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Sample records for profuse watery diarrhea

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2017-02-01

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

  3. Racecadotril in the treatment of acute watery diarrhea in children.

    Science.gov (United States)

    Salazar-Lindo, E; Santisteban-Ponce, J; Chea-Woo, E; Gutierrez, M

    2000-08-17

    Racecadotril (acetorphan), an enkephalinase inhibitor with antisecretory and antidiarrheal actions, is an effective and safe treatment for acute diarrhea in adults and children. Whether treatment with racecadotril and oral rehydration therapy is more effective than treatment with oral rehydration alone in hospitalized children with acute watery diarrhea is not known. We treated 135 boys 3 to 35 months of age who had watery diarrhea of five days' duration or less with racecadotril (1.5 mg per kilogram of body weight orally every eight hours) or placebo, in addition to oral rehydration solution. The primary end point was the 48-hour stool output (measured in grams); the total stool output, duration of diarrhea, and total intake of oral rehydration solution were also measured. The mean (+/-SE) 48-hour stool output was 92+/-12 g per kilogram in the racecadotril group and 170+/-15 g per kilogram in the placebo group (Pracecadotril. The results were similar among the 73 boys with rotavirus infections. The total stool output was 157+/-27 g per kilogram in the racecadotril group and 331+/-39 g per kilogram in the placebo group (Pracecadotril group (28 hours regardless of rotavirus status) than in the placebo group (72 and 52 hours, respectively, for rotavirus-positive and rotavirus-negative patients). The intake of oral rehydration solution was significantly lower in the racecadotril group than in the placebo group (PRacecadotril was well tolerated; only seven patients taking racecadotril had adverse effects, which were all mild and transient. In young boys with acute watery diarrhea, racecadotril is an effective and safe treatment.

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

    Science.gov (United States)

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

    2012-02-01

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

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

    African Journals Online (AJOL)

    2014-06-17

    Jun 17, 2014 ... transplacental antibodies and breast milk, which contain lactadherin.[11‑13] Repeated rotavirus ... the asymptomatic infection in older children and adults. Two licensed rotavirus vaccines have shown ... as age, sex, home address, onset of diarrhea, and sources of drinking water were obtained through a.

  6. Effectiveness of packed rice-oral rehydration solution among children with acute watery diarrhea.

    Science.gov (United States)

    Intarakhao, Sukkrawan; Sritipsukho, Paskorn; Aue-u-lan, Kwanta

    2010-12-01

    This study aims to compare the effectiveness between the packed rice-oral rehydration solution (R-ORS) and the glucose-based oral rehydration solution (G-ORS) in children with acute watery diarrhea. Randomized control trial was conducted to compare duration of diarrhea, stool frequency, incremental weight gain, intravenous fluid requirement, and duration of admission. Subjects were 70 pediatric patients (9-60 months-old) and were equally divided into two groups (n=35 for each): treatment group (with R-ORS treatment) and control group (with G-ORS treatment). The data were collected during January 1, 2007 to January 2008. All patients were treated with oral rehydration therapy within first 4 hours of admission. Intravenous rehydration was also scheduled. Both groups were fed with rice gruel or lactose-free formula as tolerated. Using survival analysis, both duration of diarrhea and admission was significantly shortened in the treatment group compared to the control group. (27.5 hrs. vs. 40.5 hrs: p = 0.01 and 40.1 hrs. vs. 56.0 hrs: p = 0.02 respectively). However, stool frequency, incremental weight gain and intravenous fluid requirement between the two groups remained insignificantly different. R-ORS was more effective in the management of acute watery diarrhea in children. Duration of diarrhea and treatment was shortened when compared to G-ORS.

  7. Hypokalemic rhabdomyolysis due to watery diarrhea, hypokalemia, achlorhydria (WDHA) syndrome caused by vipoma.

    Science.gov (United States)

    Kibria, Rizwan; Ahmed, Sameer; Ali, Syed A; Barde, Christopher J

    2009-07-01

    Mild hypokalemia is common and encountered in a multitude of diseases, but severe hypokalemia leading to rhabdomyolysis is relatively rare. The watery diarrhea, hypokalemia, achlorhydria (WDHA) syndrome caused by vasoactive intestinal polypeptide (VIP)-producing tumors, is an extremely rare cause of hypokalemic rhabdomyolysis and the literature is limited to one case report. We report a second case of an adult who presented with rhabdomyolysis due to severe hypokalemia. Further evaluation revealed that he had a VIP-producing pancreatic neuroendocrine tumor (NET), which was the cause of his hypokalemic rhabdomyolysis. Although rare in occurrence, a high index of suspicion is of paramount importance for establishing the correct diagnosis and treatment.

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

    OpenAIRE

    Rautenberg TA; Zerwes U; Foerster D; Aultman R

    2012-01-01

    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 est...

  9. Failure of Added Dietary Gluten to Induce Small Intestinal Histopathological Changes in Patients with Watery Diarrhea and Lymphocytic Colitis

    Directory of Open Access Journals (Sweden)

    Hugh James Freeman

    1996-01-01

    Full Text Available Lymphocytic colitis is a form of microscopic colitis usually characterized by watery diarrhea and often associated with biopsy-defined celiac disease. Two patients with lymphocytic colitis and normal small intestinal biopsies who were administered 40 g of added dietary gluten for four consecutive weeks are presented. Small intestinal biopsies from multiple sites in the proximal small bowel were done after three and four weeks to determine whether pathological changes in latent celiac disease could be induced in these patients with a high gluten-containing diet. In addition, colorectal biopsies were done to determine whether the colitis was sensitive to oral gluten. No alterations in the small intestinal biopsies were detected in either patient and no changes occurred in colitis severity. Although microscopic forms of colitis have been linked to celiac disease, this study indicates that lymphocytic colitis is a heterogeneous clinicopathological disorder that, in some patients, is independent of any gluten-induced intestinal pathological changes.

  10. 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

  11. Heavy infestation of Isospora belli causing severe watery diarrhea

    OpenAIRE

    Mudholkar Vishal; Namey Ravindra

    2010-01-01

    A 35-year-old male, positive for Human Immunodeficiency Virus (HIV) antibodies, was found to have heavy infestation by Isospora belli, leading to gastrointestinal opportunistic infection. Stool sample of the patient presenting with diarrhea of 2 months duration showed numerous oocysts of I. belli. His blood CD4 count was 85/cmm. The patient was from a slum area with poor sanitation. He was put on antimicrobial agent trimethoprim-sulfmethoxazole and was followed up. However, he died after 1 mo...

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

    Science.gov (United States)

    Rautenberg, Tamlyn Anne; Zerwes, Ute; Foerster, Douglas; Aultman, Rick

    2012-01-01

    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. 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. 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. 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 commonly used willingness to pay proxy threshold range of £20,000-£30,000 per QALY. Racecadotril as adjuvant therapy is more effective and less costly compared to ORS alone, from a UK payer perspective, for the treatment of children with acute diarrhea.

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

    Science.gov (United States)

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

    2017-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Chea-Woo Elsa

    2004-09-01

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

  15. Reduction of risk of watery diarrhea with point-of-use water filters during a massive outbreak of waterborne Cryptosporidium infection in Milwaukee, Wisconsin, 1993.

    Science.gov (United States)

    Addiss, D G; Pond, R S; Remshak, M; Juranek, D D; Stokes, S; Davis, J P

    1996-06-01

    The occurrence of a massive waterborne outbreak of Cryptosporidium infection in Milwaukee, Wisconsin provided an opportunity to evaluate the effectiveness of point-of-use home water filters in preventing diarrheal illness associated with Cryptosporidium infection. Of 155 filter owners who responded to a televised request to contact the City of Milwaukee Health Department, 99 (64%) completed a self-administered questionnaire regarding their sources of drinking water, the characteristics of their home water filters, and diarrheal illness during the outbreak. Diarrhea among respondents was independently associated with residence in southern or central Milwaukee (the area served by the implicated South water treatment plant), having a home water filter with a pore diameter of greater than 1 micron, and drinking unfiltered tap water in a public building in southern Milwaukee. Among residents of southern and central Milwaukee, two (18%) of 11 persons who drank only submicron-filtered water at home and who did not drink unfiltered South plant water at work had watery diarrhea, compared with 50% (n = 2), 63% (n = 35), and 80% (n = 15) who reported drinking South plant water that was unfiltered or passed through a filter with a pore diameter > 1 micron at work only, home only, or both home and work, respectively (P = 0.02). The data indicate that use of submicron point-of-use water filters may reduce risk of waterborne cryptosporidiosis.

  16. Side Effects: Diarrhea

    Science.gov (United States)

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

  17. Diarrhea

    Science.gov (United States)

    ... be a sign of a more serious problem. Chronic diarrhea -- diarrhea that lasts at least four weeks -- can be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual, or they may come ...

  18. Chronic Diarrhea in Children

    Science.gov (United States)

    ... Digestive System & How it Works Zollinger-Ellison Syndrome Chronic Diarrhea in Children View or Print All Sections Definition & Facts Chronic diarrhea is passing loose, watery stools three or more ...

  19. The effectiveness bundling of zinc with Oral Rehydration Salts (ORS) for improving adherence to acute watery diarrhea treatment in Ethiopia: cluster randomised controlled trial.

    Science.gov (United States)

    Gebremedhin, Samson; Mamo, Girma; Gezahign, Henock; Kung'u, Jacqueline; Adish, Abdulaziz

    2016-05-31

    Presumably bundling/co-packaging of zinc with ORS encourages the combined use of the products for diarrhea treatment; however, empirical evidences are scarce. The purpose of this work is to evaluate whether co-packing using a plastic pouch can enhance the joint adherence to the treatment or not. The study also compares the cost effectiveness (CE) of two co-packaging options: 'central' and 'health center (HC)' level bundling. This cluster-randomised controlled trial was conducted in 2015 in eight districts of Ethiopia. Thirty two HCs were randomly assigned to one of the following four intervention arms: (i) 'Central bundling' (zinc and ORS bundled using a pouch that had instructional message, distributed to HCs); (ii) 'HC level bundling' (zinc, ORS and a similar pouch distributed to the HCs and bundled by health workers); (iii) 'Bundling without message' (zinc, ORS and plain pouch distributed and bundled by the health workers); and, (iv) 'Status quo' (zinc and ORS co-administered without bundling). In each of the four arms, 176 children 6-59 months of age, presented with acute diarrhea were enrolled. Twelve days after enrollment, level of adherence was assessed. A composite scale of adherence was developed and modeled using mixed effects linear regression analysis. The unit costs associated with the arms were estimated using secondary data sources. Incremental CE analysis was made by taking the cost and level of adherence in fourth arm as a base value. The follow-up rate was 95.6 %. As compared with the 'status quo' arm, the joint adherences in the 'central' and 'HC level' bundling arms raised substantially by 14.8 and 15.7 percentage points (PP), respectively (P < 0.05). No significant difference was observed between 'bundling without message' and the 'status quo' arms. The unit cost incurred by the 'central bundling' is relatively higher (USD 0.658/episode) as compared with the 'HC level bundling' approach (USD 0.608/episode). The incremental CE ratio in the

  20. Diarrhea

    Science.gov (United States)

    ... to avoid dehydration. Children should be given an oral rehydration solution (ORS). Avoid solid foods until the diarrhea ... Children who have gastroenteritis should be given an oral rehydration solution (ORS) to prevent dehydration. Ease back into ...

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

    OpenAIRE

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2012-12-01

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

  3. Microbial ecology of watery kimchi.

    Science.gov (United States)

    Kyung, Kyu Hang; Medina Pradas, Eduardo; Kim, Song Gun; Lee, Yong Jae; Kim, Kyong Ho; Choi, Jin Joo; Cho, Joo Hyong; Chung, Chang Ho; Barrangou, Rodolphe; Breidt, Frederick

    2015-05-01

    The biochemistry and microbial ecology of 2 similar types of watery (mul) kimchi, containing sliced and unsliced radish and vegetables (nabak and dongchimi, respectively), were investigated. Samples from kimchi were fermented at 4, 10, and 20 °C were analyzed by plating on differential and selective media, high-performance liquid chromatography, and high-throughput DNA sequencing of 16S rDNA. Nabak kimchi showed similar trends as dongchimi, with increasing lactic and acetic acids and decreasing pH for each temperature, but differences in microbiota were apparent. Interestingly, bacteria from the Proteobacterium phylum, including Enterobacteriaceae, decreased more rapidly during fermentation at 4 °C in nabak cabbage fermentations compared with dongchimi. Although changes for Proteobacterium and Enterobacteriaceae populations were similar during fermentation at 10 and 20 °C, the homolactic stage of fermentation did not develop for the 4 and 10 °C samples of both nabak and dongchimi during the experiment. These data show the differences in biochemistry and microbial ecology that can result from preparation method and fermentation conditions of the kimchi, which may impact safety (Enterobacteriaceae populations may include pathogenic bacteria) and quality (homolactic fermentation can be undesirable, if too much acid is produced) of the product. In addition, the data also illustrate the need for improved methods for identifying and differentiating closely related lactic acid bacteria species using high-throughput sequencing methods. © 2015 Institute of Food Technologists®. This article has been contributed by US Government employees and their work is in the public domain in the USA.

  4. Severity of Rotavirus Diarrhea in Children: One Year Experience in a Children Hospital of Bangladesh

    OpenAIRE

    Soofia Khatoon; Maleeha Hussain; Aminur Rahman; ARM Luthful Kabir; Selim Ahmed; Abdul Hannan1

    2009-01-01

    Objective:This study was conducted to determine the hospital prevalence, clinical severity and treatment outcome of rotavirus versus non-rotavirus diarrhea in children attending a secondary level children hospital of Bangladesh. Methods: Total 601 children aged from 1 month to 5 years with watery diarrhea were enrolled and their stool samples were analyzed by ELISA for rotavirus antigen. Findings: Total 601 children aged from 1 month to 5 years with watery diarrhea were enrolled and their sto...

  5. Clinical approach and management of chronic diarrhea.

    Science.gov (United States)

    Abdullah, Murdani; Firmansyah, M Adi

    2013-04-01

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

  6. Toddler's Diarrhea

    Science.gov (United States)

    ... Toddler’s Diarrhea? Toddler’s diarrhea is also known as chronic nonspecific diarrhea of childhood, and it affects children from 6 months to 5 years of age. Children with toddler’s diarrhea will have 3- ...

  7. Chronic Diarrhea

    Science.gov (United States)

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

  8. Zinc: Role in the management of diarrhea and cholera

    OpenAIRE

    Qadir, M Imran; Arshad, Arfa; Ahmad, Bashir

    2013-01-01

    Diarrhea and cholera are major health problems. Vibrio cholera, the causative agent of cholera, infects the small intestine, resulting in vomiting, massive watery diarrhea and dehydration. Reduced water and electrolyte absorption is also due to zinc deficiency. Zinc has an important role in recovery from the disease. The combination of zinc with cholera vaccine and oral rehydration solutions has a positive impact on cholera and diarrhea. It has led to a decrease in the mortality and morbidity...

  9. Community Diarrhea Incidence Before and After Rotavirus Vaccine Introduction in Nicaragua

    OpenAIRE

    Becker-Dreps, Sylvia; Meléndez, Marlon; Liu, Lan; Enrique Zambrana, Luis; Paniagua, Margarita; Weber, David J.; Hudgens, Michael G.; Cáceres, Mercedes; Källeståll, Carina; Morgan, Douglas R.; Espinoza, Félix; Peña, Rodolfo

    2013-01-01

    We estimated the incidence of watery diarrhea in the community before and after introduction of the pentavalent rotavirus vaccine in León, Nicaragua. A random sample of households was selected before and after rotavirus vaccine introduction. All children < 5 years of age in selected households were eligible for inclusion. Children were followed every 2 weeks for watery diarrhea episodes. The incidence rate was estimated as numbers of episodes per 100 child-years of exposure time. A mixed effe...

  10. Congenital chloride diarrhea: a review of twelve Arabian children

    OpenAIRE

    Elrefae, Fawaz; Elhassanien, Ahmed Farag; Alghiaty, Hesham Abdel-Aziz

    2013-01-01

    Fawaz Elrefae,1 Ahmed Farag Elhassanien,2 Hesham Abdel-Aziz Alghiaty3 1Pediatric Gastroenterology, Al-Adan Hospital, Kuwait; 2Faculty of Medicine, Elmansoura University, El Mansoura, El Dakahleya, Egypt; 3Faculty of Medicine, Benha University, Egypt Background: Congenital chloride diarrhea (CCD), a rare autosomal recessive disorder, is characterized by sustained watery diarrhea (due to defect of active Chloride/HCO3 exchange in the ileum and colon) with high fecal chloride. Objective: To spo...

  11. Management of VIP Associated Diarrhea in a Case with Neuroblastoma

    OpenAIRE

    Begul Yagci-Kupeli; Ali Varan; Turan Bayhan; Hulya Demir; Munevver Buyukpamukcu

    2013-01-01

    Watery diarrhea associated with hypokalemia and achlorhydria (WDHA) syndrome is commonly caused by vasoactive intestinal peptide (VIP) secreting tumors in adults and generally associated with neural crest tumors in pediatric population. VIP secretion is associated with neuroblastic cell differentiation. Octreotide treatment can be a choice for diarrhea in such cases. However, its benefit is controversial and surgery is usually needed. A 14-month-old female with diagnosis of inoperable undiffe...

  12. Acute diarrhea in children

    Directory of Open Access Journals (Sweden)

    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.

  13. Tentorial cavernous angioma with profuse bleeding. Case report.

    Science.gov (United States)

    Mori, Hiroshi; Koike, Toshiro; Endo, Shin; Takii, Yoshitaka; Uzuka, Takeo; Takahashi, Hitoshi; Ito, Jusuke; Tanaka, Ryuichi

    2009-01-01

    This 15-year-old boy with a tentorial cavernous angioma reported occasional headache and scintillation in his left visual field. Magnetic resonance imaging revealed a well-demarcated, homogeneously enhanced tumor originating from the right cerebellar tentorium and extending into both the supratentorial and infratentorial spaces. Although a meningioma was suspected, vertebral artery angiography revealed a thickened meningeal branch originating from the right posterior inferior cerebellar artery and flecked tumor stain with pooling of contrast medium until the late venous phase. A cavernous angioma of the tentorium was suspected based on this finding, and as expected from the radiological findings, profuse bleeding was encountered during tumor removal. The histological diagnosis was a cavernous angioma. A cavernous angioma of the tentorium is extremely rare but should be differentiated from a meningioma preoperatively given that a cavernous angioma of dural origin tends to bleed massively during removal.

  14. Secretory diarrhea and hypokalemia associated with colonic pseudo-obstruction: A case study and systematic analysis of the literature.

    Science.gov (United States)

    Bazerbachi, F; Haffar, S; Szarka, L A; Wang, Z; Prokop, L J; Murad, M H; Camilleri, M

    2017-11-01

    Colonic pseudo-obstruction (CPO) is characterized by colonic distention in the absence of mechanical obstruction or toxic megacolon. Concomitant secretory diarrhea (SD) with hypokalemia (SD-CPO) due to gastrointestinal (GI) loss requires further characterization. To perform a systematic review of SD-CPO, report a case study, and compare SD-CPO with classical CPO (C-CPO). We performed a search of MEDLINE, EMBASE, Cochrane, and Scopus for reports based on a priori criteria for CPO, SD and GI loss of potassium. An additional case at Mayo Clinic was included. Nine publications met inclusion criteria, with a total of 14 cases. Six studies had high, three moderate, and our case high methodological quality. Median age was 74 years (66-97), with 2:1 male/female ratio. Kidney disease was present in 6/14 patients. Diarrhea was described as profuse, watery, or viscous in 10 patients. Median serum, stool, and urine potassium concentrations (mmol/L) were 2.4 (range: 1.9-3.1), 137 (100-180), and 17 (8-40), respectively. Maximal diameter of colon and cecum (median) were 10.2 cm and 10.5 cm, respectively. Conservative therapy alone was effective in five out of 14 patients. Median potassium supplementation was 124 mEq/d (40-300). Colonic decompression was effective in three out of six patients; one had a total colectomy; three out of 14 had died. The main differences between SD-CPO and C-CPO were lower responses to treatments: conservative measures (35.7% vs 73.6%, P=.01), neostigmine (17% vs 89.2%, PCPO is a rare phenotype associated with increased fecal potassium and is more difficult to treat than C-CPO. © 2017 John Wiley & Sons Ltd.

  15. Magnetic Resonance Imaging: Window to a Watery World

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 9; Issue 5. Magnetic Resonance Imaging: Window to a Watery World. Kavita Dorai. General Article Volume 9 Issue 5 May 2004 pp 19-32. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/009/05/0019-0032 ...

  16. Management of VIP Associated Diarrhea in a Case with Neuroblastoma

    Directory of Open Access Journals (Sweden)

    Begul Yagci-Kupeli

    2013-06-01

    Full Text Available Watery diarrhea associated with hypokalemia and achlorhydria (WDHA syndrome is commonly caused by vasoactive intestinal peptide (VIP secreting tumors in adults and generally associated with neural crest tumors in pediatric population. VIP secretion is associated with neuroblastic cell differentiation. Octreotide treatment can be a choice for diarrhea in such cases. However, its benefit is controversial and surgery is usually needed. A 14-month-old female with diagnosis of inoperable undifferantiated intraabdominal neuroblastoma who developed chronic diarrhea at first year of chemotherapy is reported. Octreotide treatment was used to control diarrhea. Because of the failure of octreotide treatment, debulking surgery was performed and diarrhea subsided after the surgery. [Cukurova Med J 2013; 38(3.000: 528-530

  17. Probiotics for prevention and treatment of diarrhea.

    Science.gov (United States)

    Guandalini, Stefano

    2011-11-01

    effective strains being Lactobacillus GG and S. boulardii. Evidence is also emerging on the importance of the dose in reducing the incidence of this type of diarrhea, and the incidence of Clostridium difficile-associated postantibiotic diarrhea. As for treatment, a large body of data is available, especially in children, on the effect of several strains of probiotics in treating sporadic infectious diarrhea. The vast majority of the published trials show a statistically significant benefit and moderate clinical benefit of a few, well-identified probiotic strains-mostly Lactobacillus GG and S. boulardii-in the treatment of acute watery diarrhea, and particularly those due to rotavirus. Such a beneficial effect results, on average, in a reduction of diarrhea duration of approximately 1 day. The effect is strain-dependent and dose-dependent.

  18. A case of protracted diarrhea in a newborn: a diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Catarina Mendes

    2014-12-01

    Full Text Available Congenital diarrhea comprises a broad range of pathologies and often requires a thor- ough workup and immediate treatment. Although rare, microvillous inclusion disease (MVID should be included in differential diagnosis of this presentation in the neonate. We report the case of a 36-week newborn who developed signs of severe dehydration and lethargy, requiring fluid resuscitation and total parenteral nutrition. MVID was diagnosed by recognition of profuse secretory diarrhea after an exhaustive etiological investigation, confirmed by DNA analysis.

  19. [Chronic diarrhea].

    Science.gov (United States)

    Stelzer, Teresa; Heuss, Ludwig Theodor

    2014-09-01

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

  20. 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.

  1. Congenital Chloride Diarrhea: Diagnosis by Easy-Accessible Chloride Measurement in Feces

    OpenAIRE

    van Gils, C.; M.-C. Eckhardt; Nielsen, P E; Nybo, M.

    2016-01-01

    Background. Congenital chloride diarrhea (CCD) is an autosomal recessive disorder caused by mutations in the genes encoding the intestinal Cl?/HCO3 ? exchanger and is clinically characterized by watery, profound diarrhea, electrolyte disturbances, and metabolic alkalosis. The CCD diagnosis is based on the clinical symptoms and measurement of high chloride concentration in feces (>90?mmol/L) and is confirmed by DNA testing. Untreated CCD is lethal, while long-term clinical outcome improves whe...

  2. Traveler's Diarrhea

    Science.gov (United States)

    ... lettuce or other leafy raw vegetables (such as spinach).Do not eat raw or rare (slightly cooked) meat or fish.Do not eat food from people who sell it on the street.Boiling water will kill the germs that cause diarrhea, making ...

  3. Cultural perceptions of diarrhea and illness management choices among yoruba mothers in oyo state, Nigeria.

    Science.gov (United States)

    Okunribido, O O; Brieger, W R; Omotade, O O; Adeyemo, A A

    1997-01-01

    Home management of childhood illness is a norm throughout most of the world. Decisions about treatment are influenced by cultural perceptions of the illness, and diarrheal illnesses are no exception. A group of 473 mothers and their pre-school age children in rural communities outside Ibadan metropolis in Nigeria were followed over a two-month period. Data were collected on actual diarrhea illness episodes: mothers' names for these illnesses were recorded, and reported treatment actions were noted. Six major ethno-medical diarrheal illnesses were identified and were grouped broadly into watery diarrheas and dysentery-like diarrheas. Although few (40%) women used home-made sugar-salt solution (SSS) in case management, those who labeled their child's illness as a watery diarrhea were more likely to use SSS. Modern and herbal medicines were commonly and equally applied to both groups of diarrheal illnesses. While very few mothers reported decreased fluid intake by their children, many said the child had reduced appetite, especially if the child had a watery diarrhea. The findings indicate that twelve years after the national Oral Rehydration Therapy (ORT) Program was launched, few mothers practice the recommended actions of giving SSS, increasing food intake and avoiding drugs. Lack of attention to studies that describe the cultural basis for mothers' decisions could be part of the reason why the ORT has not been more successful.

  4. Update on chronic diarrhea: a run-through for the clinician.

    Science.gov (United States)

    Sandhu, Davinder K; Surawicz, Christina

    2012-10-01

    Chronic diarrhea is a common patient complaint, with an estimated prevalence of 5 %. Diarrhea is defined as >200 g/day of stool with decreased consistency, and chronic diarrhea is defined as lasting more than 4 weeks. The purpose of this review is to guide the clinician's diagnostic evaluation and management of chronic diarrhea, rather than providing a textbook comprehensive review of the subject, focusing on the patient in developed countries and excluding the immune suppressed patient. While the investigation and treatment of chronic diarrhea can be challenging due to its myriad causes, when the clinician employs a practical approach, dividing chronic diarrhea into bloody, fatty, and watery causes, it simplifies and streamlines the work-up and management plan and leads to improved patient outcomes.

  5. Genetic mapping of Sbbmc, a major locus controlling the profuse wax trait of sorghum

    Science.gov (United States)

    Sorghum bicolor is one of the most valuable “fail safe” cereal crop species and is a rich repository of genes for abiotic stress tolerance that await discovery. As an example, Sorghum exhibits cuticle which produces profuse amount of epicuticular wax (bloom) on sheaths and leaves that serves as one...

  6. HIV Infection in hospitalized under-5 children with acute watery ...

    African Journals Online (AJOL)

    Prof Ezechukwu

    2011-12-31

    Dec 31, 2011 ... Five of them presented within 48 hours of diarrhoea . Associated illness. Three had malaria while two had acute respiratory infec- tion in addition to acute diarrhea. Past Medical History. Two had been admitted earlier for febrile illness but no previous history of blood transfusion. None had a chronic illness.

  7. Is racecadotril effective for acute diarrhea in children? -First update.

    Science.gov (United States)

    Sáez, Josefina; Cifuentes, Lorena

    2016-05-06

    This article updates the December 2015 Living FRISBEE (Living FRISBEE: Living FRIendly Summary of the Body of Evidence using Epistemonikos), based on the detection of two systematic reviews not identified in the previous version. Gastroenteritis or acute watery diarrhea is usually a self-limited disease, but it is still associated to substantial healthcare costs and remains a frequent demand for medical care. Racecadotril, an intestinal enkephalinase inhibitor, has been used as treatment because it would decrease the duration of acute diarrhea and fluid loss. However there is still no evidence supporting its routine use. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified five systematic reviews including nine randomized trials relevant for our question. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded racecadotril probably reduces the duration of acute diarrhea in pediatric patients, without increasing adverse effects.

  8. Management of acute diarrhea in children by community pharmacists in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Ogbo PU

    2014-03-01

    Full Text Available Background: Acute diarrhea in children leads to dehydration and death if not appropriately managed. World Health Organization (WHO recommends treating diarrhea with oral rehydration therapy (ORT, fluids and foods. Proper management is hinged on accurate assessment of patients to identify the acute watery diarrhea. Objective: To compare the knowledge and attitude of community pharmacists in the management of acute diarrhea in children with their observed practice. Methods: This study was carried out using two instruments: structured self-administered questionnaire to assess knowledge and attitude of community pharmacists in the management of acute diarrhea in children and simulated patient visits to evaluate assessment of patients, recommendation of products and instructions on feeding and fluid intake. The simulated patient visits were done in 186 pharmacies in the city of Lagos, Nigeria. Results: The study reveals that the knowledge and attitude of community pharmacists in the management of acute diarrhea in children was different from their observed practice. The difference was statistically significant (p<0.05. During the simulations, 23% carried out appropriate assessment before recommending any products, and 15% recommended ORT alone. Although information to the pharmacists indicated non-dysentery, non-cholera, acute watery diarrhea, antibiotics and antidiarrheals were irrationally recommended and these were the mainstay of symptoms’ management in practice. Questionnaire data revealed that 24% of pharmacists knew the correct instructions to give on food and fluid intake during diarrhea, whereas 8% followed WHO guideline on food and fluid intake during the visits. Conclusions: Assessment of patients to determine acute diarrhea was inadequate. Observed practice in managing acute diarrhea in children was inappropriate and significantly different from their claims in the questionnaire. The recommendation of ORT was scanty and advice on food

  9. Microscopic colitis: Common cause of unexplained nonbloody diarrhea

    Science.gov (United States)

    Ingle, Sachin B; Adgaonkar, Baban D; (Ingle), Chitra R Hinge

    2014-01-01

    Microscopic colitis (MC) is characterized by chronic, watery, secretory diarrhea, with a normal or near normal gross appearance of the colonic mucosa. Biopsy is diagnostic and usually reveals either lymphocytic colitis or collagenous colitis. The symptoms of collagenous colitis appear most commonly in the sixth decade. Patients report watery, nonbloody diarrhea of a chronic, intermittent or chronic recurrent course. With collagenous colitis, the major microscopic characteristic is a thickened collagen layer beneath the colonic mucosa, and with lymphocytic colitis, an increased number of intraepithelial lymphocytes. Histological workup can confirm a diagnosis of MC and distinguish the two distinct histological forms, namely, collagenous and lymphocytic colitis. Presently, both forms are diagnosed and treated in the same way; thus, the description of the two forms is not of clinical value although this may change in the future. Since microscopic colitis was first described in 1976 and only recently recognized as a common cause of diarrhea, many practicing physicians may not be aware of this entity. In this review, we outline the epidemiology, risk factors associated with MC, its etiopathogenesis, the approach to diagnosis and the management of these individuals. PMID:24891975

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

    Science.gov (United States)

    Gauchan, E; Malla, K K

    2015-01-01

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

  11. Management of acute diarrhea in emergency room.

    Science.gov (United States)

    Dekate, Parag; Jayashree, M; Singhi, Sunit C

    2013-03-01

    Acute diarrhea is the second leading cause of under-five mortality in India. It is defined as the passage of frequent watery stools (>3/24 h). Recent change in consistency of stools is more important than frequency. Acute diarrhea is caused by variety of viral, bacterial and parasitic agents. The common ones are: Rotavirus, E. coli, Shigella, Cholera, and Salmonella. Campylobacter jejuni, Giardia and E. histolytica are also not uncommon. The most important concern in management of acute diarrhea in Emergency room (ER) is fluid and electrolyte imbalances and treatment of underlying infection, wherever applicable. It includes, initial stabilization (identification and treatment of shock), assessment of hydration and rehydration therapy, recognition and treatment of electrolyte imbalance, and use of appropriate antimicrobials wherever indicated. For assessment of hydration clinical signs are generally reliable; however, in severely malnourished children sunken eyes and skin turgor are unreliable. Oral Rehydration Therapy is the cornerstone of management of dehydration. Intravenous fluids are not routinely recommended except in cases of persistent vomiting and/or shock. Majority of cases can be managed in ER and at home. Hospitalization is indicated in infants <3 mo, children with severe dehydration, severe malnutrition, toxic look, persistent vomiting and suspected surgical abdomen. Supplementations with zinc and probiotics have been shown to reduce severity and duration of diarrhea; however evidence does not support the use of antisecretary, antimotility and binding agents. Education of parents about hand hygiene, safe weaning and safe drinking water etc., can help in reducing incidence of this important health problem in the country.

  12. Gastrointestinal Infections and Diarrhea

    Science.gov (United States)

    ... or lakes can lead to an infection and chronic diarrhea. Infants in childcare settings can become infected with ... than 2 weeks, however, are a sign of chronic diarrhea. Call your doctor if you think that you ...

  13. Acute Local Spontaneous and Profuse Gingival Hemorrhage during Neoadjuvant Treatment with Paclitaxel and Trastuzumab

    Directory of Open Access Journals (Sweden)

    Nima D. Sarmast

    2016-06-01

    Full Text Available This case report describes a 33-year-old female currently undergoing breast cancer treatment following the AC-T-T (doxorubicin hydrochloride (Adriamycin and cyclophosphamide followed by paclitaxel (Taxol and trastuzumab (Herceptin treatment regimen. Her chief complaint at the time of the emergency visit at the dental office was that she had an episode of profuse spontaneous bleeding located at the palatal gingiva in the maxilla between the left central and lateral incisor. To our knowledge, this is a novel finding related to the medications she is utilizing and should be further investigated.

  14. Congenital chloride diarrhea: a review of twelve Arabian children

    Directory of Open Access Journals (Sweden)

    Elrefae F

    2013-06-01

    Full Text Available Fawaz Elrefae,1 Ahmed Farag Elhassanien,2 Hesham Abdel-Aziz Alghiaty3 1Pediatric Gastroenterology, Al-Adan Hospital, Kuwait; 2Faculty of Medicine, Elmansoura University, El Mansoura, El Dakahleya, Egypt; 3Faculty of Medicine, Benha University, Egypt Background: Congenital chloride diarrhea (CCD, a rare autosomal recessive disorder, is characterized by sustained watery diarrhea (due to defect of active Chloride/HCO3 exchange in the ileum and colon with high fecal chloride. Objective: To spotlight the common presentation of CCD for early management and prevention of complications. Subjects and methods: This is a retrospective case series study of patients diagnosed as CCD who were followed up in the pediatric department of Al-Adan Hospital, Kuwait. Results: Twelve patients diagnosed with CCD were born to consanguineous parents; had antenatal history of intrauterine growth retardation (IUGR; polyhydramnios; and distended hypoechoic fetal bowel; and presented with abdominal distension, hypotonia and muscle wasting. 90% of patients had maternal hypertension and 75% of patients had absence of normal meconium at birth. Our patients showed a decrease in serum sodium, potassium, chloride and urine chloride. Conclusion: A high level of suspicion for an early diagnosis of CCD should be considered for any infant presenting with chronic diarrhea, especially in the presence of consanguineous marriage, and the characteristic features in antenatal ultrasound. Thus, allowing for early investigations and appropriate management. Keywords: congenital chloride diarrhea, children, chronic diarrhea, metabolic alkalosis, prenatal diagnosis

  15. A rare cause of congenital diarrhea in a Turkish newborn: tufting enteropathy.

    Science.gov (United States)

    Kahvecioğlu, Dilek; Yıldız, Duran; Kılıç, Atilla; İnce-Alkan, Banu; Erdeve, Ömer; Kuloğlu, Zarife; Atasay, Begüm; Ensari, Arzu; Yılmaz, Resul; Arsan, Saadet

    2014-01-01

    Tufting enteropathy is an autosomal recessive congenital enteropathy presenting with early-onset severe intractable diarrhea. It presents with watery diarrhea that develops in the first days after birth and persists despite bowel rest. Growth is impaired, and most patients require total parenteral nutrition. The histological characteristic of tufting enteropathy is the presence of epithelial tufts. We hereby present a patient who was referred to our neonatal intensive care unit because of chronic diarrhea and diagnosed with tufting enteropathy according to histological examination. To the best of our knowledge, the newborn case presented here is the first one reported from Turkey. As TE is a very rare disease, it should be considered in patients with continuing diarrhea beginning in the first days of life.

  16. Management of acute diarrhea in infants.

    Science.gov (United States)

    Rhoads, M

    1999-01-01

    In 1999, children seen in the emergency room of a developed country for watery diarrhea and dehydration will most likely receive an intravenous infusion of fluid, followed by instructions to give oral rehydration solution (ORS) and clear liquids for a day, followed by half-strength lactose-free formula. In fact, the majority of these children could best be managed with supervised ORS followed by early (within 4-6 h) refeeding of their normal diet, based on large numbers of clinical trials and a meta-analysis. In the next decade, effective therapy in addition to glucose-containing oral rehydration solutions should be available which should reduce diarrheal volume and duration of purging. These include amino acid-supplemented "Super ORSs," ORS with soluble fibers, liquid zinc, and probiotic milks containing bacteria which boost the immune response and reduce stool number. In addition, children wealthy enough to be able to afford the new tetravalent vaccine will be largely protected from dehydrating rotavirus diarrhea, the most common cause of dehydration in infants.

  17. 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.

    Science.gov (United States)

    Chacón, Jose

    2010-07-21

    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 conclusion, the racecadotril overall effect, evaluated in a real-world setting of Venezuela, was in agreement with results of some earlier controlled trials. It

  18. Testing for Chronic Diarrhea.

    Science.gov (United States)

    Raman, M

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

  19. Congenital Chloride Diarrhea: Diagnosis by Easy-Accessible Chloride Measurement in Feces

    Directory of Open Access Journals (Sweden)

    C. Gils

    2016-01-01

    Full Text Available Background. Congenital chloride diarrhea (CCD is an autosomal recessive disorder caused by mutations in the genes encoding the intestinal Cl−/HCO3- exchanger and is clinically characterized by watery, profound diarrhea, electrolyte disturbances, and metabolic alkalosis. The CCD diagnosis is based on the clinical symptoms and measurement of high chloride concentration in feces (>90 mmol/L and is confirmed by DNA testing. Untreated CCD is lethal, while long-term clinical outcome improves when treated correctly. Case Presentation. A 27-year-old woman had an emergency caesarian due to pain and discomfort in gestational week 36 + 4. The newborn boy had abdominal distension and yellow fluid per rectum. Therapy with intravenous glucose and sodium chloride decreased his stool frequency and improved his clinical condition. A suspicion of congenital chloride diarrhea was strongly supported using blood gas analyzer to measure an increased chloride concentration in the feces; the diagnosis was confirmed by DNA testing. Discussion. Measurement of chloride in feces using an ordinary blood gas analyzer can serve as a preliminary analysis when congenital chloride diarrhea is suspected. This measurement can be easily performed with a watery feces composition. An easy-accessible chloride measurement available will facilitate the diagnostics and support the initial treatment if CCD is suspected.

  20. Watery Saliva Secreted by the Grain Aphid Sitobion avenae Stimulates Aphid Resistance in Wheat.

    Science.gov (United States)

    Zhang, Yong; Fan, Jia; Francis, Frédéric; Chen, Julian

    2017-10-11

    Infestation with Sitobion avenae induces localized defense responses in wheat; in this study, the role of S. avenae watery saliva in resistance induction was examined by infiltrating aphid saliva into wheat leaves. After feeding S. avenae on an artificial diet for 48 h, we first collected watery saliva from them and then separated the salivary proteins using one-dimensional gel electrophoresis. Gene expression studies showed that infiltration of S. avenae watery saliva in wheat leaves induced a strong salicylic acid-responsive defense but moderate jasmonic acid-dependent defense. Feeding on wheat leaves infiltrated with aphid saliva, compared with untreated leaves, significantly decreased the number of nymphs produced per day and the intrinsic rate of increase of the population of S. avenae. In a choice test against untreated wheat, saliva-infiltrated wheat had repellent effects on aphids. Additionally, electrical penetration graph results showed that the feeding behavior of S. avenae on saliva-treated wheat was negatively affected compared with that on untreated wheat. These findings provided direct evidence that salivary components of S. avenae are involved in the induction of wheat resistance against aphids and further demonstrated the important roles of watery saliva in aphid-plant interactions.

  1. Double blind trial of loperamide for treating acute watery diarrhoea in expatriates in Bangladesh

    NARCIS (Netherlands)

    van Loon, F. P.; Bennish, M. L.; Speelman, P.; Butler, C.

    1989-01-01

    To determine if loperamide is effective and safe in treating watery diarrhoea, we randomly assigned 50 adult expatriates in Bangladesh with more than three unformed stools in the previous 24 hours and illness of less than 72 hours to receive loperamide or a placebo. On entry into the five day study

  2. Proteome Analysis of Watery Saliva Secreted by Green Rice Leafhopper, Nephotettix cincticeps.

    Directory of Open Access Journals (Sweden)

    Makoto Hattori

    Full Text Available The green rice leafhopper, Nephotettix cincticeps, is a vascular bundle feeder that discharges watery and gelling saliva during the feeding process. To understand the potential functions of saliva for successful and safe feeding on host plants, we analyzed the complexity of proteinaceous components in the watery saliva of N. cincticeps. Salivary proteins were collected from a sucrose diet that adult leafhoppers had fed on through a membrane of stretched parafilm. Protein concentrates were separated using SDS-PAGE under reducing and non-reducing conditions. Six proteins were identified by a gas-phase protein sequencer and two proteins were identified using LC-MS/MS analysis with reference to expressed sequence tag (EST databases of this species. Full -length cDNAs encoding these major proteins were obtained by rapid amplification of cDNA ends-PCR (RACE-PCR and degenerate PCR. Furthermore, gel-free proteome analysis that was performed to cover the broad range of salivary proteins with reference to the latest RNA-sequencing data from the salivary gland of N. cincticeps, yielded 63 additional protein species. Out of 71 novel proteins identified from the watery saliva, about 60 % of those were enzymes or other functional proteins, including GH5 cellulase, transferrin, carbonic anhydrases, aminopeptidase, regucalcin, and apolipoprotein. The remaining proteins appeared to be unique and species- specific. This is the first study to identify and characterize the proteins in watery saliva of Auchenorrhyncha species, especially sheath-producing, vascular bundle-feeders.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Crofelemer, a novel agent for treatment of secretory diarrhea.

    Science.gov (United States)

    Crutchley, Rustin D; Miller, Jennifer; Garey, Kevin W

    2010-05-01

    To review the chemistry, pharmacology, pharmacokinetics, efficacy, and safety of crofelemer. A literature search using the terms SP-303, Provir, and crofelemer was performed with PubMed (up to April 2010), Google Scholar, and selected Ovid bibliography searches. Additional references from the bibliographies of articles included in the search, as well as company and Food and Drug Administration Web sites, were also assessed. English-language in vitro and clinical studies associated with the safety and efficacy of crofelemer were included. Crofelemer is a first-in-class agent that may be useful for different types of secretory diarrhea, since it prevents chloride and fluid secretion into the bowel by directly inhibiting 2 distinct intestinal chloride channels. Crofelemer significantly brought about faster symptom resolution in patients with traveler's diarrhea, along with lower rates of treatment failure compared to placebo-treated patients. In a post hoc analysis, crofelemer compared to placebo also appears to have reduced abnormal stool weight and frequency in patients with AIDS-associated diarrhea. In a third trial, crofelemer did not offer a significant benefit in improving stool consistency after 12 weeks of treatment in patients with diarrhea-predominant irritable bowel syndrome. However, a significant increase in pain-free days was noted in female patients. Preliminary studies also show that crofelemer may reduce watery stool output in patients with infectious diarrhea such as cholera. Oral crofelemer seemed to be well tolerated in clinical trials, with adverse effect profiles comparable to those with placebo. Crofelemer possesses a novel mechanism of action that shows promise in treating secretory diarrhea of several etiologies. However, results from further Phase 3 clinical trials are still needed in order to fully evaluate the efficacy and safety of this agent.

  5. Drug-induced diarrhea

    Science.gov (United States)

    ... Zantac), and nizatidine (Axid) Medicines that suppress the immune system (such as mycophenolate) Nonsteroidal anti-iflammatory drugs (NSAIDs) ... care provider about taking supplements containing healthy bacteria (probiotics). Some of these products may reduce the risk of diarrhea. Keep taking these ... References Schiller LR, Sellin JH. Diarrhea. In: ...

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

    Science.gov (United States)

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

    1998-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ener Cagri Dinleyici

    2015-08-01

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

  8. Diarrhea and Swimming

    Science.gov (United States)

    ... Externa) "Swimmer's Ear" (Otitis Externa) Prevention Head Lice MRSA Pinworm & Swimming Other Recreational Water-related Issues Pools & ... Professionals Aquatics Staff Travelers En Español Publications, Data, & Statistics Disease & Outbreak Tracking Prevention Commentaries Diarrhea & Vomiting Skin, ...

  9. Congenital chloride diarrhea: a review of twelve Arabian children.

    Science.gov (United States)

    Elrefae, Fawaz; Elhassanien, Ahmed Farag; Alghiaty, Hesham Abdel-Aziz

    2013-01-01

    Congenital chloride diarrhea (CCD), a rare autosomal recessive disorder, is characterized by sustained watery diarrhea (due to defect of active Chloride/HCO3 exchange in the ileum and colon) with high fecal chloride. To spotlight the common presentation of CCD for early management and prevention of complications. This is a retrospective case series study of patients diagnosed as CCD who were followed up in the pediatric department of Al-Adan Hospital, Kuwait. Twelve patients diagnosed with CCD were born to consanguineous parents; had antenatal history of intrauterine growth retardation (IUGR); polyhydramnios; and distended hypoechoic fetal bowel; and presented with abdominal distension, hypotonia and muscle wasting. 90% of patients had maternal hypertension and 75% of patients had absence of normal meconium at birth. Our patients showed a decrease in serum sodium, potassium, chloride and urine chloride. A high level of suspicion for an early diagnosis of CCD should be considered for any infant presenting with chronic diarrhea, especially in the presence of consanguineous marriage, and the characteristic features in antenatal ultrasound. Thus, allowing for early investigations and appropriate management.

  10. Severe Diarrhea in a 4-Month-Old Baby Girl with Acute Gastroenteritis: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ionela Loredana Guzganu

    2012-01-01

    Full Text Available A 4.5-month-old baby girl presented to hospital with a 2-day history of watery diarrhea and fever. Rehydration and electrolytic balance were restored with intravenous fluid therapy followed by oral rehydration solution but diarrhea did not improve by the fourth day of hospitalization despite treatment with a probiotic. The patient was next treated with gelatin tannate, a medical device recently marketed in Europe to control and reduce the symptoms of diarrhea in infants, children, and adults. The child’s diarrhea improved considerably within the first twelve hours and resolved completely within three days. Gelatin tannate might be considered as a useful treatment complementary to oral rehydration solution for the treatment of diarrhea in infants with rotavirus gastroenteritis.

  11. Serum Zinc Concentrations in Children with Acute Bloody and Watery Diarrhoea

    Directory of Open Access Journals (Sweden)

    Abolfazl Mahyar

    2015-11-01

    Full Text Available Objectives: The role of zinc in the pathogenesis of diarrhoea is controversial. This study was conducted to compare serum zinc levels in children with acute diarrhoea to those found in healthy children. Methods: This case-control study was carried out at the Qazvin Children’s Hospital in Qazvin, Iran, between July 2012 and January 2013. A total of 60 children with acute diarrhoea (12 children with bloody diarrhoea and 48 children with watery diarrhoea and 60 healthy children were included. Zinc levels for all subjects were measured using a flame atomic absorption spectrophotometer and data were analysed and compared between groups. Results: Mean serum zinc levels in the patients with acute bloody diarrhoea, acute watery diarrhoea and the control group were 74.1 ± 23.7 μg/dL, 169.4 ± 62.7 μg/dL and 190.1 ± 18.0 μg/dL, respectively (P = 0.01. Hypozincaemia was observed in 50.0% of children with acute bloody diarrhoea and 12.5% of those with acute watery diarrhoea. None of the patients in the control group had hypozincaemia (P = 0.01. Conclusion: Children with acute bloody diarrhoea had significantly reduced serum zinc levels in comparison to healthy children. However, a study with a larger sample size is needed to examine the significance of this trend.

  12. [Diarrhea in a patient with Down syndrome and endemic sprue].

    Science.gov (United States)

    Micklefield, G; Wenzel, I U

    2000-02-01

    Down syndrome is associated with disorders such as celiac disease, hypothyroidism, and insulin-dependent diabetes mellitus. In patients with mono- or oligosymptomatic celiac disease the time interval between the onset of symptoms and diagnosis often is unacceptably long. A female patient with Down syndrome is presented who had acute watery diarrhea, which spontaneously ceased but recurred after a few days. After endoscopic and histologic evaluation and measurement of gliadin, endomysium, and reticulin antibodies celiac sprue was diagnosed. Further investigation showed findings of autoimmune hypothyroidism and secondary hyperparathyreoidism. After the patient was put on a gluten-free diet her state quickly improved. Associations between Down syndrome and autoimmune diseases exist. Patients with acute gastrointestinal symptoms should be evaluated as to celiac disease. The time interval between the onset of symptoms and diagnosis of celiac disease can be shortened, if all diagnostic tools are used at the appropriate time.

  13. A 9-Day-Old With Weight Loss and Diarrhea.

    Science.gov (United States)

    Rajbhandari, Prabi; Mandelia, Chetan; Janjua, Halima S; Selvakumar, Praveen Kumar Conjeevaram; Krishna, Sangeeta

    2017-05-01

    A 9-day-old infant girl presented with diarrhea and weight loss of 19% since birth. She was born via spontaneous vaginal delivery at 39 weeks' gestation to a mother positive for group B Streptococcus who received adequate intrapartum prophylaxis. The infant was formula-fed every 2 to 3 hours with no reported issues with feeding or swallowing. The infant had nonmucoid watery stools ∼5 to 15 times per day. Her family history was significant for hypertrophic cardiomyopathy in several of her family members. Her initial vital signs and physical examination were normal. Laboratory data on hospital admission showed a normal complete blood cell count, but her chemistry analysis revealed significant hypernatremia, hyperkalemia, metabolic acidosis, and acute kidney injury. Her hypernatremia was resistant to fluid management. In this article, we discuss the infant's hospital course, our clinical thought process, and how we arrived at our final diagnosis. Copyright © 2017 by the American Academy of Pediatrics.

  14. Review article: Small intestinal bacterial overgrowth, bile acid malabsorption and gluten intolerance as possible causes of chronic watery diarrhoea.

    Science.gov (United States)

    Fan, X; Sellin, J H

    2009-05-15

    Chronic watery diarrhoea is one of the most common symptoms prompting GI evaluation. Recently, new diagnostic considerations have emerged as possible factors in chronic diarrhoea. To review available data regarding diagnosis and treatment of chronic diarrhoea with an emphasis on bacterial overgrowth and bile acid malabsorption. A systematic search of the English language literature of chronic diarrhoea was performed focused on three possible aetiologies of diarrhoea: small intestinal bacterial overgrowth (SIBO), idiopathic bile salt malabsorption (IBAM), gluten responsive enteropathy. Recent studies suggest that SIBO and bile acid malabsorption may have been underestimated as possible causes of chronic watery diarrhoea. Gluten intolerance with negative coeliac serology is a contentious possible cause of watery diarrhoea, but requires further research before acceptance as an entity. In patients with otherwise unexplained chronic watery diarrhoea, small intestinal bacterial overgrowth and bile salt malabsorption should be considered and investigated.

  15. Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial.

    Science.gov (United States)

    Guandalini, S; Pensabene, L; Zikri, M A; Dias, J A; Casali, L G; Hoekstra, H; Kolacek, S; Massar, K; Micetic-Turk, D; Papadopoulou, A; de Sousa, J S; Sandhu, B; Szajewska, H; Weizman, Z

    2000-01-01

    The probiotic Lactobacillus GG is effective in promoting a more rapid recovery of acute, watery diarrhea in children with rotavirus enteritis. Very limited information is available, however, on the potential role of such agents in non-rotaviral diarrheal episodes. Furthermore, no evidence is available concerning the efficacy of Lactobacillus GG administered in the oral rehydration solution during oral rehydration therapy. A multicenter trial was conducted to evaluate the efficacy of Lactobacillus GG administered in the oral rehydration solution to patients with acute-onset diarrhea of all causes. Children 1 month to 3 years of age with acute-onset diarrhea were enrolled in a double-blind, placebo-controlled investigation. Patients were randomly allocated to group A, receiving oral rehydration solution plus placebo, or group B, receiving the same preparation but with a live preparation of Lactobacillus GG (at least 10(10) CFU/250 ml). After rehydration in the first 4 to 6 hours, patients were offered their usual feedings plus free access to the same solution until diarrhea stopped. One hundred forty children were enrolled in group A, and 147 in group B. There were no differences at admission between the groups in age, sex, previous types of feeding, previous duration of diarrhea, use of antibiotics, weight, height, weight-height percentile, prevalence of fever, overall status, degree of dehydration, and percentage of in- versus outpatients. Duration of diarrhea after enrollment was 71.9 +/- 35.8 hours in group A versus 58.3 +/- 27.6 hours in group B (mean +/- SD; P = 0.03). In rotavirus-positive children, diarrhea lasted 76.6 +/- 41.6 hours in group A versus 56.2 +/- 16.9 hours in groups B (P children with acute diarrhea is safe and results in shorter duration of diarrhea, less chance of a protracted course, and faster discharge from the hospital.

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

    Science.gov (United States)

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

    2015-01-01

    Two randomized controlled clinical trials have shown that Lactobacillus (L) reuteri DSM 17938 reduces the duration of diarrhea in children hospitalized due to acute infectious diarrhea. This was the first trial evaluating the efficacy of L. reuteri DSM 17938 in outpatient children with acute infectious diarrhea. This was a multicenter, randomized, single-blinded, case control clinical trial in children with acute watery diarrhea. A total of 64 children who presented at outpatient clinics were enrolled. The probiotic group received 1×10(8)CFU L. reuteri DSM 17938 for five days in addition to oral rehydration solution (ORS) and the second group was treated with ORS only. The primary endpoint was the duration of diarrhea (in hours). The secondary endpoint was the number of children with diarrhea at each day of the five days of intervention. Adverse events were also recorded. The mean duration of diarrhea was significantly reduced in the L. reuteri group compared to the control group (approximately 15h, 60.4±24.5h [95% CI: 51.0-69.7h] vs. 74.3±15.3h [95% CI: 68.7-79.9h], pdiarrhea was lower in the L. reuteri group (13/29; 44.8%) after 48h than the control group (27/31; 87%; RR: 0.51; 95% CI: 0.34-0.79, pdiarrhea. No adverse effects related to L. reuteri were noted. L. reuteri DSM 17938 is effective, safe, and well-tolerated in outpatient children with acute infectious diarrhea. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  17. 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

    Directory of Open Access Journals (Sweden)

    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

  18. Dietary management of diarrhea.

    Science.gov (United States)

    Brown, K H; Bentley, M E

    1989-01-01

    The Dietary Management of Diarrhea project in Callejon de Huaylas, Peru is an interdisciplinary effort to reduce or eliminate the nutritional complications of diarrhea in children. A recent government nutrition and health survey showed chronic childhood malnutrition to be a common problem beginning around the time of weaning. Ethnographic studies were then used to provide: 1) specific information on beliefs about diarrhea and child feeding patterns during diarrhea; 2) information to design the questionnaire for the sample survey; and 3) cultural and social information for the educational intervention phase of the program. The sample survey administered to approximately 2500 families with children under 3. Results show diarrhea to be extremely common, with point prevalence rates reaching 20% for children 6-23 months. Breastfeeding was initiated almost universally and continued for a median of about 21 months. However, other liquids were often added unnecessarily to the infant's diet. Solid foods were being received by a majority of infants by 5 months, and by almost all by 9 months. There was no change in foods offered to children with diarrhea. Based on the research, the following activities were proposed for the pilot intervention: 1) development of an improved weaning food of enhanced energy and nutrient density that could be used for the treatment of diarrhea, 2) dissemination of information about these recipes using radio and face-to-face demonstrations in community programs and rural marketplaces, and 3) training health professionals to promote the weaning food. The recipe (eventually named sanquito) was developed with mother from the community, tested within the community for acceptability and clinically with hospitalized children. It was then heavily promoted both to the general public and to health professionals. At the completion of the educational intervention (March-August 1988) it was evaluated by 1) interviews with health professionals about whether

  19. Reinfection of adult cattle with rotavirus B during repeated outbreaks of epidemic diarrhea

    Science.gov (United States)

    Hayashi, Michiko; Murakami, Toshiaki; Kuroda, Yoshizumi; Takai, Hikaru; Ide, Hisahiro; Awang, Ainani; Suzuki, Tohru; Miyazaki, Ayako; Nagai, Makoto; Tsunemitsu, Hiroshi

    2016-01-01

    Rotavirus B (RVB) infection in cattle is poorly understood. The objective of this study was to describe the epidemiological features of repeated outbreaks of epidemic diarrhea due to RVB infection in adult cattle on a large dairy farm complex in Japan. In October 2002, approximately 550 adult cows and approximately 450 in February 2005 had acute watery diarrhea at several farms on the complex. Four months before the first outbreak, RVB antibody-positive rates at subsequently affected farms were significantly lower than at non-affected farms (30% to 32% versus 61% to 67%). During the acute phase of both outbreaks, RVB antibody-positive rates in diarrheal cows tested were as low as 15% to 26%. Most of the farms affected in the second outbreak were also involved in the first outbreak. Some adult cows with RVB diarrhea in the first outbreak showed not only RVB seroresponse, but also RVB shedding in the second outbreak, although none of these cows developed diarrhea. Nucleotide sequences of the VP7 and VP4 genes revealed a close relationship between RVB strains in both outbreaks. Taken together, these results indicate that outbreaks of epidemic RVB diarrhea in adult cows might be influenced by herd immunity and could occur repeatedly at the same farms over several years. To our knowledge, this is the first report on repeated RVB infections in the same cattle. PMID:27408331

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...

  1. Enteric bacterial pathogens in children with diarrhea in Niger: diversity and antimicrobial resistance.

    Directory of Open Access Journals (Sweden)

    Céline Langendorf

    Full Text Available Although rotavirus is the leading cause of severe diarrhea among children in sub-Saharan Africa, better knowledge of circulating enteric pathogenic bacteria and their antimicrobial resistance is crucial for prevention and treatment strategies.As a part of rotavirus gastroenteritis surveillance in Maradi, Niger, we performed stool culture on a sub-population of children under 5 with moderate-to-severe diarrhea between April 2010 and March 2012. Campylobacter, Shigella and Salmonella were sought with conventional culture and biochemical methods. Shigella and Salmonella were serotyped by slide agglutination. Enteropathogenic Escherichia coli (EPEC were screened by slide agglutination with EPEC O-typing antisera and confirmed by detection of virulence genes. Antimicrobial susceptibility was determined by disk diffusion. We enrolled 4020 children, including 230 with bloody diarrhea. At least one pathogenic bacterium was found in 28.0% of children with watery diarrhea and 42.2% with bloody diarrhea. Mixed infections were found in 10.3% of children. EPEC, Salmonella and Campylobacter spp. were similarly frequent in children with watery diarrhea (11.1%, 9.2% and 11.4% respectively and Shigella spp. were the most frequent among children with bloody diarrhea (22.1%. The most frequent Shigella serogroup was S. flexneri (69/122, 56.5%. The most frequent Salmonella serotypes were Typhimurimum (71/355, 20.0%, Enteritidis (56/355, 15.8% and Corvallis (46/355, 13.0%. The majority of putative EPEC isolates was confirmed to be EPEC (90/111, 81.1%. More than half of all Enterobacteriaceae were resistant to amoxicillin and co-trimoxazole. Around 13% (46/360 Salmonella exhibited an extended-spectrum beta-lactamase phenotype.This study provides updated information on enteric bacteria diversity and antibiotic resistance in the Sahel region, where such data are scarce. Whether they are or not the causative agent of diarrhea, bacterial infections and their antibiotic

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

    Science.gov (United States)

    Chen, Jie; Sun, Xin-Ting; Zeng, Zheng; Yu, Yan-Yan

    2011-05-01

    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. 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 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%). 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.

  3. Pharmacologic Agents for Chronic Diarrhea

    Science.gov (United States)

    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 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. PMID:26576135

  4. Ecotoxicology evaluation of watery extracts of plants on seeds of radish, lettuce and tomato

    Directory of Open Access Journals (Sweden)

    Edisleidy Águila Jiménez

    2016-02-01

    Full Text Available The effect of watery extracts of Nicotiana acuminata, Piper aduncum L. and Crotalaria juncea was evaluated on the germination and the elongación of the roots of seeds of Raphanus sativus (radish, Lactuca sativa L (lettuce and Lycopersicon esculentum (tomato. The extracts were produced at medium scale in the laboratory of formulation of the Faculty of Química- Pharmacy of the “Universidad Central Marta Abreu de las Villas” . It was demonstrated upon concluding the work that the lettuce was the most sensitive species for this type of study. It was concluded that the extracts could be poured to the means to minor concentrations that 0.01% with a margin of security that they are not going to affect the processes of germination and elongacion of the roots. It was determined that one could use the alone rehearsal using the seeds of lettuce like species of rehearsal.

  5. Cholera Information for Adults

    Science.gov (United States)

    ... found in water or food contaminated by feces. Cholera causes profuse watery diarrhea and can lead to death by sudden dehydration because of the tremendous output of liquid stool. You can contract cholera by eating or drinking food or water contaminated ...

  6. Gastro 2013 APDW/WCOG Shanghai working party report: chronic diarrhea: definition, classification, diagnosis.

    Science.gov (United States)

    Schiller, Lawrence R; Pardi, Darrell S; Spiller, Robin; Semrad, Carol E; Surawicz, Christina M; Giannella, Ralph A; Krejs, Guenter J; Farthing, Michael J G; Sellin, Joseph H

    2014-01-01

    Diarrhea is best defined as passage of loose stools often with more frequent bowel movements. For clinical purposes, the Bristol Stool Form Scale works well to distinguish stool form and to identify loose stools. Laboratory testing of stool consistency has lagged behind. Acute diarrhea is likely to be due to infection and to be self-limited. As diarrhea becomes chronic, it is less likely to be due to infection; duration of 1 month seems to work well as a cut-off for chronic diarrhea, but detailed scientific knowledge is missing about the utility of this definition. In addition to duration of diarrhea, classifications by presenting scenario, by pathophysiology, and by stool characteristics (e.g. watery, fatty, or inflammatory) may help the canny clinician refine the differential diagnosis of chronic diarrhea. In this regard, a careful history remains the essential part of the evaluation of a patient with diarrhea. Imaging the intestine with endoscopy and radiographic techniques is useful, and biopsy of the small intestine and colon for histological assessment provides key diagnostic information. Endomicroscopy and molecular pathology are only now being explored for the diagnosis of chronic diarrhea. Interest in the microbiome of the gut is increasing; aside from a handful of well-described infections because of pathogens, little is known about alterations in the microbiome in chronic diarrhea. Serological tests have well-defined roles in the diagnosis of celiac disease but have less clearly defined application in autoimmune enteropathies and inflammatory bowel disease. Measurement of peptide hormones is of value in the diagnosis and management of endocrine tumors causing diarrhea, but these are so rare that these tests are of little value in screening because there will be many more false-positives than true-positive results. Chemical analysis of stools is of use in classifying chronic diarrhea and may limit the differential diagnosis that must be considered, but

  7. Modeling and design of a spiral-shaped Mach-Zehnder interferometric sensor for refractive index sensing of watery solutions

    NARCIS (Netherlands)

    Hoekman, M.; Dijkstra, Marcel; Dijkstra, Mindert; Hoekstra, Hugo

    2006-01-01

    The modeling and design of a spiral-shaped Mach-Zehnder Interferometric sensor (sMZI sensor) for refractive index sensing of watery solutions is presented. The goal of the running project is to realise a multi-sensing array by placing multiple sMZIs in series to form a sensing branch, and to place

  8. Isolation and characterization of a variant porcine epidemic diarrhea virus in China

    Directory of Open Access Journals (Sweden)

    Pan Yongfei

    2012-09-01

    Full Text Available Abstract An outbreak of diarrhea in pigs started in Guangdong, South China in January 2011. Cases were characterized by watery diarrhea, dehydration and vomiting, with 80–100% morbidity and 50–90% mortality in suckling piglets. The causative agent of the diarrhea was ultimately identified as porcine epidemic diarrhea virus (PEDV. In this study, we isolated a PEDV strain designated CHGD-01 from piglet intestines using Vero cell cultures, and its specific cytopathic effects were confirmed in susceptible cells by direct immunofluorescence testing and electron microscopy. The complete genome of CHGD-01 was shown to be 28,035 nucleotides in length, with a similar structure to that of PEDV reference strains. Phylogenetic analyses based on the whole genome revealed that CHGD-01 shared nucleotide sequence identities of 98.2–98.4% with two other Chinese isolates reported in the same year, thus constituting a new cluster. Amino acid sequence analysis based on individual virus genes indicated a close relationship between the spike protein gene of CHGD-01 and the field strain KNU0802 in Korea. Its ORF3 and nucleoprotein genes, however, were divergent from all other sequenced PEDV isolate clusters and therefore formed a new group, suggesting a new variant PEDV isolate in China. Further studies will be required to determine the immunogenicity and pathogenicity of this new variant.

  9. Evaluating the Status of Patients Suffering from Diarrhea During the Outbreak Occurred in Shahrekord in 2015

    Directory of Open Access Journals (Sweden)

    Moslem Taheri

    2016-02-01

    Full Text Available Introduction: The term diarrheal diseases, a conventional expression and is neither an epidemiological subject nor a class of diseases, because diarrhea is a symptom of many diseases, however, it is defined as the passage of three or more loose or liquid stools per day. Materials and methods: This is a cross-sectional study in which the records of all patients with symptoms of diarrhea encountering health centers during April and May 2015 were used. Results: Females, with a frequency of 56.7 percent, have a larger proportion of clinical symptoms associated with this outbreak. Most of the clinical symptoms related to watery diarrhea (74.5%, fever (62.4%, nausea (61.9%, vomiting (58.2%, and dysentery (24.2%. Most of the food eaten by encountered people with clinical symptoms related to outbreak of diarrhea are the fruits (51.6%, vegetables (42.9%, ice cream (4 %, food outside the home (3.5%, fast food consumption (2.4%. Conclusions:It seems that the possible source of this outbreak is foods such as fruits and vegetables which are abundant in this province at spring and more attention, better management and control on the food is needed according to World Health Day 2015: "from farm to plate, make food safe".

  10. Passive antibodies derived from intramuscularly immunized toxoid fusion 3xSTaN12S-dmLT protect against STa+ enterotoxigenic Escherichia coli (ETEC) diarrhea in a pig model.

    Science.gov (United States)

    Nandre, Rahul M; Duan, Qiangde; Wang, Yin; Zhang, Weiping

    2017-01-23

    Enterotoxigenic Escherichia coli (ETEC) strains are among the most common causes of children's diarrhea and travelers' diarrhea. Developing effective vaccines against ETEC associated diarrhea becomes a top priority. ETEC heat-labile toxin (LT) and heat-stable toxin (STa) toxoid fusion 3xSTa N12S -dmLT was demonstrated recently to induce neutralizing antitoxin antibodies in intraperitoneally or subcutaneously immunized mice. However, whether antibodies derived from this toxoid fusion are protective against ETEC diarrhea has not been examined. In this study, we intramuscularly immunized pregnant gilts with toxoid fusion 3xSTa N12S -dmLT, challenged suckling piglets with a STa-positive ETEC strain, and assessed protective efficacy of passive acquire antitoxin antibodies against ETEC diarrhea. Data showed all three immunized gilts developed anti-STa IgG and IgA antibodies, and piglets born to the immunized dams acquired anti-STa and anti-LT antibodies. When challenged with a STa+ ETEC strain, none of the piglets born to the immunized dams developed watery diarrhea, with 20 piglets remained normal and the other 8 piglets developed mild diarrhea indicated with stained butt. In contrast, the control dams and born piglets had no anti-STa or anti-LT antibodies detected, and 26 out 32 piglets developed watery diarrhea after challenge of the STa+ ETEC strain. These results indicated that passive acquired anti-STa antibodies are protective against ETEC diarrhea, and suggested potential application of toxoid fusion 3xSTa N12S -dmLT in ETEC vaccine development. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Diarrhea associated with typhoid fever

    NARCIS (Netherlands)

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

    1985-01-01

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

  12. Nonantibiotic therapy for travelers' diarrhea.

    Science.gov (United States)

    Ericsson, C D; DuPont, H L; Johnson, P C

    1986-01-01

    Several trials have shown that nonantibiotic drugs are efficacious in the treatment of travelers' diarrhea. When compared with placebo (P less than .025), bismuth subsalicylate (Pepto-Bismol) taken orally at a dosage of as low as 30 ml every half hour for eight doses was shown to be effective in reducing the frequently of episodes of diarrhea. Preliminary results indicated that loperamide (two 2-mg capsules followed by one capsule after each loose bowel movement) was more effective (P less than .025) than bismuth subsalicylate in relieving diarrhea. Likewise, preliminary results showed that BW942c, an unlicensed endorphin-like pentapeptide, offered more relief of diarrhea in the first 12 hr of therapy than did trimethoprim-sulfamethoxazole (P = .02) or placebo (P = .0007). Use of a nonantibiotic drug for empiric treatment of travelers' diarrhea appears to be a reasonable approach, especially for patients with mild to moderate disease and with no evidence of high fever or dysentery.

  13. [The treatment of acute diarrhea].

    Science.gov (United States)

    Leemans, L

    2013-09-01

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

  14. Effects of Racecadotril on Weight Loss and Diarrhea Due to Human Rotavirus in Neonatal Gnotobiotic Pigs (Sus scrofa domesticus).

    Science.gov (United States)

    Bui, Tammy; Li, Guohua; Kim, Inyoung; Wen, Ke; Twitchell, Erica L; Hualei, Shaoh; Ramesh, Ashwin K; Weiss, Mariah D; Yang, Xingdong; Glark-Deener, Sherrie G; Choy, Robert Km; Yuan, Lijuan

    2017-03-01

    Diarrheal disease is the second leading cause of death in children younger than 5 y, and the most common cause of acute watery diarrhea in young children worldwide is rotaviral infection. Medicines to specifically reduce diarrhea would be a desirable adjunctive treatment to supportive fluid therapy to decrease the mortality rate of diarrheal diseases. In this study, we evaluated the efficacy of an antisecretory drug, racecadotril, in treating human rotavirus (HRV)-induced diarrhea in a neonatal gnotobiotic pig model. In total, 27 gnotobiotic pigs were randomly assigned (n = 9 per group) to receive either racecadotril, chlorpromazine (positive-control drug), or PBS (mock treatment) after inoculation with HRV. Pigs were weighed daily and rectal swabs were collected to determine fecal consistency scores and virus shedding. Rotaviral infection was confirmed by ELISA and cell culture immunofluorescence. Overall, the racecadotril-treated pigs had less severe illness than either the chlorpromazine- or mock-treated groups; this conclusion was supported by the lower fecal-consistency scores, shorter duration of diarrhea, and significant gain in body weight during the course of the study of the racecadotril-treated pigs. Through its influence on decreasing intestinal hypersecretion, racecadotril was better able to control the clinical signs of rotaviral infection in the gnotobiotic pigs. These results lend support for using racecadotril as a treatment for rotaviral diarrhea.

  15. Collagenous colitis presenting with bloody diarrhea and rectal erosions in a patient with celiac disease: a case report

    Directory of Open Access Journals (Sweden)

    Antonio Carroccio

    2013-04-01

    Full Text Available Introduction: Collagenous colitis (CC is a rare condition that is known to complicate inflammatory bowel diseases, but its relationship with celiac disease (CD is more controversial. Aims: To report a case of CC that developed in a patient with CD and was manifested by rectal erosions at onset. Case report: A 46-year-old woman was diagnosed with CD and placed on a gluten-free diet. After an initial phase of improvement, her diarrhea resumed, and she began to lose weight. Despite strict adherence to the diet, the patient's diarrhea worsened. One year after diagnosis, colonoscopy was performed and mucosal biopsies were collected, but the findings were inconclusive. Two months later, the previously watery diarrhea became bloody, and a second colonoscopy was performed. Histological examination of the biopsy specimens revealed rectal erosions and CC. The patient was treated with oral prednisone plus mesalazine for 6 weeks, and her symptoms immediately disappeared. Mesalazine was continued, and the prednisone was then gradually replaced with budesonide. Six months after the CC diagnosis, the patient was asymptomatic, and a second colonoscopy revealed no macroscopic or microscopic signs of CC. She continues to take mesalazine and budesonide. An attempt to taper the dosage of the latter drug from 6 to 3 mg/day caused the reappearance of the diarrhea. Conclusion: CC is rarely associated to CD and can cause bloody diarrhea. Excellent results were obtained in this case with prednisone plus mesalazine followed by maintenance therapy with budesonide plus mesalazine.

  16. Efficacy and Safety of Saccharomyces boulardii in Acute Rotavirus Diarrhea: Double Blind Randomized Controlled Trial from a Developing Country.

    Science.gov (United States)

    Das, Susrut; Gupta, Pradeep Kumar; Das, Rashmi Ranjan

    2016-12-01

    To study the efficacy and safety of Saccharomyces boulardii (SB) in acute childhood rotavirus diarrhea. Children (3 months to 5 years) with WHO-defined acute watery diarrhea and stool rotavirus positive (n  =  60) were randomized into intervention (n  =  30) and control (n  =  30) groups. The intervention group received SB (500 mg/day) for 5 days. The median duration (hours) of diarrhea was significantly shorter in the intervention group (60 vs. 89; 95% CI: -41.2 to - 16.8). A significantly shorter duration of hospitalization (74 vs. 91; 95% CI: -33.46 to - 0.54) was also seen in the intervention group, but no significant difference was seen for fever and vomiting. There was also no difference between the two groups in the proportion of children requiring parenteral rehydration and persistence of diarrhea lasting beyond day 7. There was no report of any adverse events. The present trial showed that SB is effective and safe in acute rotavirus diarrhea. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Watery rot of pseudo-stem (Dickeya sp. management in banana (Musa sp. under greenhouse conditions

    Directory of Open Access Journals (Sweden)

    Joaquín Guillermo Ramírez

    2014-12-01

    Full Text Available This crop has serious constraints with diseases, including those caused by bacteria, such as Dickeya sp. This research aimed to evaluate the effect of 4 resistance inductors and 3 doses in Chlorine Dioxide in handling watery rot of pseudo-stem (Dickeya sp. in banana. Resistance inducers and their doses were Potassium Phosphite: 1.5 cm 3 .l -1 ; 3-Aminobutanoic Acid: 1.0 g.l -1 ; Methyl Jasmonate: 0.2 g.l -1 ; S-Methyl-Acibenzolar: 0.3 ml.l -1 , all by foliar application, while Chlorine Dioxide was injected into the pseudo-stem, in doses of 10, 20 and 30 mg.l -1 . The evaluated variables were: development of the disease, total biomass and quantification of the bacterium in the inoculated pseudo-stems. Applications of Chlorine Dioxide achieved a reduction of disease by 65.4, 91.99 and 61.5%, in addition to an inhibition of 100% of the pathogen, using 30 and 50 mg.l -1 doses. Meanwhile, the use of resistance inductors reduced up to 60.6% of the disease, but this effect failed to improve plant growth.

  18. Mothers’ beliefs and barriers about childhood diarrhea and its management in Morang district, Nepal

    Directory of Open Access Journals (Sweden)

    Ansari Mukhtar

    2012-10-01

    Full Text Available Abstract Background In developing countries, mothers usually manage diarrhea at home with the pattern of management depending on perceived disease severity and beliefs. The study was carried out with the objective of determining mothers’ beliefs and barriers about diarrhea and its management. Methods Qualitative methods involving two focus group discussions and eight in-depth interviews were used to collect the data. The study was conducted at the following places: Tankisinuwari, Kanchanbari and Pokhariya of Morang district, Nepal during the months of February and March 2010. Purposive sampling method was adopted to recruit twenty mothers based on the inclusion criteria. A semi-structured interview guide was used to conduct the interviews. Written informed consent was obtained from all of the participants before conducting the interviews. The interviews were moderated by the main researcher with the support of an expert observer from Nobel Medical College. The interviews were recorded with the permission of the participants and notes were written by a pre trained note-taker. The recordings were transcribed verbatim. All the transcribed data was categorized and analyzed using thematic content analysis. Results Twenty mothers participated in the interviews and most (80% of them were not educated. About 75% of the mothers had a monthly income of up to 5000 Nepalese rupees (US$ 60.92. Although a majority of mothers believed diarrhea to be due to natural causes, there were also beliefs about supernatural origin of diarrhea. Thin watery diarrhea was considered as the most serious. There was diversity in mothers’ beliefs about foods/fluids and diarrhea management approaches. Similarly, several barriers were noted regarding diarrhea prevention and/or management such as financial weakness, lack of awareness, absence of education, distance from healthcare facilities and senior family members at home. The elderly compelled the mothers to visit

  19. Temperature-base and soma thermal for Zinnia ‘Profusion Cherry’ potted grown in protected environment

    Directory of Open Access Journals (Sweden)

    Charleston Gonçalves

    2016-02-01

    Full Text Available The growing of consumer market demands introduction of new species of flowers and cultivars primarily for production under protected cultivation. The zinnia by the quickness of production can be regarded as an alternative, however demand studies by the lack of information in the literature. We evaluated the duration of different periods, the base temperature and thermal accumulation, expressed as degree-days for the potted zinnia ‘Profusion Cherry’, conducted under protected cultivation for different phenological subperiods. The test was conducted in a greenhouse covered with plastic and closed laterally with shading-net and the duration of subperiods were made to twenty times after sowing. The base temperature was determined by relative development and values-based temperature and thermal time in degree-days (DD. The results for the different phases were, respectively: first open flower-planting: 4.1 °C and GD 838, first open flower - 50% of flowers open: 3.0 °C and 184 GD and 50% of flowers open - senescence: 6.9 °C and 238 GD.

  20. Pathogenesis of Infectious Diarrhea

    Directory of Open Access Journals (Sweden)

    John Stephen

    2001-01-01

    Full Text Available A brief overview of some of the main features involved in normal physiological bi-directional absorption and secretion of fluid in the gut is given, including the nature and cellular location of key enzymes, ion pumps, symports, antiports and diffusion channels; the microanatomy of intestinal villous vasculature and the dynamics of villus blood flow, which together generate hypertonic zones in villus tip regions; and the production, differentiation, escalator movement (from crypt to villus tip and subsequent shedding of intestinal epithelial cells. (Neural and hormonal mechanisms that regulate normal mucosal ion transport are not discussed. The manner in which Vibrio cholerae, several pathotypes of Escherichia coli, several Salmonella serotypes, rotavirus, Campylobacter species, Shigella dysenteriae, Yersinia species and Clostridium difficile perturb these mechanisms and cause diarrhea, is discussed. Throughout the article, the main emphasis is on experimental studies designed to elucidate biological mechanisms and (where relevant the microbial determinants responsible for diarrheal disease. Allusions are also made to the involvement of host responses such as the inflammatory response, the production and release of potent cytokines and accelerated homeostatic responses (such as increased rates of crypt cell division seen in some infections, and the role that they play in pathophysiological fluid secretion.

  1. When your child has diarrhea

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000693.htm When your child has diarrhea To use the sharing features on ... gut has while absorbing regular foods. Things Your Child Should Avoid Eating or Drinking Children should avoid ...

  2. Garcinia buchananii bark extract is an effective anti-diarrheal remedy for lactose-induced diarrhea.

    Science.gov (United States)

    Boakye, Paul A; Brierley, Stuart M; Pasilis, Sofie P; Balemba, Onesmo B

    2012-07-13

    The extract from the stem bark of Garcinia buchananii trees is used as an anti-diarrhea remedy in sub-Saharan Africa. We tested the hypothesis that G. buchananii bark extract and its anti-motility fractions are effective treatments against lactose-induced diarrhea. A high-lactose (35%) diet was used to induce diarrhea in Wistar rats, which were then treated with either G. buchananii bark extract (0.1, 0.5, 1.0 and 5.0 g bark powder), and its anti-motility fractions isolated using preparative thin layer chromatography; termed PTLC1 (15 mg) and PTLC5 (3.8 mg) or loperamide (8.4 mg). Drug preparations were dissolved in 1L except PTCL1 and PTLC5 that were dissolved in 100mL tap water. Numerous parameters were measured in each condition including consistency, fluid and mucus content of feces, body weight, water and food consumption, urine production and bloating. Diarrheic rats produced watery or loose, mucuoid, sticky, feces. Fluids constituted 86% of stool mass compared with only 42% for control rats fed standard chow. Compared with controls, diarrheic rats produced more urine, lost weight and had bloated ceca and colons. All doses of the extract, its anti-motility fractions and loperamide individually stopped diarrhea within 6-24 h of administration, whilst significantly reducing mucus and fecal fluid content, urine production and intestinal bloating. Rats treated with 0.1g extract, PTLC1 and PTLC5 gained weight, whilst PTLC5 also increased water intake. Garcinia buchananii extract and its anti-motility fractions are effective remedies against lactose-induced diarrhea. The extract contains compounds that reverse weight loss, promote food and water intake, supporting the notion that characterization of the compounds could lead to new therapies against diarrheal diseases. Published by Elsevier Ireland Ltd.

  3. Epidemiological Survey of Group A Rotaviruses Infection among Children under 5 Years with Acute Diarrhea

    Directory of Open Access Journals (Sweden)

    Mohammad Kargar

    2012-08-01

    Full Text Available Background: Rotaviruses are one of the most important causes of acute gastroenteritis and death in children worldwide. WHO suggested hospital based surveillance all over the world in order to evaluate the prevalence of rotavirus diarrhea. This study was conducted to determine the prevalence of rotavirus gastroenteritis in hospitalized children in Shiraz. Materials and Methods: In this study 138 stool samples from children aged 3 loose watery stools per 24 hours, hospitalized at Shaheed Dastgheib and Nemazee hospitals in Shiraz, were collected during 2006-2007. All the stool specimens were evaluated for Group A of rotaviruses with enzyme immunoassays (EIA. Then demographic and clinical data were analyzed by SPSS software.Results: Out of total collected samples rotavirus infection was detected in 48(34.78%. The highest infection rate was among children less than two years old (70.83%. Diarrhea (97.92%, vomiting (77.08% and fever (52.08% were the most frequent reported clinical symptoms in children with rotavirus infection. The highest of isolation of virus was observed in autumn (45.83% and the lowest in spring (8.33% (p=0.012. Also, there was no significant difference between the frequency of the rotavirus diarrhea and the pattern of nutrition (p= 0.236.Conclusion: Regarding to high frequency of rotavirus infection, concurrently surveillance of rotavirus gastroenteritis in other hospitals of Iran is recommended.

  4. ACUTE INFECTIOUS DIARRHEA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    T.V. Kulichenko

    2009-01-01

    Full Text Available The article highlights the key principles for detection and differentiation of the acute infectious diarrhea in children. The modern guidelines for treatment of the acute gastroenteritis and gastroenterocolitis are based on the rational application of the antibacterial medications and minimization drugs administration. There are therapeutic approaches recommended by WHO and ESPGHAN.Key words: acute gastroenteritis, gastroenterocolitis, diarrhea, acute enteric infections, detection, treatment, oral rehydration, nifuroxazide, children.

  5. Chronic Diarrhea: Diagnosis and Management.

    Science.gov (United States)

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

    2017-02-01

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

  6. Congenital chloride diarrhea: late presentation

    OpenAIRE

    Al Bishi, Laila; Mustafa,

    2011-01-01

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

  7. A multinational comparison of racecadotril and loperamide in the treatment of acute watery diarrhoea in adults.

    Science.gov (United States)

    Prado, D

    2002-06-01

    Racecadotril (acetorphan) is an orally active, potent inhibitor of enkephalinase, which exerts an antihypersecretory effect without increasing intestinal transit time. The aim of this study was to compare the efficacy, safety and tolerability of racecadotril with those of loperamide by assessing their effects on the resolution of the signs and symptoms of diarrhoea in patients in developing countries who had acute watery diarrhoea of less than 5 days' duration. 945 outpatients from 21 centres in 14 countries received racecadotril (100 mg) or loperamide (2 mg) three times daily in a single-blind study. Duration of diarrhoea was the primary measure of efficacy; secondary criteria were overall clinical response, occurrence and duration of abdominal pain and distension, and occurrence of other associated signs and symptoms. Occurrence of constipation and adverse events were the main safety assessments. Diarrhoea resolved rapidly with both racecadotril and loperamide (55.0 h in both groups), 92% of patients on racecadotril and 93% on loperamide being treatment successes. Racecadotril produced a significantly greater reduction in abdominal pain and distension than loperamide (P = 0.024 and 0.03, respectively). The duration of abdominal distension was significantly shorter with racecadotril (5.4 versus 24.4 h; P = 0.0001), and constipation was also significantly less frequent (16% versus 25%; P = 0.001). One-hundred-and-eighty patients (19%) experienced one or more adverse event during the study: 67 (14.2%) in the racecadotril group and 113 (23.9%) in the loperamide group (P = 0.001). Racecadotril resolved the symptoms of acute diarrhoea rapidly and effectively, and produced more rapid resolution of abdominal symptoms and less constipation than loperamide.

  8. The soluble ectodomain of herpes simplex virus gD contains a membrane-proximal pro-fusion domain and suffices to mediate virus entry.

    Science.gov (United States)

    Cocchi, Francesca; Fusco, Daniela; Menotti, Laura; Gianni, Tatiana; Eisenberg, Roselyn J; Cohen, Gary H; Campadelli-Fiume, Gabriella

    2004-05-11

    Entry of herpes simplex virus (HSV) 1 into cells requires the interaction of HSV gD with herpesvirus entry mediator or nectin1 receptors, and fusion with cell membrane mediated by the fusion glycoproteins gB, gH, and gL. We report that the gD ectodomain in soluble form (amino acids 1-305) was sufficient to rescue the infectivity of a gD-null HSV mutant, indicating that gD does not need to be anchored to the virion envelope to mediate entry. Entry mediated by soluble gD required, in addition to the receptor-binding sites contained within residues 1-250, a discrete downstream portion (amino acids 261-305), located proximal to the transmembrane segment in full-length gD. We named it as profusion domain. The pro-fusion domain was required for entry mediated by virion-bound gD, because its substitution with the corresponding region of CD8 failed to complement the infectivity of gD(-/+) HSV. Furthermore, a receptor-negative gD (gD(Delta6-259)) inhibited virus infectivity when coexpressed with wild-type gD; i.e., it acted as a dominant-negative gD mutant. The pro-fusion domain is proline-rich, which is characteristic of regions involved in protein-protein interactions. P291L-P292A substitutions diminished the gD capacity to complement gD(-/+) HSV infectivity. We propose that gD forms a tripartite complex with its receptor and, by way of the proline-rich pro-fusion domain, with the fusion glycoproteins, or with one of them. The tripartite complex would serve to recruit/activate the fusion glycoproteins and bring them from a fusion-inactive to a fusion-active state, such that they execute fusion of the virion envelope with cell membrane.

  9. Polymer-based oral rehydration solution for treating acute watery diarrhoea.

    Science.gov (United States)

    Gregorio, Germana V; Gonzales, Maria Liza M; Dans, Leonila F; Martinez, Elizabeth G

    2016-12-13

    Acute diarrhoea is one of the main causes of morbidity and mortality among children in low-income countries. Glucose-based oral rehydration solution (ORS) helps replace fluid and prevent further dehydration from acute diarrhoea. Since 2004, the World Health Organization (WHO) has recommended the osmolarity of less than 270 mOsm/L (ORS ≤ 270) versus greater than 310 mOsm/L formulation (ORS ≥ 310). Polymer-based ORS (for example, prepared using rice or wheat) slowly releases glucose and may be superior to glucose-based ORS. To compare polymer-based oral rehydration solution (polymer-based ORS) with glucose-based oral rehydration solution (glucose-based ORS) for treating acute watery diarrhoea. We searched the following sources up to 5 September 2016: the Cochrane Infectious Diseases Group (CIDG) Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 9), MEDLINE (1966 to 5 September 2016), EMBASE (1974 to 5 September 2016), LILACS (1982 to 5 September 2016), and mRCT (2007 to 5 September 2016). We also contacted researchers, organizations, and pharmaceutical companies, and searched reference lists. We included randomized controlled trials (RCTs) of people with acute watery diarrhoea (cholera and non-cholera associated) that compared polymer-based and glucose-based ORS (with identical electrolyte contents). Two review authors independently assessed the search results and risk of bias, and extracted data. In multiple-treatment arms with two or more treatment groups, we combined outcomes as appropriate and compared collectively with the control group. Thirty-five trials that included 4284 participants met the inclusion criteria: 28 trials exclusively included children, five included adults, and two included both adults and children. Polymer-based ORS versus glucose-based ORS (osmolarity ≤ 270) Eight trials (752 participants) evaluated this comparison, and seven trials used rice as a polymer source

  10. Congenital chloride diarrhea: late presentation

    Directory of Open Access Journals (Sweden)

    Al Bishi L

    2011-04-01

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

  11. Chronic Diarrhea: A Concern After Gallbladder Removal?

    Science.gov (United States)

    Chronic diarrhea: A concern after gallbladder removal? I had my gallbladder removed six months ago, and I'm ... Barkun A, et al. Bile acid malabsorption in chronic diarrhea: Pathophysiology and treatment. Canadian Journal of Gastroenterology. 2013; ...

  12. Diseases in Chronic Non-infective Diarrhea

    OpenAIRE

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

    2004-01-01

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

  13. Production of recombinant thanatin in watery rice seeds that lack an accumulation of storage starch and proteins.

    Science.gov (United States)

    Imamura, Tomohiro; Sekine, Ken-Taro; Yamashita, Tetsuro; Kusano, Hiroaki; Shimada, Hiroaki

    2016-02-10

    Molecular farming is a promising method for producing materials of commercial interest. Plants can be expected to be appropriate hosts for recombinant protein production. However, production in genetically modified plants has two major challenges that must be resolved before its practical use: insufficient accumulation of products and difficulty in establishing methods for their purification. We propose a simple procedure for the production of a desired protein using watery rice seeds lacking an accumulation of storage starch and proteins, a phenotype induced by the introduction of an antisense SPK. We produced a transgenic rice plant containing a gene for an antimicrobial peptide, thanatin, together with antisense SPK. Bioassay and proteome analysis indicated that recombinant thanatin accumulated in an active form in these watery rice seeds. These results suggest that our system worked effectively for the production of thanatin. This procedure enabled easy removal of impurities and simplified the purification process compared with production in leaves. Our system may therefore be a useful technique for the production of desired materials, including proteins. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. [Current situation on the treatment modules of diarrhea cases in 12 counties/cities of Guangdong, Henan and Gansu provinces in China].

    Science.gov (United States)

    Zhang, Jing; Liu, Min

    2008-10-01

    To understand the situation of diarrhea cases treatment modules in the areas and to provide reference data for setting up national strategies for treatment and control of diarrhea diseases. Using the method of multistage and cluster random sampling, we selected twelve counties/cities and 60 streets communities/villages from Guangdong, Henan and Gansu provinces that representing three kinds of economic development. According to the definition of diarrhea case published by World Health Organization, we conducted a four-time investigation at the community level in four different seasons. The overall incidence of diarrhea within two weeks was 0.79% (95%CI: 0.74% - 0.84%) in the residents from twelve counties/districts in Guangdong, Henan and Gansu. The incidence rate within two weeks under the 5 years old was 2.30% (95%CI: 1.96% - 2.67%), obviously higher than the incidence rates seen in other age groups. The average percentage of visiting a doctor seeking for help on diarrhea within the two weeks was 55.89% for the three provinces. The highest percentage was 79.88% in the age group under 5 years old. 35.38% of the patients with diarrhea in urban area went to the community or street clinics for treatment, but 75.04% of the diarrhea cases in rural areas went to see village or private rural doctors. Factors influencing the behaviors of visiting a doctor seeking for help were found by logistic Regression method. It was found that factors as: when diarrhea cases with voluminous or soft-rice like watery stools or with dark blood stools; when a patient was with fever, more episodes per day or with longer duration, the patients would turn more to the doctors for help. Diarrhea cases from the rural areas would see doctors more often than the cases from the urban areas. People having had partial 'new rural medical insurance' would see doctors more often than those without medical insurance. We studied the modules of diarrhea case treatment between the urban and rural area in

  15. MANIFESTATION OF AIDS WITH DIARRHEA

    Directory of Open Access Journals (Sweden)

    Rahmat Zainuddin

    2014-09-01

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

  16. TCM Syndrome Differentiation of Diarrhea during Menstruation%经行泄泻中医辨治思路

    Institute of Scientific and Technical Information of China (English)

    曲梅

    2012-01-01

    The diarrhea during menstruation means loose stool, even watery diarrhea several times a day during or before or after menstruation, and returned to normal when menstruation ends. In this paper, etiology, pathogenesis, clinical treatment of the diarrhea during menstruation both in the ancient books and literature in recent years were reviewed. It is found the pathogenesis is spleen deficiency, kidney Yang deficiency, liver stagnation and spleen deficiency, and the heat attacking large intestine. TCM treatment is safe and effective for this disease.%经行泄泻是指每值行经前后或经期,大便溏薄,甚或水泻,日解数次,经净即止.文章对古籍及近年文献对经行泄泻的中医病因病机、临床治疗进行了综述,发现经行泄泻的病机主要责之于脾虚、肾阳虚、肝郁乘脾及热迫大肠,中医药是治疗本病的一种安全有效的方法.

  17. Diarrhea Recurrence in Patients with Clostridium difficile-Associated Diarrhea: Role of Concurrent Antibiotics

    Directory of Open Access Journals (Sweden)

    MJ Alfa

    1999-01-01

    Full Text Available OBJECTIVE: To monitor prospectively patients with Clostridium difficile-associated diarrhea (CAD in a six hundred bed tertiary care hospital to determine which factors influenced the recurrence of the diarrhea.

  18. Diarrhea

    Science.gov (United States)

    ... Intestinal Pseudo-obstruction Irritable Bowel Syndrome (IBS) Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Irritable Bowel Syndrome (IBS) in Children Lactose Intolerance Ménétrier’s Disease Microscopic Colitis Ostomy Surgery of the ...

  19. Diarrhea

    Science.gov (United States)

    ... that do not have peels. DO NOT eat raw shellfish or undercooked meat. DO NOT consume dairy products. ... to ask your health care provider - adult Diet - clear liquid Diet - full liquid When you have ...

  20. Trial Evaluating Ambulatory Therapy of Travelers' Diarrhea (TrEAT TD) Study: A Randomized Controlled Trial Comparing 3 Single-Dose Antibiotic Regimens With Loperamide.

    Science.gov (United States)

    Riddle, Mark S; Connor, Patrick; Fraser, Jamie; Porter, Chad K; Swierczewski, Brett; Hutley, Emma J; Danboise, Brook; Simons, Mark P; Hulseberg, Christine; Lalani, Tahaniyat; Gutierrez, Ramiro L; Tribble, David R

    2017-11-29

    Recommended treatment for travelers' diarrhea includes the combination of an antibiotic, usually a fluoroquinolone or azithromycin, and loperamide for rapid resolution of symptoms. However, adverse events, postdose nausea with high-dose azithromycin, effectiveness of single-dose rifaximin, and emerging resistance to front-line agents are evidence gaps underlying current recommendations. A randomized, double-blind trial was conducted in 4 countries (Afghanistan, Djibouti, Kenya, and Honduras) between September 2012 and July 2015. US and UK service members with acute watery diarrhea were randomized and received single-dose azithromycin (500 mg; 106 persons), levofloxacin (500 mg; 111 persons), or rifaximin (1650 mg; 107 persons), in combination with loperamide (labeled dosing). The efficacy outcomes included clinical cure at 24 hours and time to last unformed stool. Clinical cure at 24 hours occurred in 81.4%, 78.3%, and 74.8% of the levofloxacin, azithromycin, and rifaximin arms, respectively. Compared with levofloxacin, azithromycin was not inferior (P = .01). Noninferiority could not be shown with rifaximin (P = .07). At 48 and 72 hours, efficacy among regimens was equivalent (approximately 91% at 48 and 96% at 72 hours). The median time to last unformed stool did not differ between treatment arms (azithromycin, 3.8 hours; levofloxacin, 6.4 hours; rifaximin, 5.6 hours). Treatment failures were uncommon (3.8%, 4.4%, and 1.9% in azithromycin, levofloxacin, and rifaximin arms, respectively) (P = .55). There were no differences between treatment arms with postdose nausea, vomiting, or other adverse events. Single-dose azithromycin, levofloxacin, and rifaximin with loperamide were comparable for treatment of acute watery diarrhea. NCT01618591.

  1. 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

    2008-02-01

    Full Text Available 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.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.Compared to HO-ORS, HAMS-ORS reduced diarrhea duration by 55% and significantly reduced fecal weight after the first 12 hours of ORS therapy in adults with cholera-like diarrhea.Current Controlled

  2. Watery and dark axons in Wallerian degeneration of the opossum's optic nerve: different patterns of cytoskeletal breakdown?

    Directory of Open Access Journals (Sweden)

    MARCELO S. NARCISO

    2001-06-01

    Full Text Available In this paper we report a qualitative morphological analysis of Wallerian degeneration in a marsupial. Right optic nerves of opossums Didelphis marsupialis were crushed with a fine forceps and after 24, 48, 72, 96 and 168 hours the animals were anaesthetized and perfused with fixative. The optic nerves were immersed in fixative and processed for routine transmission electron microscopy. Among the early alterations typical of axonal degeneration, we observed nerve fibers with focal degeneration of the axoplasmic cytoskeleton, watery degeneration and dark degeneration, the latter being prevalent at 168 hours after crush. Our results point to a gradual disintegration of the axoplasmic cytoskeleton, opposed to the previous view of an "all-or-nothing'' process (Griffin et al 1995. We also report that, due to an unknown mechanism, fibers show either a dark or watery pattern of axonal degeneration, as observed in axon profiles. We also observed fibers undergoing early myelin breakdown in the absence of axonal alterations.Neste trabalho, relatamos uma análise morfológica qualitativa da degeneração Walleriana em um marsupial. Os nervos ópticos direito de gambás da espécie Didelphis marsupialis foram esmagados com uma pinça fina. Após 24, 48, 72, 96 e 168 horas, os animais foram anestesiados e perfundidos com fixador. A seguir, os nervos foram imersos em fixador e processados para microscopia eletrônica de rotina. Entre as alterações precoces típicas da degeneração, observamos fibras nervosas com degeneração focal do citoesqueleto axoplasmático, degeneração aquosa e degeneração escura, com o último tipo prevalente às 168 horas após esmagamento. Nossos resultados indicam uma desintegração gradual do citoesqueleto axoplasmático, oposta à prévia visão de um processo "tudo-ou-nada''. Relatamos também que, devido a um mecanismo desconhecido, as fibras mostram ou um padrão aquoso ou um padrão escuro de degeneração axonal

  3. Profuse color-evolution-based fluorescent test paper sensor for rapid and visual monitoring of endogenous Cu(2+) in human urine.

    Science.gov (United States)

    Cai, Yueqing; You, Junhui; You, Zhengyi; Dong, Fang; Du, Shuhu; Zhang, Liying

    2018-01-15

    The fluorescent paper for colorimetric detection of metal ions has been widely fabricated using various sensing probes, but it still remains an elusive task to design a test paper with multicolor variation with target dosages for accurate determination. Herein, we report a profuse color-evolution-based fluorescent test paper sensor for rapid and visual monitoring of Cu(2+) in human urine by printing tricolor probe onto filter paper. The tricolor probe consists of blue-emission carbon dots (bCDs), green-emission quantum dots (gQDs) and red-emission quantum dots (rQDs), which is based on the principle that the fluorescence of gQDs and rQDs are simultaneously quenched by Cu(2+), whereas the bCDs as the photostable internal standard is insensitive to Cu(2+). Upon the addition of different amounts of Cu(2+), the ratiometric fluorescence intensity of the tricolor probe continuously varied, leading to color changes from shallow pink to blue with a detection limit of 1.3nM. When the tricolor probe solution was printed onto a sheet of filter paper, as-obtained test paper displayed a more profuse color evolution from shallow pink to light salmon to dark orange to olive drab to dark olive green to slate blue to royal blue and to final dark blue with the increase of Cu(2+) concentration compared with dual-color probe-based test paper, and dosage scale as low as 6.0nM was clearly discriminated. The sensing test paper is simple, rapid and inexpensive, and serves as a visual platform for ultrasensitive monitoring of endogenous Cu(2+) in human urine. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Diarrhea - what to ask your doctor - child

    Science.gov (United States)

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

  5. Global burden of childhood diarrhea and interventions.

    Science.gov (United States)

    Das, Jai K; Salam, Rehana A; Bhutta, Zulfiqar A

    2014-10-01

    Diarrhea is a leading cause of morbidity and mortality among children under 5 years in low-income and middle-income countries. Over the past 2 decades under-five mortality has decreased substantially, but reductions have been uneven and unsatisfactory in resource-poor regions. There are known interventions which can prevent diarrhea or manage children who suffer from it. Interventions with proven effectiveness at the prevention level include water, sanitation, and hygiene interventions, breastfeeding, complementary feeding, vitamin A and zinc supplementation, and vaccines for diarrhea (rotavirus and cholera). Oral rehydration solution, zinc treatment, continued feeding, and antibiotic treatment for certain strains of diarrhea (cholera, Shigella, and cryptosporidiosis) are effective strategies for treatment of diarrhea. The recent Lancet series using the 'Lives Saved' tool suggested that if these identified interventions were scaled up to a global coverage to at least 80%, and immunizations to at least 90%; almost all deaths due to diarrhea could be averted. The current childhood mortality burden highlights the need of a focused global diarrhea action plan. The findings suggest that with proper packaging of interventions and delivery platforms, the burden of childhood diarrhea can be reduced to a greater extent. All that is required is greater attention and steps toward right direction.

  6. Effect of mild diarrhea on tacrolimus exposure

    NARCIS (Netherlands)

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

    2012-01-01

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

  7. Straight Poop on Kids and Diarrhea

    Science.gov (United States)

    ... problems. “If you believe that your child has chronic diarrhea, see a pediatrician,” says Ortiz. Oct. 31, 2011 back to top For More Information Foodborne Illnesses: What You Need to Know American Academy of Pediatrics: What Is the Best Way to Treat Diarrhea? ...

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

    African Journals Online (AJOL)

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

  9. Nosocomial diarrhea in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Ana Paula Marcon

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

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

    OpenAIRE

    S.V. Bel’mer; T.V. Gasilina

    2010-01-01

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

  11. [Differential therapy of infectious diarrhea].

    Science.gov (United States)

    Grundmann, H

    1994-10-18

    Worldwide, diarrheal diseases caused by communicable pathogens rank first in morbidity and mortality, particularly in young children. Underprivileged groups of poor societies may still suffer from endemic typhus, bacillary dysentery, or cholera. In children however, a significant proportion of recurrent diarrhoeal episodes is caused by toxigenic enterobacteria, non-thyphoidal salmonella, campylobacter, and viruses. Although outbreaks of classical waterborne epidemics have not been reported from industrialized nations, infectious diarrhea is by no means scarce. Industrial cattlebreeding and food production facilitate the spread of nonthyphoidal salmonella, Campylobacter, and possibly Yersinia enterocolitica. Changes in travel patterns, an increasing number of immunocompromised patients, and migration of people from countries with lower sanitary standards warrants awareness to hitherto exceptional pathogens.

  12. Porcine Epidemic Diarrhea Virus Shedding and Antibody Response in Swine Farms: a Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Cristina Bertasio

    2016-12-01

    Full Text Available The porcine epidemic diarrhea virus (PEDV causes an acute and highly contagious enteric disease characterized by severe enteritis, vomiting, watery diarrhea and a high mortality rate in seronegative neonatal piglets. In the last few years, PED had a large economic impact on the swine industries in Asia and the United States, and in 2014, the PEDV also re-emerged in Europe. Two main PEDV variants circulate worldwide but only the S INDEL variant, considered a mild strain, is spreading in Europe. To gain insights into the pathogenicity of this variant, its viral load and temporal shedding pattern were evaluated in piglets from infected farms. Quantitative real-time PCR (qPCR targeting the spike gene, was validated according to the minimum information for quantitative real-time PCR experiments guidelines. The qPCR was applied to longitudinal studies conducted in four swine farms naturally infected with the PEDV S INDEL variant. Clinical data, fecal swabs and blood samples were collected from 103 piglets at 15–30-day intervals for 2–5 months. On all four farms, diarrhea was observed in sows during gestation and in farrowing units, and the mortality rates of piglets were 18, 25, 30 and 35%. Different clinical pictures (0-50% of diarrhea positivity, viral titer levels (mean 5.3-7.2 log10 genome copies/mL and antibody conditions (30-80% of positivity were registered among sows on the four farms. The percentage of qPCR positive piglets varied greatly from the beginning (63–100% to the end (0% of the infection course. Clinical signs were present in 96% of the qPCR positive animals. Viral loads ranged from 8.5 log10 to 4 log10 genome copies/mL in suckling pigs at 3–6 days of age and were not statistically different among farms, despite the different patterns observed in sows. After 2–3 weeks, only a few piglets still showed detectable viral levels and clinical signs, and they developed antibody responses. Moreover, co-infections with other

  13. Invasive Listeria monocytogenes Gastroenteritis Leading to Stupor, Bacteremia, Fever, and Diarrhea: A Rare Life-Threatening Condition.

    Science.gov (United States)

    Mehmood, Hassan; Marwat, Asghar Dil Jan Khan; Khan, Noman Ahmed Jang

    2017-01-01

    Listeria monocytogenes is a gram-positive, rod-shaped organism that can cause serious infections such as meningitis, invasive gastroenteritis, and endocarditis. Every year 1600 people in the United States are affected, with significant mortality of 260 people annually. Listeria gastroenteritis has the third highest mortality rate among all the food-borne infection. Invasive listeriosis most commonly affect pregnant women, those in extremes of ages, people with comorbid diseases, and people with weakened immune response. In this article, we present a rare case of invasive Listeria gastroenteritis in an 83-year-old female with multiple comorbid conditions and past medical history of type 2 diabetes mellitus and multiple risk factors who was brought to the hospital with altered mental status. She had history of fever, abdominal pain, and watery diarrhea up to 14 episodes in 24 hours for the last 7 days. Her stool culture grew Listeria monocytogenes sensitive to penicillin. She was started on penicillin for 2 weeks. She had subsequently complete resolution of fever, diarrhea, and abdominal pain. High index of suspicion is the key to ensure timely initiation of appropriate empirical treatment in the setting of invasive gastroenteritis, especially in people who have high risk factors for listeriosis. We recommend raising awareness in the health care profession about invasive listeriosis in the need of time. Intravenous ampicillin or penicillin G is the treatment of choice, with meropenem as an alternative.

  14. Invasive Listeria monocytogenes Gastroenteritis Leading to Stupor, Bacteremia, Fever, and Diarrhea: A Rare Life-Threatening Condition

    Directory of Open Access Journals (Sweden)

    Hassan Mehmood MD

    2017-05-01

    Full Text Available Listeria monocytogenes is a gram-positive, rod-shaped organism that can cause serious infections such as meningitis, invasive gastroenteritis, and endocarditis. Every year 1600 people in the United States are affected, with significant mortality of 260 people annually. Listeria gastroenteritis has the third highest mortality rate among all the food-borne infection. Invasive listeriosis most commonly affect pregnant women, those in extremes of ages, people with comorbid diseases, and people with weakened immune response. In this article, we present a rare case of invasive Listeria gastroenteritis in an 83-year-old female with multiple comorbid conditions and past medical history of type 2 diabetes mellitus and multiple risk factors who was brought to the hospital with altered mental status. She had history of fever, abdominal pain, and watery diarrhea up to 14 episodes in 24 hours for the last 7 days. Her stool culture grew Listeria monocytogenes sensitive to penicillin. She was started on penicillin for 2 weeks. She had subsequently complete resolution of fever, diarrhea, and abdominal pain. High index of suspicion is the key to ensure timely initiation of appropriate empirical treatment in the setting of invasive gastroenteritis, especially in people who have high risk factors for listeriosis. We recommend raising awareness in the health care profession about invasive listeriosis in the need of time. Intravenous ampicillin or penicillin G is the treatment of choice, with meropenem as an alternative.

  15. The dynamics of Chinese variant porcine epidemic diarrhea virus production in Vero cells and intestines of 2-day old piglets.

    Science.gov (United States)

    Wang, Yanhui; Gao, Xiaojing; Yao, Yali; Zhang, Yunjing; Lv, Chaochao; Sun, Zhe; Wang, Yuzhou; Jia, Xiangrui; Zhuang, Jinshan; Xiao, Yan; Li, Xiangdong; Tian, Kegong

    2015-10-02

    A severe porcine epidemic diarrhea (PED) epizootic has been affecting pigs of all ages that are characterized by high mortality among suckling piglets in China since late 2010, causing significant economic losses. Obtaining a current-circulating PEDV variant isolate that can grow efficiently in cell culture is prerequisite for the development of efficient vaccines. In this study, PEDV strain HN1303 was isolated successfully on Vero cells with supplemental trypsin, and the isolate has been serially propagated in cell culture for over 95 passages. The infectious titers of the virus during the first 10 passages ranged from 10(2.6) to 10(5.8) 50% tissue culture infective doses (TCID50)/ml, and the titers of 20-95 passages ranged from 10(6.2) to 10(8.0)TCID50/ml. The growth curve of Vero cell-adapted HN1303 in cell culture was determined, and dynamics of virus production was confirmed by immunoperoxidase monolayer assay (IPMA). Sequence and phylogenetic analysis based on spike gene indicate that the HN1303 strain belongs to genotype IIa. In addition, the fourth passage cell-culture HN1303 was subjected to 2-day old piglets. All piglets orally inoculated developed severe watery diarrhea and vomiting within 24 hours post-inoculation (hpi) and died within 72 hpi. The results of animal experiments reveal that this strain is highly pathogenic to 2-day old piglets. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Map-Based Cloning of Sbbmc, a Major Locus Controlling the Profuse Wax Trait of Sorghum: a Case Study in Unlocking the Abiotic Stress Tolerance of Sorghum bicolor via Integrated Physiological and Genomic Approaches

    Science.gov (United States)

    Sorghum bicolor is one of the most valuable “fail safe” cereal crop species and is a rich repository of genes for abiotic stress tolerance that await discovery. As an example, Sorghum exhibits cuticle which produces profuse amount of epicuticular wax (bloom) on sheaths and leaves that serves as key...

  17. [Investigation on Entamoeba histolytica infection in diarrhea patients from general hospitals in Shanghai City].

    Science.gov (United States)

    Zhang, Xiao-ping; He, Yan-yan; Wang, Zhen-yu; Zhang, Yao-guang; Zhu, Qian; Jiang, Shou-fu; Li, Ying; Cheng, Yu-ping; Yin, Ming-min

    2015-12-01

    To understand the status of Entamoeba histolytica infection in diarrhea patients in general hospitals, so as to provide the evidences for the prevention and control of the disease. The diarrhea patients in intestinal disease clinics of 3 general hospitals in Shanghai City were chosen as the investigation objectives, and their fecal and blood samples were collected, and then were detected by the normal saline direct smear method and iodine solution staining, immunochromatographic method and ELISA respectively to understand the infection status of E. histolytica, and the characteristics of the infected persons were analyzed. RESULTS Totally 1 015 fecal samples were detected, and among which 36 positive ones were detected by parasitological examinations, with a general positive rate of 3.55%. There were no statistically significant differences among the positive rates of patients from the three hospitals (P > 0.05), nor between or among those of the patients with different sexes, ages, occupations and education levels (all P > 0.05). The positive rate of E. histolytica in bloody purulent stools was higher than those in loose stools and watery stools (both P histolytica were 8.18% (83/1 015) and 7.12% (48/675) respectively when detected by the immunochromatographic method and ELISA. Summer and autumn are the high risk seasons for E. histolytica infection, and the surveillance should be strengthened in this period. The positive rate of E. histolytica in samples of bloody purulent stools is high, and the combined application of several detection methods can increase the detection rate.

  18. Antidiarrheal Medicines: OTC Relief for Diarrhea

    Science.gov (United States)

    ... Imodium) and bismuth subsalicylate (2 brand names: Kaopectate, Pepto-Bismol). Bismuth subsalicylate can also be used for upset stomach and ... you have less diarrhea and more formed stools.Bismuth subsalicylate works by balancing the way fluid moves through ...

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

    Science.gov (United States)

    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.

  20. Role of zinc in pediatric diarrhea

    National Research Council Canada - National Science Library

    Bajait, Chaitali; Thawani, Vijay

    2011-01-01

    .... This article reviews the available evidence on the efficacy and safety of zinc supplementation in pediatric diarrhea and convincingly concludes that zinc supplementation has a beneficial impact on the disease outcome.

  1. 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

  2. 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.

  3. A study of dietetic on the diarrhea

    Directory of Open Access Journals (Sweden)

    Tae-Hyeun Baek

    2006-06-01

    Full Text Available Objectives : This research examined about dietary therapy on the diarrhea based on the literary findings, for clinical treatment and prevention of the diarrhea. Methods : This Research examined on histories, compositions, applications, and effects of the diarrhea on about 100 cases of dietary therapy of the diarrhea from recent Chinese literatures Results : 1. Various vegetables, animals and mineral materials including herbs, grains, vegetables, fruits, food and drink were used for the dietary therapy. 2. Methods of the preparation for use as therapeutics were decoction, pulvis, gruel, medicinal wine, cake, tea, paste and gelatin and etc. 3. Frequently used materials were sesame oil, honey, ear mushroom, shiitake mushroom, kelp, walnut seed, hemp seed, groundnut, glutinous rice, apricot stone, yellow bean peel, radish, potato, spinage, and spring onion. Conclusion : Though dietary therapy for the diarrhea is not based on clinical or experimental data, but through experience. It is mostly based on Yin-Yang and five elements, visceral manifestation, channels and their collateral channels and chinese herbal medicine theories. If we use them properly according to oriental medicine method, it will be effective on treating and preventing the diarrhea.

  4. A study of nosocomial diarrhea in Calcutta.

    Science.gov (United States)

    Das, A S; Mazumder, D N; Pal, D; Chattopadhyay, U K

    1996-01-01

    Nosocomial infection is a major problem in hospitalized patients, particularly those who are debilitated. These infections may manifest as diarrhea. The spectrum of infections agents causing nosocomial diarrhea in our country is not known. Thirty-two patients, admitted to the hospital with various complaints, who developed diarrhea during their hospital stay, were studied to identify the causative agents of diarrhea. Hospital food samples were also processed for pathogens. The bacteria isolated from patients included established enteropathogens like Salmonella, enteropathogenic Escherichia coli, Campylobacter species and organisms with low pathogenicity like Serratia marsescens, Pseudomonas aeruginosa and Morganella morganii. The bacterial pathogens isolated were resistant to most antibiotics, suggesting their nosocomial character. Hospital food samples contained Salmonella typhimurium, Campylobacter jejuni (biotype 1) and enteropathogenic Escherichia coli, suggesting that food might have been the vehicle for these infections. Nosocomial infection was found to be an important cause of diarrhea (34%), EPEC and Salmonell being the predominant pathogens. Water, egg and milk were the source of infection in these cases. Special measures to obtain uneffected items will prevent occurrence of nosocomial diarrhea in our hospitals.

  5. Spectrum of Drug-induced Chronic Diarrhea.

    Science.gov (United States)

    Philip, Nissy A; Ahmed, Nazir; Pitchumoni, Capecomorin S

    2017-02-01

    The evaluation of a patient with chronic diarrhea can be quite frustrating, as it is expensive and involves multiple diagnostic studies. Moreover, identification of a drug as a cause of chronic diarrhea is a challenge in patients taking multiple medications. The disease may either be associated with intestinal mucosal changes, mimicking diseases such as celiac disease, or purely functional, with no histopathologic change. Drug-induced diarrhea may or may not be associated with malabsorption of nutrients, and a clinical improvement may occur within days of discontinuation of the drug, or may take longer when associated with mucosal injury. Diarrhea in diabetics, often attributed to poor management and lack of control, may be due to oral hypoglycaemic agents. Chemotherapy can result in diffuse or segmental colitis, whereas olmesartan and a few other medications infrequently induce a disease that mimics celiac disease, but is not associated with gluten intolerance. In short, increased awareness of a drug, as a cause for diarrhea and a clear understanding of the clinical manifestations will help clinicians to solve this challenging problem. This article aims to review drug-induced diarrhea to (a) understand known pathophysiological mechanisms; (b) assess the risk associated with frequently prescribed medications, and discuss the pathogenesis; and (c) provide easily retrievable data in tables to help identify known offending medication/s and a list of top 100 prescribed medications in the United States as a useful comprehensive reference.

  6. Differential auxin transport and accumulation in the stem base lead to profuse adventitious root primordia formation in the aerial roots (aer) mutant of tomato (Solanum lycopersicum L.).

    Science.gov (United States)

    Mignolli, F; Mariotti, L; Picciarelli, P; Vidoz, M L

    2017-06-01

    The aerial roots (aer) mutant of tomato is characterized by a profuse and precocious formation of adventitious root primordia along the stem. We demonstrated that auxin is involved in the aer phenotype but ruled out higher auxin sensitivity of mutant plants. Interestingly, polar auxin transport was altered in aer, as young seedlings showed a reduced response to an auxin transport inhibitor and higher expression of auxin export carriers SlPIN1 and SlPIN3. An abrupt reduction in transcripts of auxin efflux and influx genes in older aer hypocotyls caused a marked deceleration of auxin transport in more mature tissues. Indeed, in 20days old aer plants, the transport of labeled IAA was faster in apices than in hypocotyls, displaying an opposite trend in comparison to a wild type. In addition, auxin transport facilitators (SlPIN1, SlPIN4, SlLAX5) were more expressed in aer apices than in hypocotyls, suggesting that auxin moves faster from the upper to the lower part of the stem. Consequently, a significantly higher level of free and conjugated IAA was found at the base of aer stems with respect to their apices. This auxin accumulation is likely the cause of the aer phenotype. Copyright © 2017 Elsevier GmbH. All rights reserved.

  7. 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).

  8. Syndromic (phenotypic diarrhea in early infancy

    Directory of Open Access Journals (Sweden)

    Bodemer Christine

    2008-02-01

    Full Text Available Abstract Syndromic diarrhea (SD, also known as phenotypic diarrhea (PD or tricho-hepato-enteric syndrome (THE, is a congenital enteropathy presenting with early-onset of severe diarrhea requiring parenteral nutrition (PN. To date, no epidemiological data are available. The estimated prevalence is approximately 1/300,000–400,000 live births in Western Europe. Ethnic origin does not appear to be associated with SD. Infants are born small for gestational age and present with facial dysmorphism including prominent forehead and cheeks, broad nasal root and hypertelorism. Hairs are woolly, easily removed and poorly pigmented. Severe and persistent diarrhea starts within the first 6 months of life (≤ 1 month in most cases and is accompanied by severe malabsorption leading to early and relentless protein energy malnutrition with failure to thrive. Liver disease affects about half of patients with extensive fibrosis or cirrhosis. There is currently no specific biochemical profile, though a functional T-cell immune deficiency with defective antibody production was reported. Microscopic analysis of the hair show twisted hair (pili torti, aniso- and poilkilotrichosis, and trichorrhexis nodosa. Histopathological analysis of small intestine biopsy shows non-specific villous atrophy with low or no mononuclear cell infiltration of the lamina propria, and no specific histological abnormalities involving the epithelium. The etiology remains unknown. The frequent association of the disorder with parental consanguinity and/or affected siblings suggests a genetic origin with an autosomal recessive mode of transmission. Early management consists of total PN. Some infants have a rather milder phenotype with partial PN dependency or require only enteral feeding. Prognosis of this syndrome is poor, but most patients now survive, and about half of the patients may be weaned from PN at adolescence, but experience failure to thrive and final short stature. Disease name

  9. Persistent diarrhea in the returned traveler.

    Science.gov (United States)

    Thielman, N M; Guerrant, R L

    1998-06-01

    In conclusion, the causes of chronic diarrhea in the returned traveler are protean. Careful evaluation requires an understanding of where the traveler has been, when they were there, the type of diarrheal illness, medications taken, and knowledge of the patients' other medical problems. Protozoa, particularly G. lamblia, C. parvum, and C. cayatenensis, are among the more commonly identified agents. If the patient is immunocompromised, microsporidia and Isospora become more likely, and a prior history of antimicrobial use raises the possibility of C. difficile colitis. Occasionally helminths, which establish intimate contact with the intestinal mucosa, may also cause prolonged diarrhea. If these and other gastrointestinal insults, such as tropical sprue, small bowel overgrowth, lactose intolerance, and processes unrelated to travel are excluded by more invasive studies or clinical history, the patient can be reassured that idiopathic chronic diarrhea is usually self-limited.

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

    National Research Council Canada - National Science Library

    Shabbu Ahmadi bonakdar; Mahdieh Pouryazdanpanah; Zahra Ganie Far; Saba Ghazanfari; Abdolreza Norouzy

    2014-01-01

    ...`s reports standard enteral formula is inducing diarrhea. In this study our purpose is to evaluate the incidence of diarrhea in hospitalized patients with standard Enteral Nutrition (EN) formula intake...

  11. Location of food consumption and travelers' diarrhea.

    Science.gov (United States)

    Tjoa, W S; DuPont, H L; Sullivan, P; Pickering, L K; Holguin, A H; Olarte, J; Evans, D G; Evans, D J

    1977-07-01

    Daily food histories for one month were obtained in summer, 1975, from students attending a Mexican university to determine the influence of food consumption on the development and etiology of diarrhea. In newly-arrived students from the U.S. who ate half or more of their meals in the school cafeteria and public restaurants there were significant increases in diarrhea (p less than 0.005); shigella infection (p less than 0.05) and toxigenic E. coli infection (p less than 0.025) compared to the students eating a comparable number of meals in private homes. In the summer U.S. students there was also an association of diarrhea and eating from street vendors (p less than 0.05). In full-time U.S. students who had lived in Mexico a year or longer as well as in Latin American students a relationship between location of meals and occurrence of enteric disease was not apparent. High numbers of enteric bacteria were recovered from food from the school's cafeteria, public restaurants, street vendors and small grocery stores. Shigella were isolated from cooked and uncooked hamburger patties from the school cafeteria. Four shigella carriers were found among kitchen personnel at the school. This study demonstrates that food serves as a major vehicle through which travelers' diarrhea occurs.

  12. HIV/AIDS-associated opportunistic protozoal diarrhea.

    Science.gov (United States)

    Agholi, Mahmoud; Hatam, Gholam Reza; Motazedian, Mohammad Hossein

    2013-01-01

    Human immunodeficiency virus (HIV) infection has altered both the epidemiology and outcome of enteric opportunistic parasitic infections. This study was done to determine the prevalence and species/genotypes of intestinal coccidian and microsporidial infections among HIV/AIDS patients with diarrhea and/or a history of diarrhea alternately with an asymptomatic interval, and their association with CD4 T cell count. This cross-sectional study was done from May 2010 to May 2011 in Shiraz University of Medical Sciences, South of Iran. A blood sample was obtained from HIV-positive patients for a CD4 T cell count upon enrollment. Sociodemographic data and a history of diarrhea were collected by interviewing 356 consecutive participants (273 males and 83 females). Whenever possible more than a fecal sample was collected from all the participants and examined for parasites using direct, physiological saline solution ethyl acetate, an acid-fast trichrome stain, nested polymerase chain reaction, and sequencing techniques for the detection, confirmation, and genotyping of Cryptosporidium spp., Cyclospora cayetanensis, Isospora belli, and intestinal microsporidia (Enterocytozoon bieneusi). The most common opportunistic and nonopportunistic pathogens were Cryptosporidium spp. (C. parvum and C. andersoni), E. bieneusi, Giardia lamblia, Sarcocystis spp., and Blastocystis homonis affecting 34, 8, 23, 1, and 14 patients, respectively. C. cayetanensis, I. belli, Enterobius vermicularis, and Hymenolepis nana were observed in few patients. A CD4 count <200 cells/μl was significantly associated with the presence of opportunistic parasites and diarrhea (p<0.05). Opportunistic intestinal parasites should be suspected in any HIV/AIDS patient with chronic diarrhea. Tropical epidemic nonopportunistic enteric parasitic infections among such patients should not be neglected in Iran.

  13. Microscopic colitis in children with chronic diarrhea.

    Science.gov (United States)

    Singh, Prashant; Das, Prasenjit; Jain, A K; Mathan, Minnie; Mathur, Meera; Bhat, Abdus Sami; Varma, Sharat; Chaturvedi, Mona K; Gupta, Siddhartha Datta; Bhatnagar, Shinjini

    2013-08-01

    The aim of the present study was to study microscopic colitis (MC) in children with special reference to its role in chronic diarrhea and changes in mucosal biopsies. A total of 100 consecutive children ages 3 to 12 years, with nonbloody diarrhea (passage of ≥3 loose stools per day) of >12 weeks' duration were screened and 26 were enrolled in the study in which no specific etiology could be found and colonoscopy did not reveal any mucosal abnormality. Colonic biopsies were evaluated for the presence of lymphocytic colitis or collagenous colitis and those with the characteristic changes were defined to have MC (group A). Colonic biopsies from patients with MC were compared with biopsies from patients with chronic diarrhea but no evidence of MC (group B). One hundred children ages 3 to 12 years with bleeding per rectum were screened and colonic biopsies from 45 patients (group C) who had colonic mucosal changes but no vascular or polyp lesion were compared with patients with MC. Of the 26 patients with chronic diarrhea, MC was found in 5 (3 lymphocytic colitis and 2 collagenous colitis). Significantly higher polymorphonuclear infiltration was seen in group A as compared with group B (13.8 [5.4-20.6] vs 7.2 [0-19.6]; P = 0.03) or group C (13.8 [5.4-20.6] vs 4 [0-13.4]; P = 0.007). Intraepithelial lymphocytes (12 [4-32] vs 4 [0-24]; P = 0.008) and basement membrane thickening (3.5 [2.9-10.6] vs 2.5 [1.6-5.86]; P = 0.008) were also significantly higher in group A as compared with group C. MC was found to be present in children with nonbloody chronic diarrhea in children. Further multicentric studies may provide adequate data on its prevalence.

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

    Science.gov (United States)

    ... a diet of clear liquids, such as water, apple juice, clear broth and ice pops. Avoid milk products, as lactose intolerance may be part of your diarrhea. When you have diarrhea, you may need to drink eight to 12 cups of liquid a day. Eat low-fiber foods. As your diarrhea starts ...

  15. 9 CFR 113.311 - Bovine Virus Diarrhea Vaccine.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Bovine Virus Diarrhea Vaccine. 113.311... Virus Vaccines § 113.311 Bovine Virus Diarrhea Vaccine. Bovine Virus Diarrhea Vaccine shall be prepared..., and immunogenic shall be used for preparing the production seed virus for vaccine production. All...

  16. 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.

  17. Entamoeba moshkovskii is associated with diarrhea in infants and causes diarrhea and colitis in mice.

    Science.gov (United States)

    Shimokawa, Chikako; Kabir, Mamun; Taniuchi, Mami; Mondal, Dinesh; Kobayashi, Seiki; Ali, Ibne Karim M; Sobuz, Shihab U; Senba, Masachika; Houpt, Eric; Haque, Rashidul; Petri, William A; Hamano, Shinjiro

    2012-09-01

    Entamoeba moshkovskii is prevalent in developing countries and morphologically indistinguishable from pathogenic Entamoeba histolytica and nonpathogenic Entamoeba dispar. It is not known if E. moshkovskii is pathogenic. Mice were intracecally challenged with the trophozoites of each Entamoeba spp. to test the ability to cause diarrhea, and infants in Bangladesh were prospectively observed to see if newly acquired E. moshkovskii infection was associated with diarrhea. E. moshkovskii and E. histolytica caused diarrhea and weight loss in susceptible mice. E. dispar infected none of the mouse strains tested. In Mirpur, Dhaka, Bangladesh, E. moshkovskii, E. histolytica, and E. dispar were identified in 42 (2.95%), 66 (4.63%), and 5 (0.35%), respectively, of 1426 diarrheal episodes in 385 children followed prospectively from birth to one year of age. Diarrhea occurred temporally with acquisition of a new E. moshkovskii infection: in the 2 months preceding E. moshkvskii-associated diarrhea, 86% (36 of 42) of monthly surveillance stool samples were negative for E. moshkovskii. E. moshkovskii was found to be pathogenic in mice. In children, the acquisition of E. moshkovskii infection was associated with diarrhea. These data are consistent with E. moshkovskii causing disease, indicating that it is important to reexamine its pathogenicity.

  18. Eficácia do extrato aquoso de Azadiracta indica no controle de Boophilus microplus em bovino Effectiveness of Azadiracta indica watery extract on the control of bovine ticks Boophilus microplus

    Directory of Open Access Journals (Sweden)

    M. Valente

    2007-10-01

    Full Text Available This study was carried out with two groups of bovines naturally infected with Boophilus microplus. One group was treated every week during a month with Neem's watery extract and the other group was treated only once (at the test onset with amabectin pour-on. The results of the Kruskal-Wallis test showed no significant difference (P¹ day30] and age brackets (cowswatery extract was cheap and easy to prepare, even at farm and could replace amabectin in the control of Boophilus microplus in bovines.

  19. Does Dientamoeba fragilis cause diarrhea? A systematic review.

    Science.gov (United States)

    Wong, Zing-Wae; Faulder, Kate; Robinson, Joan L

    2018-02-05

    It remains controversial whether Dientamoeba fragilis is a commensal parasite or a pathogen. The objective of this systematic review was to establish the strength of the evidence that Dientamoeba fragilis would cause diarrhea. A search was performed for studies that reported either the association between D. fragilis detection in stools and diarrhea or diarrhea outcomes with D. fragilis therapy or challenge. Data from seven studies of specific populations reported that 22% had D. fragilis in stools of which only 23% had diarrhea. Eleven studies of stool samples submitted to laboratories reported that 4.3% of individuals had D. fragilis of which 54% had diarrhea. Twelve studies reported that D. fragilis was detected from 1.6% of individuals with diarrhea and 9.6% of diarrheal stools. Five studies analyzed the prevalence of D. fragilis in individuals with and without diarrhea; the two with a statistically significant difference between groups had discordant results. The only cohort study with an appropriate control group reported diarrhea in a higher proportion of children with D. fragilis than in controls. No D. fragilis treatment studies included diarrhea as an outcome. There were only two challenge studies involving one person each. In conclusion, the evidence that D. fragilis would cause diarrhea or that treatment would hasten diarrhea resolution is inconclusive.

  20. Prescription patterns and appropriateness of antibiotics in the management of cough/cold and diarrhea in a rural tertiary care teaching hospital

    Directory of Open Access Journals (Sweden)

    Akram Ahmad

    2016-01-01

    Full Text Available Background: Acute gastroenteritis and respiratory illnesses are the major causes of morbidity and mortality in children under 5 years of age. The objective of this study was to evaluate the prescription pattern of antibiotic utilization during the treatment of cough/cold and/or diarrhea in pediatric patients. Methods: A descriptive, cross-sectional study was conducted for 6 months in pediatric units of a tertiary care hospital in South India. Children under 5 years of age presenting with illness related to diarrhea and/or cough/cold were included in this study. Data were collected by reviewing patient files and then assessed for its appropriateness against the criteria developed in view of the Medication Appropriateness Index and Guidelines of the Indian Academy of Pediatrics. The results were expressed in frequencies and percentages. Chi-square test was used to analyze the data. A P < 0.05 was considered statistically significant. Results: A total of 303 patients were studied during the study period. The mean age of the patients was 3.5 ± 0.6 years. The majority of children were admitted mainly due to chief complaint of fever (63% and cough and cold (56.4%. The appropriateness of antibiotic prescriptions was higher in bloody and watery diarrhea (83.3% and 82.6%; P< 0.05. Cephalosporins (46.2% and penicillins (39.9% were the most commonly prescribed antibiotics, though the generic prescriptions of these drugs were the lowest (13.5% and 10%, respectively. The seniority of prescriber was significantly associated with the appropriateness of prescriptions (P < 0.05. Antibiotics prescription was higher in cold/cough and diarrhea (93.5% in comparison to cough/cold (85% or diarrhea (75% alone. Conclusions: The study observed high rates of antibiotic utilization in Chidambaram during the treatment of cough/cold and/or diarrhea in pediatric patients. The findings highlight the need for combined interventions using education and expert counseling

  1. Ancylostoma ceylanicum hookworm infection in Japanese traveler who presented chronic diarrhea after return from Lao People's Democratic Republic.

    Science.gov (United States)

    Kaya, Daisuke; Yoshikawa, Masahide; Nakatani, Toshiya; Tomo-Oka, Fumimasa; Fujimoto, Yuki; Ishida, Koji; Fujinaga, Yukihisa; Aihara, Yosuke; Nagamatsu, Shinsaku; Matsuo, Eijo; Tokoro, Masaharu; Ouji, Yukiteru; Kikuchi, Eiryo

    2016-12-01

    Ancylostoma (A.) ceylanicum, one of the most common species of hookworms infecting dogs and cats, also causes patent infections in humans and is now considered to be the second most common hookworm species infecting populations in southeast Asia. A Japanese patient who returned from a visit to Thailand and Lao People's Democratic Republic (PDR) was presented with intermittent watery diarrhea with eosinophilia. Hookworm eggs were found in feces samples, and adult worms were confirmed to be present in the jejunum with capsule endoscopy and double balloon enteroscopy. A diagnosis of A. ceylanicum infection was made based on the morphology of the adult worms along with findings of a PCR-based molecular study using larvae obtained from a fecal sample culture. The infection was considered likely to have been obtained during a 1-month stay in a Laotian village, where the patient had eaten local food, worn sandals on bare feet, and lived as a local native villager, though he had stayed in modern hotels during the visit to Thailand. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Probiotics for Prevention and Treatment of Diarrhea.

    Science.gov (United States)

    Guarino, Alfredo; Guandalini, Stefano; Lo Vecchio, Andrea

    2015-01-01

    Probiotics are increasingly used for prevention and treatment of diarrhea more in children than in adults. Given the broad spectrum of diarrhea, this review focuses on the main etiologies: acute gastroenteritis, antibiotic-associated diarrhea (AAD), and necrotizing enterocolitis (NEC). For each, we reviewed randomized controlled trials, meta-analyses, and guidelines. For acute gastroenteritis we found 12 guidelines: 5 recommended probiotics and 7 did not. However, the guidelines containing positive recommendations provided proof of evidence from clinical trials and meta-analyses. Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii had the most compelling evidence of efficacy as they reduced the duration of the disease by 1 day. For AAD 4 meta-analyses were found, reporting variable efficacy of probiotics in preventing diarrhea, based on the setting, patient's age, and antibiotics. The most effective strains were LGG and S. boulardii. For NEC, we found 3 randomized controlled trials, 5 meta-analyses, and 4 position papers. Probiotics reduced the risk of NEC enterocolitis and mortality in preterm babies. Guidelines did not support a routine use of probiotics and asked for further data for such sensitive implications. In conclusion, there is strong and solid proof of efficacy of probiotics as active treatment of gastroenteritis in addition to rehydration. There is solid evidence that probiotics have some efficacy in prevention of AAD, but the number needed to treat is an issue. For both etiologies LGG and S. boulardii have the strongest evidence. In NEC the indications are more debated, yet on the basis of available data and their implications, probiotics should be carefully considered.

  3. Antibiotic Resistance in Children with Bloody Diarrhea

    OpenAIRE

    Hamedi Abdolkarim

    2009-01-01

    Shigellosis is an important public health problem, especially in developing countries. Antibiotic treatment of bacterial dysentery, aimed at resolving diarrhea or reducing its duration is especially indicated whenever malnutrition is present. First-line drugs include ampicillin and trimethoprim sulfamethoxazole(TMP-SMX); however multidrug-resistance has occurred and careful antibiotic selection must be considered in prescribing .When epidemiologic data indicate a rise in resistancy, fluoroqui...

  4. Diarrhea after bariatric procedures: Diagnosis and therapy.

    Science.gov (United States)

    Borbély, Yves M; Osterwalder, Alice; Kröll, Dino; Nett, Philipp C; Inglin, Roman A

    2017-07-14

    Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future. A multitude of factors exert their influence on bowel habits; preoperative comorbidities and procedure-related aspects are intertwined with postoperative nutritional habits. Diagnosis may be challenging owing to the characteristics of post-bariatric surgery anatomy with hindered accessibility of excluded segments of the small bowel and restriction at the gastric level. Conventional testing measures, if available, generally yield low accuracy and are usually not validated in this specific population. Limited trials of empiric treatment are a practical alternative and oftentimes an indispensable part of the diagnostic process. This review provides an overview of causes for chronic post-bariatric surgery diarrhea and details the particularities of its diagnosis and treatment in this specific patient population. Topics of current interest such as the impact of gut microbiota and the influence of bile acids on morbid obesity and especially their role in diarrhea are highlighted in order to provide a better understanding of the specific problems and chances of future treatment in post-bariatric surgery patients.

  5. Rota virus Diarrhea in Hospitalized Children.

    Science.gov (United States)

    Habib, Muhammad Irfan; Kazi, Sayyeda Ghazala; Ahmed Khan, Khalid Mehmood; Zia, Nukhba

    2014-02-01

    To determine the frequency and clinical features of Rota virus diarrhea in children presenting in a tertiary care hospital. A cross-sectional, observational study. National Institute of Child Health, Karachi, from January to June 2007. A total of three hundred children of either gender aged 1 month to 5 years, who presented with diarrhea of Rota virus in stool was done by enzyme linked immunoassay. Out of 300 children, 188 (63%) tested positive and 112 (37%) tested negative for Rota virus. Positive Rota virus cases in 7 - 12 months of age was (n = 34, 18.08%). Overall, 151 (80.3%) children with Rota virus were less than 3 years old. 182 (60.7%) had fever, 118 (39.3%) had vomiting and 156 (82.9%) children had both fever and vomiting. This study shows that Rota virus is a common organism causing diarrhea in children less than 3 years of age. There is a need to incorporate Rota virus vaccine in the national EPI program to decrease the disease burden as highlighted in this study.

  6. Diarrhea at the Hajj and Umrah.

    Science.gov (United States)

    Gautret, Philippe; Benkouiten, Samir; Sridhar, Shruti; Al-Tawfiq, Jaffar A; Memish, Ziad A

    2015-01-01

    This systematic review aims to summarize the incidence and etiology of diarrheal illness among pilgrims attending the Hajj and Umrah. Gastroenteritis and diarrhea have been potential threats during previous Hajj pilgrimages. The last cases of Hajj related cholera were reported in 1989. Currently, respiratory tract infections account for the majority of health problems during the Hajj. This shift in epidemiology reflects the improvement of sanitary conditions in Saudi Arabia in general, and at religious sites in particular. Nevertheless, gastrointestinal diseases, food-poisoning outbreaks, and diarrhea continue to occur among pilgrims. Available studies about diarrhea among Hajj pilgrims indicate a mean prevalence of 2% with the highest prevalence of 23% among a group of French pilgrims in 2013. There is an obvious lack of information about the etiology of diarrheal disease at the Hajj. Further studies addressing this issue in hospitalized patients as well as prospective cohort studies would be of interest. During the Hajj, hand washing is regularly carried out by pilgrims under a ritual purification, often called ablution. We recommend implementation of effective hand hygiene practices focusing on the regular use of alcohol-based hand rubs, as they require less time than traditional hand washing, act more rapidly, and contribute to sustained improvement in compliance associated with decreased infection rates. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Antibiotic Resistance in Children with Bloody Diarrhea

    Directory of Open Access Journals (Sweden)

    Hamedi Abdolkarim

    2009-05-01

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

  8. Fecal calprotectin concentrations in adult dogs with chronic diarrhea.

    Science.gov (United States)

    Grellet, Aurélien; Heilmann, Romy M; Lecoindre, Patrick; Feugier, Alexandre; Day, Michael J; Peeters, Dominique; Freiche, Valérie; Hernandez, Juan; Grandjean, Dominique; Suchodolski, Jan S; Steiner, Jorg M

    2013-05-01

    To evaluate fecal calprotectin concentrations in healthy dogs and dogs with chronic diarrhea, to identify cutoff values for fecal calprotectin concentrations for use in differentiating dogs with chronic diarrhea and a canine chronic enteropathy clinical activity index (CCECAI) chronic diarrhea and a CCECAI ≥ 12, and to evaluate the association between histologic evidence of intestinal mucosal changes and fecal calprotectin concentrations in dogs with chronic diarrhea. Fecal samples from 96 adult dogs (27 dogs with chronic diarrhea and 69 healthy control dogs). Severity of clinical signs was evaluated on the basis of the CCECAI scoring system. Endoscopy was performed in all dogs with chronic diarrhea, and mucosal biopsy specimens were evaluated histologically. Fecal calprotectin concentration was quantified via radioimmunoassay. Fecal calprotectin concentrations were significantly higher in dogs with chronic diarrhea than in healthy control dogs. Fecal calprotectin concentrations were also significantly higher in dogs with a CCECAI ≥ 12, compared with concentrations for dogs with a CCECAI between 4 and 11. Fecal calprotectin concentrations were significantly higher in dogs with chronic diarrhea associated with histologic lesions, compared with concentrations in control dogs, and were significantly correlated with the severity of histologic intestinal lesions. Among dogs with chronic diarrhea, the best cutoff fecal calprotectin concentration for predicting a CCECAI ≥ 12 was 48.9 μg/g (sensitivity, 53.3%; specificity, 91.7%). Fecal calprotectin may be a useful biomarker in dogs with chronic diarrhea, especially dogs with histologic lesions.

  9. Hypoalbuminemia as a predictor of diarrhea caused by blastocystis hominis.

    Science.gov (United States)

    Laodim, Pongsakorn; Intapan, Pewpan M; Sawanyawisuth, Kittisak; Prasongdee, Thidarat K; Laummaunwai, Porntip; Maleewong, Wanchai

    2013-05-01

    Blastocystis hominis is an intestinal protozoan found worldwide, particularly in developing countries, that may cause gastrointestinal symptoms, including diarrhea. We conducted a hospital-based study to identify clinical factors predictive of diarrhea caused by B. hominis. We studied patients with positive stool samples for B. hominis by formalin ethyl acetate concentration technique at Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand between 2003 and 2010. Patients were divided into diarrhea and non-diarrhea groups. Diarrhea patients were categorized if the diarrhea was associated with B. hominis only. In total, 81 patients with isolated B. hominis infection were studied. Of those, 17 patients (21%) had diarrhea associated with B. hominis infection. Eight variables were included in the final model predicting diarrhea caused by B. hominis on multiple logistic regression analysis. Only serum albumin level was significantly associated with diarrhea cases in this study with an adjusted OR of 0.162 and a 95% CI of 0.027- 0.957. Hypoalbuminemia is associated with diarrhea associated with blastocystosis.

  10. Molecular epidemiology of rotavirus in children and animals and characterization of an unusual G10P[15] strain associated with bovine diarrhea in south India.

    Science.gov (United States)

    Rajendran, Priya; Kang, Gagandeep

    2014-08-11

    Rotaviruses are enteric pathogens causing acute, watery, dehydrating diarrhea in various host species, including birds and mammals. This study collected data on the disease burden and strain prevalence of Group A rotavirus in animals and humans in Vellore and investigated interspecies transmission by comparison of circulating genotypes. Stool samples from children aged less than 5 years, admitted to the hospital between January 2003 and May 2006 for diarrhea and diarrheal samples from animals that were collected from a veterinary clinic and several dairy farms near Vellore between February 2007 and May 2008 were processed and subjected to RNA extraction and reverse-transcription PCR for genotyping of VP7 and VP4. Of 394 children with diarrhea, 158 (40%) were positive for rotavirus and the common G types identified were G1 (47, 29.7%), G2 (43, 27.2%), G9 (22, 13.9%), G10 (2, 1.2%), G12 (1, 0.6%) and mixed infections (27, 17.8%). The common P types were P[4] accounting for 57 (36%) samples, P[8] 57 (36%), P[11] 3 (1.8%) and P[6] 2 (1.2%). Of 627 animals, 35 (1 bullock, 2 goats, 32 cows) were found to be infected with rotavirus (5.5%). The common G types identified in order of frequency were G6 (17, 48.5%), G2 (10, 28%), G10 (4, 11%), G8 (2, 5.7%) and mixed infections (2, 5.7%). The common P types were P[6] accounting for 16 (46%) samples, P[4] 7 (20%), P[1] 3 (8.5%) and P[8] 3 (8.5%). An unusual P type P[15] was seen in one sample in combination with G10. The finding of G2 infections which are rarely identified in animals implies anthroponotic transmission since this genotype is predominantly associated with infection in humans. Copyright © 2014. Published by Elsevier Ltd.

  11. Syndromic diarrhea/Tricho-hepato-enteric syndrome

    Science.gov (United States)

    2013-01-01

    Abstract Syndromic diarrhea/Tricho-hepato-enteric syndrome (SD/THE) is a rare and severe bowel disorder caused by mutation in SKIV2L or in TTC37, 2 genes encoding subunits of the putative human SKI complex. The estimated prevalence is 1/1,000,000 births and the transmission is autosomal recessive. The classical form is characterized by 5 clinical signs: intractable diarrhea of infancy beginning in the first month of life, usually leading to failure to thrive and requiring parenteral nutrition; facial dysmorphism characterised by prominent forehead and cheeks, broad nasal root and hypertelorism; hair abnormalities described as woolly and easily removable; immune disorders resulting from defective antibody production; intrauterine growth restriction. The aetiology is a defect in TTC37, a TPR containing protein, or in the RNA helicase SKIV2L, both constituting the putative human ski complex. The ski complex is a heterotetrameric cofactor of the cytoplasmic RNA exosome which ensures aberrants mRNAs decay. The diagnosis SD/THE is initially based on clinical findings and confirmed by direct sequencing of TTC37 and SKIV2L. Differential diagnosis with the other causes of intractable diarrhea is easily performed by pathologic investigations. During their clinical course, most of the children require parenteral nutrition and often immunoglobulin supplementation. With time, some of them can be weaned off parenteral nutrition and immunoglobulin supplementation. The prognosis depends on the management and is largely related to the occurrence of parenteral nutrition complications or infections. Even with optimal management, most of the children seem to experience failure to thrive and final short stature. Mild mental retardation is observed in half of the cases. Abstract in French Les diarrhées syndromiques ou syndrome tricho-hepato-enterique (SD/THE) sont un syndrome rare et sévère dont l’incidence est estimée à 1 cas pour 1 million de naissances et la transmission

  12. Syndromic diarrhea/Tricho-hepato-enteric syndrome

    Directory of Open Access Journals (Sweden)

    Fabre Alexandre

    2013-01-01

    Full Text Available Abstract Syndromic diarrhea/Tricho-hepato-enteric syndrome (SD/THE is a rare and severe bowel disorder caused by mutation in SKIV2L or in TTC37, 2 genes encoding subunits of the putative human SKI complex. The estimated prevalence is 1/1,000,000 births and the transmission is autosomal recessive. The classical form is characterized by 5 clinical signs: intractable diarrhea of infancy beginning in the first month of life, usually leading to failure to thrive and requiring parenteral nutrition; facial dysmorphism characterised by prominent forehead and cheeks, broad nasal root and hypertelorism; hair abnormalities described as woolly and easily removable; immune disorders resulting from defective antibody production; intrauterine growth restriction. The aetiology is a defect in TTC37, a TPR containing protein, or in the RNA helicase SKIV2L, both constituting the putative human ski complex. The ski complex is a heterotetrameric cofactor of the cytoplasmic RNA exosome which ensures aberrants mRNAs decay. The diagnosis SD/THE is initially based on clinical findings and confirmed by direct sequencing of TTC37 and SKIV2L. Differential diagnosis with the other causes of intractable diarrhea is easily performed by pathologic investigations. During their clinical course, most of the children require parenteral nutrition and often immunoglobulin supplementation. With time, some of them can be weaned off parenteral nutrition and immunoglobulin supplementation. The prognosis depends on the management and is largely related to the occurrence of parenteral nutrition complications or infections. Even with optimal management, most of the children seem to experience failure to thrive and final short stature. Mild mental retardation is observed in half of the cases. Abstract in French Les diarrhées syndromiques ou syndrome tricho-hepato-enterique (SD/THE sont un syndrome rare et sévère dont l’incidence est estimée à 1 cas pour 1 million de naissances et la

  13. [Efficacy of nutrition support therapy in children with chronic diarrhea].

    Science.gov (United States)

    Xu, Luo-Jia; Chen, Jie

    2016-06-01

    To investigate the efficacy of nutrition support therapy in children with chronic diarrhea. A retrospective analysis was performed for the clinical data of 48 children with chronic diarrhea who were hospitalized between July 2012 and July 2014. These children were divided into chronic diarrhea, and 24 children (50%) had unknown causes. In the aspect of nutritional assessment on admission, the diarrhea were relieved after treatment. Among 27 children receiving nutritional therapy, 4 were not improved, and the other children achieved remission of symptoms and improvements in nutritional status. Besides etiological treatment, nutrition support therapy can be applied as part of multimodality therapy in children with chronic diarrhea. This can effectively improve nutritional status and relieve the symptoms of diarrhea.

  14. 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.

  15. Surveillance of Rotavirus Diarrhea in Hasan Sadikin Hospital Bandung

    OpenAIRE

    Dwi Prasetyo; Iesje Martiza; Yati Soenarto

    2010-01-01

    The diarrhea morbidity in Indonesia has increased, however, all the reports had not been done carefully, so that accurate surveillance are essential for improving quality of morbidity data. To determine the prevalence and clinical manifestations of rotavirus diarrhea and to characterize the circulating rotavirus strains, children below 5 years old who were admitted to Hasan Sadikin Hospital, Bandung because of diarrhea, from January 2006 through March 2007 were enrolled in a surveillance stud...

  16. Cow’s milk allergy in patients with diarrhea

    OpenAIRE

    Nanis S Marzuki; Arwin AP Akib; I Boediman

    2016-01-01

    Background Cow’s milk allergy (CMA) might be one of the causes of diarrhea in children. Previous prospective studies found the prevalence of CMA in children aged 0-3 years between 1.1-5.2%, but data about the prevalence of CMA in children with diarrhea was very limited. Objective This study intended to estimate the prevalence of CMA in children with diarrhea. Methods Children aged 0-3 years, who came with diarrhea and consumed milk formula were selected for further eva...

  17. 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

    2014-10-01

    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. 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. 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. 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.

  18. Impact of Diarrhea on the Clinical Presentation and Outcome of Severe Pneumonia in Bangladeshi Children.

    Science.gov (United States)

    Chisti, Mohammod Jobayer; Duke, Trevor; Salam, Mohammed Abdus; Shahunja, K M; Shahid, Abu S M S B; Bardhan, Pradip Kumar; Faruque, Abu S G; Ahmed, Tahmeed

    2016-10-01

    We compared clinical presentation and outcome of 225 children with severe pneumonia between those with and those without diarrhea. Having diarrhea was associated with metabolic acidosis (P diarrhea versus 3/112 (3%) without diarrhea. Diarrhea is an important comorbidity in Bangladeshi children with severe pneumonia requiring attention for improved case management.

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

    Science.gov (United States)

    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.

  20. Predictors of under-five childhood diarrhea: Mecha District, West ...

    African Journals Online (AJOL)

    admin

    regression analyses were undertaken to identify predictors of childhood diarrhea. Results: The ... Maternal education (AOR=5.6, 95% CI: 1.5 - 19.4), maternal history of recent diarrhea (AOR, 5.5; 95% CI, 2.9 - 9.8), ..... compared to early rainy season, and a limitation to the ... health in Mexico Demographic and Health Survey.

  1. Overview of the causes of chronic diarrhea in children

    Science.gov (United States)

    The major causes and the prevalence of chronic diarrhea differ between developed and developing countries. In the developing world, chronic diarrhea is typically associated with serial enteric infections and malnutrition; it is manifested by a chronic enteropathy, with impaired mucosal healing, and ...

  2. [Chronic diarrhea in the diabetic. A review of the literature].

    Science.gov (United States)

    Frías Ordoñez, Juan Sebastián; Otero Regino, William

    2016-01-01

    The association of diarrhea with diabetes mellitus has been known for more than 70 years. In diabetic patients its prevalence is around 20%.Its clinical manifestations are diverse, and represents a diagnostic and therapeutic challenge.There are certain diagnoses of higher prevalence in diabetic patients than in the general population.The different related etiologies can be adequately diagnosed through the clinical history and complementary diagnostic tests.The medications used by the diabetic patient to manage their disease often cause chronic diarrhea, so the pharmacological background should be studied at the time of the study of diarrhea.Diabetic patients can present other associated pathological conditions, such as celiac disease or microscopic colitis, which only discomfort is diarrhea.Exocrine pancreatic function may be decreased in the diabetic patient, frequently leading to exocrine pancreatic insufficiency. Dietary factors, such as sugar-free sweeteners and other agents, can cause diarrhea in the diabetic patient.The presence of conditions such as autonomic neuropathy and peripheral neuropathy secondary to diabetes mellitus may explain disorders such as anorectal dysfunction and faecal incontinence. Finally, diabetic enteropathy alone or with associated bacterial overgrowth can cause diarrhea.Achieving adequate glycemic control is the pillar of the treatment of diarrhea in the diabetic, after which there are additional measures that are applied according to the specific context of the patient.This article reviews the causes of higher diarrhea incidence in the diabetic patient and the pathophysiological mechanisms involved.

  3. Maternal Education and Diarrhea among Children aged 0-24 ...

    African Journals Online (AJOL)

    USER

    Chronic diarrhea can affect children of any age but its occurrence varies across childhood period. In this study, children aged between 7 and. 18 months were found to experience higher occurrence of diarrhea than those below 7 months and those above 18 months. This pattern could be explained that this age range is the ...

  4. Myths, experiences and home management of childhood diarrhea ...

    African Journals Online (AJOL)

    Background: Diarrhea is a major threat to child survival due to its devastating complication of dehydration. Several home remedies inclusive of oral rehydration therapy have benefited many people. This study assessed nursing mothers' knowledge and experiences of home management of childhood diarrhea. Methodology: ...

  5. Diarrhea after laparoscopic cholecystectomy: Associated factors and predictors

    Directory of Open Access Journals (Sweden)

    Tuan-Pin Yueh

    2014-10-01

    Conclusion: We advise patients who have undergone laparoscopic cholecystectomy to follow a low-fat diet for at least 1 week to reduce the possibility of diarrhea, especially when they are ≤45 years of age, of male sex, and had a high preoperative tendency for diarrhea.

  6. Recurrent diarrhea associated with enterotoxigenic Clostridium perfringens in 2 dogs.

    OpenAIRE

    Weese, J. S.; Greenwood, S J; Staempfli, H.R.

    2001-01-01

    Two dogs were diagnosed with enterotoxigenic Clostridium perfringens-associated diarrhea. Diarrhea was responsive to antimicrobial therapy, but recurred after treatment was ceased. Clostridium perfringens enterotoxin was present in feces during diarrheic episodes but not when feces were normal. Both dogs responded to a prolonged course of oral cephalexin and dietary modification.

  7. Incomplete carbohydrate absorption from fruit juice consumption after acute diarrhea

    OpenAIRE

    Ribeiro Jr, Hugo; Ribeiro, Tereza Cristina; Valois, Sandra; Mattos, Angela; Lifshitz, Fima

    2001-01-01

    Texto completo: acesso restrito. p. 325–327 We carried out a double-blind, randomized study in 60 children with acute diarrhea to determine their capacity to tolerate commonly consumed fruit juices. Feedings of juice with high fructose/glucose ratios and sorbitol resulted in incomplete carbohydrate absorption and recurrence of diarrhea during the phase immediately after improvement of the illness.

  8. Breastfeeding and the risk for diarrhea morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Victora Cesar

    2011-04-01

    Full Text Available Abstract Background Lack of exclusive breastfeeding among infants 0-5 months of age and no breastfeeding among children 6-23 months of age are associated with increased diarrhea morbidity and mortality in developing countries. We estimate the protective effects conferred by varying levels of breastfeeding exposure against diarrhea incidence, diarrhea prevalence, diarrhea mortality, all-cause mortality, and hospitalization for diarrhea illness. Methods We systematically reviewed all literature published from 1980 to 2009 assessing levels of suboptimal breastfeeding as a risk factor for selected diarrhea morbidity and mortality outcomes. We conducted random effects meta-analyses to generate pooled relative risks by outcome and age category. Results We found a large body of evidence for the protective effects of breastfeeding against diarrhea incidence, prevalence, hospitalizations, diarrhea mortality, and all-cause mortality. The results of random effects meta-analyses of eighteen included studies indicated varying degrees of protection across levels of breastfeeding exposure with the greatest protection conferred by exclusive breastfeeding among infants 0-5 months of age and by any breastfeeding among infants and young children 6-23 months of age. Specifically, not breastfeeding resulted in an excess risk of diarrhea mortality in comparison to exclusive breastfeeding among infants 0-5 months of age (RR: 10.52 and to any breastfeeding among children aged 6-23 months (RR: 2.18. Conclusions Our findings support the current WHO recommendation for exclusive breastfeeding during the first 6 months of life as a key child survival intervention. Our findings also highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and mortality throughout the first 2 years of life.

  9. Does Childhood Diarrhea Influence Cognition Beyond the Diarrhea-Stunting Pathway?

    Science.gov (United States)

    2012-10-31

    1969–1987. 2. Guerrant RL, Oria RB, Moore SR, Oria MO, Lima AA (2008) Malnutrition as an enteric infectious disease with long-term effects on child ... Child Health Epidemiology Reference Group (CHERG). The participation of Dr. Lescano in this project is sponsored by the training grant NIH/FIC 2D43...of morbidity and mortality among children under 5 years of age in low- and middle-income countries [1]. While the most severe diarrhea sequela, child

  10. Chronic Diarrhea Associated with High Teriflunomide Blood Concentration.

    Science.gov (United States)

    Duquette, André; Frenette, Anne Julie; Doré, Maxime

    2016-06-01

    To report the case of a patient treated with leflunomide that presented with chronic diarrhea associated with high teriflunomide blood concentration. An 84-year-old woman taking leflunomide 20 mg once daily for the past 2 years to treat rheumatoid arthritis (RA) was investigated for severe chronic diarrhea that had been worsening for the past 5 months. The patient's general condition progressively deteriorated and included electrolyte imbalances and a transient loss of consciousness. Therefore, hospitalization was required. Teriflunomide blood concentration was 156 mg/L. After 11 days of cholestyramine washout therapy, teriflunomide blood concentration was reduced to 6 mg/L. As the teriflunomide levels decreased, diarrhea improved. All other possible causes of diarrhea were ruled out. The patient's diarrhea finally resolved 26 days after treatment with cholestyramine. Diarrhea is a known adverse effect of leflunomide. In this report, the severe diarrhea was associated with high blood teriflunomide concentrations. Available data suggests an association between teriflunomide concentrations greater than 50 mg/L and lower disease activity, but toxic teriflunomide levels still have to be clarified. Further studies are needed to establish the optimal therapeutic levels of teriflunomide. However, therapeutic drug monitoring of teriflunomide blood concentrations may be helpful to improve effectiveness and to prevent toxicity in patients taking leflunomide for RA, particularly in those with suboptimal therapeutic response to leflunomide or in patients with toxicity suspected to be induced by leflunomide.

  11. Prevalence of diarrhea and enteropathogens in racing sled dogs.

    Science.gov (United States)

    McKenzie, E; Riehl, J; Banse, H; Kass, P H; Nelson, S; Marks, S L

    2010-01-01

    Diarrhea is highly prevalent in racing sled dogs, although the underlying causes are poorly understood. Clostridium perfringens enterotoxin (CPE) and Clostridium difficile Toxin A and B are associated with diarrhea in racing sled dogs. One hundred and thirty-five sled dogs. Freshly voided feces were obtained from 55 dogs before racing and from 80 dogs after 400 miles of racing. Samples were visually scored for diarrhea, mucus, blood, and melena. CPE and C. difficile Toxin A and B were detected by ELISA. Samples were cultured for C. perfringens, C. difficile, Campylobacter, Salmonella, and Escherichia coli O157; Giardia and Cryptosporidium spp. were detected via immunofluorescence. Diarrhea occurred in 36% of dogs during racing, and hematochezia, fecal mucus or melena, or all 3 occurred in 57.5% of dogs. Salmonella was isolated from 78.2% of dogs before racing, and from 71.3% of dogs during racing. C. perfringens and C. difficile were isolated from 100 and 58.2% of dogs before racing, and from 95 and 36.3% of dogs during racing. Dogs were more likely to test positive for CPE during than before racing (18.8 versus 5.5%, P = .021); however, no enteropathogens or their respective toxins were significantly associated with hematochezia or diarrhea. Sled dogs participating in long distance racing have a high prevalence of diarrhea and hematochezia that is not associated with common enteropathogens. It is possible that diarrhea and hematochezia represent the effect of prolonged exercise on the gastrointestinal tract.

  12. Burden of Rotavirus Diarrhea in Under five Indian Children.

    Science.gov (United States)

    Kumar, Ashok; Basu, Sriparna; Vashishtha, Vipin; Choudhury, Panna

    2016-07-08

    Rotavirus is the most common cause of severe diarrhea in infants and young children worldwide. The burden of rotavirus diarrhea in Indian children is not well established. The present study reviewed the epidemiology of rotavirus diarrhea in hospitalized children and in the community, molecular serotyping and under-five mortality caused by rotavirus diarrhea. Publications, reporting rotavirus diarrhea in Indian children, were retrieved through a systematic search of databases including Medline, PubMed, IndMed, websites of WHO, UNICEF, National Family Health Survey, Ministry of Health and Family Welfare, and Government of India. Human studies in English language were included. Age group selected was 0 month to 5 years. No restrictions were applied in terms of study design and time frame. Stool sample positivity varied from 4.6% in Kolkata to 89.8% in Manipur, among hospitalized children, and from 4% in Delhi to 33.7% in Manipur in community. Most cases of rotavirus diarrhea in India are caused by G1, G2, and G untypeable strains with distinct regional variations. Rotavirus was identified as an etiological agent in 5.2 to 80.5% cases of nosocomial diarrhea. Data are lacking for rotavirus mortality.

  13. Efficacy and safety of Saccharomyces boulardii for acute diarrhea.

    Science.gov (United States)

    Feizizadeh, Sahar; Salehi-Abargouei, Amin; Akbari, Vajihe

    2014-07-01

    The efficacy of Saccharomyces boulardii for treatment of childhood diarrhea remains unclear. Our objective was to systematically review data on the effect of S. boulardii on acute childhood diarrhea. Our data sources included Medline, Embase, CINAHL, Scopus, and The Cochrane Library up to September 2013 without language restrictions. Randomized controlled trials and non-randomized trials that evaluated effectiveness of S. boulardii for treatment of acute diarrhea in children were included. Two reviewers independently evaluated studies for eligibility and quality and extracted the data. In total, 1248 articles were identified, of which 22 met the inclusion criteria. Pooling data from trials showed that S. boulardii significantly reduced the duration of diarrhea (mean difference [MD], -19.7 hours; 95% confidence interval [CI], -26.05 to -13.34), stool frequency on day 2 (MD, -0.74; 95% CI, -1.38 to -0.10) and day 3 (MD, -1.24; 95% CI, -2.13 to -0.35), the risk for diarrhea on day 3 (risk ratio [RR], 0.41; 95% CI, 0.27 to 0.60) and day 4 (RR, 0.38; 95% CI, 0.24 to 0.59) after intervention compared with control. The studies included in this review were varied in the definition of diarrhea, the termination of diarrhea, inclusion and exclusion criteria, and their methodological quality. This review and meta-analysis show that S. boulardii is safe and has clear beneficial effects in children who have acute diarrhea. However, additional studies using head-to-head comparisons are needed to define the best dosage of S. boulardii for diarrhea with different causes. Copyright © 2014 by the American Academy of Pediatrics.

  14. Review of sangre de drago (Croton lechleri)--a South American tree sap in the treatment of diarrhea, inflammation, insect bites, viral infections, and wounds: traditional uses to clinical research.

    Science.gov (United States)

    Jones, Kenneth

    2003-12-01

    The objective of this review is to provide an overview of the pharmacologic evidence that may or may not support clinical and ethnomedical uses of the sap of sangre de drago (dragon's blood; Croton lechleri Müll. Arg.). Data sources used were BIOSIS, EMBASE, PubMed, TOXLIT, International Pharmaceutical Abstracts, manual searches, papers on file from peer-reviewed journals, textbooks available at Armana Research, Inc., and researchers in the field of South American botanical medicine. The results of in vitro and in vivo studies largely support the majority of ethnomedical uses of sangre de drago including the treatment of diarrhea, wounds, tumors, stomach ulcers, herpes infection, the itching, pain and swelling of insect bites, and other conditions. Clinical studies of sangre de drago products have reported positive results in the treatment of traveler's and watery diarrhea and the symptoms of insect bites. Because the sap has shown low toxicity and preparations used in clinical studies were well tolerated, further clinical and pharmacologic studies are anticipated. Acknowledgment of the diversity in the chemical makeup of the sap from one geographic area to another and the recent characterization of alkaloid chemotypes of sangre de drago will require that materials developed for clinical use are standardized.

  15. QUALITY OF LIFE IN CHILDREN WITH CHRONIC DIARRHEA

    Directory of Open Access Journals (Sweden)

    F.F. Zhvaniya

    2009-01-01

    Full Text Available The results of evaluation of quality of life in children from 1 to 3 years old with chronic diarrhea in exacerbation or remission with QUALIN questionnaire is presented in this article. Authors used two types of questionnaire: doctors' and parents'. Obtained data was compared to indices of healthy children. Proved, that children in early age with chronic diarrhea, as in exacerbation, as in remission, have significantly lower rates of quality of life compared to healthy coevals.Key words: children, quality of life, QUALIN questionnaire, chronic diarrhea.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:16-19

  16. Encephalitozoon intestinalis: A Rare Cause of Diarrhea in an Allogeneic Hematopoietic Stem Cell Transplantation (HSCT Recipient Complicated by Albendazole-Related Hepatotoxicity

    Directory of Open Access Journals (Sweden)

    Serdar Şıvgın

    2013-06-01

    Full Text Available A 50-year-old male patient previously diagnosed with acute myelomonocytic (M4 leukemia in July 2009 underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT. During the pre-transplant period complete blood count (CBC, liver and renal function tests, coagulation tests, and other parameters were normal. On the first day of transplantation teicoplanin (400 mg d–1 for the first 3 d, and then 400 mg d-1 and caspofungin (first dose was 1×70 mg d–1, followed by 1×50 mg d–1 were started intravenously due to white plaques and oropharyngeal candidiasis in the patient’s mouth and perianal erythema. On the 14th d of transplantation watery diarrhea occurred, along with abdominal discomfort, nausea, and fatigue. Stool examination was negative for findings of bleeding. Investigation of Microsporidia confirmed a rare pathogen Encephalitozoon intestinalis in the patient’s stool sample via species-specific immunofluorescence antibody (IFA assay and albendazole treatment was started at a dose of 2×400 mg d–1. On the 5th d of albendazole treatment (d 18 of treatment liver function test (LFT results began to deteriorate. As LFT results continued to deteriorate, albendazole was withdrawn on the 7th d of treatment. Biopsy was performed on the 22nd d of transplantation and histopathological analysis confirmed the diagnosis of toxic hepatitis. LFT results began to decrease after withdrawal of albendazole treatment. On the 13th d of albendazole treatment all LFT values returned to normal. The presented allo-HSCT case had a rare pathogenic agent (E. intestinalis that caused diarrhea, as well as hepatotoxicity due to albendazole treatment. This is the first reported case of E. intestinalis diagnosed via IFA in Turkey.

  17. Diarrhea in Critically Ill Patients: The Role of Enteral Feeding.

    Science.gov (United States)

    de Brito-Ashurst, Ione; Preiser, Jean-Charles

    2016-09-01

    This tutorial presents a systematic approach to the management of diarrhea in the critical care setting. Diarrhea is a common and prevalent problem in critically ill patients. Despite the high prevalence, its management is far from simple. Professionals are confronted with a myriad of definitions based on frequency, consistency, and volume. The causes are complex and multifactorial, yet enteral tube feeding formula is believed to be the perpetrator. Potential causes for diarrhea are discussed, and 3 case reports provide context to examine the treatment from a nutrition perspective. Each scenario is comprehensively addressed discussing potential causes and providing specific clinical strategies contributing to improved bowel function in this patient group. The approach used for diarrhea management is based on a complete understanding of enteral tube formula, their composition, and their impact in the presence of gut dysfunction. Choosing the right feeding formula may positively influence bowel function and contribute to improved nutrition. © 2016 American Society for Parenteral and Enteral Nutrition.

  18. [Travel diarrhea: attempt at a clinical-epidemiologic evaluation].

    Science.gov (United States)

    Kollaritsch, H; Kremsner, P G; Tobisch, P; Ambrosch, F; Stemberger, H

    1987-06-30

    Traveller's diarrhea is the most common tourist's disease in the tropics. Therefore epidemiological data for the evaluation of factors influencing the attack rates and the severity of the disease are being required. This paper deals with the data of 1058 Austrian tourists travelling to warm climate countries. 47.3% of all travellers suffered from an episode of traveller's diarrhea during their stay. However, it could be evaluated that besides the destination seasonal influences were very important. Factors like individual hygiene and accommodation did not influence the attack rates. Age and environmental conditions, however, did partially influence the frequency of diarrhea. Furthermore, additional symptoms were interpreted and it could be seen that suspected heterogenicity of etiology leads to a similar pattern of clinical symptoms. Clinical evaluation proves that traveller's diarrhea is commonly not severe, but due to the incidence and duration of the disease it is a major health problem in modern tourism.

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

    African Journals Online (AJOL)

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

  20. Rotavirus Disease Mechanisms Diarrhea, Vomiting and Inflammation : How and Why

    OpenAIRE

    Hagbom, Marie

    2015-01-01

    Rotavirus infections cause diarrhea and vomiting that can lead to severe dehydration. Despite extensive tissue damage and cell death, the inflammatory response is very limited. The focus of this thesis was to study pathophysiological mechanisms behind diarrhea and vomiting during rotavirus infection and also to investigate the mechanism behind the limited inflammatory response. An important discovery in this thesis was that rotavirus infection and the rotavirus toxin NSP4 stimulate release of...

  1. Digestive Disorders in Children with Antibiotic-Associated Diarrhea

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    O.A. Radutna

    2016-08-01

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

  2. Predictors of under-five childhood diarrhea: Mecha District, West ...

    African Journals Online (AJOL)

    Results: The prevalence of diarrhea among mothers and under-five children was 8.2% and 18.0%, respectively. Maternal education (AOR=5.6, 95% CI: 1.5 - 19.4), maternal history of recent diarrhea (AOR, 5.5; 95% CI, 2.9 - 9.8), availability of latrine facility (AOR, 1.9; 95% CI, 1.1-3.4), duration of breast feeding (AOR=2.7, ...

  3. The Prevalence of Norovirus in returning international travelers with diarrhea

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    Löscher Thomas

    2010-05-01

    Full Text Available Abstract Background There is a high incidence of diarrhea in traveling populations. Norovirus (NV infection is a common cause of diarrhea and is associated with 7% of all diarrhea related deaths in the US. However, data on the overall prevalence of NV infection in traveling populations is limited. Furthermore, the prevalence of NV amongst travelers returning to Europe has not been reported. This study determined the prevalence of NV among international travelers returning to Germany from over 50 destinations in and outside Europe. Methods Stool samples of a total of 104 patients with a recent ( Results In our cohort, NV infection was detected in 15.7% of returning travelers with diarrhea. The closer to the date of return symptoms appeared, the higher the incidence of NV, ranging as high as 21.2% within the first four days after return. Conclusions In our cohort, NV infection was shown to be frequent among returning travelers especially in those with diarrhea, with over 1/5 of diarrhea patients tested positive for NV within the first four days after their return to Germany. Due to this prevalence, routine testing for NV infection and hygienic precautions may be warranted in this group. This is especially applicable to patients at an increased risk of spreading the disease, such as healthcare workers, teachers or food-handlers.

  4. Diagnostic utility of abdominal ultrasonography in dogs with chronic diarrhea.

    Science.gov (United States)

    Leib, M S; Larson, M M; Grant, D C; Monroe, W E; Troy, G C; Panciera, D L; Rossmeisl, J H; Werre, S R

    2012-01-01

    Chronic diarrhea is common in dogs and has many causes. Ultrasonographic descriptions of many gastrointestinal diseases have been published, but the diagnostic utility of ultrasonography in dogs with chronic diarrhea has not been investigated. Diagnostic utility of abdominal ultrasound will be highest in dogs with GI neoplasia and lowest in those with inflammatory disorders. 87 pet dogs with chronic diarrhea. Prospective study in which medical records were reviewed and contribution of abdominal ultrasound toward making diagnosis was scored. In 57/87 (66%) of dogs, the same diagnosis would have been reached without ultrasonography. In 13/87 (15%) of dogs, the ultrasound examination was vital or beneficial to making the diagnosis. Univariable analysis identified that increased diagnostic utility was associated with weight loss (P = .0086), palpation of an abdominal or rectal mass (P = .0031), diseases that commonly have mass lesions visible on ultrasound examination (P diarrhea, were identified. Overall, the diagnostic utility of abdominal ultrasonography was low in dogs with chronic diarrhea. Identification of factors associated with high diagnostic utility is an indication to perform abdominal ultrasonography in dogs with chronic diarrhea. Copyright © 2012 by the American College of Veterinary Internal Medicine.

  5. [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. © Georg Thieme Verlag KG Stuttgart · New York.

  6. 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...

  7. Probiotics in the Treatment of Acute Diarrhea in Young Children

    Directory of Open Access Journals (Sweden)

    Toktam Moghiman

    2009-09-01

    Full Text Available Background: Well-controlled clinical studies in the developedworld have shown that probiotics can shorten the duration ofacute non-bacterial diarrhea. We aimed to evaluate the efficacyof a probiotic consisting of a mixture of Lactobacillus acidophilusand Bifidobacterium bifidum in the treatment of young childrenwith acute diarrhea in Mashad, IranMethods: Sixty-two hospital inpatients aged 6 to 36 monthswith acute non-bloody, non-bacterial diarrhea of a less than 2days' duration and moderate dehydration were enrolled.Thirty-two were treated with probiotic powder three timesdaily for 5 days plus the routine oral rehydration solution(study group and the other 30 were given a placebo plus oralrehydration solution (control group.Results: Mean age at the time of admission was 14.5±7months for the study group and 13.7±6 months for controls.The mean duration of diarrhea was 3.4 days in the study groupand 4.5 days in controls (P = 0.027. Duration of hospital admissionwas 2.1±0.7 days in the probiotic group comparedwith 2.7±0.6 days in the control group (P = 0.033. Averageweight gain was 425 ± 9 and 370 ± 85 g for the study and controlgroups, respectively. Average reduction in the frequencyof diarrhea per day was 4.4 ± 1.5 times for the study groupand 3.6 ± 1.3 times for the control group.Conclusion: Lactobacillus acidophilus and Bifidobacteriumbifidum shortened the duration of diarrhea and hospital stay,and normalized stool frequency. The use of probiotics mightbe recommended for treating acute diarrhea in young children.

  8. Efficacy and tolerability of racecadotril in acute diarrhea in children.

    Science.gov (United States)

    Cézard, J P; Duhamel, J F; Meyer, M; Pharaon, I; Bellaiche, M; Maurage, C; Ginies, J L; Vaillant, J M; Girardet, J P; Lamireau, T; Poujol, A; Morali, A; Sarles, J; Olives, J P; Whately-Smith, C; Audrain, S; Lecomte, J M

    2001-03-01

    Oral rehydration therapy is the only treatment recommended by the World Health Organization in acute diarrhea in children. Antisecretory drugs available could not be used because of their side effects, except for racecadotril, which is efficient in acute diarrhea in adults. The efficacy and tolerability of racecadotril (1.5 mg/kg administered orally 3 times daily) as adjuvant therapy to oral rehydration were compared with those of placebo in 172 infants aged 3 months to 4 years (mean age, 12.8 months) who had acute diarrhea. The treatment groups were comparable in terms of age, duration of diarrhea, number of stools, and causative microorganism at inclusion. During the first 48 hours of treatment, patients receiving racecadotril had a significantly lower stool output (grams per hour) than those receiving placebo. The 95% confidence interval was 43%-88% for the full data set (n = 166; P = 0.009) and 33%-75% for the per-protocol population (n = 116; P = 0.001). There was no difference between treatments depending on rotavirus status. Significant differences between treatment groups were also found after 24 hours of treatment: full data set (n = 167; P = 0.026) and per-protocol population (n = 121; P = 0.015). Tolerability was good in both groups of patients. This study demonstrates the efficacy (up to 50% reduction in stool output) and tolerability of racecadotril as adjuvant therapy to oral rehydration solution in the treatment of severe diarrhea in infants and children.

  9. [Popular perceptions about childhood diarrheas: diversity and unity].

    Science.gov (United States)

    Desclaux, A

    1998-02-01

    Sickness is defined by culture: each society has its own way of labelling, explaining and treating symptoms. In the case of childhood diarrhea, each population selects some signs and considers them as symptoms, defines a limit between normal and pathologic, arranges symptoms in order to build syndromes that make up a local nosology. Examples from Thailand, China, Algeria, Nicaragua and Burkina Faso show the diversity of popular beliefs about diarrhea. These beliefs depend upon the epidemiological context, but they do not reflect it exactly: thus in Burkina Faso, AIDS has not been integrated in popular beliefs about childhood diarrhea. The examples discussed in this article show how popular beliefs evolve, especially under the influence of biomedicine. Moreover, every individual understands differently the popular nosology according to his (or her) social status and to the level of his (her) knowledge. To the unity of biomedical knowledge responds a great diversity of popular beliefs. In France, contemporary popular beliefs about childhood diarrhea have been seldom studied by social sciences. They seem to be close to biomedical knowledge and share some essential elements with it, but they also show some features--such as the belief that diarrhea is benign when simultaneous to teething--that relate them to popular beliefs which have been described in other cultures. By describing and analysing these popular beliefs, medical anthropology makes it possible to adapt medicine to local knowledges.

  10. Cryptosporidiosis in patients with diarrhea and chronic liver diseases.

    Science.gov (United States)

    Mousa, Nasser; Abdel-Razik, Ahmed; El-Nahas, Hala; El-Shazly, Atef; Abdelaziz, Mohammad; Nabih, Marwa; Hamed, Magdy; Eissa, Mohammad; Effat, Narmin; Eldars, Walled

    2014-12-15

    The aim of this study was to evaluate the epidemiology and clinical significance of Cryptosporidium in patients with diarrhea and chronic liver diseases. The study included 150 patients with chronic liver diseases and diarrhea, and 50 subjects with diarrhea as a control group. Stool samples were screened for the presence of Cryptosporidium by microscopic examination after modified Ziehl-Neelsen staining and detection of Cryptosporidium coproantigen by enzyme-linked immunosorbent assay (ELISA). The prevalence of Cryptosporidium infection in patients with chronic liver diseases was 30% (45/150) versus 14% (7/50) in controls. Cryptosporidium infection increased with the progression of chronic liver diseases from Child-Pugh class A to Child-Pugh class C (p 9 (pdiarrhea associated with Cryptosporidium infection developed hepatic encephalopathy, and only diarrhea was identified as a precipitating factor for hepatic encephalopathy. Cryptosporidium is one of the important causes of diarrhea in patients with chronic liver diseases. The infection significantly increased with the progression of chronic liver diseases. In patients with advanced chronic liver diseases, Cryptosporidium infection may be a precipitating factor of hepatic encephalopathy.

  11. Surveillance of Rotavirus Diarrhea in Hasan Sadikin Hospital Bandung

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    Dwi Prasetyo

    2010-12-01

    Full Text Available The diarrhea morbidity in Indonesia has increased, however, all the reports had not been done carefully, so that accurate surveillance are essential for improving quality of morbidity data. To determine the prevalence and clinical manifestations of rotavirus diarrhea and to characterize the circulating rotavirus strains, children below 5 years old who were admitted to Hasan Sadikin Hospital, Bandung because of diarrhea, from January 2006 through March 2007 were enrolled in a surveillance study and had stool specimens tested for the presence of rotavirus using enzyme immunoassay (EIA. The strains of rotavirus were determined using reverse transcriptase-polymerase chain reaction (RT-PCR. Rotavirus were detected in 47.8% analyzed samples (87/184, G and P-genotype of rotavirus were G[1] (37.5% and P[6] (53.5%. Most subjects were males (56%, 6–11 months of age (35%. Most common clinical manifestations besides diarrhea were dehydration (72.7% and vomiting (50%. Subjects with positive rotavirus more common had dehydration (72% vs 28% and vomiting (61% vs 39%. In conclusion, vomiting and dehydration are the prominent clinical manifestations of diarrhea with positive rotavirus infection. G1 and P6 are the most common genotype of rotavirus.

  12. Diagnosis and Management of AIDS-related Diarrhea

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    John F Johanson

    1996-01-01

    Full Text Available The spectrum of illness associated with the acquired immunodeficiency syndrome (AIDS has been increasing since the initial description in 1981. While virtually all organ systems may be affected, the gastrointestinal tract appears to be a major target. Diarrhea is the most common symptom, affecting up to half of all AIDS patients during the course of their disease. Although diarrhea occurs frequently, its optimal management remains controversial. An extensive evaluation including stool studies and endoscopic biopsies of both the colon and small intestine has been widely recommended to identify all potential pathogenic organisms. An alternative approach is a more limited evaluation consisting of stool and blood cultures followed by symptomatic treatment with antidiarrheal agents if no specific organisms are identified. The clinical presentation of the most common opportunistic pathogens are reviewed, including several recently discovered organisms. Recommendations for treatment are followed by a brief discussion of management strategies used to care for patients with AIDS-related diarrhea.

  13. Epidemiology of travelers' diarrhea and relative importance of various pathogens.

    Science.gov (United States)

    Black, R E

    1990-01-01

    Each year 12 million persons travel from an industrialized country to a developing country in the tropics or subtropics. These travelers experience a high rate of diarrhea caused by a wide variety of enteric pathogens acquired by ingestion of contaminated food or water. One or more pathogens can be found in the stool of a majority of ill individuals. Enterotoxigenic Escherichia coli generally are the most frequently identified pathogens, having been found in a median of 42% of travelers' diarrheal episodes in studies in Latin America, 36% in Africa, and 16% in Asia. Other pathogens that cause diarrhea in a smaller fraction of ill travelers include Shigella species, Salmonella species, Campylobacter jejuni, Vibrio, Aeromonas hydrophila, Entamoeba histolytica, Giardia lamblia, rotavirus, and 27-nm viruses, including Norwalk virus. Other organisms that may cause a fraction of the episodes of travelers' diarrhea include Plesiomonas shigelloides, enteroadherent E. coli, adenovirus or other viruses, and Cryptosporidium. Mixed infections of two or more of these pathogens also occur.

  14. Detection of parasites in children with chronic diarrhea.

    Science.gov (United States)

    Maçin, Salih; Kaya, Filiz; Çağdaş, Deniz; Hizarcioglu-Gulsen, Hayriye; Saltik-Temizel, Inci Nur; Tezcan, İlhan; Demir, Hülya; Ergüven, Sibel; Akyön, Yakut

    2016-06-01

    The aim of this study was to investigate the frequency of intestinal parasites in patients with chronic diarrhea and clarify the importance of these parasitic pathogens in such cases. A total of 60 pediatric patients with chronic diarrhea between June 2012 and October 2014 were enrolled in the study. Out of 60 stool samples, five were positive for Giardia lamblia, two, Dientamoeba fragilis, and one, Blastocystis hominis. One stool sample was positive for Entamoeba hartmanni and B. hominis, another one was positive for G. lamblia and B. hominis, another, G. lamblia and E. hartmanni and one sample was positive for Enterobius vermicularis, D. fragilis and B. hominis together. Parasitic infection, which decreases quality of life and increases susceptibility to other infections, should not be neglected, particularly in patients with chronic diarrhea. Accurate diagnosis decreases morbidity and mortality in patients with parasite infection. © 2016 Japan Pediatric Society.

  15. Multicentric Castleman's Disease in a Child Revealed by Chronic Diarrhea.

    Science.gov (United States)

    Benmiloud, Sarra; Chaouki, Sana; Atmani, Samir; Hida, Moustapha

    2015-01-01

    Multicentric Castleman's disease is a rare benign and unexplained lymphoproliferative disorder that is extremely uncommon in children. It presents with fever, systemic symptoms, generalized lymphadenopathy, and laboratory markers of inflammation. Its treatment is not standardized and its prognosis is poor. We report a novel case of multicentric Castleman's disease in a 13-year-old girl who had presented with chronic diarrhea as the only initial presenting symptom. The diagnosis of celiac or inflammatory bowel diseases was suspected, but two and a half years later, the diagnosis of multicentric Castleman's disease was brought following the appearance of abdominal mass whose biopsy revealed Castleman's disease in the plasma cell form. The outcome was favorable after treatment by corticosteroid, chemotherapy, and surgery. The occurrence of diarrhea as the initial symptom of multicentric Castleman's disease without lymph node involvement is very rare. This case report underlines the diagnostic difficulties and the long interval between onset and diagnosis when diarrhea occurs first.

  16. Viral Diarrhea in Children: Clinical Manifestations, Innovations in the Treatment

    Directory of Open Access Journals (Sweden)

    S.O. Kramariov

    2014-12-01

    Full Text Available A literature search on the study of the clinical features of viral diarrhea in children has been carried out depending on the pathogen. 1,484 children with acute enteric infections (AEI were examined, they underwent inpatient treatment in infectious disease department of Kyiv city children’s clinical hospital № 2 in 2013. It was found that among patients with AEI, 25.9 % had rotavirus infection, 56 % — AEI of uncertain aetiology, 8 % — salmonellosis, 0.1 % — shigellosis, 10 % — AEI with other origin. A literature search showed the effectiveness of the use of probiotics, containing different strains, for AEI treatment, which manifested with reduction of intoxication syndrome, diarrhea, fever by 2–3 days. It is shown that the use of probiotic Subalin, containing Bacillus subtilis strain 2335/105, is promising as etiopathogenetic therapy in the treatment of viral diarrhea in children under current conditions.

  17. Role of FODMAP content in enteral nutrition-associated diarrhea.

    Science.gov (United States)

    Halmos, Emma P

    2013-12-01

    Gastrointestinal symptoms including diarrhea are common complications of enteral nutrition (EN); however, the cause is unclear. Mode of EN delivery that alters digestion and possibly absorption is suggested to contribute to the high incidence of diarrhea; however, enteral formula is frequently blamed. Most research has focused on fiber-supplemented EN, with a meta-analysis showing that fiber reduces the incidence of diarrhea in non-intensive care unit studies. Other hypotheses include formula osmolality and FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) content. FODMAPs are poorly absorbed short-chain carbohydrates that exert an osmotic effect. Dietary FODMAPs have been shown to reduce gastrointestinal symptoms, including diarrhea, in those with irritable bowel syndrome and, given a high-enough dose, will induce a laxative effect in most people. As FODMAPs are commonly added to enteral formula and EN is frequently used as the main source of nutrition, it is reasonable to hypothesize that EN provides more FODMAPs than usual dietary intake and increases risk for developing diarrhea. This hypothesis was assessed through a retrospective study showing that the standard-use enteral formula Isosource 1.5 had a protective effect of developing diarrhea. The only characteristic unique to Isosource 1.5 was the lower FODMAP content as determined through methodologies previously validated for food analysis. Methodologies for application to enteral formulas are currently undergoing formal validation. Once confirmed for application in enteral formula, future directions include FODMAP analysis of specific ingredients to increase understanding of potential problems associated with enteral formula and a randomized, controlled trial investigating the role of formula FODMAP content. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  18. Isospora belli Infection with Chronic Diarrhea in an Alcoholic Patient

    OpenAIRE

    Kim, Min Jae; Kim, Woo Ho; Jung, Hyun-Chae; Chai, Jee-Won; Chai, Jong-Yil

    2013-01-01

    Chronic diarrhea with a 35 kg weight loss (75 kg to 40 kg) occurred during 2 years in an alcoholic patient was diagnosed with Isospora belli infection in the Republic of Korea. The patient, a 70-year old Korean male, had been a heavy drinker for more than 30 years. He was admitted to the Seoul National University Hospital because of long-standing diarrhea and severe weight loss. He had an increased white blood cell (WBC) count with high peripheral blood eosinophilia (36.8-39.9%) and lowered p...

  19. Microvillus Inclusion Disease Variant in an Infant with Intractable Diarrhea

    Directory of Open Access Journals (Sweden)

    Badr M. Rasheed Alsaleem

    2017-11-01

    Full Text Available Microvillus inclusion disease (MVID is a rare autosomal recessive congenital enteropathy characterized by intractable secretory diarrhea. We report a case of MVID variant with a homozygous gene mutation in syntaxin 3 (STX3. The patient is a male Saudi infant who presented shortly after birth with severe vomiting, metabolic acidosis, and mild diarrhea. Electron microscopy study for small intestinal biopsy was consistent with MVID. MYO5B gene mutation was excluded; subsequently, whole exome sequencing (WES was performed, which revealed homozygous gene mutation in STX3. Using WES in clinical environment can be a useful tool for diagnosing difficult and rare inherited congenital enteropathies.

  20. Infectious Diarrhea: Norovirus and Clostridium difficile in Older Adults.

    Science.gov (United States)

    White, Mary B; Rajagopalan, Shobita; Yoshikawa, Thomas T

    2016-08-01

    Norovirus infection usually results in acute gastroenteritis, often with incapacitating nausea, vomiting, and diarrhea. It is highly contagious and resistant to eradication with alcohol-based hand sanitizer. Appropriate preventative and infection control measures can mitigate the morbidity and mortality associated with norovirus infection. Clostridium difficile infection is the leading cause of health care-associated diarrhea in the United States. Antibiotic use is by far the most common risk factor for C difficile colonization and infection. Appropriate preventive measures and judicious use of antibiotics can help mitigate the morbidity and mortality associated with C difficile infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. [Microscopic colitis - a frequent cause of chronic diarrhea].

    Science.gov (United States)

    Gonciarz, Maciej; Mularczyk, Aldona; Kowalik, Tomasz; Kopała, Marek

    2016-11-25

    Chronic diarrhea is a very common problem in the general population. It requires a physician to differentiate its causes and depending on its etiology referring the patient to a hospital for diagnosis and subsequent treatment. One of the causes of chronic diarrhea may be microscopic colitis, which is characterized by the presence of clinical symptoms without endoscopic or radiological abnormalities. Diagnosis is based on a histopathological examination of the colon and thus clinical suspicion of the disease is so important for further diagnosis and treatment, which is primarily based on the use of topical steroids such as budesonide. © 2016 MEDPRESS.

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

    Directory of Open Access Journals (Sweden)

    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. The pro-fusion domain of herpes simplex virus glycoprotein D (gD) interacts with the gD N terminus and is displaced by soluble forms of viral receptors.

    Science.gov (United States)

    Fusco, Daniela; Forghieri, Cristina; Campadelli-Fiume, Gabriella

    2005-06-28

    Entry of herpes simplex virus into the cell requires the interaction of gD with one of its receptors, herpesvirus entry mediator or nectin 1, and the intervention of gB, gH, or gL, required to execute fusion of the virion envelope with cell membranes. The gD ectodomain is organized in two structurally and functionally differentiated regions. The N terminus (residues 1-260) carries the receptor binding sites, and the C terminus (residues 260-310) functions as the pro-fusion domain (PFD), which is required for viral infectivity and fusion but not for receptor binding. The objective of our studies is to elucidate how gD links receptor recognition to the triggering of fusion. Here, we show that PFD is made of subdomains 1 and 2 (amino acids 260-285 and 285-310). Each one partially contributed to herpes simplex virus infectivity. By means of glutathione S-transferase (GST) fusion proteins, we show that PFD bound soluble forms of gD, truncated at residue 260 (gD260t) or downstream. Both PFD subdomains bound gD260t, highlighting multiple contact sites between the N and C termini of gD. When gD260t was in complex with either receptor, it failed to bind GST-PFD. In turn, the receptors did not bind GST-PFD, irrespective of whether they were in complex with gD. Thus, gD260t interacted with the C terminus only if unbound to the receptor. We propose that (i) before receptor binding, gD adopts a "closed" conformation in which the N and C termini interact; and (ii) on encounter with a receptor, gD modifies its conformation and the N and C termini are released from reciprocal interactions ("opened" conformation) and enabled to trigger fusion.

  4. Pathogenetic Mechanisms of Diarrhea in Children and Methods for Its Treatment

    Directory of Open Access Journals (Sweden)

    B.I. Krivuschev

    2014-07-01

    Full Text Available The paper presents the current views on the pathogenesis of acute intestinal infections in children and principles of therapy of diarrhea syndrome. Particular attention is paid to antisecretory therapy and the role of racecadotril in relieving diarrhea.

  5. Isospora belli associated recurrent diarrhea in a child with AIDS

    OpenAIRE

    Nateghi Rostami, M.; Nikmanesh, B.; Haghi-Ashtiani, M. T.; Monajemzadeh, M; M Douraghi; Ghalavand, Z.; Kashi, L

    2013-01-01

    Persistent diarrhea is a major manifestation of Acquired Immunodeficiency Syndrome (AIDS) which might be more complicated in Human Immunodeficiency Virus (HIV) infected children especially those from developing countries. There are numerous reports showing the emergence of intestinal opportunistic coccidian parasites, mostly Cryptosporidium parvum and Isospora belli in HIV-infected individuals. The prevalence of isosporiasis is probably underestimated in developing countries because routinely...

  6. Myasthenia gravis exacerbation and diarrhea associated with erythromycin treatment

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    Sora Yasr

    2017-02-01

    Full Text Available An important problem in management of the case with myasthenia gravis (MG is the control of exacerbation. There are several possible causes of exacerbation of MG including the use of drug. Here, the authors report a case of MG exacerbation and diarrhea associated with erythromycin treatment.

  7. Detection of bovine viral diarrhea virus antibodies in camels ...

    African Journals Online (AJOL)

    This study was carried out to determine the seroprevalence of bovine viral diarrhea virus (BVDV) antibodies in camels presented for slaughter at the Maiduguri abattoir using a BVDV specific indirect enzyme-linked-immunosorbent assay (ELISA). Ninety (90) serum samples collected from adult male and female camels were ...

  8. Diarréia por parasitas Parasites induced diarrheas

    Directory of Open Access Journals (Sweden)

    Maria Eugênia Farias Almeida Motta

    2002-08-01

    Full Text Available A diarréia é uma causa importante de morbimortalidade nos países em desenvolvimento. Os agentes etiológicos mais comuns são os vírus e as bactérias. Este artigo tem o objetivo de analisar a ocorrência de diarréia como manifestação clínica de parasitose. Discute-se quais os protozoários e os helmintos que podem causar diarréia, as bases científicas atuais que explicam os mecanismos fisiopatológicos que desencadeiam a diarréia, bem como os exames complementares e o tratamento adequado para cada parasita implicado.Diarrhea is an important cause of morbidity and mortality in developing countries. The most common etiological agents are viruses and bacteria. This article has the objective of analyzing diarrhea as a clinical symptom of parasitosis. Protozoa and helminthes that may cause diarrhea are discussed, current scientific basis clarifying the pathological and physiological mechanisms causing diarrhea as well as supplementary tests and adequate treatment for each parasite involved are focused.

  9. Frequency of Rotavirus Infection among Children with Diarrhea in ...

    African Journals Online (AJOL)

    Conclusion: Rotavirus frequency was 25% among children less than 5 years. Rotavirus vaccine, routine and proper diagnosis of rotavirus infection in children with acute diarrhea help to determine appropriate treatment, prevents the unnecessary use of antibiotics and minimizes the spread of the disease among susceptible ...

  10. Epidemiology of rotavirus diarrhea in children under 5 years in ...

    African Journals Online (AJOL)

    We aimed to determine the prevalence of group A rotavirus (RVA) in children below 5 years with diarrhea in two regions of Northern Cameroon (North West and Far North Regions) so as to improve our knowledge on the burden of rotavirus disease for imminent introduction of a rotavirus vaccine. Methods: Stool samples ...

  11. Water system unreliability and diarrhea incidence among children in Guatemala.

    Science.gov (United States)

    Trudeau, Jennifer; Aksan, Anna-Maria; Vásquez, William F

    2017-11-16

    This article examines the effect of water system unreliability on diarrhea incidence among children aged 0-5 in Guatemala. We use secondary data from a nationally representative sample of 7579 children to estimate the effects of uninterrupted and interrupted water services on diarrhea incidence. The national scope of this study imposes some methodological challenges due to unobserved geographical heterogeneity. To address this issue, we estimate mixed-effects logit models that control for unobserved heterogeneity by estimating random effects of selected covariates that can vary across geographical areas (i.e. water system reliability). Compared to children without access to piped water, children with uninterrupted water services have a lower probability of diarrhea incidence by approximately 33 percentage points. Conversely, there is no differential effect between children without access and those with at least one day of service interruptions in the previous month. Results also confirm negative effects of age, female gender, spanish language, and garbage disposal on diarrhea incidence. Public health benefits of piped water are realized through uninterrupted provision of service, not merely access. Policy implications are discussed.

  12. [Nosocomial diarrhea in intensive care unit: other than Clostridium difficile].

    Science.gov (United States)

    Wang, Xiao-Hui; Cai, Lin; Hu, Tian-Yu; Tang, Li; Wu, Dan; Kang, Yan; Zong, Zhi-Yong

    2013-07-01

    To investigate the incidence and clinical features of non-Clostridium difficile (C. difficile) associated nosocomial diarrhea in intensive care unit (ICU) caused by Klebsiella oxytoca and Clostridium perfringens. The faeces of 102 patients with non-C. difficile associated nosocomial diarrhea in ICU of West China Hospital, were collected during April to November, 2012. The target bacterial genes were detected by PCR amplification and sequencing, including toxic gene pehX of Klebsiella oxytoca, species-specific 16S rRNA gene and toxic gene cpa and cpe of Clostridium perfringens, species-specific 16S rRNA gene with mapA and toxic gene hipO of Campylobacter jejuni. Clinical features of the patients with positive results were summarized. Among 102 patients with non-C. difficile associated nosocomial diarrhea, 4 patients (3.9%) were detected with toxic Klebsiella oxytoca while 4 patients (3.9%) were detected with toxic Clostridium perfringens. No toxic Campylobacter jejuni was detected. Most of the patients had severe underlying diseases and poor final outcome, accepted potent antibiotics which disturbed intestinal flora obviously.. Non-C. difficile associated nosocomial diarrhea in ICU caused by Klebsiella oxytoca is and Clostridium perfringens is associated with severe diseases and poor outcome, but the incidence in our hospital is relatively low in our hospital.

  13. Environmental determinants of diarrhea among under-five children ...

    African Journals Online (AJOL)

    wondwossen birke

    BACKGROUND: Though the relationship between environmental risk factors and the occurrence of diarrhea in children have been documented elsewhere, there are limited studies in Ethiopia in general and in Nekemte. Town in particular. The present study assessed the prevalence and environmental determinants/factors ...

  14. Anti-diarrhea and anti-oxidant properties of Magnolol

    African Journals Online (AJOL)

    HP

    stroke, typhoid fever, anxiety and nervous disturbance, diarrhea ... Jianghua Yao Autonomous County, Hunan,. China, in May 2009 ..... defense system. In this study, magnolol administration greatly elevated the total antioxidant capacity in the livers. Magnolol treatment at a dose of 50 mg/kg had the highest increase in total ...

  15. Mothers' Knowledge, Attitude and Practice Regarding Diarrhea and ...

    African Journals Online (AJOL)

    Purpose: To assess diarrhea-related knowledge, attitude and practice through successive educational interventions. Methods: This was an interventional study conducted at nine different locations of Morang district, Nepal from March 2010 to January 2011. Multistage random sampling approach was adopted to sample 630 ...

  16. Microbiological Contamination of Drinking Water Associated with Subsequent Child Diarrhea.

    Science.gov (United States)

    Luby, Stephen P; Halder, Amal K; Huda, Tarique Md; Unicomb, Leanne; Islam, M Sirajul; Arnold, Benjamin F; Johnston, Richard B

    2015-11-01

    We used a prospective, longitudinal cohort enrolled as part of a program evaluation to assess the relationship between drinking water microbiological quality and child diarrhea. We included 50 villages across rural Bangladesh. Within each village field-workers enrolled a systematic random sample of 10 households with a child under the age of 3 years. Community monitors visited households monthly and recorded whether children under the age of 5 years had diarrhea in the preceding 2 days. Every 3 months, a research assistant visited the household and requested a water sample from the source or container used to provide drinking water to the child. Laboratory technicians measured the concentration of Escherichia coli in the water samples using membrane filtration. Of drinking water samples, 59% (2,273/3,833) were contaminated with E. coli. Of 12,192 monthly follow-up visits over 2 years, mothers reported that their child had diarrhea in the preceding 2 days in 1,156 (9.5%) visits. In a multivariable general linear model, the log10 of E. coli contamination of the preceding drinking water sample was associated with an increased prevalence of child diarrhea (prevalence ratio = 1.14, 95% CI = 1.05, 1.23). These data provide further evidence of the health benefits of improved microbiological quality of drinking water. © The American Society of Tropical Medicine and Hygiene.

  17. Examination of small bowel enzymes in chronic diarrhea

    NARCIS (Netherlands)

    Simadibrata, Marcellus; Wanders, Ronald J. A.; Jan, Gerrit; Tytgat, Guido N. J.; Lesmana, Laurentius A.; Daldiyono, N. N.; Ariawan, Iwan

    2003-01-01

    In Indonesia, the proportion of daily carbohydrate intake is approximately 60-80%. A number of small bowel disorders can result in the impairment of absorption and enzyme deficiency. Chronic diarrhea is common in Indonesia. Thirty-four functional dyspeptic patients with an endoscopically normal

  18. 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 conducted to delineate ... dehydration (49%: 31/63), symptoms of upper respiratory tract infection (13%: 8/63) and abdominal pain (5%: 3/63). ... gastroenteritis epidemiology in Africa with the exception of South Africa where their ...

  19. Home Management Of Diarrhea Among Underfives In A Rural ...

    African Journals Online (AJOL)

    Introduction: Diarrheal disease is a major cause of morbidity and mortality among under-fives especially in rural and peri-urban communities in developing countries. Home management of diarrhea is one of the key household practices targeted for enhancement in the Community Integrated Management of Childhood ...

  20. Current approach in the management of diarrhea in children: from ...

    African Journals Online (AJOL)

    Current approach in the management of diarrhea in children: from theory and research to practice and pragmatism. A Chiabi, F Monebenimp, J.B Bogne, V Takou, R Ndikontar, M Nankap, J.C Youmba, P.F Tchokoteu, M.T Obama, E Tetanye ...

  1. Assessment of the anti-diarrhea function of compound Chinese ...

    African Journals Online (AJOL)

    Organ bath was used to investigate the effect of COL on peristaltic reflexes and peristaltic waves in vitro. And anti-diarrhea activity of COL was evaluated in clinical. Results: Thin layer chromatography (TLC) and HPLC analyses showed that the contents of Berberine hydrochloride, Magnolol and Honokiol in COL were ...

  2. Porcine Epidemic Diarrhea Virus among Farmed Pigs, Ukraine.

    Science.gov (United States)

    Dastjerdi, Akbar; Carr, John; Ellis, Richard J; Steinbach, Falko; Williamson, Susanna

    2015-12-01

    An outbreak of porcine epidemic diarrhea occurred in the summer of 2014 in Ukraine, severely affecting piglets <10 days of age; the mortality rate approached 100%. Full genome sequencing showed the virus to be closely related to strains reported from North America, showing a sequence identity of up to 99.8%.

  3. Probiotics for the Prevention of Nosocomial Diarrhea in Children

    NARCIS (Netherlands)

    Hojsak, Iva; Szajewska, Hania; Canani, Roberto B.; Guarino, Alfredo; Indrio, Flavia; Kolacek, Sanja; Orel, Rok; Shamir, Raanan; Vandenplas, Yvan; van Goudoever, Johannes B.; Weizman, Zvi

    2018-01-01

    This document provides recommendations developed by the ESPGHAN Working Group on Probiotics and Prebiotics on the role of probiotics in the prevention of nosocomial diarrhea in children based on a systematic review of previously completed systematic reviews and of subsequently published randomized

  4. Control of Bovine Viral Diarrhea Virus in Ruminants

    Science.gov (United States)

    This document is a consensus statement, produced at the request of the American College of Veterinary Internal Medicine that reflects the opinion of an expert panel regarding the prevalence and host range, clinical manifestations, and the potential for ultimate eradication of bovine viral diarrhea v...

  5. Molecular identification of rotavirus strains associated with diarrhea ...

    African Journals Online (AJOL)

    The study was carried out to determine the molecular characteristics of the rotavirus strains associated with diarrhea among children in Kwara state, Nigeria. A total of 150 stool samples were collected from diarrheic children. The stool samples were screened for rotavirus,using Enzyme linked Immunosorbent assay (ELISA).

  6. molecular identification of rotavirus strains associated with diarrhea

    African Journals Online (AJOL)

    DR. AMINU

    The study was carried out to determine the molecular characteristics of the rotavirus strains associated with diarrhea among children in ... The State has 16 local government areas with human population of 2,591,555 (2006 Census). ..... Infection and Immunity in Children 5: 45-54. Gomwalk, N. E., Gosham, L. T. and Umoh, ...

  7. Lactoferrin reduces mortality in preweaned calves with diarrhea.

    Science.gov (United States)

    Habing, G; Harris, K; Schuenemann, G M; Piñeiro, J M; Lakritz, J; Clavijo, X Alcaraz

    2017-05-01

    Calf diarrhea is the most common reason for mortality and antimicrobial therapy in preweaned calves on dairy farms in the United States. Conventional and organic livestock producers require alternative therapies for calf diarrhea to reduce the necessity of conventional antimicrobials. Alternatives administered for mild cases or early in the disease course may be useful to mitigate disease progression and reduce the likelihood of septicemia and negative sequelae. Lactoferrin is a bioactive protein naturally found in colostrum that has been shown to prevent septicemia in high-risk infants. Among organic producers, garlic extract is widely used for the treatment of disease and perceived to be efficacious. The objectives of the study were to determine the effectiveness of lactoferrin and garlic extract to reduce mortality and culling, improve weight gain, and reduce the duration of disease in preweaned calves with the first diagnosis of diarrhea. In total, 628 calves with diarrhea from a single commercial dairy were enrolled in a blinded, randomized field trial. Calves diagnosed with diarrhea (fecal score ≥3), were randomized to 3 consecutive days of oral garlic extract, lactoferrin, or water (control). Calves were clinically evaluated for up to 10 d. Body weight was measured at enrollment and 10 d later. For calves receiving garlic extract, the risk of death or culling was not significantly different than calves in the control group; however, calves that received lactoferrin had approximately half the risk of death or culling in the 120 d following diagnosis. Additionally, the relative risk of death or culling in the 60 d following diagnosis was significantly lower for the subset of calves with severe diarrhea at enrollment. Neither garlic nor lactoferrin had a significant effect on disease duration or average weight gain during the 10-d period. Lactoferrin significantly reduced mortality and culling when administered to preweaned calves with the first diagnosis of

  8. Characterization of the human gut microbiome during travelers' diarrhea.

    Science.gov (United States)

    Youmans, Bonnie P; Ajami, Nadim J; Jiang, Zhi-Dong; Campbell, Frederick; Wadsworth, W Duncan; Petrosino, Joseph F; DuPont, Herbert L; Highlander, Sarah K

    2015-01-01

    Alterations in the gut microbiota are correlated with ailments such as obesity, inflammatory bowel disease, and diarrhea. Up to 60% of individuals traveling from industrialized to developing countries acquire a form of secretory diarrhea known as travelers' diarrhea (TD), and enterotoxigenic Escherichia coli (ETEC) and norovirus (NoV) are the leading causative pathogens. Presumably, TD alters the gut microbiome, however the effect of TD on gut communities has not been studied. We report the first analysis of bacterial gut populations associated with TD. We examined and compared the gut microbiomes of individuals who developed TD associated with ETEC, NoV, or mixed pathogens, and TD with no pathogen identified, to healthy travelers. We observed a signature dysbiotic gut microbiome profile of high Firmicutes:Bacteroidetes ratios in the travelers who developed diarrhea, regardless of etiologic agent or presence of a pathogen. There was no significant difference in α-diversity among travelers. The bacterial composition of the microbiota of the healthy travelers was similar to the diarrheal groups, however the β-diversity of the healthy travelers was significantly different than any pathogen-associated TD group. Further comparison of the healthy traveler microbiota to those from healthy subjects who were part of the Human Microbiome Project also revealed a significantly higher Firmicutes:Bacteriodetes ratio in the healthy travelers and significantly different β-diversity. Thus, the composition of the gut microbiome in healthy, diarrhea-free travelers has characteristics of a dysbiotic gut, suggesting that these alterations could be associated with factors such as travel.

  9. 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.

  10. Bile acid malabsorption in chronic diarrhea: pathophysiology and treatment.

    Science.gov (United States)

    Barkun, Alan N; Love, Jonathan; Gould, Michael; Pluta, Henryk; Steinhart, Hillary

    2013-11-01

    Bile acid malabsorption (BAM) is a common but frequently under-recognized cause of chronic diarrhea, with an estimated prevalence of 4% to 5%. The published literature for the period 1965 to 2012 was examined for articles regarding the pathophysiology and treatment of BAM to provide an overview of the management of BAM in gastroenterology practice. BAM is classified as type 1 (secondary to ileal dysfunction), type 2 (idiopathic) or type 3 (secondary to gastrointestinal disorders not associated with ileal dysfunction). The estimated prevalence of BAM is >90% in patients with resected Crohn disease (CD) and 11% to 52% of unresected CD patients (type 1); 33% in diarrhea-predominant irritable bowel syndrome (type 2); and is a frequent finding postcholecystectomy or postvagotomy (type 3). Investigations include BAM fecal bile acid assay, 23-seleno-25-homo-tauro-cholic acid (SeHCAT) testing and high-performance liquid chromatography of serum 7-α-OH-4-cholesten-3-one (C4), to determine the level of bile acid synthesis. A less time-consuming and expensive alternative in practice is an empirical trial of the bile acid sequestering agent cholestyramine. An estimated 70% to 96% of chronic diarrhea patients with BAM respond to short-course cholestyramine. Adverse effects include constipation, nausea, borborygmi, flatulence, bloating and abdominal pain. Other bile acid sequestering agents, such as colestipol and colesevelam, are currently being investigated for the treatment of BAM-associated diarrhea. BAM is a common cause of chronic diarrhea presenting in gastroenterology practice. In accordance with current guidelines, an empirical trial of a bile acid sequestering agent is warranted as part of the clinical workup to rule out BAM.

  11. 9 CFR 113.215 - Bovine Virus Diarrhea Vaccine, Killed Virus.

    Science.gov (United States)

    2010-01-01

    ... vaccine production. All serials of vaccine shall be prepared from the first through the fifth passage from... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Bovine Virus Diarrhea Vaccine, Killed... REQUIREMENTS Killed Virus Vaccines § 113.215 Bovine Virus Diarrhea Vaccine, Killed Virus. Bovine Virus Diarrhea...

  12. Microvillus Inclusion Disease: Prenatal Ultrasound Findings, Molecular Diagnosis and Genetic Counseling of Congenital Diarrhea

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2010-12-01

    Conclusion: Prenatal sonographic identification of dilated bowel loops in association with polyhydramnios suggests congenital diarrhea and a differential diagnosis of microvillus inclusion disease in addition to congenital chloride diarrhea and congenital sodium diarrhea. Molecular analysis of the MYO5B gene is helpful in genetic counseling and prenatal diagnosis of recurrent microvillus inclusion disease in subsequent pregnancies.

  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. Assessment of chronic diarrhea in early infancy in Tehran Tertiary Care Center; Tehran-Iran

    Directory of Open Access Journals (Sweden)

    Farzaneh Motamed

    2015-03-01

    Full Text Available Introduction Chronic diarrhea of infancy is a heterogeneous syndrome that includes several diseases with different etiologies. The aim of this study was investigating chronic diarrhea, its etiologies, clinical features and outcomes in infancy.Materials and Methods Retrospective study investigating infants hospitalized in the gastroenterology department of Tehran tertiary care center.The main demographic data, etiology, characteristics of diarrhea, and outcome were evaluated. Data were analyzed by SPSS software,version 16.Results In this study, 63/9% of cases were female and 36/1% were male. 24 cases (66/7% had osmotic diarrhea and 11 (30/6% had secretory diarrhea. In this study there was no significant statistical correlation between type of diarrhea and sex, gestational Age, severity of dehydration, birth weight and nutrition. The majority of patients with osmotic (58/3% and secretory diarrhea (63/6%, had weight percentile below 3%, which showed a significant statistical difference (p value

  15. Etiology and epidemiology of travelers' diarrhea in Asia.

    Science.gov (United States)

    Taylor, D N; Echeverria, P

    1986-01-01

    Travelers' diarrhea in Asia has been studied among Peace Corps volunteers in Thailand, Japanese travelers, foreign residents in Bangladesh, guests in hotels, and members of various tour groups. Rates of diarrheal attack of greater than 50% during four- to six-week sojourns were reported for these groups. Among travelers with diarrhea, the most commonly isolated pathogen was enterotoxigenic Escherichia coli (20%-34%), followed by Salmonella (11%-15%), Shigella (4%-7%), Campylobacter (2%-5%), and Vibrio parahaemolyticus (1%-13%). In 9%-22% of diarrheal episodes, multiple pathogens were recovered. Among Japanese travelers, Salmonella was more commonly acquired in the Far East; Shigella and Campylobacter, in the Indian subcontinent; and V. parahaemolyticus, in Southeast Asia. Aeromonas hydrophila and Plesiomonas shigelloides were commonly isolated from ill travelers in Thailand but less frequently from other travelers. Protozoa and Vibrio species other than V. parahaemolyticus were isolated in less than 5% of episodes.

  16. Extremely rare cause of congenital diarrhea: enteric anendocrinosis.

    Science.gov (United States)

    Sayar, Ersin; Islek, Ali; Yilmaz, Aygen; Akcam, Mustafa; Flanagan, Sarah E; Artan, Reha

    2013-10-01

    Congenital diarrheal disorders consist of a variety of chronic enteropathies. There are approximately 30 different diseases that can be classified into four groups according to the mechanisms involved in pathogenesis: (i) absorption and transport of nutrients and electrolytes; (ii) enterocyte differentiation and polarization; (iii) enteroendocrine cell differentiation; and (iv) modulation of the intestinal immune response. Affected patients often present with life-threatening diarrhea, in the first few weeks of life. A new disorder, enteric anendocrinosis, which is characterized by severe malabsorptive diarrhea and a lack of intestinal enteroendocrine cells has recently been described in six patients with recessively inherited mutations in the Neurogenin-3 gene. In this report we describe a seventh case with a review of the literature. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  17. Experimental infection of reindeer with bovine viral diarrhea virus

    Directory of Open Access Journals (Sweden)

    J.K. Morton

    1990-08-01

    Full Text Available Two 8-month reindeer (Rangifer tarandus and a 1-month-old Hereford-Holstein calf (Bos taurus were inoculated intranasally with the Singer (cytopathogenic strain of bovine viral diarrhea (BVD virus. Clinical signs in reindeer included loose stools containing blood and mucus, and transient laminitis or coronitis. Signs in the calf were limited to bloody mucus in the stool and lesions in the nasal mucosa. Antibody titers to BVD virus in the reindeer were intermittent, and titers in the calf persisted from days 14 to 63 post-inoculation (PI. Viremia was detected on PI day 4 in one reindeer, days 3-7 in the other, and days 2-7 in the calf. Bovine viral diarrhea virus was isolated from the lung of the calf at necropsy (PI day 63.

  18. Porcine Epidemic Diarrhea Virus Induces Autophagy to Benefit Its Replication

    Directory of Open Access Journals (Sweden)

    Xiaozhen Guo

    2017-03-01

    Full Text Available The new porcine epidemic diarrhea (PED has caused devastating economic losses to the swine industry worldwide. Despite extensive research on the relationship between autophagy and virus infection, the concrete role of autophagy in porcine epidemic diarrhea virus (PEDV infection has not been reported. In this study, autophagy was demonstrated to be triggered by the effective replication of PEDV through transmission electron microscopy, confocal microscopy, and Western blot analysis. Moreover, autophagy was confirmed to benefit PEDV replication by using autophagy regulators and RNA interference. Furthermore, autophagy might be associated with the expression of inflammatory cytokines and have a positive feedback loop with the NF-κB signaling pathway during PEDV infection. This work is the first attempt to explore the complex interplay between autophagy and PEDV infection. Our findings might accelerate our understanding of the pathogenesis of PEDV infection and provide new insights into the development of effective therapeutic strategies.

  19. Current Approaches to the Treatment of Diarrhea in Children

    Directory of Open Access Journals (Sweden)

    О.S. Niankovska

    2015-10-01

    Full Text Available This article considers the current approaches to the treatment of acute diarrhea, taking into account the ESPGHAN guidelines (2014, which involves the use of oral rehydration therapy, zinc at a dose of 10 mg/day in children under 6 months, in children older than 6 months — 20 mg/day for 10–14 days, probiotics, antisecretory and antiemetic drugs, adsorbents and antibiotics.

  20. 'Halloween diarrhea'. An unexpected trick of sorbitol-containing candy.

    Science.gov (United States)

    Breitenbach, R A

    1992-10-01

    When a patient with severe diarrhea and flatulence is afebrile and the results of physical examination are negative, a food source should be suspected as the cause of the problem. Careful scrutiny of the patient's diet and a high index of suspicion may implicate the artificial sweetener sorbitol. Exclusion of sorbitol from the patient's diet is recommended in these cases before embarking on an extensive clinical investigation.

  1. PROBIOTICS AS TREATMENT OF ACUTE DIARRHEA IN INFANT AND CHILDREN

    Directory of Open Access Journals (Sweden)

    I Wayan Wawan

    2013-10-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Diarrhea is a common disease in children after acute respiratory tract infection. Expected, diarrhea was found approximately one billion cases per year and the first etiology of morbidity and mortality in children in Asia, Africa, and America Latin. The management of acute diarrhea according to WHO recommendation consisted of oral rehydration (low osmolarity ORS, diet, zinc supplementation, selective antibiotic, and education to parents. In several randomized controlled trials (RCT and meta-analysis was showing that probiotics effective for primary and secondary prevention of acute diarrhea.     st1\\:*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  2. Clinical Treatment of Nondysentery Travelers’ Diarrhea During Deployment

    Science.gov (United States)

    2010-03-01

    diarrhea, and other diar- rhea issues will be addressed in future articles. If the above recommendations are adhered to, afflicted personnel will have a...from poorly focused empiricism to fluid therapy and modem pharmacotherapy. Aliment Pharmacol Ther 2007; 25: 759-69. 38. Tribble DR, Baqar S, Pang LW...2005; 170: 492-5. 51. Wingate D, Phillips SF, Lewis SJ, et al: Guidelines for adults on self- medication for the treatment of acute diarThoea. Aliment

  3. ANTIBIOTIC-ASSOCIATED DIARRHEA AND ANTIBIOTIC-ASSOCIATED COLITIS

    Directory of Open Access Journals (Sweden)

    E. A. Belousova

    2014-01-01

    Full Text Available The article presents most recent data on antibiotic-associated intestinal disorders. The author reviews epidemiology and causative microorganisms in antibiotic-induced diarrhea and pseudomembranous colitis as well as clinical variants of antibiotic-associated disorders. Diagnosis methods are decribed at length with special attention to most sensitive and informative tests. Treatment of different clinical variants of antibiotic-induced disorders is discussed in detail.

  4. Persistent diarrhea: 15 years experience at a tertiary care hospital.

    Science.gov (United States)

    Vithayasai, Niyada; Jennuvat, Siriluck

    2014-06-01

    To determine the risk factors, causative enteric pathogens, final diagnosis and treatment outcomes of persistent diarrhea in children. A retrospective study of the patients who had diarrheal symptoms for at least 14 days diagnosed as persistent diarrhea (PD) and admitted at QSNICH during January 1997 and December 2011. Demographic data, risk factors, causative enteric pathogens, management and outcome were reviewed. The review included 79 PD patients. Excluded were patients who were HIV seropositive, had GI anomalies and/or other underlying immune deficiencies. The demographic data showed mean age 11.42 months and male:female 56:23 (2.43:1). Feeding with infant formula before admission was 43% compared to exclusive breastfeeding that was only 10%. Normal nutritional status was found in half of the cases (52.1%) and protein energy malnutrition (PEM) was present in 42.3%. Stool for enteropathogens was positive only in 49.4% and the most common being mixed enteropathogens. Secondary lactase deficiency was the cause of PD in half (50%) of the patients. Management consisted of rehydration, intravenous antibiotics 53%, and other adjuvant therapies such as cholestyramine, zinc and probiotics. Along with rehydration, all patients received aggressive nutritional management upon admission. The diarrhea subsided in less than 7 days in about 70% of the patients. The present study supports that important risk factors for PD are very young age group (especially under 1 year old), lack of breastfeeding and malnutrition. Enteropathogens were found in only about half of the patients and the most common cause of PD was secondary lactase deficiency. Most of the diarrhea subsided in less than 7 days of admission with proper management and aggressive nutrition upon admission.

  5. Enteropathogenic bacteria isolated from specimens of patients with diarrhea

    OpenAIRE

    Salary M

    1997-01-01

    Acute infectious gastroenteritis is one of the most common infectious diseases of humans in the world. Diarrheal disease still ranks very high as a major cause of illness and death especially in developing nations. This study has been carried out to investigate enteropathogenic bacteria isolated from 2517 specimens of patients with diarrhea. The results obtained are as follow: Salmonella typhimurium: 6 cases 3.1 percent, Salmonella havana: 5 cases 2.6 percent, Shigella dysenteriae: 12 cases 6...

  6. Bovine viral diarrhea virus: affinity chromatography on Crotalaria juncea lectin.

    Science.gov (United States)

    Moreno-Lopez, J; Kristiansen, T; Kårsnas, P

    1981-04-01

    Attempts were made to purify bovine viral diarrhea virus by chromatography on Crotalaria juncea lectin coupled to Sepharose 2B. A recovery of abut 65% of viral infectivity after desorption was obtained. Electron microscopy revealed mostly de-enveloped particles, rather uniform in appearance but differing in size. Immunodiffusion tests with immune calf sera showed precipitation lines of identity between the desorbed virus and extracts from infected cell cultures.

  7. Intestinal parasitic infections in leukemic patients with diarrhea

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    Serhat Uysal, Eylem Akdur, Varol Tunalı

    2017-06-01

    Full Text Available Objectives: Leukemic patients are at increased risk of severe infections with parasites. Moreover, intestinal parasites can lead to severe diarrhea in patients with immunosuppression. The purpose of this study is to decide intestinal parasitic infections and clinical aspects in leukemic patients. Methods: Analysis was done of all leukemic patients hospitalized between January 2007 and October 2015 retrospectively. Results: Ninety-one patients were evaluated. Intestinal parasites were diagnosed in nine (9.9% patient. Cryptosporidium was the most frequently identified parasite, recovered from six specimens (6.6%, while Blastocystis (n=3 and Entamoeba (n=1 accounted for 3.3% and 1.1%, respectively. Cryptosporidium spp. and E. histolytica were detected together in one patient. Duration of diarrhea in patients with and without parasite were 16.1±9.3 and 7.9±2.9days, respectively (P=0.037. Abdominal cramps in patients with and without parasite were present in seven (77.8% and 20 (24.4% patients, respectively (P=0.002. In contrast, vomiting in patient with and without parasite were present in five (55.6% and 81 (98.8% patients, respectively (P<0.0005. Conclusion: Parasitic infections should be considered for differential diagnosis in leukemic patients with diarrhea. J Microbiol Infect Dis 2017; 7(2: 63-66

  8. Isolation and antibiotic sensitivity of Aeromonas from children with diarrhea

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    Meiyanti Meiyanti

    2016-02-01

    Full Text Available Aeromonas species are gram-negative, motile, facultative anaerobic, rod shaped, oxidase positive bacteria of the recently assigned family Aeromonadaceae. The significance of Aeromonas species as causative agent of human diarrhoea has recently been established. The aim of the present study was to investigate the distribution, and antibiotic sensitivity of Aeromonas in nonhospitalized children with diarrhea.One hundred and seventeen rectal swabs from children with diarhhea were cultured for isolation of Aeromonas organisms as the etiological agents. In addition to Aeromonas, other enteric pathogens were also isolated. Overall, the isolates of enteric pathogens amounted to 36.8%, consisting of Salmonella, Shigella, Aeromonas, and Vibrio. Aeromonas was only found in 5.1% of cultures, with a ratio of A. caviae and A. hydrophila of 2:1, while Salmonella made up the majority of causative organisms with an isolation frequency of 18.8%, followed by Shigella with 11.1%. In this study no isolates of Vibrio cholerae O1 were found as etiological agents of diarrhea; however, V. cholerae non-O1 and V. parahaemolyticus were found in small numbers (<1%. All isolates of Aeromonas were resistant to ampicillin and tetracycline, but sensitive to ciprofloxacin and ceftriaxone, as were the other enteric pathogens. Although the frequency of isolation of these enteric pathogens was higher than for Vibrio spp., their role in infective diarrhea was less clearcut in comparison with Salmonella and Shigella.

  9. Traveler's diarrhea-I. Definition, etiology and epidemiology.

    Science.gov (United States)

    Broor, S L; Singal, A K

    1989-01-01

    With the development of rapid and convenient means of transportation, several million persons travel from industrialized countries to developing countries every year. From USA alone, approximately 4 million persons visit Mexico annually. These travelers are at risk to develop several infections during their stay abroad, but the most commonly experienced illness is diarrhea. The attack rate of diarrhea in travelers may be as high as 25 to 50 percent; 30 percent of those who get diarrhea are ill enough to be confined to bed and another 40% have to change their scheduled travel plans. The disease affects all ranks and it has achieved worldwide fame by its several euphemisms. Various epithets used to describe this illness include GI trots, Aden gut, Barsa belly, Turkey trot, Delhi belly, Hongkong dog, Montezuma's revenge, gyppsy tummy and turista. There have been considerable advances in our understanding about the etiology and epidemiology of this disease in the last two decades and the purpose of this review is to highlight some of this new information.

  10. Solanum paniculatum root extract reduces diarrhea in rats

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    Jonh A.B. Tenório

    Full Text Available Abstract Solanum paniculatum L., Solanaceae, locally known as "jurubeba", is widely used in Brazil for culinary purposes, and in folk medicine to treat of diverse disorder including gastric dysfunctions. In this study we investigated the antidiarrheal activity of S. paniculatum roots extract in rats at different concentrations (125, 250 and 500 mg/kg, p.o using different experimental models such as castor oil-induced diarrhea, enteropooling and gastrointestinal motility, determined by in vivo experimental models. The major compound of root extract was characterized as chlorogenic acid based in the IR, 1D and 2D NMR analysis. All the extract doses achieved antidiarrheal potency, as indicated by reduced weight of feces in castor oil-induced diarrhea, decreased intestinal motility and significantly inhibited castor oil-induced enteropooling compared to the vehicle group. The highest dose (500 mg/kg produced greater anti-motility effect and better reduction of enteropooling, similar to the reference drug Loperamide (5 mg/kg. Extract from S. paniculatum L. roots had antidiarrheal activity, as shown by the lower weight of the feces as well as decrease in the accumulation of intestinal fluid and slower transit, justifying the traditional use of plant for diarrhea.

  11. Enteric Pathogens Associated with Childhood Diarrhea in Tripoli-Libya

    Science.gov (United States)

    Rahouma, Amal; Klena, John D.; Krema, Zaineb; Abobker, Abdalwahed A.; Treesh, Khalid; Franka, Ezzedin; Abusnena, Omar; Shaheen, Hind I.; El Mohammady, Hanan; Abudher, Abdulhafid; Ghenghesh, Khalifa Sifaw

    2011-01-01

    Stool samples from children < 5 years of age with diarrhea (N = 239) were examined for enteric pathogens using a combination of culture, enzyme-immunoassay, and polymerase chain reaction methods. Pathogens were detected in 122 (51%) stool samples; single pathogens were detected in 37.2% and co-pathogens in 13.8% of samples. Norovirus, rotavirus, and diarrheagenic Escherichia coli (DEC) were the most frequently detected pathogens (15.5%, 13.4%, and 11.2%, respectively); Salmonella, adenovirus, and Aeromonas were detected less frequently (7.9%, 7.1%, and 4.2%). The most commonly detected DEC was enteroaggregative E. coli (5.4%). Resistance to ≥ 3 antimicrobials was observed in 60% (18/30) of the bacterial pathogens. Salmonella resistance to ciprofloxacin (63.1%) has become a concern. Enteric viral pathogens were the most significant causative agents of childhood diarrhea in Tripoli. Bacterial pathogens were also important contributors to pediatric diarrhea. The emergence of ciprofloxacin-resistant Salmonella represents a serious health problem that must be addressed by Libyan health authorities PMID:21633024

  12. Probiotic Weisella paramesenteroides on enteropathogenic E. coli-induced diarrhea

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    Aslinar Aslinar

    2014-02-01

    Full Text Available Background Enteropathogenic Escherichia coli (EPEC is a causative agent of intestinal inflammation and microfloral imbalance, leading to diarrhea. The presence of tumor necrosis factor-α (TNF-α in the feces is an indicator of inflammation in the intestinal mucosa. Dadih, (local made of fermented buffalo milk, contains probiotics and is widely consumed by the people in West Sumatera, Indonesia. Weisella paramesenteroides, a probiotic lactic acid bacteria (LAB, has been isolated from dadih and is believed to be useful for improving intestinal microflora balance and inhibiting the activity of harmful microbes. Objective To determine the efficacy of W. paramesenteroides administration in various doses and durations on bowel frequency, stool’s TNF-α levels, and intestinal microflora balance on mice with EPEC-induced diarrhea. Method This randomized experimental animal study examined two factors relating to the effects of W. paramesenteroides on EPEC-induced diarrhea, namely doses of probiotics (factor A, and durations of observation (factor B. The subjects consisted of 100 male white mice (Mus musculus aged 8 weeks, with weights of 25-30 grams. The outcomes measured were bowel frequency, stool’s TNF-α levels, and the balance of intestinal microflora on mice with EPEC-induced diarrhea.  Subjects were divided into 5 groups: the negative control group (received neither EPEC nor probiotic, positive control group (received only EPEC, and three experimental groups (received EPEC and different doses of W. paramesenteroides . Probiotics were given twice at the 12-hours and 24-hours for the experimental groups, while the durations of observation conssited of baseline, 12 hours, 24 hours, and 36 hours. Results After 36 hours, subjects with EPEC-induced diarrhea who received W. Paramesenteroides administration in doses of 2 x 108 (A3, were found to have the largest decline of mean defecation (a 4.4-fold decline and the largest decline of stool’s mean

  13. Growth assessment in Egyptian infants and children with chronic diarrhea.

    Science.gov (United States)

    Ei-Deeb, Marwa T; Hamid, Dalia H Abdel

    2012-12-01

    This study evaluated the various growth parameters among patients presenting with chronic diarrhea and highlight the most common causes of chronic diarrhea among a sample of Egyptian infants and children. This cross-sectional study included 146 patients with chronic diarrhea. They were 87 males and 59 females, with age ranging between 2 and 198 months and a mean age of 27.3 +/- 34.5 months. Each patient was subjected to medical history taking including age of onset and duration of diarrhea, consistency of stools, presence of blood and mucus, vomiting with or without hematemesis, fever, allergic manifestations and family history of atopy. Dietetic history included milk feeding during the first 6 months and age of weaning and age of introduction of cow's milk products. Anthropometric measurements included weight and height and weight for height were assessed and z-scores were calculated using software WHO anthro v3.2.2. Laboratory investigations included stool analysis and culture, CBC and all other investigations necessary for diagnosis of the definite cause including RAST for specific IgE against cow's milk proteins, serology for celiac disease (anti-gliadin and anti tTG), Breath hydrogen test, endoscopy (colonoscopy or esophago-gastrodudenoscopy) and histopathologic assessment of endoscopic biopsies. CMA was diagnosed on basis of withdrawal and open re-challenge technique. Causes included chronic infections (40.4%), CMA (34.9%), celiac disease (10.3%), inflammatory bowel disease (6.8%) and lactose intolerance (3.4%). Rare causes were chronic non-specific diarrhea (1.3%), cystic fibrosis (0.7%), post-surgery short bowel syndrome (0.7%), neuroblastoma (0.7%) and IBS (0.7%).78.7% of patients enrolled in the study had a low WFA z-score (< -2), 75% had low length for age z-score (<-2) and 50.7% showed wasting with low weight for height z-scores (< -2). Patients with IBD had the lowest mean value of WFA and HFA z-scores (-4.03 +/- 3.23, -6.31 +/- 3.74 respectively

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

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    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.

  15. Duodenal villous atrophy: a cause of chronic diarrhea after solid-organ transplantation.

    Science.gov (United States)

    Weclawiak, H; Ould-Mohamed, A; Bournet, B; Guilbeau-Frugier, C; Fortenfant, F; Muscari, F; Sallusto, F; Dambrin, C; Esposito, L; Guitard, J; Abbal, M; Rostaing, L; Kamar, N

    2011-03-01

    Persistent diarrhea is commonly observed after solid organ transplantation (SOT). A few cases of mycophenolate mofetil (MMF)-induced duodenal villous atrophy (DVA) have been previously reported in kidney-transplant patients with chronic diarrhea. Herein, we report on the incidence and characteristics of DVA in SOT patients with chronic diarrhea. One hundred thirty-two SOT patients with chronic diarrhea underwent an oesophago-gastroduodenoscopy (OGD) and a duodenal biopsy after classical causes of diarrhea have been ruled out. DVA was diagnosed in 21 patients (15.9%). It was attributed to mycophenolic acid (MPA) therapy in 18 patients (85.7%) (MMF [n = 14] and enteric-coated mycophenolate sodium [n = 4]). MPA withdrawal or dose reduction resulted in diarrhea cessation. The incidence of DVA was significantly higher in patients with chronic diarrhea receiving MPA compared to those who did not (24.6% vs. 5.1%, p = 0.003). DVA was attributed to a Giardia lamblia parasitic infection in two patients (9.5%) and the remaining case was attributed to azathioprine. In these three patients, diarrhea ceased after metronidazole therapy or azathioprine dose reduction. In conclusion, DVA is a frequent cause of chronic diarrhea in SOT recipients. MPA therapy is the most frequent cause of DVA. An OGD should be proposed to all transplant recipients who present with persistent diarrhea. ©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.

  16. 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. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Expression of serotonin receptors in the colonic tissue of chronic diarrhea rats.

    Science.gov (United States)

    Zhu, Tong; Qiu, Juanjuan; Wan, Jiajia; Wang, Fengyun; Tang, Xudong; Guo, Huishu

    2016-01-01

    This study aimed to investigate the difference among the expression of serotonin receptors (5-HT3, 5-HT4, and 5-HT7receptors) in colonic tissue of chronic diarrhea rats. A rat model of chronic diarrhea was established by lactose diet. The expression of 5-HT3, 5-HT4, and 5-HT7receptors in the colonic tissue was detected using immunohistochemistry, real-time PCR and Western blotting techniques. There is no significant difference on the protein expression of 5-HT3receptor between the normal group and the chronic diarrhea model group. The mRNA expression of 5-HT3receptor in the chronic diarrhea model group was significantly lower than that in the normal group (n = 10; Pchronic diarrhea model group were significantly higher than those in the normal group (n = 10; Pchronic diarrhea model group were significantly decreased compared with the normal group (n = 10; Pdiarrhea by lactose diet.

  18. 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......- and outpatient treatment separately. The primary outcome was number of days with diarrhea during hospitalization. Secondary outcomes included other diarrhea outcomes, pneumonia, weight gain, and recovery. RESULTS: There was no difference in number of days with diarrhea between the probiotic (n = 200) and placebo...... (n = 200) groups during inpatient treatment (adjusted difference +0.2 days, 95% CI -0.8 to 1.2, p = 0.69), however during outpatient treatment, probiotics reduced days with diarrhea (adjusted difference -2.2 days 95% CI -3.5 to -0.3, p = 0.025). There were no effects of probiotics on diarrhea...

  19. Etiology of Childhood Infectious Diarrhea in a Developed Region of China: Compared to Childhood Diarrhea in a Developing Region and Adult Diarrhea in a Developed Region.

    Directory of Open Access Journals (Sweden)

    Xin Wang

    Full Text Available In China, great differences in economy, social characteristics and hygiene exist between developing and developed regions. A comparative study of infectious diarrhea between two regions was needed. Three groups of diarrheal patients were collected: children ≤5 year-olds from Beijing (developed region and Henan Province (developing region, and adults over 18 year-olds from Beijing. A questionnaire was used to survey and feces samples were examined for 16 enteropathogens. We enrolled 1422 children and 1047 adults from developed region and 755 children from developing region. Virus positive rates were 32.98% for children and 23.67% for adults in developed region. The most prevalent pathogen for children was rotavirus whereas for adults was norovirus. Bacterial isolation rates were 13.92% for children from developed region, while 29.14% for children from the developing regions. For the greatest difference, Shigella accounted for 50.79% and was the dominant pathogen in the developing region, whereas in the developed region it was only 1.45%. There was no significant relationship between the local levels of development with diarrheogenic Escherichia coli (DEC categories. But it was seen the notable differences between the population with different age: enteropathogenic E.coli (EPEC and enteroaggregative E.coli (EAggEC were the primary classes of DEC in children from both regions, whereas it was enterotoxigenic E.coli (ETEC in adults. The symptoms of Shigella and Salmonella infection, such as bloody stools, white blood cells (WBC and red blood cells (RBC positivity and fever were similar in children, which may lead to the misidentification. Yersinia enterocolitica and shiga toxin-producing E.coli (STEC infections were firstly reported in Beijing. There was a large difference in etiology of bacterial diarrhea between children in developing and developed regions of China.

  20. Sensitivity and specificity of procalcitonin to determine etiology of diarrhea in children younger than 5 years.

    Science.gov (United States)

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

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    S.L. Niankovskyi

    2015-09-01

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

  2. Dientamoeba fragilis as a cause of travelers' diarrhea: report of seven cases.

    Science.gov (United States)

    Stark, Damien; Beebe, Nigel; Marriott, Deborah; Ellis, John; Harkness, John

    2007-01-01

    Dientamoeba fragilis is a pathogenic trichomonad parasite that causes gastrointestinal disease in humans. We report seven cases of travelers' diarrhea caused by D fragilis in patients who had traveled to overseas destinations within Asia or the Pacific which occurred over an 8-month period. Patients presented with diarrhea lasting from 5 days to over 4 weeks. Dientamoeba fragilis should be considered as a cause of diarrhea in returning travelers.

  3. Effect of Prolonged Diarrhea in Renal Transplant Recipients at a Single Center in Taiwan.

    Science.gov (United States)

    Wang, H-Y; Yeh, M-K; Tian, Y-F; Huang, Y-B

    2016-04-01

    Post-renal transplantation diarrhea is a common complication; however, it is easily ignored. This study aimed to determine the factors influencing graft function for renal transplant recipients with diarrhea. A single-center retrospective study with the use of the Hyperion data warehouse was conducted to search and evaluate for renal transplant recipients who came for medical care for diarrhea at our transplant center from January 2009 to August 2015. The clinical features of patients with diarrhea were compared with the features of recipients without diarrhea. The causes and risk factors of post-transplantation diarrhea were also evaluated. For the 67 patients collected for the study, infectious diarrhea (ID) was confirmed in 27 patients (40.3%), and the most common causes were cytomegalovirus and Clostridium difficile infection. A significant difference was found between ID and noninfectious (NID) groups for serum creatinine change (0.31 ± 0.51 vs 0.1 ± 0.27 mg/dL; P = .0319), revealing that the impact of diarrhea on renal function was greater for ID patients. When diarrhea of ≥10 days was used as a cutoff for serum creatinine change, the change of serum creatinine became greater when the diarrhea period was longer (14 d: 0.07 ± 0.22 vs 0.55 ± 0.6 mg/mL; P = .0001). Infectious diarrhea does more damage to the kidney graft than NID in transplant recipients. If the period of diarrhea is lengthened to >10 days, the renal function of the graft would be impaired and irreversible graft loss would be expected. Copyright © 2016. Published by Elsevier Inc.

  4. Assessment of chronic diarrhea in early infancy in Tehran Tertiary Care Center; Tehran-Iran

    OpenAIRE

    Farzaneh Motamed; Naheid Kazemi; Raheleh Nabavizadeh

    2015-01-01

    Introduction Chronic diarrhea of infancy is a heterogeneous syndrome that includes several diseases with different etiologies. The aim of this study was investigating chronic diarrhea, its etiologies, clinical features and outcomes in infancy.Materials and Methods Retrospective study investigating infants hospitalized in the gastroenterology department of Tehran tertiary care center.The main demographic data, etiology, characteristics of diarrhea, and outcome were evaluated. Data were analyze...

  5. [Glutamate dehydrogenase. Its diagnostic value in Clostridioides difficile diarrhea].

    Science.gov (United States)

    Vaustat, Daniela; Rollet, Raquel

    2017-11-14

    Clostridioides difficile is the main etiological agent of diarrhea associated with health care, it produces toxins and glutamate dehydrogenase (GDH), an enzyme that is highly conserved in this species. Rapid diagnosis and effective treatment produce prompt improvement of the patient and subsequent control of the microorganism spread. There are several techniques whose results are interpreted in the context of algorithms. However, the optimal diagnostic method is yet unknown. The performance of GDH as a screening test for the diagnosis of C. difficile diarrhea was assessed. Six hundred and fifteen stool samples were studied. The presence of GDH and toxins presence was determined by TECHLAB® C. DIFF QUIK-CHEK COMPLETE and the samples were cultured for the search of C. difficile. The values of sensitivity, specificity, PPV and NPV were calculated with a p value of 0.05 or less. GDH was detected in 266 samples (43.25%), with a sensitivity of 100% and specificity of 87.10%, IC95: 84.58-91.42; toxin/s were detected in 218 (35.45%) and C. difficile developed in 235 cultures (38.21%). From 48 samples with positive GDH and negative toxin/s, 15 toxigenic and 2 non-toxigenic isolates were obtained, the remaining 31 samples were negative for C. difficile. All GDH-negative samples were negative for toxins or culture, therefore, GDH NPV was 100%, while PPV was 81.9%. We conclude that GDH is a suitable screening test for the diagnostic algorithm of C. difficile diarrhea. Copyright © 2017 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Bovine Viral Diarrhea Virus-Associated Disease in Feedlot Cattle.

    Science.gov (United States)

    Larson, Robert L

    2015-11-01

    Bovine viral diarrhea virus (BVDv) is associated with bovine respiratory disease complex and other diseases of feedlot cattle. Although occasionally a primary pathogen, BVDv's impact on cattle health is through the immunosuppressive effects of the virus and its synergism with other pathogens. The simple presence or absence of BVDv does not result in consistent health outcomes because BVDv is only one of many risk factors that contribute to disease syndromes. Current interventions have limitations and the optimum strategy for their uses to limit the health, production, and economic costs associated with BVDv have to be carefully considered for optimum cost-effectiveness. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Diarrhea as a Presenting Symptom of Disseminated Toxoplasmosis

    Directory of Open Access Journals (Sweden)

    Matthew Glover

    2017-01-01

    Full Text Available Disseminated toxoplasmosis is uncommon in both immunocompetent and immunocompromised hosts with gastrointestinal involvement being rarely described. We report a case of disseminated gastrointestinal toxoplasmosis in an immunocompromised man who presented with one month of diarrhea and abdominal pain. Imaging showed thickening of the ascending colon and cecum. Esophagogastroduodenoscopy and colonoscopy biopsies revealed Toxoplasma gondii, confirmed by immunostain. Symptoms completely resolved following treatment with pyrimethamine, sulfadiazine, and leucovorin. This case highlights the importance of including toxoplasmosis in the differential diagnosis of any immunocompromised individual presenting with gastrointestinal symptoms.

  8. Probiotics for the Prevention of Pediatric Antibiotic-Associated Diarrhea.

    Science.gov (United States)

    Hayes, Shelby R; Vargas, Ashley J

    Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea.Cochrane Database Syst Rev2015, Issue 12. Art. No.: CD004827. http://dx.doi.org/10.1002/14651858.CD004827.pub4. Antibiotics are frequently prescribed in children. They alter the microbial balance within the gastrointestinal tract, commonly resulting in antibiotic-associated diarrhea (AAD). Probiotics may prevent AAD via restoration of the gut microflora. The primary objectives were to assess the efficacy and safety of probiotics (any specified strain or dose) used for the prevention of AAD in children. MEDLINE, EMBASE, CENTRAL, CINAHL, AMED, and the Web of Science (inception to November 2014) were searched along with specialized registers including the Cochrane IBD/FBD review group, CISCOM (Centralized Information Service for Complementary Medicine), NHS Evidence, the International Bibliographic Information on Dietary Supplements, as well as trial registries. Letters were sent to authors of included trials, nutraceutical and pharmaceutical companies, and experts in the field requesting additional information on ongoing or unpublished trials. Conference proceedings, dissertation abstracts, and reference lists from included and relevant articles were also searched. Randomized, parallel, controlled trials in children (0-18 years) receiving antibiotics, that compare probiotics to placebo, active alternative prophylaxis, or no treatment and measure the incidence of diarrhea secondary to antibiotic use were considered for inclusion. Study selection, data extraction, and methodological quality assessment using the risk of bias instrument were conducted independently and in duplicate by two authors. Dichotomous data (incidence of diarrhea and adverse events) were combined using a pooled risk ratio (RR) or risk difference (RD), and continuous data (mean duration of diarrhea and mean daily stool frequency) as mean difference (MD

  9. Inactivation of porcine epidemic diarrhea virus using heated water

    Directory of Open Access Journals (Sweden)

    Michele M. Zentkovich

    2016-12-01

    Full Text Available Porcine epidemic diarrhea virus (PEDV is a very contagious swine pathogen that spreads easily via the fecal-oral route, notably from contaminated fomites. The present study investigated heated water as a method for rapid thermal inactivation of PEDV. Cell-culture adapted PEDV was treated with water at varying temperatures and viral titers were measured at multiple time points post-treatment. Viable PEDV was not recovered after a ten second or longer treatment with water heated to ≥76 °C; however, PEDV nucleic acid was detected in all samples regardless of treatment. Hot water decontamination could be considered in settings where chemical disinfection is impractical.

  10. Recurrent diarrhea as a manifestation of temporal lobe epilepsy.

    Science.gov (United States)

    Murai, Tomohiko; Tohyama, Teruhiko; Kinoshita, Masako

    2014-01-01

    A woman with temporal lobe epilepsy manifesting with repeated episodes of sudden diarrhea and loss of consciousness is reported. A 63-year-old, right-handed female presented with chief complaints of sudden diarrhea and loss of consciousness for almost three decades. The first attack occurred in her 30s, and similar attacks repeated several times in a year. Her attacks comprised abrupt abdominal discomfort, diarrhea, sudden emergence of old memories relating to when she had played with her brother in her childhood, and loss of consciousness during defecation. She had no convulsion or automatism and fully recovered in a few minutes. Every time she was transferred to emergency hospital by ambulance, she had examinations such as blood test, head computed tomography, electrocardiogram, abdominal ultrasound, and electroencephalography (EEG), but no specific diagnosis was made. On admission to our hospital, vital signs, neurological examination, and blood tests did not show abnormal findings. During long-term video-EEG monitoring for 40 h, she had no habitual event. Interictal EEG showed intermittent irregular delta waves and sharp regional transients in the left anterio-midtemporal area. Sharp transients were not as outstanding from background activities as to be defined as epileptiform discharges, but they were reproducible in morphology and distribution and appeared not only in sleep but also in wakefulness. Brain magnetic resonance imaging was unremarkable. Single-photon emission computed tomography showed a decrease of blood flow in the left frontal and temporal lobes. Wechsler Adult Intelligence Scale-III showed a decline of verbal comprehension. We concluded that the patient was suffering from partial epilepsy originating from the left temporal lobe. Carbamazepine markedly improved her seizures. Temporal lobe epilepsy can manifest with diverse autonomic symptoms and signs. Abdominal sensations often herald the onset of epileptic seizures. Among them is an uncommon

  11. Recurrent diarrhea as a manifestation of temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Tomohiko Murai

    2014-01-01

    Full Text Available A woman with temporal lobe epilepsy manifesting with repeated episodes of sudden diarrhea and loss of consciousness is reported. A 63-year-old, right-handed female presented with chief complaints of sudden diarrhea and loss of consciousness for almost three decades. The first attack occurred in her 30s, and similar attacks repeated several times in a year. Her attacks comprised abrupt abdominal discomfort, diarrhea, sudden emergence of old memories relating to when she had played with her brother in her childhood, and loss of consciousness during defecation. She had no convulsion or automatism and fully recovered in a few minutes. Every time she was transferred to emergency hospital by ambulance, she had examinations such as blood test, head computed tomography, electrocardiogram, abdominal ultrasound, and electroencephalography (EEG, but no specific diagnosis was made. On admission to our hospital, vital signs, neurological examination, and blood tests did not show abnormal findings. During long-term video-EEG monitoring for 40 h, she had no habitual event. Interictal EEG showed intermittent irregular delta waves and sharp regional transients in the left anterio-midtemporal area. Sharp transients were not as outstanding from background activities as to be defined as epileptiform discharges, but they were reproducible in morphology and distribution and appeared not only in sleep but also in wakefulness. Brain magnetic resonance imaging was unremarkable. Single-photon emission computed tomography showed a decrease of blood flow in the left frontal and temporal lobes. Wechsler Adult Intelligence Scale—III showed a decline of verbal comprehension. We concluded that the patient was suffering from partial epilepsy originating from the left temporal lobe. Carbamazepine markedly improved her seizures. Temporal lobe epilepsy can manifest with diverse autonomic symptoms and signs. Abdominal sensations often herald the onset of epileptic seizures

  12. Foal Diarrhea: Established and Postulated Causes, Prevention, Diagnostics, and Treatments.

    Science.gov (United States)

    Oliver-Espinosa, Olimpo

    2018-01-30

    Diarrhea is one of the most important diseases in young foals and may occur in more than half of foals until weaning age. Several infectious and noninfectious underlying causes have been implicated but scientific evidence of pathogenesis is evolving. It is important to investigate all known potential causes and identify infectious agents to avoid outbreaks, evaluate the level of systemic compromise, and establish adequate therapy. It is crucial to differentiate foals that can be managed in field conditions from those that should be sent to a referral center. This article reviews these aspects and recent developments in the diagnostic and therapeutic approaches. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Celiac disease in children with diarrhea in 4 cities in China.

    Science.gov (United States)

    Wang, Xin-qiong; Liu, Wei; Xu, Chun-di; Mei, Hong; Gao, Yuan; Peng, Han-ming; Yuan, Lan; Xu, Jun-jie

    2011-10-01

    The aim of the study was to investigate whether celiac disease (CD) could be the cause of chronic diarrhea in Chinese patients. During the period of January 2005 to December 2008, patients with chronic diarrhea in pediatric hospitals from 4 major cities (Shanghai, Wuhan, Jinan, and Chengdu) in China were included in the study. The clinical history, physical findings, and laboratory data were collected and analyzed. Among 199 patients with chronic diarrhea, 118 were enrolled in the study. Fourteen (11.9%) were diagnosed as being affected by CD. The 14 patients are the first reported cases of CD in Chinese patients with chronic diarrhea.

  14. Diarrhea Caused by Rotavirus in Children Less than 5 Years of Age in Hanoi, Vietnam

    OpenAIRE

    Nguyen, Trung Vu; Le, Phung Van; Le Huy, Chinh; Weintraub, Andrej

    2004-01-01

    Group A rotaviruses are the major cause of diarrhea in young children worldwide. From March 2001 to April 2002, 836 children less than 5 years of age were investigated in Hanoi, Vietnam. This included 587 children with diarrhea and 249 age-matched controls. Group A rotavirus was identified in 46.7% of the children with diarrhea and 3.6% of the controls, which was a significant difference. Within the diarrhea group, the highest prevalence was seen in children from 13 to 24 months of age, and t...

  15. Occurrence of Tropheryma whipplei during diarrhea in Hajj pilgrims: a PCR analysis of paired rectal swabs.

    Science.gov (United States)

    Gautret, Philippe; Benkouiten, Samir; Parola, Philippe; Brouqui, Philippe; Memish, Ziad; Raoult, Didier

    2014-01-01

    Tropheryma whipplei was recently associated with gastroenteritis in children. We hypothesize that T. whipplei may be a contributing microbe in traveller's diarrhea. The presence of T. whipplei was investigated by PCR on rectal swab samples of Hajj pilgrims before and after travelling to the Kingdom of Saudi Arabia (KSA). Additionally a rectal swab was performed at the time of diarrhea for some pilgrims. A total of 129 pilgrims underwent rectal swab samples before departure and on return. All pilgrims were negative for T. whipplei before travel. One pilgrim (0.8%) was positive on return but did not reported diarrhea. A total of 30 pilgrims (23.3%) experienced diarrhea during the stay in the KSA. Nine pilgrims with diarrhea underwent the additional rectal swab during their diarrhea episode, two of them were positive for T. whipplei. This work suggests that T. whipplei may be associated with adult traveller's diarrhea, by finding T. whipplei DNA individuals negative before and after the episode of diarrhea. Further study addressing this issue in larger cohorts of Hajj pilgrims with systematic sampling at the time of diarrheal episode may help to understand the potential role of T. whipplei in traveller's diarrhea. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Epidemiology of norovirus infections among diarrhea outpatients in a diarrhea surveillance system in Shanghai, China: a cross-sectional study.

    Science.gov (United States)

    Xue, Ying; Pan, Hao; Hu, Jiayu; Wu, Huanyu; Li, Jian; Xiao, Wenjia; Zhang, Xi; Yuan, Zheng'an; Wu, Fan

    2015-04-15

    Norovirus is an important cause of gastroenteritis both in children and adults. In China, few studies have been conducted on adult populations. This study aimed to determine the contribution of norovirus to gastroenteritis, characterize the features of norovirus infections, compare them with other pathogens, and test the effectiveness of the surveillance system. A citywide surveillance network on diarrhea patients was established. Samples were collected with intervals from both children and adults among diarrhea outpatients in hospitals and tested for viruses using rRT-PCR and for bacteria in CDCs. Patient information was acquired through interviews and recorded into a dedicated online system. The Pearson χ2 test, multivariate logistic regression models and discriminant models were fitted into its comparisons with the non-norovirus group and other pathogens. Norovirus was detected in 22.91% of sampled diarrhea patients. The seasonal distribution of norovirus infections was different from non-norovirus patients (pfever (p=0.046, OR=0.758, 95% CI=0.577-0.996) and abdominal pain (p=0.018, OR=0.815, 95% CI=0.689-0.965). Children were more vulnerable to rotavirus (p=0.008, OR=1.637, 95% CI=1.136-2.358) and bacteria (p=0.027, OR=1.511, 95% CI=1.053-2.169) than norovirus. There was a seasonal difference between the GI and GII genotypes (protavirus and bacteria, children were less frequently affected by norovirus. Nausea and vomiting were typical of norovirus, whereas fever and abdominal pain were uncommon symptoms of this pathogen. GI and GII infections were centered in different seasons. Officials and clerks were more easily affected by GI than GII.

  17. Diagnosis and treatment of diarrhea-predominant irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Lacy BE

    2016-02-01

    Full Text Available Brian E Lacy Division of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA Abstract: Irritable bowel syndrome (IBS is one of the most common gastrointestinal disorders worldwide. The economic impact of IBS on the health care system is substantial, as is the personal impact on patients. Patients with diarrhea-predominant IBS (IBS-D comprise a substantial proportion of the overall IBS population. Primary care providers are often the first point of contact for patients with IBS-D and can accurately diagnose IBS after a careful history and examination without extensive diagnostic tests. Several pharmacologic treatments (eg, loperamide, alosetron, and antidepressants and non-pharmacologic treatments (eg, dietary modification and probiotics are available for IBS-D, but restrictions on use (eg, alosetron or the lack of controlled trial data showing reductions in both global and individual IBS-D symptoms (eg, bloating, pain and stool frequency emphasize the need for alternative treatment options. Two newer medications (eluxadoline and rifaximin were approved in May 2015 for the treatment of IBS-D, and represent new treatment options for this common gastrointestinal condition. Keywords: abdominal pain, antibiotic, bloating, diarrhea, irritable bowel syndrome

  18. Isospora belli Infection with Chronic Diarrhea in an Alcoholic Patient

    Science.gov (United States)

    Kim, Min Jae; Kim, Woo Ho; Jung, Hyun-Chae; Chai, Jee-Won

    2013-01-01

    Chronic diarrhea with a 35 kg weight loss (75 kg to 40 kg) occurred during 2 years in an alcoholic patient was diagnosed with Isospora belli infection in the Republic of Korea. The patient, a 70-year old Korean male, had been a heavy drinker for more than 30 years. He was admitted to the Seoul National University Hospital because of long-standing diarrhea and severe weight loss. He had an increased white blood cell (WBC) count with high peripheral blood eosinophilia (36.8-39.9%) and lowered protein and albumin levels but without any evidence of immunosuppression. A parasitic infection was suspected and fecal examination was repeated 3 times with negative results. Peroral endoscopy with mural biopsy was performed in the upper jejunum. The biopsy specimens revealed villous atrophy with loss of villi together with various life cycle stages of I. belli, including trophozoites, schizonts, merozoites, macrogamonts, and microgamonts. The patient was treated successfully with oral doses of trimethoprim 160-320 mg and sulfamethoxazole 800-1,600 mg daily for 4 weeks. A follow-up evaluation at 2.5 years later revealed marked improvement of body weight (68 kg), increased protein and albumin levels, and normal WBC count with low eosinophils (3.1%). This is the first clinical case of isoporiasis with demonstration of various parasitic stages in the Republic of Korea. PMID:23710089

  19. Association of Blastocystis subtypes with diarrhea in children

    Science.gov (United States)

    Zulfa, F.; Sari, I. P.; Kurniawan, A.

    2017-08-01

    Blastocystis hominis is an intestinal zoonotic protozoa that epidemiological surveys have shown, is highly prevalent among children and may cause chronic diarrhea. This study aimed to identify Blastocystis subtypes among children and associate those subtypes to pathology. The study’s population was children aged 6-12 years old divided into asymptomatic and symptomatic (diarrhea) groups. The asymptomatic samples were obtained from primary school students in the Bukit Duri area of South Jakarta, while the symptomatic samples were obtained from patients who visited nearby primary health centers (Puskesmas). Symptomatic stool samples were examined inParasitology Laboratory FKUI. Microscopic examination of the stool samples was performed to screen for single Blastocystic infection, followed by culture, PCR of 18S rRNA, and sequencing. In the study, 53.2% of children (n = 156) harbored intestinal parasites, Blastocysts sp. A single infection of Blastocystis sp. was present in 69 (44.23%) samples, comprised of 36 symptomatic and 33 asymptomatic participants. The Blastocystis subtypes (STs) identified in this study were STs 1-4 ST3 was the most dominant and was observed with statistically significant higher frequency in the symptomatic group. ST4 was only found in one sample in the symptomatic group. While ST1 and ST2 were found more frequently in the asymptomatic group, no statistical association was observed. ST3 is more likely to be associated with clinical symptoms than ST1 and ST2.

  20. Optimization of Pathogenetic Treatment of Secretory Diarrhea in Infants

    Directory of Open Access Journals (Sweden)

    O.K. Koloskova

    2014-02-01

    Full Text Available The aim of the research was to access clinical efficacy of oral rehydration therapy using III generation solutions in the treatment of secretory diarrhea in infants. To achieve this aim, on the basis of infectious box unit (enteric infections of regional clinical hospital (Chernivtsi we examined 116 infants, randomly selected, with acute gastroenteritis, who admitted to the hospital with signs of exycosis due to secretory diarrhea. Among examined patients, 73 (67.5 % children with the purpose of oral rehydration therapy received rehydration solutions, and 35 (32.4 % patients received other rehydration solutions. Monitoring of the dynamics of patients’ state enabled to state that, when we used III generation mixture as a main component of oral rehydration therapy, rate of positive dynamics in terms of clinical status of patients was significantly faster, in particular, body temperature, frequency and nature of bowel movements normalized significantly earlier, vomiting disappeared. In children treated with rehydration solutions, compared with patients receiving other rehydration solutions, odds ratio to confine only oral rehydration was 3.7 (95% CI 0.4–38.9 with an absolute risk to avoid the need for infusion therapy — 11 %.

  1. [Enteropathogens relating to diarrhea in HIV patients on antiretroviral therapy].

    Science.gov (United States)

    Pupulin, Aurea Regina Telles; Carvalho, Paula Galdino; Nishi, Letícia; Nakamura, Celso Vataru; Guilherme, Ana Lucia Falavigna

    2009-01-01

    The etiology of the diarrheic process in AIDS may be caused by viruses, bacteria, fungi, protozoa or helminths, as well as HIV itself. This study evaluated enteropathogens relating to diarrhea in HIV patients who were on antiretroviral therapy. The parasitological methods used were Faust, Hoffmann and Kinyoun. Isolation and culturing of fungi were carried out in accordance with the methodology recommended by the NCCLS M27-A standard. The yeast species were identified using the polymerase chain reaction (PCR). Bacteria were isolated on MacConkey and SS agar and the species were identified using Enterokit B (Probac do Brasil) and biochemical methods. Forty-nine patients were evaluated: 44.89% presented enteroparasites and 48.1% presented Candida sp, of which 61.5% were Candida albicans, 7.6% were Candida sp and 30.7% were Candida non-albicans. Bacteria were isolated from 72% of the patients, of which 49% were Escherichia coli, 13% Salmonella parathyphi, Klebsiella sp or Proteus and 6% Citrobacter freundii or Yersinia sp. There was high prevalence of Candida sp in HIV patients with diarrhea and non-albicans species were isolated. Their presence could be taken to mean that they were accomplices in or causes of the infection.

  2. Complete genome characterization of porcine epidemic diarrhea virus in Vietnam.

    Science.gov (United States)

    Vui, Dam Thi; Thanh, To Long; Tung, Nguyen; Srijangwad, Anchalee; Tripipat, Thitima; Chuanasa, Taksina; Nilubol, Dachrit

    2015-08-01

    Porcine epidemic diarrhea virus (PEDV) first emerged in Vietnam in 2009. In this study, the complete genomes of three Vietnamese PEDV isolates were characterized. These three isolates were isolated from 3-day-old pigs experiencing diarrhea. Two isolates were from swine farms in the south, and the other was from northern Vietnam. The whole genome sequences of these isolates are 28,035 nucleotides in length and have characteristics similar to those of other PEDV isolates. All three Vietnamese PEDV isolates share 99.8 % and 99.6 % sequence identity at the nucleotide and amino acid level, respectively, and have insertions of four amino acids (GENQ) and one amino acid (N) at positions 56-59 and 140, respectively, and one deletion of two amino acids (DG) at positions 160-161. Phylogenetic analysis based on the whole genome revealed that the three Vietnamese PEDV isolates are grouped together with new variants from China from 2011 to 2012 and are genetically distinct from US isolates and the classical PEDV variant. The results suggest that Vietnamese PEDV isolates are new variants, as evidenced by their genetic composition of insertions and a deletion in the spike gene, and they might have originated from the same ancestor as the Chinese PEDV strain. This study provides a better understanding of the molecular characteristics of PEDV in Vietnam.

  3. Colonoscopic findings in Peruvian patients with chronic diarrhea.

    Directory of Open Access Journals (Sweden)

    Javier Villafuerte-Gálvez

    Full Text Available OBJECTIVE: To report the colonoscopic and pathological findings in patients with chronic diarrhea from a gastroenterology unit during approximately 3 years in a general teaching hospital located in Lima-Peru. MATERIALS AND METHODS: Patients with chronic diarrhea as the motive for colonoscopy from March 2008 to December 2010 were selected from the colonoscopy report computerized database. Colonoscopic findings were registered. Biopsies taken during the procedure were prospectively reviewed. RESULTS: 226 patients were included, of which 162 (71.7% had a colon biopsy available. The average age of the patients was 53.6±16.36. 85.8% of patients were reported to have a normal colon. 14.8% of patients were found to have a normal colonic mucosa or mucosal edema, 35.8% of patients had lymphocytic colitis and 28.4% had paucicelular colitis. CONCLUSIONS: The majority of colonoscopies were reported with unremarkable macroscopic findings. Lymphocytic colitis was unusually frequent compared to previous reports.

  4. [Post-diarrhea hemolytic-uremic syndrome: clinical aspects].

    Science.gov (United States)

    Loirat, C

    2001-09-01

    Every year in France, about 100 children, most of them less than 3 years old, have typical diarrhea-associated HUS (D + HUS). Evidence of exposure to verotoxin producing E. coli (VTEC), mostly the O157: H7 serotype, is demonstrated in about 85% of cases. A prodromal illness of acute gastroenteritis with diarrhea, often bloody, precedes the HUS by 1 to 15 days. HUS onset is sudden, with the typical association of hemolytic anemia with fragmented red blood cells, thrombocytopenia and acute renal insufficiency. Involvement of other organs than the kidneys may occur, such as severe hemorrhagic colitis with rectal prolapse, bowel wall necrosis or secondary stenosis, acute pancreatitis, central nervous system involvement which determines the vital outcome. Early accurate supportive treatment allows a current mortality rate below 5%, with most deaths due to central nervous system involvement. Five to 10% of children develop end stage renal disease, rarely directly, more often after having recovered some renal function with chronic renal insufficiency during a few years. After 15 or more years follow-up, at least one third of patients have some degree of proteinuria and/or hypertension, and eventually chronic or end stage renal failure. Predictive features of poor renal outcome at the acute phase are severe gastrointestinal involvement, severe CNS involvement, polyncleosis over 20,000/mm3, and duration of initial anuria longer than one week. The role of VTEC in D + HUS makes the disease a public health problem. Preventive measures are essential.

  5. Crofelemer for the treatment of chronic diarrhea in patients living with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Patel TS

    2013-07-01

    Full Text Available Twisha S Pate, Rustin D Crutchley, Anne M Tucker, Jessica Cottreau, Kevin W Garey Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Houston, TX, USA Abstract: Diarrhea is a common comorbidity present in patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS who are treated with highly active antiretroviral therapy. With a multifactorial etiology, this diarrhea often becomes difficult to manage. In addition, some antiretrovirals are associated with chronic diarrhea, which potentially creates an adherence barrier to antiretrovirals and may ultimately affect treatment outcomes and future therapeutic options for HIV. A predominant type of diarrhea that develops in HIV patients has secretory characteristics, including increased secretion of chloride ions and water into the intestinal lumen. One proposed mechanism that may lead to this type of secretory diarrhea is explained by the activation of the cystic fibrosis transmembrane conductance regulator and calcium-activated chloride channels. Crofelemer is a novel antidiarrheal agent that works by inhibiting both of these channels. The efficacy and safety of crofelemer has been evaluated in clinical trials for various types of secretory diarrhea, including cholera-related and acute infectious diarrhea. More recently, crofelemer was approved by the US Food and Drug Administration for the symptomatic relief of noninfectious diarrhea in adult patients with HIV/AIDS on antiretroviral therapy. Results from the ADVENT trial showed that crofelemer reduced symptoms of secretory diarrhea in HIV/AIDS patients. Because crofelemer is not systemically absorbed, this agent is well tolerated by patients, and in clinical trials it has been associated with minimal adverse events. Crofelemer has a unique mechanism of action, which may offer a more reliable treatment option for HIV patients who experience chronic secretory diarrhea from

  6. Determining bovine viral diarrhea virus genotypes and biotypes circulating in cattle populations in Mexico

    Science.gov (United States)

    Bovine viral diarrhea (BVD) is the disease in cattle that results from infection with bovine viral diarrhea viruses (BVDV). BVDV is found in cattle populations throughout the world. While the term BVD encompasses a wide range of clinical manifestations, including severe respiratory disease, gastroe...

  7. Maternal education and diarrhea among children aged 0-24 months ...

    African Journals Online (AJOL)

    Childhood diarrhea remains a problem in countries like Nigeria where access to potable water, good hygiene and sanitation are lacking. Maternal education is an important determinant of health status of under-five children. Very few studies have investigated the relationship between maternal education and diarrhea in ...

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

    OpenAIRE

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

    2014-01-01

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

  9. Fecal Isolation of Corynebacterium equi from a Foal with Chronic Diarrhea

    OpenAIRE

    Smith, K. D.; Butler, D. G.

    1984-01-01

    Corynebacterium equi was isolated from the feces of a foal with chronic diarrhea. The foal had multiple walnut-sized masses associated with the intestine on rectal examination. These were thought to be enlarged lymph nodes and/or abscesses. The foal also had an elevated plasma fibrinogen. The diarrhea was controlled with antibiotics but recurred when the treatment was stopped.

  10. Novel human bufavirus genotype 3 in children with severe diarrhea, Bhutan.

    Science.gov (United States)

    Yahiro, Takaaki; Wangchuk, Sonam; Tshering, Kinlay; Bandhari, Purushotam; Zangmo, Sangay; Dorji, Tshering; Tshering, Karchung; Matsumoto, Takashi; Nishizono, Akira; Söderlund-Venermo, Maria; Ahmed, Kamruddin

    2014-06-01

    We identified a new genotype of bufavirus, BuV3, in fecal samples (0.8%) collected to determine the etiology of diarrhea in children in Bhutan. Norovirus GII.6 was detected in 1 sample; no other viral diarrheal pathogens were detected, suggesting BuV3 as a cause of diarrhea. This study investigates genetic diversity of circulating BuVs.

  11. Differential Yield of Pathogens from Stool Testing of Nosocomial versus Community-Acquired Paediatric Diarrhea

    Directory of Open Access Journals (Sweden)

    Savita Deorari

    1999-01-01

    Full Text Available OBJECTIVES: To evaluate the role of routine stool examination for all pathogens in paediatric nosocomial diarrhea (NAD and community-acquired diarrhea (CAD over a two-year period at Alberta Children’s Hospital and current practices in other Canadian hospitals. A secondary objective was to characterize features that may predict NAD or CAD etiology.

  12. [Adhesion patterns in diffusely adherent Escherichia coli (DAEC) strains isolated from children with and without diarrhea].

    Science.gov (United States)

    Riveros, Maribel; Barletta, Francesca; Cabello, Martín; Durand, David; Mercado, Erik H; Contreras, Carmen; Rivera, Fulton P; Mosquito, Susan; Lluque, Angela; Ochoa, Theresa J

    2011-03-01

    Diffusely adherent E. coli (DAEC) is the sixth recognized group of diarrheagenic E. coli. However, its association with diarrhea remains controversial. Variability in the adherence patterns of clinical strains is unknown. To compare the adherence patterns between strains isolated from children with and without diarrhea. A total of 31 DAEC strains were analyzed, 25 from children with diarrhea and 6 from asymptomatic (control) children, isolated from a cohort study of children under one year of age in the southern districts of Lima. DAEC were identified by PCR (daaD gene). The pattern and adherence score in HEp-2 cell culture were evaluated, Actin polimerization was determined by fluorescence actin staining (FAS) and motility was evaluated by conventional microbiology methods. Diffuse adherence pattern was found in 88% of diarrhea samples and in the total of control strains. The number of bacteria adhered per cell was significantly lower in diarrhea samples (p<0.05). However, actin polymerization was greater in diarrhea samples (60% vs. 17%). Motility test was positive in 60% of the diarrhea samples and in all control samples. Our findings suggest a difference between adherence patterns, actin polymerization and motility between DAEC strains corresponding to diarrhea and control groups. The significance of these results must be confirmed with a bigger number of strains and determining the presence of virulence genes in the strains.

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

    Science.gov (United States)

    Gaffey, Michelle F; Wazny, Kerri; Bassani, Diego G; Bhutta, Zulfiqar A

    2013-01-01

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

  14. Chronic unexplained diarrhea: a logical and cost-effective approach to assessment.

    Science.gov (United States)

    Dosanjh, Grace; Pardi, Darrell S

    2016-01-01

    The workup of chronic unexplained diarrhea can be equally frustrating for care providers and patients. It carries a physical, financial, and social toll. In this review we provide a sensible approach to evaluating and managing chronic diarrhea. Bile acid diarrhea is becoming increasingly recognized as a potential cause behind some cases of chronic diarrhea. A detailed history and physical examination can provide clues that guide a logical approach to the evaluation. We suggest a cost-effective approach to the workup and management of chronic diarrhea based on individual patient factors related to clinical history and physical exam. We find that this approach leads to initiation of treatment in a time-efficient fashion and avoids unnecessary testing.

  15. Malaria parasitemia and childhood diarrhea in a peri-urban area of Guinea-Bissau

    DEFF Research Database (Denmark)

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

    1999-01-01

    between diarrhea and parasite rate, parasite density, or clinical malaria. However, anti-malarials were easily available and frequently used, which was reflected by a 0.7% prevalence of children with a parasite density > 100/200 leukocytes. Thus, the findings do not preclude that diarrhea may be a sign......To examine the association between diarrhea in early childhood and malaria parasitemia, we conducted a nested case-control study in Guinea-Bissau of 297 children with diarrhea and a similar number of children without diarrhea matched for age, season, and residential area. There were no associations...... of clinical malaria or high-parasite density in endemic areas with lower use of antimalarials....

  16. Chronic diarrhea associated with persistent norovirus excretion in patients with chronic lymphocytic leukemia: report of two cases

    National Research Council Canada - National Science Library

    Capizzi, Todd; Makari-Judson, Grace; Steingart, Richard; Mertens, Wilson C

    2011-01-01

    .... Norovirus infection, a major cause of acute epidemic diarrhea, has been described as a cause of chronic diarrhea in patients who are immunosuppressed, including transplant recipients and the very young...

  17. Childhood Diarrhea Exhibits Spatiotemporal Variation in Northwest Ethiopia: A SaTScan Spatial Statistical Analysis.

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    Muluken Azage

    Full Text Available Childhood diarrhea continues to be a public health problem in developing countries, including Ethiopia. Detecting clusters and trends of childhood diarrhea is important to designing effective interventions. Therefore, this study aimed to investigate spatiotemporal clustering and seasonal variability of childhood diarrhea in northwest Ethiopia.Retrospective record review of childhood diarrhea was conducted using quarterly reported data to the district health office for the seven years period beginning July 1, 2007. Thirty three districts were included and geo-coded in this study. Spatial, temporal and space-time scan spatial statistics were employed to identify clusters of childhood diarrhea. Smoothing using a moving average was applied to visualize the trends and seasonal pattern of childhood diarrhea. Statistical analyses were performed using Excel® and SaTScan programs. The maps were plotted using ArcGIS 10.0.Childhood diarrhea in northwest Ethiopia exhibits statistical evidence of spatial, temporal, and spatiotemporal clustering, with seasonal patterns and decreasing temporal trends observed in the study area. A most likely purely spatial cluster was found in the East Gojjam administrative zone of Gozamin district (LLR = 7123.89, p <0.001. The most likely spatiotemporal cluster was detected in all districts of East Gojjam zone and a few districts of the West Gojjam zone (LLR = 24929.90, p<0.001, appearing from July 1, 2009 to June 30, 2011. One high risk period from July 1, 2008 to June 30, 2010 (LLR = 9655.86, p = 0.001 was observed in all districts. Peak childhood diarrhea cases showed a seasonal trend, occurring more frequently from January to March and April to June.Childhood diarrhea did not occur at random. It has spatiotemporal variation and seasonal patterns with a decreasing temporal trend. Accounting for the spatiotemporal variation identified in the study areas is advised for the prevention and control of diarrhea.

  18. Exploring spatial patterns and hotspots of diarrhea in Chiang Mai, Thailand

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    Tripathi Nitin K

    2009-06-01

    Full Text Available Abstract Background Diarrhea is a major public health problem in Thailand. The Ministry of Public Health, Thailand, has been trying to monitor and control this disease for many years. The methodology and the results from this study could be useful for public health officers to develop a system to monitor and prevent diarrhea outbreaks. Methods The objective of this study was to analyse the epidemic outbreak patterns of diarrhea in Chiang Mai province, Northern Thailand, in terms of their geographical distributions and hotspot identification. The data of patients with diarrhea at village level and the 2001–2006 population censuses were collected to achieve the objective. Spatial analysis, using geographic information systems (GIS and other methods, was used to uncover the hidden phenomena from the data. In the data analysis section, spatial statistics such as quadrant analysis (QA, nearest neighbour analysis (NNA, and spatial autocorrelation analysis (SAA, were used to identify the spatial patterns of diarrhea in Chiang Mai province. In addition, local indicators of spatial association (LISA and kernel density (KD estimation were used to detect diarrhea hotspots using data at village level. Results The hotspot maps produced by the LISA and KD techniques showed spatial trend patterns of diarrhea diffusion. Villages in the middle and northern regions revealed higher incidences. Also, the spatial patterns of diarrhea during the years 2001 and 2006 were found to represent spatially clustered patterns, both at global and local scales. Conclusion Spatial analysis methods in GIS revealed the spatial patterns and hotspots of diarrhea in Chiang Mai province from the year 2001 to 2006. To implement specific and geographically appropriate public health risk-reduction programs, the use of such spatial analysis tools may become an integral component in the epidemiologic description, analysis, and risk assessment of diarrhea.

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

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

    2016-10-01

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

  20. [A solitary kidney patient with diarrhea of 2 weeks duration].

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    Díaz Aguilar, C M; Recio Ramirez, J M; Vega Romero, M M; Calero Rojas, M T

    2014-01-01

    The case is presented of a 78 year old woman with a history of congenital right renal, who suffered from diarrhea of approximately 2 weeks duration and discomfort due to cramp in both legs. The laboratory results showed severe hyperkalemia, hyponatremia, and slightly elevated creatinine levels, with no symptoms associated with this finding and with the rest of the normal laboratory results. She was admitted to the intensive care unit for treatment, and when her results returned to normal she was transferred to internal medicine. Among the other tests performed, the ACTH was shown to be high, and a left adrenal adenoma was found in the MR scan. The final diagnosis was Addison's syndrome. She was treated with mineralocorticoids with follow-up by internal medicine as an outpatient. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  1. Chronic diarrhea and juvenile cataracts: think cerebrotendinous xanthomatosis and treat.

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    Berginer, Vladimir M; Gross, Bella; Morad, Khayat; Kfir, Nechama; Morkos, Siman; Aaref, Salameh; Falik-Zaccai, Tzipora C

    2009-01-01

    Cerebrotendinous xanthomatosis is an autosomal recessive disease of bile acid synthesis caused by 27-hydroxylase deficiency. Treatment with chenodeoxycholic acid normalizes cholestanol concentrations and abrogates progression of the disease. We present 4 patients with cerebrotendinous xanthomatosis within 1 family who were treated with chenodeoxycholic acid for 14 years. Two young sisters started treatment at the preclinical stage before the appearance of major symptoms. Their 2 older uncles, who had already developed the complete phenotypic form of cerebrotendinous xanthomatosis when diagnosed, commenced treatment at the same time as the sisters, thus establishing a natural control group. After 14 years of chenodeoxycholic acid therapy, the cholestanol levels of all 4 patients decreased to normal levels (chronic diarrhea and juvenile cataracts. Prevention is particularly significant in light of the availability of early genetic diagnosis and the devastating effects of this illness if not treated.

  2. Microscopic colitis as a missed cause of chronic diarrhea.

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    Mohamed, Nooroudien; Marais, Monique; Bezuidenhout, Juanita

    2011-04-21

    To determine the prevalence of increased intraepithelial lymphocytes, using immunohistochemistry in patients with normal colonoscopy and near normal biopsy. We retrospectively reviewed all non-malignant colon mucosal biopsies between 2005 and 2007, reported as normal, chronic inflammation or melanosis coli in patients who were undergoing routine colonoscopy. Immunohistochemistry using CD3 was performed on all mucosal biopsies and an intraepithelial lymphocyte 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. Twenty (8.3%) of 241 cases revealed an IEL count ≥ 20. Six (2.5%) patients were identified as having lymphocytic colitis (P colitis with an IEL count microscopic colitis in patients with diarrhea-predominant IBS.

  3. Protozoan enteric infection in AIDS related diarrhea in Thailand.

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    Waywa, D; Kongkriengdaj, S; Chaidatch, S; Tiengrim, S; Kowadisaiburana, B; Chaikachonpat, S; Suwanagool, S; Chaiprasert, A; Curry, A; Bailey, W; Suputtamongkol, Y; Beeching, N J

    2001-01-01

    The aim of this study was to determine the prevalence of enteric protozoa and other pathogens in AIDS patients with diarrhea in Bangkok, Thailand. Of 288 consecutive patients screened in the 10 month period between November 1999-August 2000 inclusive, 55 (19.2%) had Cryptosporidium spp, 13 (4.5%) had Isospora oocyst, 11 (3.8%) had Giardia lamblia, 3 (0.9%) had Entamoeba histolytica, and 1 (0.3%) had Iodamoeba butschlii infection. The prevalence of microsporidia was 11% in this study. Of 251 patients for whom stool culture for bacteria was performed, enteric bacterial pathogens isolated were Campylobacter spp in 18 (7.1%), Salmonella spp in 11 (4.3%), and Shigella spp in 1 (0.5%). Other pathogens found in these patients were Clostridium difficile in 16/102 (15.6%). Mycobacterium spp in 18/287 (6.2%), and Strongyloides stercoralis in 23/288 (8.0%). Overall, parasitic and bacterial pathogens were identified in 140 (48.6%) patients. These pathogens were identified by the routine simple wet smear technique in 32, formalin-ether concentration method in 46, culture for S. stercoralis in 5, and culture for bacteria in 30. Additional test, using modified Ziehl-Neelsen staining, identified cryptosporidial oocyst, isospora oocyst, and Mycobacterium spp in 72. The microsporidia, initially identified by modified trichrome blue staining, all were then determined to be Enterocytozoon bieneusi by thin sectioning electron microscopy. Protozoan and bacterial pathogens were confirmed to be important etiologic agents in diarrhea in AIDS in Thailand. They were all associated with increased mortality. Routine stool examination by simple wet smear detected only one-fourth of these pathogens. Therefore all diagnostic techniques for these organisms should be made more widely available in Thailand.

  4. Medications for the prevention and treatment of travellers' diarrhea.

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    Taylor, David N; Hamer, Davidson H; Shlim, David R

    2017-04-01

    . Travellers' diarrhea (TD) remains one of the most common illnesses encountered by travellers to less developed areas of the world. Because bacterial pathogens such as enterotoxigenic Escherichia coli (ETEC), enteroaggregative E. coli , Campylobacter spp. and Shigella spp. are the most frequent causes, antibiotics have been useful in both prevention and treatment of TD. Results of trials that assessed the use of medications for the prevention and treatment of TD were identified through PubMed and MEDLINE searches using search terms 'travellers' diarrhea', 'prevention' and 'treatment'. References of articles were also screened for additional relevant studies. Prevention of TD with antibiotics has been recommended only under special circumstances. Doxycycline, trimethoprim-sulfamethoxazole, fluoroquinolones and rifaximin have been used for prevention, but at present the first three antibiotics may have limited use secondary to increasing resistance, leaving rifaximin as the only current option. Bismuth subsalicylate (BSS) (Pepto-Bismol tablets) is also an option for prophylaxis. Treatment with antibiotics has been recommended for moderate to severe TD. Azithromycin is the drug of choice, especially in Asia where Campylobacter is common. Fluoroquinolone antibiotics continue to be effectively used in Latin America and Africa where ETEC is predominant. BSS and loperamide (LOP) also are effective as standalone treatments. LOP may be used alone for treatment of mild TD or in conjunction with antibiotics for treatment of TD. . Historically, antibiotic prophylaxis has not been routinely recommended and has been reserved for special circumstances such as when a traveller with an underlying illness cannot tolerate TD. Antibiotics with or without LOP have been useful in shortening the duration and severity of TD. Emerging antibiotic resistance, limited new antibiotic alternatives and faecal carriage of antibiotic-resistant bacteria by travellers may prompt a re-evaluation of

  5. Impact of porcine epidemic diarrhea on performance of growing pigs.

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    Julio Alvarez

    Full Text Available The impact of porcine epidemic diarrhea virus (PEDv infection on the US pork industry has mainly been attributed to the mortality that it causes in suckling piglets, and, consequently, much effort has been invested in the quantification of its effect in sow farms. However, no information on the performance of surviving pigs that were exposed to the PEDv as piglets is available. Here, a retrospective cohort study to evaluate the impact of porcine epidemic diarrhea virus (PEDv infection on growing pigs' performance, as indicated by mortality, average daily gain (ADG, average daily feed intake (ADFI, and feed conversion ratio (FCR was performed using production records from weaned pigs in nursery and wean-to-finish sites from sow farms that became PEDv-infected between May 2013 and June 2014. Production records from the first batch of growing pigs weaned in infected flows after the PEDv outbreak ("infected batches" were compared with those from pigs weaned within the previous 14 to 120 days ("control batches". Performance records from infected and control batches, paired by flow, were compared using non-parametric paired tests. Mortality, ADG and FCR were significantly different in PEDv-positive (infected compared with PEDv-negative (control batches, with a mean increase of mortality and FCR of 11% and 0.5, respectively, and a decrease of ADG of 0.16 lb/day. Our results demonstrate a poorer performance of growing pigs weaned after a PEDv outbreak compared with those weaned within the previous 14-120 days, suggesting that in addition to the mortality induced by PEDv in suckling pigs, the disease also impairs the performance of surviving pig. These findings help to quantify the impact of PEDv infection in the US and, ultimately, contribute to efforts to quantify the cost-effectiveness of disease prevention and control measures.

  6. Impact of porcine epidemic diarrhea on performance of growing pigs.

    Science.gov (United States)

    Alvarez, Julio; Sarradell, Javier; Morrison, Robert; Perez, Andres

    2015-01-01

    The impact of porcine epidemic diarrhea virus (PEDv) infection on the US pork industry has mainly been attributed to the mortality that it causes in suckling piglets, and, consequently, much effort has been invested in the quantification of its effect in sow farms. However, no information on the performance of surviving pigs that were exposed to the PEDv as piglets is available. Here, a retrospective cohort study to evaluate the impact of porcine epidemic diarrhea virus (PEDv) infection on growing pigs' performance, as indicated by mortality, average daily gain (ADG), average daily feed intake (ADFI), and feed conversion ratio (FCR) was performed using production records from weaned pigs in nursery and wean-to-finish sites from sow farms that became PEDv-infected between May 2013 and June 2014. Production records from the first batch of growing pigs weaned in infected flows after the PEDv outbreak ("infected batches") were compared with those from pigs weaned within the previous 14 to 120 days ("control batches"). Performance records from infected and control batches, paired by flow, were compared using non-parametric paired tests. Mortality, ADG and FCR were significantly different in PEDv-positive (infected) compared with PEDv-negative (control) batches, with a mean increase of mortality and FCR of 11% and 0.5, respectively, and a decrease of ADG of 0.16 lb/day. Our results demonstrate a poorer performance of growing pigs weaned after a PEDv outbreak compared with those weaned within the previous 14-120 days, suggesting that in addition to the mortality induced by PEDv in suckling pigs, the disease also impairs the performance of surviving pig. These findings help to quantify the impact of PEDv infection in the US and, ultimately, contribute to efforts to quantify the cost-effectiveness of disease prevention and control measures.

  7. Evaluation of Serum 3-Bromotyrosine Concentrations in Dogs with Steroid-Responsive Diarrhea and Food-Responsive Diarrhea.

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    Sattasathuchana, P; Allenspach, K; Lopes, R; Suchodolski, J S; Steiner, J M

    2017-07-01

    The clinical usefulness of serum 3-BrY concentrations for subclassifying dogs with food-responsive diarrhea (FRD) and steroid-responsive diarrhea (SRD) has not been studied. To compare serum 3-BrY concentrations in dogs with FRD, dogs with SRD, and healthy control dogs. 38 dogs with FRD, 14 dogs with SRD, and 46 healthy dogs. Prospective study. Measurement of 3-BrY concentration in serum samples was performed by gas chromatography/mass spectrometry. There was no association of peripheral eosinophilia in dogs with FRD, SRD, and healthy control dogs (P = 0.069). There was no significant correlation between peripheral eosinophil counts and serum 3-BrY concentrations (ρ = -0.15, P = 0.13). Serum 3-BrY concentrations in dogs with SRD (median [range] = 3.27, 0.9-26.23 μmol/L) were significantly higher than in dogs with FRD (median [range] = 0.99, 0.62-8.82 μmol/L; P = 0.007) or in healthy dogs (median [range] = 0.62, 0.62-1.79 μmol/L; P dogs with FRD were significantly higher than in healthy dogs (P = 0.025). There was no significant correlation between the canine chronic enteropathy clinical activity index and serum 3-BrY concentrations (ρ = 0.17, P = 0.23). Measurement of serum 3-BrY concentrations, but not the peripheral eosinophil count, is helpful for detecting dogs with SRD and FRD. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  8. Zinc supplementation reduced cost and duration of acute diarrhea in children.

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    Gregorio, Germana V; Dans, Leonila F; Cordero, Cynthia P; Panelo, Carlo A

    2007-06-01

    To determine whether zinc with oral rehydration solution (ORS) is more cost effective than ORS alone in the treatment of acute diarrhea. Cost-effectiveness analysis among patients consulting the emergency room of a government institution. Cost of treatment and outcome of participants of a randomized trial of zinc+ORS vs. ORS alone for acute diarrhea were investigated. Included were subjects 2-59 months with diarrhea <7 days and no dehydration. The direct medical, nonmedical and indirect costs were obtained, using the societal perspective. The incremental cost-effectiveness ratio (ICER) was calculated. Sixty patients were given zinc+ORS and 57 were given ORS alone. Mean duration of diarrhea was 17 hours shorter and mean total cost of treatment was 5% cheaper in the zinc than ORS group . The ICER showed that with use of zinc, the society saves $ 2.4 per day of diarrhea <4 days and spends $ 0.03 per case of diarrhea averted <4 days from consult, although the confidence interval included the null value of zero. Use of zinc with ORS reduced the total cost and duration of acute diarrhea. The ICER suggests cost effectiveness of zinc supplementation but there is a need to further assess the role of zinc supplementation in a larger population.

  9. 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.

  10. Diarrhea Prevalence, Care, and Risk Factors Among Poor Children Under 5 Years of Age in Mesoamerica.

    Science.gov (United States)

    Colombara, Danny V; Hernández, Bernardo; McNellan, Claire R; Desai, Sima S; Gagnier, Marielle C; Haakenstad, Annie; Johanns, Casey; Palmisano, Erin B; Ríos-Zertuche, Diego; Schaefer, Alexandra; Zúñiga-Brenes, Paola; Zyznieuski, Nicholas; Iriarte, Emma; Mokdad, Ali H

    2016-03-01

    Care practices and risk factors for diarrhea among impoverished communities across Mesoamerica are unknown. Using Salud Mesoamérica Initiative baseline data, collected 2011-2013, we assessed the prevalence of diarrhea, adherence to evidence-based treatment guidelines, and potential diarrhea correlates in poor and indigenous communities across Mesoamerica. This study surveyed 14,500 children under 5 years of age in poor areas of El Salvador, Guatemala, Mexico (Chiapas State), Nicaragua, and Panama. We compared diarrhea prevalence and treatment modalities using χ(2) tests and used multivariable Poisson regression models to calculate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for potential correlates of diarrhea. The 2-week point prevalence of diarrhea was 13% overall, with significant differences between countries (P < 0.05). Approximately one-third of diarrheal children were given oral rehydration solution and less than 3% were given zinc. Approximately 18% were given much less to drink than usual or nothing to drink at all. Antimotility medication was given to 17% of diarrheal children, while antibiotics were inappropriately given to 36%. In a multivariable regression model, compared with children 0-5 months, those 6-23 months had a 49% increased risk for diarrhea (aRR = 1.49, 95% CI = 1.15, 1.95). Our results call for programs to examine and remedy low adherence to evidence-based treatment guidelines. © The American Society of Tropical Medicine and Hygiene.

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

    Directory of Open Access Journals (Sweden)

    Maria Maragkoudaki

    2013-10-01

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

  12. Relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions.

    Science.gov (United States)

    Li, Hongling; Wang, Changcheng; Liu, Shuqing; Xu, Dongsheng; Zhang, Ju; Chen, Hongmei

    2014-01-01

    The causes and mechanisms of chronic diarrhea are complex. This study aimed to explore the relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions. All cases were collected from January 2009 to June 2010. The 40 patients in the patient group had chronic diarrhea with normal colonoscopy findings. Those who had hyperthyroidism, diabetes, chronic pancreatitis, cirrhosis, atrophic gastritis, short bowel syndrome and connective tissue diseases had been excluded. The control group contained 40 healthy individuals without diarrhea. Endoscopy of the terminal ileum was applied in both groups, with the endoscope inserted into terminal ileum for more than 20 cm. The patients diagnosed of chronic diarrhea with terminal ileum lesions were treated with metronidazole and probiotics for 10-14 days. Before treatment there were significant differences in endoscopy findings of the terminal ileum between the two groups (P diarrhea, and terminal ileum lesions disappeared in 30 cases as determined by endoscopy. In the control group, endoscopy showed scattered hyperplasia of lymphoid follicles in 5 cases, and the follicles were small with the maximal diameter being 3 mm. There was no hyperemia, edema, erosion or ulcers. Chronic diarrhea patients with normal colonoscopy findings may have lesions in the terminal ileum that can be detected by endoscopy; including hyperemia, erosion, ulcers and lymphoid follicle hyperplasia. Therapeutic effect is good with metronidazole and probiotics.

  13. Celiac disease in children with diarrhea is more frequent than previously suspected.

    Science.gov (United States)

    Imanzadeh, Farid; Sayyari, Ali Akbar; Yaghoobi, Mohammad; Akbari, Mohammad Reza; Shafagh, Hamed; Farsar, Ahmad Reza

    2005-03-01

    Celiac disease (CD) may be missed or diagnosed late in children with chronic diarrhea. In this study the authors estimated the frequency of CD among pediatric patients with chronic diarrhea based on serologic and pathologic examinations. During a 6-year period, all patients with chronic diarrhea of more than 6 weeks referred to the authors' department were included. For each patient, an asymptomatic control was enrolled from among the patients referred to our clinic for other reasons. Serologic tests for CD including immunoglobulin A endomysial antibody and immunoglobulin A antigliadin antibody were performed in all patients and controls. If positive, duodenal biopsy was performed to confirm the diagnosis. Patients subsequently diagnosed as CD were placed on a gluten-free diet and reevaluated after 6 months. 825 cases of diarrhea and 825 controls were enrolled. CD was diagnosed in 54 (6.5%) of the diarrhea patients and seven (0.8%) of the controls. After 6 months of gluten-free diet, 48 (88.8%) patients had significant improvement in symptoms and of these 41 (76.1%) were totally asymptomatic. Forty-two patients allowed repeat endoscopy after 6 months of gluten-free diet and 40 (95.2%) showed improvement in histologic findings. CD is common among patients labeled as chronic diarrhea. In this subgroup, gluten-free diet may lead to a significant improvement in symptoms. Routine testing for CD may be indicated in all patients being evaluated for chronic diarrhea.

  14. Who are susceptible to pseudomembranous colitis among patients with presumed antibiotic-associated diarrhea?

    Science.gov (United States)

    Lee, Ki Sung; Shin, Woon Geon; Jang, Myoung Kuk; Kim, Hyoung Su; Kim, Hee Seon; Park, Chi Jun; Lee, Ja Young; Kim, Kyung Ho; Park, Joon Young; Lee, Jin Heon; Kim, Hak Yang; Cho, Sung Jin; Yoo, Jae Young

    2006-10-01

    Pseudomembranous colitis is a severe form of antibiotic-associated diarrhea. However, there have been no reports about the factors that make patients with presumed antibiotic-associated diarrhea susceptible to pseudomembranous colitis. This study was designed to determine the clinical risk factors for pseudomembranous colitis among the patients with presumed antibiotic-associated diarrhea. This was a retrospective study of 150 consecutive patients admitted to our institution between January 2000 and December 2004 with a diagnosis of presumed antibiotic-associated diarrhea. All patients underwent sigmoidoscopy or colonoscopy because of diarrhea after administration of antibiotics. Pseudomembranous colitis was confirmed both endoscopically and histologically. Various clinical parameters were compared between the pseudomembranous colitis group and non-pseudomembranous colitis group. The mean age of patients was 61 years, and 60 percent (90/150) was female. Pseudomembranous colitis was diagnosed in 53 percent (80/150). On univariate analysis, older than aged 70 years (P = 0.014), antibiotic therapy for more than 15 days (P pseudomembranous colitis. On multivariate analysis, the important clinical risk factors were advanced age (older than aged 70 years; adjusted odds ratio, 2.7; 95 percent confidence interval, 1.208-6.131; P pseudomembranous colitis was 0.86. Advanced age and long hospital stay may make patients with presumed antibiotic-associated diarrhea susceptible to pseudomembranous colitis. Therefore, pseudomembranous colitis should be first suspected in cases with presumed antibiotic-associated diarrhea having such risk factors.

  15. Changes in Childhood Diarrhea Incidence in Nicaragua Following 3 Years of Universal Infant Rotavirus Immunization

    Science.gov (United States)

    Becker-Dreps, Sylvia; Paniagua, Margarita; Dominik, Rosalie; Cao, Hongyuan; Shah, Naman K.; Morgan, Douglas R.; Moreno, Gilberto; Espinoza, Félix

    2011-01-01

    Background While the pentavalent rotavirus vaccine was highly efficacious against rotavirus diarrhea in clinical trials, the vaccine’s effectiveness under field conditions in the developing world is unclear. In October, 2006, Nicaragua became the first developing nation to implement universal infant immunization with the pentavalent rotavirus vaccine. To assess the impact of the immunization program, we examined the incidence of diarrhea episodes between 2003 and 2009 among children in the state of León, Nicaragua. Methods We extracted data on diarrhea episodes from health ministry records. We used scaled Poisson regression models to estimate diarrhea incidence rate ratios (IRR) for the period following the program’s implementation to the period before implementation. Results Following implementation of the immunization program, diarrhea episodes among infants were reduced (IRR 0.85, 95% confidence interval [CI] 0.71–1.02) during the rotavirus season, but appear to have increased during other months. Conclusions While the immunization program appears effective in reducing diarrhea episodes during the rotavirus season, a large burden of diarrhea persists during the remainder of the year. PMID:20881511

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

    Science.gov (United States)

    Mahapatro, Samarendra; Mahilary, Nijwm; Satapathy, Amit Kumar; Das, Rashmi Ranjan

    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).

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Rotavirus Diarrhea in Children Presenting to an Urban Hospital in Western Uttar Pradesh, India.

    Science.gov (United States)

    Teotia, Neeraj; Upadhyay, Amit; Agarwal, Sunny; Garg, Amit; Shah, Dheeraj

    2016-07-08

    To determine the proportion and clinical profile of rotavirus associated diarrhea in children aged 6 months to 5 years. Clinical details and stool samples were collected from 254 children aged between 6 months to 5 years presenting with acute diarrhea, irrespective of hydration status, to the outpatient department or emergency room of a hospital in Meerut, Uttar Pradesh, India. Rotavirus accounted for 26.3% (51 of 194) of diarrhea cases overall, and 41.2% (14 of 34) in hospitalized children. Rotavirus infection was associated with significantly longer duration [3.3 (1.4) d vs. 2.5 (1.1) d; P=0.004) of diarrhea, and more chances of dehydration (OR 1.85; 95% CI 1.19, 3.57) as compared to non-rotavirus diarrhea. Rotavirus is a common cause of acute diarrhea in under-five children, and is associated with a longer duration and more chances of dehydration than non-rotavirus diarrhea.

  19. Effect of rotavirus vaccine on diarrhea mortality in different socioeconomic regions of Mexico.

    Science.gov (United States)

    Gastañaduy, Paul A; Sánchez-Uribe, Edgar; Esparza-Aguilar, Marcelino; Desai, Rishi; Parashar, Umesh D; Patel, Manish; Richardson, Vesta

    2013-04-01

    In Mexico, declines in childhood diarrhea deaths have been documented during 2008-2010 after rotavirus vaccine introduction in 2007. Because of concerns about variation in rotavirus vaccine efficacy by socioeconomic status, we compared reductions in diarrhea mortality in the lesser developed southern region versus the more developed northern and central regions of Mexico. We obtained data from national vital statistics on diarrhea deaths among children aged diarrhea mortality before (2003-2006) and after (2009-2011) vaccine introduction. Regional vaccine coverage was estimated from administrative data, and socioeconomic status was assessed by using the Human Development Index. In northern, central, and southern Mexico, the 2007 Human Development Index was 0.84, 0.82, and 0.77, respectively, and by 2010 an estimated 99%, 84%, and 89% of children aged Diarrhea mortality among children .8). After introduction of rotavirus vaccination, marked and sustained declines in diarrhea deaths were seen among children in all regions of Mexico, including in the least developed southern region with the highest baseline diarrhea mortality. This finding indicates equitable vaccine delivery to children with varying risk of mortality and reaffirms the beneficial effects of rotavirus vaccination against fatal diarrheal disease.

  20. VSL#3 probiotic treatment reduces chemotherapy-induced diarrhea and weight loss.

    Science.gov (United States)

    Bowen, Joanne M; Stringer, Andrea M; Gibson, Rachel J; Yeoh, Ann S J; Hannam, Sarah; Keefe, Dorothy M K

    2007-09-01

    One of the most common toxicities of cancer treatment is diarrhea. Probiotics have been shown effective at preventing diarrhea in inflammatory bowel disease and may prove useful in the oncology setting. The primary aim of this study was to investigate the probiotic mixture, VSL#3, for amelioration of chemotherapy-induced diarrhea (CID). This experiment was carried out in a clinically relevant model of CID. VSL#3 was administered to female DA rats in one of three schedules. Irinotecan was used to induce mucositis and diarrhea, with rats monitored for seven days to record incidence of weight-loss and diarrhea. At study completion, intestines were collected to investigate histological and proliferative changes, apoptosis levels and mucin composition. VSL#3 reduced weight loss following irinotecan when administered before and after chemotherapy. Moderate and severe diarrhea was also prevented in these rats. This was associated with a significant increase in crypt proliferation combined with an inhibition of apoptosis in both the small and large intestines. VSL#3 also prevented irinotecan-induced increases in goblet cells within jejunal crypts. VSL#3 is effective at preventing severe diarrhea following chemotherapy with irinotecan and therefore has potential to be used clinically by cancer patients.

  1. Behavioural factors associated with diarrhea among adults over 18 years of age in Beijing, China.

    Science.gov (United States)

    Ma, Chunna; Wu, Shuangsheng; Yang, Peng; Li, Haiyue; Tang, Song; Wang, Quanyi

    2014-05-13

    To date, a large proportion of people still suffer from diarrhea diseases. In addition to the burden of diarrhea, there are substantial social and economic costs caused by the high incidence of diarrheal diseases. Therefore, the purpose of this study was to explore the self-reported prevalence of diarrhea and associated risk factors of diarrhea among adults in Beijing, China. A multistage, stratified study based on cross-sectional data was performed using randomized and systematic sampling, recruiting 12,936 adults over 18 years of age in Beijing. All adults were requested to complete a questionnaire, including information such as demographic characteristics, incidence of diarrhea, and behaviors related to the diarrhea. The self-reported prevalence of diarrhea was 17.5% during the last year prior to the survey. Six behavioral factors were significantly associated with diarrhea in our study including: (1) washing hands before meals and after defecation (Adjusted Odds Ratio (AOR) 0.707, 95% CI 0.597 ~ 0.837), (2) washing hands with soap and running water (AOR 0.872, 95% CI 0.786 ~ 0.967), (3) consuming raw seafood (AOR 1.285, 95% CI 1.138 ~ 1.450), (4) using the same chopping block and knife when processing raw and cooked food (AOR 1.375, 95% CI 1.225 ~ 1.542), (5) using the same chopsticks to handle raw and cooked food (AOR1.149, 95% CI 1.041 ~ 1.268), and (6) regularly participating in physical exercise (AOR 0.719, 95% CI 0.651 ~ 0.793). Good health habits, good eating habits, and regular exercise can prevent the episodes of diarrhea, and thus decrease the potential for disease occurrence.

  2. An Assessment of Diarrhea Among Long-Distance Backpackers in the Sierra Nevada.

    Science.gov (United States)

    Meyer, Derek J; Costantino, Amber; Spano, Susanne

    2017-03-01

    Diarrhea is a common problem among long-distance backpackers, ranging in overall incidence from 11-56% as reported by previous studies on the Appalachian Trail and Long Trail. Differences in age, sex, and regularity of standard backcountry hygiene recommendations and practices have been shown to significantly affect the incidence of diarrhea. No study to date has investigated these trends among long-distance backpackers on the John Muir Trail (JMT) in the Sierra Nevada mountain range of California. Retrospective analysis of online survey data gathered from long-distance backpackers who attempted a JMT trek in 2014. Data were assessed for the significance of variables that might contribute to the incidence and severity of on-trail diarrhea. Of 737 valid responders, 16.4% reported experiencing diarrhea (82% with minimal/mild severity; 18% with significant severity). Regular hand sanitizer use was significantly correlated with more severe diarrhea (P < .05), but had no effect on incidence. Regular hand sanitizer users followed all other recommended hygiene practices as frequently as or better than those not using hand sanitizer regularly. Of all backpackers, 88% filtered or treated their drinking water regularly, with 18% of those reporting diarrhea of any severity. JMT backpackers have a comparatively lower incidence of diarrhea than backpackers on other major long-distance backpacking routes in the United States. Most JMT backpackers follow standard backcountry hygiene recommendations, including regular filtration or treatment of drinking water. No statistical significance was found between the incidence of diarrhea and compliance with standard hygiene recommendations. Regular hand sanitizer use was significantly correlated with more severe diarrhea but was not associated with incidence. There was no significant difference in compliance with standard backcountry hygiene practices between regular and infrequent hand sanitizer users. Copyright © 2017 Wilderness

  3. An uncommon cause of unexplained nonbloody diarrhea: When mind knows eyes may see

    Directory of Open Access Journals (Sweden)

    Hemanta Kumar Nayak

    2016-01-01

    Full Text Available Collagenous colitis (CC is characterized by chronic secretory diarrhea with the apparently normal gross appearance of the colonic mucosa. A biopsy is usually diagnostic. The symptoms of CC appear most commonly in the elderly. In CC, the major microscopic characteristic is a thickened collagen layer beneath the colonic mucosa. The reported case represents unexplained nonbloody diarrhea of a systemic lupus erythematosus patient, on extensive evaluation found to have CC. This case highlights the importance of considering a rare possibility of CC as a differential in a patient of unexplained nonbloody diarrhea.

  4. Grounded Eyes on Distant Watery Skies

    Science.gov (United States)

    Kohler, Susanna

    2017-08-01

    What can we learn about exoplanets from high-resolution, ground-based observations? A new view of the nearby upsilon Andromedae system has revealed a great deal about the systems closest-in exoplanet including the presence of water vapor in its atmosphere.Search for WobblesIllustration of how spectral lines shift when observing two objects that orbit each other. Click here to see a simulation of this process. [R. Pogge, OSU]The upsilon Andromedae system is located roughly 44 light-years from Earth. In 1997, a hot Jupiter exoplanet was discovered orbiting the primary star, and more planets were found not long after making this the first multiple-planet system discovered around a main-sequence star.These planets, however, were not discovered due to transits; their orbital planes are not aligned with our line of sight to the star. Instead, the hiddenplanets were first detected via the stars spectrum. The radial velocity method of detecting exoplanets searches for telltale periodic shifts of a stars spectral lines, which are induced by the orbiting planets gravitational tugs.In recent years, ground-based spectroscopy has become ever more powerful; thus revisiting old systems with higher resolution instruments can often open a whole new world of data to us. In the case of a recent study, a team of astronomers led by Danielle Piskorz (California Institute of Technology) revisited upsilon Andromedae with the high-resolution Near Infrared Spectrometer (NIRSPEC) at the Keck telescope in Hawaii. Their goal: to gather data about upsilon Andromedae b, the closest-in planet in the system.Top-down schematic of the orbit of upsilon Andromedae b around its star and the location in the orbit of the authors observations. [Piskorz et al. 2017]An Unusual ArchitecturePiskorz and collaborators obtained 13 different sets of observations of upsilon Andromedae with NIRSPEC across three different wavelength bands. By treating the starplanet system as though it were a spectroscopic binary, the authorshigh-resolution observations allowed them to resolve not only the stellar spectrum, but also the spectral lines fromthe hot Jupiter exoplanet itself.Obtaining a thermal spectrum of the planet permitted the team to break the usual observational degeneracy that occurs with exoplanet observations: they were able to disentangle the planet mass and its orbital inclination angle. Piskorz and collaborators found that the planet is roughly 1.7 Jupiter masses and its orbit is inclined 24 relative to our line of sight.Artists illustration of the closest three planets in the upsilon Andromedae system. The system also has a distant red-dwarf binary companion, as well as a possible fourth planet. [NASA/ESA/A. Feild (STScI)]These measurements of the orbital structure of upsilon Andromedae are critical for understanding this unusual system. With non-coplanar planets and a distant red-dwarf companion, the upsilon Andromedae system has long been suspected to lie on the precipice of instability. The new measurements of upsilon Andromeda bs orbital properties will help us to better understand how the system may have formed, evolved, and survived to today.Water FoundOne of the biggest benefits of spectroscopy of an exoplanet is the potentialto learn about its atmospheric composition. Using their NIRSPEC observations of upsilon Andromedae b and detailed atmospheric modeling, Piskorz and collaborators found that the planets opacity structure is dominated by water vapor at the wavelengths they probed.This detection of water vapor in upsilon Andromedae bs atmosphere and the constraints on the planets orbital properties demonstrate the power and potential of ground-based, high-resolution spectroscopy for characterizing exoplanets and constraining the architecture of distantsolar systems.CitationDanielle Piskorz et al 2017 AJ 154 78. doi:10.3847/1538-3881/aa7dd8

  5. Enteric Pathogens and Coinfections in Foals with and without Diarrhea

    Directory of Open Access Journals (Sweden)

    Giovane Olivo

    2016-01-01

    Full Text Available Diarrhea is a major clinical problem affecting foals up to 3 months of age. The aim of this study was to identify enteric microorganisms involved in monoinfections and coinfections and the associated virulence factors in healthy and diarrheic foals. Diarrheic (D (n=56 and nondiarrheic (ND foals (n=60 up to three months of age were studied. Fecal samples were analyzed for identification of infectious agents (microbiological culturing, molecular techniques, and microscopic analyses. Escherichia coli fimH (30% versus 25%, Salmonella spp. (25% versus 7%, Strongyloides westeri (25% versus 25%, Clostridium perfringens type A (21% versus 10%, E. coli ag43 (20% versus 35%, Strongylus (11% versus 18%, and vapA-positive Rhodococcus equi (5% versus 2% were the most frequent enteric pathogens detected in D and ND foals, respectively. The frequency of toxin A-positive C. perfringens was significantly increased in the D (p=0.033 compared with the ND animals. R. equi strains harboring virulent plasmids were also identified (VapA 85-kb type I and VapA 87-kb type I in D and ND foals. Coinfections were observed in 46% of the D and 33% of the ND foals. Our results demonstrate the great diversity of enteric pathogens, virulence factors, and coinfections involved in enteric infections of foals.

  6. Immunoglobulin G response in patients with Campylobacter concisus diarrhea.

    Science.gov (United States)

    Nielsen, Hans Linde; Kaakoush, Nadeem O; Mitchell, Hazel M; Nielsen, Henrik

    2016-02-01

    Limited information is available on the systemic immunoglobulin response in patients infected with the emerging pathogen Campylobacter concisus. The aim of the present study was to detect anti-C. concisus antibodies in serum of 88 patients with C. concisus gastroenteritis. Specific IgG antibodies to C. concisus were measured in serum using an in-house enzyme-linked immunosorbent assay, and pooled donor serum was used as a control. The mean optical density was 0.135 (SEM: 0.020) for the 88 adult patients and 0.100 (SEM: 0.011) in controls. When using an optical density value equal to the mean +3 SEM for the control serum, 22 (25%) C. concisus-positive patients had increased IgG antibodies. Patients with high IgG levels more often reported headache, and they had a trend toward more mucus in stools, whereas IgG levels were unrelated to age, duration of diarrhea, number of stools per day, and weight loss. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Enteropathogenic bacteria isolated from specimens of patients with diarrhea

    Directory of Open Access Journals (Sweden)

    Salary M

    1997-09-01

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

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

    Science.gov (United States)

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

    2010-07-01

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

  9. [Etiological and molecular characteristics of diarrhea caused Proteus mirabilis].

    Science.gov (United States)

    Shi, Xiaolu; Hu, Qinghua; Lin, Yiman; Qiu, Yaqun; Li, Yinghui; Jiang, Min; Chen, Qiongcheng

    2014-06-01

    To analyze the etiological characteristics, virulence genes and plasmids that carrying diarrhea-causing Proteus mirabilis and to assess their relationship with drug resistance and pathogenicity. Proteus mirabilis coming from six different sources (food poisoning, external environment and healthy people) were analyzed biochemically, on related susceptibility and pulsed-field gel electrophoresis (PFGE). Virulence genes were detected by PCR. Plasmids were extracted and sequenced after gel electrophoresis purification. The biochemical characteristics of Proteus mirabilis from different sources seemed basically the same, and each of them showed having common virulence genes, as ureC, rsmA, hpmA and zapA. However, the PFGE patterns and susceptibility of these strains were different, so as the plasmids that they carried. Plasmid that presented in the sequenced strain showed that the 2 683 bp length plasmid encodes qnrD gene was associated with the quinolone resistance. Etiological characteristics and molecular characteristics of Proteus mirabilis gathered from different sources, were analyzed. Results indicated that traditional biochemical analysis and common virulence gene identification might be able to distinguish the strains with different sources. However, PFGE and plasmids analysis could distinguish the sources of strains and to identify those plasmids that commonly carried by the drug-resistant strains. These findings also provided theoretical basis for further study on the nature of resistance and pathogenicity in Proteus mirabilis.

  10. Recombinant porcine norovirus identified from piglet with diarrhea

    Directory of Open Access Journals (Sweden)

    Shen Quan

    2012-09-01

    Full Text Available Abstract Background Noroviruses (NoVs are members of the family Caliciviridae and are emerging enteric pathogens of humans and animals. Some porcine NoVs are genetically similar to human strains and are classified into GII, like most epidemic human NoVs. So far, PoNoV have been exclusively detected in fecal samples of adult pig without clinical signs. Results Result showed that 2 of the 12 evaluated fecal samples were positive for PoNoVs, one of which was positive for PoNoV alone, and the other was coinfected with porcine circovirus and PoNoV. Phylogenetic and recombination analysis showed that the PoNoV positive alone strain was a recombinant new genotype strain. Experimental infection of miniature pigs with fecal suspensions confirmed that this strain can cause gastroenteritis in piglets. Conclusion This is the first report that recombinant new genotype PoNoV exised in pig herd of China, which cause diarrhea in pigs in nature condition. This find raised questions about the putative epidemiologic role of PoNoV.

  11. Intractable diarrhea with tufting enteropathy: a favorable outcome is possible.

    Science.gov (United States)

    Lemale, Julie; Coulomb, Aurore; Dubern, Béatrice; Boudjemaa, Sabah; Viola, Sheila; Josset, Patrice; Tounian, Patrick; Girardet, Jean-Philippe

    2011-06-01

    Tufting enteropathy (TE) is a congenital abnormality of intestinal mucosa development characterized by severe intestinal failure requiring parenteral nutrition (PN) and, in some cases, small bowel transplantation. A few patients have had a more favorable outcome. The objective of this study was to evaluate possible correlations between histological lesion severity in duodenal biopsies and clinical outcomes in children with TE. We retrospectively reviewed the records of patients diagnosed with TE between 1993 and 2003 at our institution based on intractable neonatal-onset diarrhea with prolonged dependence on PN and duodenal biopsy findings of villous atrophy, epithelial dysplasia with enterocyte dedifferentiation and disorganization (tufting) of the surface epithelium, and crypt abnormalities. The histological lesions were assessed semiquantitatively and compared with the clinical outcomes including dependence on PN. Seven children, all from consanguineous parents, were studied for a median of 6.5 years. Three were permanently weaned off PN and experienced normal growth without nutritional assistance. Initial biopsies in all 3 children showed severe diffuse histological lesions. At weaning off PN, 2 of these 3 patients had persistent, although less diffuse, histological lesions. Progressive weaning off PN is possible in some children with TE. In our experience, this favorable outcome was not predicted by histological lesion severity, although the lesions improved in some patients. New biomarkers for identifying the histological lesions and predicting the outcome would be useful.

  12. [Abdominal spasms, meteorism, diarrhea: fructose intolerance, lactose intolerance or IBS?].

    Science.gov (United States)

    Litschauer-Poursadrollah, Margaritha; El-Sayad, Sabine; Wantke, Felix; Fellinger, Christina; Jarisch, Reinhart

    2012-12-01

    Meteorism, abdominal spasms, diarrhea, casually obstipation, flatulence and nausea are symptoms of fructose malabsorption (FIT) and/or lactose intolerance (LIT), but are also symptoms of irritable bowel syndrome (IBS). Therefore these diseases should be considered primarily in patients with digestive complaints. For diagnosis an H(2)-breath test is used.In 1,935 patients (526 m, 1,409 f) a fructose intolerance test and in 1,739 patients (518 m,1,221 f) a lactose intolerance test was done.FIT is found more frequently than LIT (57 versus 52 % in adults (p < 0,02) and in children 90 versus 62 % (p < 0,001)) and is in polyintolerances most frequently correlated to histamine intolerance (HIT). Headache (ca. 10 %), fatigue (ca. 5 %) and dizziness (ca. 3 %) may occur after the test, irrespective whether the test was positive or negative.In more than 2/3 of patients a diet reduced in fructose or lactose may lead to improvement or remission of these metabolic disorders. IBS, which is often correlated with FIT (183/221 patients = 83 %), can be improved by relevant but also not relevant diets indicating that irritable bowel disease seems to be caused primarily by psychological disorders.

  13. Bovine viral diarrhea (BVD: A review emphasizing on Iran perspective

    Directory of Open Access Journals (Sweden)

    Mohammad Khezri

    2015-09-01

    Full Text Available Bovine viral diarrhea (BVD is one of the most important diseases of cattle responsible for major economic losses in dairy industries of Iran. So far, no nationwide program has been taken in Iran to control and eradicate the disease. Moreover, until now, no vaccination program has been practiced against BVD in Iran, although the disease is prevailing in the country. For effective controlling of BVD, it is necessary to cull the affected animals, and new entry of BVD in the farm should be prevented. Focusing on biosecurity in systematic control programs of BVD can also reduce the risks of introduction and spread of other epizootic and zoonotic diseases, thereby improving both cattle health and welfare in general. In this review paper, an overview on BVD emphasizing on Iran perspective has been discussed focusing on clinical manifestations of BVD, routes of transmission of BVD virus (BVDV, its diagnostic methods and possible prevention strategies. [J Adv Vet Anim Res 2015; 2(3.000: 240-251

  14. Cost analysis of hospitalized Clostridium difficile-associated diarrhea (CDAD

    Directory of Open Access Journals (Sweden)

    Hübner, Claudia

    2015-10-01

    Full Text Available Aim: -associated diarrhea (CDAD causes heavy financial burden on healthcare systems worldwide. As with all hospital-acquired infections, prolonged hospital stays are the main cost driver. Previous cost studies only include hospital billing data and compare the length of stay in contrast to non-infected patients. To date, a survey of actual cost has not yet been conducted.Method: A retrospective analysis of data for patients with nosocomial CDAD was carried out over a 1-year period at the University Hospital of Greifswald. Based on identification of CDAD related treatment processes, cost of hygienic measures, antibiotics and laboratory as well as revenue losses due to bed blockage and increased length of stay were calculated.Results: 19 patients were included in the analysis. On average, a CDAD patient causes additional costs of € 5,262.96. Revenue losses due to extended length of stay take the highest proportion with € 2,555.59 per case, followed by loss in revenue due to bed blockage during isolation with € 2,413.08 per case. Overall, these opportunity costs accounted for 94.41% of total costs. In contrast, costs for hygienic measures (€ 253.98, pharmaceuticals (€ 22.88 and laboratory (€ 17.44 are quite low.Conclusion: CDAD results in significant additional costs for the hospital. This survey of actual costs confirms previous study results.

  15. [Proliferation of anaerobic flora in the small intestine of infants with acute and protracted diarrhea].

    Science.gov (United States)

    da Cruz, A S; Fagundes Neto, U

    1995-01-01

    Bacterial proliferation in the small intestine can induce the protraction of diarrhea due to malabsorption of the nutrients. We performed the culture of the small intestine juice for the aerobic and anaerobic flora in 40 infants with persistent and acute diarrhea. Bacterial proliferation was observed in 32 (80%) patients, being 30 (75%) due to the aerobic microflora and 17 (43%) due to the anaerobic microflora. There was no statistical difference in the bacterial growth between acute and persistent diarrhea. The aerobic bacteria most frequently isolated was E. coli in 23 patients, and Bacteroides sp was the most prevalent anaerobic bacteria, isolated in 9 cases. The transitory flora was significantly more abundant in patients with persistent diarrhea.

  16. Prevalence of Clostridium perfringens enterotoxin A in stool samples of patients with antibiotic-associated diarrhea

    OpenAIRE

    Granzow, Katharina

    2010-01-01

    The present prospective study revealed a prevalence of Clostridium perfringens enterotoxin A (CPE) of less than 1%. Routine screening of stool samples for CPE does not appear to be justified in patients with antibiotic-associated diarrhea.

  17. Factors associated with food workers working while experiencing vomiting or diarrhea

    National Research Council Canada - National Science Library

    Sumner, Steven; Brown, Laura Green; Frick, Roberta; Stone, Carmily; Carpenter, L Rand; Bushnell, Lisa; Nicholas, Dave; Mack, James; Blade, Henry; Tobin-D'Angelo, Melissa; Everstine, Karen

    2011-01-01

    This study sought to determine the frequency with which food workers said they had worked while experiencing vomiting or diarrhea, and to identify restaurant and worker characteristics associated with this behavior...

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

    National Research Council Canada - National Science Library

    Rautenberg TA; Zerwes U

    2017-01-01

    ...; 3Assessment in Medicine GmbH, Lörrach, Germany Objective: To evaluate the cost utility and the budget impact of adjuvant racecadotril for the treatment of acute diarrhea in children in Thailand. Methods...

  19. Oral rehydration salts, zinc supplement and rota virus vaccine in the management of childhood acute diarrhea

    Directory of Open Access Journals (Sweden)

    Abdulwahab MA Telmesani

    2010-01-01

    Full Text Available Acute diarrhea remains a major cause of morbidity and mortality in children. Since the introduction of oral rehydration salts (ORS mortality has dropped to less than 50% worldwide. Low osmolarity ORS improved the outcome and reduced the hospitalization further. Zinc difficiency has been found to be associated with severe episodes of acute diarrhea. Zinc supplement in developing countries did reduce the incidence and prevalence of diarrhea. In addition, Zinc supplement significantly reduced the severity of diarrhea and duration of the episode. In the Americas and Europe, Rota virus vaccine was 90% effective in preventing severe episodes of severe rotavirus gastroenteritis. This review concludes that low osmolarilty ORS, zinc supplementation and rotavirus vaccine are major factors in reducing the morbidity, mortality and hospitalization resulting from to acute gastroenteritis in childhood.

  20. Oral rehydration salts, zinc supplement and rota virus vaccine in the management of childhood acute diarrhea.

    Science.gov (United States)

    Telmesani, Abdulwahab Ma

    2010-05-01

    Acute diarrhea remains a major cause of morbidity and mortality in children. Since the introduction of oral rehydration salts (ORS) mortality has dropped to less than 50% worldwide. Low osmolarity ORS improved the outcome and reduced the hospitalization further. Zinc difficiency has been found to be associated with severe episodes of acute diarrhea. Zinc supplement in developing countries did reduce the incidence and prevalence of diarrhea. In addition, Zinc supplement significantly reduced the severity of diarrhea and duration of the episode. In the Americas and Europe, Rota virus vaccine was 90% effective in preventing severe episodes of severe rotavirus gastroenteritis. This review concludes that low osmolarilty ORS, zinc supplementation and rotavirus vaccine are major factors in reducing the morbidity, mortality and hospitalization resulting from to acute gastroenteritis in childhood.

  1. RISK FACTORS AND PECULIARITIES OF NUTRITION OF INFANTS WITH CHRONIC DIARRHEA

    Directory of Open Access Journals (Sweden)

    T.S. Lazareva

    2008-01-01

    Full Text Available Results of observation of children from 2,5 months to 4 years old, treated in hospital with diagnosis chronic diarrhea are analyzed in this article. Diarrhea debuted in first year of living in most cases. The reason of onset of diarrhea often was alimentary factor. Hereditary predisposition, pathologic pregnancy, and diseases in women at the time of pregnancy played an important role in development of disease. Nutrition of children in early age was characterized by low duration of breast feeding and early conversion of children to the mixed and artificial feeding. Main food stuffs in children's nutrition on mixed and artificial feeding was adapted milk formulas, and rarely non adapted milk food (cow's and goat's milk, kefir. Only 30% of mothers had a definite knowledge of proper child's feeding and advantages of breast feeding. This fact indicates necessity of more active educational work by medical staff.Key words: children, chronic diarrhea, nutrition.

  2. [Study of traditional Chinese medicine syndrome features of AIDS-related chronic diarrhea].

    Science.gov (United States)

    Ni, Liang; Wang, Rong-Bing; Yang, Xiao-Ping; Gao, Hui; Tan, Xing-Hua; Wang, Cui-Fang; Li, Feng

    2013-08-01

    To study the AIDS-related chronic diarrhea in traditional Chinese medicine (TCM) clinical manifestations and syndrome factors, explore the characteristics of syndrome. A multicenter, prospective collection of 311 cases of AIDS patients with chronic diarrhea, study the characteristics of TCM syndrome by using the method of descriptive statistics and exploratory factor analysis. The common clinical manifestation of TCM: fatigue (229 cases, 73.63%), bowel (229 cases, 68.81%), diarrhea (194 cases, 62.38%), thin fur (201 cases, 64.63%), pink tongue (166 cases, 53.38%), greasy fur, thready pulse (126 cases, 40.51%), sink vein (64 cases, 20.58%), slippery pulse. 17 common factors were extracted, common disease syndrome factor as the spleen, stomach, liver, gallbladder and colon syndrome factors of disease, Qi, Yang deficiency, Qi stagnation, dampness and heat evil. AIDS-related chronic diarrhea symptoms involving multiple organs, the disease belongs to deficiency and excess.

  3. Management of chronic diarrhea in HIV-infected patients: current treatment options, challenges and future directions

    Directory of Open Access Journals (Sweden)

    Lidia Elfstrand

    2010-11-01

    Full Text Available Lidia Elfstrand, Claes-Henrik FlorénDepartment of Medicine, Division of Clinical Sciences, Skåne University Hospital, Lund University, Lund, SwedenAbstract: Diarrhea is a common clinical manifestation of HIV infection regardless of whether the patients have AIDS. HIV and malnutrition tend to occur in the same populations, the underprivileged and resource-poor. Malnutrition increases severity and mortality of infection. Occurrence of chronic diarrhea in HIV-infected patients, gut status and pathogenic agents, nutritional status and the crucial role of nutrition are reviewed. Bovine colostrum-based food can be useful for managing chronic diarrhea in HIV-infected patients, enhancing both nutritional and immunological status.Keywords: HIV, diarrhea, nutrition, bovine colostrum, CD4+ 

  4. An outbreak of Clostridium difficile-associated diarrhea in piglets in Brazil

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    Rodrigo Otávio Silveira Silva

    2014-02-01

    Full Text Available In spite of the substantial role of Clostridium difficile in causing diarrhea in piglets, there have been few reports of the disease caused by this bacterium in Rio Grande do Sul, Brazil. In this paper, we describe an outbreak of C. difficile-associated diarrhea in a pig farm in Brazil. The diarrhea rate increased in piglets 1-to-7 days old from an average of 2% to approximately 20%. Necropsied piglets showed mesocolon edema, and in a histological evaluation, severe necrotizing neutrophilic colitis was observed. The intestinal contents were positive for the A/B toxins of C. difficile and negative for other tested enteropathogens. The association between the clinical signs, post mortem findings and laboratory exams confirmed the diagnosis of C. difficile-associated diarrhea. The present report confirms C. difficile as a pathogen in swine in Brazil and highlights the need for up to date routine laboratory protocols for the diagnosis of this disease in swine.

  5. Rotavirus vaccines and health care utilization for diarrhea in the United States (2007-2011).

    Science.gov (United States)

    Leshem, Eyal; Moritz, Rebecca E; Curns, Aaron T; Zhou, Fangjun; Tate, Jacqueline E; Lopman, Benjamin A; Parashar, Umesh D

    2014-07-01

    To examine reductions in diarrhea-associated health care utilization after rotavirus vaccine implementation and to assess direct and indirect effectiveness of vaccination. Retrospective cohort analysis of claims data of commercially insured US children aged diarrhea-associated health care utilization in prevaccine (2001-2006) versus postvaccine introduction (2007-2011) years, compared rates of diarrhea-associated health care utilization in vaccinated versus unvaccinated children and compared rates in unvaccinated children in postvaccine versus prevaccine years. Among children aged diarrhea health care utilization in US children. Both rotavirus vaccines conferred high protection against rotavirus hospitalizations; RV5 conferred durable protection through the fourth year of life. Vaccination also conferred indirect benefits to unvaccinated children. Copyright © 2014 by the American Academy of Pediatrics.

  6. Use of an Oral Elemental Diet in Infants with Severe Intractable Diarrhea

    Science.gov (United States)

    Sherman, Joseph O.; And Others

    1975-01-01

    Evaluated was the use of an oral elemental diet consisting of crystalline amino acids, glucose, electrolytes, and vitamins to control severe intractable diarrhea in 27 infants (1-day to 9-months of age). (DB)

  7. Treatment of pediatric diarrhea: a simulated client study at private pharmacies of Ujjain, Madhya Pradesh, India

    National Research Council Canada - National Science Library

    Diwan, Vishal; Sabde, Yogesh D; Byström, Emma; De Costa, Ayesha

    2015-01-01

    .... The present study used simulated client methodology to assess the actual dispensing practices for patients with pediatric diarrhea at private pharmacies in an urban setting of an Indian province...

  8. New diagnostic biomarker in acute diarrhea due to bacterial infection in children

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    Hassan M. Al-Asy

    2017-06-01

    Conclusions: Both serum PCT and sTREM-1 are valuable in the early diagnosis of acute bacterial infection-induced diarrhea in children, and there was markedly higher diagnostic discriminatory power for sTREM-1.

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

    National Research Council Canada - National Science Library

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

    2017-01-01

    .... 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...

  10. Childhood Diarrhea Determinants in Sub-Saharan Africa: A Cross Sectional Study of Tiko-Cameroon

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    Ayuk Betrand Tambe

    2015-09-01

    Full Text Available Introduction: Diarrhea remains the second leading cause of death among children under five years globally. Nearly one in five child deaths, about 1.5 million each year, are due to diarrhea. It kills more young children than Acquired Immunodeficiency Syndrome (AIDS, malaria and measles combined. World Health Organization has accordingly underlined the need for epidemiological surveys of infantile diarrhea in all geographical areas. The main research objectives were to estimate the prevalence of diarrhea and identify factors associated with diarrheal diseases in Tiko city in Cameroon. Method: The present study was a cross-sectional community household survey which was conducted in Tiko town from 1st to 31st of August 2012. With the use of a questionnaire, a total of 602 households that had at least one child under five years of age were interviewed. Mothers/caregivers were questioned on the morbidity of diarrhea and the logistic regression model was employed to examine the determinants of childhood diarrhea. Both univariable and multivariable data analysis was performed using SPSS version 16.0. Results: The results of this study showed that the prevalence of diarrhea was 23.8% and children under 24 months were highly affected. We found children using the main toilet and other types of toilet facilities such as bushes, diaper, and streams (OR: 0.194; p < 0.001, 95% CI and usage of narrow-mouth container for storage of drinking water (OR: 0.492; p < 0.001, 95% CI less likely to suffer from diarrhea. In contrast, higher rates of diarrhea prevalence were seen in children from households with two or more siblings (OR: 1.222; p < 0.001, 95% CI and whose mothers/caregivers never had the knowledge of safe sources of drinking water (OR: 1.849; p < 0.01, 95% CI. Conclusion: Childhood diarrhea is a public health problem in Tiko city. Hence, interventions aimed at reducing the prevalence should take into consideration the integration of family planning

  11. Novel Human Bufavirus Genotype 3 in Children with Severe Diarrhea, Bhutan

    Science.gov (United States)

    Yahiro, Takaaki; Wangchuk, Sonam; Tshering, Kinlay; Bandhari, Purushotam; Zangmo, Sangay; Dorji, Tshering; Tshering, Karchung; Matsumoto, Takashi; Nishizono, Akira; Söderlund-Venermo, Maria

    2014-01-01

    We identified a new genotype of bufavirus, BuV3, in fecal samples (0.8%) collected to determine the etiology of diarrhea in children in Bhutan. Norovirus GII.6 was detected in 1 sample; no other viral diarrheal pathogens were detected, suggesting BuV3 as a cause of diarrhea. This study investigates genetic diversity of circulating BuVs. PMID:24856373

  12. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya.

    Science.gov (United States)

    Kawakatsu, Yoshito; Tanaka, Junichi; Ogawa, Kazuya; Ogendo, Kenneth; Honda, Sumihisa

    2017-02-16

    The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS). In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area's CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Factors significantly associated with a lower prevalence of diarrhea among children under five were the child's increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate treatment. It was suggested that CHWs could have a positive effect on

  13. Self-reported description of diarrhea among military populations in operations Iraqi Freedom and Enduring Freedom.

    Science.gov (United States)

    Putnam, Shannon D; Sanders, John W; Frenck, Robert W; Monteville, Marshall; Riddle, Mark S; Rockabrand, David M; Sharp, Trueman W; Frankart, Carla; Tribble, David R

    2006-01-01

    Infectious diarrhea is among the most common medical problems associated with military deployments and has been reported as a frequent problem for troops currently deployed to Iraq and Afghanistan. Lacking is information describing clinical presentation, risk behaviors, and treatment of travelers' diarrhea in this population. An anonymous cross-sectional survey was conducted among 15,459 US military personnel deployed to Southwest Asia during 2003 to 2004. Overall, diarrhea was commonly reported (76.8% in Iraq and 54.4% in Afghanistan) and was frequently severe (more than six stools/d) (20.8% in Iraq and 14.0% in Afghanistan) or associated with fever (25.8%), vomiting (18% with diarrhea and 16.5% without), persistent symptoms (>14 d, 9.8%), or chronic symptoms (>30 d, 3.3%). Diarrhea was associated with time spent off military compounds and eating local food. Over 80% of respondents sought care for their symptoms, usually at the lowest echelon of care (field medic), and were most often treated with either loperamide or an antibiotic. Self-treatment with loperamide or Pepto-Bismol was also common and successful with only 9% of self-treated individuals reporting seeking further medical care. Infectious diarrhea is a common problem for US military personnel, and associated fevers and vomiting are more common than in past conflicts in the region. As with past studies, time spent off base and local food consumption, both more common in Iraq than Afghanistan, continue to be the most important risk factors for acquiring diarrhea. The majority of soldiers reported seeking care for diarrhea, but appropriate treatment, including self-treatment with over-the-counter medicines, was generally successful. Further studies should be conducted to evaluate appropriate treatment algorithms, including the use of self-treatment, for deployed military personnel.

  14. Lack of Evidence of Enterotoxin Involvement in Pathogenesis of Campylobacter Diarrhea

    Science.gov (United States)

    1992-01-01

    production in Campylobacter strains, we TABLE 5. C. jejuni ELISA determination for serum samples of patients with sporadic diarrhea in Thailand Mean OD t...p AD-A271 890 1 April 1993 Reprint Lack of Evidence of Enterotoxin Involvement in Pathogenesis of Campylobacter Diarrhea Army Project Order 90PP0820...Order: Studies of the Outer Membrane Proteins of Campylobacter Jejuni for Vaccine Development Approved for public release; distribution unlimited

  15. 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 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.

  16. The Role of Probiotics in the Prevention and Treatment of Diarrhea in Children

    Directory of Open Access Journals (Sweden)

    M Razi

    2014-04-01

    Full Text Available Introduction: Diarrhea remains a major cause of death in children under 5 years are considered. However, following the overuse of antibiotics and the arbitrary use of broad-spectrum antibiotic, as well as diarrhea associated with antibiotic use is increasing. This study aimed to determine the role of probiotics in the prevention and treatments of diarrhea in children have been conducted.   Materials and Methods: Search on the subject of electronic journals and databases such as Web sites SID, Iran Medex, Pubmed and Google scholr from 2010 to 2014 was conducted.   Results: Food and Agriculture Organization of the United Nations as probiotic " microorganisms that have beneficial health effect on the host has sufficient volume " can be defined. Probiotics on the intestinal microbial balance improves. The most important function of probiotics , development , maturation and regulation of the secretory immune system - is mucous . Other proposed mechanisms include probiotics strengthen the immune system by strengthening tight junctions , stimulation of cytokinin production and the production of secondary materials as protective nutrients ( short chain fatty acids, arginine for visceral action , is .Thibault and their colleagues in their study on 90 children were living in orphanages, kindergartens in France showed that days of diarrhea and daily probability of diarrhea in the probiotic group consumed significantly reduced compared with the control group.   Conclusions: According to studies, due to the wide acceptance and lack of side effects of probiotics, probiotic products are increasingly the trend is rising, so it is recommended due to the high incidence of diarrhea among children in the prevention and used to treat diarrhea.   Keywords: Child, Diarrhea, Probiotics.

  17. Microscopic colitis in patients with chronic diarrhea and normal colonoscopic findings in Southern China.

    Science.gov (United States)

    Gu, Hong-Xiang; Zhi, Fa-Chao; Huang, Ying; Li, Ai-Min; Bai, Yang; Jiang, Bo; Zhang, Ya-Li

    2012-09-01

    Microscopic colitis includes lymphocytic colitis and collagenous colitis. The entity is considered as an important cause for unknown chronic diarrhea, but rarely reported in China before. This study aimed to determine the prevalence of microscopic colitis in patients with chronic diarrhea and normal colonoscopy findings in Southern China, and to reveal the clinical feature of microscopic colitis in these patients. Patients with chronic diarrhea and normal colonoscopic findings were enrolled from three hospitals in Southern China from January, 2009 to June, 2010. Multiple colorectal biopsies were obtained in these patients and histological examination was underwent with hematoxyin and eosin stain, Masson's trichrome stain and immunohistochemistry for tenascin to screen lymphocytic colitis and collagenous colitis. The clinical symptom and risk factor of microscopic colitis were assessed by comparing with controls. The diagnostic overlap between microscopic colitis and irritable bowel syndrome or functional diarrhea was also analyzed. Randomly mucosal biopsies were performed in 613 patients with chronic diarrhea and normal or near normal colonoscopic finding. Fifty-nine cases of lymphocytic colitis and 28 cases of collagenous colitis were found by histological examination. The rates of rheumatoid arthritis in lymphocytic colitis group (15.4 %) and collagenous colitis group (14.3 %) were significant higher than in control group (2.2 %). Rheumatoid arthritis was confirmed as the risk factor of microscopic colitis by logistic regression analysis. There was no difference on the symptoms among the controls, patients with lymphocytic colitis, and patients with collagenous colitis. There were 13.8 % (12/87) of patients with microscopic colitis fulfilled Rome III criteria of irritable bowel syndrome and 42.5 % (37/87) fulfilled the criteria of functional diarrhea. Microscopic colitis is not an uncommon disorder in Chinese population. Rheumatoid arthritis is the risk factor of

  18. Management of chronic diarrhea in HIV-infected patients: current treatment options, challenges and future directions

    OpenAIRE

    Elfstrand, Lidia; Flor?n, Claes-Henrik

    2010-01-01

    Lidia Elfstrand, Claes-Henrik FlorénDepartment of Medicine, Division of Clinical Sciences, Skåne University Hospital, Lund University, Lund, SwedenAbstract: Diarrhea is a common clinical manifestation of HIV infection regardless of whether the patients have AIDS. HIV and malnutrition tend to occur in the same populations, the underprivileged and resource-poor. Malnutrition increases severity and mortality of infection. Occurrence of chronic diarrhea in HIV-infected patien...

  19. [Effect of glutamine on small intestinal repair in weanling rats after chronic diarrhea].

    Science.gov (United States)

    Huang, Zu-xiong; Ye, Li-yan; Zheng, Zhi-yong; Chen, Xin-min; Ren, Rong-na; Tong, Guo-yuan

    2005-05-01

    To investigate the nutrient effect of glutamine on small intestinal repair in weanling rats after chronic diarrhea. Forty 21-day-old wistar rats were randomly divided into five groups (8 in each). Animal model of chronic diarrhea was induced by a lactose enriched diet in the weanling Wistar rat, normal control group was fed with a standard semipurified diet, and after 14 days the rats in both groups were killed to test the establishment of the model. After the establishment of the model, the other groups were fed with the standard semipurified diet to recover for 7 days, and were randomly divided into three groups: non-intervention group, glutamine (Gln)-intervention group and control group. Glutamine concentrations in blood was detected by high-performance liquid chromatography (HPLC). Morphological changes including villus height and villus surface area of the jejunum were measured under a light microscope and electron microscope, expression of proliferating cell nuclear antigen (PCNA) as an index of cell proliferation was observed using immunohistochemical staining and image analysis. The diarrhea rate in model group was 100 percent, average diarrhea index was 1.16 +/- 0.06, but both diarrhea rate and average diarrhea index in control group were 0 (P 0.05). And compared with non-intervened group, except for body weight (P > 0.05), plasma glutamine, villus height, villus surface area and expression of PCNA were all significantly increased in Gln-intervened group. Chronic diarrhea can induce malnutrition and reduce the villus height, villus surface area, expression of PCNA and plasm glutamine concentration. Oral glutamine could improve the proliferation of crypt cell and promote repair of intestinal mucosa after chronic diarrhea.

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

    Directory of Open Access Journals (Sweden)

    Antonietta Giannattasio

    2016-02-01

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

  1. Incidence of diarrhea in children living in urban slums in Salvador, Brazil

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    Maria Clotildes N. de Melo

    Full Text Available Diarrhea remains a major health issue in developing countries, with high morbidity and mortality rates. Determining the incidence of acute diarrhea in children and its associated factors is crucial to the planning of preventive approaches. The objective of this study was to determine the incidence of diarrhea and to assess some relevant associated factors to it in children younger than 40 months living in two slums of Salvador, Brazil. This is the first prospective cohort, community-based study that was performed in two periurban slums of Salvador, Brazil. Eighty-four children younger than 40 months were randomly selected and visited every other day for one year. The chi-square test was used to evaluate the occurrence of diarrhea and its associated factors. During the surveillance period, 232 diarrhea episodes were identified, resulting in an incidence rate of 2.8 episodes/child/year. In average (mean value of 84 children,each child suffered 11.1 days of diarrhea per year, yielding an average duration of 3.9 days per episode. The highest incidence rates were found among children under one year old. Early weaning, male sex, malnutrition, having a mother younger than 25 years or who considered her child malnourished, missed immunizations and previous pneumonia were associated factors for suffering diarrheal episodes. The rates of incidence and duration of diarrhea that we found are in accordance to those reported by others. Additionally, our results reinforce the importance of environmental and health-related associated factors to the onset of diarrhea.

  2. Epidemiology of rotavirus diarrhea in children under 5 years in Northern Cameroon

    OpenAIRE

    Ndze, Valentine Ngum; Akum, Achidi Eric; Kamga, Gonsu Hortense; Enjema, Lyonga Emilia; Esona, Mathew Dioh; Banyai, Krisztian; Therese, Obama Abena Marie

    2012-01-01

    Background Rotavirus still remains the major cause of diarrhea in children below 5 years. No data on rotavirus epidemiology is available in the Northern regions of Cameroon. We aimed to determine the prevalence of group A rotavirus (RVA) in children below 5 years with diarrhea in two regions of Northern Cameroon (North West and Far North Regions) so as to improve our knowledge on the burden of rotavirus disease for imminent introduction of a rotavirus vaccine. Methods Stool samples were colle...

  3. Uncertainties associated with quantifying climate change impacts on human health: a case study for diarrhea.

    Science.gov (United States)

    Kolstad, Erik W; Johansson, Kjell Arne

    2011-03-01

    Climate change is expected to have large impacts on health at low latitudes where droughts and malnutrition, diarrhea, and malaria are projected to increase. The main objective of this study was to indicate a method to assess a range of plausible health impacts of climate change while handling uncertainties in a unambiguous manner. We illustrate this method by quantifying the impacts of projected regional warming on diarrhea in this century. We combined a range of linear regression coefficients to compute projections of future climate change-induced increases in diarrhea using the results from five empirical studies and a 19-member climate model ensemble for which future greenhouse gas emissions were prescribed. Six geographical regions were analyzed. The model ensemble projected temperature increases of up to 4°C over land in the tropics and subtropics by the end of this century. The associated mean projected increases of relative risk of diarrhea in the six study regions were 8-11% (with SDs of 3-5%) by 2010-2039 and 22-29% (SDs of 9-12%) by 2070-2099. Even our most conservative estimates indicate substantial impacts from climate change on the incidence of diarrhea. Nevertheless, our main conclusion is that large uncertainties are associated with future projections of diarrhea and climate change. We believe that these uncertainties can be attributed primarily to the sparsity of empirical climate-health data. Our results therefore highlight the need for empirical data in the cross section between climate and human health.

  4. Cost of Hospitalization for Foodborne Diarrhea: A Case Study from Vietnam.

    Science.gov (United States)

    Hoang, Van Minh; Tran, Tuan Anh; Ha, Anh Duc; Nguyen, Viet Hung

    2015-11-01

    Vietnam is undergoing a rapid social and economic developments resulting in speedy urbanization, changes in methods for animal production, food marketing systems, and food consumption habits. These changes will have major impacts on human exposures to food poisoning. The present case study aimed to estimate hospitalization costs of foodborne diarrhea cases in selected health facilities in Vietnam. This is a facility-based cost-of-illness study conducted in seven health facilities in Northern Vietnam. All suspect cases of foodborne diarrhea, as diagnosed by doctors, who admitted to the studied health facilities during June-August, 2013 were selected. Costs associated with hospitalization for foodborne diseases were estimated from societal perspective using retrospective approach. We included direct and indirect costs of hospitalization of foodborne diarrhea cases. During the study period, 87 foodborne diarrhea cases were included. On average, the costs per treatment episode and per hospitalization day for foodborne diarrhea case were US$ 106.9 and US$ 33.6 respectively. Indirect cost (costs of times to patient, their relatives due to the patient's illness) made up the largest share (51.3%). Direct medical costs accounted for 33.8%; direct non-medical costs (patient and their relatives) represented 14.9%. Cost levels and compositions varied by level of health facilities. More attentions should be paid on prevention, control of foodborne diarrhea cases in Vietnam. Ensuring safety of food depends on efforts of everyone involved in food chain continuum, from production, processing, and transport to consumption.

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

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    Hammarström Lennart

    2007-09-01

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

  6. Spatial variation and hot-spots of district level diarrhea incidences in Ghana: 2010–2014

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    Frank Badu Osei

    2017-07-01

    Full Text Available Abstract Background Diarrhea is a public health menace, especially in developing countries. Knowledge of the biological and anthropogenic characteristics is abundant. However, little is known about its spatial patterns especially in developing countries like Ghana. This study aims to map and explore the spatial variation and hot-spots of district level diarrhea incidences in Ghana. Methods Data on district level incidences of diarrhea from 2010 to 2014 were compiled together with population data. We mapped the relative risks using empirical Bayesian smoothing. The spatial scan statistics was used to detect and map spatial and space-time clusters. Logistic regression was used to explore the relationship between space-time clustering and urbanization strata, i.e. rural, peri-urban, and urban districts. Results We observed substantial variation in the spatial distribution of the relative risk. There was evidence of significant spatial clusters with most of the excess incidences being long-term with only a few being emerging clusters. Space-time clustering was found to be more likely to occur in peri-urban districts than in rural and urban districts. Conclusion This study has revealed that the excess incidences of diarrhea is spatially clustered with peri-urban districts showing the greatest risk of space-time clustering. More attention should therefore be paid to diarrhea in peri-urban districts. These findings also prompt public health officials to integrate disease mapping and cluster analyses in developing location specific interventions for reducing diarrhea.

  7. 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.

  8. Selenium status and fungi in the protein-losing enteropathy of persistent diarrhea.

    Science.gov (United States)

    Dwipoerwantoro, Pramita G; Lukito, Widjaja; Aulia, Diana; Arnaud, Josiane; Roussel, Anne-Marie

    2017-06-01

    A vicious cycle of infection, malabsorption, and malnutrition has been implicated in the perpetuation of diarrheal disease. This study examined whether persistent diarrhea is associated with changes in selenium status and stool alpha-1 antitrypsin (AAT) concentration. This cross-sectional study included 30 children aged 1-12 years with persistent diarrhea who were hospitalized in Cipto Mangunkusumo Hospital and Fatmawati Hospital, Jakarta, and 30 apparently healthy children who were matched by age and sex and lived in a rural area of Jakarta. Clinical examinations, blood routine tests, erythrocyte glutathione peroxidase (GPX) activity and plasma selenium levels as well as AAT in fresh stool samples were performed in all the subjects. Of 30 children with persistent diarrhea, 17 had moderate malnutrition and 13 had severe malnutrition. The mean plasma selenium was significantly lower in children with persistent diarrhea than in children without diarrhea (86.0 μg/L [95% CI: 76.1-95.9] vs 110 μg/L [95% CI: 104-116, pSelenium correlated with AAT (p=0.05). Fecal fungi were persistently present. Although selenium status in both groups was optimal for the obtained plasma GPX activity, children with persistent diarrhea exhibited lower plasma selenium levels. This study suggests that the decrease in the plasma selenium level may be the consequence of protein loss and that fungi may be involved.

  9. Is microscopic colitis a missed diagnosis in diarrhea-predominant Irritable Bowel Syndrome?

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    Hamid Tavakoli

    2008-08-01

    Full Text Available

    • BACKGROUND: There are controversies about the importance of biopsies of normal colon mucosa in the investigation of patients with diarrhea predominant irritable bowel syndrome (IBS. On the other hand, microscopic colitis may bemissed based on normal colonoscopy and laboratory examination in this group of patients
    • METHODS: The study took place in Alzahra and Noor hospitals and Poursina Hakim Research Institute, from 2002 to 2004. Eligible patients were those suffering from diarrhea for at least 4 weeks. A total of 138 patients were included in the study after meeting Rome criteria (II with normal CBC, ESR, stool examination and no endoscopic abnormality.
    • RESULTS: The histologic findings in 138 patients with diarrhea predominant IBS with mean age of 34.7 years (female 55.1% and male 44.9% were as follows: 10 patients (7.2% had collagenous colitis and 3 patients (2.2% were compatible with lymphocytic colitis. No significant diagnostic histologic findings were seen in the rest of patients. Collagenouscolitis was detected in 13% of right colon biopsies and in 10% of sigmoid and transverse colon biopsies. Nocturnal diarrhea was found in 30% of collagenous colitis patients.
    • CONCLUSIONS: Total colonoscopy and multiple biopsies in diarrhea predominant IBS patients are necessary for earlydiagnosis of microscopic colitis.
    • KEY WORDS: Irritable bowel syndrome, microscopic colitis, colonoscopy, biopsy, diarrhea.

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

    Science.gov (United States)

    Pant, Neha; Marcotte, Harold; Brüssow, Harald; Svensson, Lennart; Hammarström, Lennart

    2007-09-27

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

  11. Assessment of the maternal self-efficacy for child diarrhea prevention

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    Taís Capistrano Lopes

    2014-01-01

    Full Text Available This study aims at assessing self-efficacy for preventing child diarrhea among mothers of children living in Quixadá, Ceará, Brazil. A descriptive, quantitative study was conducted in three Basic Health Units of Quixadá, CE, Brazil from March to May2012.We interviewed 150 mothers of children under five years, using the socio demographic form and the Maternal Self-Efficacy Scale for Child Diarrhea Prevention. 51.3% of children had had diarrhea, 89% of the mothers had low self-efficacy for preventing child diarrhea. Items that showed greater disagreement were “I am able to avoid my son putting dirty objects in his mouth" (10.2%, ’I am able to wash fruits and vegetables with sodium hypochlorite or bleach" (25.3%and "I am able not to give my child left over meals‘ (25.3%. The majority (89.0% of the mothers had low self-efficacy for preventing child diarrhea. Thus, maternal self-efficacy should be considered for the prevention of child diarrhea.

  12. Probiotics use in childhood acute diarrhea: a web-based survey.

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    Weizman, Zvi

    2011-01-01

    To evaluate practices and barriers for the use of probiotics in acute diarrhea among pediatric gastroenterologists. Probiotics have shown significant therapeutic potential in acute infectious diarrhea. However, literature data regarding practice patterns in childhood are limited. A web-based 9-item survey among 1854 pediatric gastroenterologists worldwide. Only 634 (34%) responded. Forty-one were excluded owing to incomplete data. Finally 593, USA (n=407) and non-USA (n=186) participants, showed: limited use in acute diarrhea (28% and 32% prospectively), prescription of a 1 strain product only by 31% and 24%, respectively, and limited utilization in ambulatory settings (43% and 51%, respectively) and in prevention of diarrhea (2.6% and 3.4%, respectively). Most participants felt there is lack of useful clinical guidelines (91% and 84%, respectively), and found this therapy effective or very effective (54% and 62%, respectively). Dosing and duration were extremely variable, the youngest age treated ranged from 2 months to 2 years of age, and adverse effects were extremely rare. These characteristics were shared by USA and by non-USA participants, with no significant differences between groups (P>0.05). Many pediatric gastroenterologists worldwide do not use probiotics for acute diarrhea owing to lack of appropriate guidelines and/or poorly designed products. Therefore, worldwide health authorities should provide pharmaceutical and clinical guidelines for the appropriate use of probiotics in acute diarrhea of childhood.

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

    Science.gov (United States)

    Muhsen, Khitam; Levine, Myron M.

    2012-01-01

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

  14. Diarrhea management in children under five in sub-Saharan Africa: does the source of care matter? A Countdown analysis

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    Liliana Carvajal-Vélez

    2016-08-01

    Full Text Available Abstract Background Diarrhea remains a high burden disease, responsible for nine percent of deaths in children under five globally. We analyzed diarrhea management practices in young children and their association with the source of care. Methods We used Demographic and Health Survey data from 12 countries in sub-Saharan Africa with high burdens of childhood diarrhea. We classified the quality of diarrhea management practices as good, fair, or poor based on mothers’ reports for children with diarrhea, using WHO/UNICEF recommendations for appropriate treatment. We described the prevalence of diarrhea management by type and assessed the association between good management and source of care, adjusting for potential confounders. Results Prevalence of good diarrhea management is low in 11 of the 12 analyzed surveys, varying from 17 % in Cote d’Ivoire to 38 % in Niger. The exception is Sierra Leone, where prevalence of good practice is 67 %. Prevalence of good management was low even among children taken to health facilities [median 52 %, range: 34–64 %]. Diarrhea careseeking from health facilities or community providers was associated with higher odds of good management than care from traditional/informal sources or no care. Careseeking from facilities did not result systematically in a higher likelihood of good diarrhea management than care from community providers. The odds of good diarrhea management were similar for community versus facility providers in six countries, higher in community than facility providers in two countries, and higher in facility than in community providers in four countries. Conclusion Many children’s lives can be saved with correct management of childhood diarrhea. Too many children are not receiving adequate care for diarrhea in high-burden sub-Saharan African countries, even among those seen in health facilities. Redoubling efforts to increase careseeking and improve quality of care for childhood diarrhea

  15. Travelers' preferences for the treatment and prevention of acute diarrhea.

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    Ericsson, Charles D; Melgarejo, Nicolas A; Jelinek, Tomas; McCarthy, Anne

    2009-01-01

    A survey was designed to assess travelers' willingness to take antibiotic chemoprophylaxis against travelers' diarrhea (TD) or to intervene with antibiotic or symptomatic treatments. A brief written questionnaire was administered to clients in North American (United States and Canadian) and European (UK and German) travel clinic waiting rooms to assess length, purpose, and destination of their upcoming trips; their perceived risk of developing TD at their destination; and their preferences for hypothetical treatment or chemoprophylaxis options, which included descriptions, but no mention of brand names, of a systemically absorbed antibiotic based on a fluoroquinolone, a nonabsorbed antibiotic based on rifaximin, and an over-the-counter antidiarrheal similar to loperamide. The 209 UK and German travelers planned significantly longer travel than the 277 US and Canadian travelers (25 vs 15 d, p preferred any therapy options compared with the Europeans; only 14% of the North Americans preferred no treatment compared with 29% of the Europeans (p preferred the nonabsorbed antibiotic than the systemically absorbed antibiotic, regardless of if combined with the antidiarrheal agent. Significantly more of the Europeans preferred not to take antibiotic chemoprophylaxis than North Americans (66% vs 37%, p travelers preferred chemoprophylaxis with the nonabsorbed than the systemic antibiotic (45% vs 33%, p= 0.003). Among the relatively small groups of travelers studied, the UK and German travelers were more cognizant of TD risk than US and Canadian travelers. The Europeans were less inclined to take chemoprophylaxis or treatment. Both groups preferred treatment or prophylaxis with the nonabsorbed antibiotic over the systemically absorbed antibiotic or the antidiarrheal agent.

  16. Rotavirus genotypes associated with acute diarrhea in Egyptian infants.

    Science.gov (United States)

    Ahmed, Salwa F; Mansour, Adel M; Klena, John D; Husain, Tupur S; Hassan, Khaled A; Mohamed, Farag; Steele, Duncan

    2014-01-01

    Before the introduction of rotavirus vaccine in Egypt, information on the burden of disease and the circulating rotavirus genotypes is critical to monitor vaccine effectiveness. A cohort of 348 Egyptian children was followed from birth to 2 years of age with twice-weekly home visits to detect diarrheal illness. VP7 and VP4 genes were genotyped by reverse-transcription polymerase chain reaction and DNA sequencing. Forty percentage of children had rotavirus-associated diarrhea at least once by their second birthday. One hundred and twelve children experienced a single rotavirus diarrheal episodes (RDE) at a median age of 9 months; while 27 infants had their second RDE at a median age of 15 months and 1 infant had 3 RDE at the age of 2, 16 and 22 months. Of the 169 RDE, 82% could be assigned a G-type, while 58% had been identified a P-type. The most prevalent genotype was G2 (32%), followed by G1 (24%) and G9 (19%). G2P[4] rotavirus episodes were significantly associated with fever (P = 0.03) and vomiting (P = 0.06) when compared with other genotypes. G2 strains were the predominant genotype causing 50% of the second RDE while G9 represented 25% of the second RDE. Genotypes identified are similar to those detected globally except for absence of G4. Our finding that 75% of the second RDE were due to G2 and G9 indicates a possible reduction in natural protection afforded by these types compared with G1, where 90% of G1 cases did not experience a second xposure, indicating greater protection against recurrent symptomatic infection.

  17. Molecular diversity of bovine viral diarrhea virus in uruguay.

    Science.gov (United States)

    Maya, L; Puentes, R; Reolón, E; Acuña, P; Riet, F; Rivero, R; Cristina, J; Colina, R

    2016-03-01

    Bovine viral diarrhea (BVD) affects bovine production and reproduction causing significant economic losses all over the world. Two viral species has been recognized: BVDV-1 and BVDV-2, both distributed worldwide. Recently, novel specie of BVDV named HoBi-like pestivirus was discovered. The presence of BVDV was confirmed in 1996 in Uruguay, however, does not exist until today a schedule of compulsory vaccination along the country. Serological studies with samples from all Uruguayan herds were performed during 2000 and 2001 demonstrating that all of them were seropositive to BVDV with a mean prevalence of 69%. In addition, there have been no new studies done since those previously described and it is important to mention that the genetic diversity of BVD has never been described in Uruguay. Nowadays, there is strongly suspect that BVDV is one of the most important causes of reproductive failures in our herds. The aim of this study was to describe for the first time in Uruguay the genetic diversity of BVDV with samples collected from different regions along the country. Serological status of 390 non-vaccinated animals against BVDV with reproductive problems from farms of Rivera, Tacuarembó and Florida departments of Uruguay were studied. All herds were seropositive to BVDV and high proportion of animals were positive (298/390), while 4.1% (16/390) of the animals were positive to Antigen Capture ELISA test and Real Time PCR. Phylogenetic analysis performed with concatenated sequences from the 5'UTR and Npro genomic regions revealed that BVDV-1 and BVDV-2 are infecting our herds, being BVDV-1 the most frequently found. The major subtype was BVDV-1a, followed by BVDV-1i and BVDV-2b. This is the first study that describes the genetic diversity of BVDV in Uruguay and it will contribute to the elaboration of sanitization programs.

  18. Predictors of rational management of diarrhea in an endemic setting: observation from India.

    Science.gov (United States)

    Mahapatra, Tanmay; Mahapatra, Sanchita; Banerjee, Barnali; Mahapatra, Umakanta; Samanta, Sandip; Pal, Debottam; Datta Chakraborty, Nandini; Manna, Byomkesh; Sur, Dipika; Kanungo, Suman

    2015-01-01

    Decades after the establishment of clear guidelines for management, mostly due to irrational approach, diarrhea is still a major concern in the developing world, including India. The scenario is even worse in urban slums owing to poor health-seeking and socio-environmental vulnerability. Determining the distribution of rational diarrhea management by practitioners and identification of its important predictors seemed urgent to minimize the potential for antibiotic resistance, diarrhea-related mortality and morbidity in these areas. Between May 2011 and January 2012, 264 consenting, randomly selected qualified and non-qualified practitioners (including pharmacists) were interviewed in the slums of Kolkata, a populous city in eastern India, regarding their characteristics, diarrhea-related knowledge (overall and in six separate domains: signs/symptoms, occurrence/spread, management, prevention/control, cholera and ORS), prescribed antibiotics, intravenous fluid (IVF) and laboratory investigations. Rationality was established based on standard textbooks. Among participants, 53.03% had no medical qualifications, 6.06% were attached to Governmental hospitals, 19.32% had best knowledge regarding diarrhea. While treating diarrhea, 7.20%, 17.80% and 20.08% respectively advised antibiotics, IVF and laboratory tests rationally. Logistic regression revealed that qualified and Governmental-sector practitioners managed diarrhea more rationally. Having best diarrhea-related knowledge regarding signs/symptoms (OR=5.49, p value=0.020), occurrence/spread (OR=3.26, p value=0.035) and overall (OR=6.82, p value=0.006) were associated with rational antibiotic prescription. Rational IVF administration was associated with best knowledge regarding diarrheal signs/symptoms (OR=3.00, p value=0.017), occurrence/spread (OR=3.57, p value=0.004), prevention/control (OR=4.89, p value=0.037), ORS (OR=2.55, p value=0.029) and overall (OR=4.57, p valuerational laboratory testing strategy. Diarrheal

  19. Incidence of Parasitic Diarrhea in Patients with Common Variable Immune Deficiency.

    Science.gov (United States)

    Uysal, Serhat; Tunalı, Varol; Akdur Öztürk, Eylem; Ardeniz, Ömür; Işıkgöz Taşbakan, Meltem; Pullukçu, Hüsnü; Özensoy Töz, Seray; Turgay, Nevin; Arda, Bilgin

    2016-06-01

    Parasites might cause atypical and severe infections in immunocompromised hosts. The prevalence of diarrhea among common variable immune deficiency (CVID) syndrome patients varies between 20% and 94%, which indicates that diarrhea and gastrointestinal system (GIS) complaints could be the second leading cause of morbidity in CVID patients after respiratory tract infections. This study aimed to assess the prevalence of intestinal parasites in CVID patients with GIS complaints and diarrhea. In this study, all cases followed up in the Immunology and Allergy Clinic of Ege University School of Medicine from July 2008 to August 2015 with the diagnosis of CVID were reviewed retrospectively. The stool samples of patients with diarrhea were identified using direct microscopy of native (0.09% NaCl) and Lugol's iodine preparations followed by formol-ethyl acetate concentration to apply modified Kinyoun, trichrome, acid-fast trichrome, and modified trichrome stains for the presence of intestinal parasites. Overall, 26 of 37 CVID patients had diarrhea; white and red blood cells (WBCs and RBCs, respectively) were identified in 11 and 10 of these 26 samples, respectively. Intestinal parasites were found to be present in 7 of the 11 patients with WBCs and 3 of the 10 patients with RBCs. With the addition of patients who neither had WBCs nor RBCs in their stool, a parasitic agent was detected in 13 (50%) of the 26 patients with diarrhea. There was no significant difference between the diarrheic patients with or without intestinal parasites with respect to cramps, fever, nausea and vomiting, tenesmus, bloody feces, and presence of mucus in the stool. Only one patient had malabsorption, which was not associated with intestinal parasites. The most common parasites detected in this study were Cryptosporidium spp. (n=9; 69.2%), Giardia spp. (n=7; 53.8%), and Blastocystis spp. (n=3; 23.1%). We also identified that parasitic diarrhea in CVID patients tended to last longer (M (mean): 16

  20. Predictors of rational management of diarrhea in an endemic setting: observation from India.

    Directory of Open Access Journals (Sweden)

    Tanmay Mahapatra

    Full Text Available Decades after the establishment of clear guidelines for management, mostly due to irrational approach, diarrhea is still a major concern in the developing world, including India. The scenario is even worse in urban slums owing to poor health-seeking and socio-environmental vulnerability. Determining the distribution of rational diarrhea management by practitioners and identification of its important predictors seemed urgent to minimize the potential for antibiotic resistance, diarrhea-related mortality and morbidity in these areas.Between May 2011 and January 2012, 264 consenting, randomly selected qualified and non-qualified practitioners (including pharmacists were interviewed in the slums of Kolkata, a populous city in eastern India, regarding their characteristics, diarrhea-related knowledge (overall and in six separate domains: signs/symptoms, occurrence/spread, management, prevention/control, cholera and ORS, prescribed antibiotics, intravenous fluid (IVF and laboratory investigations. Rationality was established based on standard textbooks.Among participants, 53.03% had no medical qualifications, 6.06% were attached to Governmental hospitals, 19.32% had best knowledge regarding diarrhea. While treating diarrhea, 7.20%, 17.80% and 20.08% respectively advised antibiotics, IVF and laboratory tests rationally. Logistic regression revealed that qualified and Governmental-sector practitioners managed diarrhea more rationally. Having best diarrhea-related knowledge regarding signs/symptoms (OR=5.49, p value=0.020, occurrence/spread (OR=3.26, p value=0.035 and overall (OR=6.82, p value=0.006 were associated with rational antibiotic prescription. Rational IVF administration was associated with best knowledge regarding diarrheal signs/symptoms (OR=3.00, p value=0.017, occurrence/spread (OR=3.57, p value=0.004, prevention/control (OR=4.89, p value=0.037, ORS (OR=2.55, p value=0.029 and overall (OR=4.57, p value<0.001. Best overall (OR=2.68, p value

  1. Risk Factors of Diarrhea in Children Under Five Years in Urban Slums

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    Balakrishna Kalakheti

    2016-12-01

    Full Text Available Introduction: Diarrhea is a leading cause of mortality in children in developing countries and the condition is worse in slums. In order to provide effective preventive and management strategies, it is important to identify factors associated with the disease. This study was carried out to investigate the risk factors of diarrhea in  children under five years of age in urban slums. Methods: Parents of all children under five years from the urban slums of Tansen municipality, Palpa, Nepal were interviewed using a standardized pretested questionnaire and proforma. Parental variables, environmental factors, and presence of diarrhea in those children in past three months were collected by trained enumerators and the data were analyzed with statistical software SPSS-10. Results: A total of 450 under five years children were enrolled in the study. There were 216 (48% male and 234 (52% female children with F:M ratio of 1.08:1. Occurrence of diarrhea was lower if the children were breast-fed for more than six months, well-nourished, used fountain water for drinking, or used boiled or treated water. Similarly, diarrhea prevalence was lower if father had a regular job, daily income in the family was more than one US dollar, there was a toilet in the house, practice of hand washing was followed before feeding or preparing food, or there was no child suffering from diarrhea in the neighborhood. Conclusion: There are a few variables that are significantly related to diarrhea in children under five years of age. In order to decrease the diarrheal episodes in children in the slums of the developing countries, priority could be given in the improvement of those variables.

  2. [Consensus paper treatment of acute traveler's diarrhea. Practice recommendation for travel advice].

    Science.gov (United States)

    Jelinek, Tomas; Nothdurft, Hans-Dieter; Haditsch, Martin; Weinke, Thomas

    2017-03-01

    In times of mass tourism, traveler's diarrhea is one of the most common health problems of long-distance travel. Globally, some 40 million cases occur annually. Travellers to risk areas should therefore be comprehensively advised beforehand, as to what action to take in case of an acute traveler's diarrhea and what drugs to add to their first-aid kit. To date none, or hardly any specific studies or valid specific guidelines for the treatment of traveler's diarrhea are available for Germany. Drafting a consensus paper based on results of a specialists' meeting to evaluate therapeutic options in the treatment of acute uncomplicated travelers' diarrhea. The foundation for the present consensus recommendations is current evidence on antidiarrheals available in Germany for symptomatic treatment of gastrointestinal infections, summarized in the S2k guideline for gastrointestinal infections and Whipple's disease. Further taken into account for the present consensus recommendations were Pubmed-listed publications on symptomatic treatment of traveler's diarrhea, practical aspects, and the experts' experience in travel medicine. For the treatment of acute uncomplicated traveler's diarrhea - more than 90 % of all cases - the secretion inhibitor racecadotril is considered first choice, based on our evaluation criteria. The previously usual practice of recommending the antimotility drug loperamide as first choice should be reconsidered, in favor of the recent active ingredient racecadotril. Antibiotics should be used only in complicated cases. A large number of travelers who generally demand antibiotic therapy should be disabused of their expectations. Other therapeutic measures that are currently available for the treatment of acute diarrhea while traveling play a subordinate role.

  3. dbDiarrhea: the database of pathogen proteins and vaccine antigens from diarrheal pathogens.

    Science.gov (United States)

    Ramana, Jayashree; Tamanna

    2012-12-01

    Diarrhea occurs world-wide and is most commonly caused by gastrointestinal infections which kill around 2.2 million people globally each year, mostly children in developing countries. We describe here dbDiarrhea, which is currently the most comprehensive catalog of proteins implicated in the pathogenesis of diarrhea caused by major bacterial, viral and parasitic species. The current release of the database houses 820 proteins gleaned through an extensive and critical survey of research articles from PubMed. The major contributors to this compendium of proteins are Escherichia coli and Salmonella enterica. These proteins are classified into different categories such as Type III secretion system effectors, Type III secretion system components, and Pathogen proteins. There is another complementary module called 'Host proteins'. dbDiarrhea also serves as a repository of the research articles describing (1) trials of subunit and whole organism vaccines (2) high-throughput screening of Type III secretion system inhibitors and (3) diagnostic assays, for various diarrheal pathogens. The database is web accessible through an intuitive user interface that allows querying proteins and research articles for different organism, keywords and accession number. Besides providing the search facility through browsing, the database supports sequence similarity search with the BLAST tool. With the rapidly burgeoning global burden of the diarrhea, we anticipate that this database would serve as a source of useful information for furthering research on diarrhea. The database can be freely accessed at http://www.juit.ac.in/attachments/dbdiarrhea/diarrhea_home.html. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Guidelines for the prevention and treatment of travelers' diarrhea: a graded expert panel report.

    Science.gov (United States)

    Riddle, Mark S; Connor, Bradley A; Beeching, Nicholas J; DuPont, Herbert L; Hamer, Davidson H; Kozarsky, Phyllis; Libman, Michael; Steffen, Robert; Taylor, David; Tribble, David R; Vila, Jordi; Zanger, Philipp; Ericsson, Charles D

    2017-04-01

    : Travelers' diarrhea causes significant morbidity including some sequelae, lost travel time and opportunity cost to both travelers and countries receiving travelers. Effective prevention and treatment are needed to reduce these negative impacts. : This critical appraisal of the literature and expert consensus guideline development effort asked several key questions related to antibiotic and non-antibiotic prophylaxis and treatment, utility of available diagnostics, impact of multi-drug resistant (MDR) colonization associated with travel and travelers' diarrhea, and how our understanding of the gastrointestinal microbiome should influence current practice and future research. Studies related to these key clinical areas were assessed for relevance and quality. Based on this critical appraisal, guidelines were developed and voted on using current standards for clinical guideline development methodology. : New definitions for severity of travelers' diarrhea were developed. A total of 20 graded recommendations on the topics of prophylaxis, diagnosis, therapy and follow-up were developed. In addition, three non-graded consensus-based statements were adopted. : Prevention and treatment of travelers' diarrhea requires action at the provider, traveler and research community levels. Strong evidence supports the effectiveness of antimicrobial therapy in most cases of moderate to severe travelers' diarrhea, while either increasing intake of fluids only or loperamide or bismuth subsalicylate may suffice for most cases of mild diarrhea. Further studies are needed to address knowledge gaps regarding optimal therapies, the individual, community and global health risks of MDR acquisition, manipulation of the microbiome in prevention and treatment and the utility of laboratory testing in returning travelers with persistent diarrhea.

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

    Science.gov (United States)

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

    2016-04-01

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

  6. Randomized trial of probiotics and calcium on diarrhea and respiratory tract infections in Indonesian children.

    Science.gov (United States)

    Agustina, Rina; Kok, Frans J; van de Rest, Ondine; Fahmida, Umi; Firmansyah, Agus; Lukito, Widjaja; Feskens, Edith J M; van den Heuvel, Ellen G H M; Albers, Ruud; Bovee-Oudenhoven, Ingeborg M J

    2012-05-01

    To investigate the effects of calcium and probiotics on the incidence and duration of acute diarrhea and acute respiratory tract infections (ARTIs) in low-socioeconomic communities of Jakarta, Indonesia. We conducted a 6-month, double-blind, placebo-controlled study in 494 healthy children aged 1 to 6 years who received low-lactose milk with low calcium content (LC; ∼50 mg/day; n = 124), regular calcium content (RC; ∼440 mg/day; n = 126), RC with 5.10(8) colony-forming units per day of Lactobacillus casei CRL431 (casei; n = 120), or RC with 5.10(8) colony-forming units per day of Lactobacillus reuteri DSM17938 (reuteri; n = 124). Number and duration of diarrhea and ARTIs episodes were primary and secondary outcomes, respectively. Incidence of World Health Organization-defined diarrhea (≥3 loose/liquid stools in 24 hours) was not significantly different between RC and LC (relative risk [RR]: 0.99 [95% confidence interval (CI): 0.62-1.58]), between casei and RC (RR: 1.21 [95% CI: 0.76-1.92]), or between reuteri and RC (RR: 0.76 [95% CI: 0.46-1.25]) groups. Incidence of all reported diarrhea (≥2 loose/liquid stools in 24 hours) was significantly lower in the reuteri versus RC group (RR: 0.68 [95% CI: 0.46-0.99]). Irrespective of the definition used, reuteri significantly reduced diarrhea incidence in children with lower nutritional status (below-median height-and-weight-for-age z score). None of the interventions affected ARTIs. RC milk, alone or with L casei, did not reduce diarrhea or ARTIs in Indonesian children. L reuteri may prevent diarrhea, especially in children with lower nutritional status.

  7. Hospital-acquired diarrhea in adults: a prospective case-controlled study in Mexico.

    Science.gov (United States)

    Zaidi, M; Ponce de León, S; Ortiz, R M; Ponce de León, S; Calva, J J; Ruiz-Palacios, G; Camorlinga, M; Cervantes, L E; Ojeda, F

    1991-06-01

    To know the incidence, etiology, risk factors, morbidity, and mortality of nosocomial diarrhea in adults. Nested case-control study, matched by service, length of stay, date of admission, and presence of leukopenia and/or the acquired immunodeficiency syndrome (AIDS). Cases were those who developed nosocomial diarrhea. Controls were those who did not develop nosocomial diarrhea during a comparative period nor during the next ten days. Stool samples were processed in search for parasites, yeasts, bacteria, and rotavirus. Third-level referral center, in Mexico City, Mexico, for general internal medicine and surgical problems. Eligible subjects were all new admissions to the hospital from November 1987 to September 1988. Reasons for exclusion were presence of chronic diarrheal disease or melena. There were 115 cases and 111 controls. Overall risk of acquiring nosocomial diarrhea was 5.5%, or 1.8 episodes per 100 patient-weeks. A potential pathogen was found in 59%. Yeasts and Entamoeba histolytica were the most frequently isolated pathogens. Mortality in cases was 18%, as compared with 5% in controls (p less than .01). Multivariate analysis showed enteral feeding, recent enemas, presence of Candida species, use of antacids/H2-blockers, and presence of nasogastric tubes as significant risk factors for nosocomial diarrhea. Diarrhea is a common complication in hospitalized patients. It occurs more often than previously suspected and is linked with a substantial mortality. The spectrum of etiologic agents is different from that reported in pediatric hospitals. Given that nosocomial diarrhea may constitute, at least, a marker of severity of illness, it should receive more attention in general hospitals.

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

    OpenAIRE

    McMahon, Shannon A; George, Asha S.; 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...

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

    OpenAIRE

    Hammarström Lennart; Svensson Lennart; Brüssow Harald; Marcotte Harold; Pant Neha

    2007-01-01

    Abstract Background Rotavirus is a worldwide cause of infectious infantile diarrhea that claims over 600,000 lives annually. Recently, two new vaccine candidates have been developed but their efficacy in developing countries, still remains to be proven. Oral delivery of specific immunoglobulins provides passive immunity and is a fast acting treatment for rotavirus diarrhea. Probiotic bacteria have also gained considerable attention lately as treatment for rotavirus diarrhea. Here we report an...

  10. Experiencia con pacientes hospitalizados en la unidad de capacitación para el tratamiento de la diarrea del Hospital Univertario San Vicente de Paúl de Medellín Experience with hospitalized children at a training unit for diarrhea treatment, in Medellín, Colombia

    Directory of Open Access Journals (Sweden)

    Carlos A. Bernal Parra

    1995-02-01

    Full Text Available

    Entre 1988 y 1994 se atendieron 1.755 niños en la sala de hospitalización de la Unidad de Capacitación para el Tratamiento de la Diarrea, del Hospital Universitario San Vicente de Paúl, de Medellín; 1.022 (58.2% fueron hombres y 733 (41.8% mujeres; mil setenta y ocho eran menores de un año (61.4% y 677 (38.6% tenían más de un año. Eran desnutridos 888 (50.6%. Presentaban diarrea persistente 418 (23.8%; 1.056 (82.2% diarrea acuosa, 213 (16.6% diarrea disentérica y 16 (1.2% solamente vómitos. Novecientos trece pacientes (52% consultaron o estuvieron en la sala de hidratación oral y 276 (15.7% habían estado hospitalizados por diarrea durante el último mes. Al ingreso 670 (38.2% se encontraban hidratados, 151 (8.6% tenían deshidratación grave y 934 (53.2% presentaban otros grados de deshidratación. La bacteria más frecuentemente identificada fue Salmonella enteritidis (258 casos; 23.9%. Setecientos ochenta y seis pacientes (44.8% recibieron los líquidos solamente por vía oral o por sonda nasogástrica y 969 (55.2% por vía intravenosa. Al egreso 1.088 (62% tuvieron el diagnóstico de diarrea aguda y 667 (38% el de diarrea persistente. La mortalidad fue de 1.5% (27 pacientes.

    We present the results of our experience in the in-patient treatment of children with diarrhea. Between 1988 and 1994,1.755 children were hospitalized for this purpose at the Training Unit for Diarrhea Treatment, Hospital San Vicente, in Medellín, Colombia; 1.022 (58.2% were males and 733 (41.8% females; 1.078 (61.4% were younger than one year and 677 (38.6% were above this age. Eight hundred and eighty eight (50.6% were undernourished. At admission, persistent diarrhea was found in 418 (23.8%; stools were watery in 1.056 (82.2% and dysenteric in 213 (16.6%; 16

  11. Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh.

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    Albert, M J; Faruque, A S; Faruque, S M; Sack, R B; Mahalanabis, D

    1999-11-01

    The International Centre for Diarrhoeal Disease Research, Bangladesh, is a major center for research into diarrheal diseases. The center treats more than 100,000 patients a year. To obtain useful information representative of all patients, a surveillance system in which a 4% systematic sample of all patients is studied in detail, including etiological agents of diarrhea, was installed in October 1979. The first paper on etiology for the surveillance patients was published in 1982, which identified a potential enteric pathogen in 66% of patients. In subsequent years, several new agents of diarrhea have been identified. To assess the importance of a broader spectrum of diarrheal agents including the ones identified relatively recently, we studied 814 children with diarrhea. The children were up to 5 years of age and were part of the surveillance system. They were matched with an equal number of community controls without diarrhea. The study was conducted from February 1993 to June 1994. A potential enteric pathogen was isolated from 74.8% of diarrheal children and 43.9% of control children (P = 0.0001). Even though the first study was not a case-control study, it identified rotavirus, Campylobacter jejuni, enterotoxigenic Escherichia coli, Shigella spp. , and Vibrio cholerae O1 as major pathogens. The present study identified these pathogens as being significantly associated with diarrhea. In addition, the study also identified six additional agents, including enteropathogenic E. coli, Aeromonas spp., V. cholerae O139, enterotoxigenic Bacteroides fragilis, Clostridium difficile, and Cryptosporidium parvum, as being significantly associated with diarrhea. Plesiomonas shigelloides, Salmonella spp., diffusely adherent E. coli, enteroaggregative E. coli, Entamoeba histolytica, and Giardia lamblia were not significantly associated with diarrhea. Enteroinvasive E. coli, enterohemorrhagic E. coli, and Cyclospora cayetanensis were not detected in any of the children. The

  12. Home management of diarrhea among underfives in a rural community in Kenya: household perceptions and practices.

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    Othero, Doreen M; Orago, Alloys S S; Groenewegen, Ted; Kaseje, Dan O; Otengah, P A

    2008-12-01

    Diarrheal disease is a major cause of morbidity and mortality among under-fives especially in rural and peri-urban communities in developing countries. Home management of diarrhea is one of the key household practices targeted for enhancement in the Community Integrated Management of Childhood Illness (C-IMCI) strategy. The aim of this study was to determine the perceptions of mothers/caregivers regarding the causes of diarrhea among under-fives and how it was managed in the home before seeking help from Community Health Workers or health facilities. A household longitudinal study was conducted in Nyando district, Kenya in 2004-2006 adopting both qualitative and quantitative approaches. A total of 927 mothers/caregivers of under-fives participated in the study. Perceived causes of childhood diarrhoea, action taken during diarrhea, fluid intake, recognition of signs of dehydration, feeding during convalescence, adherence to treatment and advice. Majority of the respondents 807 (87.1%) reported that their children had suffered from diarrhea within the last 2 weeks before commencement of the study. Diarrhea was found to contribute to 48% of child mortality in the study area. Perceived causes of diarrhea were: unclean water 524 (55.6%), contaminated food 508 (54.9%), bad eye 464 (50.0%), false teeth 423 (45.6%) and breast milk 331 (35.8%). More than 70% of mothers decreased fluid intake during diarrhea episodes. The mothers perceived wheat flour, rice water and selected herbs as anti-diarrheal agents. During illness, 239 (27.8%) of the children were reported not to have drunk any fluids at all, 487 (52.5%) drunk much less and only 93 (10.0%) were reported to have drunk more than usual. A significant 831 (89.6%) withheld milk including breast milk with the notion that it enhanced diarrhea. Based on these findings, there is need to develop and implement interactive communication strategies for the health workers and mothers to address perceptions and misconceptions and

  13. Scoring system to distinguish between rotavirus and non-rotavirus diarrhea in children

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    Atika Akbari

    2017-01-01

    Full Text Available Background Distinguishing rotavirus from non-rotavirus diarrhea is helpful for managing the illness. However, definitively diagnosing rotavirus diarrhea from serology is difficult and expensive. Objectives To distinguish between the clinical manifestations of rotavirus and non-rotavirus diarrhea, and to assess the accuracy of using such clinical manifestations to predict the type of diarrhea in children. Methods A cross-sectional study was performed from April to October 2015 in all children less than five years of age who presented with acute diarrhea at the Pediatric Outpatient Clinic of the Department of Child Health and Emergency Department, Dr. Mohammad Hoesin and Bari Hospitals, Palembang, South Sumatera. Clinical manifestations were collected from history and physical examinations; stool specimens were examined by immunochromatography. Clinical parameters were analyzed by multivariate analysis, and scores given to each significant parameter. The accuracy of the scoring system based in these parameters was analyzed by means of receiver-operating characteristic (ROC area under the curve (AUC. Results Of 184 children, 92 had rotavirus and 92 had non-rotavirus diarrhea. Multivariate analysis showed 3 clinical parameters commonly seen in the rotavirus diarrhea cases: male sex (OR 2.718; 95%CI 1.373 to 5.382, cough (OR 3.500; 95%CI 1.788 to 6.582, and yellow-greenish stool (OR 4.009; 95%CI 2.061 to 7.797. A scoring system was constructed based on the parameters: male (score of 1, cough (score of 2, and yellow-greenish stool (score of 3. From ROC analysis, the AUC was 0.755. Using a cut-off score of > 3, the sensitivity was 81.5%, specificity 51.1%, and PPV 62.5%. Conclusion Cough, yellow-greenish stool, and male are significant parameters for differentiating rotavirus from non-rotavirus diarrhea. A scoring system from these parameters is sensitive for predicting rotavirus vs. non-rotavirus diarrhea in children less than five years of age.

  14. Fecal lactoferrin and intestinal permeability are effective non-invasive markers in the diagnostic work-up of chronic diarrhea.

    Science.gov (United States)

    Caccaro, Roberta; D'Incà, Renata; Martinato, Matteo; Pont, Elisabetta Dal; Pathak, Surajit; Frigo, Anna Chiara; Sturniolo, Giacomo Carlo

    2014-10-01

    Non-invasive markers able to identify patients with chronic diarrhea at risk of organic disease are missing. Aim of the study was to assess the diagnostic ability of intestinal permeability (IP) test and fecal lactoferrin (FL) in distinguishing functional from organic disease in patients with chronic diarrhea. We retrospectively enrolled patients referring to the gastroenterology outpatient clinic for chronic diarrhea. Among the 103 patients included, 40 % had an organic disease, with IP and FL levels significantly higher compared to those with a functional disorder (p chronic diarrhea patients. Together these tests could recognize both the presence of intestinal damage and its site.

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

    Science.gov (United States)

    Ye, X; Van, J N; Munoz, F M; Revell, P A; Kozinetz, C A; Krance, R A; Atmar, R L; Estes, M K; Koo, H L

    2015-07-01

    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, matched by transplanted organ type, were compared. Norovirus infection was identified in 25 (22%) of 116 patients, more frequently than other enteropathogens. Fifty percent of norovirus patients experienced diarrhea lasting ≥14 days, with median duration of 12.5 days (range 1-324 days); 29% developed diarrhea recurrence. Fifty-five percent of norovirus patients were hospitalized for diarrhea, with 27% requiring intensive care unit (ICU) admission. One HSCT recipient developed pneumatosis intestinalis. Three HSCT patients expired ≤6 months of norovirus diarrhea onset. Compared to non-norovirus diarrhea patients, norovirus patients experienced significantly more frequent ICU admission (27% vs. 0%, p = 0.02), greater serum creatinine rise (median 0.3 vs. 0.2 mg/dL, p = 0.01), and more weight loss (median 1.6 vs. 0.6 kg, p diarrhea in pediatric transplant patients and are associated with significant clinical complications. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  16. [Epidemiological characteristics of diarrheagenic Escherichia coli among diarrhea outpatients in China, 2012-2015].

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    Zhang, Z K; Lai, S J; Yu, J X; Yang, W Q; Wang, X; Jing, H Q; Li, Z J; Yang, W Z

    2017-04-10

    Objective: To understand the epidemiological characteristics of diarrheagenic Escherichia (E.) coli (DEC) among diarrhea outpatients in China. Methods: Diarrhea surveillance program was conducted in outpatient and emergency departments from 170 hospitals that under the sentinel programs in 27 provinces, from 2012-2015. Clinical and epidemiological data regarding diarrhea patients were collected, with fecal specimens sampled and tested for DEC in 92 network-connected laboratories. Results: Among all the 46 721 diarrhea cases, 7.7% of them appeared DEC positive in those with geographic heterogeneity. In 2 982 cases (6.4%) with available data on PCR subtypes of DEC, enteroaggregative E. coli (EAEC, 1 205 cases, 40.4%) appeared the most commonly seen pathogens, followed by enteropathogenic E. coli (EPEC, 815 cases, 27.3%), and enterotoxigenic E.coli (ETEC, 653 cases, 21.9%). The highest positive rate of DEC was observed in outpatients of 25-34 years old (10.1%), living in the warm temperate zones (11.1%), and with mucous-like stool (9.4%). The positive rate of DEC showed a strong seasonal pattern, with peaks in summer, for all the subtypes. Conclusions: DEC seemed easy to be detected among diarrhea outpatients in China, with EAEC, EPEC and ETEC the most commonly identified subtypes. Epidemiological characteristics regarding the heterogeneities of DEC appeared different, in regions, age groups and seasons. Long-term surveillance programs should be strengthened to better understand the epidemiology of DEC, in China.

  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. Effect of rotavirus vaccine on childhood diarrhea mortality in five Latin American countries.

    Science.gov (United States)

    Paternina-Caicedo, Angel; Parashar, Umesh D; Alvis-Guzmán, Nelson; De Oliveira, Lucia Helena; Castaño-Zuluaga, Andres; Cotes-Cantillo, Karol; Gamboa-Garay, Oscar; Coronell-Rodríguez, Wilfrido; De la Hoz-Restrepo, Fernando

    2015-07-31

    The aim of this study was to estimate the association between rotavirus vaccine (RV) introduction and reduction of all-cause diarrhea death rates among children in five Latin American countries that introduced RV in 2006. Diarrhea mortality data was gathered from 2002 until 2009 from the Pan American Health Organization Mortality Database for five "vaccine adopter" countries (Brazil, El Salvador, Mexico, Nicaragua, and Panama) that introduced RV in 2006 and four "control" countries (Argentina, Chile, Costa Rica, and Paraguay) that did not introduce RV by 2009. Time trend analyses were carried out, and effects and 95% confidence intervals (CI) were estimated. Each of the five vaccine adopter countries, except Panama, showed a significant trend in declining mortality rates during the post-vaccine period from 2006 to 2009, whereas no decline was seen in control countries during these years. Furthermore, trends of reduction of all-cause diarrhea mortality in both children trends over time in diarrhea mortality. These data strongly support continuous efforts to increase vaccination coverage of RV vaccines, particularly in countries with high levels of child mortality from diarrhea. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. 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.

  20. Current concepts in the evaluation, diagnosis and management of acute infectious diarrhea.

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    Gadewar, Swati; Fasano, Alessio

    2005-12-01

    Despite recent advances in our understanding of the pathogenesis of enteric diseases, acute infectious diarrhea remains a major cause of morbidity and mortality worldwide. Infection is the most common cause of acute diarrhea. Some causes of infectious diarrhea also result in serious long-term sequelae such as hemolytic uremic syndrome, Guillain-Barré syndrome and malnutrition. A better understanding of bacterial pathogenesis has grown increasingly important because of the emergence of new pathogens and the growing problems of resistance among enteric pathogens and other enteric flora. Non-antimicrobial approaches to therapy have become increasingly important with the emergence of serious antimicrobial resistance, such as vancomycin-resistant enterococcal colonization of the gastrointestinal tract. Finally, new understanding of how intestinal bacteria cause disease is revealing that enteric infections might trigger damage to epithelial cells or the intestinal barrier, or disrupt intestinal barrier and absorptive function (without necessarily causing overt diarrhea); thus, enteric infections might be far more important as emerging causes of malnutrition than has been previously appreciated. Therefore, diarrhea is both a cause and an effect of malnutrition. Treatment in most cases of bacterial and viral diseases consists of correcting fluid loss and electrolyte imbalance by oral or parenteral rehydration. Prevention of enteric illness by virtue of improved hygiene and provision of sanitation and water treatment is impractical in most developing countries, where morbidity and mortality rates are highest. For this reason, development of vaccines against the most important gastrointestinal infections remains a high priority.

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

    Science.gov (United States)

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

    2010-07-01

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

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

    Science.gov (United States)

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

    2016-05-15

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

  3. Viral Agents of Diarrhea in Young Children in Two Primary Health Centers in Edo State, Nigeria.

    Science.gov (United States)

    Imade, Paul Erhunmwunse; Eghafona, Nosakhare Odeh

    2015-01-01

    Enteric viruses have been shown to be responsible for diarrhea among children during their early childhood. This study was carried out to determine the prevalence of rotavirus, adenovirus, and norovirus infection in young children with diarrhea in two primary health centers in Edo State, Nigeria. A total of 223 stool specimens were collected from children aged 0-36 months with clinical signs of diarrhea and 59 apparently healthy age-matched children as control. These specimens were investigated for three viral agents using immunochromatographic technique (ICT). The overall results showed that at least one viral agent was detected in 95/223 (42.6%) of the children with diarrhea while the control had none. The prevalence of rotavirus was 28.3%, adenovirus 19.3%, and norovirus 3.6%. There was a significant association between age group and infection (P < 0.0001). Seasonal pattern of enteric viruses was not statistically significant (P = 0.17). The overall coinfection rate was 7.6% and rotavirus-adenovirus coinfection had the highest with 5.4%. Rotavirus was the most prevalent viral agent. Coinfections are not uncommon among the population studied. The most commonly associated clinical symptom of viral diarrhea in this study was vomiting. Viral diagnostic tests are advocated for primary health care facilities in this locality.

  4. Controlling Rotavirus-associated diarrhea: Could single-domain antibody fragments make the difference?

    Science.gov (United States)

    Maffey, Lucia; Vega, Celina G; Parreño, Viviana; Garaicoechea, Lorena

    2015-01-01

    Group A Rotavirus (RVA) remains a leading cause of severe diarrhea and child mortality. The variable domain of camelid heavy chain antibodies (VHH) display potent antigen-binding capacity, have low production costs and are suitable for oral therapies. Two sets of anti-RVA VHHs have been developed: ARP1-ARP3; 2KD1-3B2. Here, we explore the potential of both sets as a prevention strategy complementary to vaccination and a treatment option against RVA-associated diarrhea in endangered populations. Both sets have been expressed in multiple production systems, showing extensive neutralizing capacity against strains of RVA in vitro. They were also tested in the neonatal mouse model with various degrees of success in preventing or treating RVA-induced diarrhea. Interestingly, mitigation of the symptoms was also achieved with freeze-dried ARP1, so that it could be applied in areas where cold chains are difficult to maintain. 3B2 was tested in a pre-clinical trial involving gnotobiotic piglets where it conferred complete protection against RVA-induced diarrhea. ARP1 was used in the first clinical trial for anti-RVA VHHs, successfully reducing stool output in infants with RVA diarrhea, with no detected side effects. Copyright © 2015 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Efficacy of a travelers' diarrhea vaccine system in travelers to India.

    Science.gov (United States)

    Steffen, Robert; Cramer, Jakob P; Burchard, Gerd; Jelinek, Tomas; Schwarz, Ute; Ramdas, Prabhugaunker; Chatterjee, Santanu; Jiang, Zhi-Dong; DuPont, Herbert L; Dewasthaly, Shailesh; Westritschnig, Kerstin; Behrens, Ronald H

    2013-01-01

    A patch vaccine containing heat-labile toxin (LT) from enterotoxigenic Escherichia coli (ETEC) has demonstrated to be beneficial in reducing the rate and severity of travelers' diarrhea in Latin America. To evaluate the efficacy of this transdermal vaccine system in an area with a different diarrheal pathogen profile, an additional phase 2 study was conducted in European travelers to India. For this multicenter, randomized, double-blinded, placebo-controlled field study 723 subjects were recruited; 603 (299 LT vaccine, 304 placebo) were included in the per-protocol-population (PPP). Although the LT patch induced a measurable LT immune response in recipients, it failed to protect against LT ETEC or all-cause diarrhea. In the PPP the incidence rate of diarrhea as per primary endpoint was 6.0% (18 of 299) in the vaccine group and 5.9% (18 of 304) in the placebo group. Additionally, lower than expected rates of LT ETEC diarrheas were observed in India. The vaccine delivery system frequently produced rash and pruritus at the site of application, long term hyperpigmentation persisted in a minority of LT recipients, and also few site reactions were noted in the placebo group. The evaluated patch vaccine failed to satisfy mainly with respect to protective efficacy. Noninvasive prophylactic agents against travelers' diarrhea, particularly vaccines against the most frequent pathogens, thus continue to be badly needed. © 2013 International Society of Travel Medicine.

  6. Chronic and persistent diarrhea in infants and young children: status statement.

    Science.gov (United States)

    Mathai, John; Raju, Bhaskar; Bavdekar, Ashish

    2011-01-01

    Diarrhea that lasts for more than two weeks is a common cause of mortality and morbidity in infants and children. There is a need to update the information available on this subject in Indian context. This review has analyzed the available published data on the subject with particular focus on developing countries. It has also outlined the current diagnostic and management practices in India based on the experience of the participants from major hospitals in different parts of the country. Problem areas in both persistent and chronic diarrhea have been identified and remedial measures relevant to India are presented. Micronutrient supplementation, algorithm based diet regimens, and good supportive care are sufficient in most children above 6 months of age with persistent diarrhea. Paucity of diagnostic facilities limits evaluation of chronic diarrhea in most parts of the country and regional laboratories need to be set up urgently. Lack of awareness regarding cows milk protein allergy, celiac disease and immunodeficiency associated diarrhea is of particular concern.

  7. [Prevalence of celiac disease in children with chronic diarrhea in China].

    Science.gov (United States)

    Wang, Xin-qiong; Liu, Wei; Xu, Jun-jie; Mei, Hong; Peng, Han-ming; Gao, Yuan; Yuan, Lan; Xu, Chun-di

    2010-04-01

    To investigate the prevalence of celiac disease in children with chronic diarrhea in China. Inpatients of the pediatric hospitals in Shanghai, Jinan, Wuhan and Chengdu who were diagnosed as chronic diarrhea were recruited from Jan. 2005 to Dec. 2008. Their clinical history, physical examination and laboratory data were collected. The SPSS version 11.5 statistical package for Microsoft Windows was used for statistical analysis. Data of 199 patients and finally enrolled 118 hospitalized chronic diarrhea inpatients during the observation period were collected and 14 (12%) of the chronic diarrhea patients were suspected as having celiac disease and in one the diagnosis of celiac disease was confirmed. Gluten-free diet (GFD) treatment was effective. M/F: 12/2, the age ranged from 6 months to 12 years; 43% (6/14) had malnutrition, 29% (4/14) had anemia, villous atrophy was found in 4 patients by endoscopy. Duodenal biopsies revealed stage I in 1, stage II in 2, stage IIIa in 7, stage IIIb in 3 and stage IIIc in 1 patient according to the modified Marsh classification. This study was the first time to report the research of celiac disease in children with chronic diarrhea in China. The percentage of suspicious celiac disease patients was 12% (14/118) in children and one was confirmed. CD exists in China. Chinese pediatricians should pay attention to the disease.

  8. Serum interleukin-6 as a prognostic marker in neonatal calf diarrhea.

    Science.gov (United States)

    Fischer, Stephani; Bauerfeind, Rolf; Czerny, Claus-Peter; Neumann, Stephan

    2016-08-01

    Neonatal calf diarrhea is still one of the most important diseases in calf rearing, and severe diarrhea has a marked effect on animal welfare. Furthermore, significant economic losses can result from this disease due to high mortality rates, high medical costs, and low weight gain. To avoid a fatal outcome of the disease, it is crucial that vulnerable calves are identified as early as possible. Interleukin-6 is described as an early and reliable prognostic marker in several diseases. In this study, 20 scouring calves were tested by ELISA for their IL-6 serum concentrations. Samples were collected twice, at the beginning of diarrhea and 7 to 10d later. Regarding the clinical outcome after 7 to 10d, calves were classified as recovered or nonrecovered. A receiver operating characteristic analysis was conducted to determine the prognostic value of IL-6 for the progress of clinical symptoms. At the beginning of diarrhea, the IL-6 concentration was significantly higher in nonrecovering calves compared with those that recover 7 to 10d after the onset of diarrhea. Interleukin-6 proved to be a useful additional parameter in the clinical examination. High initial IL-6 values can support the decision for closer monitoring and an adapted therapeutic strategy for the respective calves. This may help to prevent unnecessary animal suffering and reduce economic losses. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  9. An intercultural comparison of home case management of acute diarrhea in Mexico: implications for program planners.

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    Martinez, H; Ryan, G W; Guiscafre, H; Gutierrez, G

    1998-01-01

    The objective was to assess the extent to which similarities in cultural beliefs and practices related to home management of diarrhea would permit general recommendations to improve the content of health care messages. We studied six communities in Mexico, covering rural and urban conditions, different ethnic groups, and different socioeconomic levels. Systematic data collection relied on open-ended, face-to-face interviews with mothers of children under 5 years of age who had had an episode of diarrhea. Similarities among communities were assessed by means of a quadratic assignment procedure applied to signs, symptoms, and treatment matrices. Significant similarity among most of the communities sustained use of a global composite matrix to represent all communities. We suggest specific recommendations to promote sound home management of diarrhea based on significant correlations among signs and symptoms with treatments. Signs and symptoms include those promoted by the National Program for the Control of Diarrheal Diseases (diarrhea, fever, vomiting) and others commonly mentioned by mothers (stomach ache, sadness, restlessness, refusal to eat). Similarly, recommendations to use home-based treatments based on beliefs related to their use may include the feeding of rice water, soups, and broth to a child who is sad, or rice-gruel and teas for a child with a fever. Our study supports that there are enough similarities among mothers' beliefs and practices for the care of acute diarrhea in childhood to support general recommendations at the program level.

  10. Clinical Significance of Fecal Lactoferrin and Multiplex Polymerase Chain Reaction in Patients with Acute Diarrhea.

    Science.gov (United States)

    Lee, Hae Mi; Lee, Seungok; Lee, Bo-In; Jekarl, Dong Wook; Song, Joo-Yong; Choi, Hye-Jung; Kang, Bong Koo; Im, Eun Joo; Kim, Joon Sung; Kim, Jong In; Kim, Byung-Wook; Choi, Hwang

    2015-09-23

    The diagnostic yield of fecal leukocyte and stool cultures is unsatisfactory in patients with acute diarrhea. This study was performed to evaluate the clinical significance of the fecal lactoferrin test and fecal multiplex polymerase chain reaction (PCR) in patients with acute diarrhea. Clinical parameters and laboratory findings, including fecal leukocytes, fecal lactoferrin, stool cultures and stool multiplex PCR for bacteria and viruses, were evaluated prospectively for patients who were hospitalized due to acute diarrhea. A total of 54 patients were included (male, 23; median age, 42.5 years). Fecal leukocytes and fecal lactoferrin were positive in 33 (61.1%) and 14 (25.4%) patients, respectively. Among the 31 patients who were available for fecal pathogen evaluation, fecal multiplex PCR detected bacterial pathogens in 21 patients, whereas conventional stool cultures were positive in only one patient (67.7% vs 3.2%, p=0.000). Positive fecal lactoferrin was associated with presence of moderate to severe dehydration and detection of bacterial pathogens by multiplex PCR (21.4% vs 2.5%, p=0.049; 100% vs 56.5%, p=0.032, respectively). Fecal lactoferrin is a useful marker for more severe dehydration and bacterial etiology in patients with acute diarrhea. Fecal multiplex PCR can detect more causative organisms than conventional stool cultures in patients with acute diarrhea.

  11. 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.

  12. Home Care of Children With Diarrhea in Bangui's Therapeutic Landscape (Central African Republic).

    Science.gov (United States)

    Giles-Vernick, Tamara; Bainilago, Louis; Fofana, Moussa; Bata, Petulla; Vray, Muriel

    2016-01-01

    We explore how the therapeutic landscape of Bangui, capital of the Central African Republic, shaped and reflected caregivers' home care of childhood diarrhea. Using interviews, group discussions, and participant observation, we found that caregivers described several categories of diarrhea, but in practice, adopted an experimental approach to home diarrheal care. Many managed incertitude by initially dosing children with street medicines and herbal infusions; they delayed seeking professional medical care to avoid expenses, observed their children's symptoms, consulted social networks, and used therapeutic foods. The logics underpinning these practices emerged from caregivers' conviction that diarrhea necessitated medical therapy and restricted choices within Bangui's therapeutic landscape, a consequence of lengthy political economic crisis. This crisis impoverished Bangui populations, eroded formal health care, and sharpened religious differences, discouraging care seeking from traditional healers. Analyses of therapeutic landscapes illuminate why caregivers embraced specific practices and logics and should guide the elaboration of more effective public health interventions. © The Author(s) 2015.

  13. Diarrhea: the nemesis of the artificially reared, early weaned piglet and a strategy for defense.

    Science.gov (United States)

    Lecce, J G

    1986-10-01

    Rearing early weaned piglets artificially for the purpose of increasing the efficiency of the sow is an attractive management concept. However, high death losses resulting from diarrhea in artificially reared piglets have dampered enthusiasm for early weaning. Enterotoxigenic Escherichia coli, transmissible gastroenteritis virus and rotavirus are the three main enteropathogens responsible for causing the diarrhea. The enteropathogens infect the small intestine, which produces a secretory or malabsorptive diarrhea. In nature, the nursing piglet is protected from the enteropathogens by antibody bathing his gut. The source of the antibody is the dam's colostrum and milk. It should be possible to protect artificially reared, early weaned piglets from enteropathogens by feeding them diets that contain antibodies to putative enteropathogens.

  14. MODERN TECHNOLOGIES OF TREATMENT AND PROPHYLAXIS OF ANTIBIOTIC-ASSOCIATED DIARRHEA IN CHILDREN

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    A.N. Surkov

    2011-01-01

    Full Text Available Intestinal microflora derangement is quite common among children with various somatic abnormalities. Jne of the most common reasons for disbacteriosis development — antibiotic therapy. The vast majority of antibiotics affects gastrointestinal microflora that leads to dyspeptic syndrome development and so-called antibiotic-associated diarrhea. Intestinal disbacteriosis affects homeostasis, leading to considerable shifts in the state of different systems and organs. That’s why correction and prophylaxis of intestinal disbacteriosis against the background of antibiotic treatment is quite important for a pediatrician. This article contains main information upon epidemiology, pathogenesis, clinical forms and clinical presentation, diagnostics and treatment of antibiotic-associated diarrhea among children. Key words: indigenous intestinal microflora, antibiotic-associated diarrhea, treatment, prophylaxis, ecoantibiotics, children. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (5: 146–151.

  15. Imipenem-induced clostridium difficile diarrhea in a patient with chronic renal failure

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    R Enríquez

    2011-01-01

    Full Text Available An 80-year-old man was diagnosed to have pneumonia and advanced chronic kidney disease. He presented with anuria and hemodialysis, by temporary femoral catheter, was initiated. He was empirically treated with imipenem/cilastatin 500 mg/24 h after hemodialysis. After 10 days of antibiotic intake, he developed severe diarrhea. Diagnosis of Clostridium difficile (CD-associated diarrhea was confirmed by detection of the toxins A and B in his stool. Imipenem therapy was discontinued; Vancomycin 500 mg orally every 6 h and 1000 mg per rectum every day was added. After two weeks of this treatment, the patient reported complete resolution of the diarrhea and stool samples were negative for Clostridium toxin. In this case, the most possible cause of CD colitis was considered to be imipenem because of the temporal relationship between exposure to the drug and onset of symptoms.

  16. Norovirus-related chronic diarrhea in a patient treated with alemtuzumab for chronic lymphocytic leukemia.

    Science.gov (United States)

    Ronchetti, Anne-Marie; Henry, Benoit; Ambert-Balay, Katia; Pothier, Pierre; Decroocq, Justine; Leblond, Véronique; Roos-Weil, Damien

    2014-05-06

    Norovirus infection is increasingly recognized as an important cause of persistent gastroenteritis in immunocompromised hosts and can be a potential cause of morbidity in these populations. Here, we report a case of norovirus-related chronic diarrhea occurring in a 62-year-old immunocompromised patient treated with alemtuzumab for chronic lymphocytic leukemia. Despite different therapeutic strategies including tapering of immunosuppressive therapy and immunoglobulin administration, diarrhea unfortunately did not resolve and lasted for a total of more than twelve weeks with prolonged norovirus fecal excretion. Norovirus infection can occur in the setting of alemtuzumab treatment, even as a single agent, and should be included in the differential diagnoses of acute and chronic diarrhea in these immunocompromised patients. Although the administration of oral immunoglobulin has been described as a promising efficient therapy, this was not the case in our patient. Clinical trials are thus clearly warranted to better define risk factors and efficient therapies for norovirus infection in immunocompromised populations.

  17. Toddler's diarrhea: is it an under-recognized entity in developing countries?

    Science.gov (United States)

    Poddar, Ujjal; Agarwal, Jaya; Yachha, Surender Kumar; Srivastava, Anshu

    2013-12-01

    As there is no report of toddler's diarrhea (TD) from the developing world, we have analyzed our experience of 191 children (chronic diarrhea over 7 years. Clinical details, investigations and outcome were retrieved and recorded in a proforma. TD was ascribed in those who had normal growth and no evidence of malabsorption or enteric infections. The etiology of chronic diarrhea was TD 16%, celiac disease (CD) 37%, cow's milk protein allergy (CMPA) 35% and others 12%. The mean age of 30 children with TD was 2.7 ± 1.2 years (22 boys). While comparing TD with CD and CMPA, weight z score (>-2.2) and hemoglobin (>10 or 10.9 g/dL for CD and CMPA, respectively) were independent variables to discriminate TD from CD and CMPA. TD is common in developing countries like India too. Anthropometry and hemoglobin can differentiate it from CD and CMPA.

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

    Science.gov (United States)

    Hasosah, Mohammed; Satti, Mohamed; Hayat, Amirshazad

    2014-06-01

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

  19. 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 prevalence in children prevalence of diarrhea and ARTIs in younger children. Interventions specifically designed to promote maternal autonomy and decision-making may lead to improved child health.

  20. 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.

  1. OPPORTUNITIES OF PROBIOTIC TREATMENT IN COMPLEX THERAPY OF ANTIBIOTIC-ASSOCIATED DIARRHEA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    A.N. Surkov

    2011-01-01

    Full Text Available Disorder of normal intestinal flora is widespread state in children with different types of somatic pathology. Intestinal disbiosis disturbs homeostasis, leads to significant disorders in function of other organs and systems. Thus the correction of intestinal disbacteriosis is an actual problem of clinical pediatrics, and different specialists meet this problem. One of common causes of intestinal disbiosis is antibacterial treatment. Almost all antimicrobial drugs influence gastrointestinal tract and their administration lead to dyspepsia and antibiotic-associated diarrhea. Normalization of intestinal microflora is significant stage of complex treatment of these pathological states in children. The choice of probiotic drug should be well grounded. The article presents main data on epidemiology, pathogenesis, clinical symptoms, diagnostics and treatment of antibiotic-associated diarrhea in children, efficacy of probiotic drugs is demonstrated.Key words: children, indigenous intestinal microflora, antibiotic-associated diarrhea, probiotics, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2: 132–136

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

    Science.gov (United States)

    Alejo-Cancho, Izaskun; Fernández Avilés, Francesc; Capón, Alicia; Rodríguez, Cristina; Barrachina, Josep; Salvador, Pilar; Valls, Mª Eugenia; Álvarez-Martínez, Miriam J; Zboromyrska, Yuliya; Vila, Jordi; Marcos, Mª Ángeles

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Izaskun Alejo-Cancho

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

  5. Socioeconomic, hygienic, and sanitation factors in reducing diarrhea in the Amazon

    Science.gov (United States)

    Imada, Katiuscia Shirota; de Araújo, Thiago Santos; Muniz, Pascoal Torres; de Pádua, Valter Lúcio

    2016-01-01

    ABSTRACT OBJECTIVE To analyze the contributions of the socioeconomic, hygienic, and sanitation improvements in reducing the prevalence of diarrhea in a city of the Amazon. METHODS In this population-based cross-sectional study, we analyzed data from surveys conducted in the city of Jordão, Acre. In 2005 and 2012, these surveys evaluated, respectively, 466 and 826 children under five years old. Questionnaires were applied on the socioeconomic conditions, construction of houses, food and hygienic habits, and environmental sanitation. We applied Pearson’s Chi-squared test and Poisson regression to verify the relationship between origin of water, construction of homes, age of introduction of cow’s milk in the diet, place of birth and the prevalence of diarrhea. RESULTS The prevalence of diarrhea was reduced from 45.1% to 35.4%. We identified higher probability of diarrhea in children who did not use water from the public network, in those receiving cow’s milk in the first month after birth, and in those living in houses made of paxiúba. Children born at home presented lower risk of diarrhea when compared to those who were born in hospital, with this difference reversing for the 2012 survey. CONCLUSIONS Sanitation conditions improved with the increase of bathrooms with toilets, implementation of the Programa de Saúde da Família (PSF – Family Health Program), and water treatment in the city. The multivariate regression model identified a statistically significant association between use of water from the public network, construction of houses, late introduction of cow’s milk, and access to health service with occurrence of diarrhea. PMID:28099660

  6. Enteropathogens identified in dogs entering a Florida animal shelter with normal feces or diarrhea.

    Science.gov (United States)

    Tupler, Tiffany; Levy, Julie K; Sabshin, Stephanie J; Tucker, Sylvia J; Greiner, Ellis C; Leutenegger, Christian M

    2012-08-01

    To determine the frequency of enteropathogens in dogs entering an animal shelter with normal feces or diarrhea. Cross-sectional study. 100 dogs evaluated at an open-admission municipal animal shelter in Florida. Fecal samples were collected within 24 hours after admission from 50 dogs with normal feces and 50 dogs with diarrhea. Feces were tested by fecal flotation, antigen testing, PCR assay, and electron microscopy for selected enteropathogens. 13 enteropathogens were identified. Dogs with diarrhea were significantly more likely to be infected with ≥ 1 enteropathogens (96%) than were dogs with normal feces (78%). Only Clostridium perfringens enterotoxin A gene was significantly more common in dogs with diarrhea (64%) than in dogs with normal feces (40%). Other enteropathogens identified in dogs with and without diarrhea included hookworms (58% and 48%, respectively), Giardia spp (22% and 16%, respectively), canine enteric coronavirus (2% and 18%, respectively), whipworms (12% and 8%, respectively), Cryptosporidium spp (12% and 2%, respectively), ascarids (8% and 8%, respectively), Salmonella spp (2% and 6%, respectively), Cystoisospora spp (2% and 4%, respectively), canine distemper virus (8% and 0%, respectively), Dipylidium caninum (2% and 2%, respectively), canine parvovirus (2% and 2%, respectively), and rotavirus (2% and 0%, respectively). Dogs entered the shelter with a variety of enteropathogens, many of which are pathogenic or zoonotic. Most infections were not associated with diarrhea or any specific dog characteristics, making it difficult to predict the risk of infection for individual animals. Guidelines for preventive measures and empirical treatments that are logistically and financially feasible for use in shelters should be developed for control of the most common and important enteropathogens.

  7. Disposal of children's stools and its association with childhood diarrhea in India.

    Science.gov (United States)

    Bawankule, Rahul; Singh, Abhishek; Kumar, Kaushalendra; Pedgaonkar, Sarang

    2017-01-05

    Children's stool disposal is often overlooked in sanitation programs of any country. Unsafe disposal of children's stool makes children susceptible to many diseases that transmit through faecal-oral route. Therefore, the study aims to examine the magnitude of unsafe disposal of children's stools in India, the factors associated with it and finally its association with childhood diarrhea. Data from the third round of the National Family Health Survey (NFHS-3) conducted in 2005-06 is used to carry out the analysis. The binary logistic regression model is used to examine the factors associated with unsafe disposal of children's stool. Binary logistic regression is also used to examine the association between unsafe disposal of children's stool and childhood diarrhea. Overall, stools of 79% of children in India were disposed of unsafely. The urban-rural gap in the unsafe disposal of children's stool was wide. Mother's illiteracy and lack of exposure to media, the age of the child, religion and caste/tribe of the household head, wealth index, access to toilet facility and urban-rural residence were statistically associated with unsafe disposal of stool. The odds of diarrhea in children whose stools were disposed of unsafely was estimated to be 11% higher (95% CI: 1.01-1.21) than that of children whose stools were disposed of safely. An increase in the unsafe disposal of children's stool in the community also increased the risk of diarrhea in children. We found significant statistical association between children's stool disposal and diarrhea. Therefore, gains in reduction of childhood diarrhea can be achieved in India through the complete elimination of unsafe disposal of children's stools. The sanitation programmes currently being run in India must also focus on safe disposal of children's stool.

  8. Clinical utility of retrograde terminal ileum intubation in the evaluation of chronic non-bloody diarrhea.

    Science.gov (United States)

    Makkar, Rohit; Lopez, Rocio; Shen, Bo

    2013-10-01

    The aims of this study were to investigate the frequency and factors involved in the terminal ileum intubation of patients with chronic, non-bloody diarrhea and to compare diagnostic yields of colonoscopy and ileocolonoscopy. The medical records of 945 patients undergoing colonoscopy for chronic, non-bloody diarrhea were reviewed. Findings of microscopic colitis, Clostridium difficile colitis, celiac disease, inflammatory bowel disease or tropical sprue were considered as definitive causes of diarrhea. A total of 689 patients met the diagnosis of chronic, non-bloody diarrhea, in which 370 (53.7%) underwent ileocolonoscopy. Specific histological diagnosis could explain the patient's symptoms in 107 (15.5%) patients. The diagnostic yield were 15.0% in the colonoscopy-only group, 16.9% in the ileocolonoscopy without biopsy group, and 15.5% in the ileocolonoscopy with biopsy group. Of the 19 patients with an abnormal terminal ileal biopsy, six (31.6%) had an otherwise normal colonic appearance which would have been diagnosed as normal if the ileum had not been reached and biopsied. In those with Crohn's disease (n = 7), five had ileocolitis and two had colitis only. A multivariate analysis showed that age of the patients and otherwise normal gross endoscopic results to be the only factors associated with a lower likelihood of ileal intubation by endoscopists. The ileal intubation rate was 53.7% in our patients with chronic, non-bloody diarrhea. Diagnostic yield of ileocolonoscopy with biopsy in US patients with chronic, non-bloody diarrhea appeared to be low, if the colon side was normal on endoscopy. But this may provide supportive evidence in patients diagnosed with ileocolonic Crohn's disease. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine.

  9. Identification and Characterization of Bovine Viral Diarrhea Virus from Indonesian Cattle (IDENTIFIKASI DAN KARAKTERISASI VIRUS BOVINE VIRAL DIARRHEA DARI SAPI INDONESIA

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    Muharam Saepulloh

    2015-05-01

    Full Text Available Bovine viral diarrhea virus (BVDV is an important viral disease, which a ubiquitous pathogen ofcattle with worldwide economic importance and due to its misdiagnose with other viruses. The goal of thecurrent study was to identify and characterize of BVDV by reverse transcriptase polymerase chainreaction (RT-PCR and followed by sequence genome analyses. Blood, feces, and semen samples werecollected from 588 selected cattle from animals suffering from diarrhea and respiratory manifestation. RTPCRresults showed that the 69 (11.74% samples were positive to BVDV. Further molecularcharacterization was conducted only with 17 PCR positive samples. The results indicated the 17 IndonesianBVD virus isolates were belonging to the genotype-1 of BVDV (BVDV-1 based on sequence analysis anda phylogenetic relationship between Indonesian BVDV isolates and BVDV in the world. This finding is thefirst report of BVD-1 circulated in Indonesian cattle.

  10. Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis

    OpenAIRE

    Walker, Christa L. Fischer; Friberg, Ingrid K.; Binkin, Nancy; Young, Mark; Walker, Neff; Fontaine, Olivier; Weissman, Eva; Gupta, Akanksha; Black, Robert E.

    2011-01-01

    Editors' Summary Background Diarrhea—passing three or more loose or liquid stools per day—kills about 1.5 million young children every year, mainly in low- and middle-income countries. It is the second leading cause of death in under-5-year olds and causes nearly one in five child deaths. Diarrhea, which can lead to life-threatening dehydration, is a common symptom of gastrointestinal infections. The viruses, bacteria and parasites that cause diarrhea spread through contaminated food or drink...

  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

    In a household survey in Guinea-Bissau, 319 episodes of diarrhea in children were followed by interviews every second day with the aim of investigating perceived morbidity and subsequent actions taken. The majority of the mothers had good knowledge of oral rehydration salts (ORS). However, only 58......, 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...

  12. ANTIBIOTIC-ASSOCIATED DIARRHEA IN CHILDREN: PRINCIPLES OF PROPHYLAXIS AND TREATMENT

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    V. V. Chernikov

    2012-01-01

    Full Text Available Antibacterial treatment has wide usage in modern practical medicine, as it allows achieve rapid positive effect in treatment of infectious diseases. However it is necessary to remember, that various side-effects are not rare during antibacterial therapy. One of the main side-effects is intestinal microflora disturbances, including antibiotic-associated diarrhea. That is why it is so important to understand the principles of its prophylaxis and treatment. The fundamental knowledge about normal intestinal microflora and its functions, epidemiology, pathogenesis, clinical presentation, diagnostics, treatment and prophylaxis of antibiotic-associated diarrhea in children are reviewed in this study.

  13. Effects of Mothers’ Attitude as Breeders and Distance of Stockyard toward Diarrhea Incidence among Toddlers

    OpenAIRE

    Yarmaliza - Yarmaliza; Sugito Sugito; Teuku Reza Ferasyi; Nurliana Nurliana; Razali Razali

    2016-01-01

    Diarrhea is a disease with change of feces form and concentration in which feces is mushy to liquid, and the increase of poop frequency more than usual (three times or more in a day). In Aceh Province, there were diarrhea cases as many as 48/1,000 live births. In West Aceh District, there were 1,071 cases in 2014, meanwhile there were 70 cases among toddlers in Meureubo Subdistrict. This study aimed to determine relation between mothers’attitude as breeders and distance of stockyard toward...

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

    Science.gov (United States)

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

    2010-08-01

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

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

    DEFF Research Database (Denmark)

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

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

  16. Prevalence of isosporiasis in relation to CD4 cell counts among HIV-infected patients with diarrhea in Odisha, India

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    Indrani Mohanty

    2013-01-01

    Conclusion: I. belli was the predominant parasite with a prevalence of 22% among HIV-positive patients with diarrhea, majority having CD4 cell count <200/μl. This study highlights the importance of routine screening for coccidian parasites in HIV-positive patients with and without diarrhea especially in those with low CD4 cell counts.

  17. Association of food-hygiene practices and diarrhea prevalence among Indonesian young children from low socioeconomic urban areas

    NARCIS (Netherlands)

    Agustina, R.; Sari, T.P.; Satroamidjojo, S.; Bovee-Oudenhoven, I.M.J.; Feskens, E.J.M.; Kok, F.J.

    2013-01-01

    Background: Information on the part that poor food-hygiene practices play a role in the development of diarrhea in low socioeconomic urban communities is lacking. This study was therefore aimed at assessing the contribution of food-hygiene practice to the prevalence of diarrhea among Indonesian

  18. Lack of association between the presence of the pVir plasmid and bloody diarrhea in Campylobacter jejuni enteritis.

    Science.gov (United States)

    Louwen, R P L; van Belkum, A; Wagenaar, J A; Doorduyn, Y; Achterberg, R; Endtz, H P

    2006-05-01

    The main mechanisms by which Campylobacter jejuni causes diarrhea are unknown. In contrast to a recent communication, we report here the absence of an association with the plasmid pVir in patients infected with C. jejuni who developed bloody diarrhea in The Netherlands, and we suggest a role for other virulence determinants.

  19. Lack of association between the presence of the pVir plasmid and bloody diarrhea in Campylobacter jejuni Enteritis

    NARCIS (Netherlands)

    Louwen, R.P.; Belkum, van A.; Wagenaar, J.A.; Doorduyn, Y.; Achterberg, R.P.; Endtz, H.P.

    2006-01-01

    The main mechanisms by which Campylobacter jejuni causes diarrhea are unknown. In contrast to a recent communication, we report here the absence of an association with the plasmid pVir in patients infected with C. jejuni who developed bloody diarrhea in The Netherlands, and we suggest a role for

  20. Clinical Characteristics of the Course of Antibiotic-Associated Diarrhea in Respiratory Infections in Children, the Value of Clostridium difficile

    Directory of Open Access Journals (Sweden)

    L.I. Chernyshova

    2014-04-01

    Full Text Available The article highlighted the dependence of the incidence of antibiotic-associated diarrhea in children on risk factors, age, prescribed antibiotics and probiotic preparations; clinical features of its course in children with respiratory infections were shown, Clostridium difficile value was clarified in the etiological structure of diarrhea, associated with antibiotics intake.

  1. Gut Microbial Dysbiosis May Predict Diarrhea and Fatigue in Patients Undergoing Pelvic Cancer Radiotherapy: A Pilot Study

    Science.gov (United States)

    Wang, Aiping; Ling, Zongxin; Yang, Zhixiang; Kiela, Pawel R.; Wang, Tao; Wang, Cheng; Cao, Le; Geng, Fang; Shen, Mingqiang; Ran, Xinze; Su, Yongping; Cheng, Tianmin; Wang, Junping

    2015-01-01

    Fatigue and diarrhea are the most frequent adverse effects of pelvic radiotherapy, while their etiologies are largely unknown. The aim of this study is to investigate the correlations between fatigue, diarrhea, and alterations in gut microbiota induced by pelvic radiotherapy. During the 5-week treatment of pelvic radiotherapy in 11 cancer patients, the general fatigue score significantly increased and was more prominent in the patients with diarrhea. The fatigue score was closely correlated with the decrease of serum citrulline (an indicator of the functional enterocyte mass) and the increases of systemic inflammatory proteins, including haptoglobin, orosomuoid, α1-antitrypsin and TNF-α. Serum level of lipopolysaccharide (LPS) was also elevated, especially in the patients with diarrhea indicating epithelial barrier breach and endotoxemia. Pyrosequencing analysis of 16S rRNA gene revealed that microbial diversity, richness, and the Firmicutes/Bacteroidetes ratio were significantly altered prior to radiotherapy in patients who later developed diarrhea. Pelvic radiotherapy induced further changes in fecal microbial ecology, some of which were specific to the patients with or without diarrhea. Our results indicate that gut microbial dysbiosis prior to radiation therapy may be exploited to predict development of diarrhea and to guide preventive treatment options. Radiation-induced dysbiosis may contribute to pelvic radiation disease, including mucositis, diarrhea, systemic inflammatory response, and pelvic radiotherapy-associated fatigue in cancer patients. PMID:25955845

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

    Directory of Open Access Journals (Sweden)

    Marilyn Binning

    1994-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Xu-Hui Zhu

    2016-01-01

    Conclusions: The etiology of acute diarrhea varies in children of different age groups. The high frequency of infection with viruses suggests the urgent demand for new viral vaccine development. Proper use of antibiotics in the treatment of acute diarrhea is crucial due to the high level of antibiotic resistance.

  5. Spatial patterns of childhood diarrhea in Ethiopia: data from Ethiopian demographic and health surveys (2000, 2005, and 2011).

    Science.gov (United States)

    Bogale, Getahun Gebre; Gelaye, Kassahun Alemu; Degefie, Degefie Tibebe; Gelaw, Yalemzewod Assefa

    2017-06-15

    Childhood diarrhea is a major public health problem, especially in developing countries, including Ethiopia. Exploring the spatial pattern of childhood diarrhea is important to monitor and design effective intervention programs. Therefore, this study aimed to explore the spatial patterns of childhood diarrhea in Ethiopia over the past one decade. A total of 29,358 under-five children were retrieved from three consecutive Ethiopian demographic and health surveys (2000, 2005, and 2011) and included into the study. Spatial cluster and autocorrelation analysis was done to explore the patterns of childhood diarrhea. Childhood diarrhea clustered spatially at a national level in all survey periods (Moran's I: 0.3830-1.3296, p Childhood diarrhea also clustered at the border areas of Southern Nations Nationalities and People and Tigray, Central Somali and Western Oromia, Gambella and Amhara (West Gojam, Awi, Oromia, and Wag Himra) regions. In 2000, the most likely clusters were found in Southern Nations Nationalities and People, West Oromia, and Gambella regions (LLR = 55.37, p childhood diarrhea remains public health problem and had a spatial variation across the regions. Identifying the risk areas would help in designing effective interventions to reduce childhood diarrhea in these areas.

  6. Association between diarrhea and quality of life in HIV-infected patients receiving highly active antiretroviral therapy

    NARCIS (Netherlands)

    Tramarin, A; Parise, N; Campostrini, S; Yin, DD; Postma, MJ; Lyu, R; Grisetti, R; Capetti, A; Cattelan, AM; Di Toro, MT; Mastroianni, A; Pignattari, E; Mondardini, [No Value; Calleri, G; Raise, E; Starace, F

    Diarrhea is a common symptom that many HIV patients experience either as a consequence of HIV infection or of highly active antiretroviral therapy (HAART). A multicenter, prospective observational study was conducted in 11 AIDS clinics in Italy to determine the effect of diarrhea on health-related

  7. [A prospective control study of Saccharomyces boulardii in prevention of antibiotic-associated diarrhea in the older inpatients].

    Science.gov (United States)

    Zhang, D M; Xu, B B; Yu, L; Zheng, L F; Chen, L P; Wang, W

    2017-06-01

    Objective: To study the value of Saccharomyces boulardii for the prevention of antibiotic-associated diarrhea in older inpatients. Methods: A total of 163 older patients who were treated with wide-spectrum antibiotics at least three days during January 2014 to December 2015 were randomly divided into control and study group. In study group, 81 patients were administrated with oral Saccharomyces boulardii 500 mg twice a day for 21 days. The control group was of no intervention. Morbidity rate of antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea, frequency and duration of diarrhea were recorded. Results: The incidence of antibiotic-associated diarrhea in study group was significantly lower than that in control group [14.8%(12/81) vs 28.0%(23/82), P0.05] in two groups. The frequency and duration of diarrhea in the study group were significantly lower and shorter than those in control group[(4.3±1.7) times/day vs (6.9±2.0) times/day; (3.0±1.1) days vs (5.7±1.8) days, both P<0.01]. Conclusion:Saccharomyces boulardii may reduce the incidence of antibiotic-associated diarrhea therefore improving the symptom of diarrhea in older inpatients.

  8. Lack of association between the presence of the pVir plasmid and bloody diarrhea in Campylobacter jejuni enteritis.

    NARCIS (Netherlands)

    R.P.L. Louwen (Rogier); A.F. van Belkum (Alex); J.A. Wagenaar (Jaap); Y. Doorduyn; R. Achterberg; H.P. Endtz (Hubert)

    2006-01-01

    textabstractThe main mechanisms by which Campylobacter jejuni causes diarrhea are unknown. In contrast to a recent communication, we report here the absence of an association with the plasmid pVir in patients infected with C. jejuni who developed bloody diarrhea in The Netherlands, and we suggest a

  9. Risk Factors for Diarrhea in Children under Five Years of Age Residing in Peri-urban Communities in Cochabamba, Bolivia

    Science.gov (United States)

    George, Christine Marie; Perin, Jamie; Neiswender de Calani, Karen J.; Norman, W. Ray; Perry, Henry; Davis, Thomas P.; Lindquist, Erik D.

    2014-01-01

    This study examined the relationship between childhood diarrhea prevalence and caregiver knowledge of the causes and prevention of diarrhea in a prospective cohort of 952 children < 5 years of age in Cochabamba, Bolivia. The survey of caregiver knowledge found that more than 80% of caregivers were unaware that hand washing with soap could prevent childhood diarrhea. Furthermore, when asked how to keep food safe for children to eat only 17% of caregivers reported hand washing before cooking and feeding a child. Lack of caregiver awareness of the importance of practices related to hygiene and sanitation for diarrhea prevention were significant risk factors for diarrheal disease in this cohort. The knowledge findings from this study suggest that health promotion in these communities should put further emphasis on increasing knowledge of how water treatment, hand washing with soap, proper disposal of child feces, and food preparation relate to childhood diarrhea prevention. PMID:25311693

  10. Association of Safe Disposal of Child Feces and Reported Diarrhea in Indonesia: Need for Stronger Focus on a Neglected Risk

    Directory of Open Access Journals (Sweden)

    Aidan A. Cronin

    2016-03-01

    Full Text Available Indonesia still faces several challenges in the areas of water, sanitation, and hygiene (WASH. Diarrhea remains a major killer of children and it is important to understand the local diarrhea transmission pathways to prioritise appropriate WASH interventions to reduce diarrhea burden. This study used a cross-sectional data set from a recent national household survey (the 2012 Indonesia Demographic and Health Survey to examine the associations between diarrhea in children aged less than 24 months with WASH interventions and population characteristics. Unsafe disposal of child feces was strongly associated with an increased odds of child diarrhea (OR: 1.46; 95% CI: 1.18–1.82, p = 0.001. However, other WASH practices were not found to be associated. The findings underline the dangers of unsafe disposal of child feces and highlight the need for strengthening the related policies and program strategies and their implementation.

  11. High frequency of diarrheagenic Escherichia coli in human immunodeficiency virus (HIV) patients with and without diarrhea in Lima, Peru.

    Science.gov (United States)

    Garcia, Coralith; Chincha, Omayra; Leon, Mey; Iglesias, David; Barletta, Francesca; Mercado, Erik; Ochoa, Theresa

    2010-06-01

    Diarrhea is still a prevalent health issue in HIV patients. Our objective was to characterize the different diarrheagenic E. coli (DEC) groups in stools from adult HIV patients. Cross sectional study: We enrolled HIV-positive and -negative patients with and without diarrhea from a tertiary-care center of Lima, Peru. Clinical data was recorded and a stool sample per patient was cultured. Multiplex PCR was used to detect different DECs. One hundred eighty-four participants were enrolled. The frequency of having at least one DEC was more common in HIV-positive than HIV-negative patients with diarrhea (42% versus 20%, P < 0.05). The enterotoxigenic E. coli (ETEC) was the most common DEC in patients with diarrhea, 13% in HIV patients. The diffusely adherent E. coli (DAEC) was only present in HIV positive patients with diarrhea (10.1%). Different types of DEC are frequent in stools from HIV-positive patients.

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    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......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...

  13. an embarrassment of riches or a profusion of confusion

    African Journals Online (AJOL)

    Bradley Smith

    2010-08-12

    Robbie) Robinson. BJuris LLB ... be amended – see Smith Domestic Partnership Rubric 465-467. 10 Clause 4(1) and (2) read with ... multiple unregistered domestic partnerships – see Smith (n 9) 508. 20 Clause 26(1). 21 Clause ...

  14. An embarrassment of riches or a profusion of confusion? an ...

    African Journals Online (AJOL)

    As it stands, South African family law currently holds that the Marriage Act 25 of 1961 applies exclusively to the solemnisation of heterosexual civil marriages while samesex couples have no choice but to formalise their relationships in terms of the Civil Union Act 17 of 2006. In addition, the legal position is complicated by the ...

  15. an embarrassment of riches or a profusion of confusion

    African Journals Online (AJOL)

    Bradley Smith

    2010-08-12

    Aug 12, 2010 ... Bonthuys that when the conscientious objection clauses in the Marriage Act and the Civil Union Act are compared, it becomes clear that the provision in the latter Act is more widely phrased than its counterpart in that it allows objections on the basis of "conscience" and "belief" in addition to those based on ...

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

    Science.gov (United States)

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

    2018-01-21

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

  17. A model of Salmonella colitis with features of diarrhea in SLC11A1 wild-type mice.

    Directory of Open Access Journals (Sweden)

    Heungjeong Woo

    Full Text Available BACKGROUND: Mice do not get diarrhea when orally infected with S. enterica, but pre-treatment with oral aminoglycosides makes them susceptible to Salmonella colitis. However, genetically susceptible ItyS mice (Nramp1(G169D allele die from systemic infection before they develop diarrhea, so a new model is needed to study the pathogenesis of diarrhea. We pretreated ItyR mice (Nramp1(G169 with oral kanamycin prior to infecting them with virulent S. Typhimurium strain 14028s in order to study Salmonella-induced diarrhea. We used both a visual scoring system and the measurement of fecal water content to measure diarrhea. BALB/c.D2(Nramp1 congenic started losing weight 5 days post-infection and they began to die from colitis 10-14 days after infection. A SPI-1 (invA mutant caused cecal, but not colonic inflammation and did not cause diarrhea. A phoP- mutant did not cause manifestations of diarrhea in either normal or NADPH-deficient (gp91(phox mice. However, strain 14028s caused severe colitis and diarrhea in gp91(phox-deficient mice on an ItyR background. pmr A and F mutants, which are less virulent in orally infected BALB/c mice, were fully virulent in this model of colitis. CONCLUSIONS: S. enterica must be able to invade the colonic epithelium and to persist in the colon in order to cause colitis with manifestations of diarrhea. The NADPH oxidase is not required for diarrhea in Salmonella colitis. Furthermore, a Salmonella phoP mutant can be cleared from the colon by non-oxidative host defenses.

  18. Clinical, epidemiological, and spatial characteristics of Vibrio parahaemolyticus diarrhea and cholera in the urban slums of Kolkata, India

    Directory of Open Access Journals (Sweden)

    Kanungo Suman

    2012-09-01

    Full Text Available Abstract Background There is not much information on the differences in clinical, epidemiological and spatial characteristics of diarrhea due to V. cholerae and V. parahaemolyticus from non-coastal areas. We investigated the differences in clinical, epidemiological and spatial characteristics of the two Vibrio species in the urban slums of Kolkata, India. Methods The data of a cluster randomized cholera vaccine trial were used. We restricted the analysis to clusters assigned to placebo. Survival analysis of the time to the first episode was used to analyze risk factors for V. parahaemolyticus diarrhea or cholera. A spatial scan test was used to identify high risk areas for cholera and for V. parahaemolyticus diarrhea. Results In total, 54,519 people from the placebo clusters were assembled. The incidence of cholera (1.30/1000/year was significantly higher than that of V. parahaemolyticus diarrhea (0.63/1000/year. Cholera incidence was inversely related to age, whereas the risk of V. parahaemolyticus diarrhea was age-independent. The seasonality of diarrhea due to the two Vibrio species was similar. Cholera was distinguished by a higher frequency of severe dehydration, and V. parahaemolyticus diarrhea was by abdominal pain. Hindus and those who live in household not using boiled or treated water were more likely to have V. parahaemolyticus diarrhea. Young age, low socioeconomic status, and living closer to a project healthcare facility were associated with an increased risk for cholera. The high risk area for cholera differed from the high risk area for V. parahaemolyticus diarrhea. Conclusion We report coexistence of the two vibrios in the slums of Kolkata. The two etiologies of diarrhea had a similar seasonality but had distinguishing clinical features. The risk factors and the high risk areas for the two diseases differ from one another suggesting different modes of transmission of these two pathogens.

  19. Clinical, epidemiological, and spatial characteristics of Vibrio parahaemolyticus diarrhea and cholera in the urban slums of Kolkata, India.

    Science.gov (United States)

    Kanungo, Suman; Sur, Dipika; Ali, Mohammad; You, Young Ae; Pal, Debottam; Manna, Byomkesh; Niyogi, Swapan K; Sarkar, Banwarilal; Bhattacharya, Sujit K; Clemens, John D; Nair, G Balakrish

    2012-09-28

    There is not much information on the differences in clinical, epidemiological and spatial characteristics of diarrhea due to V. cholerae and V. parahaemolyticus from non-coastal areas. We investigated the differences in clinical, epidemiological and spatial characteristics of the two Vibrio species in the urban slums of Kolkata, India. The data of a cluster randomized cholera vaccine trial were used. We restricted the analysis to clusters assigned to placebo. Survival analysis of the time to the first episode was used to analyze risk factors for V. parahaemolyticus diarrhea or cholera. A spatial scan test was used to identify high risk areas for cholera and for V. parahaemolyticus diarrhea. In total, 54,519 people from the placebo clusters were assembled. The incidence of cholera (1.30/1000/year) was significantly higher than that of V. parahaemolyticus diarrhea (0.63/1000/year). Cholera incidence was inversely related to age, whereas the risk of V. parahaemolyticus diarrhea was age-independent. The seasonality of diarrhea due to the two Vibrio species was similar. Cholera was distinguished by a higher frequency of severe dehydration, and V. parahaemolyticus diarrhea was by abdominal pain. Hindus and those who live in household not using boiled or treated water were more likely to have V. parahaemolyticus diarrhea. Young age, low socioeconomic status, and living closer to a project healthcare facility were associated with an increased risk for cholera. The high risk area for cholera differed from the high risk area for V. parahaemolyticus diarrhea. We report coexistence of the two vibrios in the slums of Kolkata. The two etiologies of diarrhea had a similar seasonality but had distinguishing clinical features. The risk factors and the high risk areas for the two diseases differ from one another suggesting different modes of transmission of these two pathogens.

  20. Pathogenetic Rationale for the Use of Probiotics in Antibiotic-Associated Diarrhea in Children

    Directory of Open Access Journals (Sweden)

    O.Ye. Chernysheva

    2015-09-01

    Full Text Available The article deals with the topical issues of irrational administration of antibiotics in children, development of abnormal side effects and complications, in particular antibiotic-associated diarrhea. The modern means for the prevention and treatment of this group of diseases, in particular the use of probiotics, are presented.

  1. Self-limiting diarrhea in an infant exposed to sertraline in breast milk

    Directory of Open Access Journals (Sweden)

    N A Uvais

    2017-01-01

    Full Text Available Sertraline is widely used to treat postpartum depression. Though studies found detectable levels of sertraline in infant blood, very few adverse effects are reported. Reporting hereby is a case of an infant who developed self-limiting diarrhea, probably due to exposure to sertraline in breast milk.

  2. Management of acute diarrhea in adults in China: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Hou Feng-Qin

    2013-01-01

    Full Text Available Abstract Background The aim of this study was to evaluate the management of acute adult diarrhea in China and assess adherence of clinical practice to national guidelines and 2012 World Gastroenterology Organization guidelines. Methods A cross-sectional survey was carried out among physicians in 20 hospitals in two different areas of China (Beijing, 10; Shaanxi province, 10. Summary statistics were calculated for the overall study group and for each region. Between-region differences were assessed with χ2 or t-tests. Results Data were collected for 800 patients (≥18 years; mean ± SD age 37.0 ± 16.3 years; 56.4% female. The mean ± SD time between diarrhea onset and visiting a diarrhea clinic was 2.4 ± 1.6 days; this interval was significantly shorter in Beijing than Shaanxi (2.0 ± 1.4 vs 2.8 ± 1.8 days, respectively; p p p p  Conclusions Adherence to both national guidelines and 2012 World Gastroenterology Organization guidelines for the management of acute diarrhea in adult was limited among tertiary hospital physicians. The findings suggest nationwide education and effective health policies are needed to improve medical practice and reduce the unnecessary burden on the healthcare system.

  3. Circulating microRNAs in serum from cattle challenged with Bovine Viral Diarrhea Virus

    Science.gov (United States)

    Bovine viral diarrhea virus (BVDV) is an RNA virus that is often associated with respiratory disease in cattle. MicroRNAs have been proposed as indicators of exposure to respiratory pathogens. The objective of this study was to identify microRNAs in cattle that had been challenged with a non-cytopat...

  4. Management of childhood diarrhea among private providers in Uttar Pradesh, India

    Directory of Open Access Journals (Sweden)

    Christa L. Fisher Walker

    2016-06-01

    Full Text Available In Uttar Pradesh (UP, India, a new initiative to introduce zinc and reinvigorate ORS for diarrhea treatment in the public and private sectors was rolled out in selected districts. We conducted an external evaluation of the program that included assessing the knowledge and practices of private sector providers 6 months after the initial program rollout.

  5. Campylobacter spp among children with acute diarrhea attending Mulago hospital in Kampala--Uganda.

    Science.gov (United States)

    Mshana, S E; Joloba, M; Kakooza, A; Kaddu-Mulindwa, D

    2009-09-01

    Campylobacter infections occur worldwide. A recent study in Kampala, Uganda, found that 87% of broiler chickens had Campylobacter jejuni; these are potential source of human infection. Isolation rate in developing countries is between 5-35%. This study aimed at finding prevalence of children with campylobacter infection among children with acute diarrhea attending Mulago hospital. The objective was to establish the proportion of children infected with Campylobacter spp among children with acute diarrhea at Mulago hospital. A crossectional study from July to October 2005 was conducted involved 226 children with acute diarrhea. Serial sampling was done a total of 226 stool specimens were obtained and cultured on selective media. Identification was done using biochemical test and susceptibility using standard discs diffusion method. Campylobacter spp were isolated in 21 (9.3%) of 226 stool specimens analyzed. Campylobacter jejuni 17 (80.9%), Campylobacter lari 2 (9.5%), Campylobacter coli 1 (4.5%) and Campylobacter jejuni/coli 1(4.5%). All Campylobacter isolates were sensitive to erythromycin, and 20% had intermediate resistance to Ampicillin. Campylobacter spp are prevalent among children with acute diarrhea in Kampala- Uganda. A large multicenter study should be undertaken so that the extent of campylobacter infection in our setting can be established.

  6. Consuming transgenic goats' milk containing the antimicrobial protein lysozyme helps resolve diarrhea in young pigs

    National Research Council Canada - National Science Library

    Cooper, Caitlin A; Garas Klobas, Lydia C; Maga, Elizabeth A; Murray, James D

    2013-01-01

    .... Young pigs were used as a model for children and infected with enterotoxigenic E. coli. Once clinical signs of diarrhea developed, pigs were fed hLZ-milk or non-transgenic control goat milk three times a day for two days...

  7. Proteolytic Activation of the Porcine Epidemic Diarrhea Coronavirus Spike Fusion Protein by Trypsin in Cell Culture.

    NARCIS (Netherlands)

    Wicht, Oliver|info:eu-repo/dai/nl/32291177X; Li, Wentao|info:eu-repo/dai/nl/411296272; Willems, Lione; Meuleman, Tom J; Wubbolts, Richard W|info:eu-repo/dai/nl/181688255; van Kuppeveld, Frank J M|info:eu-repo/dai/nl/156614723; Rottier, Peter J M|info:eu-repo/dai/nl/068451954; Bosch, Berend Jan|info:eu-repo/dai/nl/273306049

    2014-01-01

    Isolation of porcine epidemic diarrhea coronavirus (PEDV) from clinical material in cell culture requires supplementation of trypsin. This may relate to the confinement of PEDV natural infection to the protease-rich small intestine of pigs. Our study focused on the role of protease activity on

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

    OpenAIRE

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

    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 loperamide in the outpatient treatment of acute diarrhea in adults.

  9. Histopathological, morphometrical and FISH investigation of New Neonatal Porcine Diarrhea in Denmark

    DEFF Research Database (Denmark)

    Jonach, Beata Renata; Boye, Mette; Jensen, Tim Kåre

    In recent years a new kind of neonatal diarrhea of unknown etiology has been identified in swine herds in Denmark1. The aim of the study was to clarify the pathomechanism of this disease by characterization of the morphological lesions in the intestinal mucosa with respect to determination of pos...

  10. Manure treatment and natural inactivation of porcine epidemic diarrhea virus in soils

    Science.gov (United States)

    The outbreak of porcine epidemic diarrhea virus (PEDv) in North America has substantially impacted U.S. swine production in recent years. The virus it is easily transmitted among pigs and causes nearly 100% mortality in pre-weaned piglets. Because PEDv is an enteric virus spread via fecal-oral conta...

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

    Directory of Open Access Journals (Sweden)

    M. Simadibrata

    2002-09-01

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

  12. Oral polio vaccine response in breast fed infants with malnutrition and diarrhea

    Science.gov (United States)

    Haque, Rashidul; Snider, Cynthia; Liu, Yue; Ma, Jennie Z.; Liu, Lei; Nayak, Uma; Mychaleckyj, Josyf C.; Korpe, Poonum; Mondal, Dinesh; Kabir, Mamun; Alam, Masud; Pallansch, Mark; Oberste, M. Steven; Weldon, William; Kirkpatrick, Beth D.; Petri, William A.

    2016-01-01

    Oral vaccines for polio (OPV) and rotavirus are less effective in children in the developing world. The reasons for this are not well understood. We tested for risk factors for poor response to OPV in infants from an urban slum of Dhaka, Bangladesh. Diminished serum neutralizing response to OPV, but not failure of intramuscularly administered vaccines, was associated with malnutrition, diarrhea, and shorter breastfeeding duration. Children with malnutrition (WAZ <−2) had significantly lower OPV 3 titers (p = 0.029). Children who had 2 or more diarrhea episodes during the 1st months of life were more than twice as likely to experience OPV failure as those who had 1 diarrhea episode or no diarrhea (p = 0.0245). In contrast, each additional month in exclusive breastfeeding was associated with an increase in OPV 3 titer by 0.41 (p = 0.0072) and 0.16 (p = 0.0065) at the 25th and 50th percentiles of OPV 3 titers respectively. These data are consistent with a defect in induction of immunity in the gut for OPV but not parenteral vaccines, a defect that may be amenable to intervention in part via promotion of exclusive breastfeeding. PMID:24300591

  13. Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Children

    NARCIS (Netherlands)

    Szajewska, Hania; Canani, Roberto Berni; Guarino, Alfredo; Hojsak, Iva; Indrio, Flavia; Kolacek, Sanja; Orel, Rok; Shamir, Raanan; Vandenplas, Yvan; van Goudoever, Johannes B.; Weizman, Zvi

    2016-01-01

    This article provides recommendations, developed by the Working Group (WG) on Probiotics of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition, for the use of probiotics for the prevention of antibiotic-associated diarrhea (AAD) in children based on a systematic review of

  14. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: a prospective study

    NARCIS (Netherlands)

    Surawicz, C. M.; Elmer, G. W.; Speelman, P.; McFarland, L. V.; Chinn, J.; van Belle, G.

    1989-01-01

    Saccharomyces boulardii, a nonpathogenic yeast, has been widely used in Europe to prevent antibiotic-associated diarrhea (AAD). We performed a prospective double-blind controlled study to investigate AAD in hospitalized patients and to evaluate the effect of S. boulardii, a living yeast, given in

  15. Isolation of Shigella dysenteriae serotypes 11, 12, and 13 from patients with diarrhea in Bangladesh.

    OpenAIRE

    Ansaruzzaman, M; Kibriya, A K; Mitra, A. K.; Sack, R B; Albert, M. J.

    1993-01-01

    Nine isolates of bacteria biochemically resembling Shigella dysenteriae but not belonging to the 10 recognized serotypes were isolated from patients with diarrhea in Bangladesh. Further studies suggested that two, one, and six isolates belonged to the recently recognized S. dysenteriae serotypes 11, 12, and 13, respectively.

  16. Effect of probiotic preparation in preventing antibiotic associated diarrhea and colitis: a Clinical trial

    Directory of Open Access Journals (Sweden)

    Nader Zarinfar

    2014-08-01

    Full Text Available Background: Clostridium Difficile is the most common cause of antibiotic- associated diarrhea (AAD and antibiotic associated colitis (AAC in the hospital setting. In this Study, the preventive effect of Lactobacillus coagulance probiotic preparation was investigated on AAD and AAC. Material and Methods: In this double blind randomized clinical trial study, 300 patients under antibiotics treatment according to our inclusion and exclusion criteria were enrolled to the study and randomly divided into two groups, case (tab probiotic, 100mg/day and control group (placebo from initial antibiotic administration till one week after termination of antibiotic consumption. All patients were trained about the signs of diarrhea and colitis. Colitis signs, incidence of diarrhea and its culture findings for the presence of the toxin of Clostridium difficile were recorded and compared between groups. Data were analyzed with appropriate statistical tests and using version 16 of SPSS statistical software. Results: Antibiotic associated diarrhea (AAD was seen in 10 (6.6% and 16 (%10.6 patients of case and control group respectively. There was no significant difference between groups in AAD incidence and positive stool exam regarding the presence of Clostridium difficile toxin. Colitis syndrome were develop in 34 (22.8% and 86 (57% patients of the probiotic and placebo group respectively that was significantly low in case group (p<0.001. Conclusion: There was no statistically significant difference between probiotic group and placebo group in reducing AAD. But, consumption of Lactobacillus coagulance probiotic can reduce the incidence of antibiotic associated colitis.

  17. Diarrhea in children less than two years of age with known HIV status in Kisumu, Kenya

    NARCIS (Netherlands)

    van Eijk, A.M.; Brooks, J.T.; Adcock, P.M.; Garrett, V.; Eberhard, M.; Rosen, D.H.; Ayisi, J.G.; Ochieng, J.B.; Kumar, L.; Gentsch, J.R.; Nahlen, B.L.; Mintz, E.D.; Slutsker, L.

    2010-01-01

    Objective: To compare the frequency and etiology of diarrhea in children aged less than 2 years with known HIV status. Methods: This was a nested cohort study, whereby children were followed during monthly routine and unscheduled visits. The HIV status of children was determined with PCR. A stool

  18. Fatal Trichuris spp. infection in a Holstein heifer persistently infected with bovine viral diarrhea virus

    Science.gov (United States)

    2004-01-01

    Abstract Whipworms (Trichuris spp.) were identified in the colon of a recently purchased, 10-month-old dairy heifer that died suddenly. A skin test was positive for bovine viral diarrhea virus (BVDV). Signs of BVDV occurred in other heifers in the group, but fecal flotations were negative for whipworm eggs. PMID:15283522

  19. 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.

  20. Assessing gut microbiota perturbations during the early phase of infectious diarrhea in Vietnamese children.

    Science.gov (United States)

    The, Hao Chung; Florez de Sessions, Paola; Jie, Song; Pham Thanh, Duy; Thompson, Corinne N; Nguyen Ngoc Minh, Chau; Chu, Collins Wenhan; Tran, Tuan-Anh; Thomson, Nicholas R; Thwaites, Guy E; Rabaa, Maia A; Hibberd, Martin; Baker, Stephen

    2017-08-02

    Diarrheal diseases remain the second most common cause of mortality in young children in developing countries. Efforts have been made to explore the impact of diarrhea on bacterial communities in the human gut, but a thorough understanding has been impeded by inadequate resolution in bacterial identification and the examination of only few etiological agents. Here, by profiling an extended region of the 16S rRNA gene in the fecal microbiome, we aimed to elucidate the nature of gut microbiome perturbations during the early phase of infectious diarrhea caused by various etiological agents in Vietnamese children. Fecal samples from 145 diarrheal cases with a confirmed infectious etiology before antimicrobial therapy and 54 control subjects were analyzed. We found that the diarrheal fecal microbiota could be robustly categorized into 4 microbial configurations that either generally resembled or were highly divergent from a healthy state. Factors such as age, nutritional status, breastfeeding, and the etiology of the infection were significantly associated with these microbial community structures. We observed a consistent elevation of Fusobacterium mortiferum, Escherichia, and oral microorganisms in all diarrheal fecal microbiome configurations, proposing similar mechanistic interactions, even in the absence of global dysbiosis. We additionally found that Bifidobacterium pseudocatenulatum was significantly depleted during dysenteric diarrhea regardless of the etiological agent, suggesting that further investigations into the use of this species as a dysentery-orientated probiotic therapy are warranted. Our findings contribute to the understanding of the complex influence of infectious diarrhea on gut microbiome and identify new opportunities for therapeutic interventions.