impact of norovirus/sapovirus-related diarrhea in renal transplant recipients hospitalized for diarrhea.

    Science.gov (United States)

    Roos-Weil, Damien; Ambert-Balay, Katia; Lanternier, Fanny; Mamzer-Bruneel, Marie-France; Nochy, Dominique; Pothier, Pierre; Avettand-Fenoel, Véronique; Anglicheau, Dany; Snanoudj, Renaud; Bererhi, Lynda; Thervet, Eric; Lecuit, Marc; Legendre, Christophe; Lortholary, Olivier; Zuber, Julien

    2011-07-15

    Diarrhea of unspecified cause frequently occurs after renal transplantation and is usually ascribed to mycophenolic acid toxicity. Norovirus (NoV) and sapovirus (SaV) have been sporadically reported to cause chronic diarrhea in immunocompromised patients. We undertook a retrospective study (2008-2009) to examine the clinical and epidemiologic significance of NoV and SaV infections in adult renal transplant recipients hospitalized for acute or chronic diarrhea. Ninety-six renal transplant recipients were hospitalized for diarrhea at our institution during a 16-month period, 87 of whom were included in the study, including 46 patients with chronic diarrhea. Among 41 patients with unexplained diarrhea, 20 patients were screened for NoV/SaV, 16 of whom were positive. Fifteen of them (94%) had chronic diarrhea. When compared with bacterial and parasitic infections, NoV/SaV infections were associated with a greater weight loss at the time of admission, a 8.7-fold longer duration of symptoms and a more frequent need for mycophenolic acid dosage reduction. Eighty-one percent of patients hospitalized for NoV/SaV-associated diarrhea experienced acute renal failure. Five and one patients subsequently had biopsy-diagnosed active graft rejection and oxalate nephropathy, respectively. Ten of the 14 patients who underwent a longitudinal study of NoV/SaV stool's clearance exhibited a prolonged viral shedding period with a median time of 289 days (107-581 days). Our study indicates that NoV/SaV infection causes posttransplant chronic diarrhea potentially complicated by severe kidney graft impairment.

  1. Pseudomembranous colitis presenting as acute colonic obstruction without diarrhea in a patient with gastric Burkitt lymphoma

    Institute of Scientific and Technical Information of China (English)

    Kenichi Nomura; Shigeo Horiike; Takeshi Okanoue; Masafumi Taniwaki; Kohei Fukumoto; Daisuke Shimizu; Takashi Okuda; Naohisa Yoshida; Yuri Kamitsuji; Yosuke Matsumoto; Hideyuki Konishi; Yuji Ueda

    2005-01-01

    Pseudomembranous colitis (PMC) usually manifests asfever and diarrhea in hospitalized patients treated withsystemic antibiotics. We described a case of PMC withintestinal obstruction but without diarrhea. A 60-yearold man was hospitalized for chemotherapy for the treatment of Burkitt lymphoma of the stomach. The patient became febrile and complained of crampy abdominal pain during the post-chemotherapy nadir. Plain abdominal radiography showed some intestinal gas and niveau. Because stool cytotoxin assay for clostridium difficile was positive and colon fiberscopic examination showed a pseudomembrane at the left side of the colon,and a diagnosis of PMC was made. Treatment with intracolonic vancomycin administration by colonoscopy and nasoileus tube was successful. Physicians should take into account the possibility of bowel obstruction due to PMC occurring in patients undergoing chemotherapy and perform emergency colonoscopy examination of suspected cases.

  2. Evaluating the cost utility of racecadotril for the treatment of acute watery diarrhea in children: the RAWD model

    Directory of Open Access Journals (Sweden)

    Rautenberg TA

    2012-04-01

    Full Text Available Tamlyn Anne Rautenberg1,2, Ute Zerwes1, Douglas Foerster3,4, Rick Aultman51Assessment in Medicine GmbH, Lörrach, Germany; 2Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom; 3Abbott Products Operations AG, Allschwil, Switzerland; 4University of Bielefeld, School of Public Health, Bielefeld, Germany; 5Semalytics, Arizona, United States of AmericaBackground: The safety and efficacy of racecadotril to treat acute watery diarrhea (AWD in children is well established, however its cost effectiveness for infants and children in Europe has not yet been determined.Objective: To evaluate the cost utility of racecadotril adjuvant with oral rehydration solution (ORS compared to ORS alone for the treatment of AWD in children younger than 5 years old. The analysis is performed from a United Kingdom National Health Service (NHS perspective.Methods: A decision tree model has been developed in Microsoft® Excel. The model is populated with the best available evidence. Deterministic and probabilistic sensitivity analyses (PSA have been performed. Health effects are measured as quality-adjusted life years (QALYs and the model output is cost (2011 GBP per QALY. The uncertainty in the primary outcome is explored by probabilistic analysis using 1000 iterations of a Monte Carlo simulation.Results: Deterministic analysis results in a total incremental cost of –£379 in favor of racecadotril and a total incremental QALY gain in favor of racecadotril of +0.0008. The observed cost savings with racecadotril arise from the reduction in primary care reconsultation and secondary referral. The difference in QALYs is largely attributable to the timely resolution of symptoms in the racecadotril arm. Racecadotril remains dominant when base case parameters are varied. Monte Carlo simulation and PSA confirm that racecadotril is the dominant treatment strategy and is almost certainly cost effective, under the central assumptions of the model, at a

  3. The effectiveness and safety of treatments used for acute diarrhea and acute gastroenteritis in children: protocol for a systematic review and network meta-analysis.

    Science.gov (United States)

    Florez, Ivan D; Al-Khalifah, Reem; Sierra, Javier M; Granados, Claudia M; Yepes-Nuñez, Juan J; Cuello-Garcia, Carlos; Perez-Gaxiola, Giordano; Zea, Adriana M; Hernandez, Gilma N; Veroniki, Areti-Angeliki; Guyatt, Gordon H; Thabane, Lehana

    2016-01-20

    Acute diarrhea and acute gastroenteritis (AD/AGE) are common among children in low- and middle-income countries (LMIC) and high-income countries (HIC). Supportive therapy including maintaining feeding, prevention of dehydration, and use of oral rehydration solution (ORS), is the mainstay of treatment in all children. Several additional treatments aiming to reduce the episode duration have been compared to placebo, but the differences in effectiveness among them are unknown. We will conduct a systematic review of all randomized controlled trials evaluating the use of zinc, vitamin A, probiotics, prebiotics, synbiotics, racecadotril, smectite, and fermented and lactose-free milk/formula for AD/AGE treatment in children. The primary outcomes are diarrhea duration and mortality. Secondary outcomes are diarrhea lasting 3 or 7 days, stool frequency, treatment failure, hospitalizations, and adverse events. We will search MEDLINE, Ovid EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS through Ovid, as well as grey literature resources. Two reviewers will independently screen titles and abstracts, review full texts, extract information, and assess the risk of bias (ROB) and the confidence in the estimate (with the grading of recommendations, assessment, development, and evaluation [GRADE] approach). Results will be summarized narratively and statistically. Subgroup analysis according to HIC vs. LMIC, age, nutrition status, and ROB is planned. We will perform a Bayesian network meta-analysis to combine the pooled direct and indirect treatment effect estimates for each outcome, if adequate data is available. This is the first systematic review and network meta-analysis that aims to determine the relative effectiveness of pharmacological and nutritional treatments for reducing the duration of AD/AGE in children. The results will help to reduce the uncertainty of the effectiveness of the interventions, find knowledge gaps, and

  4. [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.

  5. 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

  6. Clinical efficacy comparison of Saccharomyces boulardii and yogurt fluid in acute non-bloody diarrhea in children: a randomized, controlled, open label study.

    Science.gov (United States)

    Eren, Makbule; Dinleyici, Ener C; Vandenplas, Yvan

    2010-03-01

    The purpose of this trial is to evaluate the clinical efficacy and cost/effectiveness of Saccharomyces boulardii compared with yogurt fluid (YF) in acute non-bloody diarrhea in children. This randomized, prospective open-label clinical trial includes 55 children (36 boys, 19 girls; mean age 21.2 +/- 28.2 months). Group A (N = 28) received lyophilized S. boulardii and group B (N = 27) received YF. The duration of diarrhea was shorter with S. boulardii but the hospital stay was reduced with YF, although these differences were not significant. However, diarrhea had resolved in significantly more children on day 3 in the S. boulardii group (48.5% versus 25.5%; P yogurt treatment was cheaper than S. boulardii whereas in hospitalized patients, treatment cost was similar. In conclusion, the effect of daily freshly prepared YF was comparable to S. boulardii in the treatment of acute non-bloody diarrhea in children. The duration of diarrhea was shorter in the S. boulardii group, expressed as a significantly higher number of patients with normal stools on day 3.

  7. Clinical Efficacy Comparison of Saccharomyces boulardii and Yogurt Fluid in Acute Non-Bloody Diarrhea in Children: A Randomized, Controlled, Open Label Study

    OpenAIRE

    Makbule EREN; Dinleyici, Ener C; Vandenplas,Yvan

    2010-01-01

    The purpose of this trial is to evaluate the clinical efficacy and cost/effectiveness of Saccharomyces boulardii compared with yogurt fluid (YF) in acute non-bloody diarrhea in children. This randomized, prospective open-label clinical trial includes 55 children (36 boys, 19 girls; mean age 21.2 ± 28.2 months). Group A (N = 28) received lyophilized S. boulardii and group B (N = 27) received YF. The duration of diarrhea was shorter with S. boulardii but the hospital stay was reduced with YF, a...

  8. Multiplex-Touchdown PCR to Simultaneously Detect Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis, the Major Causes of Traveler's Diarrhea.

    Science.gov (United States)

    Shin, Ji-Hun; Lee, Sang-Eun; Kim, Tong Soo; Ma, Da-Won; Chai, Jong-Yil; Shin, Eun-Hee

    2016-10-01

    This study aimed to develop a multiplex-touchdown PCR method to simultaneously detect 3 species of protozoan parasites, i.e., Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis, the major causes of traveler's diarrhea and are resistant to standard antimicrobial treatments. The target genes included the Cryptosporidium oocyst wall protein for C. parvum, Glutamate dehydrogenase for G. lamblia, and 18S ribosomal RNA (18S rRNA) for C. cayetanensis. The sizes of the amplified fragments were 555, 188, and 400 bps, respectively. The multiplex-touchdown PCR protocol using a primer mixture simultaneously detected protozoa in human stools, and the amplified gene was detected in >1×10(3) oocysts for C. parvum, >1×10(4) cysts for G. lamblia, and >1 copy of the 18S rRNA gene for C. cayetanensis. Taken together, our protocol convincingly demonstrated the ability to simultaneously detect C. parvum, G. lamblia, and C. cayetanenesis in stool samples.

  9. 锌制剂治疗小儿急性腹泻效果观察%Effect of zinc sulfate on acute diarrhea in children

    Institute of Scientific and Technical Information of China (English)

    蒋莉; 王丽娟

    2012-01-01

      Objective To observe the clinical effect of zinc sulfate on infants with acute diarrhea and study its mechanisms. Methods This study consisted of 136 infants with acute diarrhea,who were randomly divided into treatment and control groups. Both groups received conventional therapy.Results The total effective rate of the treatment group was significantly higher than that of the control group. There were significant differences between the two groups in terms of fever,diarrhea,and hospital stay.Conclusion Zinc sulfate is effective in treating infants with acute diarrhea and preventing recurrence of the disease.%  目的探讨锌制剂治疗小儿急性腹泻的疗效。方法将136例小儿急性腹泻患儿随机分为治疗组和对照组,每组68例,均给予相同综合治疗,治疗组加用硫酸锌口服。结果治疗组在腹泻、发热,住院时间均较对照组减少,差异有显著性。结论口服锌制剂治疗小儿急性腹泻可减轻腹泻症状、缩短病程。

  10. Porcine epidemic diarrhea virus introduction into the United States: Root cause investigation.

    Science.gov (United States)

    Scott, Aaron; McCluskey, Brian; Brown-Reid, Monica; Grear, Dan; Pitcher, Paul; Ramos, Greg; Spencer, Denise; Singrey, Aaron

    2016-01-01

    Porcine epidemic diarrhea (PED) was identified in the United States in the spring of 2013, and professionals from many parts of the U.S. swine industry responded rapidly to understand and control the newly emerging disease. In less than two months, the disease had spread to more than 200 herds in thirteen states. Experts from the US Department of Agriculture (USDA) engaged in laboratory diagnostics, analytic support, epidemiology expertise, and data management to facilitate the effort. By 2014, a great deal had been learned about the disease; however, the question of how it entered the United States remained unanswered. In 2014, USDA formed an investigative group to address the question and leverage current knowledge with resources and partnerships not readily available to non-federal investigators. The group formed collaborations with other government and non-government organizations and individuals, and followed many avenues of inquiry; ultimately arriving at a small number of scenarios that describe possible mechanisms for PED introduction. For a scenario to be plausible, it had to explain: contamination of a person or product in the source country, its transit and entry to the United States, rapid dispersal across a wide geographic area, and exposure/infection of pigs. It had to be compatible with findings of swine herd investigations and research studies. Potential products had to have been imported legally during the time prior to the beginning of the epidemic, or delivered to the United States through prohibited channels. Follow-up studies were initiated to gather more evidence for the most plausible scenarios. Of the scenarios, flexible intermediate bulk containers ("feed totes") used to transport bulk feed serving as fomites for movement of PED virus provided the simplest explanation for the accumulated findings of the investigation. Copyright © 2015. Published by Elsevier B.V.

  11. Noroviruses as a Cause of Diarrhea in Immunocompromised Pediatric Hematopoietic Stem Cell and Solid Organ Transplant Recipients

    OpenAIRE

    Ye, Xunyan; Van, John N.; Munoz, Flor M.; Revell, Paula A; Kozinetz, Claudia A.; Krance, Robert A.; Atmar, Robert L.; Estes, Mary K.; Hoonmo L Koo

    2015-01-01

    Case reports describe significant norovirus gastroenteritis morbidity in immunocompromised patients. We evaluated norovirus pathogenesis in prospectively enrolled solid organ (SOT) and hematopoietic stem cell transplant (HSCT) patients with diarrhea who presented to Texas Children’s Hospital and submitted stool for enteric testing. Noroviruses were detected by real-time reverse transcription polymerase chain reaction. Clinical outcomes of norovirus diarrhea and non-norovirus diarrhea patients...

  12. 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)

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

    2017-01-01

    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. 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. 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. This study reveals the slum environment to be high risk for diarrhea due to close proximity

  13. A 3-YEAR FOLLOW-UP OF A BRAZILIAN AIDS PATIENT WITH PROTRACTED DIARRHEA CAUSED BY Enterocytozoon bieneusi

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    Patrícia BRASIL

    1998-07-01

    Full Text Available Enterocytozoon bieneusi is the most prevalent microsporidian parasite that causes gastrointestinal infection in persons with AIDS. Microsporidia are increasingly recognized as important opportunistic pathogens all over the world but in Brazil only few cases have been reported due either to the non awareness of the clinical presentation of the disease or to difficulties in the laboratory diagnosis. We report a 3-year follow-up of a Brazilian HIV-positive patient in whom microsporidial spores were detected in stools and were identified as E. bieneusi using electron microscopy and PCR. The patient presented with chronic diarrhea, CD4 T-lymphocytes count below 100/mm3 and microsporidial spores were consistently detected in stools. Albendazole was given to the patient in several occasions with transient relief of the diarrhea, which reappeared as soon as the drug was discontinued. Nevertheless, a diarrhea-free period with weight gain up to 18 Kg occurred when a combination of nucleoside and protease inhibitors was initiated as part of the antiviral treatment.Enterocytozoon bieneusi é o mais comum microsporídio agente de infecções gastrointestinais que ocorre predominantemente em pessoas com AIDS. Em todo o mundo os microsporídios são reconhecidos como importantes patógenos oportunistas, entretanto poucos casos já foram diagnosticados no Brasil, provavelmente devido ao pouco conhecimento do quadro clínico que os agentes produzem ou a dificuldades no diagnóstico laboratorial. No presente trabalho relatamos o caso de um paciente brasileiro HIV-positivo acompanhado durante 3 anos, em que foram detectados esporos de microsporídios nas fezes, identificados como Enterocytozoon bieneusi por microscopia eletrônica e PCR. O paciente apresentava diarréia crônica, contagem de linfócitos CD4 abaixo de 100/mm3 e fez uso de albendazol em diferentes ocasiões com melhora transitória da diarréia, que reaparecia logo que a droga era suspensa

  14. Analysis of factors influencing the overall effect of racecadotril on childhood acute diarrhea. Results from a real-world and post-authorization surveillance study in Venezuela

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    Jose Chacón

    2010-06-01

    Full Text Available Jose ChacónOn behalf of the Racecadotril Post-authorization Record Group; Centro Clinico Profesional Caracas, Caracas, VenezuelaAbstract: Drug efficacy might differ from clinical trial results when performed in clinical daily conditions. Therefore, it is mandatory to conduct trials about effectiveness to improve external validity. This post-authorization, open-label, noncontrolled, prospective, multicenter, observational, and naturalistic trial was designed to search for factors influencing the racecadotril overall effect on childhood acute watery diarrhea in a real-world setting of Venezuela. There were 3,873 children with acute watery diarrhea treated with racecadotril, an enkephalin breakdown blocker plus oral rehydration therapy by 97 pediatricians. Evaluations were carried out daily until emission of two consecutive formed stools or absence of watery bowel movements for 24 hours. The primary end-point was time-to-relief, defined as the time from first racecadotril dose to the last watery bowel movement time. Age, gender, nursing type, nursing status during diarrhea, diarrhea severity, and co-medication were considered as factors in the statistical analysis. The primary end-point was evaluated by factors using UNIANOVA, and post-hoc tests were done. A multiple regression analysis was carried out to identify factors affecting drug performance, racecadotril effectiveness and tolerability overall assessment was searched by physicians and patients, and inter-observer agreement was evaluated by kappa statistics. The mean time-to-relief was 18.5 ± 12.5 hours [95% confidence interval 17.9–19.0] and the diarrhea severity was the only variable with significant and independent weight on racecadotril effectiveness explaining 23% of time-to-relief variance, but even in severe diarrhea cases this time was less than 24 hours. High agreement about satisfactory perception on effectiveness and tolerability was reached among physicians and patients. In

  15. Production effects of pathogens causing bovine leukosis, bovine viral diarrhea, paratuberculosis, and neosporosis.

    Science.gov (United States)

    Tiwari, A; Vanleeuwen, J A; Dohoo, I R; Keefe, G P; Haddad, J P; Tremblay, R; Scott, H M; Whiting, T

    2007-02-01

    The primary purpose of this research was to determine associations among seropositivity for bovine leukemia virus (BLV), bovine viral diarrhea virus (BVDV), Mycobacterium avium ssp. paratuberculosis (MAP), and Neospora caninum (NC) and each of 3 outcome variables (305-d milk, fat, and protein production) in Canadian dairy cattle. Serum samples from up to 30 randomly selected cows from 342 herds on monthly milk testing were tested for antibodies against BLV (IDEXX ELISA; IDEXX Corporation, Westbrook, ME), MAP (IDEXX or Biocor ELISA; Biocor Animal Health, Inc., Omaha, NE), and NC (IDEXX or Biovet ELISA; Biovet Inc., St. Hyacinthe, Quebec, Canada). Up to 5 unvaccinated cattle over 6 mo of age were tested for virus-neutralizing antibodies to the Singer strain of type 1 BVDV. Dairy Herd Improvement records were obtained electronically for all sampled cows. Linear mixed models with herd and cow as random variables were fit, with significant restricted maximum likelihood estimates of outcome effects being obtained, while controlling for potential confounding variables. Bovine leukemia virus seropositivity was not associated with 305-d milk, 305-d fat, or 305-d protein production. Cows in BVDV-seropositive herds (at least one unvaccinated animal with a titer > or =1:64) had reductions in 305-d milk, fat, and protein of 368, 10.2, and 9.5 kg, respectively, compared with cows in BVDV-seronegative herds. Mycobacterium avium ssp. paratuberculosis seropositivity was associated with lower 305-d milk of 212 kg in 4+-lactation cows compared with MAP-seronegative 4+-lactation cows. Neospora caninum seropositivity in primiparous cows was associated with lower 305-d milk, fat, and protein of 158, 5.5, and 3.3 kg, respectively, compared with NC-seronegative primiparous cows. There were no interactions among seropositivity for any of the pathogens and their effects on any of the outcomes examined, although the low MAP seroprevalence limited this analysis. Results from this research

  16. Antibiogram of E. coli serotypes isolated from children aged under five with acute diarrhea in Bahir Dar town.

    Science.gov (United States)

    Adugna, Ayrikim; Kibret, Mulugeta; Abera, Bayeh; Nibret, Endalkachew; Adal, Melaku

    2015-06-01

    Diarrheal disease and its complications remain a major cause of morbidity and mortality in children. The prevalence and antibiogram of E. coli as causative agents of diarrhea vary from region to region, and even within countries in the same geographical area. To determine the serotype and antimicrobial susceptibility of E. coli in children under-five years of age. A cross-sectional study was conducted among 422 children with diarrhea from December 2011 to February 2012. Identification of E. coli and antimicrobial susceptibility testing were done following standard procedures. The overall isolation rate of E. coli was 48.3%. Poly 2 sero-groups, poly 3 sero-groups, poly 4 sero-groups and E. coli O157:H7 accounted for 80 (39.2%), 40 (19.6%), 25 (12.3%), and 59 (28.9%) of the isolates, respectively. Poly 2 sero-groups, constituting isolates belonging to enteropathogenic E. coli were the most commonly isolated serotypes. E. coli exhibited high levels of antimicrobial resistance to ampicillin (86.8%), tetracycline (76%) and cotrimoxazole (76%). Low levels of resistance to ciprofloxacin (6.9%) and norfloxacin (9.3%) were documented. High prevalence of diarrheagenic E. coli compounded by alarming antimicrobial resistances is a serious public health problem. Regular determination of antibiogram and public education are recommended.

  17. A randomized controlled trial of glucose versus amylase resistant starch hypo-osmolar oral rehydration solution for adult acute dehydrating diarrhea.

    Directory of Open Access Journals (Sweden)

    Balakrishnan S Ramakrishna

    Full Text Available BACKGROUND: Reduction of gross diarrhea rate in excess of that seen over time with intravenous therapy and appropriate antibiotics is not usually achieved by oral glucose-electrolyte rehydration therapy for cholera and cholera-like diarrheas. METHODOLOGY AND PRINCIPAL FINDINGS: This prospective randomized clinical trial at a tertiary referral hospital in southern India was undertaken to determine whether amylase resistant starch, substituting for glucose in hypo-osmolar oral rehydration solution, would reduce diarrhea duration and weight in adults with acute severe dehydrating diarrhea. 50 adult males with severe watery diarrhea of less than three days' duration and moderate to severe dehydration were randomized to receive hypo-osmolar ORS (HO-ORS or HO-ORS in which amylase resistant high amylose maize starch 50g/L substituted for glucose (HAMS-ORS. All remaining therapy followed standard protocol. Duration of diarrhea (ORS commencement to first formed stool in hours was significantly shorter with HAMS-ORS (median 19, IQR 10-28 compared to HO-ORS (median 42, IQR 24-50 (Bonferroni adjusted P, P(adj<0.001. Survival analysis (Kaplan-Meier showed faster recovery from diarrhea in the HAMS-ORS group (P<0.001, log rank test. Total diarrhea fecal weight in grams (median, IQR was not significantly lower in the HAMS-ORS group (2190, 1160-5635 compared to HO-ORS (5210, 2095-12190 (P(adj = 0.08. However, stool weight at 13-24 hours (280, 0-965 vs. 1360, 405-2985 and 25-48 hours (0, 0-360 vs. 1080, 55-3485 were significantly lower in HAMS-ORS compared to HO-ORS group (P(adj = 0.048 and P = 0.012, respectively. ORS intake after first 24 hours was lower in the HAMS-ORS group. Subgroup analysis of patients with culture isolates of Vibrio cholerae indicated similar significant differences between the treatment groups. CONCLUSIONS: Compared to HO-ORS, HAMS-ORS reduced diarrhea duration by 55% and significantly reduced fecal weight after the first 12 hours of ORS

  18. Incidence and cause of acute confusion in elderly patients

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    Rejeki A. Rahayu

    2002-03-01

    Full Text Available Acute confusion is a clinical syndrome in the elderly whose diagnosis is made by acute onset of disturbance of consciousness, impairment of cognition and fluctuating perception and has an underlying medical cause associated with usually serious medical illness. Acute confusion has a high morbidity and mortality, and patient need to stay longer in the hospital, have a higher risk for institutionalization and immobilization. The aim of this study is to recognize the incidence and most of medical illness, which cause acute confusion in elderly patients, a retrospective study based on medical record of elderly patients who were hospitalized in Dr Kariadi hospital since 1998 to 1999. 5407 elderly patients were hospitalized, but only 5191 were analyzed and included in this study. 35% (992 men and 846 women elderly patients had acute confusion on first arrival and 7% ( 197 men and 176 women acute confusion appears in the ward. Total acute confusion was 40.89%. The mortality rate was 29% (263 women and 381 men. Three most frequent cause of death were sepsis (10.04%; hemorrhagic stroke (5.11%; multifactor (4.16%. Top ten diseases, which cause acute confusion, were hepatic encephalopathy, hemorrhagic stroke, sepsis, moderate dehydration due to gastoenteritis, hyponatremia, acute myocardial infarction, pneumonia, urinary tract infection, congestive heart failure, and arrhythmia cordis. (Med J lndones 2002; 11: 30-35Keywords: acute confusional state, geriatric patients, hospital study

  19. The Incidence of Acute Diarrhea in Children under Five Years Old in Rasht City in 2009: The First Phase if the Effect of Using Sewerage System

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    Shahnam Arshi

    2015-02-01

    Full Text Available Background and Objective: The lack of a proper sewage collection & disposal system, the water and sewerage project, in the city of Rasht, became a priority by Guilan province Urban Water and Sewerage Company with the government partnership and World Bank financial support. The objective of this research was to complete the first phase of a two-phase study, to determine the impact of using an urban sewerage system on acute diarrhea in children under five years old, in Rasht city in the Guilan province.Materials and Methods: The study is a concurrent control before and after field trial which is carried out in two phases: before (phase I and after (phase II. Sampling for phase I was performed in the middle month of each season, November and February 2009 and May and August 2010. The incidence of acute Diarrhea was measured with the participation of 1560 mothers of children under 5 years old. This was done in two groups: the intervention group (inside the sewerage system project perimeters and the control group (outside the project perimeters. Data was collected by local female general practitioners and medical students by door-to-door interviews with mothers. Data was analyzed using the SPSS 11.5 software package. The Pearson Chi-Square was used to compare qualitative variables between groups, whilst the t-test and One-Way ANOVA was used to compare quantitative variables.Results: The average annual incidence of acute diarrhea in children under five years old was 10.4% (9.4% in the intervention group and 11.4% in the control group. The seasonal pattern of acute diarrhea incidence was 10.5% (9.3% in the intervention group and 11.7% in the control group in May, 12.5% (11.5% in the intervention group and 13.4% in the control group in August, 9.3% (8.1% in the intervention group and 10.5% in the control group in November, and 9.1% (8.5% in the intervention group and 9.8% in the control group in February respectively.Conclusion: The study showed the

  20. Acute rhabdomyolysis caused by Spirulina (Arthrospira platensis).

    Science.gov (United States)

    Mazokopakis, Elias E; Karefilakis, Christos M; Tsartsalis, Athanasios N; Milkas, Anastasios N; Ganotakis, Emmanuel S

    2008-06-01

    Rhabdomyolysis is a potentially life-threatening disorder that occurs as a primary disease or as a complication of a broad spectrum of other diseases. We report the first case of acute rhabdomyolysis after ingestion of Spirulina (Arthrospira platensis), a plantonic blue-green alga, as a dietary supplement.

  1. An uncommon cause of acute pulmonary edema.

    Science.gov (United States)

    Nepal, Santosh; Giri, Smith; Bhusal, Mohan; Siwakoti, Krishmita; Pathak, Ranjan

    2016-09-01

    Acute cardiogenic pulmonary edema secondary to catecholamine-induced cardiomyopathy is a very uncommon and fatal initial presentation of pheochromocytoma. However, with early clinical suspicion and aggressive management, the condition is reversible. This case report describes a patient who presented with hypertension, dyspnea, and cough with bloody streaks, and who recovered within 48 hours after appropriate treatment.

  2. IDIOPATHIC OMENTAL INFARCTION : A RARE CAUSE OF ACUTE PAIN ABDOMEN

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    Narendra Nath

    2015-02-01

    Full Text Available Omental torsion leading on to omental infarction is an unusual cause of acute abdominal pain in adults. Often the condition mimics common causes of acute abdomen like acute cholecystitis, acute appendicitis or acute pancreatitis. A review of literature reveals that this enigmatic condition has been managed both non - operatively and by surgery in the past. We report the case of a 46 - year - old man who presented with a 4 - day history of severe right - sided abdominal pain mimicking acute cholecystitis. Abdominal CT scan revealed a right upper quadrant mass with a whirl - like appearance, suspicious for omental infarction. He was started on conservative management with analgesics and antibiotics. He improved symptomatically and was discharged

  3. Diarréia aguda: o conhecimento materno sobre a doença reduz o número de hospitalizações nos menores de dois anos? Acute diarrhea: does mother's knowledge of the disease reduce admission of children under two years of age?

    Directory of Open Access Journals (Sweden)

    Lygia Carmen de Moraes Vanderlei

    2004-09-01

    Full Text Available OBJETIVOS: Analisar o conhecimento materno sobre as causas, sinais de desidratação e manejo da diarréia aguda e a ocorrência de hospitalização, por complicações desta doença, em seus filhos menores de dois anos. MÉTODOS: Desenho de corte transversal aninhado em estudo de caso _ controle. Casos: crianças internadas por complicações da diarréia aguda no Instituto Materno Infantil de Pernambuco. Controles: crianças com doenças ambulatoriais exceto diarréia aguda. Variáveis: internamento por diarréia aguda (dependente; condições socioeconômicas; estado nutricional das crianças; tempo de aleitamento materno; conhecimento materno sobre diarréia aguda e seu manejo. Na análise foi utilizado software Epi-info 6.0. RESULTADOS: Houve associação estatística entre internamento por diarréia aguda e condições socioeconômicas precárias (p OBJECTIVES: To analyze the relationship of mother's knowledge about signs of dehydration, causes and management of acute diarrhea with admission of children under two years of age with the disease. METHODS: A nested cross-sectional and case-control study was carried out with children who were admitted at the "Instituto Materno Infantil de Pernambuco" with acute diarrhea: and control children admitted with other diseases. Variables were: patient admission having or not acute diarrhea (dependent; social-economic condition, nutritional state; duration of breastfeeding; mother's knowledge about acute diarrhea and its management (independent. The Epi-info software, 6.0 was used for analysis. RESULTS: There was statistical association between patient admission with acute diarrhea and poor social-economic conditions (p= 0.01; malnutrition (p=0.01; short time of breastfeeding (p=0.01, lack of mother's knowledge about how to avoid dehydration (p=0.05 and effectiveness of oral rehydration solutions (p=0.02. There was no statistical association with knowledge about causes, signs of dehydration or

  4. Acute Mastoiditis Caused by Streptococcus pneumoniae.

    Science.gov (United States)

    Obringer, Emily; Chen, Judy L

    2016-05-01

    Acute mastoiditis (AM) is a relatively rare complication of acute otitis media (AOM). The most common pathogens include Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus. Pneumococcal vaccination and changes in antibiotic prescribing recommendations for AOM may change the incidence of AM in the future. Diagnosis of AM can be made based on clinical presentation, but computed tomography of the temporal bone with contrast should be considered if there is concern for complicated AM. Both extracranial and intracranial complications of AM may occur. Previously, routine cortical mastoidectomy was recommended for AM treatment, but new data suggest that a more conservative treatment approach can be considered, including intravenous (IV) antibiotics alone or IV antibiotics with myringotomy. [Pediatr Ann. 2016;45(5):e176-e179.].

  5. Utilization of health facilities and predictors of health-seeking behavior for under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia: a community-based cross-sectional study

    National Research Council Canada - National Science Library

    Metadel Adane; Bezatu Mengistie; Worku Mulat; Helmut Kloos; Girmay Medhin

    2017-01-01

    .... The purpose of this study is to assess the status of health facilities utilization and predictors for health-seeking behavior of mothers/caregivers of under-five children with acute diarrhea in slums...

  6. Short-term effect of prebiotics administration on stool characteristics and serum cytokines dynamics in very young children with acute diarrhea.

    Science.gov (United States)

    Vaisman, Nachum; Press, Josef; Leibovitz, Eugene; Boehm, Güenther; Barak, Vivian

    2010-07-01

    We investigated the effect of a mixture of long-chain fructo-oligosaccharides, galacto-oligosaccharides and acidic oligosaccharides on the number and consistency of stools and on immune system biomarkers in 104 supplemented and non-supplemented subjects (aged 9-24 months) with acute diarrhea. Interleukin-1 (IL-1), IL-1RA, IL-6, IL-8, IL-10, TNF-α and sIL-2R cytokine levels were determined. The significant decrease in number of stools and increase in stool consistency in the supplemented group was of little clinical relevance. The only significant change in pro- and anti-inflammatory cytokines was decreased TNF-α levels in the supplemented group. Prebiotic supplementation during acute diarrhea episodes did not influence the clinical course.

  7. Short-Term Effect of Prebiotics Administration on Stool Characteristics and Serum Cytokines Dynamics in Very Young Children with Acute Diarrhea

    Directory of Open Access Journals (Sweden)

    Nachum Vaisman

    2010-06-01

    Full Text Available We investigated the effect of a mixture of long-chain fructo-oligosaccharides, galacto-oligosaccharides and acidic oligosaccharides on the number and consistency of stools and on immune system biomarkers in 104 supplemented and non-supplemented subjects (aged 9–24 months with acute diarrhea. Interleukin-1 (IL-1, IL-1RA, IL-6, IL-8, IL-10, TNF-α and sIL-2R cytokine levels were determined. The significant decrease in number of stools and increase in stool consistency in the supplemented group was of little clinical relevance. The only significant change in pro- and anti-inflammatory cytokines was decreased TNF-α levels in the supplemented group. Prebiotic supplementation during acute diarrhea episodes did not influence the clinical course.

  8. Acute carpal tunnel syndrome caused by peritendinitis calcarea. Case report.

    Science.gov (United States)

    Boström, L; Svartengren, G

    1993-01-01

    Two women presented with similar symptoms of acute pain in the hand that was diagnosed as acute carpal tunnel syndrome caused by peritendinitis calcarea. Radiological examinations in both cases showed calcifications in the carpal tunnel. Both patients were operated on immediately and the median nerve was decompressed. Both were completely relieved of pain after operation and hand function returned to normal.

  9. Unusual Cause of Acute Abdomen—Ruptured Retroperitoneal Paraganglioma

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    Kwok-Kay Yau

    2008-01-01

    Full Text Available Ruptured retroperitoneal paraganglioma is a rare cause of acute abdomen. Its clinical presentation and laparoscopic features have seldom been reported in the literature. Herein, we report a case of ruptured retroperitoneal paraganglioma that presented as acute abdomen, and its subsequent management.

  10. The effectiveness of a rotavirus vaccine in preventing hospitalizations and deaths presumably due to acute infectious diarrhea in Brazilian children: a quasi-experimental study.

    Science.gov (United States)

    Teles, Estêvão; Moscovici, Leonardo; Monteiro, Rosane Aparecida; Alves, Domingos; Laprega, Milton Roberto; Bellissimo-Rodrigues, Fernando

    2015-01-01

    Rotavirus is the main etiologic agent of acute infectious diarrhea in children worldwide. Considering that a rotavirus vaccine (G1P8, strain RIX4414) was added to the Brazilian vaccination schedule in 2006, we aimed to study its effectiveness and safety regarding intestinal intussusception. A quasi-experimental trial was performed in which the primary outcome was the number of hospitalizations that were presumably due to acute infectious diarrhea per 100,000 children at risk (0-4 years old). The secondary outcomes included mortality due to acute infectious diarrhea and the intestinal intussusception rates in children in the same age range. We analyzed three scenarios: Health Division XIII of the State of São Paulo (DRS XIII) from 2002 to 2008, the State of São Paulo, and Brazil from 2002 to 2012. The averages of the hospitalization rates for 100,000 children in the pre- and post-vaccination periods were 1,413 and 959, respectively, for DRS XIII (RR=0.67), 312 and 249, respectively, for the State of São Paulo (RR=0.79), and 718 and 576, respectively, for Brazil (RR=0.8). The mortality rate per 100,000 children in the pre- and post-vaccination periods was 2.0 and 1.3, respectively, for DRS XIII (RR=0.66), 5.5 and 2.5, respectively, for the State of São Paulo (RR=0.47), and 15.0 and 8.0, respectively, for Brazil (RR=0.53). The average annual rates of intussusception for 100,000 children in DRS XIII were 28.0 and 22.0 (RR=0.77) in the pre- and post-vaccination periods, respectively. A monovalent rotavirus vaccine was demonstrated to be effective in preventing the hospitalizations and deaths of children that were presumably due to acute infectious diarrhea, without increasing the risk of intestinal intussusception.

  11. Bladder rupture causing pseudo acute renal failure

    Directory of Open Access Journals (Sweden)

    Luciana Andrea Avena Smeili

    2011-09-01

    Full Text Available Bladder rupture is a rare condition associated with significant morbidityand mortality. It is classified into traumatic, nontraumatic or idiopathic andspontaneous. The nonspecific initial clinical presentation is followed bydiscomfort in the lower abdomen, oliguria, hematuria and ascitis. Laboratoryabnormalities simulate the picture of acute renal failure and occurs by amechanism called auto reverse dialysis, with absorption of excreta throughthe peritoneal membrane. The authors describe a case of bladder rupturein morphologically and functionally normal urinary bladder associated withalcohol intake in young healthy man, manifested by abdominal discomfort,pseudo renal failure and massive ascitis. The diagnosis was made by anabdominal multidetector computed tomography confirmed by the finding of7 cm laceration at laparotomy.

  12. Aspergillus coronary embolization causing acute myocardial infarction.

    Science.gov (United States)

    Laszewski, M; Trigg, M; de Alarcon, P; Giller, R

    1988-05-01

    An increased frequency of disseminated aspergillosis has been observed in the last decade, mostly occurring in immunocompromised patients including the bone marrow transplant population. Cardiac involvement by Aspergillus remains rare. We report the clinical and postmortem findings of an unusual case of Aspergillus pancarditis in a 7-year-old bone marrow transplant patient with Aspergillus embolization to the coronary arteries leading to a massive acute myocardial infarction. This case suggests that myocardial injury secondary to disseminated aspergillosis should be included in the differential diagnosis of chest pain in the immunocompromised pediatric patient.

  13. Hydronephrosis as an Unusual Cause of Acute Pancreatitis

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    Nata Pratama Hardjo Lugito

    2015-01-01

    Full Text Available Acute pancreatitis is an inflammatory disease of the pancreas. The most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic duct (38% and alcoholism (36%. There have been a few reports in the literature of acute pancreatitis associated with an obstructed urinary system. This case describes a 38-year-old male with acute pancreatitis occurring in the setting of hydronephrosis. A magnetic resonance cholangiopancreaticography (MRCP showed right-sided severe hydronephrosis pushing the duodenum and head of pancreas anteriorly, thus obliterating distal segment of the common bile duct. There were also multiple right renal stones causing ureteral obstruction and hydronephrosis. Right nephrostomy was performed to release bile duct obstruction. However, sepsis and disseminated intravascular coagulation developed as a complication of acute pancreatitis, and the patient passed away. Although gallstone and alcoholism are the most common causes of acute pancreatitis, other causes should always be considered. Physicians should be aware of right hydronephrosis as one of the possible causes of acute pancreatitis in their workup of patients.

  14. Can fruit seeds and undigested plant residuals cause acute appendicitis

    Directory of Open Access Journals (Sweden)

    Omer Engin

    2011-04-01

    Conclusions: The ratio of acute appendicitis caused by plants is minimal among all appendectomised patients, but avoidence of eating undigested fruit seeds and chewing plants well may help to prevent appendicitis.

  15. Pure Red Cell Aplasia Caused by Acute Hepatitis A

    OpenAIRE

    Lee, Tae Heon; Oh, Suk Joong; Hong, Soojung; Lee, Kyu Bek; Park, Hyosoon; Woo, Hee-Yeon

    2011-01-01

    Pure red cell aplasia is characterized as a normocytic anemia associated with reticulocytopenia and the absence of erythroblasts in the bone marrow. Pure red cell aplasia can be induced by various causes such as thymoma, connective tissue disease, viral infection, lymphoma, and adverse drug reactions. There have been only a few reports of pure red cell aplasia associated with acute viral hepatitis A. In Korea, no case of pure red cell aplasia caused by acute hepatitis A has yet been reported....

  16. 儿童迁延性及慢性腹泻病因研究进展%Research progress in causes of persistent or chronic diarrhea in children

    Institute of Scientific and Technical Information of China (English)

    赵红梅

    2012-01-01

    The disease course of children with persistent or chronic diarrhea lasts from two weeks to two months or over. Diarrhea is a clinical syndrome caused by a group of multiple etiologies. This paper reviews common causes of persistent or chronic diarrhea in children, including intestinal infections, nonspecific inflammatory bowel diseases, food allergy, lactose intolerance, antibiotic-associated diarrhea, neural regulation abnormality, immunodeficiency disease, malnutrition, Celiac disease and zinc deficiency.%儿童迁延性、慢性腹泻的病程为2周至2个月或超过2个月,是一组多病因导致的临床综合征.本文对其常见病因进行了综述,常见病因包括感染、非特异性炎症性肠病、食物过敏、乳糖不耐受以及抗生素相关性腹泻、神经调节异常、免疫缺陷病、营养不良、乳糜泻、锌缺乏等.

  17. Drug development against the major diarrhea-causing parasites of the small intestine, Cryptosporidium and Giardia

    Directory of Open Access Journals (Sweden)

    Lars eEckmann

    2015-11-01

    Full Text Available Diarrheal diseases are among the leading causes of morbidity and mortality in the world, particularly among young children. A limited number of infectious agents account for most of these illnesses, raising the hope that advances in the treatment and prevention of these infections can have global health impact. The two most important parasitic causes of diarrheal disease are Cryptosporidium and Giardia. Both parasites infect predominantly the small intestine and colonize the lumen and epithelial surface, but do not invade deeper mucosal layers. This review discusses the therapeutic challenges, current treatment options, and drug development efforts against cryptosporidiosis and giardiasis. The goals of drug development against Cryptosporidium and Giardia are different. For Cryptosporidium, only one moderately effective drug (nitazoxanide is available, so novel classes of more effective drugs are a high priority. Furthermore, new genetic technology to identify potential drug targets and better assays for functional evaluation of these targets throughout the parasite life cycle are needed for advancing anticryptosporidial drug design. By comparison, for Giardia, several classes of drugs with good efficacy exist, but dosing regimens are suboptimal and emerging resistance begins to threaten clinical utility. Consequently, improvements in potency and dosing, and the ability to overcome existing and prevent new forms of drug resistance are priorities in antigiardial drug development. Current work on new drugs against both infections has revealed promising strategies and new drug leads. However, the primary challenge for further drug development is the underlying economics, as both parasitic infections are considered Neglected Diseases with low funding priority and limited commercial interest. If a new urgency in medical progress against these infections can be raised at national funding agencies or philanthropic organizations, meaningful and timely

  18. 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.

  19. Hypertriglyceridemia-induced acute pancreatitis in pregnancy causing maternal death.

    Science.gov (United States)

    Jeon, Hae Rin; Kim, Suk Young; Cho, Yoon Jin; Chon, Seung Joo

    2016-03-01

    Acute pancreatitis in pregnancy is rare and occurs in approximately 3 in 10,000 pregnancies. It rarely complicates pregnancy, and can occur during any trimester, however over half (52%) of cases occur during the third trimester and during the post-partum period. Gallstones are the most common cause of acute pancreatitis. On the other hand, acute pancreatitis caused by hypertriglyceridemia due to increase of estrogen during the gestational period is very unusual, but complication carries a higher risk of morbidity and mortality for both the mother and the fetus. We experienced a case of pregnant woman who died of acute exacerbation of hypertriglyceridemia-induced acute pancreatitis at 23 weeks of gestation. We report on progress and management of this case along with literature reviews.

  20. Schistosomiasis: A Rare Cause of Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Faten Limaiem

    2015-06-01

    Full Text Available Schistosomiasis is a water-borne trematode infestation and is one of the most widespread parasitic diseases in the world. Schistosomiasis can affect any organ, but is rare in the appendix. In this paper, the authors report a new case of appendicular schistosomiasis that was incidentally discovered in a 27-year-old male patient from Mali who underwent appendectomy for acute appendicitis. Appendectomy specimens removed from patients with appendicular schistosomiasis often appear macroscopically normal, but histopathological analysis of these cases confirms the diagnosis by revealing schistosomal eggs. The authors strongly recommend that all appendectomy specimens be examined histopathologically regardless of whether the specimens are macroscopically normal. [J Interdiscipl Histopathol 2015; 3(2.000: 78-80

  1. Infantile Diarrhea on Clinical Therapeutic Effect and Montmorillonite Powder in Treatment of Acute Diarrhea in Children%小儿腹泻贴与蒙脱石散治疗小儿急性腹泻的临床疗效

    Institute of Scientific and Technical Information of China (English)

    闫四会

    2015-01-01

    目的:探讨小儿腹泻贴与蒙脱石散治疗小儿急性腹泻的临床疗效。方法收集2013年1月至12月我院收治的60例急性腹泻患儿资料,随机分为对照组和观察组,各30例。对照组患儿给予蒙脱石散治疗,观察组患儿给予小儿腹泻贴治疗,两组患儿同时根据脱水情况口服补液盐。比较两组患儿疗效和临床症状。结果治疗2d后,观察组患儿总有效率为90.0%,明显高于对照组的76.7%,差异有统计学意义(P<0.05);治疗4 d后,观察组患儿总有效率为96.7%,对照组患儿总有效率为93.3%,且两组患儿的水样便、蛋花样便明显减少,腹痛、腹胀明显好转,两组比较差异均无统计学意义(均P>0.05)。结论小儿腹泻贴和蒙脱石散治疗小儿急性腹泻效果均明显,且减轻患儿痛苦。%Objective To investigate the infantile diarrhea Montmoril onite powder paste and the therapeutic effect in the treatment of acute diarrhea in children.Methods 60 cases of acute diarrhea in children from 2013 January to December in our hospital,were randomly divided into control group and observation group,30 cases in each.The control group were given Montmoril onite powder treatment,the observation group were given the treatment of infantile diarrhea paste,two groups of children at the same time according to the dehydration of oral rehydration salts. And the curative effects were compared between the two groups of children.Results After 2 d treatment,the observation group with total effective rate was 90.0%,significantly higher than 76.7% in the control group,the difference was statistical y significant(P0.05).Conclusion Children with diarrhea posted and Montmoril onite powder in treatment of acute diarrhea in children are obvious effect,and reduce the pain of patients.

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

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    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

  3. Pravastatin: A potential cause for acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Constantine Tsigrelis; CS Pitchumoni

    2006-01-01

    Acute pancreatitis (AP) secondary to drugs is uncommon, with an incidence ranging from 0.3% to 2.0%of AP cases. Drug-induced AP due to statins is rare, and only 12 cases have thus far been reported. In this case report, we report a case of a 50-year-old female on pravastatin therapy for 3 d prior to developing symptoms of AP. The common etiological factors for AP were all excluded. The patient was admitted to the intensive care unit secondary to respiratory distress, though she subsequently improved and was discharged 14 d after admission. Although the incidence of drug-induced AP is low, clinicians should have a high index of suspicionfor it in patients with AP due to an unknown etiology.Clinicians should be aware of the association of statins with AP. If a patient taking a statin develops abdominal pain, clinicians should consider the diagnosis of AP and conduct the appropriate laboratory and diagnostic evaluation if indicated.

  4. Progress on treatment of acute infectious diarrhea in adults%成人急性感染性腹泻治疗新进展

    Institute of Scientific and Technical Information of China (English)

    孙峰; 张文宏

    2013-01-01

    成人急性感染性腹泻与儿童感染性腹泻在发病率、严重程度、预后等方面有所不同,其治疗以补液、止泻为主,必要时使用抗微生物药物。近年来,成人急性感染性腹泻在补液治疗和益生菌、新止泻药物应用等方面更新了一些新的循证医学证据,在进一步确保现有药物安全性的同时促进了腹泻治疗思路与手段的发展。%Acute infectious diarrhea in adults is different from children infectious diarrhea in incidence rate , severity and prognosis . Fluid infusion and antidiarrheal treatment are suggested first and antibiotics are prescribed under the needed conditions . Current medical evidences in fluid infusion , probiotics and new antidiarrheal medicines for acute infectious diarrhea in adults are summarized in this paper .Accumulated evidences demonstrate that these treatments are safe and effective .

  5. Simultaneous investigation of influenza and enteric viruses in the stools of adult patients consulting in general practice for acute diarrhea

    Directory of Open Access Journals (Sweden)

    Arena Christophe

    2012-06-01

    Full Text Available Abstract Background Gastrointestinal symptoms are not an uncommon manifestation of an influenza virus infection. In the present study, we aimed to investigate the presence of influenza viruses in the stools of adult patients consulting their general practitioner for uncomplicated acute diarrhea (AD and the proportion of concurrent infections by enteric and influenza viruses. Method A case-control study was conducted from December 2010 to April 2011. Stool specimens were collected and tested for influenza viruses A (seasonal A/H3N2 and pandemic A/H1N1 and B, and for four enteric viruses (astrovirus, group A rotavirus, human enteric adenovirus, norovirus of genogroups I – NoVGI - and genogroup II - NoVGII. Results General practitioners enrolled 138 cases and 93 controls. Of the 138 stool specimens collected, 92 (66.7% were positive for at least one of the four enteric viruses analysed and 10 (7.2% tested positive for one influenza virus. None of these 10 influenza positive patients reported respiratory symptoms. In five influenza-positive patients (3.6%, we also detected one enteric virus, with 4 of them being positive for influenza B (2 had co-detection with NoVGI, 1 with NoVGII, and 1 with astrovirus. None of the 93 controls tested positive for one of the enteric and/or other influenza viruses we investigated. Conclusions In this study we showed that the simultaneous detection of influenza and enteric viruses is not a rare event. We have also reported, for the first time in general practice, the presence of seasonal and pandemic influenza viruses in the stools of adult patients consulting for uncomplicated AD. A simultaneous investigation of enteric and influenza viruses in patients complaining of gastrointestinal symptoms could be useful for future studies to better identify the agents responsible for AD.

  6. Chylous ascites caused by acute pancreatitis with portal vein thrombosis

    OpenAIRE

    Park, Dong Eun; Chae, Kwon Mook

    2011-01-01

    Chylous ascites is defined as the accumulation of chyle in the peritoneum due to obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands. Chylous ascites that arises from acute pancreatitis with portal vein thrombosis is very rare. We report here on a case of chylous ascite that was caused by acute pancreatitis with portal vein thrombosis, in which the patient showed an impressive response to conservative therapy with total parenteral nutrition and octerotide. We also rev...

  7. Ultrasonographic Findings of Extratesticular Diseases Causing Acute Scrotal Disorders

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jae Joon; Lee, Tack; Chang, So Yong; Kim, Myeong Jin; Yoo, Hyung Sik; Lee, Jong Tae [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1996-12-15

    To evaluate the kinds of extratesticular diseases causing acute scrotal disorders by emergent sonography of the scrotum. Scrotal sonography in sixty-five patients, with age ranging from 5months to 82 years (mean : 27.3 years), with acute scrotal pain and swelling, was prospectively carried out by either a 10 or 7.5 MHz transducer. We evaluated the size and echogenicity of the epididymis, the presence of extratesticular solid mass or cyst, testicular involvement by extratesticular diseases, calcification, hydrocele and scrotal wall thickening. The most common cause of acute scrotal disorders was acute epididymitis (n= 50), followed by acute epididymo-orchitis (n = 4), mumps epididymo-orchitis (n = 2), enlarged epididymis secondary to testicular torsion (n = 2), infected hydrocele (n = 2), epididymal cyst (n = 2), rupture of varicocele (n = 1), angioneurotic edema (n = 1), and sperm granuloma (n = 1). Hydrocele was seen in 20 cases, and epididymal calcification was noted in 6 cases. Emergent scrotal sonography was useful for correct diagnosis and proper treatment in patients with acute scrotal disorders, especially in the differentiation of the acute epididymitis from other intrascrotal diseases

  8. A Rare Cause for Acute Cor Pulmonale

    Directory of Open Access Journals (Sweden)

    C. Rajasekharan

    2011-06-01

    Full Text Available A number of diseases may cause right atrial mass. Primary cardiac tumors range from 0.002 to 0.25%. Intracardiac manifestation and pulmonary embolism of hepatocellular carcinoma (HCC is a very rare finding and uncommon even at autopsy. Here we describe the case of a 32-year-old Asian man who was referred for shortness of breath lasting for a month, along with unproductive cough. He was a manual laborer with a history of diabetes, alcoholism, and smoking. Clinically he was diagnosed as having pulmonary embolism. Echocardiogram showed a mass in the right atrium. Magnetic resonance imaging showed that he had a large mass in the right atrium extending down into the inferior vena cava. Further evaluation showed that he had chronic liver disease with portal hypertension and was hepatitis B surface antigen-positive, indicating hepatitis B infection. He underwent excision of the mass, and the pathological report showed metastasis of HCC with multiple vascular emboli in the lungs. As this is the second reported case of this kind in the literature, we highlight the need of screening at least 6-monthly all patients with chronic liver disease, hepatitis B and C virus infection for the early detection of HCC.

  9. A rare cause for acute cor pulmonale.

    Science.gov (United States)

    Rajasekharan, C; Ganga, V

    2011-05-01

    A number of diseases may cause right atrial mass. Primary cardiac tumors range from 0.002 to 0.25%. Intracardiac manifestation and pulmonary embolism of hepatocellular carcinoma (HCC) is a very rare finding and uncommon even at autopsy. Here we describe the case of a 32-year-old Asian man who was referred for shortness of breath lasting for a month, along with unproductive cough. He was a manual laborer with a history of diabetes, alcoholism, and smoking. Clinically he was diagnosed as having pulmonary embolism. Echocardiogram showed a mass in the right atrium. Magnetic resonance imaging showed that he had a large mass in the right atrium extending down into the inferior vena cava. Further evaluation showed that he had chronic liver disease with portal hypertension and was hepatitis B surface antigen-positive, indicating hepatitis B infection. He underwent excision of the mass, and the pathological report showed metastasis of HCC with multiple vascular emboli in the lungs. As this is the second reported case of this kind in the literature, we highlight the need of screening at least 6-monthly all patients with chronic liver disease, hepatitis B and C virus infection for the early detection of HCC.

  10. Acute epiploic appendagitis: A rare cause of acute abdomen and a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Afnan F Almuhanna

    2016-01-01

    Full Text Available Acute epiploic appendagitis is a relatively rare cause of lower abdominal pain that clinically mimics other acute abdomen conditions that require surgery such as acute diverticulitis or appendicitis. Here, we report a case of a 50-year-old lady who presented with an unusual lower abdominal pain. Awareness of such a clinical condition with its characteristic imaging findings is important to avoid costly hospitalization, unnecessary antibiotic courses, and the morbidity and mortality associated with surgical procedures.

  11. pic gene of enteroaggregative Escherichia coli and its association with diarrhea in Peruvian children.

    Science.gov (United States)

    Durand, David; Contreras, Carmen A; Mosquito, Susan; Ruíz, Joaquim; Cleary, Thomas G; Ochoa, Theresa J

    2016-08-01

    Enteroaggregative Escherichia coli (EAEC) causes acute and persistent diarrhea among children, HIV-infected patients, and travelers to developing countries. We have searched for 18 genes-encoding virulence factors associated with aggregative adherence, dispersion, biofilm, toxins, serine protease autotransporters of Enterobacteriaceae (SPATEs) and siderophores, analyzed in 172 well-characterized EAEC strains (aggR(+)) isolated from stool samples of 97 children with diarrhea and 75 healthy controls from a passive surveillance diarrhea cohort study in Peru. Eighty-one different genetic profiles were identified, 37 were found only associated with diarrhea and 25 with control samples. The most frequent genetic profile was aggC(+)aatA(+)aap(+)shf(+)fyuA(+), present in 19 strains, including diarrhea and controls. The profile set1A(+)set1B(+)pic(+) was associated with diarrhea (P pic was associated with diarrhea (P < 0.05) and with prolonged diarrhea (diarrhea ≥ 7 days) (P < 0.05). In summary, this is the first report on the prevalence of a large set of EAEC virulence genes and its association with diarrhea in Peruvian children. More studies are needed to elucidate the exact role of each virulence factor.

  12. Hiatus Hernia: A Rare Cause of Acute Pancreatitis

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    Shruti Patel

    2016-01-01

    Full Text Available Hiatal hernia (HH is the herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm. A giant HH with pancreatic prolapse is very rare and its causing pancreatitis is an even more extraordinary condition. We describe a case of a 65-year-old man diagnosed with acute pancreatitis secondary to pancreatic herniation. In these cases, acute pancreatitis may be caused by the diaphragmatic crura impinging upon the pancreas and leading to repetitive trauma as it crosses the hernia; intermittent folding of the main pancreatic duct; ischemia associated with stretching at its vascular pedicle; or total pancreatic incarceration. Asymptomatic hernia may not require any treatment, while multiple studies have supported the recommendation of early elective repair as a safer route in symptomatic patients. In summary, though rare, pancreatic herniation should be considered as a cause of acute pancreatitis. A high index of suspicion for complications is warranted in cases like these.

  13. CXCR2-dependent mucosal neutrophil influx protects against colitis-associated diarrhea caused by an attaching/effacing lesion-forming bacterial pathogen.

    Science.gov (United States)

    Spehlmann, Martina E; Dann, Sara M; Hruz, Petr; Hanson, Elaine; McCole, Declan F; Eckmann, Lars

    2009-09-01

    Enteropathogenic Escherichia coli (EPEC) is a major cause of diarrheal disease in young children, yet symptoms and duration are highly variable for unknown reasons. Citrobacter rodentium, a murine model pathogen that shares important functional features with EPEC, colonizes mice in colon and cecum and causes inflammation, but typically little or no diarrhea. We conducted genome-wide microarray studies to define mechanisms of host defense and disease in C. rodentium infection. A significant fraction of the genes most highly induced in the colon by infection encoded CXC chemokines, particularly CXCL1/2/5 and CXCL9/10, which are ligands for the chemokine receptors CXCR2 and CXCR3, respectively. CD11b(+) dendritic cells were the major producers of CXCL1, CXCL5, and CXCL9, while CXCL2 was mainly induced in macrophages. Infection of gene-targeted mice revealed that CXCR3 had a significant but modest role in defense against C. rodentium, whereas CXCR2 had a major and indispensable function. CXCR2 was required for normal mucosal influx of neutrophils, which act as direct antibacterial effectors. Moreover, CXCR2 loss led to severe diarrhea and failure to express critical components of normal ion and fluid transport, including ATPase beta(2)-subunit, CFTR, and DRA. The antidiarrheal functions were unique to CXCR2, since other immune defects leading to increased bacterial load and inflammation did not cause diarrhea. Thus, CXCR2-dependent processes, particularly mucosal neutrophil influx, not only contribute to host defense against C. rodentium, but provide protection against infection-associated diarrhea.

  14. Surveillance of rotavirus diarrhea

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    Titis Widowati

    2012-01-01

    Full Text Available Background Rotavirus is a major cause of severe diarrhea and dehydration in children worldwide. Data on the burden of disease in Indonesia is limited. Objective To provide an epidemiological profile of rotavirus infection among children hospitalized for diarrhea in Mohammad Hoesin Hospital, Palembang. Methods In January - December 2006, a prospective, hospital-based surveillance was carried out in children aged less than five years, presenting with diarrhea. Stool samples were examined for rotavirus using enzyme immunoassay (EIA. G- and P-typing were performed on specimens confirmed to be positive by EIA. Results A total of 513 fecal specimens from 534 children were tested for rotavirus. Rotavirus was detected in 64% of the specimens, mostly of the G9 type (62.5%. Incidence of rotavirus diarrhea was highest in the 6 month to 2 years age group (60.4%. Children with rotavirus diarrhea were more likely to present with dehydration, compared to those with non-rotavirus diarrhea (94% vs 70%, respectively, P=0.03. Conclusion Rotavirus was the most common pathogen found in children with diarrhea. Rotavirus was detected in 64% of pediatric diarrheal specimens tested in our study. This finding warrants the use of a large-scale program to prevent disease, such as vaccination against rotavirus. [Paediatr Indones. 2012;52:22-7].

  15. Splenic duplication: a rare cause of acute upper gastrointestinal bleeding.

    Science.gov (United States)

    Sharma, Pankaj; Alkadhi, Hatem; Gubler, Christoph; Bauerfeind, Peter; Pfammatter, Thomas

    2013-02-01

    Acute gastrointestinal bleeding represents a common medical emergency. We report the rare case of acute upper gastrointestinal bleeding caused by varices in the gastric fundus secondary to splenic duplication. Splenic duplication has been only rarely reported in the literature, and no case so far has described the associated complication of gastrointestinal bleeding, caused by venous drainage of the upper spleen via varices in the gastric fundus. We describe the imaging findings from endoscopy, endosonography, computed tomography (CT), flat-panel CT, and angiography in this rare condition and illustrate the effective role of intra-arterial embolization.

  16. Diarrhea in neonatal intensive care unit

    Institute of Scientific and Technical Information of China (English)

    Annalisa; Passariello; Gianluca; Terrin; Maria; Elisabetta; Baldassarre; Mario; De; Curtis; Roberto; Paludetto; Roberto; Berni; Canani

    2010-01-01

    AIM:To investigate the frequency,etiology,and current management strategies for diarrhea in newborn.METHODS:Retrospective,nationwide study involving 5801 subjects observed in neonatal intensive care units during 3 years.The main anamnesis and demographic characteristics,etiology and characteristics of diarrhea,nutritional and therapeutic management,clinical outcomes were evaluated.RESULTS:Thirty-nine cases of diarrhea(36 acute,3 chronic) were identified.The occurrence rate of diarrhea was 6.72 per 1000 hosp...

  17. [Monitoring and research on pathogen spectrum in patients with acute diarrhea from sentinel hospital of Zhejiang Province during 2009 to 2014].

    Science.gov (United States)

    Zheng, S F; Yu, F; Chen, X; Cui, D W; Yang, X Z; Xie, G L; Wang, Y Y; Yu, J X; Li, Z J; Chen, Y

    2016-12-06

    Objective: To explore pathogen spectrum constitution of acute diarrhea in outpatient and emergency of Zhejiang Province, and provide basis for treatment, prevention and control of the disease. Methods: During January 2009 to December 2014, we selected seven sentinel hospitals in different regions of Zhejiang, monitored and researched on pathogen spectrum in patients with acute diarrhea from outpatient and emergency. We recorded patients' personal basic information, the main symptoms and signs, and collected stool samples (5 g). Eight kinds of bacteria (Vibrio cholerae, Shigella spp., Salmonella spp., Diarrheagenic E. coli, Vibrio parahaemolyticus, Aeromonas hydrophila, Yersinia enterocolitica and Plesiomonas shigelloides) and five kinds of viruses (Rotavirus, Norovirus, Sappovirus, Astrovirus and Adenovirus) were detected. Chi-square test and Fisher's exact probability method were used to compare different characteristics of patients with single bacterial infection, single virus infection and multiple infection (bacteria-bacteria, bacteria-viruses, virus-virus). Results: During 2009 to 2014, 9 364 fecal samples from acute diarrhea patients were collected and tested, among which 3 500 cases were tested positive, with total positive rate of 37.38%. Positive rates of bacteria and viruses were 13.14% (1 230 cases) and 20.75% (1 943 cases), respectively. Mixed infection positive rate of multiple pathogens was 3.49% (327 cases). Positive rate of Vibrio parahaemolyticus (5.96% , 558 cases) was the highest among bacterial pathogens, followed by pathogenic Escherichia coli (3.86%, 361 cases). Viruses were mainly Norovirus (10.73%, 1 005 cases) and rotavirus (8.35%, 782 cases). A big difference existed in diarrheogenic pathogen spectrum between patients less than 15 years old and patients equal or older than 15 years old. Pathogens for patients less than 15 years old were mainly virus, with the positive rate of 32.69% (1 014 cases). However, the positive rate of bacteria was

  18. Hepatic artery pseudoaneurysm caused by acute idiopathic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Yeon Hwa Yu; Joo Hyun Sohn; Tae Yeob Kim; Jae Yoon Jeong; Dong Soo Han; Yong Cheol Jeon; Min Young Kim

    2012-01-01

    Hepatic artery pseudoaneurysm (HAP) is a very rare disease but in cases of complication,there is a very high mortality.The most common cause of HAP is iatrogenic trauma such as liver biopsy,transhepatic biliary drainage,cholecystectomy and hepatectomy.HAP may also occur with complications such as infections or inflammation associated with septic emboli.HAP has been reported rarely in patients with acute pancreatitis.As far as we are aware,there is no report of a case caused by acute idiopathic pancreatitis,particularly.We report a case of HAP caused by acute idiopathic pancreatitis which developed in a 61-year-old woman.The woman initially presented with acute pancreatitis due to unknown cause.After conservative management,her symptoms seemed to have improved.But eight days after admission,abdominal pain abruptly became worse again.Abdominal computed tomography (CT) was rechecked and it detected a new HAP that was not seen in a previous abdominal CT.Endoscopic retrograde cholangiopancreatography (ERCP) was performed because of a suspicion of hemobilia as a cause of aggravated abdominal pain.ERCP confirmed hemobilia by observing fresh blood clots at the opening of the ampulla and several filling defects in the distal common bile duct on cholangiogram.Without any particular treatment such as embolization or surgical ligation,HAP thrombosed spontaneously.Three months after discharge,abdominal CT demonstrated that HAP in the left lateral segment had disappeared.

  19. Clinical Observation of Colitis a Pill in Treating Acute Diarrhea%结肠炎A片治疗急性腹泻临床研究

    Institute of Scientific and Technical Information of China (English)

    陈晖; 赵星海; 高履冰

    2012-01-01

    目的:观察结肠炎A片治疗急性腹泻的临床疗效.方法:将80例急性腹泻患者随机平均分为治疗组和对照组.治疗组以结肠炎A片(主要成分:葛根、黄连、黄芩、木香、败酱草、马齿苋、厚朴、枳实、神曲、焦山楂)治疗;对照组以思密达治疗.观察两组临床疗效.结果:治疗组有效率为95%,对照组有效率为85%,两组有效率比较,差异有统计学意义(P<0.05).结论:结肠炎A片能有效的缓解患者症状,提高对急性腹泻的临床治疗效果.%Objective: Observe colonitis A tablet in the treatment of acute diarrhea. Methods: 80 cases of acute diarrhea were randomly divided into 2 groups. 40 patients in treatment group with colitis film was given colonitis A tablet ( Bases: gegen, huanglian, huangqin, mux-iang,baijiangcao,machixian,houpu,zhishi,shenqu,jiaoshanzha). The control group was treated with smecta. Observe and compare the clinical efficacy. Results ;The clinical total effective rate of treatment group is 95% and 85% of control group. The difference has statistics significance(P <0. 05). Conclusion: Colitis A tablet can effectively relieve symptoms and improve the clinical treatment of acute diarrhea.

  20. Clinical Analysis of Treatment on Children with Acute Diarrhea%小儿急性腹泻的临床治疗分析

    Institute of Scientific and Technical Information of China (English)

    邹敏; 祖敏; 李莉

    2014-01-01

    Objective:To analyze the clinical treatment and comprehensive effect of acute diarrhea in children. Method:150 patients with acute diarrhea in children in our hospital from 2012 March to in 2013 March were received as object for study. The children were divided into three groups(group A,B and group C),50 cases in each group. Patients in the group A were treated with Qingkailing,patients in the group B received the Leigh Bhave Lin treatment,patients in the group C were treated with antibiotics,racecadotril combined ORS treatment. Result:The group C was better than the other group (P<0.05). Conclusion:For patients with acute diarrhea in children,antibiotics,racecadotril combined ORS treatment has high curative effect,is worth popularizing in clinic.%目的:综合探析小儿急性腹泻的临床治疗措施与效果。方法:选取2012年3月-2013年3月本院接收的150例小儿急性腹泻患者为研究对象,将其均分成三组(A、B组和C组),每组50例。A组患者接受清开灵治疗,B组患者接受利巴韦林治疗,C组患者接受抗生素、消旋卡多曲联合ORS治疗。结果:C组治疗效果优于其他组(P<0.05)。结论:对小儿急性腹泻患者来说,采用抗生素、消旋卡多曲联合ORS治疗具有较高的治疗效果,值得在临床上大力推广。

  1. Fever without apparent source on clinical examination, lower respiratory infections in children, other infectious diseases, and acute gastroenteritis and diarrhea of infancy and early childhood.

    Science.gov (United States)

    McCarthy, P L; Klig, J E; Kahn, J S; Shapiro, E D; Baron, M A

    1997-02-01

    This section focuses on issues in infectious disease that are commonly encountered in pediatric office practice. Paul McCarthy discusses recent literature regarding the evaluation and management of acute fevers without apparent source on clinical examination in infants and children and the evaluation of children with prolonged fevers of unknown origin. Jean Klig reviews recent literature about lower respiratory tract infection in children. Jeffrey Kahn and Eugene Shapiro discuss literature concerning several infectious diseases commonly seen in office settings and concerning which recent developments are of interest. Michael Baron reviews recent literature about gastroenteritis and diarrhea of infancy and early childhood.

  2. The effectiveness of a rotavirus vaccine in preventing hospitalizations and deaths presumably due to acute infectious diarrhea in Brazilian children: a quasi-experimental study

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    Estêvão Teles

    2015-04-01

    Full Text Available INTRODUCTION: Rotavirus is the main etiologic agent of acute infectious diarrhea in children worldwide. Considering that a rotavirus vaccine (G1P8, strain RIX4414 was added to the Brazilian vaccination schedule in 2006, we aimed to study its effectiveness and safety regarding intestinal intussusception. METHODS: A quasi-experimental trial was performed in which the primary outcome was the number of hospitalizations that were presumably due to acute infectious diarrhea per 100,000 children at risk (0-4 years old. The secondary outcomes included mortality due to acute infectious diarrhea and the intestinal intussusception rates in children in the same age range. We analyzed three scenarios: Health Division XIII of the State of São Paulo (DRS XIII from 2002 to 2008, the State of São Paulo, and Brazil from 2002 to 2012. RESULTS: The averages of the hospitalization rates for 100,000 children in the pre- and post-vaccination periods were 1,413 and 959, respectively, for DRS XIII (RR=0.67, 312 and 249, respectively, for the State of São Paulo (RR=0.79, and 718 and 576, respectively, for Brazil (RR=0.8. The mortality rate per 100,000 children in the pre- and post-vaccination periods was 2.0 and 1.3, respectively, for DRS XIII (RR=0.66, 5.5 and 2.5, respectively, for the State of São Paulo (RR=0.47, and 15.0 and 8.0, respectively, for Brazil (RR=0.53. The average annual rates of intussusception for 100,000 children in DRS XIII were 28.0 and 22.0 (RR=0.77 in the pre- and post-vaccination periods, respectively. CONCLUSIONS: A monovalent rotavirus vaccine was demonstrated to be effective in preventing the hospitalizations and deaths of children that were presumably due to acute infectious diarrhea, without increasing the risk of intestinal intussusception.

  3. 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

    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.

  4. Acute myonecrosis in horse caused by Clostridium novyi type A.

    Science.gov (United States)

    Farias, Luana D'avila; Azevedo, Marcos Da Silva; Trost, Maria Elisa; De La Côrte, Flávio Desessards; Irigoyen, Luiz Francisco; de Vargas, Agueda Castagna

    2014-01-01

    The objective of this study was to describe the first report involving a case of equine acute myonecrosis caused by C. novyi type A with an emphasis on clinical signs, the pathological and bacteriological analysis, and molecular identification of the microorganisms as the key of the definitive diagnosis.

  5. Acute myonecrosis in horse caused by Clostridium novyi type A

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    Luana D'avila Farias

    2014-01-01

    Full Text Available The objective of this study was to describe the first report involving a case of equine acute myonecrosis caused by C. novyi type A with an emphasis on clinical signs, the pathological and bacteriological analysis, and molecular identification of the microorganisms as the key of the definitive diagnosis.

  6. 104例急性散发腹泻病例病原学分析%Analysis of etiology and epidemiology in 104 sporadic acute diarrhea cases

    Institute of Scientific and Technical Information of China (English)

    李继珊; 庞晶晶; 高波; 崔海洋

    2012-01-01

    目的:了解北京市宣武区春季就诊的急性散发腹泻病例中病原感染分布现状,为制定相关防治策略提供依据.方法:以北京市宣武医院就诊的腹泻病例作为监测对象,留取便标本进行霍乱弧菌、沙门菌、志贺菌、副溶血弧菌、致泻大肠杆菌和诺如病毒、轮状病毒检测及分析.结果:共调查并检测腹泻病例104例,总阳性率38.5%,细菌培养阳性率21.2%,病毒检测阳性率为20.2%,有3例患者便检结果细菌、病毒皆为阳性.结论:急性散发腹泻病原类型复杂多样,应进行必要的病原学监测及研究,以进一步明确感染性腹泻的流行特征.%Objective: To investigate the pathology, epidemiology and the clinical characteristic of sporadic acute diarrhea cases in Xuanwu district of Beijing. Methods: Diarrhea cases in Xuanwu hospital were selected as monitoring objects, and the stool specimens were collected from these cases for detection and analysis of vibrio cholerae, salmonella, shigella, vibrio parahaemolyticus, diarrheagenic escherichia coli, norovirus and rotavirus. Results: 104 diarrhea cases were detected with the total positive rate of 38.5% , bacterial culture positive rate of 21.2% and virus positive rate of 20. 2% , and 3 cases were positive for both bacteria and virus. Conclusion: Sporadic acute diarrhea cases were various, which should be strengthened pathogenic monitoring to further show the epidemic characteristics of infectious diarrhea.

  7. Acute Diarrhea attributed to Yindan Pinggan Capsule%茵胆平肝胶囊致急性腹泻1例

    Institute of Scientific and Technical Information of China (English)

    文娱

    2015-01-01

    A 31-year-old male with moderate Chronic Hepatitis B took yindanpinggan capsule by clearing heat and promoting diuresis 2 grain every time, 3 times a day. On the third day, the patient appeared acute diarrhea, but didn't give special treatment. On the fifth day, the patient continued diarrhea, yindanpinggan capsule was stopped, then took Smectite powder 3 g every time, 3 times a day and bacillus licheniformis capsules 0.5g every time, 3 times a day. Not again on the 7th of diarrhea.Because Yindanpinggan capsule is of bitter cold, those patients with spleen deficiency were easily led to gastrointestinal reactions, therefore recommended medication in patients with comprehensive analysis, dialectical theory of governance, in order to reduce the occurrence of diarrhea.%1例31岁男性患者,因中度慢性乙型肝炎口服茵胆平肝胶囊清热利湿,2粒 /次,3次/日.第3日患者出现急性腹泻症状,未给予特殊处理.第5日仍持续腹泻,停用茵胆平肝胶囊,给予蒙脱石散剂3g/次,口服,3次/日.地衣芽孢杆菌胶囊0.5g/次,口服,3次/日 .第7日未再腹泻.由于茵胆平肝胶囊性味苦寒,如患者脾胃虚寒,易导致消化道反应,因此建议用药时综合分析患者症型,辩证论治,以减少腹泻的发生.

  8. Nosocomial diarrhea in children:is astrovirus the leading pathogen?

    Institute of Scientific and Technical Information of China (English)

    Anita Chakravarti; Manisha Jain; Mayank Singh Chauhan; Anju Sharma; Sayani Tewari

    2010-01-01

    Objective:To screen for the presence of mixed infection with rotavirus. Methods:The present study included 140 children aged less than 2 years with acute diarrhea. Fecal samples of all these patients were analyzed for the presence of astroviral antigen by enzyme immunoassay. Also 40 rotavirus positive fecal samples were screened for the presence of astrovirus. Results:In case of acute diarrhea in children the prevalence of astrovirus was around 34%(48/140). It was seen that even in rotavirus positive cases astrovirus co infection was 25%. Conclusions:Astrovirus is a growing problem which is often underrecognised. With the rotavirus vaccine licensure being imminent astrovirus will emerge out as the single most important cause of viral diarrhea.

  9. [Viral diarrhea].

    Science.gov (United States)

    Stalder, H

    1982-04-12

    Viruses are one of the most frequent causes of acute infectious gastroenteritis. Thus, rotaviruses are responsible for 40-60%--and in winter sometimes for over 90% - of diarrhoea in infants. These viruses may also cause disease in adults, but small viruses of a size of about 27 nm, such as the Norwalk agent, play a much more important role. Several other non-cultivable viruses such as adeno-, calici- and astroviruses have been implicated as a cause of infectious diarrhoea. Knowledge of rotaviruses is so far advanced that routine laboratory diagnosis can easily be performed and active immunization against rotavirus infection envisaged.

  10. Case of cytomegalovirus colitis in an immunocompetent patient: a rare cause of abdominal pain and diarrhea in the elderly

    Directory of Open Access Journals (Sweden)

    Harano Y

    2015-03-01

    Full Text Available Yumi Harano, Lisa Kotajima, Hiroko Arioka Department of General Internal Medicine, St Luke's International Medical Center, Tokyo, Japan Abstract: Cytomegalovirus (CMV colitis usually occurs in immunocompromised patients after undergoing organ transplantation or chemotherapy. We report the case of a 60-year-old immunocompetent Japanese woman who presented with abdominal pain and bloody diarrhea. She was initially diagnosed as having ischemic colitis with pseudomembranous colitis on the basis of her symptoms, Clostridium difficile antigen positivity, and colonoscopic findings, which showed ulcer formation from the sigmoid colon to rectum. In spite of bowel rest and administration of metronidazole, her symptoms did not improve. On follow-up colonoscopy, ulcerations remained unchanged. Biopsy of the ulceration revealed CMV-infected cells leading to a diagnosis of CMV colitis. CMV colitis is a rare but possible differential diagnosis in immunocompetent patients. We recommend endoscopic biopsy in a case of refractory abdominal pain and bloody diarrhea. Keywords: cytomegalovirus, colitis, immunocompetent, enterocolitis

  11. Case of cytomegalovirus colitis in an immunocompetent patient: a rare cause of abdominal pain and diarrhea in the elderly.

    Science.gov (United States)

    Harano, Yumi; Kotajima, Lisa; Arioka, Hiroko

    2015-01-01

    Cytomegalovirus (CMV) colitis usually occurs in immunocompromised patients after undergoing organ transplantation or chemotherapy. We report the case of a 60-year-old immunocompetent Japanese woman who presented with abdominal pain and bloody diarrhea. She was initially diagnosed as having ischemic colitis with pseudomembranous colitis on the basis of her symptoms, Clostridium difficile antigen positivity, and colonoscopic findings, which showed ulcer formation from the sigmoid colon to rectum. In spite of bowel rest and administration of metronidazole, her symptoms did not improve. On follow-up colonoscopy, ulcerations remained unchanged. Biopsy of the ulceration revealed CMV-infected cells leading to a diagnosis of CMV colitis. CMV colitis is a rare but possible differential diagnosis in immunocompetent patients. We recommend endoscopic biopsy in a case of refractory abdominal pain and bloody diarrhea.

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

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    Hectorina Rodulfo

    2012-06-01

    Full Text Available INTRODUCTION: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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

  13. Chylous ascites caused by acute pancreatitis with portal vein thrombosis.

    Science.gov (United States)

    Park, Dong Eun; Chae, Kwon Mook

    2011-12-01

    Chylous ascites is defined as the accumulation of chyle in the peritoneum due to obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands. Chylous ascites that arises from acute pancreatitis with portal vein thrombosis is very rare. We report here on a case of chylous ascite that was caused by acute pancreatitis with portal vein thrombosis, in which the patient showed an impressive response to conservative therapy with total parenteral nutrition and octerotide. We also review the relevant literature about chylous ascites with particular reference to the management of this rare disease.

  14. Acute Pulmonary Edema Caused by a Giant Atrial Myxoma

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    Andrea Fisicaro

    2013-01-01

    Full Text Available Atrial myxoma is the most common primary cardiac tumor. Its clinical presentation spreads from asymptomatic incidental mass to serious life-threatening cardiovascular complications. We report the case of a 44-year-old man with evening fever and worsening dyspnea in the last weeks, admitted to our hospital for acute pulmonary edema. The cardiac auscultation was very suspicious for mitral valve stenosis, but the echocardiography revealed a huge atrial mass with a diastolic prolapse into mitral valve orifice causing an extremely high transmitral gradient pressure. Awareness of this uncommon acute presentation of atrial myxoma is necessary for timely diagnosis and prompt surgical intervention.

  15. An unusual cause of intraoperative acute superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    Adam W Amundson

    2013-01-01

    Full Text Available Acute intraoperative superior vena cava (SVC syndrome is an exceedingly rare complication in the cardiac surgical population. We describe the case of a 71-year-old female undergoing multi-vessel coronary artery bypass grafting who developed acute intraoperative SVC syndrome following internal thoracic artery harvest retractor placement. Her symptoms included severe plethora, facial engorgement and scleral edema, which was associated with hypotension and severe elevation of central venous pressure. Transesophageal echocardiography was crucial in the diagnosis, management, and optimal retractor placement ensuring adequate SVC flow. Potential causes of intraoperative SVC syndrome are reviewed as well as management options.

  16. A Rare Cause of Acute Pancreatitis: Intramural Duodenal Hematoma

    Directory of Open Access Journals (Sweden)

    Hemant Goyal

    2012-01-01

    Full Text Available We describe an interesting case of intramural duodenal hematoma in an otherwise healthy male who presented to emergency room with gradually progressive abdominal pain, nausea, and vomiting. This condition was missed on initial evaluation and patient was discharged from emergency room with diagnosis of acute gastritis. After 3 days, patient came back to emergency room and abdominal imaging studies were conducted which showed that patient had intramural duodenal hematoma associated with gastric outlet obstruction and pancreatitis. Hematoma was the cause of acute pancreatitis as pancreatic enzymes levels were normal at the time of first presentation, but later as the hematoma grew in size, it caused compression of pancreas and subsequent elevation of pancreatic enzymes. We experienced a case of pancreatitis which was caused by intramural duodenal hematoma. This case was missed on initial evaluation. We suggest that physicians should be more vigilant about this condition.

  17. Acute cardiac tamponade: an unusual cause of acute renal failure in a renal transplant recipient.

    Science.gov (United States)

    Nampoory, Naryanan; Gheith, Osama; Al-Otaibi, Torki; Halim, Medhat; Nair, Prasad; Said, Tarek; Mosaad, Ahmed; Al-Sayed, Zakareya; Alsayed, Ayman; Yagan, Jude

    2015-04-01

    We report a case of slow graft function in a renal transplant recipient caused by uremic acute pericardial effusion with tamponade. Urgent pericardiocentesis was done with an improvement in blood pressure, immediate diuresis, and quick recovery of renal function back to baseline. Pericardial tamponade should be included in consideration of causes of type 1 cardiorenal syndrome in renal transplant recipients.

  18. A Rare Cause of Acute Abdominal Pain: Primary Appendagitis Epiploica

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    Tarkan Ergun

    2014-03-01

    Primary appendagitis epiploica – one of the causes of acute abdominal pain – is a self-limited rare benign inflammatory condition involving the colonic epiploic appendages. Their therapy is conservative and clinically mimics other conditions requiring surgery such as acute diverticulitis or appendicitis. However, being a quite rare condition is the reason they are usually neglected by both the surgeon and the radiologist. However the computed tomography (CT findings are rather characteristic and pathognomonic. Thus, to consider CT as the diagnostic modality of choice is extremely important in order to diagnose the condition and to avoid unnecessary surgical interventions.             This is a paper reporting an acute abdominal pain case of primary appendicitis epiploica diagnosed using computed tomography. 

  19. Acute Myocardial Infarction Caused by Filgrastim: A Case Report

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    Cemil Bilir

    2012-01-01

    Full Text Available Common uses of the granulocyte-colony stimulating factors in the clinical practice raise the concern about side effects of these agents. We presented a case report about an acute myocardial infarction with non-ST segment elevation during filgrastim administration. A 73-year-old man had squamous cell carcinoma of larynx with lung metastasis treated with the chemotherapy. Second day after the filgrastim, patient had a chest discomfort. An ECG was performed and showed an ST segment depression and negative T waves on inferior derivations. A coronary angiography had showed a critical lesion in right coronary arteria. This is the first study thats revealed that G-CSF can cause acute myocardial infarction in cancer patients without history of cardiac disease. Patients with chest discomfort and pain who are on treatment with G-CSF or GM-CSF must alert the physicians for acute coronary events.

  20. Management of the Returning Traveler with Diarrhea

    Science.gov (United States)

    2009-01-01

    Abstract: Traveler's diarrhea (TD) strikes 20—60% of travelers visiting developing countries. It occurs shortly after the return and can be distinguished into two categories: acute and persistent TD. Acute TD, mostly caused by bacterial and viral pathogens, is usually mild and self-limited, and deserves empirical symptomatic and/or antibiotic therapy in selected cases. Fluoroquinolones are progressively superseded in this indication by azithromycin, a well tolerated macrolide active against most bacteria responsible for TD, including the quinolone-resistant species of Campylobacter jejuni that are now pervasive, especially in Southeast Asia and India. Persistent TD in the returning traveler is much rarer than its acute counterpart and may be associated with three types of causes. Persistent infections, among which Giardia and possibly Entamoeba predominate, account for a significant proportion of cases. Postinfectious processes represent a second cause and comprise temporary lactose malabsorption and postinfectious irritable bowel syndrome, now considered a major cause of persistent TD. Finally, apparently unrelated chronic diseases causing diarrhea are occasionally unmasked by TD and represent a third type of persistent TD, among which the well established case of incident inflammatory bowel disease poses intriguing pathogenesis questions. This review discusses recent advances in the field and provides practical recommendations for the management of TD in adult, immunocompetent returning travelers. PMID:21180583

  1. Management of the returning traveler with diarrhea.

    Science.gov (United States)

    de Saussure, Philippe P H

    2009-11-01

    Traveler's diarrhea (TD) strikes 20-60% of travelers visiting developing countries. It occurs shortly after the return and can be distinguished into two categories: acute and persistent TD. Acute TD, mostly caused by bacterial and viral pathogens, is usually mild and self-limited, and deserves empirical symptomatic and/or antibiotic therapy in selected cases. Fluoroquinolones are progressively superseded in this indication by azithromycin, a well tolerated macrolide active against most bacteria responsible for TD, including the quinolone-resistant species of Campylobacter jejuni that are now pervasive, especially in Southeast Asia and India. Persistent TD in the returning traveler is much rarer than its acute counterpart and may be associated with three types of causes. Persistent infections, among which Giardia and possibly Entamoeba predominate, account for a significant proportion of cases. Postinfectious processes represent a second cause and comprise temporary lactose malabsorption and postinfectious irritable bowel syndrome, now considered a major cause of persistent TD. Finally, apparently unrelated chronic diseases causing diarrhea are occasionally unmasked by TD and represent a third type of persistent TD, among which the well established case of incident inflammatory bowel disease poses intriguing pathogenesis questions. This review discusses recent advances in the field and provides practical recommendations for the management of TD in adult, immunocompetent returning travelers.

  2. Travelers' Diarrhea

    Science.gov (United States)

    ... Visiting Friends and Family in Areas with Chikungunya, Dengue, or Zika Visiting Friends or Family in an ... East, Africa, Mexico, and Central and South America. Prevention In otherwise healthy adults, diarrhea is rarely serious ...

  3. Pharmacologic Agents for Chronic Diarrhea.

    Science.gov (United States)

    Lee, Kwang Jae

    2015-10-01

    Chronic diarrhea is usually associated with a number of non-infectious causes. When definitive treatment is unavailable, symptomatic drug therapy is indicated. Pharmacologic agents for chronic diarrhea include loperamide, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, diosmectite, cholestyramine, probiotics, antispasmodics, rifaximin, and anti-inflammatory agents. Loperamide, a synthetic opiate agonist, decreases peristaltic activity and inhibits secretion, resulting in the reduction of fluid and electrolyte loss and an increase in stool consistency. Cholestyramine is a bile acid sequestrant that is generally considered as the first-line treatment for bile acid diarrhea. 5-HT3 receptor antagonists have significant benefits in patients with irritable bowel syndrome (IBS) with diarrhea. Ramosetron improves stool consistency as well as global IBS symptoms. Probiotics may have a role in the prevention of antibiotic-associated diarrhea. However, data on the role of probiotics in the treatment of chronic diarrhea are lacking. Diosmectite, an absorbent, can be used for the treatment of chronic functional diarrhea, radiation-induced diarrhea, and chemotherapy-induced diarrhea. Antispasmodics including alverine citrate, mebeverine, otilonium bromide, and pinaverium bromide are used for relieving diarrheal symptoms and abdominal pain. Rifaximin can be effective for chronic diarrhea associated with IBS and small intestinal bacterial overgrowth. Budesonide is effective in both lymphocytic colitis and collagenous colitis. The efficacy of mesalazine in microscopic colitis is weak or remains uncertain. Considering their mechanisms of action, these agents should be prescribed properly.

  4. Identification of bacteria causing acute otitis media using Raman microspectroscopy

    Science.gov (United States)

    Ayala, Oscar D.; Wakeman, Catherine A.; Skaar, Eric P.; Mahadevan-Jansen, Anita

    2016-03-01

    Otitis media (OM) is the leading cause of acute physician visits and prescription of antibiotics for children. Current standard techniques to diagnose acute otitis media (AOM) are limited by their ability to probe only changes in symptoms of the bacterial infection that cause AOM. Furthermore, they are not able to detect the presence of or identify bacteria causing AOM, which is important for diagnosis and proper antibiotic treatment. Our goal is to detect the presence of and identify the pathogens involved in causing AOM based on their biochemical profile using Raman spectroscopy (RS). An inVia confocal Raman microscope (Renishaw) at 785 nm was used to detect bacteria causing AOM in vitro. The three main bacteria that cause AOM, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae were cultured in chocolate agar and Mueller-Hinton agar to determine which agar type would minimize Raman signal from the growth agar. Preliminary results identified specific Raman spectral features characteristic of S. pneumoniae. RS has the potential to accurately diagnose AOM, which will help in identifying the antibiotic that will be most beneficial for the patient and ultimately decrease the course of infection.

  5. Causes of Acute Intranatal and Postnatal Hypoxia in Neonatal Infants

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    S. A. Perepelitsa

    2012-01-01

    Full Text Available Objective: to study the causes of acute intranatal hypoxia and reveal a relationship of placental changes to respiratory failure (RF in newborn infants. Subjects and methods. The investigation included 252 neonates with the complicated course of an early neonatal period. Their gestational age was 26 weeks to 40 weeks, birth weight varied from 850 g to 4100 g. 95.3% of the newborn infants were born with a low Apgar score and RF, which required mechanical ventilation immediately after birth. The neonatal status was clinically evaluated; the values of blood gas composition and acid-base balance were recorded; the pathogen was discharged from the tracheobronchial tree; chest X-ray survey and placental morphological examination were performed. Results. The main cause of neonatal respiratory failure is chronic intrauterine hypoxia caused by placental inflammatory changes and fetal-placental blood circulatory disorders, which gives rise to preterm delivery, cerebral hemodynamic disorders, and neonatal amniotic fluid aspiration. Bacteriological examination of tracheobronchial aspirations showed that no microflora growth occured in the majority of the newborns acute intranatal hypoxia. Enterococcus faecalis and Staphylococcus epidermidis were isolated in 12.3% and 8.7%, respectively. Growth of в-hemolytic streptococcus was observed in 2.8% of cases. The rate of microbial association specific only for rate premature infants with neonatal respiratory distress syndrome (NRDS was 4.8%. Conclusion. Placental changes causing fetal-placental circulatory disorders were ascertained to be responsible for acute intranatal and postnatal neonatal hypoxia. Placental inflammatory changes occurred in the majority of cases, as confirmed by bacteriological examinations of neonatal infants. Isolation of the varying microbial flora in infants with RF to a greater extent is, indicative of the infectious process occurring in the maternal body. Key words: acute intranatal

  6. Vaccines for viral and bacterial pathogens causing acute gastroenteritis: Part I: Overview, vaccines for enteric viruses and Vibrio cholerae.

    Science.gov (United States)

    O'Ryan, Miguel; Vidal, Roberto; del Canto, Felipe; Salazar, Juan Carlos; Montero, David

    2015-01-01

    Efforts to develop vaccines for prevention of acute diarrhea have been going on for more than 40 y with partial success. The myriad of pathogens, more than 20, that have been identified as a cause of acute diarrhea throughout the years pose a significant challenge for selecting and further developing the most relevant vaccine candidates. Based on pathogen distribution as identified in epidemiological studies performed mostly in low-resource countries, rotavirus, Cryptosporidium, Shigella, diarrheogenic E. coli and V. cholerae are predominant, and thus the main targets for vaccine development and implementation. Vaccination against norovirus is most relevant in middle/high-income countries and possibly in resource-deprived countries, pending a more precise characterization of disease impact. Only a few licensed vaccines are currently available, of which rotavirus vaccines have been the most outstanding in demonstrating a significant impact in a short time period. This is a comprehensive review, divided into 2 articles, of nearly 50 vaccine candidates against the most relevant viral and bacterial pathogens that cause acute gastroenteritis. In order to facilitate reading, sections for each pathogen are organized as follows: i) a discussion of the main epidemiological and pathogenic features; and ii) a discussion of vaccines based on their stage of development, moving from current licensed vaccines to vaccines in advanced stage of development (in phase IIb or III trials) to vaccines in early stages of clinical development (in phase I/II) or preclinical development in animal models. In this first article we discuss rotavirus, norovirus and Vibrio cholerae. In the following article we will discuss Shigella, Salmonella (non-typhoidal), diarrheogenic E. coli (enterotoxigenic and enterohemorragic), and Campylobacter jejuni.

  7. Acute scrotum in a neonate caused by renal vein thrombosis.

    Science.gov (United States)

    Maas, C; Müller-Hansen, I; Flechsig, H; Poets, C F

    2011-03-01

    The authors report on a rare case of neonatal scrotal oedema occurring concurrently with pain upon palpation of the spermatic cord on the first day of life. An ultrasound examination showed poor perfusion of the left testicle and a thrombosis of the left renal vein; intraoperative exploration indicated necrosis of the left testicle without signs of torsion. Gorged vessels with paravasal bleeding were found in the spermatic cord. The authors hypothesise that necrosis of the testicle may result from haemorrhagic infarction caused by renal venous thrombosis. Acute scrotal discolouration with pain upon palpation in neonates is usually attributed to testicular torsion. The authors report a case where these symptoms had a different cause.

  8. Pharmacologic Agents for Chronic Diarrhea

    OpenAIRE

    Lee, Kwang Jae

    2015-01-01

    Chronic diarrhea is usually associated with a number of non-infectious causes. When definitive treatment is unavailable, symptomatic drug therapy is indicated. Pharmacologic agents for chronic diarrhea include loperamide, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, diosmectite, cholestyramine, probiotics, antispasmodics, rifaximin, and anti-inflammatory agents. Loperamide, a synthetic opiate agonist, decreases peristaltic activity and inhibits secretion, resulting in the reductio...

  9. VP4 and VP7 genotyping by reverse transcription-PCR of human rotavirus in mexican children with acute diarrhea.

    Science.gov (United States)

    Rodríguez Castillo, A; Villa, A V; Ramírez González, J E; Mayén Pimentel, E; Melo Munguía, M; Díaz De Jesús, B; Olivera Díaz, H; García Lozano, H

    2000-10-01

    Dual typing (VP4 and VP7) of rotavirus obtained from 257 Mexican children during three epidemiological seasons was performed by reverse transcription-PCR. The P1G1 genotype was the most prevalent (40%), followed by P1G3 (19%) and P2G2 (16%). Thirty-one specimens (12%) presented mixed infections, while some genotypes were not found. This is the first dual typing of isolates from diarrhea cases in Mexico.

  10. 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.

  11. 消旋卡多曲治疗成人急性腹泻的临床疗效%Clinical effect of racecadotril tablets for acute diarrhea in adults

    Institute of Scientific and Technical Information of China (English)

    姚萍; 席利力

    2011-01-01

    目的 观察消旋卡多曲(抗腹泻药)治疗成人急性腹泻的临床疗效及安全性.方法 将109例急件腹泻患者随机分为消旋卡多曲治疗组(55例)和对照组(54例).对照组用WHO标准化口服补液治疗,纠正电解质和酸碱失衡;治疗组在此基础七,加用消旋卡多曲每次100 mg,每天3次.观察2组临床疗效及不良反应发生情况.结果 治疗组大便次数及性质恢复时间较对照组缩短,分别为(33.3±23.96)h vs(64.3±27.32)h;(47.8±10.46)h vs(70.8±12.82)h;脱水、电解质紊乱纠正时间也较对照组明显缩短,分别为(30.7±14.51)h vs(56.0±16.58)h;消旋卡多曲治疗总病程短于对照组,分别为(56.8 4±20.51)hvs(90.9±21.35)h;治疗72 h后,治疗组总有效率(90.90%)高于对照组(72.22%),差异有统计学意义(P<0.05).结论 常规治疗基础上配合消旋卡多曲治疗,可较快缓解急性腹泻的病情,缩短病程,且安全.%Objective To observe the curative effects of racecadotril tablets for acute diarrhea in adults. Methods One hundred and nine patients with acute diarrhea were randomly divided into racecadotril group (55 cases) and control group (54 cases). The control group was treated only by standardized oral rehydration therapy,and the racecadotril group was treated by racecadotril tablets with the dosage of 100 mg/time, three times a day,based on the standardized oral rehydration therapy. The improvement time of diarrhea and dehydration /electrolyte disturbances and the total duration of treatment was observed. Results The improvement time of frequency and quality of diarrhea in racecadotril group was significantly shorter than that of the control group, ( 33. 3 ± 23. 96 ) h vs ( 64. 3±27. 32) h; (47. 8 ± 10. 46) h vs (70. 8 ± 12. 82) h, respectively. The improvement time of dehydration /electrolyte disturbances was also significantly shorter than that of the control group, (30. 7 ± 14. 51) h vs (56. 0±16. 58) h, respectively. The course of treatment in

  12. Burkitt's lymphoma causing acute pancreatitis in a child

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    Muhammed Akıl

    2013-01-01

    Full Text Available A 8-year-old boy admitted with abdominal pain, fever and vomiting for the previous 10 days. Sensitivity was detected in the epigastric area. There was not defense and rebond. Aspartate aminotransferase was 106 U/L, alanine aminotransferase 25 U/L, alkaline phosphatase 311 U/L, blood amylase level 748 U/L, blood lipase level 391 U/L. In thoracic CT, soft tissue with smooth contours measuring 32 mm×28 mm was identified in the posterior mediastinum. Bone marrow aspiration biopsy was normal. A mass specimen obtained from the duodenum endoscopic biopsy. This specimen was diffuse staining by leukocyte common antigen, CD10 and CD20. The patient was diagnosed with acute pancreatitis associated with stage 3 duodenal Burkitt's lymphoma. Modified LMB-98 was initiated. Burkitt's lymphoma may rarely cause acute pancreatitis.

  13. Acute Cholecystitis Caused by Ceftriaxone Stones in an Adult

    Directory of Open Access Journals (Sweden)

    Christian D. Becker

    2009-01-01

    Full Text Available Acute cholecystitis is a major health problem. There are multiple etiologies to be considered and early recognition of the condition is important to optimize management and outcome. We report the first case in the medical literature of symptomatic acute cholecystitis triggered by ceftriaxone-associated gallbladder sludge formation and, importantly, solid ceftriaxone gallstone formation in an adult patient with underlying mineral and pigment cholecystolithiasis, necessitating cholecystectomy. This case serves as a reminder for physicians to keep this uncommon cause of cholecystolithiasis and cholecystitis in mind in patients who receive prolonged ceftriaxone therapy. These patients should be cautioned to promptly report to their physicians any signs or symptoms of cholecystitis in order to ensure timely and appropriate evaluation.

  14. [An unusual cause of acute respiratory distress: obstructive bronchial aspergillosis].

    Science.gov (United States)

    Margery, J; Perez, J-P; Vaylet, F; Bordier, E; Dot, J-M; Saint-Blancard, P; Bonnichon, A; Guigay, J; Pats, B; L'Her, P

    2004-06-01

    We report the case of a 77-Year-old immunocompetent woman who required intensive care for acute dyspnea revealing complete atelectasia of the left lung related to an aspergillus mycelium plug blocking the principal bronchus. The clinical course was favorable after deobstruction by thermocoagulation and oral itraconazole given for six Months. The patient was free of parenchymatous or endobronchial sequelae. Adjuvant oral corticoid therapy was given temporarily during the second Month of treatment when signs of transition towards allergic aspergillosis developed. Four Months after discontinuing the antifungal treatment, the patient developed a new episode of acute dyspnea caused by atelectasia limited to the right lower lobe. Treatment by itraconazole was resumed and continued as long-term therapy. No recurrence has been observed for eighteen Months. The diagnostic and therapeutic problems raised by Aspergillus fumigatus are well known in the immunocompromised subject, but can also be encountered in the immunocompetent subject.

  15. An Unusual Cause of Supraventricular Tachycardia: Acute Carbon Monoxide Poisoning

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    Suat Zengin

    2014-03-01

    Full Text Available      Carbon monoxide (CO is a toxic gas produced by the incomplete combustion of carbon-containing compounds. Exposure to high concentrations of CO can be letha and is the most common cause of death from poisoning worldwide. Cardiac manifestations after exposure to CO, including myocardial ischemia, heart failure, and arrhythmias, have been reported. A 28-year-old a patient was admitted to our emergency department with altered consciousness as a consequence of acute domestic exposure to CO from a stove. His carboxyhemoglobin level was 39%. The oxygen treatment was started promptly, and therapeutic red cell exchange was performed. An electrocardiogram revealed supraventricular tachycardia (SVT, and an echocardiographic examination demonstrated normal cardiac functions. To the best of our knowledge, this study is the second to report a case of SVT attack due to acute CO intoxication. This paper discusses the management of this complication in patients poisoned with CO.

  16. Acute myeloid leukaemia as a cause of acute ischaemic heart disease

    NARCIS (Netherlands)

    van Haelst, P.L.; Schot, Bart; Hoendermis, E.S.; van den Berg, M.P.

    2006-01-01

    Ischaemic heart disease is almost invariably the result of atherosclerotic degeneration of the coronary arteries. However, other causes of ischaemic heart disease should always be considered. Here we describe two patients with a classic presentation of ischaemic heart disease resulting from acute le

  17. Acute myeloid leukaemia as a cause of acute ischaemic heart disease

    NARCIS (Netherlands)

    van Haelst, P.L.; Schot, Bart; Hoendermis, E.S.; van den Berg, M.P.

    2006-01-01

    Ischaemic heart disease is almost invariably the result of atherosclerotic degeneration of the coronary arteries. However, other causes of ischaemic heart disease should always be considered. Here we describe two patients with a classic presentation of ischaemic heart disease resulting from acute

  18. Acute myeloid leukaemia as a cause of acute ischaemic heart disease

    NARCIS (Netherlands)

    van Haelst, P.L.; Schot, Bart; Hoendermis, E.S.; van den Berg, M.P.

    2006-01-01

    Ischaemic heart disease is almost invariably the result of atherosclerotic degeneration of the coronary arteries. However, other causes of ischaemic heart disease should always be considered. Here we describe two patients with a classic presentation of ischaemic heart disease resulting from acute le

  19. Study on epidemiological characteristics of cluster A rotavirus from stool specimens of patients with acute diarrhea%腹泻患者粪便标本中A组轮状病毒感染特征分析

    Institute of Scientific and Technical Information of China (English)

    孙亚萍; 宋士利; 张心会; 檀薇; 陈燕

    2012-01-01

    目的:分析病毒性腹泻患者中人轮状病毒( Human Rotavirus,HRV)的感染情况及毒株流行特点.方法:收集杭州市239份疑似病毒性腹泻患者粪便标本分别应用酶联免疫吸附法及RT-PCR法进行HRV抗原及核酸检测..其中HRV阳性核酸应用巢式RT-PCR进行轮状病毒分型检测.结果:239份粪便标本中HRV抗原阳性为44份(18.4%),HRV核酸阳性为55份(23.0%),其中G血清分型:G3型15份(27.3%),G1型9份(16.4%),G2型为7份(12.7%),G9型为1份(1.8%),G2 +G3混合感染1份(1.8%),未分型22份(40%).结论:A组轮状病毒是婴幼儿病毒性腹泻的重要病原体,同时也可引起成人腹泻散发流行,成人A组轮状病毒流行季节和流行株与婴幼儿一致,G3为主要流行株,且同时存在多种血清型流行,未分型标本的比例较大有待深入研究.%Objective;To analyze the infectious status and epidemiological characteristics of acute viral diarrhea caused by cluster A human rotavirus. Methods: A total of 239 stool specimens from suspected cases with acute virus diarrhea were collected in Hangzhou. IDEIATM kits of Lanzhou institute for biological products were used for antigen detection of human rotavirus. The nucleic acid identifications of the rotavirus were determined by RT - PCR, and the positive samples of HRV nucleic acid were analyzed for genotypes by nested - PCR. Results: Among 239 detected stool specimens,rotavirus antigen positive was 44 cases( 18. 4% ) . Rotavirus nucleic acid positive was 55 cases(23.0% ) , the serotypes were G3(15 cases, 27. 3% ) , Gl (9 cases, 16.4% ) , G2(7 cases, 12. 7% ) , G9 (1 case, 1.8%), G2 + G3 (1 case, 1.8%) and unidentified ones (22 cases, 40% ). Conclusion: Cluster A rotavirus remained the most important pathogen causing diarrhea among infants and sporadic epidemic case with acute diarrhea among adults. The epidemic season and serotype of group A rotavirus in adults are all just the same as those in infant and children. G3

  20. Acute acalculous cholecystitis complicated with peritonitis caused by Lactobacillus plantarum.

    Science.gov (United States)

    Tena, Daniel; Martínez, Nora Mariela; Losa, Cristina; Fernández, Cristina; Medina, María José; Sáez-Nieto, Juan Antonio

    2013-08-01

    Lactobacillus spp. rarely causes human disease. We report a case of a 57-year-old man with non-insulin-dependent diabetes and vascular disease admitted to our hospital with severe abdominal pain and fever. Signs of peritonitis were found upon examination. The patient underwent surgery, and a diagnosis of perforated cholecystitis with purulent peritonitis was made intra-operatively. A cholecystectomy was performed, and therapy with imipenem was initiated. Lactobacillus plantarum was isolated from bile and peritoneal fluid cultures 2 days later. The patient recovered well and was discharged on post-operative day 16 after 14 days of treatment with imipenem. To our knowledge, this is the second case reported of acute cholecystitis caused by Lactobacillus spp. This organism should be considered as a cause of biliary infections, especially in patients with underlying diseases. Correct identification is often difficult, but it is very important because these organisms are usually resistant to vancomycin and other antibiotics.

  1. Greater numbers of nucleotide substitutions are introduced into the genomic RNA of bovine viral diarrhea virus during acute infections of pregnant cattle than of non-pregnant cattle

    Directory of Open Access Journals (Sweden)

    Neill John D

    2012-08-01

    Full Text Available Abstract Background Bovine viral diarrhea virus (BVDV strains circulating in livestock herds show significant sequence variation. Conventional wisdom states that most sequence variation arises during acute infections in response to immune or other environmental pressures. A recent study showed that more nucleotide changes were introduced into the BVDV genomic RNA during the establishment of a single fetal persistent infection than following a series of acute infections of naïve cattle. However, it was not known if nucleotide changes were introduce when the virus crossed the placenta and infected the fetus or during the acute infection of the dam. Methods The sequence of the open reading frame (ORF from viruses isolated from four acutely infected pregnant heifers following exposure to persistently infected (PI calves was compared to the sequences of the virus from the progenitor PI calf and the virus from the resulting progeny PI calf to determine when genetic change was introduced. This was compared to genetic change found in viruses isolated from a pregnant PI cow and its PI calf, and in three viruses isolated from acutely infected, non-pregnant cattle exposed to PI calves. Results Most genetic changes previously identified between the progenitor and progeny PI viruses were in place in the acute phase viruses isolated from the dams six days post-exposure to the progenitor PI calf. Additionally, each progeny PI virus had two to three unique nucleotide substitutions that were introduced in crossing the placenta and infection of the fetus. The nucleotide sequence of two acute phase viruses isolated from steers exposed to PI calves revealed that six and seven nucleotide changes were introduced during the acute infection. The sequence of the BVDV-2 virus isolated from an acute infection of a PI calf (BVDV-1a co-housed with a BVDV-2 PI calf had ten nucleotides that were different from the progenitor PI virus. Finally, twenty nucleotide changes were

  2. Fever without apparent source on clinical examination, lower respiratory infections in children, bacterial infections, and acute gastroenteritis and diarrhea of infancy and early childhood.

    Science.gov (United States)

    McCarthy, P L; Bachman, D T; Shapiro, E D; Baron, M A

    1995-02-01

    This section focuses on issues in infectious disease that are commonly encountered in pediatric office practice. Paul McCarthy discusses recent literature regarding the evaluation and management of acute fevers without apparent source on clinical examination in infants and children and the evaluation of children with prolonged fevers of unknown origin. David Bachman reviews recent literature about lower respiratory tract infection in children and focuses on community-acquired lower respiratory infections and respiratory syncytial virus. Eugene Shapiro discusses literature concerning several infectious diseases commonly seen in office settings and concerning which recent developments are of interest: the hemolytic-uremic syndrome and enterohemorrhagic Escherichia coli. Streptococcus pneumoniae resistant to penicillin, infections in day care centers, and new antimicrobial drugs. Michael Baron reviews recent literature about gastroenteritis and diarrhea of infancy and early childhood and discusses diagnosis, complications, pathogenesis and physiology, epidemiology, and treatment.

  3. 急性腹泻住院婴幼儿轮状病毒和诺如病毒感染的临床研究%Comparison of clinical features between rotavirus and norovirus infections in hospitalized infants with acute diarrhea

    Institute of Scientific and Technical Information of China (English)

    王娟; 王小琴; 刘蓬勃

    2012-01-01

    Objective To study the infection status and clinical features of human rotavirus (HRV) and norovirus (NoV) as well as NoV genotypes in hospitalized children with acute diarrhea. Methods Fecal specimens and clinical data were collected from 198 hospitalized children under 5 years old diagnosed of acute diarrhea from April 2009 to May 2010. Fifty-three children without diarrhea were selected as control. Group A rotavirus antigen was tested by enzyme-linked immunosorbent assay (ELISA). NoV was detected by one-step real-time quantitative reverse-transcription polymerase chain reaction (RT-qPCR). After detection of noroviruses, positive samples were reamplified using conventional RT-PCR and the PCR amplicons were sequenced. The severity of diarrhea in children was compared. Results Group A rotaviruses and norovirus were identified in 137 (69.2%) and 40 (20.2%) children with diarrhea, respectively. These two viruses were also detected in 7 (13.2%) and 19 (35.8%) control children, respectively. Co-infection with both rotavirus and norovirus was found in 6.1% (12/198) of children with diarrhea and also in 5.7% (3/53) of children without diarrhea. The average severity scores of diarrhea didn’t indicate a statistically significant difference between groups with rotavirus alone and with norovirus alone. Sequencing analysis of NoV in cases and controls showed that GⅡ.3 and GⅡ.4 were the predominant genotypes. Conclusions Rotavirus is the most common pathogen of childhood diarrhea.In addition, data showed that NoV was the second most common cause of acute diarrhea in children after rotavirus. Asymptomatic infection of NoV was found in young children.%目的 了解腹泻婴幼儿诺如病毒 (NoV) 和A组轮状病毒 (HRV) 的感染状况、临床表现以及NoV的基因 型分布.方法 收集2009年4月至2010年5月间,198例<5岁的住院腹泻患儿的粪便标本和临床资料,并同时收集53例 非腹泻患儿作为对照;采用酶联免疫吸附法 (ELISA) 检

  4. 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.

  5. [Acute abdomen caused by eosinophilic enteritis: six observations].

    Science.gov (United States)

    Martínez-Ubieto, Fernando; Bueno-Delgado, Alvaro; Jiménez-Bernadó, Teresa; Santero Ramírez, María Pilar; Arribas-Del Amo, Dolores; Martínez-Ubieto, Javier

    2013-01-01

    Eosinophilic enteritis is a rather rare condition characterized by infiltration of the gastrointestinal tract by eosinophils; as a casue of acute abdomen it is really exceptional. The etiology is unclear and its description in the literature is sparse, but associations have been made with collagen vascular disease, inflammatory bowel disease, food allergy and parasitic infections as it was confirmed in one of our pathologic studies. From 1997 to 2011 six cases of eosinophilic enteritis that involved a small bowel segment were diagnosed. A partial resection by an irreversible necrosis was necessary in three of them; in the other three only a biopsy was necessary due to the inflammatory aspect of the affected loop causing the acute abdomen. Eosinophilic enteritis can originate acute abdomen processes where an urgent surgical treatment is necessary. The intraoperative aspect can be from a segment of small bowel with inflammatory signs up to a completely irrecoverable loop, where removing of the affected segment is the correct treatment, which can be done laparoscopically.

  6. Porcine epidemic diarrhea virus: current insights

    Directory of Open Access Journals (Sweden)

    Lv C

    2016-05-01

    Full Text Available Chaochao Lv,1,* Yan Xiao,1,* Xiangdong Li,1 Kegong Tian,1,2 1National Research Center for Veterinary Medicine, Luoyang, People's Republic of China; 2College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, People's Republic of China *These authors contributed equally to this review Abstract: Porcine epidemic diarrhea virus (PEDV, an enveloped, single-stranded, positive-sense RNA virus belonging to the genus Alphacoronavirus in the family Coronaviridae, can infect pigs of all ages and causes acute and watery diarrhea, vomiting, dehydration, and high mortality in neonatal piglets. This disease was first observed in England in 1971 and was subsequently reported in many swine-producing countries in Europe and Asia. In contrast to the situation in Europe, the disease has remained a major cause of diarrhea outbreaks on swine farms in Asia. Since late 2010, severe porcine epidemic diarrhea (PED epizootics caused by new variants have been affecting pigs in the People's Republic of China, resulting in substantial economic losses. In April 2013, PEDV was identified for the first time in the United States and resulted in the estimated death of over seven million piglets during a 1-year epidemic. Nowadays, it has spread into North and South America, Asia, and Europe, causing significant economic problems worldwide. More studies have been conducted in PEDV research, and the number of scientific literatures published during the last 5 years has exceeded the total of that in the past several decades. This review focuses on the current understanding of the etiology, molecular epidemiology, transmission, diagnosis, and pathogenesis of PEDV, as well as the vaccine to prevent PEDV infection. Keywords: PEDV, molecular epidemiology, transmission, diagnosis, pathogenesis, immune response, vaccine

  7. Factors that explain excretion of enteric pathogens by persons without diarrhea.

    Science.gov (United States)

    Levine, Myron M; Robins-Browne, Roy M

    2012-12-01

    Excretion of enteropathogens by subjects without diarrhea influences our appreciation of the role of these pathogens as etiologic agents. Characteristics of the pathogens and host and environmental factors help explain asymptomatic excretion of diarrheal pathogens by persons without diarrhea. After causing acute diarrhea followed by clinical recovery, some enteropathogens are excreted asymptomatically for many weeks. Thus, in a prevalence survey of persons without diarrhea, some may be excreting pathogens from diarrheal episodes experienced many weeks earlier. Volunteer challenges with Vibrio cholerae O1, enterotoxigenic Escherichia coli (ETEC), enteropathogenic E. coli, Campylobacter jejuni, and Giardia lamblia document heterogeneity among enteropathogen strains, with some inexplicably not eliciting diarrhea. The immune host may not manifest diarrhea following ingestion of a pathogen but may nevertheless asymptomatically excrete. Some human genotypes render them less susceptible to symptomatic or severe diarrheal infection with certain pathogens such as Vibrio cholerae O1 and norovirus. Pathogens in stools of individuals without diarrhea may reflect recent ingestion of inocula too small to cause disease in otherwise susceptible hosts or of animal pathogens (eg, bovine or porcine ETEC) that do not cause human illness.

  8. Infectious diarrheas of infants and young children

    OpenAIRE

    Mata, Leonardo

    1985-01-01

    artículo -- Universidad de Costa Rica, Instituto de Investigaciones en Salud. 1985 Acute diarrhea' disease was once attributed to "indigestion." Although shigellosis, cholera, salmonellosis, giardiasis, and amebiasis have long been recognized as distinct clinical entities, it was not too long ago that many medical personnel had difficulty accepting the fact that most diarrheas are of infectious origin. The occurrence of diarrhea with the onset of weaning in many animal speci...

  9. A rare cause of acute flaccid paralysis: Human coronaviruses

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    Cokyaman Turgay

    2015-01-01

    Full Text Available Acute flaccid paralysis (AFP is a life-threatening clinical entity characterized by weakness in the whole body muscles often accompanied by respiratory and bulbar paralysis. The most common cause is Gullian-Barre syndrome, but infections, spinal cord diseases, neuromuscular diseases such as myasthenia gravis, drugs and toxins, periodic hypokalemic paralysis, electrolyte disturbances, and botulism should be considered as in the differential diagnosis. Human coronaviruses (HCoVs cause common cold, upper and lower respiratory tract disease, but in the literature presentation with the lower respiratory tract infection and AFP has not been reported previously. In this study, pediatric case admitted with lower respiratory tract infection and AFP, who detected for HCoV 229E and OC43 co-infection by the real-time polymerase chain reaction, has been reported for the first time.

  10. Chronic Recurrent Multifocal Osteomyelitis Causing an Acute Scoliosis

    Directory of Open Access Journals (Sweden)

    Alexander Armstrong

    2013-01-01

    Full Text Available Study Design. A Case Report. Objective. We present a 15-year-old girl with an acute atypical scoliosis secondary to chronic recurrent multifocal osteomyelitis (CRMO. Summary of Background Data. CRMO is a rare nonpyogenic inflammatory bone condition with unclear aetiology. CRMO mainly affects the metaphyses of long bones, the pelvis, shoulder girdle, and less commonly the spine. Methods. Our case presented with a 6-month history of worsening thoracic back pain, asymmetry of her shoulders and abnormal posture. Whole spine radiographs revealed a right atypical thoracic scoliosis. Magnetic Resonance Imaging showed abnormal signal on the short TI inversion recovery (STIR sequences in multiple vertebrae. A bone biopsy demonstrated evidence of fibrosis and chronic inflammatory changes. Interval MRI scans revealed new oedematous lesions and disappearance of old lesions. Symptoms improved. Results. It is important to consider CRMO as an acute cause of atypical scoliosis. Malignancy, pyogenic infections and atypical presentations of juvenile arthritis need excluding. Conclusion. This 24-month follow-up describes a rare cause of an atypical scoliosis and fortifies the small amount of the currently available literature. The case highlights the relapsing and remitting nature of CRMO with new lesions developing and older lesions burning out. We advise close radiological surveillance and symptomatic management.

  11. Research Progress of the Classification and Prevention Against Bacteria Caused Calf Diarrhea%细菌性犊牛腹泻分类与防治研究进展

    Institute of Scientific and Technical Information of China (English)

    鹿书强; 刘延国; 张琳

    2012-01-01

    Calf diarrhea often occurs within 1-30 days, there is a big threat to livestock production. Calf diarrhea is caused by infections, nutritional, environmental and management factors. The major reason caused bacterial infection is bacteria. This paper mainly reviewed the progress of the cause and prevention of bacterial diarrhea.%犊牛腹泻常发生于1~30日龄,对畜牧业生产存在很大威胁。犊牛腹泻是由感染、营养、环境、管理等因素造成的。其中细菌感染是导致犊牛发生腹泻一个主要原因。文章综述了细菌性腹泻病因及防治研究进展。

  12. Acute Parasitic Infections as a Cause of Fever of Unknown Origin in Egypt

    Science.gov (United States)

    1993-10-01

    patients with acute Fasciola and Beeson, 1961) and tuberculosis was hepatica infection, 9 patients with acute the most common infection causing FUO...fascioliasis Safwat Y and Woody JN. (1990b): in Egypt. Am. J. Trop. Med. -,9g. 32, The treatment of acute Fasciola hepatica 550: 554. infection in children...infection. Clinically, acute Fasciola and patients with an infection. 32 were caused acute Schistosoma infection present a by tuberculosis and of these 32

  13. Porcine epidemic diarrhea virus infection: Etiology, epidemiology, pathogenesis and immunoprophylaxis.

    Science.gov (United States)

    Jung, Kwonil; Saif, Linda J

    2015-05-01

    Porcine epidemic diarrhea virus (PEDV), a member of the genera Alphacoronavirus in the family Coronaviridae, causes acute diarrhea/vomiting, dehydration and high mortality in seronegative neonatal piglets. For the last three decades, PEDV infection has resulted in significant economic losses in the European and Asian pig industries, but in 2013-2014 the disease was also reported in the US, Canada and Mexico. The PED epidemic in the US, from April 2013 to the present, has led to the loss of more than 10% of the US pig population. The disappearance and re-emergence of epidemic PED indicates that the virus is able to escape from current vaccination protocols, biosecurity and control systems. Endemic PED is a significant problem, which is exacerbated by the emergence (or potential importation) of multiple PEDV variants. Epidemic PEDV strains spread rapidly and cause a high number of pig deaths. These strains are highly enteropathogenic and acutely infect villous epithelial cells of the entire small and large intestines although the jejunum and ileum are the primary sites. PEDV infections cause acute, severe atrophic enteritis accompanied by viremia that leads to profound diarrhea and vomiting, followed by extensive dehydration, which is the major cause of death in nursing piglets. A comprehensive understanding of the pathogenic characteristics of epidemic or endemic PEDV strains is needed to prevent and control the disease in affected regions and to develop an effective vaccine. This review focuses on the etiology, epidemiology, disease mechanisms and pathogenesis as well as immunoprophylaxis against PEDV infection.

  14. Multiplex-Touchdown PCR to Simultaneously Detect Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis, the Major Causes of Traveler’s Diarrhea

    Science.gov (United States)

    Shin, Ji-Hun; Lee, Sang-Eun; Kim, Tong Soo; Ma, Da-Won; Chai, Jong-Yil; Shin, Eun-Hee

    2016-01-01

    This study aimed to develop a multiplex-touchdown PCR method to simultaneously detect 3 species of protozoan parasites, i.e., Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis, the major causes of traveler’s diarrhea and are resistant to standard antimicrobial treatments. The target genes included the Cryptosporidium oocyst wall protein for C. parvum, Glutamate dehydrogenase for G. lamblia, and 18S ribosomal RNA (18S rRNA) for C. cayetanensis. The sizes of the amplified fragments were 555, 188, and 400 bps, respectively. The multiplex-touchdown PCR protocol using a primer mixture simultaneously detected protozoa in human stools, and the amplified gene was detected in >1×103 oocysts for C. parvum, >1×104 cysts for G. lamblia, and >1 copy of the 18S rRNA gene for C. cayetanensis. Taken together, our protocol convincingly demonstrated the ability to simultaneously detect C. parvum, G. lamblia, and C. cayetanenesis in stool samples. PMID:27853120

  15. AKTIVITAS ANTIBAKTERI EKSTRAK BIJI TERATAI (Nymphaea pubescens Willd TERHADAP BAKTERI PATOGEN PENYEBAB DIARE [Antibacterial Activity of Water lily Seed Extract Toward Diarrhea-causing Pathogenic Bacteria

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    Yuspihana Fitrial1

    2008-12-01

    Full Text Available The objectives of this study was to observe antibacterial activities of water lily seed, against diarrhea-causing pathogenic bacteria as well as lactic acid bacteria; phytochemistry components in water lily seed and to evaluate each component’s activities against pathogen bacteria.Extraction of antibacterial components in the seed was done by fractional extraction methods using solvent based on its polar level, i.e. hexane, ethyl acetate and ethanol. The activities of each extract was tested by using diarrhea-causing bacteria, Enteropathogenic Escherichia coli K.1.1 (EPEC K1.1 and S. typhimurium with agar well diffusion method. The minimum inhibitory concentration (MIC and minimum bactericidal concentration (MBC values were calculated with plate counting. Qualitative phytochemical tests were performed on all extracts. Fractionation was performed on extract with the largest antimicrobial activity by using thin-layer chromatography. The activities of each fraction were tested qualitatively by bio-autography method on thin layer chromatographic plates. The water lily seed had an antibacterial activity against EPEC K.1.1 and Salmonella typhimurium, especially in ethyl acetate extract. Ethanol extract had the same, yet lower activity. Ethyl acetate and ethanol extract of the seed did not show inhibition against the growth of lactic acid bacteria (Lactobacillus sp and Bifidobacterium bifidum.The MIC and MBC values of the ethyl acetate extract on EPEC K1.1 were 0.89 (mg/mL and 1.33 (mg/mL, respectively, while similar values of that on S. Typhimurium were 1.11 (mg/mL and 1.33 (mg/mL¬, respectively. Phytochemistry components within ethyl acetate extract were alkaloids, flavonoids, tannins, glycosides, saponins, and triterpenoids. All fractions in the ethyl acetate extract had antimicrobial activities against EPEC K.1.1 and S. Typhimurium. These fractions were thought to inhibit the growth of the test-microbes by synergic action of each component.

  16. 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; Fiore, Lucia

    2015-01-01

    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. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  17. Wallenberg Syndrome: An Exceptional Cause of Acute Vertigo in Children.

    Science.gov (United States)

    Ehresmann, Aude Ménétrey; Van, Hélène Cao; Merlini, Laura; Fluss, Joel

    2016-01-01

    The assessment of acute vertigo in childhood is often challenging, but fortunately a central cause is rarely identified. We present the case of a 7-year-old boy who developed, after a mild head trauma, a rotary vertigo associated with nausea and vomiting. A posttraumatic peripheral vestibular dysfunction was first suspected but not confirmed by an otoneurological evaluation. When subtle neurological signs were elicited, a brain magnetic resonance imaging was promptly requested. This showed a small infarct on the lateral posterior left part of the medulla oblongata of the brainstem, typical of Wallenberg syndrome. Vascular imaging was normal and no defined etiology was found. The child was started on prophylactic acetylsalicylic acid. The rapid disappearance of vertigo was noted. On follow-up at 6 months, there has been no recurrence and neurological examination was fully normal. Our case extends the differential diagnosis of acute vertigo in childhood that rarely includes the possibility of a brainstem infarct whose recognition through appropriate clinical examination is nevertheless capital for appropriate investigations and management. Georg Thieme Verlag KG Stuttgart · New York.

  18. Microbiological and epidemiological analysis of 320 acute diarrhea cases%320例腹泻患者病原菌分离及流行病学分析

    Institute of Scientific and Technical Information of China (English)

    李珉珉; 朱勤爱; 张苹; 张培; 于德宪; 李曦; 苏建新

    2012-01-01

    目的 了解广州市2009年至2010年肠道门诊就诊的细菌性腹泻患者病原谱的分布情况,为制定针对重点人群肠道传染病防治策略提供依据.方法 收集2009年5月至2010年5月暨南大学附属第一医院腹泻患者的粪便标本,使用卡-布运送培养基,增菌培养后,采用生化反应和氧化酶试验进行菌株鉴定,并用梅里埃API生化板条进行验证,用病原菌诊断血清进行细菌分型.结果 从320份粪便标本中分离到38株菌株,其中沙门菌15株,产毒大肠埃希菌12株,致病大肠埃希菌6株,志贺菌2株,出血性大肠埃希菌、霍乱弧菌、气单胞菌各1株.0~ 20岁年龄段高发,以1岁以内婴幼儿为主;7~10月为发病高峰期.结论 来该院肠道门诊就诊的细菌性腹泻患者,其病原体以沙门菌为主,其次为产毒大肠埃希菌.因此,广州地区细菌性腹泻的预防,应有针对性的面向重点人群和重点病原菌.%Objective To study the bacterial pathogens distribution of acute diarrhea in the First Affiliated Hospital of Jinan University. Method 320 cases of stool specimens were collected from acute diarrhea patients in the First Affiliated Hospital of Jinan University during May, 2009 to May, 2010. Specimens were transported by Cary-Blair transport media. Bi-omerieux API biochemistry strip and serological diagnosis were used to identify the bacteria after enrichment cultivation. Result There were 38 strains isolated from the 320 stool samples, which contained 15 strains of Salmonella, 12 strains of Bacterium coli and 3 strains of Sgigella. Patients at the age of 0 - 20 were the high risk population, especially baby under 1 year old. The peak period of diarrhea was during July and October. Conclusion Salmonella is the top-ranking pathogen in bacterial diarrhea patients who went to the intestinal disease clinic of the First Affiliated Hospital of Jinan University, followed by Bacterium coli. Prevention and control target the high

  19. [Urgent laparoscopic adrenalectomy in acute crisis caused by pheochromocytoma].

    Science.gov (United States)

    Bereczky, Bíborka; Madách, Krisztina; Gál, János; István, Gábor; Sugár, István; Ondrejka, Pál; Vörös, Attila

    2014-06-01

    Authors present the case of a 30-year-old female patient, who was admitted to the ICU because of hypertensive crisis accompanied by chest complains, cardiac decompensation, progrediating short of breath and unconsciousness. Despite the quick examinations and the prompt treatment multi-organ failure developed 3 days after admission. Investigations revealed the underlying cause, which was a left-sided suprarenal neoplasm. Hence, multidisciplinary decision was made to carry out a laparoscopic adrenalectomy urgently. The histology examination of the removed neoplasm was pheochromocytoma. In the postoperative period the condition of the patient gradually improved, her symptoms and complains settled, and finally she was discharged in a healthy condition. The diagnosis of a pheochromocytoma is a difficult task, the symptoms and complains caused by it can simulate many other illnesses. The acute crisis caused by pheochromocytoma usually can be treated conservatively, but in more severe cases with impending multi-organ failure an urgent operative treatment can be unavoidable. Though the operative risk is relatively high, the correct intra- and postoperative treatment with a quick laparoscopic procedure can be effective.

  20. Acute onset headache complicating labor epidural caused by intrapartum pneumocephalus.

    Science.gov (United States)

    Smarkusky, Loren; DeCarvalho, Helena; Bermudez, Ady; González-Quintero, Víctor Hugo

    2006-09-01

    Epidural placement for obstetric anesthesia is a common procedure. Pneumocephalus, the introduction of air into the cranial cavity after epidural placement, is a rare complication encountered when air is used for identification of the epidural space. A 42-year-old primipara undergoing epidural placement reported sudden onset of severe headache with associated neurologic symptoms and nuchal rigidity. Emergent CT scan revealed pneumocephalus. With conservative management, her symptoms resolved with interval resumption of the air collection evidenced on interval CT. Acute onset headache after epidural placement can present with impressive neurologic signs and symptoms. Prompt identification of the cause of this pathology is of vital importance to delineate pneumocephalus from potentially treatable or life-threatening disorders.

  1. [An operated case of a meningioma causing acute subdural hematoma].

    Science.gov (United States)

    Chonan, Masashi; Niizuma, Kuniyasu; Koyama, Shinya; Kon, Hiroyuki; Sannohe, Seiya; Kurotaki, Hidekachi; Midorikawa, Hiroshi; Sasaki, Tatsuya; Nishijima, Michiharu

    2013-03-01

    We report a rare case of a meningioma causing acute hematoma. A 67-year-old woman presented with sudden headache. No evidence of trauma was seen. CT demonstrated a subdural hematoma in the convexity of the fronto-temporal lobe. Magnetic resonance imaging showed marked signal heterogeneity in the convexity of the frontal lobe. One week later, the patient underwent hematoma evacuation and tumor resection including the attached dura mater. The histological diagnosis was meningothelial meningioma. The clot was connected directly to the tumor and the origin of the subdural hematoma was identified as the meningioma. Postoperative course was uneventful, and the headache improved. Meningiomas have a relatively benign course but rarely present with hemorrhage. Surgical exploration is the effective and recommended treatment.

  2. A Rare Cause of Acute Abdomen: Idiopathic Isolated Cecal Necrosis

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    Ender Özer

    2015-03-01

    Full Text Available Idiopathic isolated cecal necrosis is a clinical problem characterized by right-sided inferior abdominal pain. It is rarely seen, develops due to decreased blood flow to the colon and, imitates acute appendicitis. Its clinical signs are similar to many illnesses causing sensitivity in the right inferior quadrant and, the diagnosis is generally determined during surgery. An 86-year-old male patient presented with the complaints of abdominal pain, trichiniasis, nausea and vomiting. Surgical intervention was decided when physical examination and laboratory results were taken into consideration. After diagnostic laparoscopy, right hemicolectomy was performed because of cecal necrosis. While the mortality and morbidity rates for ischemic bowel disease are high, prognosis for early diagnosed patients with isolated cecal necrosis is better, provided that timely surgical treatment is decided.

  3. Can fruit seeds and undigested plant residuals cause acute appendicitis

    Institute of Scientific and Technical Information of China (English)

    Omer Engin; Mehmet Yildirim; Savas Yakan; Gulnihal Ay Coskun

    2011-01-01

    Objective:To investigate the relation between fruit seeds, plants residuals and appendicitis. Methods: Among cases that underwent appendectomy, the appendicitis cases having fruit seeds and undigested plant residuals in their etiology were examined retrospectively. Also, histopathological features, age, sex, and parameters of morbidity and mortality were used. Results: Fruit seed was found in one case(0.05%) with presence of pus in appendix lumen, undigested plant residuals in 7 cases(0.35%). It was determined that there were appendix inflammation in 2 of the plant residuals cases, while there were obstruction and lymphoid hyperplasia in the appendix lumen of5 cases. No mortality was observed.Conclusions: The ratio of acute appendicitis caused by plants is minimal among all appendectomised patients, but avoidence of eating undigested fruit seeds and chewing plants well may help to prevent appendicitis.

  4. Pseudoradial Nerve Palsy Caused by Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Hassan Tahir MD

    2016-07-01

    Full Text Available Pseudoperipheral palsy has been used to characterize isolated monoparesis secondary to stroke. Isolated hand nerve palsy is a rare presentation for acute cerebral stroke. Our patient presented with clinical features of typical peripheral radial nerve palsy and a normal computed tomography scan of the head, which, without a detailed history and neurological examination, could have been easily misdiagnosed as a peripheral nerve lesion deferring further investigation for a stroke. We stress the importance of including cerebral infarction as a critical differential diagnosis in patients presenting with sensory-motor deficit in an isolated peripheral nerve pattern. A good history and physical exam can differentiate stroke from peripheral neuropathy as the cause of radial nerve palsy.

  5. Adenomyomatous polyp causing acute urinary retention in a postmenopausal woman

    Directory of Open Access Journals (Sweden)

    Selver Özekinci

    2011-09-01

    Full Text Available A case of adenomyomatous polyp (AP causig acute urinary retention in postmenopausal period is presented. A 65-year-old, G8P8 women admitted to our clinic with the complaint of vaginal bleeding and vaginal mass was identified. During preoperative hospitalization she complained about not able to urinate. Serum urea and creatinine levels increased [66 mg/dL (range= 10-45 and 2,49 mg/dL (range= 0. 6-1.3 respectively]. Emergent abdominopelvic tomography showed vaginal mass and overdistended bladder. Mass was removed by vaginal route and abdominal hysterectomy was also performed. Pathologic examination revealed non-malignant AP with massive necrosis. A variety of female reproductive tract diseases can cause urinary obstruction. Treatment choice depends on reproductive expectance of the patient. J Clin Exp Invest 2011; 2 (3: 312-314.

  6. [Star fruit as a cause of acute kidney injury].

    Science.gov (United States)

    Scaranello, Karilla Lany; Alvares, Valeria Regina de Cristo; Carneiro, Daniely Maria Queiroz; Barros, Flávio Henrique Soares; Gentil, Thais Marques Sanches; Thomaz, Myriam José; Pereira, Benedito Jorge; Pereira, Mariana Batista; Leme, Graziella Malzoni; Diz, Mary Carla Esteves; Laranja, Sandra Maria Rodrigues

    2014-01-01

    The star fruit belongs to the family Oxalidacea, species Averrhoa carambola. It is rich in minerals, vitamin A, C, B complex vitamins and oxalic acid. Recent studies show that the toxicity of the fruit differs between the patients and may be explained by single biological responses, age, and the intake quantity of the neurotoxin in each fruit in addition to glomerular filtration rate given by each patient. Additionally, the nephrotoxicity caused by the fruit is dose-dependent and may lead to the deposition of crystals of calcium oxalate intratubular, as well as by direct injury to the renal tubular epithelium, leading to apoptosis of the same. We report the case of a patient who after ingestion of the juice and fresh fruit, developed acute renal failure requiring dialysis, evolving with favourable outcome and recovery of renal function.

  7. Acute compartment syndrome of the forearm caused by calcific tendinitis of the distal biceps.

    Science.gov (United States)

    Garayoa, Santiago Amillo; Romero-Muñoz, Luis M; Pons-Villanueva, Juan

    2010-12-01

    Acute compartment syndrome of the forearm requires immediate treatment to avoid damage of the soft tissues and a poor functional outcome for the forearm. Muscular and bone lesions are the main causes of acute compartment syndromes. We report a case of acute compartment syndrome of the forearm caused by a calcific tendinitis of the distal biceps.

  8. 门诊急性腹泻儿童的肠道病原监测%Surveillance of enteric pathogens in outpatient children with acute diarrhea

    Institute of Scientific and Technical Information of China (English)

    常海岭; 曾玫; 黄峥; 蔡洁皓; 郭家胤; 许学斌; 王相诗; 葛艳玲; 王中林

    2016-01-01

    目的监测门诊急性腹泻儿童的临床流行特征及肠道病原分布特点。方法2013年8月至2014年7月对复旦大学附属儿科医院门诊临床诊断为急性腹泻的儿童进行主动监测,对患儿的粪便标本进行包括诺如病毒、致泻大肠埃希菌、非伤寒沙门菌、弯曲菌、志贺菌、致病性弧菌和小肠结肠炎耶尔森菌在内的病原进行检测。统计分析采用卡方检验。结果881例急性腹泻患儿粪便中有246例(27.92%)检出病原体,其中诺如病毒、致泻大肠埃希菌、非伤寒沙门菌、弯曲菌和志贺菌分别检出98株(11.12%)、74株(8.40%)、61株(6.92%)、34株(3.86%)和2株(0.23%),未检出致病性弧菌及小肠结肠炎耶尔森菌。<36月龄(3.27%,26/794)儿童较>36月龄(9.20%,8/87)儿童感染弯曲菌的风险低(χ2=7.41,P=0.006)。感染诺如病毒的患儿呕吐比较常见(37.76%),且水样便比例高(21.34%);感染非伤寒沙门菌和弯曲菌的患儿发热(40.98%和29.41%)及粪便含黏液(21.31%和26.47%)多见。结论肠道病原感染在本次研究的急性腹泻患儿中占有重要地位,对肠道病原的持续性监测有助于儿童急性腹泻的防治。%Objective To monitor the clinical epidemiology and etiology of acute diarrhea in children in the outpatient setting in Shanghai .Methods An active surveillance study in Children′s Hospital of Fudan University between August 2013 and July 2014 was conducted .Outpatient children with acute diarrhea were enrolled in this study and stool samples were collected .Pathogens including norovirus ,diarrheagenic Escherichia coli (DEC) , nontyphoidal Salmonella spp .(NTS),Campylobacter,Shigella,pathogenic vibrio and Yersinia enterocolitica were identified and typed .The χ2 test was used for statistical analysis .Results Of the 881 stool samples from enrolled

  9. Acute chemical pneumonitis caused by nitric acid inhalation: case report

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Hyung Shim; Lee, In Jae; Ko, Eun Young; Lee, Jae Young; Kim, Hyun Beom; Hwang, Dae Hyun; Lee, Kwan Seop; Lee, Yul; Bae, Sang Hoon [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2003-06-01

    Chemical pneumonitis induced by nitric acid inhalation is a rare clinical condition. The previously reported radiologic findings of this disease include acute permeability pulmonary edema, delayed bronchiolitis obliterans, and bronchiectasis. In very few published rare radiologic reports has this disease manifested as acute alveolar injury; we report a case of acute chemical pneumonitis induced by nitric acid inhalation which at radiography manifested as bilateral perihilar consolidation and ground-glass attenuation, suggesting acute alveolar injury.

  10. An unusual cause of acute abdominal pain in dengue fever.

    Science.gov (United States)

    Waseem, Tariq; Latif, Hina; Shabbir, Bilquis

    2014-07-01

    Dengue fever is an acute febrile viral disease caused by the bite of Aedes aegypti mosquito. It is a major health problem especially in tropical and subtropical areas including South East Asia and Pakistan. In the past few years, dengue fever has been endemic in Northern Punjab. Physicians managing dengue fever come across varied and uncommon complications of dengue fever. We report a case of dengue fever that developed severe right upper quadrant abdominal pain and induration after extreme retching and vomiting for 2 days. A rectus sheath hematoma was confirmed on noncontrast computed tomography (CT). Rectus sheath hematoma as a complication of dengue fever has rarely been reported before and never from this part of the world. Rectus sheath hematoma is an uncommon and often clinically misdiagnosed cause of abdominal pain. It is the result of bleeding into the rectus sheath from damage to the superior or inferior epigastric artery or their branches or from a direct tear of the rectus muscle. It can mimic almost any abdominal condition (See Fig.) (See Table).

  11. Management of childhood diarrhea and use of oral rehydration salts in a suburban West African community

    DEFF Research Database (Denmark)

    Sodemann, Morten; Jakobsen, M S; Mølbak, Kare

    1999-01-01

    . Children with diarrhea considered to be caused by teething were less likely to receive ORS in the acute phase (risk ratio = 0.6, 95% confidence interval [CI] = 0.5-0.9). Univariate analyses showed that the use of ORS was related to number of reported symptoms, the mother being the care taker, consultations......, previous use of ORS, good knowledge of ORS, and having ORS sachets at home. Multivariate Cox regression analyses showed that the presence of ORS sachets at home at the onset of diarrhea was the strongest predictor of use (hazard ratio = 3.3, 95% CI = 1.9-3.6). Improved health education should focus more...... on the quantity of ORS needed, early signs of dehydration, treatment of teething diarrhea, and breast feeding, and address mothers who have no prior knowledge of ORS. Management of diarrhea may be improved by a more liberal distribution of ORS sachets....

  12. Effect of Shenlingbaizhu San on Delayed-onset Diarrhea Caused by Irinotecan in Rats%参苓白术散对伊立替康化疗后大鼠迟发性腹泻的作用研究

    Institute of Scientific and Technical Information of China (English)

    丁军利; 许隽颖; 刘超英

    2011-01-01

    目的:研究参苓白术散对模型大鼠伊立替康(Irinotecun,CPT-11)所致迟发性腹泻的预防作用.方法:健康雄性SD大鼠40只,随机分为正常对照组,腹泻模型组,中药低剂量组+腹泻模型组,中药中剂量组+腹泻模型组,中药高剂量组+腹泻模型组.尾静脉注射CPT-11 150mg/kg·d,连续两天,复制迟发性腹泻模型;中药十腹泻模型组于注射CPT-11前3天开始,每天一次用参苓白术散灌胃,共用10天;对各组大鼠腹泻情况进行评分;光镜下对大鼠肠黏膜损伤程度进行分级;ELISA法检测大鼠血清中IL-6,TNF-a,IL-10的水平.结果:中药各剂量组+腹泻模型组大鼠迟发性腹泻发生率均低于腹泻模型组(P<0.05);光镜下中药各剂量组+腹泻模型组大鼠肠黏膜损伤分级亦较模型组轻微(P<0.05);中药各剂量组+腹泻模型组大鼠的IL-6,TNF-a水平均比模型组低(P<0.05),而IL-10水平比模型组高(P<0.05).结论:参苓白术散可调节大鼠免疫功能,抑制炎症反应,预防迟发性腹泻的发生.%Objective:To study the effect of Shenlingbaizhu San on delayed-onset diarrhea caused by Irinotecan in rats models. Methods:40 healthy male SD rats were randomly divided into normal control group,diarrhea model group,low dose + diarrhea model group,middle dose group + diarrhea model group,high dose group + diarrhea model group.A model of delayed-onset diarrhea was established through injection with 150mg/kg body weigh/day CPT-11 for consecutive days into the tail vein. Herb groups were treated with Shenlingbaizhu San three days before CPT-11 injected and kept for 9 days.Scoring of delayed-onset diarrhea,histological studies of intestinal tissues under high power microscope,Elisa measuring the serum levels of IL-6,TNF-α and IL-10.Results:Scores of diarrhea in each herb dose + diarrhea model group were significantly lower than those of diarrhea model group (P<0.05);the severity of intestinal injury in each herb dose + diarrhea model group

  13. Investigation of Diarrhea in AIDS

    OpenAIRE

    Mönkemüller, Klaus E; C Mel Wilcox

    2000-01-01

    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 ...

  14. 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...

  15. Antibiotic-Associated Diarrhea

    Science.gov (United States)

    Antibiotic-associated diarrhea Overview By Mayo Clinic Staff Antibiotic-associated diarrhea refers to passing loose, watery stools ... after taking medications used to treat bacterial infections (antibiotics). Most often, antibiotic-associated diarrhea is mild and ...

  16. The evolution of bovine viral diarrhea: a review

    OpenAIRE

    Goens, Denise

    2002-01-01

    The economic importance of bovine viral diarrhea is increasing with the emergence of seemingly more virulent viruses, as evidenced by outbreaks of hemorrhagic syndrome and severe acute bovine viral diarrhea beginning in the 1980s and 1990s. It appears that evolutionary changes in bovine viral diarrhea virus were responsible for these outbreaks. The genetic properties of the classical bovine viral diarrhea virus that contribute to the basis of current diagnostic tests, vaccines, and our unders...

  17. 急性腹泻中医证候季节性分布规律的临床研究%Clinical Research of Seasonal Distribution Regularity of Chinese Medicine Patterns in Acute Diarrhea

    Institute of Scientific and Technical Information of China (English)

    崔宁; 谢春娥; 李安德; 王晓才; 张秋林

    2011-01-01

    目的 通过对急性腹泻患者的中医证候进行分析、归纳,总结出急性腹泻患者的临床中医证候特点和常见的证候类型,为急性腹泻的中医辨证论治提供指导.方法 通过观察本年度在肠道门诊就医的急性腹泻患者,根据临床病史,结合舌、脉表现,参考流行病学史,经综合分析,从急性腹泻患者中随机入选609例作为临床研究病例.辨别相应的证候归类为寒湿证、湿热证、疫毒泻、食滞胃肠、肝气乘脾、脾胃虚弱等证型.结果 总体样本证型分布以湿热证、寒湿证和食滞胃肠证为主,其他证型不足5%.春季湿热证候多于冬季,冬季寒湿证候多于春季;夏季湿热证候多于秋季,秋季寒湿证候多于夏季.夏、秋季节湿热证候明显多于春、冬季节;而冬、春季节寒湿证候明显多于夏、秋季节.结论 通过归纳急性腹泻中医证候季节分布规律,有助于分析急性腹泻初期的病因病机,为中医辨证治疗急性腹泻提供更多客观依据.%Objective To summarize the clinical pattern characteristics of Chinese medicine and common patterns of acute diarrhea through the analysis and synthesis of Chinese medicine patterns for the patients with acute diarrhea so as to provide the guidance for pattern differentiation and treatment of acute diarrhea in terms of traditional Chinese medicine. Methods For the patients with acute diarrhea visited in enteric clinic in the year, according to clinical history,in association with tongue and pulse conditions and in reference to epidemic history, after comprehensive analysis,609 patients with acute diarrhea were selected in random as clinical research cases and they were differentiated as cold damp pattern, damp heat pattern, epidemic toxin pattern, food retention in the stomach and intestine pattern,liver qi stagnation counteracting the spleen pattern and spleen and stomach deficiency pattern. Results The samples were differentiated generally

  18. 急性感染性腹泻患儿血清CRP值变化的临床意义%Change of Serum CRP in Acute Infectious Diarrhea in Children

    Institute of Scientific and Technical Information of China (English)

    叶国华; 张锦光; 黎惠璋; 郭德康; 郭溉宗

    2009-01-01

    [目的]探讨急性感染性腹泻患儿血清C反应蛋白(CRP)的变化及临床意义.[方法]对132例急性感染性腹泻患儿按病原体不同分为病毒性肠炎组82例和细菌性肠炎组50例;按病情程度不同分为重型腹泻组73例和轻型腹泻组59例.应用免疫比浊法测定血清CRP及血生化,同时测定53例健康对照组CRP.[结果]82例病毒性肠炎组及50例细菌性肠炎组CRP均明显高于对照组(P<0.01),病毒性肠炎组与细菌性肠炎组比较CRP差异无显著性(P>0.05),73例重型腹泻组与59例轻型腹泻组比较CRP差异有显著性(P<0.01).[结论]急性感染性腹泻患儿CRP不能作为鉴别病毒或细菌感染的指标,但可作为评价病情严重与否的有用指标.%[Objective] To explore the change of serum C-reaction protein (CRP) level in the acute infectious diarrhea and evaluation its clinical significance. [Methods]A total of 132 cases of acute infectious diarrhea in children were divided into viral enteritis group(n=82) and bacterial enteritis group (n=50) by different pathogens. According to the degree of the disease state, all patients were divided into severe diarrhea group (n=73) and light diarrhea group (n=59). The serum CRP and blood biochemistry were measured by immunoturbidimetry method. Fifty three healthy children were selected as controls. [Results]The serum CRP level in the viral enteritis group and bacterial enteritis group was obviously higher than that in the control group(P0.05). There was significant difference between severe diarrhea group and light diarrhea group (P<0.01). [Conclusion] The serum CRP level in the acute infectious diarrhea can not be the indicator for distinguishing viral and bacterial infections, but it can evaluate the disease severity.

  19. 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...

  20. 儿泻停颗粒联合双歧杆菌乳杆菌三联活菌片治疗小儿急性腹泻的疗效分析%Efficacy of Child Diarrhea Stops Particles Joint Triple Viable Bifidobacterium Lactobacillus in the Treatment of Children With Acute Diarrhea

    Institute of Scientific and Technical Information of China (English)

    刘文霞; 张晓

    2015-01-01

    目的:研究分析儿泻停颗粒联合双歧杆菌乳杆菌三联活菌片治疗小儿急性腹泻的临床效果。方法选取2013年2月~2015年2月我院收治的小儿急性腹泻患儿82例,随机分为对照组、观察组,各41例。对照组给予蒙脱石散联合双歧杆菌乳杆菌三联活菌片治疗,观察组给予儿泻停颗粒联合双歧杆菌乳杆菌三联活菌片治疗,对比两组临床治疗效果。结果观察组治疗3d后总有效率高于对照组,差异具有统计学意义(P0.05);观察组不良反应情况与对照组相比,无差异(P>0.05)。结论儿泻停颗粒联合双歧杆菌乳杆菌三联活菌片治疗小儿急性腹泻能够迅速缓解患儿临床症状,提高临床效果。%Objective To analysis the clinical effect of child diarrhea stops particles joint triple viable bifidobacterium lactobacil us in the treatment of children with acute diarrhea. Methods Children with acute diarrhea in children chosen from February 2013 to February 2015 in our hospital 82 cases,randomly divided into two groups,the observation group,41 cases each. The control group received montmorillonite joint triple viable bifidobacterium lactobacil us tablets in the treatment,the observation group were children diarrhea stops particles joint triple viable bifidobacterium lactobacil us tablets in the treatment,compared two groups of clinical effect. Results Total effective observation group was significantly higher than after 3 d,the difference was significant(P0.05). Adverse reactions observed group compared with the control group,no significant difference(P>0.05). Conclusion Child diarrhea stops particles joint triple viable bifidobacterium lactobacil us tablets in the treatment of children with acute diarrhea can quickly relieve symptoms in children, improve clinical results.

  1. 中医药治疗急性腹泻的临床研究进展%Research advances on the application of traditional Chinese medicine in the treatment of acute diarrhea

    Institute of Scientific and Technical Information of China (English)

    陈星余

    2012-01-01

    近年来,中医药治疗急性腹泻的疗效日益受到国内外医学界的重视.中医药治疗急性腹泻的报道很多,临床研究方案不尽相同,各有特色.本文从中医药治疗急性腹泻的病因病机分析及临床辨证治疗方案等方面进行综述,认为中医药治疗急性腹泻的疗效好,副作用小,并提出优化选方、进行作用机制研究等建议,为进一步研究提供参考.%In recent years, the efficacy of traditional Chinese medicine in the treatment of acute diarrhea has been paid attention in the domestic and international medical community. There have been many reports on using traditional Chinese medicine in the treatment of acute diarrhea. The clinical research programs used are different and have their own characteristics. This paper reviewed the use of traditional Chinese medicine in the treatment of acute diarrhea, from the aspects of etiology, pathogenesis and treatment of clinical syndromes, etc. A great number of studies have proved that the traditional Chinese medicine for treatment of acute diarrhea have better therapeutic effect, less side effects. It is suggested that prescription should be well selected, and the mechanism should be studied, which provides consultations for studies in the future.

  2. A Rare Cause of Acute Urinary Retention: Retroperitoneal Ganglioneuroma and Concurrent Mediastineal Schwannoma

    Directory of Open Access Journals (Sweden)

    Salih Budak

    2013-04-01

    Full Text Available The underlying prior cause at the old male patients refered with acute urinary retention is frequently benign prostatic hypertrophy and urethral pathologies. Acute urinary retention can develop with obstruction as well as neurogenic causes. Neurogenic tumors develops from the cells which takes its origin from the neural crest and they can be seen every neural tissue. In this study rarely seen retroperitoneal ganglioneuroma which causes acute urinary retention and coexisting asymptomatic mediastineal schwannoma case is presented.

  3. Glutamine Attenuates Acute Lung Injury Caused by Acid Aspiration

    Directory of Open Access Journals (Sweden)

    Chih-Cheng Lai

    2014-08-01

    Full Text Available Inadequate ventilator settings may cause overwhelming inflammatory responses associated with ventilator-induced lung injury (VILI in patients with acute respiratory distress syndrome (ARDS. Here, we examined potential benefits of glutamine (GLN on a two-hit model for VILI after acid aspiration-induced lung injury in rats. Rats were intratracheally challenged with hydrochloric acid as a first hit to induce lung inflammation, then randomly received intravenous GLN or lactated Ringer’s solution (vehicle control thirty min before different ventilator strategies. Rats were then randomized to receive mechanical ventilation as a second hit with a high tidal volume (TV of 15 mL/kg and zero positive end-expiratory pressure (PEEP or a low TV of 6 mL/kg with PEEP of 5 cm H2O. We evaluated lung oxygenation, inflammation, mechanics, and histology. After ventilator use for 4 h, high TV resulted in greater lung injury physiologic and biologic indices. Compared with vehicle treated rats, GLN administration attenuated lung injury, with improved oxygenation and static compliance, and decreased respiratory elastance, lung edema, extended lung destruction (lung injury scores and lung histology, neutrophil recruitment in the lung, and cytokine production. Thus, GLN administration improved the physiologic and biologic profiles of this experimental model of VILI based on the two-hit theory.

  4. Observation of therapeutic effectiveness of Qiuxieling granules on child acute diarrhea%秋泻灵颗粒治疗小儿急性腹泻疗效观察

    Institute of Scientific and Technical Information of China (English)

    李菊芬; 鲁春红

    2014-01-01

    目的:探讨秋泻灵颗粒治疗小儿急性腹泻的临床疗效。方法随机分成2组,对照组60采用常规治疗措施,治疗组在常规治疗的基础上加用秋泻灵治疗。比较两组主要症状和体征改善情况。结果总有效率治疗组95.4%,对照组83.3%,两组比较有显著差异(p<0.05)。结论秋泻灵颗粒治疗小儿急性腹泻疗效好。%Objectives:To study the efficacy of Qiuxieling granules in treating of child acute diarrhea.Methods:126 cases of child acute diarrhea were randomly divideded into treating group(n=66)who were given qiuxieling granules and the normal therapy.The same therapy was performed in control group(n=60)except qiuxieling granules.Main symptom and improvement of two groups were compared.Results:The incidence of clinical effect in treating group is94.5% which was morethan 83.3%of control group (p<0.01).Conclusions:The Qiuxieling granules is satisfactory in the treatment of child acute diarrhea.

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

    OpenAIRE

    Abegaz TM; Belachew SA; Abebe TB; Gebresilassie BM; Teni FS; Woldie HG

    2016-01-01

    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 diarr...

  6. Causes and nursing countermeasures for diarrhea of hospitalized critical patients%住院危重患者发生腹泻的原因分析及护理措施

    Institute of Scientific and Technical Information of China (English)

    罗彩珍

    2013-01-01

    OBJECTIVE To explore the causes and nursing countermeasures for diarrhea of the hospitalized critical patients. METHODS The clinical data of 220 critical patients were retrospectively analyzed, the causes of the diarrhea were analyzed, and influence of diarrhea on the patients condition was observed, the nursing countermeasures were observed. RESULTS Of 270 critical patients investigated, there were 40 (14. 81%) patients with diarrhea, including 18 cases of infectious diarrhea (45. 00%), 13 cases of antibiotics-associated diarrhea (32.50%), 3 cases of enteral nutrition cid-associated diarrhea (15. 00%), 3 cases of gastrointestinal drug cid-associated diarrhea (7. 50%). The mortality of the patients with diarrhea was 17. 50% , the hospital stay was (24. 56 ± 4. 34) days, and the mortality of the patients without diarrhea was 4. 35% , the hospital stay was (18.12 ± 3.45 )days, the differences were statistically significant. CONCLUSION The incidence of the diarrhea in the critical patients is high, which has an adverse effect on the prognosis, thus it is necessary to take the corresponding countermeasures to avoid or prevent the incidence of the diarrhea.%目的 探讨住院危重患者发生腹泻的原因及护理对策.方法 回顾性分析220例危重患者的临床资料,分析腹泻的原因,腹泻对病情的影响,探讨其护理措施.结果 270例危重患者合并腹泻40例占14.81%,其中感染性腹泻18例占45.00%、抗生素相关性腹泻13例占32.50%、肠内营养相关性腹泻6例占15.00%、胃肠动力药物相关性腹泻3例占7.50%;合并腹泻患者死亡率17.50%、住院时间(24.56±4.34)d,无腹泻组死亡率的4.35%、住院时间(18.12±3.45)d,两组差异有统计学意义.结论 住院危重患者腹泻发生率较高,对预后有不良影响,针对腹泻原因实施相应护理干预措施,避免或减少腹泻的发生.

  7. Epidemiology of traveler's diarrhea.

    Science.gov (United States)

    Castelli, F; Carosi, G

    1995-01-01

    Annually, over 75 million international passengers travel to tropical areas, more than 20 million of whom come from industrialized countries. They experience a high rate of traveler's diarrhea (TD), varying from 20 to 56%, which may result in serious limitations to their activities. The cause of TD is considered to be infectious in the overwhelming majority of cases and, apart from differences in relative importance, the list of responsible microbial agents is fairly constant regardless of geographic origin. The ingestion of contaminated food or water is considered to be the principal mode of transmission of the enteric pathogens of TD. Several factors have been proposed as playing a role in the etiogenesis of diarrhea in travelers, including personal (age, socioeconomic status, body weight, preexisting gastrointestinal illnesses), behavioral (mode of travel, standard of accommodation, eating in public places, dietary errors) and travel-related (destination, duration of stay, country of origin, season) factors, which are reviewed in detail.

  8. Small intestinal bacterial overgrowth as an uncommon cause of false positive lactose hydrogen breath test among patients with diarrhea-predominant irritable bowel syndrome in Asia.

    Science.gov (United States)

    Wang, Yilin; Xiong, Lishou; Gong, Xiaorong; Li, Weimin; Zhang, Xiangsong; Chen, Minhu

    2015-06-01

    It has been reported that small intestinal bacterial overgrowth (SIBO) may lead to false positive diagnoses of lactose malabsorption (LM) in irritable bowel syndrome patients. The aim of this study was to determine the influence of SIBO on lactose hydrogen breath test (HBT) results in these patients. Diarrhea-predominant irritable bowel syndrome patients with abnormal lactose HBTs ingested a test meal containing (99m) Tc and lactose. The location of the test meal and the breath levels of hydrogen were recorded simultaneously by scintigraphic scanning and lactose HBT, respectively. The increase in hydrogen concentration was not considered to be caused by SIBO if ≥ 10% of (99m) Tc accumulated in the cecal region at the time or before of abnormal lactose HBT. LM was present in 84% (31/37) of irritable bowel syndrome patients. Twenty of these patients agreed to measurement of oro-cecal transit time. Only three patients (15%) with abnormal lactose HBT might have had SIBO. The median oro-cecal transit time between LM and lactose intolerance patients were 75 min and 45 min, respectively (Z=2.545, P=0.011). Most of irritable bowel syndrome patients with an abnormal lactose HBT had LM. SIBO had little impact on the interpretation of lactose HBTs. The patients with lactose intolerance had faster small intestinal transit than LM patients. © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  9. Acute bacterial meningitis caused by acute otitis media in adults: A series of 12 patients.

    Science.gov (United States)

    Kaplan, Daniel M; Gluck, Ofer; Kraus, Mordechai; Slovik, Youval; Juwad, Hindy

    2017-01-01

    We conducted a retrospective chart review to characterize the outcomes of 12 patients-9 men and 3 women, aged 21 to 79 years (mean: 49)-who had been treated at our tertiary care center for acute bacterial meningitis caused by acute otitis media (ABMAO). Fever was the most common presenting sign/symptom, observed in 8 patients, followed by otalgia, neck stiffness, headache, and confusion. An opaque and bulging tympanic membrane was observed in 8 patients. Cultures were positive for Streptococcus pneumoniae in the cerebrospinal fluid, ear, and blood in 7, 5, and 3 patients, respectively. Immediate treatment included tympanocentesis, with aspirates sent for bacteriologic cultures. Seven patients (58.3%) underwent surgery; 5 were operated on early, and 2 underwent surgery at a later stage because of a suspected defect in the mastoid bone. A cortical mastoidectomy was performed in 6 of the 7 surgical patients; the remaining patient underwent a canal-wall-down procedure. Ten patients experienced a full recovery, 1 died, and 1 had a poor neurologic outcome (vegetative state); both of the latter 2 patients were older than 60 years. We conclude that early diagnosis, administration of antibiotics, and myringotomy are crucial for control of ABMAO. A cortical mastoidectomy with ventilation tube insertion can be reserved for patients who do not respond, which is common.

  10. Acute Esophageal Necrosis: An Uncommon Cause of Hematemesis

    Directory of Open Access Journals (Sweden)

    George Sarin Zacharia

    2014-07-01

    Full Text Available Acute esophageal necrosis or black esophagus is an uncommon clinical entity, diagnosed at the upper gastrointestinal endoscopy with the presence of strikingly black necrotic esophagus. Very often no definite etiology will be identified even though a large list of potential associations has been postulated. Upper gastrointestinal bleeding is the most common clinical presentation, others being epigastric pain, retrosternal chest discomfort and dysphagia. Only about a hundred cases of acute esophageal necrosis have been described in medical literature till this date. We report a case of acute esophageal necrosis in an elderly female who had presented with hematemesis.

  11. Is Bortezomib a Rare Cause of Acute Pancreatitis?

    Directory of Open Access Journals (Sweden)

    Tevfik Solakoglu

    2013-11-01

    Full Text Available Recently we have read an interesting case with bortezomib-induced pancreatitis in JOP. Journal of the Pancreas (Online by Elouni et al. [1]. To the best of our knowledge, this was the first reported case of bortezomib-induced acute pancreatitis in the English literature. We know that drug-induced pancreatitis is rare and each year the list of drugs associated with acute pancreatitis increases. Bortezomib is a new drug which is selective and reversible proteasome inhibitor used for the treatment of patients with multiple myeloma [2]. Herein we present a case of acute pancreatitis induced by bortezomib.

  12. Acute renal infarction: an unusual cause of abdominal pain.

    Science.gov (United States)

    Javaid, Muhammad M; Butt, Mohammed A; Syed, Yadullah; Carr, Patrick

    2009-01-01

    Acute renal infarction is an uncommon and under-diagnosed disease. Its clinical presentation is nonspecific and often mimics other more common disease entities. The diagnosis is usually missed or delayed, which frequently results in irreversible renal parenchyma damage. High index of suspicion is required for early diagnosis, as timely intervention may prevent loss of kidney function. We report a case of acute renal infarction following coronary angiography in a patient with paroxysmal atrial fibrillation who initially presented with acute abdominal pain mimicking appendicitis.

  13. Acute localized exanthematous pustulosis caused by cefoperazone and sodium sulbactam*

    Science.gov (United States)

    Qu, Yan-Jing; Jin, Shu-Bin; Han, Xiang-Chun; Zheng, Li-Qiang

    2016-01-01

    Acute localized exanthematous pustulosis is a localized variant of acute generalized exanthematous pustulosis, which is characterized by the eruption of multiple scattered pustules following drug administration. A 72-year-old woman presented with multiple erythematous pustules on her face, which had appeared two days after using cefoperazone and sodium sulbactam. Histopathological findings showed subcorneal pustules and mixed inflammatory cell infiltration in the dermis. The pustules resolved within about two weeks after the patient discontinued the antibiotics. This report discusses the case of a woman with a cutaneous drug reaction consistent with acute localized exanthematous pustulosis that occurred after cefoperazone and sodium sulbactam were administered. PMID:28099605

  14. An Unusual Cause of Acute Upper Gastrointestinal Bleeding: Acute Esophageal Necrosis

    Directory of Open Access Journals (Sweden)

    Nikhil R. Kalva

    2016-01-01

    Full Text Available Acute esophageal necrosis (AEN, also called “black esophagus,” is a condition characterized by circumferential necrosis of the esophagus with universal distal involvement and variable proximal extension with clear demarcation at the gastroesophageal junction. It is an unusual cause of upper gastrointestinal bleeding and is recognized with distinct and striking mucosal findings on endoscopy. The patients are usually older and are critically ill with shared comorbidities, which include atherosclerotic cardiovascular disease, diabetes mellitus, hypertension, chronic renal insufficiency, and malnutrition. Alcoholism and substance abuse could be seen in younger patients. Patients usually have systemic hypotension along with upper abdominal pain in the background of clinical presentation of hematemesis and melena. The endoscopic findings confirm the diagnosis and biopsy is not always necessary unless clinically indicated in atypical presentations. Herein we present two cases with distinct clinical presentation and discuss the endoscopic findings along with a review of the published literature on the management of AEN.

  15. A cross-sectional survey on acute diarrhea and risk factors of dietary behavior in Shanghai%上海市急性腹泻及饮食行为危险因素现况调查

    Institute of Scientific and Technical Information of China (English)

    刘弘; 罗宝章; 吴春峰; 陆冬磊; 邢之慧

    2012-01-01

    Objective To study acute diarrhea status and risk factors of dietary behavior in Shanghai. Methods A stratified multi-stage cluster random household sampling was used in this cross-sectional survey. Results The incidence rate of acute diarrhea among Shanghai residents was 0. 68 episodes per person-year. It was 0. 75 episodes per person-year for males and 0.62 episodes per person-year for females. It was estimated to be 0.96, 0.54, 0.71, 0.71 and 0.64 episodes per person-year for age groups of 0 - 7 , 8 - 17 , 18 - 33 , 34 - 59 and ≥60, respectively. 24. 34% of respondents suspected their illness was due to contaminated food. 40. 03% of respondents had visited doctor. Single variable and logistic regression analysis showed that odds ratio of acute diarrhea were 1.37 ( 95 % confidence interval, 1. 13 - 1. 67 ) , 0.66 (95% confidence interval, 0.49 -0.88) and 0.76 (95% confidence interval, 0.62 -0.94) for the respondents who had the behavior of eating delicatessen, keeping food at low temperature and salty taste. Conclusion Acute diarrhea is a common illness among residents in Shanghai. The incidence of acute diarrhea was slightly higher in males. After the age of eight, the incidence declined, but increased again in adult and then declined above 60. The behavior of eating delicatessen was a risk factor for acute diarrhea. The habit of keeping the food at low temperature and salty taste might be the protective factors for acute diarrhea.%目的 了解上海市急性腹泻现况及饮食行为危险因素.方法 采用多阶段随机抽样,进行横断面入户问卷调查.结果 上海市居民急性腹泻年发生率0.68次/人年.男性0.75次/人年、女性0.62次/人年,0~7岁、8 ~17岁、18 ~33岁、34 ~59岁、≥60岁分别为0.96、0.54、0.71、0.71、0.64次/人年.有24.34%人自诉有可疑食物史、40.03%的人就诊.单因素及Logistic回归多因素分析显示:食用散装熟食者的急性腹泻OR值为1.37、95%CI (1.13~1.67),

  16. Acute pancreatitis caused by leptospirosis: Report of two cases

    Institute of Scientific and Technical Information of China (English)

    Ekrem Kaya; Adem Dervisoglu; Cafer Eroglu; Cafer Polat; Mustafa Sunbul; Kayhan Ozkan

    2005-01-01

    Two cases of acute pancreatitis with leptospirosis are reported in this article. Case 1: A 68-year-old woman,presented initially with abdominal pain, nausea, vomiting,and jaundice. She was in poor general condition, and had acute abdominal signs and symptoms on physical examination. Emergency laparotomy was performed, acute pancreatitis and leptospirosis were diagnosed on the basis of surgical findings and serological tests. The patient died on postoperative d 6. Case 2: A 62-year-old man, presented with fever, jaundice, nausea, vomiting, and malaise. Acute pancreatitis associated with leptospirosis was diagnosed,according to abdominal CT scanning and serological tests.The patient recovered fully with antibiotic treatment and nutritional support within 19 d.

  17. A multiattribute utility evaluation of different methods for the detection of enteric protozoa causing diarrhea in AIDS patients

    Directory of Open Access Journals (Sweden)

    Sundar Shyam

    2010-01-01

    Full Text Available Abstract Background Enteric protozoa and sporozoa have emerged as important opportunistic parasites and can cause fatal infections in AIDS patients. The line of treatment being different for them necessitates an accurate and prompt identification of these to avoid empirical treatment. In this study which is the first of its kind from India we did a comprehensive evaluation of different techniques, comparing them on the basis of the attributes like yield, cost, time taken, expertise and infrastructure. For the first time combination of Calcoflour White and DAPI, a nuclear stain, were used to identify Microsporidia spp. Thus, a diagnostic protocol was devised for rapid, sensitive and cost effective identification of the opportunistic enteric protozoa. Results The organisms isolated from the stool samples of the cases (450 HIV patients were predominantly Cryptosporidium spp., Microsporidia spp. and Cyclospora spp. Interestingly, the control group (200 relatives of the patients who were HIV negative showed a high incidence (21% of Cryptosporidium spp. We found a significant increase in the sensitivity of microscopy in detecting Cryptosporidium spp. and Cyclospora spp. after formol ether concentration. Kinyoun's staining was better compared to Modified safranin staining for Cryptosporidium spp. identification. Although ELISA had a sensitivity of 93.25% and specificity of 97% for Cryptosporidium spp. detection, we ranked Kinyoun's staining better than ELISA because it is not affordable to most of our patients. For detecting Cyclospora cayetanensis, autoflourescence was the easiest and most cost effective method followed by Safranin technique. Combination of Calcoflour White stain and DAPI gave good results for the identification of Microsporidia spp. We assessed the above techniques and graded the attributes in the following descending order: cost effectiveness, sensitivity, ease of use and interpretation, time taken for the procedure and batch

  18. Acute Abdominal Pain in Children: Causes and Development Factors

    Directory of Open Access Journals (Sweden)

    E. A. Romanova

    2017-01-01

    Full Text Available Currently differential diagnosis of acute abdominal pain syndrome in children at prehospital care units is vital and urgent problem which requires solution. Unfortunately, embarrassing mistakes are still followed by late or inadequate treatment and complications as a result. The problem solution requires both medical stuff alert and diagnosis algorithm revision and improvement. Improvement of technical equipment and availability of instrumental diagnostic methods at the out-hospital settings is a pressing need. The article provides a classification, detailed pathogenesis, and clinical presentation of acute abdominal pain in children under different nosologies (therapeutic and surgical. We considered the problem of adequate differential diagnosis of acute abdominal pain in children when the diagnostics is performed by primary care physicians and specialists of emergency medical services at the prehospital stage.

  19. A rare cause of acute coronary syndrome: Kounis syndrome.

    Science.gov (United States)

    Almeida, João; Ferreira, Sara; Malheiro, Joana; Fonseca, Paulo; Caeiro, Daniel; Dias, Adelaide; Ribeiro, José; Gama, Vasco

    2016-12-01

    Kounis syndrome is an acute coronary syndrome in the context of a hypersensitivity reaction. The main pathophysiological mechanism appears to be coronary vasospasm. We report the case of a patient with a history of allergy to quinolones, who was given ciprofloxacin before an elective surgical procedure and during drug administration developed symptoms and electrocardiographic changes suggestive of ST-segment elevation acute coronary syndrome. The drug was suspended and coronary angiography excluded epicardial coronary disease. Two hours after withdrawal of the drug the symptoms and ST elevation had resolved completely.

  20. Bath Salts: A Newly Recognized Cause of Acute Kidney Injury

    Directory of Open Access Journals (Sweden)

    Jonathan McNeely

    2012-01-01

    Full Text Available Bath salts are substance of abuse that are becoming more common and are difficult to recognize due to negative toxicology screening. Acute kidney injury due to bath salt use has not previously been described. We present the case of a previously healthy male who developed acute kidney injury and dialysis dependence after bath salt ingestion and insufflation. This was self-reported with negative toxicology screening. Clinical course was marked by severe hyperthermia, hyperkalemia, rhabdomyolysis, disseminated intravascular coagulation, oliguria, and sepsis. We discuss signs and symptoms, differential diagnoses, potential mechanisms of injury, management, and review of the literature related to bath salt toxicity.

  1. Bath salts: a newly recognized cause of acute kidney injury.

    Science.gov (United States)

    McNeely, Jonathan; Parikh, Samir; Valentine, Christopher; Haddad, Nabil; Shidham, Ganesh; Rovin, Brad; Hebert, Lee; Agarwal, Anil

    2012-01-01

    Bath salts are substance of abuse that are becoming more common and are difficult to recognize due to negative toxicology screening. Acute kidney injury due to bath salt use has not previously been described. We present the case of a previously healthy male who developed acute kidney injury and dialysis dependence after bath salt ingestion and insufflation. This was self-reported with negative toxicology screening. Clinical course was marked by severe hyperthermia, hyperkalemia, rhabdomyolysis, disseminated intravascular coagulation, oliguria, and sepsis. We discuss signs and symptoms, differential diagnoses, potential mechanisms of injury, management, and review of the literature related to bath salt toxicity.

  2. Blastocystis hominis and Endolimax nana Co-Infection Resulting in Chronic Diarrhea in an Immunocompetent Male

    Directory of Open Access Journals (Sweden)

    Mitanshu Shah

    2012-06-01

    Full Text Available Blastocystis hominis and Endolimax nana exist as two separate parasitic organisms; however co-infection with the two individual parasites has been well documented. Although often symptomatic in immunocompromised individuals, the pathogenicity of the organisms in immunocompetent subjects causing gastrointestinal symptoms has been debated, with studies revealing mixed results. Clinically, both B. hominis and E. nana infection may result in acute or chronic diarrhea, generalized abdominal pain, nausea, vomiting, flatulence and anorexia. We report the case of a 24-year-old immunocompetent male presenting with chronic diarrhea and abdominal pain secondary to B. hominis and E. nana treated with metronidazole, resulting in symptom resolution and eradication of the organisms. Our case illustrates that clinicians should be cognizant of both B. hominis and E. nana infection as a cause of chronic diarrhea in an immunocompetent host. Such awareness will aid in a timely diagnosis and possible parasitic eradication with resolution of gastrointestinal symptoms.

  3. Blastocystis hominis and Endolimax nana Co-Infection Resulting in Chronic Diarrhea in an Immunocompetent Male.

    Science.gov (United States)

    Shah, Mitanshu; Tan, Christopher Bryan; Rajan, Dhyan; Ahmed, Shadab; Subramani, Krishnaiyer; Rizvon, Kaleem; Mustacchia, Paul

    2012-05-01

    Blastocystis hominis and Endolimax nana exist as two separate parasitic organisms; however co-infection with the two individual parasites has been well documented. Although often symptomatic in immunocompromised individuals, the pathogenicity of the organisms in immunocompetent subjects causing gastrointestinal symptoms has been debated, with studies revealing mixed results. Clinically, both B. hominis and E. nana infection may result in acute or chronic diarrhea, generalized abdominal pain, nausea, vomiting, flatulence and anorexia. We report the case of a 24-year-old immunocompetent male presenting with chronic diarrhea and abdominal pain secondary to B. hominis and E. nana treated with metronidazole, resulting in symptom resolution and eradication of the organisms. Our case illustrates that clinicians should be cognizant of both B. hominis and E. nana infection as a cause of chronic diarrhea in an immunocompetent host. Such awareness will aid in a timely diagnosis and possible parasitic eradication with resolution of gastrointestinal symptoms.

  4. [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

  5. Acute forearm compressive myopathy syndrome secondary to upper limb entrapment: an unusual cause of renal failure.

    Science.gov (United States)

    Tachtsi, Maria D; Kalogirou, Thomas E; Atmatzidis, Stefanos K; Papadimitriou, Dimitrios K; Atmatzidis, Konstantinos S

    2011-05-01

    Compressive myopathy syndrome (SCM) is a syndrome characterized by the lesion of skeletal muscle resulting in subsequent release of intracellular contents (myoglobin, creatine phosphokinase, potassium, etc.) into the circulatory system, which can cause potentially lethal complications. There are numerous causes that can lead to SCM resulting to acute rhabdomyolysis, and many patients present with multiple causes. The most common potentially lethal complication is acute renal failure. The occurrence of acute rhabdomyolysis should be considered as a possibility in any patient who can remain stationary for long periods, or is in a coma, or is intoxicated in any form. We report the rare case of a 26-year-old patient who developed SCM caused by ischemia reperfusion, with subsequent acute rhabdomyolysis and acute renal failure after prolonged compression of the right upper extremity.

  6. Dyselectrolytemia in acute kidney injury causing tetany and quadriparesis.

    Science.gov (United States)

    Palkar, Atul Vijay; Mewada, Mayur; Thakur, Sonal; Shrivastava, Makardhwaj Sarvadaman

    2011-11-15

    A 40-year-old female, presented with prerenal acute kidney injury secondary to diarrhoea. With appropriate hydration, she went into diuretic phase and subsequently developed hypokalemic quadriparesis with hypocalcaemic tetany due to hypomagnesemia and subclinical vitamin D deficiency. The patient improved with oral potassium, magnesium, calcium and vitamin D supplementation.

  7. Acute generalized exanthematous pustulosis caused by terazosin hydrochloride.

    Science.gov (United States)

    Speck, Laura M; Wilkerson, Michael G; Perri, Anthony J; Kelly, Brent C

    2008-04-01

    Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous eruption mainly provoked by drugs. A case of AGEP in a 74-year-old male that was attributed to the ingestion of terazosin hydrochloride is presented. This is the first reported case of this association in medical literature. The history, clinical presentation, and pathogenesis of AGEP are discussed.

  8. Blastomyces gilchristii as Cause of Fatal Acute Respiratory Distress Syndrome.

    Science.gov (United States)

    Dalcin, Daniel; Rothstein, Aaron; Spinato, Joanna; Escott, Nicholas; Kus, Julianne V

    2016-02-01

    Since the 2013 description of Blastomyces gilchristii, research describing the virulence or clinical outcome of B. gilchristii infection has been lacking. We report molecular evidence of B. gilchristii as an etiologic agent of fatal acute respiratory distress syndrome. B. gilchristii infection was confirmed by PCR and sequence analysis.

  9. Curative Evaluation on Infants Diarrhea Stopping Granule Combined with Montmorillonite Powder in Treatment of Children with Acute Diarrhea%儿泻停颗粒联合蒙脱石散剂治疗小儿急性腹泻疗效评价

    Institute of Scientific and Technical Information of China (English)

    崔亚梅; 阮志稳; 郭丽琴

    2016-01-01

    Objective To study the clinical curative effect and security of infants diarrhea stopping granule combined with montmorillonite powder in treatment of children with acute diarrhea and provide reference for clinical drug uses. Methods 100 cases of children with acute diarrhea treated in our hospital from January 2014 to January 2015 were selected as the research object and randomly divided into two groups with 50 cases in each, the two groups were given the same conven-tional treatment measures, the control group were treated with montmorillonite powder, the research group were treated with infants diarrhea stopping granule combined with montmorillonite powder, the curative effect, symptom improvement time and adverse drug reaction of the two groups were compared. Results The total effective rate in the research group was obviously higher than that in the control group (98.0%vs 78.0%), the difference was statistically significant (P﹤0.05);the body tem-perature recovery time, vomiting, stomachache and diarrhea disappearance time in the research group were obviously lower than those in the control group , the differences were statistically significant (P﹤0.05), each group has 2 cases with mild constipation phenomenon during treatment, there was no other adverse reaction (P﹥0.05). Conclusion Infants diarrhea stopping granule combined with montmorillonite powder in treatment of children with acute diarrhea has an obvious curative effect, and it can improve the curative effect and improve the symptoms quickly compared with simple montmorillonite pow-der treatment, and it has good security and is worthy of promotion and application in clinic.%目的:探究儿泻停颗粒联合蒙脱石散剂治疗小儿急性腹泻的临床疗效及安全性,为临床用药提供参考依据。方法研究对象为随机选取为2014年1月—2015年1月之间该院收治的100例急性腹泻患儿,采用数字表法随机分为研究组和对照组各50例,两组患儿均

  10. 两种锌剂辅助治疗小儿急性腹泻患儿的临床疗效%The Clinical Curative effect of Two Kinds of zinc in Adjuvant Treatment of Infantile Acute Diarrhea

    Institute of Scientific and Technical Information of China (English)

    张玉珍

    2015-01-01

    目的:探讨葡萄糖酸锌和乳酸锌辅助治疗小儿急性腹泻患儿的临床疗效。方法选取小儿急性腹泻患儿160例,将其采用随机数字表法分为A组和B组,各80例,分别在常规综合治疗基础上加用葡萄糖酸锌和乳酸锌,比较两组患儿的临床疗效和腹泻停止时间。结果 B组患儿的临床疗效明显优于A组,且腹泻停止时间明显短于A组,差异均有统计学意义(均P<0.05)。结论乳酸锌辅助治疗小儿急性腹泻的临床疗效优于葡萄糖酸锌,具有临床应用价值。%Objective To investigate clinical effects differences of zinc gluconate and zinc lactate in adjuvant treatment of acute diarrhea in children.Methods Selection of children with acute diarrhea in 160 cases,which were randomly divided into A group and B group,each 80 cases,the use of zinc gluconate and zinc lactate respectively on the basis of routine comprehensive treatment,compared the clinical efficacy of two groups of children with diarrhea stop time.Results The clinical curative effect of group B was better than that of A group,and diarrhea stopping time was significantly shorter in the A group,the differences were statisticaly significant(P<0.05).Conclusion Compared with zinc gluconate treatment,zinc lactate in adjuvant treatment of acute diarrhea in children possess better clinical effects.

  11. Characterization of clinical and immune response in a rotavirus diarrhea model in suckling Lewis rats.

    Science.gov (United States)

    Pérez-Cano, Francisco J; Castell, Margarida; Castellote, Cristina; Franch, Angels

    2007-12-01

    Group A rotaviruses (RVs) are the leading pathogens causing diarrhea in children and animals. The present study was designed to establish an experimental model of RV infection and immune response in suckling rats. Wistar (W) and Lewis (L) suckling rats were inoculated orally with two different doses of a simian RV SA-11 strain. RV infection was evaluated by growth rate and clinical indexes. Virus-shedding and serum anti-RV antibodies were measured by enzyme-linked immunosorbent assay (ELISA). Mucosal interferon-gamma (IFN gamma), specific splenocyte proliferation, and spleen and intestinal intraepithelial lymphocyte (IEL) phenotype were analyzed. No diarrhea was observed in any inoculated Ws. All Ls developed acute moderate diarrhea, and a high score and incidence of diarrhea were found in rats infected with higher titers of RV. Specific humoral and cell systemic immune response was confirmed by splenocyte proliferation and by the presence of serum anti-RV antibodies. Moreover, RV infection induced changes in IEL composition, which showed an increase in the proportion of innate immune cells with respect to cells involved in acquired immunity. This acute moderate diarrhea process constitutes a good experimental model that also provides some immune biomarkers that may allow establishing modulation by drugs or diet components.

  12. An unusual cause of acute cor pulmonale--significance of the 'continuous diaphragm sign'.

    Science.gov (United States)

    Mohanan, Sandeep; Sajeev, C G; Muneer, Kader; Rajesh, G; Krishnan, M N; Pillai, Vivek

    2014-01-01

    A patient presented with chest pain and clinical features of acute right heart failure. Initial work up revealed the presence of severe PAH. Acute pulmonary embolism is the commonest and most life-threatening cause for acute cor pulmonale. Even though the clinical picture suggested pulmonary embolism, a subtle sign was missed from the first chest X-ray taken in the emergency department. However on reanalysis the 'continuous diaphragm sign' later guided us towards the diagnosis. Our case represents one of the first reports of a rare etiology for acute cor pulmonale--hypersensitivity pneumonitis. Right ventricular dysfunction was caused by an acute rise in pulmonary artery pressures as well as by the compressive effects of pneumomediastinum. We emphasize the role played by a good quality chest X-ray early in the management of acute chest pain syndromes. However pulmonary embolism should be ruled out conclusively before redirecting attention to less malignant conditions.

  13. [Clostridium difficile isolation in children hospitalized with diarrhea].

    Science.gov (United States)

    Santiago, B; Guerra, L; García-Morín, M; González, E; Gonzálvez, A; Izquierdo, G; Martos, A; Santos, M; Navarro, M; Hernández-Sampelayo, M T; Saavedra-Lozano, J

    2015-06-01

    Clostridium difficile is the leading cause of nosocomial and antibiotic-associated diarrhea in adults, and its incidence has substantially risen over the last few years. The prevalence of this infection in children is difficult to assess due to the high rates of colonization in this setting. A one-year retrospective study was conducted on children under 15 years admitted to hospital with acute diarrhea. Epidemiological, clinical, laboratory findings and outcome of children with Clostridium difficile infection (CDI) were compared to other causes of diarrhea. Risk factors for CDI were identified by multivariate analysis. Two hundred and fifty children with acute diarrhea were identified. A microbiological pathogen was identified in 79 (45.4%) of 174 patients who underwent complete testing: 19 CDI (25.6%, 13 of which were enterotoxin-producing), 21 other bacteria (28.6%), and 34 viruses (45.8%; rotavirus n=31; adenovirus n=3). The estimated incidence of CDI was 3 cases/1,000 admissions, with 68.4% of them occurring in children younger than 2 years. Overall, 15.8% were community-acquired. Compared to other causes of diarrhea, CDI was associated with comorbidity (P<.0001), recent contact with the health-care system (P<.0001) or intensive care unit stay (P=.003) and exposure to antibiotics in the previous month (P<.0001). The clinical course of children with CDI was less symptomatic. There were no clinical differences between Clostridium difficile toxin-producers and non-toxin producers. Comorbidity was identified as the main risk factor associated with CDI (OR 40.02, 95% CI 6.84-232.32; P<.0001). The isolation of Clostridium difficile is common in hospitalized children with diarrhea in our setting. CDI is more frequent in children with comorbidity and recent contact with the health-care system, presenting a mostly oligosymptomatic clinical course. Further studies are needed to understand the epidemiology of this infection in pediatrics, especially the percentage of

  14. Coccidioidomycosis: an unusual cause of acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Kelson Nobre Veras

    2003-01-01

    Full Text Available A male farmer, 20 years old, from the countryside of the State of Piauí, developed acute respiratory infection. Despite adequate antimicrobial therapy, his conditions worsened, requiring mechanical ventilation. His X-rays showed diffuse pulmonary infiltrates. His PaO2/FiO2 ratio was 58. Direct microscopy and culture of tracheal aspirates showed the presence of Coccidioides immitis. Autochthonous cases of coccidioidomycosis have only recently been described in Brazil, most of them from the State of Piauí. C. immitis has been isolated from humans, dogs and armadillos (Dasypus novemcinctus, and also from soil samples of armadillo's burrows. Failure to respond to antimicrobial therapy and a patient's origin from recognized endemic areas should alert to the possibility of acute pulmonary coccidioidomycosis.

  15. [Acute respiratory distress caused by a mediastinal pancreatic pseudocyst].

    Science.gov (United States)

    Guillaume, A; Desport, J C; Dolan, P; Fressard, D; Feiss, P

    1993-01-01

    The pseudocyst of the pancreas is a frequent complication of acute pancreatitis. However to intrathoracic localization remains exceptional. A case of acute respiratory insufficiency in a 66-year-old man in whom artificial ventilation was required for such a complication is reported. This case stresses the difficulty often encountered for the differential diagnosis of these liquid tumors. The clinical signs are variable and non specific, especially in case of absence of any history of pancreatitis. The radiographic studies, in particular ultrasonography and CT-scanner defines its liquid nature and its connections. Endoscopy examination confirms its retro-oesophageal extension due to the migration through the oesophageal hiatus. Only the percutaneous needle aspiration of a collection or an associated pleural effusion confirms the diagnosis by the high content of amylases. The treatment of this type of localisation is surgical and essentially consists of an internal derivation.

  16. Paroxysmal nocturnal hemoglobinuria: rare cause of acute renal failure

    Directory of Open Access Journals (Sweden)

    Vilma Takayasu

    2012-12-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria is a rare acquired disease, characterized by hemolytic anemia, recurrent infections, cytopenias, and vascular thrombosis. It occurs by non-malignant clonal expansion of one or more hematopoietic stem cells that acquired somatic mutations in PIG-A gene linked to chromosome X. This mutation results in lower erythrocyte expression of CD55 and CD59 surface proteins and consequently increased susceptibility to the complement system. The renal involvement is generally benign, resulting in mild impairment in urinary concentration. Acute renal failure requiring hemodialytic support accompanying PNH is rarely observed. The authors report a case of a 37-year-old male who presented with bicytopenia (hemolytic anemia and thrombocytopenia associated with acute renal failure requiring dialysis. Diagnosis was challenging because of the rarity and unfamiliarity with this entity, but was confirmed by flow cytometry. In the course of the disease, acute pyelonephritis with multiple renal abscesses was diagnosed requiring prolonged antibiotic therapy. Patient outcome was favorable after the control of hemolysis and the infection treatment.

  17. Research on Nutrition Related Diarrhea Causes and Nursing of Enteral%肠内营养相关性腹泻的原因及护理对策探讨

    Institute of Scientific and Technical Information of China (English)

    陈秀霞

    2013-01-01

      Objective Analyze causes of enteral nutrition related diarrhea,and discuss the nursing strategies, for clinical reference. Method Analyze causes of intestinal nutrition related diarrhea patients with ICU in our hospital, implement the pertinent nursing intervention. Choose 476 cases in Jan.~Dec. 2012 as observation group,452 cases in Jan.~Dec.2011 as control group. Two groups were observed with diarrhea rate and nursing satisfaction rate. Results Intestinal nutrition related diarrhea and nutrition, diseases, drugs and other factors. Compared with control group,observation group had lower incidence of diarrhea, nursing satisfaction rate is higher,there is a statistically significant difference(P<0.05). Conclusion The implementation of nursing intervention for patients on ICU, can reduce the intestinal nutrition related diarrhea incidence, reduce the workload of nursing staff, improve the nurse-patient relationship.%  目的分析引起肠内营养相关性腹泻的原因,并探讨护理对策,以供临床参考。方法分析我院ICU患者发生肠内营养相关性腹泻的原因,并于2012年1月开始实施针对性护理干预。以2012年1月至12月的476例患者为观察组,以2011年1月至12月的452例患者为对照组。观察两组患者腹泻发生率和护患满意率的差异。结果肠内营养相关性腹泻与营养液、疾病、药物等因素有关。与对照组相比较,观察组腹泻发生率较低,护患满意率较高,有显著的统计学差异(P<0.05)。结论对ICU患者实施针对性护理干预,可明显降低肠内营养相关性腹泻的发生率,也减轻护理人员工作量,有效增进了护患关系。

  18. Incidence of Diarrhea in Hospitalized Patients with Standard Enteral Formula

    Directory of Open Access Journals (Sweden)

    Shabbu Ahmadi bonakdar

    2014-10-01

    Conclusion: Evaluation of patients receiving Milatech standard formula showed that diarrhea wasn’t seen in hospitalized patients. Diarrhea was reported by the nurses may refer to other diarrhea genic causes including of long length of stay, entral duration or medical side effects or infections.

  19. 不同喂养方式对小儿急性腹泻病程影响的观察%Observation of the effect of different feeding methods on the acute diarrhea of children

    Institute of Scientific and Technical Information of China (English)

    戚丽娟; 张旭亚

    2013-01-01

    目的观察不同喂养方式对小儿急性腹泻病程的影响。方法将98例小儿急性腹泻患儿按不同喂养方式分为两组,分别给予限量喂养和全量喂养,在其他治疗方法相同情况下,比较其病程转归。结果全量喂养组平均痊愈时间(6.2±1.4)d,限量喂养组平均痊愈时间(4.7±1.1)d,两组比较差异具有统计学意义(P<0.05)。结论小儿急性腹泻应继续进食,适当限制进食量有利于疾病康复,缩短病程。%Objective To observe the impact of different feeding methods on the acute diarrhea of children. Methods According to different feeding methods, 98 children with acute diarrhea were divided into two groups. The other treatments were of the same. The disease turnover was compared between the two groups. Results Compared with the full capacity feeding group,The average healing time was (6.2±1.4)days,restricted feeding group, The average healing time was(4.7±1.1)days was superior in shortening the length of the disease(P < 0.05). Conclusion Children with acute diarrhea should continue eating.Restricting food intake properly contributes to shortening the length of the disease.

  20. 布拉氏酵母菌治疗小儿急性腹泻的临床效果观察%Effect of Saccharomyces Boulardii in Treatment of Acute Diarrhea in Children

    Institute of Scientific and Technical Information of China (English)

    白光磊

    2016-01-01

    目的:探究急性腹泻患儿实施布拉氏酵母菌治疗效果及其在细胞免疫学方面的影响。方法收集我院治疗的急性腹泻儿童74名,治疗组实施布拉氏酵母菌治疗,对照组实施基础治疗。结果治疗组有效率(97.30%)高于对照组(86.49%),差异具有统计学意义。结论急性腹泻儿童实施布拉氏酵母菌治疗效果良好,能够提高细胞免疫功能,从根本上治疗疾病。%Objective To explore children with acute diarrhea in implementation of Saccharomyces boulardii treatment effect and its influence in cellular immunology. Methods A total of 74 in our hospital treatment of children with acute diarrhea,the treatment group implementation of Saccharomyces boulardii treatment. The control group received basic treatment. Results The effective rate of treatment group(97.30%)was significantly higher than that of the control group(86.49%),the difference was statistical y significant. Conclusion Children with acute diarrhea implementation of Saccharomyces boulardii treatment effect is good,can improve the cel ular immune function,fundamental y treatment of disease.

  1. Diarrhea in infants

    Science.gov (United States)

    ... baby food that makes diarrhea worse, such as: Apple juice Milk Fried foods Full-strength fruit juice ... Diarrhea Browse the Encyclopedia A.D.A.M., Inc. is accredited by URAC, also known as the ...

  2. [CHRONIC DIARRHEA OF INFECTIOUS ETIOLOGY

    Science.gov (United States)

    Farfán F G, Gustavo

    1997-01-01

    Chronic Diarrhea syndrome is due to several causes. In LatinAmericen countries, infectious and parasitic etiology is frequent. Withinthese infections, the following has been determined: parasitic and enterobacterial agents, overpopulation of bacteria syndrome in the upper small bowel (SOBIA, abbreviation for Síndrome de Sobrepoblación Bacteriana del Intestino Delgado Alto), intestinal TBC, and AIDS. In these processes, the precipitating factor may be unique or multifactor; or there could also exist a tendency towards pathologies for these infections. There has been evidence of SOBIA cases without associated factor in Latin American countries. A study made in Peru shows SOBIA cases in 30 percent of chronic diarrhea.In chronic diarrhea cases, and even more, in those diarrheas of infectiousetiology, a complete study should be made, considering the several factorsthat generate diarrhea in a same one case, such as the mechanisms ofimmunodeficiency, neurological, endocrinemetabolic, and others associated with intestinal infections. This approach will be helpful to make a complete diagnosis and apply timely treatment.

  3. A rare cause of acute abdomen in adults: Parasitic infection-related acute appendicitis.

    Science.gov (United States)

    Küpeli, Aydın Hakan; Özdemir, Murat; Topuz, Sezgin; Sözütek, Alper; Paksoy, Tuğba

    2015-01-01

    Ascaris lumbricoides is a common parasitic disease all over the world, especially in less developed countries. Acute appendicitis related to parasitic infection is a rare condition. Parasitic infections should be kept in mind in patients who are admitted to the emergency department with acute abdomen, especially in endemic areas.

  4. [Digestive bleeding and acute abdomen caused by jejunal diverticulosis. Case report].

    Science.gov (United States)

    Nari, Gustavo A; Azar, Ricardo; Feliu, Luis; Moreno, Eduardo; Bonaparte, Fernando

    2012-03-01

    We present a patient with acute abdomen and digestive bleeding caused by jejunal diverticulosis. Jejunal diverticulosis, mainly asymptomatic, when is symptomatic have a wide clinical spectrum, ranging from chronic anemic syndrome to acute abdomen. In this communication, we reviewed the clinical presentation, the pathogenesis and the treatment this infrequent pathology.

  5. Analysis of the Utilization of Antibacterials in Hospitalized Children with Acute Diarrhea%我院急性腹泻病住院患儿抗菌药物应用分析

    Institute of Scientific and Technical Information of China (English)

    许琼; 宋新文; 汪洋

    2011-01-01

    目的:评价我院急性腹泻病住院患儿抗菌药物的应用情况.方法:随机抽取我院2009年6-8月及10-12月诊断为急性腹泻病的住院患儿病历668份,按腹泻病发病月份分为A,B组,对2组患儿的病原学检测结果、抗菌药物应用及用药合理性等进行分析.结果:病原学检测结果显示,B组患儿轮状病毒感染率(41.43%)明显高于A组(10.94%),而B组患儿杭菌药物应用率、应用时间同A组比较差异无统计学意义(P>0.05).结论:我院腹泻病患儿抗菌药物应用存在不合理现象,临床需根据病原菌不同区别用药.%OBJECTIVE: To analyze the utilization of antibacterials in hospitalized children with acute diarrhea in our hospital.METHODS: 668 hospitalized cases of acute diarrhea were randomly collected from our hospital during Jun.~Aug.2009 (group A)or Oct.~Dec.2009 (group B).The etiological inspection, the utilization of antibacterials and the rationality of drug use in two groups were analyzed.RESULTS: Results of etiological inspection showed that the rotavirus infection rate of group B (41.43%)was significantly higher than that of group A (10.94%).There were no significant differences in utilization rate of antibacterials and medication duration between two groups.CONCLUSION: The utilization of antibacterials in acute diarrhea children is irrational.The treatment for acute diarrhea should vary according to different pathogenic bacteria.

  6. Toddler's Diarrhea

    Science.gov (United States)

    ... may consider: 1) Giardia, Cryptosporidium, or Clostridium difficile (C. diff) —these are infections that can cause chronic diar- rhea and are treated with antibiotics. 2) Celiac disease —sensitivity to gluten, a protein ...

  7. An unusual cause of acute scrotum in a child.

    LENUS (Irish Health Repository)

    Aworanti, O

    2014-11-01

    Acute non-traumatic scrotal pain in children, commonly due to a torted testicular appendage (hydatid of Morgagni) or torted epididymal appendage is well described. These vestigial embryonal duct remnants are of Müllerian and Wolffian duct origin respectively. Very rarely, the other infrequently encountered Wolffian duct remnants known as the paradidymis or organ of Giraldés and the superior and inferior aberrant ducts known as the organs of Haller can become torted. We describe the presentation, management and diagnosis of a torted embryonal remnant arising from the distal spermatic cord.

  8. Sildenafil: Can Cause Acute Ischaemic Stroke? A Case Report

    Directory of Open Access Journals (Sweden)

    Zeynep Özözen Ayas

    2015-12-01

    Full Text Available Sildenafil is an inhibitor of phosphodiesterase type-5 (PDE-5, is used for erectile dysfunction. There is not enough information about its effects on the central nervous system Headache, nasal congestion, facial flushing, nausea are the most common side effects. However, neurological complications such as third cranial nerve palsy, transient global amnesia, seizures, cerebral hemorrhage, and infarction are less commonly observed. We present a case of a 60-year-old man with acute ischaemic stroke, which we considered to be interrelated to sildenafil intake. Clinicians must be aware of the possibility of neurological side effects when the patient use sildenafil.

  9. Uncommon Cause of Acute Adrenal Failure - Case Report

    Directory of Open Access Journals (Sweden)

    Tariq

    2010-12-01

    Full Text Available Adrenomyeloneuropathy is a rare X-linked inherited disorder of peroxisomes characterized by accumulation of very-long-chain fatty acids (VLCFA in the central and peripheral nervous system, adrenal glands and testes, leading to dysfunction of these organs and systems (1. Here, we report a case of adrenomyeloneuropathy presenting initially as acute adrenal crisis, which progressed rapidly within one year to variant neurological manifestations, dementia, sensory, motor and psycho-intellectual dysfunction, and generalized spasticity. Turk Jem 2010; 14: 103-5

  10. Acute Compartment Syndrome in Orthopedics: Causes, Diagnosis, and Management

    Science.gov (United States)

    Raza, Hasnain; Mahapatra, Anant

    2015-01-01

    Almost all orthopaedic surgeons come across acute compartment syndrome (ACS) in their clinical practice. Diagnosis of ACS mostly relies on clinical findings. If the diagnosis is missed and left untreated, it can lead to serious consequences which can endanger limb and life of the patient and also risk the clinician to face lawsuits. This review article highlights the characteristic features of ACS which will help an orthopaedic surgeon to understand the pathophysiology, natural history, high risk patients, diagnosis, and surgical management of the condition. PMID:25688303

  11. [Goodpasture Syndrome: a Rare Cause of Acute Anuric Renal Failure].

    Science.gov (United States)

    Bareiss, Dirk; Hopfer, Helmut; Menter, Thomas; Jehle, Andreas; Burkhalter, Felix

    2016-06-08

    We report a case of a 68 year old male who presented with an acute onset of anuric renal failure. Investigations revealed a histologically confirmed “double-positive” anti-GBM disease with initially undetectably high antibody values. An induction therapy with plasma exchange, cyclophosphamide and initially high dose steroids and further maintenance therapy for three months was initiated. The patient remained dialysis-dependent despite partial recovering of renal function. Without pulmonary involvement there were no clues for Goodpasture’s disease. Renal prognosis is unfavourable.

  12. Dengue as a cause of acute undifferentiated fever in Vietnam

    NARCIS (Netherlands)

    Phuong, H.L.; de Vries, P.J.; Nga, T.T.T.; Giao, P.T.; Hung, L.Q.; Binh, T.Q.; Nam, N.V.; Nagelkerke, N.; Kager, P.A.

    2006-01-01

    Background: Dengue is a common cause of fever in the tropics but its contribution to the total burden of febrile illnesses that is presented to primary health facilities in endemic regions such as Vietnam, is largely unknown. We aimed to report the frequency of dengue as a cause of fever in Binh

  13. Dengue as a cause of acute undifferentiated fever in Vietnam

    NARCIS (Netherlands)

    Phuong, H.L.; de Vries, P.J.; Nga, T.T.T.; Giao, P.T.; Hung, L.Q.; Binh, T.Q.; Nam, N.V.; Nagelkerke, N.; Kager, P.A.

    2006-01-01

    Background: Dengue is a common cause of fever in the tropics but its contribution to the total burden of febrile illnesses that is presented to primary health facilities in endemic regions such as Vietnam, is largely unknown. We aimed to report the frequency of dengue as a cause of fever in Binh Thu

  14. Case report A Rare Cause of Sub-Acute Proximal Intestinal ...

    African Journals Online (AJOL)

    KIGZ

    A Rare Cause of Sub-Acute Proximal Intestinal Obstruction Due to Annular Pancreas ... obstruction may initially be non-specific, including poor feeding, vomiting, and irritability. If ... The most common association is with Down's syndrome.

  15. Bilateral simultaneous acute angle closure caused by sulphonamide derivatives: A case series

    Directory of Open Access Journals (Sweden)

    Senthil Sirisha

    2010-01-01

    Full Text Available The sulphonamide group of drugs is implicated in bilateral acute angle closure (AAC due to an idiosyncratic response. We report a series of three cases with bilateral AAC caused by different sulphonamide derivatives, their presentation and management.

  16. Bilateral simultaneous acute angle closure caused by sulphonamide derivatives: A case series

    OpenAIRE

    Senthil Sirisha; Garudadri Chandrasekhar; Rao Harsha; Maheshwari Rajat

    2010-01-01

    The sulphonamide group of drugs is implicated in bilateral acute angle closure (AAC) due to an idiosyncratic response. We report a series of three cases with bilateral AAC caused by different sulphonamide derivatives, their presentation and management.

  17. Bilateral simultaneous acute angle closure caused by sulphonamide derivatives: a case series.

    Science.gov (United States)

    Senthil, Sirisha; Garudadri, Chandrasekhar; Rao, Harsha B L; Maheshwari, Rajat

    2010-01-01

    The sulphonamide group of drugs is implicated in bilateral acute angle closure (AAC) due to an idiosyncratic response. We report a series of three cases with bilateral AAC caused by different sulphonamide derivatives, their presentation and management.

  18. 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

  19. An unusual cause of acute renal failure: renal lymphoma.

    Science.gov (United States)

    Ozaltin, Fatih; Yalçin, Bilgehan; Orhan, Diclehan; Sari, Neriman; Caglar, Melda; Besbas, Nesrin; Bakkaloglu, Aysin

    2004-08-01

    Renal involvement is a common finding in non-Hodgkin's lymphoma (NHL). Acute renal failure at initial presentation due to lymphomatous infiltration of the kidneys has been described infrequently. We report a 17-year-old male who presented with acute renal failure due to massive lymphomatous infiltration of the kidneys, which necessitated hemodialysis. The diagnosis of B-cell NHL was established by tru-cut biopsy of the kidneys and the patient had an excellent response to high-dose chemotherapy with no major complication. The presence of extrarenal involvement in the testes and the retroperitoneal lymph nodes made the diagnosis of primary renal lymphoma debatable. However, considering the delay in diagnosis and the high proliferative rate of B-cell NHL, we might postulate that the disease had originated primarily in the kidneys. We recommend that in NHL cases with severe renal involvement, full-dose chemotherapy should be instituted with meticulous clinical and laboratory follow-up in order to improve clinical and renal failure status rapidly and to avoid further dissemination of NHL.

  20. 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

  1. Effect of corticosteroid therapy in acute pain edema caused by ...

    African Journals Online (AJOL)

    and skin lesions caused by herpes zoster, and to develop some pertinent therapeutic guidelines. Methods: A total of ... neuralgia continues after skin lesions subside. (usually 4 weeks ..... nursing progress of cancer patients. Med Innov Chin,.

  2. Analysis of cases caused by acute spider bite

    Institute of Scientific and Technical Information of China (English)

    Zihni Sulaj; Gentian Vyshka; Amarda Gashi

    2015-01-01

    We performed a retrospective study of 176 patients in the University Hospital Center of Tirana (Albania), during the period 2001-2011, admitted with the diagnosis of a suspected spider bite. Three fatalities were registered during this decade covered from our study, with a clinical picture of marked hypertension, tachycardia and acute cardiac failure leading to death within a minimum of 25 hours and a maximum of 42 hours from the occurrence. Out of the total of 176 patients, we had 59% (104 cases) females, and 41% males. The overwhelming majority of the patients lived in rural areas (155 of the cases); extremities were mostly affected from the bites. A summary of clinical signs and a brief review of the available literature are made in the results and discussion section of this paper. Authors advocate that special precautions should be taken especially in severe forms of interesting autonomous nerve system, with aggressive fluid resuscitation, supportive therapy and close monitoring of vital signs.

  3. Giant Coronary Artery Aneurysm Causing Acute Anterior Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Ahmet Yanık

    2016-01-01

    Full Text Available A 70-year-old man with hypertension was admitted to our coronary ICU with acute anterior MI. Emergent primary PCI was planned and coronary angiography was performed. LAD artery was totally occluded in the proximal segment just after a huge 32 × 26 mm sized aneurysm. Emergent CABG operation was performed in 75 minutes because of multivessel disease including the RCA and left circumflex artery. Aneurysm was ligated and coronary bypass was performed using LIMA and saphenous grafts. The postoperative course of the patient was uneventful. He was discharged with medical therapy including ASA, clopidogrel, and atorvastatin. He was asymptomatic at his polyclinic visit in the first month.

  4. Acute radiation syndrome caused by accidental radiation exposure - therapeutic principles

    Directory of Open Access Journals (Sweden)

    Dörr Harald

    2011-11-01

    Full Text Available Abstract Fortunately radiation accidents are infrequent occurrences, but since they have the potential of large scale events like the nuclear accidents of Chernobyl and Fukushima, preparatory planning of the medical management of radiation accident victims is very important. Radiation accidents can result in different types of radiation exposure for which the diagnostic and therapeutic measures, as well as the outcomes, differ. The clinical course of acute radiation syndrome depends on the absorbed radiation dose and its distribution. Multi-organ-involvement and multi-organ-failure need be taken into account. The most vulnerable organ system to radiation exposure is the hematopoietic system. In addition to hematopoietic syndrome, radiation induced damage to the skin plays an important role in diagnostics and the treatment of radiation accident victims. The most important therapeutic principles with special reference to hematopoietic syndrome and cutaneous radiation syndrome are reviewed.

  5. Small Bowel Perforation due to Gossypiboma Caused Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Tahsin Colak

    2013-01-01

    Full Text Available Gossypiboma, an infrequent surgical complication, is a mass lesion due to a retained surgical sponge surrounded by foreign body reaction. In this case report, we describe gossypiboma in the abdominal cavity which was detected 14 months after the hysterectomy due to acute abdominal pain. Gossypiboma was diagnosed by computed tomography (CT. The CT findings were a rounded mass with a dense central part and an enhancing wall. In explorative laparotomy, small bowel loops were seen to be perforated due to inflammation of long standing gossypiboma. Jejunal resection with end-to-end anastomosis was performed. The patient was discharged whithout complication. This case was presented to point to retained foreign body (RFB complications and we believed that the possibility of a retained foreign body should be considered in the differential diagnosis of who had previous surgery and complained of pain, infection, or palpable mass.

  6. Prevalence of Clostridium Difficile- Associated Diarrhea in Hospitalized Patients with Nosocomial Diarrhea

    Directory of Open Access Journals (Sweden)

    N Sadeghifard

    2005-09-01

    Full Text Available Clostridium difficile is a frequently identified cause of nosocomial gastrointestinal disease. It has been proved to be a causative agent in antibiotic-associated diarrhea, antibiotic-associated colitis, and pseudomembraneous colitis. This study was aimed to determine the prevalence of C.difficile- associated diarrhea in hospitalized patients with nosocomial diarrhea. The 942 hospitalized patients stool samples with nosocomial diarrhea were collected at three hospitals in Tehran from Dec 2002 to Feb 2004.All the stool samples were cultured and in 97 (prevalence: 10.9% samples grew C.difficile that 57 (prevalence: 6.1% isolates were toxigenic by cytotoxicity assay and so 57 patients had C.difficile- associated diarrhea. Results of statistical analysis showed significant difference between the rate of C.difficile associated diarrhea and the patients ages (P<0.05.

  7. CHOLECYSTITIS AS A CAUSE OF ABDOMINAL PAIN IN PATIENTS WITH ACUTE VIRAL HEPATITIS A AND B

    Directory of Open Access Journals (Sweden)

    Miodrag Radunović

    2012-03-01

    Full Text Available Acute cholecystitis is an inflammation of the gallbladder wall, usually caused by gallstones in the cystic duct, which causes attacks of severe pain. At least 95% of the population with acute inflammation of the gallbladder have gallstones. Acute viral hepatitis is the liver inflammation accompanied by nausea, faintness, vomiting, pain below the right rib arch, jaundice. The presence of acute cholecystitis intensifies the existing symptoms. The aim of the paper was to show the incidence of the gallbladder inflammation in patients with acute hepatitis A or B. This retrospective-prospective study involved 110 patients treated for viral hepatitis A or B and had severe abdominal pain during hospitalization. The selected sample involved more male examinees - 63 (62% compared to female ones - 47 (38%. The most frequent age of examinees was 30-50 years, 82 (83%, and cholecystitis during hepatitis was also most common in the age group 30-50 years, 28 (73% patients. Cholecystitis was more common in patients with acute hepatitis B - 21 (55% examinees than in patients with acute hepatitis A - 17 (45% examinees. Ultrasound examination, performed in 24 (63% examinees showed gallstones in inflamed gallbladder, while 14 (37% examinees had the inflammation of the gallbladder without gallstones. The most common cause of severe abdominal pain in patients with acute liver infection caused by HAV and HBV infection was the gallbladder, 38 (34.5% patients. Cholecystitis was more common in patients with acute hepatitis B, 21 (55% examinees, than in those with an acute hepatitis A, 17 (45% examinees.

  8. Effect of amino acid powder on infants with acute diarrhea complicated with lactose intolerance%氨基酸奶粉对急性腹泻并发乳糖不耐受患儿的疗效

    Institute of Scientific and Technical Information of China (English)

    王仁丰; 项秀荷

    2013-01-01

    目的:观察氨基酸奶粉在婴儿急性腹泻并发乳糖不耐受治疗中的效果。方法选取大便检测还原糖阳性的急性腹泻患儿130例作为研究对象,随机分为治疗组62例和对照组68例。两组均给予常规药物治疗的基础上,治疗组给予氨基酸特殊配方奶粉喂养,对照组给予无乳糖婴儿配方奶粉喂养,观察5天后两组的治疗效果。结果氨基酸奶粉喂养组腹泻的总有效率为95.16%,无乳糖奶粉喂养组的总有效率为82.35%,治疗组的总有效率高于对照组,差异有统计学意义(χ2=5.212,P<0.05)。结论氨基酸奶粉在婴儿急性腹泻并发乳糖不耐受的治疗中效果显著,能减轻腹泻症状,疗效优于无乳糖奶粉。%Objective To observe the efficacy of amino acid powder on infants with acute diarrhea complicated with lactose intolerance . Methods Totally 130 infants with acute diarrhea whose stool examination was positive for reducing sugar were selected in the study , and they were randomly divided into treatment group ( n =62 ) and control group ( n =68 ) .Based on conventional drug treatment , the treatment group was given special amino acid powder feeding , while the control group was given lactose-free infant powder feeding .The curative effect of two groups was observed after 5 days.Results The total effective rate was 95.16% and 82.35% in the treatment group and the control group, respectively, and the difference was statistically significant (χ2 =5.212, P<0.05).Conclusion The effect of amino acid powder on infants with acute diarrhea complicated with lactose intolerance is remarkable .Amino acid powder can alleviate the symptoms of diarrhea , and its efficacy is better than that of lactose-free powder .

  9. Flavored according decoction syndrome of acute diarrhea curative effect analysis%加味葛根芩连汤治疗湿热型急性腹泻疗效分析

    Institute of Scientific and Technical Information of China (English)

    李琦

    2014-01-01

    目的:分析加味葛根芩连汤治疗湿热型急性腹泻疗效。方法选取2013年3月~2013年11月我院收诊的湿热型急性腹泻患者120例,将其随机分成对照组和观察组,各60例,对照组采取常规治疗,观察组采取加味葛根芩连汤治疗,比较两组患者临床治疗的有效情况。结果观察组显效的有26例,总有效率达到95%,远高于对照组的75%,差异有统计学意义(P<0.05)。结论湿热型急性腹泻进行加味葛根芩连汤治疗对腹泻、腹痛、呕吐等症状具有显著的治疗效果,且在疗程治疗中,值得推广与应用。%Objective to analyze lfavored according decoction syndrome of acute diarrhea curative effect. SelectionMethods March 2013~in November 2013, our hospital into clinical syndrome 120 patients with acute diarrhea were randomly divided into control group and observation group, 60 cases, control group treated with conventional, flavored according soup treatment group adopted to compare the situation of effective in clinical treatment in both groups.Results the observation group of 26 cases were markedly effective, total effective rate reached 95%, far higher than that of control group 75%, the difference was statistically signiifcant (P<0.05). Conclusion the syndrome of acute diarrhea is flavored according soup treatment of diarrhea, abdominal pain, vomiting has signiifcant therapeutic effect, and in the course of treatment, is worthy of popularization and application.

  10. 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.

  11. Eosinophilic cholecystitis: an infrequent cause of acute cholecystitis.

    Science.gov (United States)

    del-Moral-Martínez, María; Barrientos-Delgado, Andrés; Crespo-Lora, Vicente; Cervilla-Sáez-de-Tejada, María Eloísa; Salmerón-Escobar, Javier

    2015-01-01

    Eosinophilic cholecystitis (EC) is a rare disease that is characterised by eosinophilic infiltration of the gallbladder. Its pathogenesis is unknown, although many hypotheses have been made. Clinical and laboratory manifestations do not differ from those of other causes of cholecystitis. Diagnosis is histological and usually performed after analysis of the surgical specimen. We report the case of a woman aged 24 years, with symptoms of fever, vomiting and pain in the right upper quadrant. When imaging tests revealed acalculous cholecystitis, an urgent cholecystectomy was performed. Histological examination of the surgical specimen revealed eosinophilic cholecystitis. No cause of the symptoms was found.

  12. Eosinophilic cholecystitis: an infrequent cause of acute cholecystitis

    Directory of Open Access Journals (Sweden)

    María del Moral-Martínez

    2015-01-01

    Full Text Available Eosinophilic cholecystitis (EC is a rare disease that is characterised by eosinophilic infiltration of the gallbladder. Its pathogenesis is unknown, although many hypotheses have been made. Clinical and laboratory manifestations do not differ from those of other causes of cholecystitis. Diagnosis is histological and usually performed after analysis of the surgical specimen. We report the case of a woman aged 24 years, with symptoms of fever, vomiting and pain in the right upper quadrant. When imaging tests revealed acalculous cholecystitis, an urgent cholecystectomy was performed. Histological examination of the surgical specimen revealed eosinophilic cholecystitis. No cause of the symptoms was found.

  13. Molecular characterization of rotavirus isolated from alpaca (Vicugna pacos) crias with diarrhea in the Andean Region of Cusco, Peru.

    Science.gov (United States)

    Garmendia, Antonio E; Lopez, Wellington; Ortega, Nastassja; Chamorro, Marycris J

    2015-10-22

    Alpacas (Vicugna pacos), a species of South American camelids (SAC), suffer high morbidity and mortality from infectious diseases. Diarrhea is one of the leading causes of alpaca cria mortality in Peru and elsewhere. In order to develop appropriate control and/or treatment, it is necessary to identify infectious pathogens that cause diarrhea in crias. Rotavirus was isolated in cell culture from feces collected from crias with acute diarrhea that tested positive to rotaviral antigen by rapid immunochromatographic methods in an earlier study. The isolates were identified as rotaviruses by RT-PCR run with specific primers for human rotavirus VP7 coding sequences using total RNA extracted from cells displaying cytopathic effects as template. These alpaca isolates were further identified as group A rotaviruses by means of a VP6-specific PCR and were designated as ALRVA-K'ayra/Perú/3368-10 and ALRVA-K'ayra/Perú/3386-10. Molecular G and P typing, placed the former as G3/P11 and the latter as G3/P?. Sequence analysis of two genome segments (coding for VP4 and VP7) from the alpaca isolates revealed partial homologies to swine and human rotaviruses, respectively. These results demonstrate that rotaviruses are associated with a proportion of cases of diarrhea in crias, although prevalence and impact remain to be determined. The isolation of rotaviruses from alpaca crias with diarrhea will contribute positively to further understand the pathogen and its role in the diarrhea complex.

  14. Perforated jejunal diverticulitis as a rare cause of acute abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Peters, R.; Grust, A.; Fuerst, G. [Department of Radiology, Heinrich-Heine-University, Duesseldorf (Germany); Gerharz, C.D. [Department of Pathology, Heinrich-Heine-University, Duesseldorf (Germany); Dumon, C. [Department of Surgery, Heinrich-Heine-University, Duesseldorf (Germany)

    1999-09-01

    Jejunal diverticula is rare and in most cases without any symptoms. They become clinically relevant when complications, such as diverticulitis, malabsorption caused by bacterial overgrowth, intestinal hemorrhage, or obstruction, occur. In this case report a case of perforated jejunal diverticulitis is presented and the problems in finding the correct diagnosis are discussed. (orig.) With 3 figs., 13 refs.

  15. Clinical Observation on Metoclopramide in the Treatment of Acute Infectious Abdominal Pain and Diarrhea%胃复安治疗急性感染性腹痛腹泻的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    杨卫东

    2016-01-01

    Objective To observe the effect of metoclopramide in the treatment of acute infectious abdominal pain and diarrhea. Methods We divided 68 patients into two groups,the control group received routine treatment,and observation group used Metoclopramide on the basis of control group. Results The total effective rate,the improvement time of clinical symptoms of observation group were significantly better than control group(P < 0.05). Conclusion The effect of Metoclopramide in the treatment of acute infective abdominal pain and diarrhea is ideal.%目的:观察胃复安治疗急性感染性腹痛腹泻的效果。方法随机将68例急性感染性腹痛腹泻患者平均分为两组,对照组行常规治疗,观察组在对照组的基础上行胃复安治疗。结果观察组治疗总有效率、临床症状改善时间等均优于对照组(P <0.05)。结论胃复安治疗急性感染性腹痛腹泻效果理想。

  16. Tinea corporis with acute inflammation caused by Trichophyton tonsurans.

    Science.gov (United States)

    Ohno, Sayoko; Tanabe, Hiroshi; Kawasaki, Masako; Horiguchi, Yuji

    2008-09-01

    A 13-year-old Japanese boy presented with acute skin inflammation on the extremities. He belonged to a judo club of a junior high school in which club tinea capitis and tinea corporis seemed to be prevalent. Vesicles and pustules appeared on his right forearm and right leg. They increased in numbers and formed annular lesions. Pruritic erythema appeared surrounding these lesions. Direct microscopic examination of the lesions detected hyphae, and culture for the fungi yielded yellowish colonies. The result of culture from pustules revealed Staphylococcus aureus. At first, a topical antifungal drug and systemic antibiotics seemed to cure annular lesions, but pustules arose again. A large surrounding erythema was cured by topical treatment with a steroid agent. A biopsy specimen from a pustule showed hyphae of fungi within a hair shaft and in the bulb. The restriction fragment length polymorphism in the internal transcribed spacer regions of the ribosomal gene (polymerase chain reaction restriction fragment length polymorphism) revealed a banding pattern compatible with Trichophyton tonsurans. Treatment with systemic itraconazole was begun and lesions disappeared immediately. Systemic antifungal therapy was needed in our case. Tinea corporis with inflammation necessitates systemic antifungal therapy.

  17. Analysis of cases caused by acute spider bite

    Directory of Open Access Journals (Sweden)

    Zihni Sulaj

    2015-08-01

    Full Text Available We performed a retrospective study of 176 patients in the University Hospital Center of Tirana (Albania, during the period 2001–2011, admitted with the diagnosis of a suspected spider bite. Three fatalities were registered during this decade covered from our study, with a clinical picture of marked hypertension, tachycardia and acute cardiac failure leading to death within a minimum of 25 h and a maximum of 42 h from the occurrence. Out of the total of 176 patients, we had 59% (104 cases females, and 41% males. The overwhelming majority of the patients lived in rural areas (155 of the cases; extremities were mostly affected from the bites. A summary of clinical signs and a brief review of the available literature are made in the results and discussion section of this paper. Authors advocate that special precautions should be taken especially in severe forms of interesting autonomous nerve system, with aggressive fluid resuscitation, supportive therapy and close monitoring of vital signs.

  18. Acute radiation enteritis caused by dose-dependent radiation exposure in dogs: experimental research.

    Science.gov (United States)

    Xu, Wenda; Chen, Jiang; Xu, Liu; Li, Hongyu; Guo, Xiaozhong

    2014-12-01

    Accidental or intended radiation exposure in mass casualty settings presents a serious and on-going threat. The development of mitigating and treating agents requires appropriate animal models. Unfortunately, the majority of research on radiation enteritis in animals has lacked specific assessments and targeted therapy. Our study showed beagle dogs, treated by intensity-modulated radiation therapy (IMRT) for abdominal irradiation, were administered single X-ray doses of 8-30 Gy. The degree of intestinal tract injury for all of the animals after radiation exposure was evaluated with regard to clinical syndrome, endoscopic findings, histological features, and intestinal function. The range of single doses (8 Gy, 10-14 Gy, and 16-30 Gy) represented the degree of injury (mild, moderate, and severe, respectively). Acute radiation enteritis included clinical syndrome with fever, vomiting, diarrhea, hemafecia, and weight loss; typical endoscopic findings included edema, bleeding, mucosal abrasions, and ulcers; and intestinal biopsy results revealed mucosal necrosis, erosion, and loss, inflammatory cell infiltration, hemorrhage, and congestion. Changes in serum diamine oxides (DAOs) and d-xylose represented intestinal barrier function and absorption function, respectively, and correlated with the extent of damage (P enteritis, thus obtaining a relatively objective evaluation of intestinal tract injury based on clinical performance and laboratory examination. The method of assessment of the degree of intestinal tract injury after abdominal irradiation could be beneficial in the development of novel and effective therapeutic strategies for acute radiation enteritis.

  19. 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

  20. Mutations in LPIN1 cause recurrent acute myoglobinuria in childhood.

    Science.gov (United States)

    Zeharia, Avraham; Shaag, Avraham; Houtkooper, Riekelt H; Hindi, Tareq; de Lonlay, Pascale; Erez, Gilli; Hubert, Laurence; Saada, Ann; de Keyzer, Yves; Eshel, Gideon; Vaz, Frédéric M; Pines, Ophry; Elpeleg, Orly

    2008-10-01

    Recurrent episodes of life-threatening myoglobinuria in childhood are caused by inborn errors of glycogenolysis, mitochondrial fatty acid beta-oxidation, and oxidative phosphorylation. Nonetheless, approximately half of the patients do not suffer from a defect in any of these pathways. Using homozygosity mapping, we identified six deleterious mutations in the LPIN1 gene in patients who presented at 2-7 years of age with recurrent, massive rhabdomyolysis. The LPIN1 gene encodes the muscle-specific phosphatidic acid phosphatase, a key enzyme in triglyceride and membrane phospholipid biosynthesis. Of six individuals who developed statin-induced myopathy, one was a carrier for Glu769Gly, a pathogenic mutation in the LPIN1 gene. Analysis of phospholipid content disclosed accumulation of phosphatidic acid and lysophospholipids in muscle tissue of the more severe genotype. Mutations in the LPIN1 gene cause recurrent rhabdomyolysis in childhood, and a carrier state may predispose for statin-induced myopathy.

  1. Eosinophilic cholecystitis: an infrequent cause of acute cholecystitis

    OpenAIRE

    María del Moral-Martínez; Andrés Barrientos-Delgado; Vicente Crespo-Lora; María Eloísa Cervilla-Sáez-de-Tejada; Javier Salmerón-Escobar

    2015-01-01

    Eosinophilic cholecystitis (EC) is a rare disease that is characterised by eosinophilic infiltration of the gallbladder. Its pathogenesis is unknown, although many hypotheses have been made. Clinical and laboratory manifestations do not differ from those of other causes of cholecystitis. Diagnosis is histological and usually performed after analysis of the surgical specimen. We report the case of a woman aged 24 years, with symptoms of fever, vomiting and pain in the right upper quadrant. Whe...

  2. Mutations in LPIN1 Cause Recurrent Acute Myoglobinuria in Childhood

    OpenAIRE

    Zeharia, Avraham; Shaag, Avraham; Houtkooper, Riekelt H.; Hindi, Tareq; de Lonlay, Pascale; Erez, Gilli; Hubert, Laurence; Saada, Ann; de Keyzer, Yves; Eshel, Gideon; Vaz, Frédéric M.; Pines, Ophry; Elpeleg, Orly

    2008-01-01

    Recurrent episodes of life-threatening myoglobinuria in childhood are caused by inborn errors of glycogenolysis, mitochondrial fatty acid beta-oxidation, and oxidative phosphorylation. Nonetheless, approximately half of the patients do not suffer from a defect in any of these pathways. Using homozygosity mapping, we identified six deleterious mutations in the LPIN1 gene in patients who presented at 2–7 years of age with recurrent, massive rhabdomyolysis. The LPIN1 gene encodes the muscle-spec...

  3. Mutations in LPIN1 Cause Recurrent Acute Myoglobinuria in Childhood

    OpenAIRE

    Zeharia, Avraham; Shaag, Avraham; Houtkooper, Riekelt H.; Hindi, Tareq; De Lonlay, Pascale; Erez, Gilli; Hubert, Laurence; Saada, Ann; de Keyzer, Yves; Eshel, Gideon; Vaz, Frédéric M.; Pines, Ophry; Elpeleg, Orly

    2008-01-01

    Recurrent episodes of life-threatening myoglobinuria in childhood are caused by inborn errors of glycogenolysis, mitochondrial fatty acid beta-oxidation, and oxidative phosphorylation. Nonetheless, approximately half of the patients do not suffer from a defect in any of these pathways. Using homozygosity mapping, we identified six deleterious mutations in the LPIN1 gene in patients who presented at 2–7 years of age with recurrent, massive rhabdomyolysis. The LPIN1 gene encodes the muscle-spec...

  4. Analysis on the Characteristics of Infections Caused by Rotavirus Among 4160 Infants with Diarrhea%4160例婴幼儿腹泻轮状病毒感染情况分析

    Institute of Scientific and Technical Information of China (English)

    李方去; 刘彩霞; 蒋伟燕

    2011-01-01

    目的 分析温州市6岁以下婴幼儿腹泻轮状病毒的感染情况.方法 利用胶体金法检测标本中A群轮状病毒抗原,用聚丙烯酰胺凝胶电泳进行核酸分型.结果 2007~2009年轮状病毒检测的阳性率分别为46.1%、42.7%、30.0%,在6个月~2岁腹泻患儿中检出率最高,最高达40%.每年的2月、5月和10~11月是感染的高峰期.引起婴幼儿腹泻的轮状病毒以长型为主,占94.4%,其中长型以L1型为主.结论 轮状病毒是引起春秋季节6个月~2岁婴幼儿腹泻的主要病原体.轮状病毒不同电泳型引起的临床症状差异明显.%Objective To investigate the prevalence of infections caused by rotavirus among infants with diarrhea aged less than 6 years old in Wenzhou. China. Methods Colloidal gold test was used to detect the group A antigen of rotavirus. The genotypes of rotavirus were determined by polyacrylamide gel electrophoresis. Results The positive rates of rotavirus in 2007 . 2008 and 2009 were 46. 1% ,42.7% and 30.0% , respectively. The prevalence of rotavirus among infants with diarrhea aged from 6 months to 2 years was high to 40% . The peak of infection caused by rotavirus occurred in February, May, October and November of every year. Long type of rotavirus isolates causing infantile diarrhea accounted for 94. 4% . in which the type L1 was the most prevalent type. Conclusion Rotavirus is the major pathogen causing infantile diarrhea of the patients aged from 6 months to 2 years in spring and autumn. Different electrophoresis types of rotavirus can cause different clinical symptoms.

  5. Effect of racecadotril granules combined with compound ocimum oil oral suspension on acute diarrhea in infants%消旋卡多曲联合服药对婴幼儿急性水样泻的治疗

    Institute of Scientific and Technical Information of China (English)

    张燕妮; 朱昌琼

    2012-01-01

    目的 观察消旋卡多曲颗粒联合复方丁香罗勒口服混悬液治疗婴幼儿急性水样泻的疗效及安全性.方法 筛选84例符合条件的腹泻婴幼儿,随机分为两组:对照组为43例,给予消旋卡多曲颗粒治疗;治疗组为41例,在对照组的基础上加用复方丁香罗勒口服混悬液治疗,观察两组疗效.结果 治疗组的大便性状改善时间和总病程较对照组短,两组比较有显著性差异(t值分别为2.019、2.021,均P<0.05);治疗组的有效率明显高于对照组,两组比较有显著性差异(χ2=4.484,P<0.05).结论 消旋卡多曲颗粒联合复方丁香罗勒口服混悬液治疗婴幼儿急性水样泻,较单一应用消旋卡多曲颗粒可较快减少腹泻次数,缩短病程,无明显不良反应.%Objective To observe the efficacy and security of the treatment of infantile acute diarrhea by using racecadotril granules combined with compound ocimum oil oral suspension. Methods Eighty-four cases of acute diarrhea were randomly divided into two groups, 43 cases in control group and 41 cases in treatment group. Both groups were treated with racecadotril granules,and compound ocimum oil oral suspension was given to the treatment group besides. The clinical efficacy of two groups was observed. Results Diarrhea time and total duration in the treatment group were shorter than those in the control group, and there were statistically significant differences ( t value was 2. 019 and 2. 021, respectively, both P <0. 05 ). The effective rate in the treatment group was significantly higher than that in the control group, and the difference was statistically significant (x2= 4. 484, P < 0. 05 ). Conclusion Compared with the treatment with only racecadotril granules, the treatment of infantile acute diarrhea by using racecadotril granules combined with compound ocimum oil oral suspension can reduce the frequency of diarrhea quickly and shorten duration of diarrhea without significant adverse reactions.

  6. Parasitic diarrhea in normal and malnourished children.

    Science.gov (United States)

    Gendrel, D; Treluyer, J M; Richard-Lenoble, D

    2003-04-01

    Diarrhea is only one of the many manifestations of intestinal parasites. Environmental influences are inescapable, regardless of an individual's state of health: in a highly endemic region, intestinal parasitic colonization is almost the rule. The clinical expression of the parasitoses, however, is largely determined by host defenses; and when they are weakened, parasitic diarrhea is frequent and severe. Protein-energy malnutrition is by far the most important cause of immune deficiency in developing countries. Diarrhea caused by Strongyloides or Giardia is common and severe in malnourished children, while well-nourished children remain healthy carriers. These parasites require specific treatment in the malnourished; and the well-nourished should have preventive treatment when they are to receive corticosteroids or immunosuppressive agents. Diarrhea caused by Cryptosporidium spp. may be severe in malnourished or immunodeficient children, and recovery is achieved only after renutrition or treatment of the immunodeficiency.

  7. Subcutaneous Emphysema in Acute Asthma: A Cause for Concern?

    Science.gov (United States)

    Mitchell, Patrick D; King, Thomas J; O'Shea, Donal B

    2015-08-01

    Pneumomediastinum has been described in patients with asthma. In this case report, we describe a young patient who presented to our medical assessment unit with an asthma exacerbation and progressive dyspnea. The patient developed pneumomediastinum, a rare complication of an asthma exacerbation. Pneumomediastinum is usually characterized by chest pain, dyspnea, and neck swelling caused by subcutaneous emphysema. Although the condition is usually benign and treatment is primarily supportive, surgical intervention may be needed if the patient develops hemodynamic compromise or respiratory failure through mechanisms similar to those seen in a tension pneumothorax.

  8. Apophysomyces elegans causing acute otogenic cervicofacial zygomycosis involving salivary glands.

    Science.gov (United States)

    Goyal, Amit; Tyagi, Isha; Syal, Rajan; Marak, R S K; Singh, Jagdeep

    2007-08-01

    Zygomycosis is an invasive, life threatening fungal infection that usually affects immunocompromised hosts. In the head and neck region, rhino-orbito-cerebral zygomycosis is more common than the cervicofacial variety. We report the first case of otogenic cervicofacial zygomycosis caused by Apophysomyces elegans involving the salivary glands, an uncommon site of infection. The case began after a trivial trauma in a diabetic patient and despite surgical debridement and liposomal amphotericin B therapy, the patient died due to extensive involvement and metabolic/hemodynamic complications.

  9. An unusual cause of acute kidney injury due to oxalate nephropathy in systemic scleroderma.

    Science.gov (United States)

    Mascio, Heather M; Joya, Christie A; Plasse, Richard A; Baker, Thomas P; Flessner, Michael F; Nee, Robert

    2015-08-01

    Oxalate nephropathy is an uncommon cause of acute kidney injury. Far rarer is its association with scleroderma, with only one other published case report in the literature. We report a case of a 75-year-old African-American female with a history of systemic scleroderma manifested by chronic pseudo-obstruction and small intestinal bacterial overgrowth (SIBO) treated with rifaximin, who presented with acute kidney injury with normal blood pressure. A renal biopsy demonstrated extensive acute tubular injury with numerous intratubular birefringent crystals, consistent with oxalate nephropathy. We hypothesize that her recent treatment with rifaximin for SIBO and decreased intestinal transit time in pseudo-obstruction may have significantly increased intestinal oxalate absorption, leading to acute kidney injury. Oxalate nephropathy should be considered in the differential diagnosis of acute kidney injury in scleroderma with normotension, and subsequent evaluation should be focused on bowel function to include alterations in gut flora due to antibiotic administration.

  10. Does childhood diarrhea influence cognition beyond the diarrhea-stunting pathway?

    Directory of Open Access Journals (Sweden)

    Christa L Fischer Walker

    Full Text Available BACKGROUND: Diarrhea is a leading cause of morbidity among children under 5 years of age in low- and middle-income countries yet the additional effects and sequelae, such as cognitive impairment associated with diarrhea, have not been quantified. METHODS: We quantified the association between diarrhea prevalence and cognitive outcomes while controlling for linear growth in 4 study populations. Cognition was assessed using different methods across sites and was expressed in standardized units. We built linear regression models for each study with standardized cognitive score as the outcome and diarrhea prevalence as the main predictor variable. We then conducted meta-analyses of the regression coefficients to generate pooled estimates of the association between diarrhea prevalence and cognition whilst controlling for anthropometric status and other covariates. RESULTS: Diarrhea was not a significant predictor of cognitive score in any site in the regression models or in the meta-analyses (Coefficient = 0.07; 95% CI: -0.1, 0.2. The length for age Z- score was negatively related to cognition in all sites (0.18; 95% CI: 0.14, 0.21, with coefficients remarkably similar across sites (Coefficient Range: 0.168-0.186. CONCLUSIONS: We did not demonstrate an association between diarrhea and cognition with stunting included in the model. The links between diarrhea, stunting, and cognition provide additional rationale for accelerating interventions to reduce diarrhea.

  11. [Intestinal tuberculosis--cause of acute surgical abdomen].

    Science.gov (United States)

    Ciurea, M; Ion, D; Ionescu, S; Tica, M R

    2001-01-01

    Tuberculosis, in its various forms, remains an important cause of morbidity and mortality in developing countries in immunodeficitary patients. The indicatives of epidemiology of tuberculosis show that Romania presents a fresh outbreak of the disease in the last few years. The purpose of this paper is to present from the various forms of extrapulmonary tuberculosis, the intestinal tipe which have a high incidence. The authors describe theirs preliminary experience of intraoperative small and large bowel emergencies resections in a short period (1 year) of three young patients (between 30 and 40 years old) with history of pulmonary tuberculosis. The pathology was complex (bowel obstructions, peritonitis) and so were the surgical operations (resections, devirations). The patients showed short and long term good results.

  12. Probiotics for children with diarrhea: an update.

    Science.gov (United States)

    Guandalini, Stefano

    2008-07-01

    This review focuses on the efficacy of probiotics for diarrhea in children in different settings: day-care centers, diarrhea acquired in the hospital, antibiotic-associated diarrhea, and treatment of acute infectious diarrhea. For prevention of diarrhea acquired in day-care centers, 5 randomized and placebo-controlled trials have been published. Probiotics tested were Lactobacillus GG, Bifidobacterium lactis (alone or in combination with Streptococcus thermophilus), and Lactobacillus reuteri. The evidence of their efficacy in these settings is only modest: statistically significant for some strains only and in any case of minimal to mild clinical importance. Few trials have examined the potential role of probiotics in preventing the spread of diarrhea in hospitalized children, an event most commonly due to either rotavirus or Clostridium difficile, and they have yielded conflicting results. Overall, these studies provide only weak evidence on the efficacy of probiotics. On the other hand, a large number of trials on the role of probiotics in preventing the onset of antibiotic-associated diarrhea have been published. Most commonly employed probiotics were Lactobacillus GG, Bifidobacterium spp., Streptococcus spp., and the yeast Saccharomyces boulardii. In general, these trials do show clear evidence of efficacy, with the 2 most effective strains being Lactobacillus GG and S. boulardii. Today, we have a large number of published clinical trials on the role of probiotics in treating sporadic infectious diarrhea in children, and many of them are randomized, blinded, and controlled. They consistently show a statistically significant benefit and moderate clinical benefit of a few, well-identified probiotic strains-mostly Lactobacillus GG and S. boulardii, but also L. reuteri-in the treatment of acute watery diarrhea, primarily rotaviral, in infants and young children of developed countries. Such a beneficial effect seems to result in a reduction of diarrhea duration of

  13. Acute diarrhea associated with Salmonella enterica in Belo Horizonte-MG: prevalence and characterization of isolates Diarreia aguda associada a Salmonella enterica em Belo Horizonte-MG: prevalência e caracterização das amostras isoladas

    Directory of Open Access Journals (Sweden)

    Mireille Ângela Bernardes Sousa

    2013-02-01

    Full Text Available Introduction: Acute infectious diarrhea is still regarded as a public health problem associated with a wide range of etiologic agents, from which Salmonella enterica is particularly worth mentioning inasmuch as it is a major cause of inflammatory diarrhea in both developed and developing countries. Objective: To assess the distribution of S. enterica among children with acute diarrhea in Belo Horizonte and to characterize bacterium isolates. Material and methods: The study group comprised a total of 157 children from low socioeconomic background. Stool samples were collected for leukocyte analysis and Salmonella bacterial culture. The isolates were serotyped and evaluated as to antimicrobial susceptibility profile, extended-spectrum β-lactamases (ESBL production, and presence of virulence markers (invA, iroB, and spvC. RESULTS: A total of 5/3.2% children were infected by S. enterica, 3/60% by S. enterica Typhimurium, 1/20% by S. enterica Enteritidis and 1/20% S. enterica subsp. enterica serotype 8.20:z4,z23:-. Fecal leucocytes were detected in two out of five fecal specimens positive for S. enterica. Isolates from three children were resistant to nalidixic acid, nalidixic acid + chloramphenicol, and nalidixic acid + chloramphenicol + ampicillin. ESBL production was not detected. All samples presented invA and iroB genes. spvC marker was observed in isolates from two children infected by S. Typhimurium and S. Enteritidis. Conclusion: The results demonstrate that S. enterica infection is uncommon among children from our region. Furthermore, they indicate the need for periodic monitoring of bacterial antimicrobial susceptibility profile in order to establish suitable antimicrobial therapy when required.INTRODUÇÃO: A diarreia infecciosa aguda é considerada um problema de saúde pública associado a uma ampla gama de agentes etiológicos, entre os quais destaca-se Salmonella enterica, causa importante de diarreia inflamatória em pa

  14. Recurrent Acute Decompensated Heart Failure Owing to Severe Iron Deficiency Anemia Caused by Inappropriate Habitual Bloodletting

    Science.gov (United States)

    Lim, Woo-Hyun; Kim, Hack-Lyoung; Kim, Ki-Hwan; Na, Sang Hoon; Lee, Hyun-Jung; Kang, Eun Gyu; Seo, Jae-Bin; Chung, Woo-Young; Zo, Joo-Hee; Hong, Jung Ae; Kim, Kwangyoun; Kim, Myung-A

    2015-01-01

    A 68-year-old woman visited the emergency department twice with symptoms of acute heart failure including shortness of breath, general weakness, and abdominal distension. Laboratory findings showed extremely low level of serum hemoglobin at 1.4 g/dL. Echocardiographic examination demonstrated dilated left ventricular cavity with systolic dysfunction and moderate amount of pericardial effusion. In this patient, acute heart failure due to severe iron deficiency anemia was caused by inappropriate habitual bloodletting. PMID:26755934

  15. Acute myocardial injury caused by Sydney funnel-web spider (Atrax robustus) envenoming.

    Science.gov (United States)

    Isbister, G K; Warner, G

    2003-12-01

    A 67-year-old female suffered envenoming by a Sydney funnel-web spider (Atrax robustus), complicated by ST elevation and elevated troponin levels consistent with an acute myocardial injury. She was treated primarily with funnel-web spider antivenom, admission to intensive care and initial respiratory support for acute pulmonary oedema. The mechanism by which funnel-web spider envenomation caused myocardial injury is unclear but follow-up nuclear studies in the patient demonstrated that she had minimal atherosclerotic disease.

  16. DIARRHEA OUTBREAK IN PERNAMBUCO, BRAZIL, ASSOCIATED WITH A HEAT-STABLE CYTOTOXIC ENTEROTOXIN PRODUCED BY Aeromonas caviae.

    Science.gov (United States)

    Lopes, Ana Carolina Amaral; Martins, Luciano Moura; Gatti, Maria Silvia Viccari; Falavina Dos Reis, Cristhiane Moura; Hofer, Ernesto; Yano, Tomomasa

    2015-01-01

    In the present study enterotoxic and cytotoxic activities of twenty Aeromonas caviae strains were examined. They originated from fecal specimens of patients with acute diarrhea during an outbreak in Brazil in 2004. Culture supernatants of fourteen strains (70%) caused fluid accumulation in rabbit ileal intestinal loops and in suckling mice assays, and also showed a cytotoxic activity in Vero and Caco-2 cells. The enterotoxic and cytotoxic factors were heat-stable after culture supernatants treatment at 100 ºC. The results revealed that A. caviae strains produce a putative diarrheagenic virulence factor, a heat-stable cytotoxic enterotoxin that could be linked to the diarrhea outbreak that took place in Brazil.

  17. Imaging in emphysematous epididymo-orchitis: A rare cause of acute scrotum

    Directory of Open Access Journals (Sweden)

    Anitha Mandava

    2014-01-01

    Full Text Available Emphysematous epididymo-orchitis is an uncommon, acute inflammatory process of epididymis and testis characterized by the presence of air within the tissue. Patient presents with fever, acute pain, swelling and tenderness in the scrotum. Imaging is needed for rapid accurate diagnosis and to differentiate it from other causes of acute scrotum such as testicular torsion. We report a case of emphysematous epididymo-orchitis with imaging findings on plain radiography, ultrasound, CT and MRI and a brief review of the literature.

  18. Angioedema - a rare cause of acute episodic dysuria: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Panicker Radhakrishna

    2007-01-01

    Full Text Available The presentations of acute angioedema vary and depend upon the organs involved. Acute episodes of angioedema can be life-threatening if it involves the larynx leading to the obstruction of upper airways and it is a major cause of death. Angioedema involving the lips, cheek and tongue are common with bizarre presentations. Angioedema of the gastro intestinal tract frequently mimic an acute abdomen resulting in unnecessary surgical intervention and increased morbidity. Here we present an unusual case of angioedema involving the external urethra resulting in severe discomfort and burning sensation during micturition. He was later investigated and diagnosed as idiopathic urticaria with angioedema and promptly responded to antihistamines.

  19. Causes of Acute Water Scarcity in the Barind Tract, Bangladesh

    Directory of Open Access Journals (Sweden)

    Md. Bazlar Rashid

    2013-06-01

    Full Text Available The Barind tract is an elevated landmass (about 11-48 m amsl comprised with Pleistocene terraces and is situated in the northwestern part of Bangladesh. At present, this area faces scarcity of water. The present study is an attempt to unveil the causes of water scarcity of the area. Several aspects like change in climatic condition, irrigation practice and drainage characteristics of major rivers are the prime factors for water scarcity. Interpretation of recent satellite imagery and historical records reveal that the major rivers of the area like Ganges (Padma, Tista and Kosi have remarkably migrated from Barind tract during last few hundred years. Shifting of these rivers causes great change in hydrodynamics of the Barind tract. As a result, flow of other related rivers of the area like the Mahananda, Kulic, Tangon, Punarbhaba, Atrai, Little Jamuna, Karatoya and Nagar reduces remarkably in the dry season. As a result aquifers in the area are not recharged sufficiently by river water in the dry season. India constructed Farakka barrage on the Ganges (Padma river in 1975 to divert the flow of water from Bangladesh to the other parts of India. This diversion of water also leads to the decreasing of water in the area. Climatic data interpretation of the last 50 years also reveals that annual rainfall in the area is decreasing while overall temperature is increasing. To boost up the cropping intensity (117% to 200% compared to national average of 174% and to meet present demand 74% of cultivable lands are being irrigated with 96% share of groundwater owing to unavailability or scarcity of rainfall and hence surface water. Irrigation by groundwater has dramatically been increased (250 times in the last 30 years. Due to over exploitation, water table progressively declined (av. rate 0.10 m/year which ultimately leads the area to water scarcity zone. The aquifers are confined or semi-confined and do not get appreciable vertical recharge through clay

  20. Citrin deficiency: A treatable cause of acute psychosis in adults

    Directory of Open Access Journals (Sweden)

    Sunita Bijarnia-Mahay

    2015-01-01

    Full Text Available Citrin deficiency is an autosomal recessive genetic disorder caused by a defect in the mitochondrial aspartate/glutamate antiporter, citrin. The disorder manifests either as neonatal intra-hepatic cholestasis or occurs in adulthood with recurrent hyperammonemia and neuropsychiatric disturbances. It has a high prevalence in the East Asian population, but is actually pan-ethnic. We report the case of a 26-year-old male patient presenting with episodes of abnormal neuro-psychiatric behavior associated with hyperammonemia, who was diagnosed to be having citrin deficiency. Sequencing of the SLC25A13 gene revealed two novel mutations, a single base pair deletion, c. 650delT (p.Phe217SerfsFNx0133 in exon 7, and a missense mutation, c. 869T>C (p.Ile290Thr in exon 9. Confirmation of the diagnosis allowed establishment of the appropriate management. The latter is an essential pre-requisite for obtaining a good prognosis as well as for family counseling.

  1. Acute cholestatic hepatitis caused by amoxicillin/clavulanate

    Science.gov (United States)

    Beraldo, Daniel Oliveira; Melo, Joanderson Fernandes; Bonfim, Alexandre Vidal; Teixeira, Andrei Alkmim; Teixeira, Ricardo Alkmim; Duarte, André Loyola

    2013-01-01

    Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used, especially for the treatment of respiratory and cutaneous infections. In general, it is a well-tolerated oral antibiotic. However, amoxicillin/clavulanate can cause adverse effects, mainly cutaneous, gastrointestinal, hepatic and hematologic, in some cases. Presented here is a case report of a 63-year-old male patient who developed cholestatic hepatitis after recent use of amoxicillin/clavulanate. After 6 wk of prolonged use of the drug, he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia (total bilirubin > 300 mg/L). Diagnostic investigation was conducted by ultrasonography of the upper abdomen, serum tests for infection history, laboratory screening of autoimmune diseases, nuclear magnetic resonance (NMR) of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by ultrasound. The duration of disease was approximately 4 mo, with complete resolution of symptoms and laboratory changes at the end of that time period. Specific treatment was not instituted, only a combination of anti-emetic (metoclopramide) and cholestyramine for pruritus. PMID:24379601

  2. Effect of Wenwei Huashi Tang on acute diarrhea and gastric empty in mice%温胃化湿汤对小鼠急性腹泻及胃排空作用的研究

    Institute of Scientific and Technical Information of China (English)

    杨正腾

    2011-01-01

    目的 观察温胃化湿汤对番泻叶所致的腹泻模型作用及胃排空作用的影响,探讨其作用机制.方法 采用番泻叶煎剂致小鼠腹泻模型,连续4d观察温胃化湿汤给药后3h内的腹泻指数,并观察小鼠小肠墨汁推进率;采用甲基橙为标志物,观察温胃化湿汤对新斯的明致小鼠胃排空亢进的影响.结果 温胃化湿汤各组均能明显降低小鼠腹泻指数,减慢小鼠小肠推进速度,与模型组比较有显著性差异(P<0.05),与香连丸组比较,高、中剂量组有显著性差异(P<0.05);溘温化湿汤各组能增加新斯的明致胃排空亢进小鼠的胃残留率,与模型组比较有显著性差异(P<0.05),与香连丸组比较,高、中剂量组有显著性差异(P<0.05).结论 温胃化湿汤对小鼠腹泻和胃排空亢进有较好的防治作用,其作用优于香连丸.%Objective To observe the effect of Wenwei Huashi Tang on diarrhea induced by sennae folium and gastric empty in mice and investigate the mechanism. Methods The acute diarrhea models were induced by giving senna decoction, and then Wenwei Huashi Tang and positive control drug were fed for 3 h to compare the diarrhea index. We observed the diarrhea index, and the advance rate of ink in the small intestine of the mice for 4 d. Gastric residual rate of methyl orange method was used for gastric emptying in mice pretreated with neostigmine. Results Compared with the model group, each dosage group of Wenwei Huashi Tang significantly decreased the diarrhea index and slowed down the advance rate of ink in the small intestine in the mice (P <0. 05). Compared with Xianglian Wan group, the high- and middle-dose Wenwei Huashi Tang groups significantly decreased the diarrhea index in the mice (P <0. 05). Compared with the model group, each dosage group of Wenwei Huashi Tang significantly increased the gastric residual rate in the gastrointestinal hyperfunctional model of hyperactivity (P <0. 05). Compared with

  3. Brady's Yeast Powder Treatment of Acute Diarrhea of Children with Dia-betes Results Analysis%布拉氏酵母菌散剂治疗小儿糖尿病急性腹泻病效果分析

    Institute of Scientific and Technical Information of China (English)

    冯蕴慧

    2015-01-01

    Objective to investigate and study the clinical treatment of acute diarrhea of children with diabetes, the curative effect of application of brady′s yeast powder. Methods select in May 2014 to April 2015, we treated 120 cases of children with acute diarrhea of children with diabetes as the object of study and observation. Patients aged from 6 months to 7 years old, the sufferer randomly divided into observation group and control group, two groups of 60 cases. Two groups of patients were given including oral montmorillonite powder, and anti-infection and rehydration of routine treatment, at the same time, the observation group was given oral brady′s yeast powder treatment. On two groups of children with diarrhea used time and relieve diarrhea remission rate, and number of traits and stool. Results After two weeks of treatment, the observation group of patients with the total effective rate was 92.7% (56/60), significantly higher than the control group (71.4%, 47/60) pa-tients, the total effective rate in patients with two groups of contrast, there are significant differences, statistically significant (P value is less than 0.05), with statistical significance. Conclusion in the conventional treatment at the same time, it is in giving children with diarrhea combination treatment with oral brady′s yeast powder, diarrhea can effectively shorten the course of the disease and the curative effect is obviously improved, has good clinical application and popularization value.%目的 探讨和研究临床上治疗小儿糖尿病急性腹泻病,应用布拉氏酵母菌散剂的疗效. 方法 选取2014年5月—2015年4月间,该院收治的120例小儿糖尿病急性腹泻病患儿为研究和观察对象. 患者年龄在6个月~7岁, 随机将患者分成观察组和对照组,两组人数各为60例. 两组患者均给予包括口服蒙脱石散,以及抗感染和补液等常规性治疗,同时,对观察组还给予口服布拉氏酵母菌散剂治疗. 对两组患

  4. [Scorpionism causing severe acute flaccid paralysis. Case report].

    Science.gov (United States)

    Villa-Manzano, Alberto I; Vázquez-Solís, Ma Guadalupe; Zamora-López, Xochitl Xitlalli; Arias-Corona, Fernando; Palomera-Ávila, Francisco Miguel; Pulido-Galaviz, Carlos; Pacifuentes-Orozco, Adán

    2016-01-01

    Introducción: el alacranismo es un problema de salud pública en diversas regiones del mundo, siendo México el país que tiene mayor número de casos. Las manifestaciones clínicas oscilan desde sintomatología local hasta cuadros graves con repercusiones a nivel cardiovascular, respiratorio y neurológico, e incluso la muerte. No existen reportes de parálisis flácida como una manifestación del cuadro clínico por picadura del alacrán del género Centruroides, familia Buthidae, especie altamente tóxica, endémica y causante de altos índices de morbimortalidad en nuestra región. Caso clínico: documentamos un caso de alacranismo grave, provocado por escorpión de la familia Buthidae del género Centruroides, que causó parálisis flácida aguda, posterior a resolución de otras manifestaciones severas. Solo existe un reporte de caso de alacranismo que produce parálisis flácida aguda en la literatura médica, pero relacionado con el escorpión de la familia Parabuthus, endémico de Sudáfrica, el cual no es endémico en México. Conclusiones: conocer esta complicación, nueva para nuestra región, permitirá maximizar esfuerzos para diagnosticar y manejar oportunamente esta entidad con la aplicación temprana de faboterápico específico y soporte vital avanzado.

  5. molecular identification of rotavirus strains associated with diarrhea ...

    African Journals Online (AJOL)

    DR. AMINU

    3Department of Medical Microbiology, University of Jos teaching Hospital, Jos, Nigeria. ABSTRACT ... associated with diarrhea among children in Kwara state, Nigeria. A total of 150 ... each case. ..... Children with Acute Gastroenteritis in Zaria,.

  6. 多西他赛致迟发性腹泻和肺水肿%Pulmonary edema and delayed-onset diarrhea caused by docetaxel

    Institute of Scientific and Technical Information of China (English)

    曾倩; 谢学渊; 刘平; 李晓荟

    2013-01-01

    A 52-years-old female patient with breast cancer received chemotherapy regimen (epirubicin and cyclophosphamide for 4 cycles followed by docetaxel for another 4 cycles) after operation.She experienced diarrhea with watery stool around 10 days after each treatment cycle of docetaxel,was treated with montmorillonite powder and her diarrhea disappeared.A chest CT scan revealed no abnormal finding before sequential chemotherapy with docetaxel,while effusion in both lungs after docetaxel chemotherapy.Two months later,effusion in both lungs disappeared.%1例52岁女性乳腺癌患者术后化疗方案为表柔比星+环磷酰胺4个周期,序贯多西他赛4个周期.患者在多西他赛治疗每个周期的第10天左右均出现水样便,给予蒙脱石散口服后腹泻消失.多西他赛序贯化疗前患者胸部CT未见异常改变,多西他赛化疗结束后胸部CT示双肺渗出.2个月后双肺渗出消失.

  7. 急性腹泻婴幼儿患者实施粪便轮状病毒检测的检验学研究%Study on the detection of fecal rotavirus in infants with acute diarrhea

    Institute of Scientific and Technical Information of China (English)

    李晶伟

    2014-01-01

    目的:检测急性腹泻婴幼儿患者粪便轮状病毒对急性腹泻的感染情况,得出准确快捷的临床治疗方案。方法:抽取我院2013年4月—2014年6月465例急性腹泻婴幼儿患者作为研究对象,采用乳胶凝集试验(LAT)对我院就诊的465例急性腹泻婴幼儿患者进行粪便轮状病毒检测。结果:在不同季节,对急性腹泻婴幼儿患者粪便轮状病毒进行检测,研究结果表明,在抽取的465例急性腹泻婴幼儿患者中,总阳性例数为132,阳性率达到28.4%。不同季节轮状病毒检测阳性检出率比较差异有统计学意义(x2=21.2806,P=0.0001)。对不同年龄阶段的急性腹泻婴幼儿粪便轮状病毒进行检测,0~5个月大的婴幼儿病例达168例,感染率达17.9%,在婴儿6个月~2岁时病例达299例,阳性率高达26.8%。2~5岁病例数为98,感染率达16.3%。不同年龄阶段检测轮状病毒阳性检出率比较差异具有数学统计意义(x2=7.3579,P=0.0252)。结论:及时检测急性腹泻婴幼儿患者轮状病毒,有助于减少感染,达到更好的治疗效果。%Objective:To detect the infection of acute diarrhea stool rotavirus in infant with acute diarrhea in order to accurately and quickly draw the clinical treatment scheme. Methods:465 cases with acute diarrhea from April,2013 to June,2014 in our hospital were selected as the research objects and detected fecal rotavirus by latex agglutination test (LAT). Results:In different seasons, the detection of acute diarrhea feces infants with rotavirus was carried out and the results of the study showed that, in the sample of 465 cases of acute diarrhea in infants and young children , 132 cases were positive, the positive rate was 28.4%. Detection of different seasonal rotavirus positive rate had a significant difference (x2=21.2806, P=0.0001). The different ages of children acute diarrhea stool rotavirus were detected, 0~5 month­old infants

  8. [A case of acute intracranial epidural hematoma caused by chronic nasal sinusitis].

    Science.gov (United States)

    Kihara, Kazunori; Sato, Motoki; Kado, Ken; Fukuda, Kazumasa; Nakamura, Takao; Yamakami, Iwao

    2015-01-01

    Non-traumatic intracranial acute epidural hematoma(EDH)is rare. It is mostly caused by coagulation disorders, dural metastasis, or vascular malformations of the dura. We report a case of non-traumatic acute EDH caused by chronic nasal sinusitis and review the literature comprising 10 cases of acute EDH caused by chronic nasal sinusitis. A 16-year-old boy visited our outpatient clinic with a 2-day history of severe headache. He did not have fever or neurological abnormalities and showed no evidence of head trauma. Cranial computed tomography(CT)revealed sphenoid sinusitis and a small amount of epidural air in the middle fossa, but no other intracranial abnormalities. After eight days with no subsequent history of trauma, radiological exams showed a massive acute epidural hematoma in the left middle fossa and temporal convexity without any vascular lesion or skull fracture. The patient underwent a hematoma evacuation that revealed neither a skull fracture nor a vascular abnormality. In this adolescent, chronic nasal sinusitis caused fragility of the meningeal artery wall, an air collection in the epidural space, and the detachment of the dura mater from the inner surface of the skull, thereby resulting in a non-traumatic acute EDH.

  9. Umbilical Compress Therapy Combined with Smecta for 127 Cases of Acute Diarrhea in Infants%脐疗法联合思密达治疗小儿急性腹泻127例

    Institute of Scientific and Technical Information of China (English)

    李晗怡; 董亚娜

    2012-01-01

    目的:观察脐疗法联合思密达治疗小儿急性腹泻的临床疗效.方法:将254例腹泻患儿随机分为治疗组和对照组各127例,对照组给予正确的饮食指导,通过口服补液盐(ORS)或静脉补液及时纠正水、电解质紊乱、酸碱失衡及酸中毒等一般常规治疗,同时用胃肠黏膜保护剂思密达止泻;治疗组在上述方案治疗的基础上加中药粉剂调敷脐中.结果:与对照组相比,治疗组的显效率、总有效率均明显增高(P<0.01).结论:脐疗法联合思密达治疗小儿腹泻疗效显著.%Objective: To approach curative effects of umbilical compress therapy and smecta in treating infants with acute diarrhea. Method: All 254 cases were randomly divided into treatment group and control group. Control group were administered with dietary instruction, correcting water and electrolyte disturbance, acid-base imbalance and acid poisoning through oral rehydration salt or intravenous dripping, and smecta to stop diarrhea; treatment group received herbal powder applied to the navel. Result: Compared with control group, effectual rate and total effective rate of treatment group raised remarkably (P<0.01). Conclusion: Applications of umbilical compress therapy and smecta to infant diarrhea are effective.

  10. Unusual cause of acute abdominal pain in a postmenopausal woman: adnexal torsion

    Directory of Open Access Journals (Sweden)

    Alper Biler

    2016-03-01

    Full Text Available Adnexal torsion is an infrequent but significant cause of acute lower abdominal pain in women. While adnexal torsion is generally considered in premenopausal women presenting with acute abdominal pain and a pelvic mass, it is a rare cause of acute abdominal pain during postmenopausal period. The diagnosis of adnexal torsion is often challenging due to nonspesific clinical, laboratory and physical examination findings. Causes of adnexal torsion is also different in premenopausal and postmenopausal women. While a simple functional cyst is often the cause of torsion in premenopausal women, it is more rarely the cause in postmenopausal women. Adnexal torsion is a surgical emergency. The surgery of adnexal torsion is performed either via conventional exploratory laparotomy or laparoscopic surgery. Adnexal torsion in postmenopausal women should be considered not only in the setting of sudden onset pain, but also in long-term abdominal discomfort. In this article, we presented a case with adnexal torsion that rarely cause acute abdominal pain in postmenopausal women. [Cukurova Med J 2016; 41(1.000: 167-170

  11. 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.

  12. Factors Associated with the Duration of Moderate-to-Severe Diarrhea among Children in Rural Western Kenya Enrolled in the Global Enteric Multicenter Study, 2008-2012.

    Science.gov (United States)

    Schilling, Katharine A; Omore, Richard; Derado, Gordana; Ayers, Tracy; Ochieng, John B; Farag, Tamer H; Nasrin, Dilruba; Panchalingam, Sandra; Nataro, James P; Kotloff, Karen L; Levine, Myron M; Oundo, Joseph; Parsons, Michelle B; Bopp, Cheryl; Laserson, Kayla; Stauber, Christine E; Rothenberg, Richard; Breiman, Robert F; O'Reilly, Ciara E; Mintz, Eric D

    2017-07-01

    Diarrheal disease is a leading cause of death among young children worldwide. As rates of acute diarrhea (AD; 1-6 days duration) have decreased, persistent diarrhea (PD; > 14 days duration) accounts for a greater proportion of the diarrheal disease burden. We describe factors associated with the duration of moderate-to-severe diarrhea in Kenyan children diarrhea (ProAD; 7-13 days duration), and 73 (7%) had PD. We constructed a Cox proportional hazards model to identify factors associated with diarrheal duration. Risk factors independently associated with longer diarrheal duration included infection with Cryptosporidium (hazard ratio [HR]: 0.868, P = 0.035), using an unimproved drinking water source (HR: 0.87, P = 0.035), and being stunted at enrollment (HR: 0.026, P improve drinking water are imperative, and nutrition should be improved through exclusive breastfeeding in infants ≤ 6 months and appropriate continued feeding practices for ill children.

  13. 婴幼儿急性腹泻病原微生物临床检验120例效果分析及预防措施%Analysis of infant acute diarrhea clinical pathogenic microorganism inspection 120 cases and preventive measures

    Institute of Scientific and Technical Information of China (English)

    郑国荣

    2015-01-01

    目的:分析婴幼儿急性腹泻病原微生物临床检验效果,积极探讨相关预防措施。方法选取我院2012年1月—2014年1月收治的120例急性腹泻婴幼儿患者作为研究对象,采集患儿大便标本进行病原微生物临床检测,总结婴幼儿急性腹泻出现的原因。结果在本组120例急性腹泻婴幼儿患者中,67例患儿病原微生物检查结果为阳性,感阳性率为55.83%,年龄≤5个月患儿检查结果感阳性率为41.82%,5个月~1岁患儿感阳性率为76.92%,1~2岁患儿感阳性率为53.85%,不同年龄段患儿病原微生物检查结果感阳性比例差异具有统计学意义(P<0.05);本组研究中,检测到的病原微生物包括大肠埃希菌、腺病毒、轮状病毒、沙门菌属、志贺菌属等其它病原菌,其中轮状病毒比例最高为40.00%(48/120),组间差异具有统计学意义(P<0.05)。结论针对婴幼儿急性腹泻患者,应加强病原微生物项目的检验,为临床疾病诊断、治疗及预防提供科学的参考依据,为患儿提供一个健康成长的环境。%Objective: to analyze the infant acute diarrhea clinical pathogenic microorganism inspection results, and actively explore the relevant preventive measures.Methods: selected in our hospital in 2012 January—2014 year in January admitted 120 cases of acute diarrhea of infant patients as research object, collecting in stool specimens were clinical pathogenic microorganism detection, summarize the cause of acute diarrhea in infants and young children appear.Results: children of different ages of pathogenic microorganism examination results positive proportional difference has statistics significance (P<0.05); in the study group, the detected pathogenic microorganisms including Escherichia coli, adeno-associated virus, rotavirus, Salmonella, Shigella and other pathogens, of which the highest proportion of rotavirus was 40% (48/120), with statistically

  14. Genotypes and molecular characteristics of Norovirus from children with acute diarrhea in Hangzhou area from 2010 to 2011%杭州地区2010~2011年急性腹泻患儿病原诺如病毒基因型及分子特征研究

    Institute of Scientific and Technical Information of China (English)

    金赛燕; 林洁; 徐秀娟; 钟德明

    2012-01-01

    Objective To investigate the genotypes and molecular characteristics of Norovirus (NV) in young children with acute diarrhea in Hangzhou area from 2010 to 2011. Methods Fecal specimens were collected from the young children ( <5 years) with acute diarrhea. Norovirus in 325 specimens was detected by multiplex RT-PCR. PCR products of positive samples were randomly selected and sequenced. The sequences were analyzed by phylogenetic analysis. Results The positive rate of norovirus infection was 13. 85% in 325 fecal specimens of young children with acute diarrhea in Hangzhou area. Among the 45 positive specimens 7 isolates were norovirus G I subtype, 38 isolates were norovirus G II subtype. Sequences analysis showed that the homology of norovirus G I isolated strains was from 93. 2% to 100% comparing with AB522407. 1, EU085525. 1, EU085523. 1 and FJ383829. 1 strains. The close relation among them was shown by phylogenetic tree. Phylogenetic tree analysis revealed that 12 isolated strains were G II -4 genotype, and the homology was from 94.7% to 100% comparing with GQ845367.2, AB291542.2, JQ934814. 1 and JQ613509. 1 strains. The homology of 4 G II -3 genotypes compared with JF896130. 1 and EU400377. 1 was from 97. 9% to 100% ; The homology of the single G II -4 genotype compared with GQ380647. 1 strain was 93. 6% . Conclusion Norovirus was one of the most common cause of young children with acute diarrhea, and Gil -4 variant strain was identified as the possibly prevalent strains from 2010 to 2011 in Hangzhou area.%目的 探讨杭州地区2010 ~2011年婴幼儿急性腹泻病原诺如病毒(NV)基因型及其分子特征.方法 用多重RT-PCR方法对325份5岁以下急性腹泻患儿粪便标本进行NV检测,选择阳性扩增片段进行基因测序,并对序列进行系统进化分析.结果 杭州地区急性腹泻患儿感染NV的阳性率为13.85%(45/325),NV GⅠ型7株,GⅡ型38株;序列结果分析显示3株NV GⅠ型与AB522407.1、EU085525.1

  15. Analysis on the use of antibiotics in treatment of 180 infantile patients with acute diarrhea in our hospital%180例小儿急性腹泻病住院患者抗菌药物应用分析

    Institute of Scientific and Technical Information of China (English)

    罗宏丽; 肖顺林; 王国俊

    2011-01-01

    Objective: To investigate the usage of antibiotics in treatment of infantile acute diarrhea in our hospital and provide reference for clinical rational administration. Methods: The application of antibiotics in the treatment of 180 infantile inpatients with acute diarrhea from October 2010 to March 2011 was investigated retrospectively, and the basic situation of the patient diagnosis, pathogeny examination,outcomes and the use of the antibiotics in infantile patients with acute diarrhea were statistically analysed. Results: Among 180 patients, 135 patients received antibiotics (75.0%). Aztreonam took the highest proportion (49.39%) in use frequency of antibiotics. In terms of drug combination (14.81%), the first place was piperacillin sodium and sulbactam sodium in combination with cefazolin sodium pentahydrate (4.44%). Conclusion: Clinical management of rational use of antibiotics must be enhanced because the application of antibiotics had unreasonable administration problems in terms of indications, drug selection, dosage, length of the treatment and combination therapy.%目的:了解我院小儿急性腹泻病住院患者应用抗菌药物的情况,为临床合理用药提供参考.方法:回顾性调查我院2010年10月-2011年3月180例小儿腹泻病住院患者抗菌药物的应用情况,从患者基本情况、诊断及病原学检查、患儿转归情况、抗菌药物应用基本情况等方面进行统计.结果:180例患儿中,有135例(75.0%)应用抗菌药物,应用频率最高的药物是氨曲南,占49.39%;联合用药率为14.81,以哌拉西林钠舒巴坦钠联用五水头孢唑啉钠最多,占4.44%.结论:我院治疗小儿腹泻病抗菌药物的应用在用药指征、品种选择、剂量、疗程及联合使用等方面存在不合理现象,需加强管理.

  16. 磷酸铝凝胶治疗小儿急性腹泻病的临床疗效观察%Observation of Clinical Effect of Aluminum Phosphate Gel in Treatment of Children with Acute Diarrhea

    Institute of Scientific and Technical Information of China (English)

    郭易苗; 方艳; 罗颂; 何周康

    2015-01-01

    目的:探讨磷酸铝凝胶对小儿急性腹泻病的临床治疗效果。方法选择我院2013年7月至2014年8月收治的260例小儿急性腹泻病患儿为研究对象,随机分为对照组和观察组各130例。对照组患儿给予对症治疗,观察组在对症治疗的基础上给予磷酸铝凝胶治疗,比较两组的临床疗效以及腹泻、发热、脱水、呕吐等症状缓解时间。结果观察组的总有效率为95.38%,显著高于对照组的73.08%,差异具有统计学意义(P<0.05)。观察组呕吐、腹泻、发热及脱水等症状缓解时间均显著短于对照组,差异具有统计学意义(P<0.05)。结论小儿急性腹泻治疗在常规用药基础上加磷酸铝凝胶,可提高治疗效果,缩短见效时间,促进患者远期预后。%Objective To investigate the clinical effect of aluminum phosphate gel in the treatment of children with acute diarrhea. Methods 260 cases of children with acute diarrhea admitted to our hospital from July 2013 to August 2014 were selected as research objects and randomly divided into control group and observation group, with 130 cases in each group. The control group was given with symptomatic treatment, the observation group was treated with aluminum phosphate gel on the basis of symptomatic treatment. The clinical effect, alleviation time of diarrhea, fever, dehydration and emesis were compared between the two groups. Results The total effective rate of the observation group was 95.38%, significantly higher than 73.08% of the control group, with statistical difference (P <0.05). The alleviation time of diarrhea, fever, dehydration and emesis in the observation group were significantly shorter than those in the control group, with statistical difference (P<0.05). Conclusions For children with acute diarrhea, aluminum phosphate gel on the basis of conventional medicine can improve the therapeutic effect, shorten the response time and promote the long-term prognosis of

  17. 葡萄糖酸锌治疗婴幼儿急性腹泻疗效观察%THE EFFECT OF ZINC GLUCONATE ON INFANTS WITH ACUTE DIARRHEA

    Institute of Scientific and Technical Information of China (English)

    柴爱兰

    2011-01-01

    Objective To observe the clinical effect of zinc gluconate on infants with acute diarrhea and study its mechanisms. Methods This study consisted of 172 infants with acute diarrhea, who were randomly divided into treatment and control groups. Both groups received conventional therapy. In addition to that, zinc gluconate was given to patients in the treatment group for two weeks, 10 mg/d for those below 6 months old and 20 mg/d for those over 6 months old. The total effective rate, symptomdisappearing time, and recurrence during a 3-month follow-up were compared between the two groups. Results The total effective rate of the treatment group was significantly higher than that of the control group (x2= 6.14, P<0.05). There were significant differences between the two groups in terms of fever, diarrhea, and hospital stay (t=2. 976-5. 907,P<0.01), but no significant difference in terms of vomiting between the two groups (t=O. 532,P>0. 05). During the follow-up duration, the recurrence rate of diarrhea in the treatment group was significantly lower than that of the control (x2 =4.40, P<0.05). Conclusion Zinc gluconate is effective in treating infants with acute diarrhea and preventing recurrence of the disease within three months.%目的 观察葡萄糖酸锌治疗婴幼儿急性腹泻的临床疗效,探讨其作用机制.方法 将172例急性腹泻婴幼儿随机分为治疗组和对照组.两组均给予常规治疗,治疗组在此基础上加用葡萄糖酸锌治疗.剂量为≤6个月儿给予葡萄糖酸锌10 mg/d,>6个月儿给予葡萄糖酸锌20 mg/d,疗程均为14 d.比较两组治疗总有效率、I临床症状消失时间及随访3个月腹泻再发生率.结果 治疗组总有效率明显高于对照组(X=6.14,P0.05).在随访3个月过程中,治疗组腹泻再发生率与对照组比较差异有显著性(X=4.40,P<0.05).结论 葡萄糖酸锌可有效治疗婴幼儿急性腹泻并预防3个月内腹泻的再次发生.

  18. Diarrhea and its effect on growth

    OpenAIRE

    Mata, Leonardo

    1986-01-01

    Artículo científico -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1986 The predominant etiology of diarrhea in the general population of underdeveloped countries is infection by viruses and bacteria. Studies in rural areas clearly suggest an infectious cause. For example, diarrhea initially affects one individual in the family (index case) and then spreads to other family and community members. Infants and toddlers are affected more frequently than older children, ad...

  19. Analysis of efficacy and safety in the treatment of acute diarrhea in children with diarrhea stop Montmorillonite powder%蒙脱石散与儿泻停联合治疗小儿急性腹泻病的疗效与安全性分析

    Institute of Scientific and Technical Information of China (English)

    陈丰

    2015-01-01

    目的:探析蒙脱石散与儿泻停联合用药下小儿急性腹泻病的临床疗效与安全性。方法:从2014年1月~2015年2月入住我院的急性腹泻患儿中随机选取92例作为研究对象。并按随机分组法分为观察组和对照组,各46例。观察组实施蒙脱石散与儿泻停联合治疗,对照组给予单纯蒙脱石散治疗,对比两组患儿的临床疗效、症状复常时间、住院时间及不良反应情况。结果:观察组的总有效率为97.83%,显著高于对照组的84.78%,且腹泻、呕吐、发热复常时间及住院时间明显少于对照组(P<0.05),上述差异均有统计学意义。观察组的不良反应发生率为2.17%,低于对照组的8.70%(P>0.05),差异无统计学意义。结论:蒙脱石散与儿泻停联合不仅能有效治疗小儿急性腹泻,缩短临床症状复常时间,且安全性高,值得临床推荐。%Objective: To study the clinical efficacy and safety of acute diarrhea in children of Montmorillonite powder with erxieting combined medication. Methods:From January 2014~February 2015 in our hospital with acute diarrhea were randomly selected 92 cases as the research object, which were randomly divided into observation group and control group, 46 cases in each. The observation group received Montmorillonite powder with erxieting combined treatment, control group was treated with Montmorillonite powder treatment. The symptoms, clinical curative effect were compared between the two groups in the recovery time, hospitalization time and adverse reaction. Results: The total effective rate of observation group was 97.83%, significantly higher than that of the control group was 84.78%, and diarrhea, vomiting, fever recovery time and hospitalization time was significantly less than that of the control group (P0.05), but the difference was not statistically significant. Conclusion: Montmorillonite powder with erxieting joint not only can be effective in

  20. 急性腹泻患者粪便细菌培养及临床特征分析%Clinical features and bacterial culture on stools of patients with acute diarrhea

    Institute of Scientific and Technical Information of China (English)

    李安德; 王晓才; 王蕻馨; 王作梅; 黄象安

    2012-01-01

    目的:对急性腹泻患者的粪多细菌培养结果和临床特征分析.方法:在2010年4月-2011年3月在东方医院和佑安医院肠道门诊就医的急性腹泻患者中,随机抽取158例粪标本作细菌培养,对其临床诊断、临床特征、细菌培养结果进行综合分析.结果:158例中包括急性肠炎60例,急性菌痢17例,胃肠功能紊乱58例,消化不良7例,腹泻待查16例;粪细菌培养阳性41例(25.95%、41/158),包括副溶血弧菌17例(41.46%、17/41)、志贺菌属10例(24.39%、10/41)、沙门菌7例(17.07%、7/41)、类志贺邻单胞4例(9.76%、4/41)、温和气单胞2例(4.88%、2/41)、霍乱弧菌1例(2.44%、1/41).41例粪细菌培养阳性患者的临床诊断分别为:急性肠炎24例,急性菌痢10例,胃肠功能紊乱3例,腹泻待查3例,消化不良1例.结论:北京市丰台区急性腹泻患者肠道致病菌以副溶血弧菌为主,志贺菌属次之;急性腹泻的临床诊断存在过分依赖便常规化验结果的情况,值得临床医师引起重视.%Objective;To analyze clinical features and multi - bacteria culture result of acute diarrhea patients. Methods; Among the acute diarrhea patients who seek medical advice in intestinal outpatient service in Dongfang Hospitital and Youan Hospitital from April in 2010 to March in 2011, 158 cases were randomly selected carry out the dung bacteria culture, then their clinical diagnosis, clinical features and the multi - bacteria culture result were analyzed. Results; Among the 158 cases, 60 cases were acute enteritis, 17 cases were acute bacterial dysentery, 58 cases were gastrointestinal dysfunction, 7 cases were indigestion, and 12 cases were diarrhea referred;41 cases were found dung bacteria culture positive (25.95% , 41/158) , which consist of 17 cases of (41.46% , 17/41 )Vibrio parahaemolyticus, 10 cases of Shigella (24. 39% , 10/41) , 7 cases of Salmonella (17.07% , 7/41), 4 cases of plesiomonas shigelloides(9. 76% , 4/41 ) , 2

  1. Acute Pancreatitis in Association with Campylobacter jejuni- Associated Diarrhea in a 15-Year-Old with CFTR Mutations: Is There a Link?

    OpenAIRE

    Leena Kandula; Lowe, Mark E.; Seema Khan; Whitcomb, David C.

    2006-01-01

    Context: Acute pancreatitis has occasionally been reported in association with Campylobacter jejuni infection in humans. However, the mechanism linking Campylobacter jejuni infection and pancreatitis isunclear. Acute pancreatitis in association with an infectious illness may be related to underlying genetic mutations. For instance, studies show that mutations in the cystic fibrosis transmembrane conductance regulator gene increase the susceptibility for acute and chronic pancreatitis. Case re...

  2. Duodenal obstruction following acute pancreatitis caused by a large duodenal diverticular bezoar

    Institute of Scientific and Technical Information of China (English)

    Ji Hun Kim; Jae Hyuck Chang; Sung Min Nam; Mi Jeong Lee; Il Ho Maeng; Jin Young Park; Yun Sun Im

    2012-01-01

    Bezoars are concretions of indigestible materials in the gastrointestinal tract.It generally develops in patients with previous gastric surgery or patients with delayed gastric emptying.Cases of periampullary duodenal divericular bezoar are rare.Clinical manifestations by a bezoar vary from no symptom to acute abdominal syndrome depending on the location of the bezoar.Biliary obstruction or acute pancreatitis caused by a bezoar has been rarely reported.Small bowel obstruction by a bezoar is also rare,but it is a complication that requires surgery.This is a case of acute pancreatitis and subsequent duodenal obstruction caused by a large duodenal bezoar migrating from a periampullary diverticulum to the duodenal lumen,which mimicked pancreatic abscess or microperforation on abdominal computerized tomography.The patient underwent surgical removal of the bezoar and recovered completely.

  3. Ultrasonography of adnexal causes of acute pelvic pain in pre-menopausal non-pregnant women

    Directory of Open Access Journals (Sweden)

    Carolyn S. Dupuis

    2015-10-01

    Full Text Available Acute-onset pelvic pain is an extremely common symptom in premenopausal women presenting to the emergency department. After excluding pregnancy in reproductive-age women, ultrasonography plays a major role in the prompt and accurate diagnosis of adnexal causes of acute pelvic pain, such as hemorrhagic ovarian cysts, endometriosis, ovarian torsion, and tubo-ovarian abscess. Its availability, relatively low cost, and lack of ionizing radiation make ultrasonography an ideal imaging modality in women of reproductive age. The primary goal of imaging in these patients is to distinguish between adnexal causes of acute pelvic pain that may be managed conservatively or medically, and those requiring emergency/urgent surgical or percutaneous intervention.

  4. 94 cases of Levofloxacin Therapy for Severe acute Bacterial Infectious Diarrhea Curative Effect Analysis%94例左氧氟沙星治疗急性重症细菌性感染性腹泻疗效分析

    Institute of Scientific and Technical Information of China (English)

    熊飞

    2013-01-01

    目的:探讨左氧氟沙星治疗急性重症细菌性感染性腹泻的临床疗效。方法回顾性分析94例急性重症细菌性感染性腹泻患者临床资料,随机将患者分为研究组和对照组,每组各47例。两组患者均给予补液、退热、止泻等基础治疗,其中研究组加以左氧氟沙星进行治疗,对照组给予硫酸依替米星注射液治疗。对比两组患者的临床疗效。结果研究组总有效45例(95.74%),对照组总有效38例(80.85%),对比两组总有效率,研究组明显高于对照组(P<0.05),具有统计学差异意义(P<0.05)。采用左氧氟沙星治疗急性重症细菌性感染性腹泻疗效优于依替米星抗感染治疗。结论采用左氧氟沙星治疗急性重症细菌性感染性腹泻安全有效,可明显改善临床症状,值得临床推广应用。%Objective To explore the levofloxacin clinical curative effect for the treatment of severe acute bacterial infectious diarrhea .Methods A retrospective a-nalysis of clinical data of 94 cases of severe acute bacterial infectious diarrhea patients,the patients randomly divided into research group and the control group,each group(n=47).Two groups of patients were given rehydration,antifebrile,antidiarrheal therapy,including levofloxacin in treatment group,control group given sulfate for m star injection treatment.Compare the clinical efficacy of two groups of patients.Results The team total effective 45 cases(95.74%),control group total effective 38 ca-ses(80.85%),compared to two group total effective rate,the team is significantly higher than control group(P<0.05),statistically significance(P<0.05).With levo-floxacin therapy for severe acute bacterial infectious diarrhea curative effect is superior to the for m star anti -infection treatment.Conclusion Levofloxacin in treatment of acute severe bacterial infectious diarrhea is safe and effective,and can obviously improve the clinical

  5. Survey of diagnosis and treatment of acute diarrhea in adults in 10 hospitals of Beijing%北京10所三级医院成人急性腹泻的诊断治疗调查研究

    Institute of Scientific and Technical Information of China (English)

    侯凤琴; 王艳; 李俊; 刘颖; 王贵强

    2015-01-01

    目的:评估北京成人急性腹泻的诊断治疗与Manatsathit成人腹泻诊疗指南的一致性,了解各级医院急性腹泻的诊断治疗水平,为有针对性的腹泻诊断治疗提供依据。方法在北京10所医院,采取诊治医师自行填写诊断治疗报告的形式进行腹泻诊断治疗的调查;采用SPSS13.0软件进行统计分析。结果2011年5-6月10所医院报告了400例急性腹泻患者的诊断治疗情况,患者年龄(35.5±14.8)岁,女性209例,占52.3%;患者从起病到就诊时间为(2.0±1.4)d;所有400例被调查患者中89.8%进行了粪便检查,所有患者均进行了粪便霍乱弧菌培养,但只有8.5%的患者进行了其他细菌的粪便培养;400例患者中69.3%给予了补液,其中48.8%给予口服补液、20.5%给予静脉补液;所有患者中,有抗菌药物应用指征的患者只有17.8%,却有57.0%的患者给予抗菌药物治疗,且27.0%的患者给予了静脉抗菌药物治疗;在非教学医院,更多患者给予了无适应证的抗菌治疗,与重点大学教学医院及普通大学教学医院比较,差异有统计学意义(P<0.01)。结论北京三级甲等医院对成人腹泻的诊治与指南有一定差距,需进一步加强腹泻诊治的培训,以提高腹泻治疗的合理性。%OBJECTIVE To assess if the diagnosis and treatment of the adults with acute diarrhea in Beijing adhere to the guidelines recommended by Manatsathit working group and understand the conditions of diagnosis and treat‐ment of acute diarrhea in different levels of hospitals so as to provide guidance for targeted diagnosis and treatment of the diarrhea .METHODS A survey was conducted for the diagnosis and treatment of diarrheas in 10 hospitals of Beijing by using the diagnosis and treatment reports filled out by clinicians ,and the statistical analysis was per‐formed with the use of SPSS 13 .0

  6. Etiological study of enteric viruses and the genetic diversity of norovirus, sapovirus, adenovirus, and astrovirus in children with diarrhea in Chongqing, China.

    Science.gov (United States)

    Ren, Zengzhi; Kong, Yuanmei; Wang, Jun; Wang, Qianqian; Huang, Ailong; Xu, Hongmei

    2013-09-03

    Enteric viruses are a major cause of diarrhea in children, especially those sapovirus, and astrovirus using enzyme-linked immunosorbent assay, reverse transcription-polymerase chain reaction (RT-PCR), or PCR. Partial sequences of norovirus, sapovirus, adenovirus, and astrovirus were phylogenetically analyzed to determine the genotype. Enteric viruses were detected in 302 of the 500 children who presented with acute diarrhea (277/477; 58.07%) and persistent diarrhea (5/23; 21.74%). In 277 samples from children with acute diarrhea in whom at least one viral agent was found, rotavirus A was the most frequent virus identified (132 cases; 27.67%), followed by norovirus GII in 130 cases (27.25%), adenovirus in 30 cases (6.29%), sapovirus in 9 cases (1.89%) and astrovirus in one case (0.21%). Twenty-two of the norovirus GII-positive cases were randomly selected for genotyping. GII/4 was the predominant strain, followed by GII/6, GII/2, GII/3, and GII/7. Sapovirus was classified into four genotypes: GI/1 was predominant, followed by GI/2, GII/1, and GIV. The predominant adenovirus was type 41. Mixed infections were found in 25 cases, all of which presented with acute diarrhea (25/477; 5.24%). Viruses were positive in 5/23 (21.74%) cases with persistent diarrhea. Neither rotavirus B, rotavirus C, nor norovirus GI were found in any of the samples. Enteric viruses are a major cause of diarrhea in children <5 years old in Chongqing. Rotavirus A is the most common etiological agent, follow by norovirus.

  7. [Renoprotective effects of statins under the conditions of acute renal failure, caused by rhabdomyolysis].

    Science.gov (United States)

    Zamorskiĭ, I I; Zeleniuk, V G

    2014-01-01

    The experiment on white rats was targeted at the examination of influence of statins (atorvastatin, lovastatin, simvastatin) under the conditions of acute renal failure, caused by rhabdomyolysis. Renoprotective effects of statins were demonstrated by reduction of hyperazotemia and proteinuria and improvement of renal excretory function, which correlated with antioxidant properties of drugs.

  8. 临床营养干预路径在婴儿急性腹泻治疗中的应用%Application of clinical nutritional intervention pathway in infants with acute diarrhea

    Institute of Scientific and Technical Information of China (English)

    李莉; 薛继红

    2013-01-01

    目的评价临床营养干预路径在急性腹泻病患儿中实施的效果。方法将104名患儿随机分为治疗组和对照组,治疗组严格应用临床营养干预路径;对照组采用传统治疗方法,不进行临床营养干预。结果治疗组腹泻缓解时间平均约(3.79±0.37)天;对照组腹泻缓解时间平均约(4.26±0.43)天;静脉补液时间治疗组平均为(4.24±0.40)天,对照组为(4.97±0.70)天;平均住院日治疗组为(5.98±0.67)天,对照组为(7.04±0.69)天;两组比较差异均有统计学意义(P<0.05)。治疗组临床显效率明显高于对照组(P<0.05)。结论应用临床营养干预路径明显缩短静脉补液时间,缩短腹泻缓解平均时间,减少并发症,缩短住院时间,增加了患儿家属的满意度。%Objective To explore the effect of clinical nutritional intervention pathway in treatment of infant with acute diarrhea . Methods Totally 104 cases of diarrhea disease were randomly divided into treatment group and control group .In the treatment group cases were treated with clinical nutritional pathway , but the control group was treated with traditional way .Results The average time of diarrhea relief, during of venous transfusion and average hospitalization length in the treatment group and control group was 3.79 ±0.37 and 4.26 ± 0.43 days, 4.24 ±0.40 and 4.97 ±0.70 days, 5.98 ±0.67 and 7.04 ±0.69 days, respectively.There were statistical significant differences between two groups (P<0.05).The clinical significant efficiency of the treatment group was obviously higher than that of the control grope(P<0.05).Conclusion Application of clinical nutritional intervention pathway in treatment of infant with acute diarrhea can shorten the time of venous transfusion , reduce the average duration of diarrhea , reduce complications and hospital stay significantly , which improves the satisfactory rate of

  9. Acute Appendicitis in Infants. A Case Report

    Directory of Open Access Journals (Sweden)

    Sergio Luis González López

    2013-04-01

    Full Text Available Acute appendicitis is more common in school-age children, but it rarely occurs in infants. The younger the patient, the fastest the course of the disease. In addition, there are greater risks of complications. A case of a nine-month-old infant, admitted to the pediatric hospital with fever and diarrhea, is presented. After several tests, he underwent surgery. Peritonitis caused by acute gangrenous appendicitis was diagnosed. While the patient was in the intensive care unit, he suffered a septic shock and acute multiple organ failure. As a result, he died 24 hours later. The biopsy confirmed the diagnosis of acute gangrenous appendicitis. Acute appendicitis is a disease that must be considered by doctors who treat infants with fever, diarrhea and abdominal pain related to irritability. Thus, an early diagnosis of the disease as well as the implementation of an appropriate surgical treatment can be performed.

  10. Myocardial bridging as a cause of acute myocardial infarction: a case report

    Directory of Open Access Journals (Sweden)

    Emiroglu Yunus

    2002-09-01

    Full Text Available Abstract Background Systolic compression of a coronary artery by overlying myocardial tissue is termed myocardial bridging. Myocardial bridging usually has a benign prognosis, but some cases resulting in myocardial ischemia, infarction and sudden cardiac death have been reported. We are reporting a case of myocardial bridging which was complicated with acute myocardial infarction associated with inappropriate blood donation. Case presentation A 33 year-old-man was admitted to our emergency with acute anteroseptal myocardial infarction after a blood donation. The electrocardiography showed sinus rhythm and was consistent with an acute anteroseptal myocardial infarction. We decided to perform primary percutanous intervention (PCI. Myocardial bridging was observed in the mid segment of the left anterior descending coronary artery on coronary angiogram. PCI was canceled and medical follow up was decided. Blood transfusion was made because he had a deep anemia. A normal hemaglobin level and clinical reperfusion was achieved after ten hours by blood transfusion. At the one year follow up visit, our patient was healthy and had no cardiac complaints. Conclusions Myocardial bridging may cause acute myocardial infarction in various clinical conditions. Although the condition in this case caused profound anemia related acute myocardial infarction, its treatment and management was unusual.

  11. 猪流行性腹泻的研究进展%Progress in research of porcine epidemic diarrhea

    Institute of Scientific and Technical Information of China (English)

    陈刚; 李伟; 张阳; 吴昊; 施慈; 任晓峰; 赵凯

    2013-01-01

    猪流行性腹泻(porcine epidemic diarrhea,PED)是由猪流行性腹泻病毒(porcine epidemic diarrhea virus,PEDV)引起的猪的一种急性接触性肠道传染病,以呕吐、腹泻、食欲下降和脱水为基本特征.近年来,该病的流行区域和强度有不断扩大和增强的趋势,对哺乳仔猪造成了很高的致死率,给养猪业造成了很大经济损失.为了能有效的防制PED,本文就PED病原学、发病机制、诊断和预防等方面的研究进展做一概述.%Porcine epidemic diarrhea (PED) is a highly contagious, enteric swine disease caused by porcine epidemic diarrhea virus (PEDV), which is characterized by severe enteritis with vomiting, acute diarrhea, anorexia, and dehydration. In recent years, the epidemic area and intensity of PED have continuously enlarged, causing a significantly high mortality of suckling piglets and huge economic losses in pig industry. This paper summarizes the etiology, pathogenesis, diagnosis, and prevention of PED.

  12. Non Obstetric Causes and Presentation of Acute Abdomen among the Pregnant Women.

    Directory of Open Access Journals (Sweden)

    Monoarul Haque

    2014-09-01

    Full Text Available To identify the non-obstetric causes and presentation of acute abdomen among pregnant women.This was a cross sectional hospital-based study among 128 pregnant women by face to face interview using a semi-structured questionnaire. This study was conducted at the Gynecology & Obstetric Ward of 250 Bed General Hospital, Noakhali, Bangladesh, from January to August 2013. Data were analyzed by a software package used for statistical analysis (SPSS version 11.5 (SPSS, Inc., Chicago, IL, USA.Mean age of participants was 25±4 years. Our findings showed that 81% were Muslim, 67% were lower middle income group, as well as 47% completed primary level of education. The results revealed that 28% had biliary ascariasis, 24% had peptic ulcer disease and 10% had lower urinary tract infection. We also found that 6% had acute pyelonephritis, 6% had acute gastroenteritis, 6% had acute cholecystitis, 6% had acute appendicitis, 2% had acute pancreatitis, 3% had choledocolithiasis, 2% had ovarian solid mass, 2% had twisted ovarian cyst, 4% had renal colic, and 1% had renal calculus. In non-obstetrical presentation of acute abdomen, the study found that 84% of respondents complained their pain lasting more than 24 hours. Besides, half of respondents felt pain in epigastrium and right hypochondrium. Cramping, prickling and aching type of pain were more, while 66% suffered from continuous pain. Our results also showed that 73% did not explain any aggravating factor and relieving factor, and the rest said food, fasting state and position change aggravated pain as well as relieved pain.The study concludes that precise diagnosis of the acute abdomen in pregnant women by continual updating of abdominal assessment knowledge, and clinical skills is necessary in the management of abdominal pain in obstetric settings.

  13. 辨证施护在小儿急性非细菌感染性腹泻中的应用效果%Application effect of dialectical care in children with acute non-bacterial infectious diarrhea

    Institute of Scientific and Technical Information of China (English)

    张萍

    2015-01-01

    目的:分析辨证施护在小儿急性非细菌感染性腹泻中的应用效果。方法选取2014年5月~2015年3月本院收治的96例急性非细菌感染性腹泻患儿,按照1:1比例配对法分为对照组和观察组,每组48例。对照组采用基础治疗以及常规护理,观察组采用基础治疗联合辨证施护,对比两组的疗效、症状改善情况以及护理满意度。结果观察组的治疗总有效率、每日大便次数、止泻时间、成形便患儿比例、护理满意度分别为93.7%、(1.69±0.43)次、(4.10±2.40)d、22.9%和97.9%,与对照组[50.0%、(2.50±0.78)次、(4.35±2.20)d、2.1%、83.3%]比较差异有统计学意义(P<0.05)。结论辨证施护用于治疗小儿急性非细菌性感染性腹泻,可有效改善患儿的症状,提高护理满意度。%Objective To analysis the clinical effect of dialectical care in children with acute non-bacterial infectious diarrhea. Methods 96 children with acute non-bacterial infectious diarrhea in our hospital from May 2014 to March 2015 were selected.They were divided into control group and observation group by proportion of 1:1 matching method, 48 cases in each group.The control group was given basic therapy and common nursing,the observation group was given basic therapy combined with dialectical care.Effect,symptom improvement and nursing satisfaction were compared between two groups. Results The effective rate,times of defecation per day,time of checking diarrhea,children of stool forming and nursing satisfaction rate in observation group were respectively 93.7%, (1.69±0.43) times, (4.10±2.40) d, 22.9% and 97.9%,above these compared with the control group [50.0%, (2.50±0.78) times, (4.35±2.20) d,2.1% and 83.3%],the differences were significant (P<0.05). Conclusion Dialectical care in treating for children with acute non-bacterial infectious diarrhea can improve patients’symptoms effectively and improve nursing satisfaction.

  14. Life-threatening Cerebral Edema Caused by Acute Occlusion of a Superior Vena Cava Stent

    Energy Technology Data Exchange (ETDEWEB)

    Sofue, Keitaro, E-mail: keitarosofue@yahoo.co.jp; Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp; Arai, Yasuaki, E-mail: arai-y3111@mvh.biglobe.ne.jp [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan); Sugimura, Kazuro, E-mail: sugimura@med.kobe-u.ac.jp [Kobe University, Department of Radiology, Graduate School of Medicine (Japan)

    2013-02-15

    A71-year-old man with advanced lung cancer developed a life-threatening cerebral edema caused by the acute occlusion of a superior vena cava (SVC) stent and was successfully treated by an additional stent placement. Although stent occlusion is a common early complication, no life-threatening situations have been reported until now. Our experience highlights the fact that acute stent occlusion can potentially lead to the complete venous shutdown of the SVC, resulting in life-threatening cerebral edema, after SVC stent placement. Immediate diagnosis and countermeasures are required.

  15. "Sagging heart syndrome": a cause of acute lead dislodgment in two patients.

    Science.gov (United States)

    Iskos, D; Lurie, K G; Shultz, J J; Fabian, W H; Benditt, D G

    1999-02-01

    Acute passive fixation atrial lead dislodgment occurred due to an unexpected and marked postural descent of the heart after permanent pacemaker implantation in two patients. Sagging of the heart in these two individuals may have been related to a history of morbid obesity followed by weight loss of over 100 pounds. Lead replacement with active fixation leads was required in both cases. The term "sagging heart syndrome" is proposed to describe this clinical entity. In certain adult populations, such as in patients with a history of significant weight loss, the "sagging heart syndrome" may represent a previously unrecognized cause of acute lead dislodgment.

  16. Undiagnosed nephrogenic diabetes insipidus as a cause of acute urinary retention in a young soldier.

    Science.gov (United States)

    Kim, Hyung Jin; Shin, Y S; Choi, H; Kim, M K; Jeong, Y B; Park, J K

    2016-10-01

    We present a case of undiagnosed nephrogenic diabetes insipidus as a cause of acute urinary retention in a 21-year-old male soldier. Soldiers live in close quarters, and have a regimented lifestyle that may not allow for frequent voiding; therefore, undiagnosed nephrogenic diabetes insipidus may result in acute urinary retention. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Persistent and acute diarrhoea as the leading causes of child mortality in urban Guinea Bissau

    DEFF Research Database (Denmark)

    Mølbak, K; Aaby, P; Ingholt, L;

    1992-01-01

    An investigation of child mortality in a semi-urban community, Bandim II, in the capital of Guinea Bissau was carried out from April 1987 to March 1990. 153 deaths were recorded among 1426 live-born children who were followed for 2753 child-years. The under-five mortality risk was 215 per 1000...... children (95% confidence interval [CI] 176-264), infant mortality 94 per 1000 (95% CI 73-115), and perinatal mortality 52 per 1000 (95% CI 41-63). By prospective registration of morbidity, post-mortem interviews, and examination of available hospital records, a presumptive cause of death was established...... in 86% of the deaths. Persistent and acute diarrhoea were the most frequent causes of death, accounting for 43 and 31 deaths per 1000 children, respectively. Fever deaths (possibly malaria), neonatal deaths, acute respiratory infections, and measles were other frequent causes. The access to health...

  18. Cardiac myxoma causing acute ischemic stroke in a pediatric patient and a review of literature.

    Science.gov (United States)

    Fuchs, Jennifer; Leszczyszyn, David; Mathew, Don

    2014-05-01

    Ischemic stroke in the pediatric population is a rare occurrence, and its possible causes span a wide differential that includes atrial myxomas. Myxomas are friable cardiac tumors that produce "showers" of emboli resulting in transient neurological deficits, cutaneous eruptions, and ophthalmologic deficits. We present an 11-year-old boy with a months-long history of an intermittent spotted "rash" who presented with acute ischemic stroke caused by a left atrial myxoma. We also review clinical features in all 16 other cases of cardiac myxoma causing pediatric stroke reported in the literature. Our case, along with the review of the literature, highlights the fact that myxomas often initially present as stroke with acute hemiplegia and transient cutaneous eruptions due to fragmentation of the tumor. Cardiac myxoma should be considered in any child presenting with ischemic stroke, and transient skin findings may provide an important diagnostic clue prior to onset of neurological symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Spontaneous Renal Artery Dissection as a Cause of Acute Renal Infarction: Clinical and MDCT Findings.

    Science.gov (United States)

    Yoon, Kibo; Song, Soon Young; Lee, Chang Hwa; Ko, Byung Hee; Lee, Seunghun; Kang, Bo Kyeong; Kim, Mi Mi

    2017-04-01

    The purpose of this study was to assess the incidence of spontaneous renal artery dissection (SRAD) as a cause of acute renal infarction, and to evaluate the clinical and multidetector computed tomography (MDCT) findings of SRAD. From November 2011 to January 2014, 35 patients who were diagnosed with acute renal infarction by MDCT were included. We analyzed the 35 MDCT data sets and medical records retrospectively, and compared clinical and imaging features of SRAD with an embolism, using Fisher's exact test and the Mann-Whitney test. The most common cause of acute renal infarction was an embolism, and SRAD was the second most common cause. SRAD patients had new-onset hypertension more frequently than embolic patients. Embolic patients were found to have increased C-reactive protein (CRP) more often than SRAD patients. Laboratory results, including tests for lactate dehydrogenase (LDH) and blood urea nitrogen (BUN), and the BUN/creatinine ratio (BCR) were significantly higher in embolic patients than SRAD patients. Bilateral renal involvement was detected in embolic patients more often than in SRAD patients. MDCT images of SRAD patients showed the stenosis of the true lumen, due to compression by a thrombosed false lumen. None of SRAD patients progressed to an estimated glomerular filtration rate renal disease during the follow-up period. SRAD is not a rare cause of acute renal infarction, and it has a benign clinical course. It should be considered in a differential diagnosis of acute renal infarction, particularly in patients with new-onset hypertension, unilateral renal involvement, and normal ranges of CRP, LDH, BUN, and BCR.

  20. Microorganisms and viruses causing diarrhea in infants and primary school children and their relation with age and sex in Zakho city, Kurdistan Region, Iraq

    Directory of Open Access Journals (Sweden)

    Wijdan M.S. Mero

    2015-11-01

    Full Text Available Background: Diarrheal diseases in children are a major public health concern in developing countries. Diarrheal infection spreads through contaminated food or drinking-water, or from person-to-person as a result of poor hygiene. This study was conducted to investigate the incidence of different microorganisms associated with diarrhea in infants and primary school children and their relation to sex and age in Zakho city, Kurdistan region, Iraq. Methods: During the period from September 2013 to May 2014, 600 diarrheic samples were collected from both sexes and different ages (4-8 years (65.38 and 64.07%, while parasites were among >6-10 years (64.67 and 60.11%. High viral prevalence were recorded among ages <2 to 6 years with the peak among <2 years (40.54%. Conclusions: From this study we conclude that about 57% of diarrheal cases were associated with bacteria, parasites, and viruses with E. coli, E. histolytica, G. lamblia and rotavirus as leading microorganisms. The mixed prevalence with two or more microorganisms was documented in 179 (37.36% out of 479 positive samples and the rate of microbial prevalence was found to be gender and age dependent. [Int J Res Med Sci 2015; 3(11.000: 3266-3273

  1. Carbamazepine-Induced Diarrhea

    OpenAIRE

    J Gordon Millichap

    1992-01-01

    Intractable diarrhea induced by carbamazepine (CBZ) in 3 patients and necessitating discontinuation of the drug is reported from the Departments of Neurology and Medicine, University of Louisville School of Medicine, Kentucky.

  2. Infusion of glucose and lipids at physiological rates causes acute endoplasmic reticulum stress in rat liver.

    Science.gov (United States)

    Boden, Guenther; Song, Weiwei; Duan, Xunbao; Cheung, Peter; Kresge, Karen; Barrero, Carlos; Merali, Salim

    2011-07-01

    Endoplasmic reticulum (ER) stress has recently been implicated as a cause for obesity-related insulin resistance; however, what causes ER stress in obesity has remained uncertain. Here, we have tested the hypothesis that macronutrients can cause acute (ER) stress in rat liver. Examined were the effects of intravenously infused glucose and/or lipids on proximal ER stress sensor activation (PERK, eIF2-α, ATF4, Xbox protein 1 (XBP1s)), unfolded protein response (UPR) proteins (GRP78, calnexin, calreticulin, protein disulphide isomerase (PDI), stress kinases (JNK, p38 MAPK) and insulin signaling (insulin/receptor substrate (IRS) 1/2 associated phosphoinositol-3-kinase (PI3K)) in rat liver. Glucose and/or lipid infusions, ranging from 23.8 to 69.5 kJ/4 h (equivalent to between ~17% and ~50% of normal daily energy intake), activated the proximal ER stress sensor PERK and ATF6 increased the protein abundance of calnexin, calreticulin and PDI and increased two GRP78 isoforms. Glucose and glucose plus lipid infusions induced comparable degrees of ER stress, but only infusions containing lipid activated stress kinases (JNK and p38 MAPK) and inhibited insulin signaling (PI3K). In summary, physiologic amounts of both glucose and lipids acutely increased ER stress in livers 12-h fasted rats and dependent on the presence of fat, caused insulin resistance. We conclude that this type of acute ER stress is likely to occur during normal daily nutrient intake.

  3. Death due to diarrhea and agranulocytosis caused by irinotecan%伊立替康相关腹泻及粒细胞缺乏致死亡

    Institute of Scientific and Technical Information of China (English)

    曹凯; 司继刚; 孙敏

    2014-01-01

    A 62-year-old man with colon cancer was given irinotecan at a dose of 80 mg by intravenous administration on day 1 and day 8. After the treatment, diarrhea was followed lasting for 11 days, and it aggravated with fever on day 13. The patient was sent to the emergency for the further therapy. The laboratory examination revealed that WBC was 0.34×109·L-1, NEUT was 5.94%, L was 85.34%, RBC was 3.84×1012·L-1, Hb was 114.0 g·L-1, PLT was 33×109·L-1, blood urea nitrogen was 13.71 mmol·L-1 and serum creatinine was 291μmol·L-1. The patient received a serial of therapy, including anti-infection with cefpirome, enhancing leukocytes with recombinant human granulocyte colony stimulating factor injection, immune regulation, controlling diarrhea, protecting the renal functions and lfuid resuscitation, etc. On the second day of admission, the patient appeared septic shock while the anti-shock treatment was adopted. On the third day, the patient was in deep coma and blood pressure was dififcult to maintain. The patient eventually died of circulatory and respiratory failure.%1例62岁结肠癌男性患者,接受伊立替康80 mg静脉滴注d1、d8化疗。化疗后反复腹泻11 d,化疗第13天腹泻加重伴发热,急诊入院。查血常规示:WBC 0.34×109·L-1,NEUT 5.94%,L 85.34%,RBC 3.84×1012·L-1,Hb 114.0 g·L-1, PLT 33×109·L-1。BUN 13.71 mmol·L-1,Scr 291μmol·L-1。给予头孢匹罗抗感染,重组人粒细胞集落刺激因子升白细胞,免疫调节,止泻、护肾、补液等对症治疗,入院第2天出现感染性休克,给予抗休克等治疗。第3天出现深度昏迷,血压难以维持。最终因循环、呼吸衰竭死亡。

  4. Importância de Cryptosporidium spp. como causa de diarréia em bezerros Importance of Cryptosporidium spp. as a cause of diarrhea in calves

    Directory of Open Access Journals (Sweden)

    Francisco L.F. Feitosa

    2008-10-01

    Full Text Available Avaliou-se a presença de oocistos de Cryptosporidium spp. em amostras de fezes de 14 bezerros e de suas mães até a oitava semana pós parição. A maior taxa de excreção de oocistos foi verificada em bezerros com sete dias de idade. Das vacas, 42,8% foram positivas para Cryptosporidium no período pós-parto. Em outra etapa deste estudo, foram acompanhados 57 bezerros positivos para Cryptosporidium, com até 30 dias de idade, provenientes de 32 propriedades leiteiras, e estudouse o grau de eliminação dos oocistos com a possível ocorrência de diarréia. Em todos os animais positivos para Cryptosporidium foi pesquisada a presença de bactérias enteropatogênicas, vírus (Rotavirus e Coronavirus e protozoários (Eimeria spp..The aim of this research was to evaluate the shedding of Cryptosporidium spp. oocysts in fecal samples from 14 calves from one dairy farm, from birth until 60 days old and from cows until eight weeks after parturition. The higher percentage of oocysts excreted was observed in 7-day-old calves. In the post-partum period 43.7% of cows were positive for Cryptosporidium oocysts. Further analyses were accomplished in 57 calves from another 32 milk farms, previously known as positive for Cryptosporidium, through oocysts fecal screening and clinical signs analyses until calves were 30 days old. Fecal samples from all animals that presented diarrhea were screened for the presence of bacteria, virus (Rotavirus and Coronavirus and protozoa (Eimeria spp..

  5. [Parasitic diarrhea in eutrophic and malnourished children].

    Science.gov (United States)

    Gendrel, D

    2003-01-01

    Almost all children living in endemic zones are infected by gastrointestinal parasites. However only 3 to 5% develop diarrhea directly related to parasite infection. Entamoeba hystolytica and Entamoeba dispar coexist in many areas. In the past Entamoeba dispar was called non-pathogenic ameba. The vegetating forms are microscopically identical and detection of wall differences using biochemical tests is unreliable. Thus since it is rarely possible to determine whether or not a vegetating ameba found in stools is hematophagous treatment using metronidazole is the only alternative. Failure of such treatment indicates that dysentery is probably due to a cause other than amibiasis, e.g., bacterial infection in most cases. Another protozoan commonly found in endemic areas is Giardia. Giardia can cause diarrhea and this is frequently the case in undernourished children. Giardia infection leads to severe atrophic villosity requiring appropriate specific treatment. In children cryptosporidioses may be asymptomatic or lead to diarrhea especially in cases associated with malnutrition or immunodeficiency related in particular to AIDS. Helminths are a rare cause of significant diarrhea except Anguillula in undernourished children. In children presenting severe malnutrition, anguilluliasis can lead to serious consequences and requires immediate treatment using ivermectin. To avoid severe diarrhea in children presenting immunodeficiency induced by corticotherapy or chemotherapy for cancer, prophylaxis is mandatory against anguilluliasis using ivermectin and usually against giardiasis using metronidazole.

  6. Acute infection with bovine viral diarrhea virus of low or high virulence leads to depletion and redistribution of WC1(+) γδ T cells in lymphoid tissues of beef calves.

    Science.gov (United States)

    Palomares, Roberto A; Sakamoto, Kaori; Walz, Heather L; Brock, Kenny V; Hurley, David J

    2015-10-15

    The objective of this study was to determine the abundance and distribution of γδ T lymphocytes in lymphoid tissue during acute infection with high (HV) or low virulence (LV) non-cytopathic bovine viral diarrhea virus (BVDV) in beef calves. This study was performed using tissue samples from a previous experiment in which thirty beef calves were randomly assigned to 1 of 3 groups: LV [n=10; animals inoculated intranasally (IN) with LV BVDV-1a (strain SD-1)], HV [n=10; animals inoculated IN with HV BVDV-2 (strain 1373)], and control (n=10; animals inoculated with cell culture medium). On day 5 post inoculation, animals were euthanized, and samples from spleen and mesenteric lymph nodes (MLN) were collected to assess the abundance of WC1(+) γδ T cells. A higher proportion of calves challenged with BVDV showed signs of apoptosis and cytophagy in MLN and spleen samples compared to the control group. A significantly lower number of γδ T cells was observed in spleen and MLN from calves in HV and LV groups than in the control calves (P<0.05). In conclusion, acute infection with HV or LV BVDV resulted in depletion of WC1(+) γδ T cells in mucosal and systemic lymphoid tissues at five days after challenge in beef calves. This reduction in γδ T cells in the studied lymphoid tissues could be also due to lymphocyte trafficking to other tissues.

  7. Etiological analysis of acute infectious diarrhea in adults of west district sentinel hospital of Shanghai in 2011-2013%2011-2013年上海西区哨点医院成人急性腹泻细菌感染的病原学分析

    Institute of Scientific and Technical Information of China (English)

    沈思兰; 李颖; 史慧晶; 刘岩红; 张万菊; 何静; 朱绍琴; 胡芸文; 钱方兴

    2016-01-01

    OBJECTIVE To understand the distribution of pathogens causing acute infectious diarrhea in adults of west district sentinel hospital of Shanghai and analyze the change trend so as to put forward targeted prevention and control measures of the acute diarrhea .METHODS A total of 2 091 patients with acute diarrhea who were not treated with antibiotics in diarrhea outpatient department of west district sentinel hospital of Shanghai from Jan 2011 to Dec 2013 were enrolled in the study ,then the stool specimens were collected to culture and isolate the common species of intestinal tract pathogenic bacteria (Vibrio parahaemolyticus ,Escherichia coli ,Salmonella , Campylobacter jejuni ,and Shigella) ,and the isolated positive strains were identified and preserved by center for disease control and prevention of Changning district .RESULTS The stool specimens were cultured positive in 671 patients ,with the positive rate 32 .1% .Totally 671 strains of pathogens were isolated;the V .parahaemolyticus , E .coli ,Salmonella ,and Shigella were dominant among the pathogens ,accounting for 33 .8% ,22 .1% ,21 .5% , and 10 .3% ,respectively ;the enterotoxigenic E .coli was dominant among the E .coli strains ,accounting for 74 . 3% (110/148);the Salmonella Enteritidis was the most common species of Salmonella ,accounting for 44 .4%(64/144);the Shigellasonnei was dominant among the Shigellaspp ,accounting for 84 .1% (58/69) .The isola‐tion rate of pathogens was highest (29 .5% ) in the patients aged from 21 to 30 years old (198/671);68 .70%(461/671) of the pathogens were isolated in July‐September .CONCLUSION The adults with acute diarrhea in the western district of Shanghai show remarkable seasonal character ,and the young patients are dominant .The inci‐dence of E .coli infection shows an upward trend .It is necessary to actively conduct the targeted prevention and control of the diarrhea in the key population .%目的:了解上海市西区哨点医院成人急性腹泻病

  8. Myeloid Sarcoma: An Unusual Presentation of Acute Promyelocytic Leukemia Causing Spinal Cord Compression

    Directory of Open Access Journals (Sweden)

    Tay Za Kyaw

    2012-09-01

    Full Text Available Acute promyelocytic leukemia with concurrent myeloid sarcoma is a rare clinical event. Herein we describe a patient that presented with back pain and bilateral leg weakness caused by spinal cord compression due to extramedullary deposition of leukemic cells. Acute promyelocytic leukemia was suspected based on immunophenotypic findings of malignant cells in bone marrow aspirate. The diagnosis was confirmed by the presence of PML-RARα fusion copies. MRI showed multiple hyperintense changes on the vertebral bodies, together with intraspinal masses causing spinal cord compression. The patient immediately underwent radiotherapy, and was treated with all-trans retinoic acid and idarubicin. Reassessment MRI showed complete resolution of all intraspinal masses and the disappearance of most of the bony lesions. Post-treatment bone marrow aspirate showed complete hematological and molecular remission. The motor power of his legs fully recovered from 0/5 to 5/5; however, sensory loss below the T4 level persisted.

  9. Acute Liver Injury with Severe Coagulopathy in Marasmus Caused by a Somatic Delusional Disorder

    Directory of Open Access Journals (Sweden)

    Lance L. Stein

    2011-01-01

    Full Text Available Marasmus is a severe form of protein-calorie malnutrition characterized by the depletion of fat stores, muscle wasting, and the lack of edema. In developed countries, marasmus is often the result of anorexia nervosa. Abnormal transaminases with liver synthetic dysfunction have rarely been reported with anorexia nervosa. To our knowledge, we report the first detailed case of acute liver injury with severe coagulopathy (INR>1.5 in a patient with marasmus due to self-induced calorie restriction caused by a somatic delusional disorder. This case highlights the severity of liver injury that may occur with significant weight loss from self-induced calorie restriction and the rapid normalization of this injury with treatment. It is important for clinicians to be aware of patterns of acute liver injury in patients with severe protein-calorie malnutrition, regardless of the underlying cause.

  10. Acute Pancreatitis in Association with Campylobacter jejuni- Associated Diarrhea in a 15-Year-Old with CFTR Mutations: Is There a Link?

    Directory of Open Access Journals (Sweden)

    Leena Kandula

    2006-09-01

    Full Text Available Context: Acute pancreatitis has occasionally been reported in association with Campylobacter jejuni infection in humans. However, the mechanism linking Campylobacter jejuni infection and pancreatitis isunclear. Acute pancreatitis in association with an infectious illness may be related to underlying genetic mutations. For instance, studies show that mutations in the cystic fibrosis transmembrane conductance regulator gene increase the susceptibility for acute and chronic pancreatitis. Case report :We describe a patient with Campylobacter jejuni infection who developed acute pancreatitis in the setting of an underlying cystic fibrosis transmembrane conductance regulator gene mutation. Discussion :In this patient with an underlying mutation in the CFTR gene, we propose that the interaction between the mutant gene and an environmental factor, Campylobacter jejuni infection, resulted in pancreatitis.

  11. Progress in understanding the relationship between diarrhea and intestinal ion transport%腹泻与肠道离子转运关系的研究进展

    Institute of Scientific and Technical Information of China (English)

    张志博; 韩雪峰; 谭支良; 肖文军

    2012-01-01

    Diarrhea is a major cause of morbidity and mortality in the world. There are millions of people dying of diarrhea, and most of them are children. Diarrhea can be divided into acute diarrhea and chronic diarrhea based on the length of the course, and into infectious diarrhea and noninfectious diarrhea according to the etiology.Diarrhea is an imbalance in absorption and secretion of water and electrolytes in the intestine, which involves abnormal ion transport. This paper reviews recent advances in understanding the causes of diarrhea, the relationship between intestinal ion transport and diarrhea, and ion transport in different kinds of diarrhea, with an aim to providing a reference and some new ideas on the comprehensive understanding of the pathogenesis, pathophysiology and treatment of diarrhea.%腹泻作为全球性发病率和致死率较高的疾病之一,全世界每年有几百万的人因腹泻而死,其中绝大部分是婴幼儿童,腹泻按病程的长短可分为急性腹泻和慢性腹泻两类,而根据病因学又可分为感染性腹泻和非感染性腹泻,其本质上是肠道中水、电解质吸收和分泌功能的紊乱,这其中就与肠道离子的异常转运密切相关.本文从腹泻的发病原因,腹泻症状的产生与肠道不同离子转运的关系以及不同类型腹泻中的各种离子的转运过程进行了综述,以期为更全面地了解不同类型腹泻的相关发生发病机制,并为腹泻的病理生理学研究及相关肠道病症的治疗提供一定的依据.

  12. Unusual pharyngeal pain caused by acute coronary syndrome: a report of three cases

    Directory of Open Access Journals (Sweden)

    Takashi Anzai

    2017-01-01

    Full Text Available Most patients complaining of pharyngeal pain have an upper respiratory tract infection or other local explanation for their pain. Here we show 3 rare cases of patients visiting our Otorhinolaryngology Department who had an initial symptom of pharyngeal pain caused by acute coronary syndrome (ACS. An electrocardiogram and a cardiac biomarker test are recommended to exclude ACS with atypical presentation in cases without pharyngolaryngeal findings comparable to pharyngeal pain.

  13. Biceps tendinitis as a cause of acute painful knee after total knee arthroplasty.

    Science.gov (United States)

    Pandher, Dilbans Singh; Boparai, Randhir Singh; Kapila, Rajesh

    2009-12-01

    The case report highlights an unusual case of posterolateral knee pain after total knee arthroplasty. Tendinitis of the patellar tendon or pes anserinus is a common complication after total knee arthroplasty; however, there is no report in the literature regarding the biceps femoris tendinitis causing acute pain in the early postoperative period. In this case, the biceps tendinitis was diagnosed and treated by ultrasound-guided injection into the tendon sheath.

  14. 轮状病毒引起婴幼儿腹泻伴心肌损害的检测分析%Detection and Analysis of Myocardial Damage Accompanied with Rotavirus-caused Infantile Diarrhea

    Institute of Scientific and Technical Information of China (English)

    李莉; 任华; 李保存

    2012-01-01

    Objective To analyze myocardial damage in child patients with rotavirus-caused diarrhea and its accompanied biochemical changes. Methods From July 2008 to July 2010, 72 children with diarrhea were treated in our hospital, with their age ranged from 6 to 27 months, averaging at 12.9 months. There were 50 cases of rotavirus diarrhea (group A), and 30 cases of the non-rotavirus diarrhea (group B). Children in group A were in line with the rotavirus diarrhea diagnosis standard of myocardial damage, which was abnormal but could not reach the standard of myocarditis. Children in group B had watery diarrhea, but their symptoms were lighter, and their rotavirus antigen detection showed negative. Automatic biochemistry analyzer was used to determine serum levels of aspertate aminotransferase (AST), lactate dehydrogenase (LDH), creatine phosphokinase (CPK), and CPK isozyme. The serum level of troponin was detected with immune affinity chromatography method, and electrocardiography was carried out. Results Of the 50 patients in group A, 44 (88.0%) had myocardial damage. AST, CPK and CPK isozyme levels in group A [(74.32 ± 13.77), (52.01 ± 10.37), (273.43 ± 27.55) U/L] increased obviously, and were significantly higher than those values in group B children [(24.98 ± 7.03), (17.11 ± 6.52), (151.46 ± 16.52) U/L] (P 0.05). Conclusions Rotavirus-caused viral diarrhea is usually accompanied with myocardial damage and the corresponding biochemical index change; In the several biochemical indicators, CPK isozyme is a more specific and sensitive diagnostic index of recent myocardial damage.%目的 分析轮状病毒性腹泻患儿心肌受损情况和所伴随生化检验指标改变.方法 2008年7月-2010年7月收治腹泻患儿80例,年龄6~27个月,平均12.9个月.其中有50例为轮状病毒腹泻(A组),30例为非轮状病毒性腹泻(B组).A组患儿均符合轮状病毒腹泻诊断标准,有心肌损伤的异常指标但达不到心肌炎诊断标准者诊断为心

  15. Acute urinary retention caused by seminoma in a case of persistent Mullerian duct syndrome

    Directory of Open Access Journals (Sweden)

    Jayesh Modi

    2015-01-01

    Full Text Available Urinary symptoms have been described secondary to a pelvic mass originating from the ovary, uterus, cervix, prostate, or rectum. Persistent Mullerian duct syndrome is a rare form of intersex disorder, characterized by the presence of uterus and fallopian tubes in an otherwise 46 XY male. We report an adult male with bilateral cryptorchidism and a pelvic mass, who presented with acute urinary retention, and was diagnosed with a seminoma of the right testis, intratubular germ cell neoplasia of the left testis with the presence of Mullerian remnants. Pelvic mass was caused due to seminoma is a rare cause of urinary retention.

  16. Calcific tendinitis of the biceps-labral complex: a rare cause of acute shoulder pain.

    Science.gov (United States)

    Ji, Jong-Hun; Shafi, Mohamed; Kim, Weon-Yoo

    2008-06-01

    Calcific tendinitis most commonly affects the rotator cuff and has not been previously reported affecting the biceps-labral complex. We report a case of calcific tendinitis of the biceps-labral complex attachment, a rare cause of acute, severe shoulder pain. Clinically, it can be misdiagnosed as supraspinatus tendinitis or septic arthritis of the shoulder joint. Non-operative treatment failed to resolve the symptoms. Arthroscopic debridement of the calcific deposit resulted in resolution of symptoms. Knowledge of this clinical condition and its imaging features is crucial for a correct diagnosis of this uncommon cause of shoulder pain.

  17. Hepatitis E virus as a Cause of Acute Hepatitis in The Netherlands.

    Directory of Open Access Journals (Sweden)

    Aletta T R Tholen

    Full Text Available Recent studies indicate that 27% of Dutch blood donors have evidence of past infection with HEV. However, the low number of diagnosed HEV infections indicates either an asymptomatic course or under diagnosis.We investigated whether HEV is a cause of acute hepatitis in Dutch patients and which diagnostic modality (serology or PCR should be used for optimal detection.Serum samples were retrospectively selected from non-severely immuno-compromised patients from a university hospital population, suspected of having an infectious hepatitis. Criteria were: elevated alanine aminotransferase (ALT> 34 U/l and request for antibody testing for CMV, EBV or Hepatitis A (HAV.All samples were tested for HEV using ELISA and PCR. Ninety patients/sera were tested, of which 22% were HEV IgG positive. Only one serum was IgM positive. HEV PCR was positive in two patients: one patient was both HEV IgM and IgG positive, the other patient was only IgG positive. Both HEV RNA positive samples belonged to genotype 3. Evidence of recent infection with CMV, EBV and HAV was found in 13%, 10% and 3% respectively.Although our study is limited by small numbers, we conclude that HEV is a cause of acute hepatitis in hospital associated patients in The Netherlands. Moreover, in our study population the prevalence of acute HAV (3% was almost similar to acute HEV (2%. We propose to incorporate HEV testing in panels for acute infectious hepatitis. Negative results obtained for HEV IgM in a HEV PCR positive patient, indicates that antibody testing alone may not be sufficient and argues for PCR as a primary diagnostic tool in hospital associated patients. The high percentage of HEV IgG seropositivity confirms earlier epidemiological studies.

  18. High protective efficacy of probiotics and rice bran against human norovirus infection and diarrhea in gnotobiotic pigs

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    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.

  19. Epidemiology of rotavirus A diarrhea in Chókwè, Southern Mozambique, from February to September, 2011.

    Science.gov (United States)

    Langa, Jerónimo S; Thompson, Ricardo; Arnaldo, Paulo; Resque, Hugo Reis; Rose, Tatiana; Enosse, Sonia M; Fialho, Alexandre; de Assis, Rosane Maria Santos; da Silva, Marcelle Figueira Marques; Leite, José Paulo Gagliardi

    2016-10-01

    Acute diarrhea disease caused by Rotaviruses A (RVA) is still the leading cause of morbidity and mortality in children ≤5 years old in developing countries. An exploratory cross-sectional study was conducted between February and September, 2011 to determine the proportion of acute diarrhea caused by RVA. A total of 254 stool specimens were collected from children ≤5 years old with acute diarrhea, including outpatients (222 children) and inpatients (32 children), in three local health centers in Chókwè District, Gaza Province, South of Mozambique. RVA antigens were detected using enzyme immunoassay (EIA); the RVA G (VP7) and P (VP4) genotypes were determined by RT-PCR or analysis sequencing. Sixty (24%) out of 254 fecal specimens were positive for RVA by EIA; being 58 (97%) from children ≤2 years of age. RVA prevalence peaks in June and July (coldest and drier months) and the G[P] binary combination observed were G12P[8] (57%); G1P[8] (9%); G12P[6] (6%); and 2% for each of the following genotypes: G1P[6], G2P[6] G4P[6], and G9P[8]. Non-Typeable (NT) G and/or P genotypes were observed as follows: G12P [NT] (6%); G1P [NT], G3P[NT] and GNTP[NT] (4%). Considering the different GP combinations, G12 represented 67% of the genotypes. This is the first data showing the diversity of RVA genotypes in Mozambique highlighting the epidemiological importance of these viruses in acute diarrhea cases in children ≤2 years old. In addition, these findings will provide a baseline data before the introduction of the RVA monovalent (Rotarix(®) ) vaccine in the National Immunization Program in September 2015. J. Med. Virol. 88:1751-1758, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. Utilization of health facilities and predictors of health-seeking behavior for under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia: a community-based cross-sectional study.

    Science.gov (United States)

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

    2017-04-04

    Information on health-seeking behavior and utilization of health facilities in slums of Addis Ababa is scarce, impeding the implementation of effective interventions. The purpose of this study is to assess the status of health facilities utilization and predictors for health-seeking behavior of mothers/caregivers of under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia. A community-based cross-sectional study design was employed in five rounds of surveys in seven kebeles in slums of Addis Ababa among 472 mothers/caregivers of 472 under-five children with acute diarrhea in reference to Andersen's behavioral model. Data were entered into EpiData Version 3.1 and analyzed using STATA Version 14.0. Descriptive statistics were used to examine patterns of health facilities utilization and multivariable logistic regression analysis was applied to identify predictors associated with health-seeking behavior. Most mothers/caregivers (70.8%) sought care either at home (14.2%) or health facilities (56.6%), whereas 29.2% reported that they did not seek any care. Of those who consulted health facilities, government health facilities (76.9%) were more utilized than private (18.0%) and informal (5.1%) health facilities. Nearly all (93.9%) of the mothers/caregivers using government health facilities used health centers, and of those who took their children to private health facilities (60.9%) used clinics and 26.1% used pharmacies/drug vendors. Mothers/caregivers visiting health facilities obtained mainly oral rehydration salt (ORS) (39.8%) and home-recommended fluids (HRF) (40.3%), but few of them (11.9%) obtained ORS plus zinc supplementation. Predisposing factors of literacy of mothers/caregivers (adjusted odds ratio (AOR) = 2.4; 95% CI 1.4-4.1) and occupation (AOR = 2.6; 95% CI 1.5-4.6), the enabling factors of households monthly income of 50 United States Dollars (US$) and above (AOR = 2.9; 95% CI 1.5-5.6) and availability of nearest health