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https://www.readbyqxmd.com/read/28229523/pathophysiology-of-fecal-incontinence-in-obese-patients-a-prospective-case-matched-study-of-201-patients
#1
C Brochard, A Vénara, A Bodère, A Ropert, G Bouguen, L Siproudhis
BACKGROUND: Obesity is an emerging risk factor for fecal incontinence (FI). The aim of this study was to characterize pathophysiologic mechanisms of FI in obese patients compared with non-obese patients in a prospective case-matched study. METHODS: The general characteristics and data of the anorectal manometry and endosonography of patients who were evaluated for FI at a single institution from 2005 to 2015 were prospectively assessed. Fecal incontinence was defined by a Cleveland Clinic Incontinence Score (CCIS) >4...
February 23, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28228902/mri-diagnosis-of-herpes-simplex-encephalitis-in-an-elderly-man-with-nonspecific-symptoms
#2
Benjamin J Croll, Zachary M Dillon, Kevin R Weaver, Marna Rayl Greenberg
A 78-year-old male presented to the Emergency Department complaining of a 1-week onset of increasing fatigue and anorexia. The patient was previously well but had a history of depression, chronic diarrhea, and hypertension. His examination was remarkable for mild fever (100.1°F). He had no acute neurologic deficits. The patient felt better after intravenous fluids and was discharged to follow-up with the primary care provider. With no resolution of symptoms and new memory loss, the patient's primary care doctor ordered an MRI which revealed abnormal signal/patchy enhancement of the left temporal lobe indicative (pathognomonic) of herpes simplex encephalitis...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228493/hepatitis-e-virus-detection-and-quantification-by-an-rt-qpcr-assay-calibrated-to-the-world-health-organization-standard-for-hev-rna
#3
Jeffrey J Germer, Irina Ankoudinova, Yevgeniy S Belousov, Walt Mahoney, Chen Dong, Jihong Meng, Jayawant N Mandrekar, Joseph D Yao
Hepatitis E virus (HEV) has emerged as a cause of chronic hepatitis among immunocompromised patients. Molecular assays have become important tools for the diagnosis and management of these chronically-infected patients. A reverse transcription, real-time PCR (RT-qPCR) assay utilizing Pleiades probe chemistry and an RNA internal control for simultaneous detection and quantification of HEV RNA in human serum was developed based on adaptation of a previously described and broadly reactive primer set targeting the overlapping open reading frame (ORF) 2/3 nucleotide sequence of HEV...
February 22, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28228106/long-term-treatment-with-ruxolitinib-for-patients-with-myelofibrosis-5-year-update-from-the-randomized-double-blind-placebo-controlled-phase-3-comfort-i-trial
#4
Srdan Verstovsek, Ruben A Mesa, Jason Gotlib, Vikas Gupta, John F DiPersio, John V Catalano, Michael W N Deininger, Carole B Miller, Richard T Silver, Moshe Talpaz, Elliott F Winton, Jimmie H Harvey, Murat O Arcasoy, Elizabeth O Hexner, Roger M Lyons, Ronald Paquette, Azra Raza, Mark Jones, Deanna Kornacki, Kang Sun, Hagop Kantarjian
BACKGROUND: The randomized, double-blind, placebo-controlled, phase 3 COMFORT-I trial evaluated the JAK1/JAK2 inhibitor ruxolitinib in patients with intermediate-2/high-risk myelofibrosis. The primary and planned 3-year analyses of COMFORT-I data demonstrated that ruxolitinib-the first myelofibrosis-approved therapy-reduced splenomegaly and prolonged overall survival versus placebo. Here, we present the final 5-year results. METHODS: Patients managed in Australia, Canada, and the USA were randomized centrally (interactive voice response system) 1:1 to oral ruxolitinib twice daily (15 or 20 mg per baseline platelet counts) or placebo...
February 22, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28224456/zinc-toxicosis-in-a-boxer-dog-secondary-to-ingestion-of-holiday-garland
#5
Karyn Bischoff, Anne Chiapella, Jaime Weisman, Lisa M Crofton, Joseph Hillebrandt
INTRODUCTION: Increased admissions occur in small animal veterinary emergency clinics during some holidays, and some of the increased caseload is due to ingestion of toxic substances. This report documents zinc toxicosis contributing to the death of a dog after ingestion of holiday tinsel garland. CASE STUDY: A mature boxer dog presented with a 4-day history of vomiting and diarrhea. Radiodense foreign material was detected in the stomach and removed via gastrotomy...
February 21, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#6
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28222456/nausea-vomiting-%C3%A2-tachycardia-%C3%A2-unintentional-weight-loss-%C3%A2-dx
#7
Daryl J Selen, Matthew P Gilbert
A 22-year-old woman presented to the emergency department (ED) with a 24-hour history of nausea, vomiting, diarrhea, generalized abdominal pain, and mild headache. She denied shortness of breath, chest pain, or anxiety, and didn't have a history of cardiac problems. The physical examination revealed tachycardia (heart rate, 135 beats/min) and a respiratory rate of 24 breaths per minute.
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28213364/safety-and-antitumor-activity-of-apalutamide-arn-509-in-metastatic-castration-resistant-prostate-cancer-with-and-without-prior-abiraterone-acetate-and-prednisone
#8
Dana E Rathkopf, Emmanuel S Antonarakis, Neal D Shore, Ronald F Tutrone, Joshi J Alumkal, Charles J Ryan, Mansoor Saleh, Ralph J Hauke, Rajesh Bandekar, Edna Chow Maneval, Carla J de Boer, Margaret K Yu, Howard I Scher
PURPOSE: To evaluate the efficacy of apalutamide before or after treatment with abiraterone acetate and prednisone (AAP) in patients with progressive metastatic castration-resistant prostate cancer (mCRPC). EXPERIMENTAL DESIGN: Two cohorts were studied: AAP-naïve and post-AAP patients who had received ≥6 months of AAP. Patients had progressive mCRPC per rising prostate-specific antigen (PSA) and/or imaging, without prior chemotherapy exposure. All received apalutamide 240 mg/day...
February 17, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28209267/assessment-of-volume-status-and-appropriate-fluid-replenishment-in-the-setting-of-nephrotic-syndrome
#9
Pierluigi Marzuillo, Stefano Guarino, Andrea Apicella, Rosaria Marotta, Vincenzo Tipo, Laura Perrone, Angela La Manna, Giovanni Montini
BACKGROUND: When the permeability of the glomerular filtration barrier increases, leading to proteinuria, nephrotic syndrome (NS) occurs. First episodes or relapses of NS can be concurrent with acute gastroenteritis (AGE) infections. This condition can cause further deterioration of the hypovolemic state, as intravascular water is lost through both AGE-related vomiting/diarrhea and NS-related fluid shifting into the interstitium. In this case report, we wish to raise the issues about the difficult management of children presenting with both NS and AGE...
February 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28208602/a-review-of-the-strain-diversity-and-pathogenesis-of-chicken-astrovirus
#10
REVIEW
Victoria J Smyth
Although a relatively recently emerged virus, identified only in 2004 as a separate species of avian astrovirus, chicken astrovirus (CAstV) has been associated with poor growth of broiler flocks, enteritis and diarrhea and is a candidate pathogen in cases of runting stunting syndrome. More recently CAstV has been implicated in cases of two other diseases of broilers as the sole etiological agent, namely severe kidney disease of young broilers with visceral gout and the "White Chicks" hatchery disease. Examination of the strains of CAstV associated with the two latter diseases reveals they are closely related genetically...
February 10, 2017: Viruses
https://www.readbyqxmd.com/read/28203283/current-and-emergent-pharmacologic-treatments-for-irritable-bowel-syndrome-with-diarrhea-evidence-based-treatment-in-practice
#11
REVIEW
Susan Lucak, Lin Chang, Albena Halpert, Lucinda A Harris
Irritable bowel syndrome with diarrhea (IBS-D) is a common, chronic functional gastrointestinal disorder with symptoms that can be distressing for patients and often result in substantially impaired quality of life. This review focuses on providing clinicians with information on practical, evidence-based treatment for IBS-D. Current therapies commonly used for the treatment of IBS-D, including pharmacologic and nonpharmacologic interventions, are briefly reviewed, followed by discussion of the emergent pharmacologic treatments (rifaximin and eluxadoline) and medical foods (IBgard(®) and EnteraGam(®))...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28185296/a-report-of-cerebral-malaria-treated-with-automated-red-blood-cell-exchange
#12
Waseem Q Anani, Gerald P Smith, Mehraboon Irani, Kathleen E Puca
BACKGROUND: Adjunctive automated whole blood or red blood cell exchange (RBCEx) can rapidly decrease malarial hyperparasitemia. Several case reports and series suggest improvement in clinical symptomatology; however, recent Centers of Disease Control and Prevention (CDC) recommendations concluded that RBCEx has no efficacy as an adjunctive therapy. We present a case of mental status changes secondary to cerebral malaria treated with automated RBCEx resulting in rapid and dramatic neurologic improvement...
February 10, 2017: Transfusion
https://www.readbyqxmd.com/read/28169840/bile-acid-disease-the-emerging-epidemic
#13
Ibironke Oduyebo, Michael Camilleri
PURPOSE OF REVIEW: Our objective was to review advances in bile acids in health and disease published in the last 2 years. Bile acid diarrhea (BAD) is recognized as a common cause of chronic diarrhea, and its recognition has been facilitated by development of new screening tests. RECENT FINDINGS: Primary BAD can account for 30% of cases of chronic diarrhea. The mechanisms leading to BAD include inadequate feedback regulation by fibroblast growth factor 19 (FGF-19) from ileal enterocytes, abnormalities in synthesis or degradation of proteins involved in FGF-19 regulation in hepatocytes and variations as a function of the bile acid receptor, TGR5 (GPBAR1)...
February 6, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28169285/a-randomized-phase-iii-clinical-trial-of-plecanatide-a-uroguanylin-analog-in-patients-with-chronic-idiopathic-constipation
#14
Philip B Miner, William D Koltun, Gregory J Wiener, Marianela De La Portilla, Blas Prieto, Kunwar Shailubhai, Mary Beth Layton, Laura Barrow, Leslie Magnus, Patrick H Griffin
OBJECTIVES: This study assessed the efficacy and safety of plecanatide, a guanylate cyclase-C (GC-C) agonist and the first uroguanylin analog approved for the treatment of chronic idiopathic constipation (CIC). METHODS: This phase III, multicenter, double-blind, placebo-controlled study randomized 1,394 patients with CIC. Patients received either plecanatide (3 or 6 mg) or placebo, orally, once daily, for 12 weeks. The primary efficacy endpoint was the percentage of patients who were durable overall complete spontaneous bowel movement (CSBM) responders over the 12-week treatment period...
February 7, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28161435/multi-locus-sequence-typing-of-laribacter-hongkongensis-isolates-from-freshwater-animals-environment-and-diarrhea-patients-in-southern-china
#15
Zhiyun Wang, Jiangfeng Zhu, Zhihua Liu, Youzhao Liu, Nancai Zheng, Mei Feng, Qing Chen, Weijun Yu, Lina Jiang, Jing Hu
Laribacter hongkongensis is a novel emerging bacterium associated with gastroenteritis and invasive bacteremic infections. Freshwater fish and edible frogs have been identified as major reservoirs of L. hongkongensis. Currently one of the main challenges in L. hongkongensis research is to identify their sources and possible transmission routes. The aim of this study was to determine the genetic diversity and relatedness of these L. hongkongensis isolates to their hosts in the hope of shedding light on these issues...
January 27, 2017: International Journal of Food Microbiology
https://www.readbyqxmd.com/read/28161256/cecal-perforation-associated-with-clostridium-difficile-infection-a%C3%A2-case-report
#16
Sarah Kyuragi Luthe, Ryota Sato
BACKGROUND: Various complications are reported with Clostridium difficile infection (CDI), including fulminant CDI. Fulminant CDI is an underappreciated life-threatening condition associated with complications such as toxic megacolon and bowel perforation. CASE REPORT: A 79-year-old woman presented to the Emergency Department with altered mental status. She was admitted and conservatively treated for a left thalamic hemorrhage. While hospitalized, she developed watery diarrhea due to Clostridium difficile...
February 2, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28161211/cranberry-extract-inhibits-in-vitro-adhesion-of-f4-and-f18-escherichia-coli-to-pig-intestinal-epithelium-and-reduces-in-vivo-excretion-of-pigs-orally-challenged-with-f18-verotoxigenic-e-coli
#17
Annelies Coddens, Michaela Loos, Daisy Vanrompay, Jean Paul Remon, Eric Cox
F4(+)E. coli and F18(+)E. coli infections are an important threat for pig industry worldwide. Antibiotics are commonly used to treat infected piglets, but the emerging development of resistance against antibiotics raises major concerns. Hence, alternative therapies to prevent pigs from F4(+)E. coli and F18(+)E. coli infections need to be developed. Since cranberry previously showed anti-adhesive activity against uropathogenic E. coli, we aimed to investigate whether cranberry extract could also inhibit binding of F4(+)E...
January 20, 2017: Veterinary Microbiology
https://www.readbyqxmd.com/read/28158186/a-high-throughput-phenotypic-screen-identifies-clofazimine-as-a-potential-treatment-for-cryptosporidiosis
#18
Melissa S Love, Federico C Beasley, Rajiv S Jumani, Timothy M Wright, Arnab K Chatterjee, Christopher D Huston, Peter G Schultz, Case W McNamara
Cryptosporidiosis has emerged as a leading cause of non-viral diarrhea in children under five years of age in the developing world, yet the current standard of care to treat Cryptosporidium infections, nitazoxanide, demonstrates limited and immune-dependent efficacy. Given the lack of treatments with universal efficacy, drug discovery efforts against cryptosporidiosis are necessary to find therapeutics more efficacious than the standard of care. To date, cryptosporidiosis drug discovery efforts have been limited to a few targeted mechanisms in the parasite and whole cell phenotypic screens against small, focused collections of compounds...
February 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28155175/incidence-and-timing-of-common-adverse-events-in-lenvatinib-treated-patients-from-the-select-trial-and-their-association-with-survival-outcomes
#19
Robert I Haddad, Martin Schlumberger, Lori J Wirth, Eric J Sherman, Manisha H Shah, Bruce Robinson, Corina E Dutcus, Angela Teng, Andrew G Gianoukakis, Steven I Sherman
PURPOSE: In the study of (E7080) lenvatinib in differentiated cancer of the thyroid, most patients experienced an adverse event. In this report, we examine common lenvatinib-emergent adverse events in this phase three, randomized, double-blind study. METHODS: Adverse events were graded per Common Terminology Criteria for Adverse Events v4.0. 392 patients were enrolled (lenvatinib: 261, placebo: 131) and received lenvatinib 24 mg/day or placebo. The main outcome measures were: associations with progression-free survival and overall survival in exploratory univariate and multivariate analyses along with additional variables...
February 3, 2017: Endocrine
https://www.readbyqxmd.com/read/28153057/unusual-presentation-of-a-severely-ill-patient-having-severe-fever-with-thrombocytopenia-syndrome-a-case-report
#20
Masahiko Kaneko, Masaki Maruta, Hisaharu Shikata, Kengo Asou, Hiroto Shinomiya, Tadaki Suzuki, Hideki Hasegawa, Masayuki Shimojima, Masayuki Saijo
BACKGROUND: Severe fever with thrombocytopenia syndrome is an emerging infectious disease caused by a novel phlebovirus belonging to the family Bunyaviridate. Emergence of encephalitis/encephalopathy during severe fever with thrombocytopenia syndrome progression has been identified as a major risk factor associated with a poor prognosis. Here we report the case of a severely ill patient with severe fever with thrombocytopenia syndrome virus-associated encephalitis/encephalopathy characterized by a lesion of the splenium, which resolved later...
February 3, 2017: Journal of Medical Case Reports
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