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diarrhea emergency

J Berdeja, F Palandri, M R Baer, D Quick, J J Kiladjian, G Martinelli, A Verma, O Hamid, R Walgren, C Pitou, P L Li, A T Gerds
BACKGROUND: The Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) are associated with increases in janus kinase 2 (JAK2) signaling, often resulting from the JAK2 V617F mutation. LY2784544 (gandotinib) is a potent, selective, small-molecule inhibitor of JAK2 that has potential dose-dependent selectivity for the JAK2 V617F mutation and may inhibit additional JAK2 mutant isoforms in nonclinical testing. METHODS: A multicenter, single-arm, outpatient phase 2 study evaluated the efficacy, safety, and pharmacokinetics (PK) of gandotinib administered to patients (120 mg once daily) with MPNs, including polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF)...
June 30, 2018: Leukemia Research
Jonatan Vukovic, Pavle Vrebalov Cindro, Snjezana Tomic, Ante Tonkic
Primary signet ring cell carcinoma is a rare event in surgery. It looks like acute appendicitis and it is difficult to diagnose it on clinical grounds alone. The diagnosis is always confirmed by histopathology of a surgically removed appendix. A young man, 22 years old, presented with vomiting, diarrhea, and cramps in his abdomen without abdominal tenderness (mild abdominal discomfort in the right lower abdominal quadrant without signs of peritoneal irritation) during the previous month. The first endoscopic results showed only changes of mucosa that could be attributed to endoscopic and clinical representation of Crohn's disease...
May 2018: Case Reports in Gastroenterology
Jesse Elliott, Deirdre DeJean, Tammy Clifford, Doug Coyle, Beth Potter, Becky Skidmore, Christine Alexander, Alexander E Repetski, Bláthnaid McCoy, George A Wells
BACKGROUND: Pediatric epilepsy, including treatment-resistant forms, has a major effect on the quality of life, morbidity, and mortality of affected children. Interest has been growing in the use of medical cannabis as a treatment for pediatric epilepsy, yet there has been no comprehensive review of the benefits and harms of cannabis use in this population. In this systematic review, we will search for, synthesize, and assess the published and gray literature in order to provide usable and relevant information to parents, clinicians, and policy makers...
July 18, 2018: Systematic Reviews
Iramiot Jacob Stanley, Henry Kajumbula, Joel Bazira, Catherine Kansiime, Innocent B Rwego, Benon B Asiimwe
BACKGROUND: Antimicrobial resistance is a worldwide public health emergency that requires urgent attention. Most of the effort to prevent this coming catastrophe is occurring in high income countries and we do not know the extent of the problem in low and middle-income countries, largely because of low laboratory capacity coupled with lack of effective surveillance systems. We aimed at establishing the magnitude of antimicrobial resistance among Escherichia coli and Klebsiella pneumoniae carried in the gut of out-patients from pastoralist communities of rural Western Uganda...
2018: PloS One
Amber Howerton, Cale O Seymour, Senthil K Murugapiran, Zhenlin Liao, Jacqueline R Phan, Alan Estrada, Adam J Wagner, Chrisabelle C Mefferd, Brian P Hedlund, Ernesto Abel-Santos
Clostridium difficile infection (CDI) is the leading cause of antibiotic-associated diarrhea and has gained worldwide notoriety due to emerging hypervirulent strains and high incidence of recurrence. We previously reported protection of mice from CDI using the anti-germinant bile salt analog CamSA. Here we describe the effects of CamSA on the hamster model of CDI. CamSA treatment of hamsters showed no toxicity and did not affect the richness or diversity of gut microbiota; however, minor changes in community composition were observed...
July 16, 2018: Antimicrobial Agents and Chemotherapy
Steven C Lin, Carolyn D Alonso, Alan C Moss
Clostridium difficile, an anaerobic gram-positive, spore-forming bacillus, has become the most common cause of nosocomial infectious diarrhea, and is associated with increased mortality in all populations. Patients who have received solid organ transplants (SOT) are at increased risk of Clostridium difficile infection (CDI) and CDI recurrence (rCDI). This may be related to chronic immunosuppression, frequent antibiotic exposure, and increased or prolonged hospitalizations. Increased morbidity and mortality from CDI is well described in SOT patients...
July 16, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Mailan Natarajan, Deepika Kumar, Jharna Mandal, Niranjan Biswal, Selvaraj Stephen
BACKGROUND: Emergence of atypical enteropathogenic Escherichia coli (EPEC) and hybrid E. coli (harboring genes of more than one DEC pathotypes) strains have complicated the issue of growing antibiotic resistance in diarrhoeagenic Escherichia coli (DEC). This ongoing evolution occurs in nature predominantly via horizontal gene transfers involving the mobile genetic elements like integrons notably class 1 integron. This study was undertaken to determine the virulence pattern and antibiotic resistance among the circulating DEC strains in a tertiary care center in south of India...
July 13, 2018: Journal of Health, Population, and Nutrition
Kambiz Soltaninejad
From April 28 to May 28, 2018, more than 1200 patients with impression of mushroom poisoning were referred to hospital emergency departments in 13 west and northwestern provinces, Iran; 112 (8.9%) patients were hospitalized and 19 were expired ( ie , a fatality rate of 1.5%). The outbreak began in Kermanshah province with increasing number of patients presenting with severe abdominal pain, nausea, vomiting, and diarrhea soon after consumption of wild mushrooms. Lepiota brunneioncarnata, Hypholoma fascicalare, and Coprinopsis atramentaria have been involved in this outbreak...
July 2018: International Journal of Occupational and Environmental Medicine
Sufei Tian, Chen Rong, Hua Nian, Fushun Li, Yunzhuo Chu, Shitong Cheng, Hong Shang
For the first time, we identified 15 cases of Candida auris in Shenyang, China, and then performed a risk factor assessment for these patients compared with 30 control subjects who were hospitalized in the same ward during the same period of time as the infected patients. We found that diarrhea, gastrointestinal decompression, infection, or colonization with other Candida isolates (especially Candida albicans) and tetracycline antibiotics were all risk factors for C. auris infection or colonization. Diarrhea and tetracycline antibiotics were independent risk factors...
July 11, 2018: Emerging Microbes & Infections
Abdul Rauf, Sunit Singhi, Karthi Nallasamy, Mandeep Walia, Pallab Ray
Acute febrile illnesses (AFIs) in children from the developing world can have varying etiologies. Awareness of local epidemiology helps in prioritizing investigations and empiric treatment. This prospective study was carried out in a tertiary care center in North India, aiming to determine the burden, etiology, and outcome of AFI other than pneumonia and diarrhea in hospitalized children. A total of 613 consecutive children aged 3 months to 12 years with febrile illness of < 7 days during four selected months of 2014 representing different seasons were screened for eligibility...
July 9, 2018: American Journal of Tropical Medicine and Hygiene
Jerry Vockley, Barbara Burton, Gerard T Berry, Nicola Longo, John Phillips, Amarilis Sanchez-Valle, Pranoot Tanpaiboon, Stephanie Grunewald, Elaine Murphy, Alexandra Bowden, Wencong Chen, Chao-Yin Chen, Jason Cataldo, Deborah Marsden, Emil Kakkis
Long-chain fatty acid oxidation disorders (LC-FAOD) are rare disorders characterized by acute crises of energy metabolism and severe energy deficiency that may present with cardiomyopathy, hypoglycemia, and/or rhabdomyolysis, which can lead to frequent hospitalizations and early death. An open-label Phase 2 study evaluated the efficacy of UX007, an investigational odd-carbon medium-chain triglyceride, in 29 subjects with severe LC-FAOD. UX007 was administered over 78 weeks at a target dose of 25-35% total daily caloric intake (mean 27...
July 9, 2018: Journal of Inherited Metabolic Disease
James L Lawrence, Hussam Hindi
A 41-year-old female presented to the emergency department with nausea, vomiting, and diarrhea. Five days prior to this, she tested positive for influenza type A in an urgent care clinic and received Tamiflu. She also complained of generalized weakness in her extremities. Her initial labs were concerning for a grossly elevated hemoglobin and hematocrit despite adequate fluid resuscitation. Her condition continued to worsen as she developed distal cyanosis in all of her extremities and pulselessness. She was treated with IV hydration, bicarbonate, heparin, vasopressors, albumin replacement, Tamiflu, and phlebotomy...
April 30, 2018: Curēus
Jing Xie, Fuli Wu, Xuebin Xu, Xiaoxia Yang, Rongtao Zhao, Qiuxia Ma, Peng Li, Ligui Wang, Rongzhang Hao, Leiji Jia, Xinying Du, Shaofu Qiu, Hongbin Song
BACKGROUND: Among 2179 Salmonella isolates obtained during national surveillance for salmonellosis in China from 2005 to 2013, we identified 46 non-H2 S-producing strains originating from different sources. METHODS: The isolates were characterized in terms of antibiotic resistance and genetic variability by pulsed-field gel electrophoresis and multilocus sequence typing. Mutation in the phs operon, which may account for the non-H2 S-producing phenotype of the isolated Salmonella strains, was performed in this study...
July 3, 2018: BMC Infectious Diseases
Chia-Yu Chang, Wei-Ting Hsu, Yu-Chan Chao, Hui-Wen Chang
A new variant of the porcine epidemic diarrhea virus (PEDV) is an emerging swine disease, killing considerable numbers of neonatal piglets in North America and Asia in recent years. To generate immunogens mimicking the complex spike (S) protein folding with proper posttranslational modification to mount a robust immune response against the highly virulent PEDV, two baculoviruses displaying the full-length S protein (S-Bac) and the S1 protein (S1-Bac) of the virulent Taiwan genotype 2b (G2b) PEDV Pintung 52 (PEDV-PT) strain were constructed...
June 27, 2018: Viruses
Erden Erol Unluer, Togay Evrin, Burak Katipoglu, Serdar Bayata
Fluid therapy is one of the main issues for hemodynamic resuscitation. Tissue Doppler imaging (TDI) of the right ventricle (RV) with bedside ultrasound (BUS) technique is a new dynamic method to identify fluid responsiveness in patients with hypotension. Here, we present the case of a hypotensive patient monitored with TDI measurements of RV. A 75-year-old male patient was admitted to the emergency department (ED) with the complaint of diarrhea. He was in severe hypovolemia, with hypotension, tachycardia, and tachypnea...
December 2017: Interventional Medicine & Applied Science
Spencer Corey Greene, Thiago Halmer, John Morgan Carey, Brian John Rissmiller, Matthew Allen Musick
A healthy 4-year-old female presented to the emergency department for vomiting and diarrhea. She was diagnosed with a urinary tract infection, treated with antibiotics and anti-emetics and discharged. Within four hours, her symptoms recurred, followed by decreasing responsiveness and seizures. She had significant hypokalemia, hyperglycemia, and a combined respiratory and metabolic acidosis. A sibling then mentioned that the patient ingested their father's 200 mg sustained-release theophylline tablets the previous morning...
March 2018: Turkish Journal of Emergency Medicine
Satish S C Rao
Chronic constipation affects millions of Americans, consumes significant healthcare resources, and significantly affects quality of life (QOL). Recently, several new treatment options have become available for the treatment of constipation, including intestinal secretagogues such as lubiprotone, and linaclotide, prokinetics such as prucalopride, and bile acid transporter antagonists. Plecanatide is the newest of the secretagogue class of compounds that has been approved by the US Food and Drug Administration for the treatment of adults with chronic idiopathic constipation (CIC) in the USA...
2018: Therapeutic Advances in Gastroenterology
Maureen Egan, Glenn T Furuta
OBJECTIVE: Eosinophilic Gastrointestinal Diseases (EGIDs) are a rare group of disorders that can have varied clinical presentations dependent on the involved segment within the gastrointestinal tract. Eosinophilic gastritis presents with abdominal pain or vomiting; Eosinophilic gastroenteritis presents with diarrhea and anemia/hypoalbuminemia and Eosinophilic colitis can present with diarrhea or bloody stools. These nonspecific symptoms remain poorly understood as to their relationship to the underlying pathogenesis but a significant percentage of patients are atopic...
June 22, 2018: Annals of Allergy, Asthma & Immunology
Winson Y Cheung, Michelle K White, Martha S Bayliss, Angela Stroupe, Andrew Lovley, Bellinda L King-Kallimanis, Kathryn Lasch
BACKGROUND: Little is known on the impact of emerging treatments for advanced melanoma (stages III and IV) on patients' functioning and well-being. The objective of this study was to describe the patient-reported treatment-related symptom (TRS) burden in advanced melanoma. METHOD: Twenty-nine in-depth, qualitative interviews were conducted among adult patients with advanced melanoma in Canada using a semi-structured interview method. Interviews were transcribed verbatim, and key concepts were identified using a grounded theory analytic approach...
June 23, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
John M Burke, Andrei Shustov, James Essell, Dipti Patel-Donnelly, Jay Yang, Robert Chen, Wei Ye, Wen Shi, Sarit Assouline, Jeff Sharman
BACKGROUND: Entospletinib (GS-9973) is an oral, selective inhibitor of spleen tyrosine kinase. Entospletinib monotherapy was evaluated in a multicenter, phase II study of subjects with relapsed or refractory B-cell malignancy. PATIENTS AND METHODS: The study included 43 patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). The participants received 800 mg of the original, monomesylate formulation of entospletinib twice daily as a starting dose; the doses could be reduced because of toxicity throughout the study...
June 6, 2018: Clinical Lymphoma, Myeloma & Leukemia
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