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https://www.readbyqxmd.com/read/28095824/community-based-health-care-is-an-essential-component-of-a-resilient-health-system-evidence-from-ebola-outbreak-in-liberia
#1
Kendra Siekmans, Salim Sohani, Tamba Boima, Florence Koffa, Luay Basil, Saïd Laaziz
BACKGROUND: Trained community health workers (CHW) enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. METHODS: A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16), government health facility workers and project staff...
January 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28093134/management-of-clostridium-difficile-infection-in-inflammatory-bowel-disease-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#2
REVIEW
Sahil Khanna, Andrea Shin, Ciarán P Kelly
The purpose of this expert review is to synthesize the existing evidence on the management of Clostridium difficile infection in patients with underlying inflammatory bowel disease. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current practice guidelines. This review is a summary of expert opinion in the field without a formal systematic review of evidence. Best Practice Advice 1: Clinicians should test patients who present with a flare of underlying inflammatory bowel disease for Clostridium difficile infection...
February 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28068177/safety-profile-of-nivolumab-monotherapy-a-pooled-analysis-of-patients-with-advanced-melanoma
#3
Jeffrey S Weber, F Stephen Hodi, Jedd D Wolchok, Suzanne L Topalian, Dirk Schadendorf, James Larkin, Mario Sznol, Georgina V Long, Hewei Li, Ian M Waxman, Joel Jiang, Caroline Robert
Purpose We conducted a retrospective analysis to assess the safety profile of nivolumab monotherapy in patients with advanced melanoma and describe the management of adverse events (AEs) using established safety guidelines. Patients and Methods Safety data were pooled from four studies, including two phase III trials, with patients who received nivolumab 3 mg/kg once every 2 weeks. We evaluated rate of treatment-related AEs, time to onset and resolution of select AEs (those with potential immunologic etiology), and impact of select AEs and suppressive immune-modulating agents (IMs) on antitumor efficacy...
November 14, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28063287/clinical-practice-guidelines-for-the-use-of-video-capsule%C3%A2-endoscopy
#4
Robert A Enns, Lawrence Hookey, David Armstrong, Charles N Bernstein, Steven J Heitman, Christopher Teshima, Grigorios I Leontiadis, Frances Tse, Daniel Sadowski
BACKGROUND & AIMS: Video capsule endoscopy (CE) provides a noninvasive option to assess the small intestine, but its use with respect to endoscopic procedures and cross-sectional imaging varies widely. The aim of this consensus was to provide guidance on the appropriate use of CE in clinical practice. METHODS: A systematic literature search identified studies on the use of CE in patients with Crohn's disease, celiac disease, gastrointestinal bleeding, and anemia...
January 4, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28049258/the-impact-of-implementation-of-an-enteral-feeding-protocol-on-the-improvement-of-enteral-nutrition-in-critically-ill-adults
#5
Seoung-Hyun Kim, Chi-Min Park, Jeong-Meen Seo, Mingew Choi, Dae-Sang Lee, Dong Kyung Chang, Miyong Rha, Soyoung Yu, Seonhye Lee, Eunmee Kim, Young Yun Cho
BACKGROUND AND OBJECTIVES: The optimal delivery of enteral nutrition (EN) may improve clinical outcomes in critically ill patients; thus, optimal EN protocols should be developed. The purpose of this study was to evaluate the impact of implementing an EN protocol on the improvement of EN practices and on the clinical outcomes of critically ill patients. METHODS AND STUDY DESIGN: This was a retrospective study with prospectively collected data. Multidisciplinary working group developed an evidence-based EN protocol based on an extensive review of literature and existing guidelines...
January 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28043020/management-of-childhood-diarrhea-by-healthcare-professionals-in-low-income-countries-an-integrative-review
#6
REVIEW
Ana F Diallo, Xiaomei Cong, Wendy A Henderson, Jacqueline McGrath
BACKGROUND: The significant drop in child mortality due to diarrhea has been primarily attributed to the use of oral rehydration solutions, continuous feeding and zinc supplementation. Nevertheless uptake of these interventions have been slow in developing countries and many children suffering from diarrhea are not receiving adequate care according to the World Health Organization recommended guidelines for the clinical management of childhood diarrhea. OBJECTIVES: The aim of this integrative review is to appraise healthcare professionals' management of childhood diarrhea in low-income countries...
January 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28033143/probiotics-for-trauma-patients-should-we-be-taking-a-precautionary-approach
#7
Heather A Vitko, L Kathleen Sekula, Martin A Schreiber
The use of probiotics in the hospital setting is largely understudied and highly controversial. Probiotics are living organisms that, when taken internally, can produce an immunomodulating effect and improve the gastrointestinal (GI) mucosal barrier. Although used for centuries by healthy individuals for GI health, their use in the hospital setting is now gaining wide attention for the prevention of infectious complications such as antibiotic-associated diarrhea, Clostridium difficile infections, multiple-organ dysfunction syndrome, and ventilator-associated pneumonia...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28018330/porcine-epidemic-diarrhea-virus-shedding-and-antibody-response-in-swine-farms-a-longitudinal-study
#8
Cristina Bertasio, Enrico Giacomini, Massimiliano Lazzaro, Simona Perulli, Alice Papetti, Antonio Lavazza, Davide Lelli, Giovanni Alborali, Maria B Boniotti
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 US, 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...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27984397/donor-screening-experience-for-fecal-microbiota-transplantation-in-patients-with-recurrent-c-difficile-infection
#9
Raseen Tariq, Renee Weatherly, Patricia Kammer, Darrell S Pardi, Sahil Khanna
GOALS: To evaluate our experience with stool donor recruitment, screening, retention, and donor perception for fecal microbiota transplantation (FMT). BACKGROUND: Multiply recurrent Clostridium difficile infection is being increasingly managed with FMT from donor stools. However, donor selection and recruitment is challenging due to lack of standard evidence-based guidelines, donor exclusion criteria, frequency of screening and donor commitment. METHODS: Data on donors screened using institutional guidelines with history, blood and stool testing and their perspectives on donation were analyzed...
December 14, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27981760/infliximab-for-ipilimumab-induced-colitis-a-series-of-13-patients
#10
Nadine T Hillock, Sharryn Heard, Ganessan Kichenadasse, Catherine L Hill, Jane Andrews
OBJECTIVE: To review the outcomes of metastatic melanoma patients treated with infliximab for severe steroid-refractory colitis secondary to ipilimumab therapy. BACKGROUND: Immune-related colitis is a known potential adverse effect of ipilimumab, that causes significant morbidity and extended hospital stays. There are limited outcome data for patients treated with infliximab for ipilimumab-induced colitis refractory to corticosteroids. Management guidelines have been developed based on case study evidence only...
December 16, 2016: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27956320/primary-tumour-resection-may-improve-survival-in-functional-well-differentiated-neuroendocrine-tumours-metastatic-to-the-liver
#11
D Citterio, S Pusceddu, A Facciorusso, J Coppa, M Milione, R Buzzoni, M Bongini, F deBraud, V Mazzaferro
BACKGROUND: Functional well-differentiated neuroendocrine tumours (NET) with liver metastases represent a therapeutic challenge with few alternative options in guidelines. In these patients, the role of surgical resection of the primary tumour is controversial. PATIENTS AND METHODS: From a regional registry collecting somatostatin analogue (SSA)-treated tumours from 1979 to 2005, a series of 139 patients presenting with symptomatic, liver-metastatic, well-differentiated NET (G1-G2, mitoses: ≤20, Ki-67: ≤20%) was prospectively collected and retrospectively analysed...
November 24, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27902672/essential-content-for-discharge-instructions-in-pediatric-emergency-care-a-delphi-study
#12
Janet A Curran, Andrea Murphy, Emma Burns, Amy Plint, Monica Taljaard, Shannon MacPhee, Eleanor Fitzpatrick, Andrea Bishop, Jill Chorney, Megan Bourque
OBJECTIVE: The aim of this study was to identify the 5 most essential discharge instruction content elements that should be communicated to all caregivers of children who present to the emergency department (ED) with asthma, vomiting/diarrhea, abdominal pain, fever, minor head injury, or bronchiolitis. METHODS: A discharge information content list was developed for each illness presentation following a review of the literature. Using a modified Delphi technique, 6 lists were distributed to a panel of experts from EDs across Canada using a secure online survey tool with the goal of achieving the 5 most essential discharge instruction elements...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27834066/fecal-calprotectin-level-reflects-the-severity-of-clostridium-difficile-infection
#13
Jieun Kim, Heejung Kim, Hyun Ju Oh, Hyung Sun Kim, Youn Jee Hwang, Dongeun Yong, Seok Hoon Jeong, Kyungwon Lee
Clostridium difficile is a significant nosocomial and community-acquired pathogen, and is the leading cause of antibiotic-induced diarrhea associated with high morbidity and mortality. Given that the treatment outcome depends on the severity of C. difficile infection (CDI), we aimed to establish an efficient method of assessing severity, and focused on the stool biomarker fecal calprotectin (FC). FC directly reflects the intestinal inflammation status of a patient, and can aid in interpreting the current guidelines, which requires the integration of indirect laboratory parameters...
January 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/27816564/community-health-workers-provide-integrated-community-case-management-using-malaria-rapid-diagnostic-test-kits
#14
Bright C Orji, Namratha Rao, Elizabeth Thompson, William R Brieger, Emmanuel 'Dipo Otolorin
BACKGROUND: Throughout Nigeria malaria is an endemic disease. Efforts to treat malaria can also be combined with other illnesses including pneumonia and diarrhea, which are killing children under five years of age. The use of Rapid Diagnostic Test (RDT) aids early diagnosis of malaria and informs when other illnesses should be considered. Those with positive RDT results should be treated with Artemisinin-based Combination Therapy (ACTs), while those with negative RDTs results are further investigated for pneumonia and diarrhea...
October 26, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27790616/a-comprehensive-comparison-of-the-efficacy-and-tolerability-of-racecadotril-with-other-treatments-of-acute-diarrhea-in-adults
#15
REVIEW
Wolfgang Fischbach, Viola Andresen, Marion Eberlin, Tobias Mueck, Peter Layer
Racecadotril is a guideline-recommended treatment to alleviate symptoms of acute diarrhea. A systematic review of randomized studies was performed comparing efficacy and safety of treatment with racecadotril to that with placebo or active treatments in adults. In five double-blind studies, racecadotril and placebo had comparable tolerability, but racecadotril was more effective. This was consistent across multiple efficacy parameters including duration of diarrhea, number of diarrheic stools, abdominal pain, and meteorism; it was also consistent across countries in Africa, Asia, and Europe...
2016: Frontiers in Medicine
https://www.readbyqxmd.com/read/27747018/efficiency-and-safety-of-roflumilast-combined-with-long-acting-bronchodilators-on-moderate-to-severe-stable-chronic-obstructive-pulmonary-disease-patients-a-meta-analysis
#16
Peng Luo, Shuo Li, Yitai Chen, Yuwen Luo, Yun Li, Kai Wang, Yuxia Huang, Xin Chen
BACKGROUND: Roflumilast, a phosphodiesterase-4 inhibitor recommended by clinical guideline, is always being used in combination with at least one long-acting bronchodilator in patients with stable chronic obstructive pulmonary disease (COPD). However, there are few evidences about whether the combination of roflumilast and long-acting bronchodilators is safer and more effective in patients with moderate-to-very severe stable COPD. In our study, we investigate the effect and safety of roflumilast combined with long-acting bronchodilators on moderate-to-severe stable COPD patients...
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27725652/a-randomized-controlled-trial-comparing-the-low-fodmap-diet-vs-modified-nice-guidelines-in-us-adults-with-ibs-d
#17
Shanti L Eswaran, William D Chey, Theresa Han-Markey, Sarah Ball, Kenya Jackson
OBJECTIVES: There has been an increasing interest in the role of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) in irritable bowel syndrome (IBS). We report results from the first randomized controlled trial of the low FODMAP diet in US adults with IBS and diarrhea (IBS-D). The objectives were to compare the efficacy of the low FODMAP diet vs. a diet based upon modified National Institute for Health and Care Excellence guidelines (mNICE) on overall and individual symptoms in IBS-D patients...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27635209/role-of-enterotoxigenic-bacteroides-fragilis-in-children-less-than-5-years-of-age-with-diarrhea-in-tabriz-iran
#18
Mohammad Taghi Akhi, Sirus Jedari Seifi, Mohammad Asgharzadeh, Mohammad Ahangarzadeh Rezaee, Shahram Abdoli Oskuei, Tahereh Pirzadeh, Mohammad Yousef Memar, Naser Alizadeh, Hasan Seifi Yarijan Sofla
BACKGROUND: Diarrhea is the most frequent health problem among children in developing countries. Defining the etiology of acute diarrhea is critical to disease therapy and prevention. Some anaerobic bacteria such as Enterotoxigenic Bacteroides fragilis (ETBF) strains cause diarrheal disease by production of enterotoxin in children less than 5 years old. OBJECTIVES: This study aimed to evaluate the prevalence of ETBF among common bacteria and viruses causing diarrhea in children aged less than five years...
June 2016: Jundishapur Journal of Microbiology
https://www.readbyqxmd.com/read/27601525/effectiveness-of-membrane-filtration-to-improve-drinking-water-a-quasi-experimental-study-from-rural-southern-india
#19
Mark Rohit Francis, Rajiv Sarkar, Sheela Roy, Shabbar Jaffar, Venkata Raghava Mohan, Gagandeep Kang, Vinohar Balraj
Since point-of-use methods of water filtration have shown limited acceptance in Vellore, southern India, this study evaluated the effectiveness of decentralized membrane filtration 1) with safe storage, 2) without safe storage, versus 3) no intervention, consisting of central chlorination as per government guidelines, in improving the microbiological quality of drinking water and preventing childhood diarrhea. Periodic testing of water sources, pre-/postfiltration samples, and household water, and a biweekly follow up of children less than 2 years of age was done for 1 year...
September 6, 2016: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27592311/safety-evaluation-acute-and-sub-acute-studies-of-the-aqueous-extract-of-the-leaves-of-myrianthus-arboreus-p-beauv-cecropiaceae-in-wistar-rats
#20
Charline Florence Awounfack, Sylvin Benjamin Ateba, Stéphane Zingue, Oumarou Riepouo Mouchili, Dieudonné Njamen
ETHNOPHARMACOLOGICAL RELEVANCE: Myrianthus arboreus P. Beauv (Cecropiaceae) is a medicinal plant distributed in forests and damp places of tropical Africa. Its leaves are widely used as food and/or for the treatment of various ailments including dysmenorrhoea, female infertility, tumors and diarrhea. However, to the best of our knowledge, no safety assessment of this plant has been reported yet. AIM OF STUDY: The present study aimed at evaluating the safety of the aqueous extract of leaves of Myrianthus arboreus (MAA) in Wistar rats through an acute and sub-acute oral administration...
December 24, 2016: Journal of Ethnopharmacology
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