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diarrhea emergency

Brecht Ingelbeen, Mathias Bruyand, Patricia Mariani-Kurkjian, Simon Le Hello, Kostas Danis, Cécile Sommen, Stéphane Bonacorsi, Henriette de Valk
To generate hypotheses on possible sources of Shiga toxin-producing Escherichia coli (STEC) serogroup O80 associated hemolytic-uremic syndrome (HUS), we explored differences in factors associated with STEC O80 associated HUS, compared with STEC O157 or STEC of other serogroups, in France during 2013-16. STEC was isolated from 153/521 (30%) reported HUS cases: 45 serogroup O80, 46 O157 and 62 other serogroups. Median ages were 1.1 years, 4.0 years and 1.8 years, respectively. O80 infected patients were less likely to report ground beef consumption (aOR [adjusted Odds Ratio] 0...
2018: PloS One
Emmanuel Roilides, Fabianne Carlesse, Heidi Leister-Tebbe, Umberto Conte, Jean L Yan, Ping Liu, Margaret Tawadrous, Jalal A Aram, Flavio Queiroz-Telles
BACKGROUND: Treatment with an echinocandin is recommended as first-line therapy for patients with invasive candidiasis including candidemia (ICC). Little is known about the efficacy and safety of anidulafungin in children with ICC. METHODS: Eligible patients with ICC aged 2-<18 years were enrolled into this prospective, open-label, non-comparative, international study (NCT00761267), and received anidulafungin for 10-35 days (3 mg/kg on Day 1, 1.5 mg/kg daily thereafter)...
November 9, 2018: Pediatric Infectious Disease Journal
Dennis Rubbenstroth, Elisabeth Peus, Eva Schramm, Daniel Kottmann, Hilke Bartels, Christina McCowan, Christoph Schulze, Valerij Akimkin, Nicole Fischer, Claudia Wylezich, Andreas Hlinak, Anja Spadinger, Ernst Großmann, Henning Petersen, Adam Grundhoff, Silke Rautenschlein, Lydia Teske
Rotaviruses are well-known causative agents of enteric disorders in humans and other mammals, but little is known about their virulence and pathogenic role in pigeons and other birds. Starting in summer 2017, a series of outbreaks of an acute disease with high mortalities was reported in domestic pigeons in Germany, Belgium and Denmark. The clinical picture was characterized by diarrhea, vomiting, hepatic necrosis, and sudden fatalities. From these severe outbreaks, we discovered several previously unknown group A rotavirus (RVA) lineages of genotype G18P[17]-I4-R4-C4-M4-A4-T4-N4-E19-H4, which were closely related but not identical to an RVA variant identified in cases of fatal hepatic necrosis in Australian pigeon lofts in 2016...
November 8, 2018: Transboundary and Emerging Diseases
Shun-Ching Chien, Kuan-Ting Liu, Yen-Hung Wu
RATIONALE: Lithium has been used to treat bipolar disorder. Lithium has a narrow therapeutic index, with a therapeutic level between 0.6 and 1.5 mEq/L. The possible complications of lithium overdose include altered mental status, hand tremor, muscle weakness, nausea, vomiting, diarrhea, seizure, syncope, and arrhythmia. Lithium intoxication can be fatal and is difficult to diagnose in patients without a history of lithium intake. The occurrence of serious cardiac arrhythmias is rare in lithium intoxication...
November 2018: Medicine (Baltimore)
Geneva A DeGregorio, Joseph Singer, Katherine N Cahill, Tanya Laidlaw
BACKGROUND: Aspirin challenge and desensitization remains the gold standard in diagnosis and treatment for patients with aspirin-exacerbated respiratory disease (AERD), but the protocols can be time and resource intensive. OBJECTIVE: To provide evidence that oral aspirin challenge and desensitization can be safely performed in an outpatient setting in one day. METHODS: Forty-four patients with a confirmed diagnosis of AERD, stable asthma and baseline FEV1 ≥70% of predicted, completed an oral aspirin challenge and desensitization protocol...
November 1, 2018: Journal of Allergy and Clinical Immunology in Practice
David Gremse, Benjamin D Gold, Betsy Pilmer, Barbara Hunt, Bartosz Korczowski, Maria Claudia Perez
BACKGROUND: In gastroesophageal reflux disease (GERD), the frequency of heartburn symptoms and erosive esophagitis (EE) increases with age in children and adolescents. Proton pump inhibitor, dexlansoprazole, is approved for healing EE of all grades, maintenance of healed EE, relief of heartburn, and treatment of symptomatic non-erosive GERD in patients ≥ 12 years. AIM: To assess safety and efficacy of dexlansoprazole dual delayed-release capsule in healing of EE and maintenance of healed EE in adolescents...
November 2, 2018: Digestive Diseases and Sciences
Jean-Pierre Raufman, Melissa Metry, Jessica Felton, Kunrong Cheng, Su Xu, James Polli
In up to 50% of people diagnosed with a common ailment, diarrhea-predominant irritable bowel syndrome, diarrhea results from excess spillage of bile acids into the colon-data emerging over the past decade identified deficient release of a gut hormone, fibroblast growth factor 19 (FGF19), and a consequent lack of feedback suppression of bile acid synthesis as the most common cause. 75 Selenium homotaurocholic acid (SeHCAT) testing, considered the most sensitive and specific means of identifying individuals with bile acid diarrhea, is unavailable in many countries, including the United States...
November 1, 2018: Magma
Waseem Ahmad, Nghia H Nguyen, Brigid S Boland, Parambir S Dulai, David T Pride, Daniel Bouland, William J Sandborn, Siddharth Singh
BACKGROUND AND AIMS: Gastrointestinal pathogen panels (GPPs) are increasingly being used for evaluation of diarrhea. The impact of these tests on patients with inflammatory bowel diseases (IBD) is unknown. We performed a time-interrupted cohort study comparing GPPs and conventional stool evaluation in patients with IBD with diarrhea. METHODS: We included 268 consecutive patients with IBD who underwent GPP (BioFire Diagnostics® ) (n = 134) or conventional stool culture and Clostridium difficile polymerase chain reaction testing (n = 134) during suspected IBD flare between 2012 and 2016...
October 25, 2018: Digestive Diseases and Sciences
Zhoujia Yao, Jun Zheng, Youguang Si, Xudong Xu, Tingting Li
BACKGROUND: Emphysematous cholecystitis and spontaneous hepatic hemorrhage are uncommon and serious conditions with non-specific presentations that can lead to a poor clinical outcome. We report a case of spontaneous hepatic hemorrhage of emphysematous cholecystitis. A 49-year-old male presented to the emergency department with fever, chills, right upper quadrant pain, vomiting, and diarrhea of four days' duration. He had a history of diabetes mellitus, hypertension, and uarthritis. Computed tomography (CT) revealed an enlarged gallbladder with intra-luminal, intra-mural, and peri-cholecystic air; subcapsular high-density fluid collection; and an intra-hepatic mass with gas and liquid in the right lobe of the liver...
October 23, 2018: Surgical Infections
Kristine Elberg Dengsø, Tine Tjørnhøj-Thomsen, Susanne Oksbjerg Dalton, Bo Marcel Christensen, Jens Hillingsø, Thordis Thomsen
BACKGROUND: How patients recover and resume everyday life after curative hepato-pancreato-biliary (HPB) surgery with intestinal reconstruction has, to our knowledge, not previously been investigated. We wanted to explore the patient experience in order to develop our capability to support their rehabilitation and identify interventional gaps in the current post-surgical care of these patients. Therefore, the aim of the present study was to explore patients' experiences of their gut, digestion, recovery and uptake of everyday life after HPB surgery with intestinal reconstruction...
October 22, 2018: BMC Cancer
Aaron Fisher, Alexandra Halalau
Klebsiella oxytoca hemorrhagic colitis is a rare form of antibiotic associated hemorrhagic colitis that is Clostridium difficile negative. Klebsiella oxytoca colitis has been shown to be triggered by penicillin administration, yet other antibiotics have been implicated as well. It can mimic the appearance of ischemic colitis on endoscopy; however it will generally be found in young, otherwise healthy patients without risk factors. We present a case of a 33-year-old Caucasian female who presented to the emergency room with profuse, bloody diarrhea for 5 days, after a one-week course of ampicillin...
2018: Case Reports in Gastrointestinal Medicine
Krishani Dinali Perera, Anushka C Galasiti Kankanamalage, Athri D Rathnayake, Amanda Honeyfield, William Groutas, Kyeong-Ok Chang, Yunjeong Kim
Ferret and mink coronaviruses typically cause catarrhal diarrhea in ferrets and minks, respectively. In recent years, however, systemic fatal coronavirus infection has emerged in ferrets, which resembles feline infectious peritonitis (FIP) in cats. FIP is a highly fatal systemic disease caused by a virulent feline coronavirus infection in cats. Despite the importance of coronavirus infections in these animals, there are no effective commercial vaccines or antiviral drugs available for these infections. We have previously reported the efficacy of a protease inhibitor in cats with FIP, demonstrating that a virally encoded 3C-like protease (3CLpro) is a valid target for antiviral drug development for coronavirus infections...
October 19, 2018: Antiviral Research
Astrid Donoso, Felipe Inostroza, María Celedón, José Pizarro-Lucero
BACKGROUND: Bovine Viral Diarrhea Virus causes significant economic losses in cattle. BVDV has high genomic diversity, with two species, BVDV-1 and BVDV-2, and at least twenty-one subgenotypes for BVDV-1 and four subgenotypes for BVDV-2. Vaccines are important tools to reduce the economic losses caused by this virus. However, vaccine strains must correspond to the antigenic profile of the viruses present in the region where the vaccine is applied. A restricted phylogenetic study with 14 viruses isolated from cattle between 1993 and 2001 showed that the genetic profile of BVDV in Chile consisted of viruses of both species and sub-genotypes 1a, 1b, 1c (currently 1j) and 2a...
October 19, 2018: BMC Veterinary Research
Bing Han, Louis M Weiss
Microsporidia have been increasingly reported to infect humans. The most common presentation of microsporidiosis is chronic diarrhea, a significant mortality risk in immune-compromised patients. Albendazole, which inhibits tubulin, and fumagillin, which inhibits methionine aminopeptidase type 2 (MetAP2), are the two main therapeutic agents used for treatment of microsporidiosis. In addition, to their role as emerging pathogens in humans, microsporidia are important pathogens in insects, aquaculture, and veterinary medicine...
October 19, 2018: Expert Opinion on Therapeutic Targets
Saira Chaughtai, Bhavika Gandhi, Zeeshan Chaughtai, Dana Tarina, Mohammad A Hossain, Arif Asif
Recently, the incidence of Clostridium difficile- ( C. difficile- ) associated infection has increased significantly in hospital and ambulatory care settings in parallel to the increasing use of inappropriate antibiotics. According to the CDC, approximately 83,000 patients who developed C . difficile experienced at least one recurrence and 29,000 died within 30 days of the initial diagnosis. Patients on dialysis (particularly peritoneal dialysis) are predisposed to this infection due to an inherent immunocompromised state and transmural translocation of the bacteria due to the close association of gastrointestinal tract and peritoneal cavity...
2018: Case Reports in Medicine
Michael H Guo, Reesa L Monir, Ashleigh Wright, Neal P Holland
BACKGROUND Serotonin syndrome is a common yet potentially life-threatening condition caused by increased serotonergic activity, usually from serotonergic pharmaceutical agents. Primary features of serotonin syndrome include mental status changes, autonomic hyperactivity, and neuromuscular abnormalities. However, the presentation of serotonin syndrome is often quite variable, leading to its under-diagnosis. CASE REPORT A 50-year-old female with chronic kidney disease on peritoneal dialysis presented to the Emergency Department with severe, diffuse body pain...
October 15, 2018: American Journal of Case Reports
G D Sclar, G Penakalapati, B A Caruso, E A Rehfuess, J V Garn, K T Alexander, M C Freeman, S Boisson, K Medlicott, T Clasen
The WHO defines health not as the absence of disease but as a "state of complete physical, mental, and social well-being." To date, public health research on sanitation has focused mainly on the impact of sanitation on infectious diseases and related sequelae, such as diarrhea and malnutrition. This review focuses on the mental and social well-being implications of sanitation. We systematically searched leading databases to identify eligible studies. Qualitative studies were assessed using a 17-point checklist adapted from existing tools, while quantitative studies were assessed using the Liverpool Quality Appraisal Tool...
November 2018: Social Science & Medicine
Masayuki Saijo
Severe fever with thrombocytopenia syndrome (SFTS) was first reported in 2011 as an emerging virus infection caused by a novel Phlebovirus in the Bunyaviridae family [SFTS virus (SFTSV)]. In addition, it was reported to be endemic to Hubei, Henan, Shandong, and Heilongjiang provinces in China. The primary symptoms of SFTS are gastrointestinal symptoms such as fever, general fatigue, nausea, vomiting, and diarrhea. The total blood cell counts in patients with SFTS reveal thrombocytopenia and leukopenia. A woman in her 50s died due to multiorgan failure, intestinal hemorrhage, and hemophagocytosis in the autumn of 2012...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
M Zhang, Y F Long, L M Guo, S L Wu, L Fang, F Yang, H Li, Q Huang, L M Sun
Objective: To understand the epidemiologic characteristics of outbreaks, caused by norovirus-GⅡ.2、GⅡ.17 and GⅡ.4/Sydney in Guangdong Province from 2013 to 2017 and to provide scientific evidence for epidemic prevention and control. Methods: Incidence data of norovirus outbreaks in Guangdong from January 1(st) 2013 to November 30(th) 2017 were collected from Public Health Emergency Management Information System. RT-PCR was performed for every case of each outbreak to detect norovirus nucleic acid and gene sequencing was conducted to identify the genotype of norovirus...
September 10, 2018: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Eugene R Viscusi
OBJECTIVES: Opioid analgesics may be associated with chronic adverse effects, such as opioid-induced constipation (OIC). Available and emerging prescription medications for OIC in patients with chronic noncancer pain are described, including concerns and challenges associated with OIC management. METHODS: Narrative review. RESULTS: Opioid-induced constipation is characterized by a change in bowel habits and defecation patterns that occurs when initiating opioid therapy and is associated with reduced bowel frequency, straining, sensation of incomplete evacuation, and/or patient distress related to bowel habits...
October 4, 2018: Clinical Journal of Pain
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