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Persistent Diarrhea

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https://www.readbyqxmd.com/read/30099108/functional-gastrointestinal-symptoms-in-patients-with-inflammatory-bowel-disease-a-clinical-challenge
#1
REVIEW
Jean-Frederic Colombel, Andrea Shin, Peter R Gibson
DESCRIPTION: The purpose of this clinical practice update review is to describe key principles in the diagnosis and management of functional gastrointestinal (GI) symptoms in patients with inflammatory bowel disease (IBD). METHODS: The evidence and best practices summarized in this manuscript are based on relevant scientific publications, systematic reviews, and expert opinion where applicable. BEST PRACTICE ADVICE 1: A stepwise approach to rule-out ongoing inflammatory activity should be followed in IBD patients with persistent GI symptoms (measurement of fecal calprotectin, endoscopy with biopsy, cross-sectional imaging)...
August 9, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/30089172/clostridium-difficile-exosporium-cysteine-rich-proteins-are-essential-for-the-morphogenesis-of-the-exosporium-layer-spore-resistance-and-affect-c-difficile-pathogenesis
#2
Paulina Calderón-Romero, Pablo Castro-Córdova, Rodrigo Reyes-Ramírez, Mauro Milano-Céspedes, Enzo Guerrero-Araya, Marjorie Pizarro-Guajardo, Valeria Olguín-Araneda, Fernando Gil, Daniel Paredes-Sabja
Clostridium difficile is a Gram-positive spore-former bacterium and the leading cause of nosocomial antibiotic-associated diarrhea that can culminate in fatal colitis. During the infection, C. difficile produces metabolically dormant spores, which persist in the host and can cause recurrence of the infection. The surface of C. difficile spores seems to be the key in spore-host interactions and persistence. The proteome of the outermost exosporium layer of C. difficile spores has been determined, identifying two cysteine-rich exosporium proteins, CdeC and CdeM...
August 8, 2018: PLoS Pathogens
https://www.readbyqxmd.com/read/30083554/phenytoin-and-rifampin-do-not-decrease-levels-in-acute-tacrolimus-toxicity
#3
Benjamin O Lawson, Heemesh Seth, Dan Quan
Tacrolimus is used in bone marrow transplant patients to prevent graft-versus-host disease. There have been few case reports of tacrolimus toxicity (>30 ng/mL) in solid organ recipients as well as in nontransplant patients. Several case reports suggest phenytoin and rifampin decrease tacrolimus levels in toxicity, but does it actually make a difference? A 60-year-old man with acute myeloblastic leukemia after allogenic stem cell transplant with fever, diarrhea, and abdominal pain was transferred to the intensive care unit for persistent hypotension and acute hypoxic respiratory failure requiring intubation...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/30057833/an-unusual-case-of-ototoxicity-with-use-of-oral-vancomycin
#4
Umut Gomceli, Srija Vangala, Cosmina Zeana, Paul J Kelly, Manisha Singh
Introduction: Systemic absorption of oral vancomycin is poor due to the size of the molecule and its pharmacokinetics. It has an elimination half life of 5-11 hours in patients with normal renal function. We present a rare case of ototoxicity after oral vancomycin administration and detectable serum vancomycin levels 24 hours after cessation of vancomycin. Case Presentation: A 42-year-old woman with a history of hypertension, diabetes mellitus, and previously treated Clostridium difficile colitis presented with abdominal pain and diarrhea for two weeks...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/30050362/protein-losing-enteropathy-and-joint-contractures-caused-by-a-novel-homozygous-antxr2-mutation
#5
Edith Schussler, Rita V Linkner, Jacob Levitt, Lakshmi Mehta, John A Martignetti, Kimihiko Oishi
Infantile systemic hyalinosis (ISH) is a rare autosomal recessive disorder and an allelic form of hyaline fibromatosis syndrome that is caused by mutations in the ANTRX2 gene encoding the transmembrane anthrax toxin receptor 2. Its main features include characteristic skin lesions, joint contractures, persistent diarrhea, and failure to thrive due to accumulation of hyaline material in multiple organs. The resulting severe malnutrition can cause death in early infancy. Because of its rarity and high fatality rate, timely diagnosis is difficult and ISH may be underdiagnosed...
2018: Advances in Genomics and Genetics
https://www.readbyqxmd.com/read/30050286/adverse-drug-events-affecting-medication-persistence-with-rivastigmine-patch-application
#6
Takashi Osada, Norio Watanabe, Naomitsu Asano, Yuzo Adachi, Keiko Yamamura
Purpose: The rivastigmine transdermal patch, the only existing cholinesterase inhibitor available as a transdermal delivery system for treating Alzheimer's disease, has been reported to inhibit progression of cognitive impairment and impairment in activities of daily living, in addition to reducing care burden and improving adherence. However, application of the rivastigmine patch also frequently results in erythema, pruritus, contact dermatitis, and other cutaneous adverse events at the application site, making it difficult to increase the effective dose and continue treatment...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/30043130/pattern-of-use-and-long-term-safety-of-tyrosine-kinase-inhibitors-a-decade-of-real-world-management-of-chronic-myeloid-leukemia
#7
Alessandra Bettiol, Ettore Marconi, Niccolò Lombardi, Giada Crescioli, Filippo Gherlinzoni, Thomas Walley, Alfredo Vannacci, Alessandro Chinellato, Pietro Giusti
BACKGROUND AND OBJECTIVES: First-line treatment of chronic phase (CP) chronic myeloid leukemia (CML) is based on the first-generation tyrosine kinase inhibitor (TKI) imatinib or the second-generation TKIs dasatinib or nilotinib. Thanks to the efficacy of TKIs, CML has switched from a fatal to a 'chronic' pathology, and data from clinical trials have become insufficient to drive physicians' prescription choices and address long-term treatment outcomes. On the brink of commercialization of generic imatinib, this study aims to evaluate the therapeutic pattern of CP-CML and the occurrence of adverse events (AEs) over a decade of local real clinical practice...
July 24, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/30038854/short-and-long-term-effects-of-a-synbiotic-on-clinical-signs-the-fecal-microbiome-and-metabolomic-profiles-in-healthy-research-cats-receiving-clindamycin-a-randomized-controlled-trial
#8
Jacqueline C Whittemore, Jennifer E Stokes, Nicole L Laia, Joshua M Price, Jan S Suchodolski
Background: Antibiotic-associated gastrointestinal signs (AAGS) occur commonly in cats. Co-administration of synbiotics is associated with decreased AAGS in people, potentially due to stabilization of the fecal microbiome and metabolome. The purpose of this double-blinded randomized-controlled trial was to compare AAGS and the fecal microbiome and metabolome between healthy cats that received clindamycin with a placebo or synbiotic. Methods: 16 healthy domestic shorthair cats from a research colony were randomized to receive 150 mg clindamycin with either a placebo (eight cats) or commercially-available synbiotic (eight cats) once daily for 21 days with reevaluation 603 days thereafter...
2018: PeerJ
https://www.readbyqxmd.com/read/30038780/extended-spectrum-%C3%AE-lactamase-prevalence-and-virulence-factor-characterization-of-enterotoxigenic-escherichia-coli-responsible-for-acute-diarrhea-in-nepal-from-2001-to-2016
#9
Katie R Margulieux, Apichai Srijan, Sirigade Ruekit, Panida Nobthai, Kamonporn Poramathikul, Prativa Pandey, Oralak Serichantalergs, Sanjaya K Shrestha, Ladaporn Bodhidatta, Brett E Swierczewski
Background: Multidrug-resistant (MDR) Gram-negative bacterial species are an increasingly dangerous public health threat, and are now endemic in many areas of South Asia. However, there are a lack of comprehensive data from many countries in this region determining historic and current MDR prevalence. Enterotoxigenic Escherichia coli (ETEC) is a leading cause of both acute infant diarrhea and traveler's diarrhea in Nepal. The MDR prevalence and associated resistance mechanisms of ETEC isolates responsible for enteric infections in Nepal are largely unknown...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/30038209/dengue-cerebellitis-a-case-report-and-literature-review
#10
Ching Soong Khoo
BACKGROUND Dengue-associated neurological manifestations have recently been on the rise. Cerebellar syndrome complicating dengue fever has rarely been reported in the literature. We present a case report of dengue-associated cerebellar syndrome and performed a literature review to draw attention to this rare neurological complication. CASE REPORT A 60-year-old man presented with 4 days of fever, myalgia, arthralgia, headaches, and warning symptoms (persistent diarrhea and vomiting). He was admitted with serologically-confirmed dengue fever...
July 24, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/30020001/comparison-of-complication-rates-following-elective-arthroscopy-performed-as-inpatient-versus-outpatient-surgery-in-horses
#11
Erica J Secor, Santiago D Gutierrez-Nibeyro, Stuart C Clark-Price
OBJECTIVE To report complication rates following elective arthroscopy in horses and determine whether postoperative complication rates are higher for outpatient procedures, compared with inpatient procedures. DESIGN Retrospective cohort study. ANIMALS 357 client-owned horses that had undergone 366 elective arthroscopic procedures between January 2008 and February 2015. PROCEDURES Medical records were retrospectively reviewed. Data collected included signalment, travel time to the hospital, clinical signs, joints treated, lesions diagnosed, medications administered, anesthesia and surgery times, details of the procedure (including closure method and surgeons involved), and hospitalization status (inpatient or outpatient)...
August 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/30015703/chikungunya-on-kidney-transplant-recipients-is-it-the-same
#12
Bruno M Tavares, Paula Fcbc Fernandes, Cláudia Maria C Oliveira, Sônia L Silva, Márcia U Mota, Tacilla Hs Andrade, Samuel F Cunha, Evelyne S Girão
BACKGROUND: Chikungunya virus (CHIKV) infection is an acute febrile illness with polyarthralgia and arthritis. There are few data about CHIKV infection in kidney transplant recipients (KTR). We report the largest case series of CHIKV infection in this population. METHODS: We retrospectively analyzed 32 cases of CHIKV infection in KTR between January 2016 and December 2017 at Hospital Universitário Walter Cantídio of Federal University of Ceará. RESULTS: All patients had been in endemic area before the beginning of the symptoms...
July 13, 2018: Transplantation
https://www.readbyqxmd.com/read/30013741/role-of-biopsy-in-diagnosis-and-treatment-of-adult-celiac-disease
#13
REVIEW
Hugh James Freeman
Celiac disease (CD) is an immune-mediated enteropathy that characteristically responds to treatment with a gluten-free diet. In most, clinical features improve with resolution of diarrhea and weight loss. Serological studies also tend to normalize. Small intestinal biopsies from the duodenum reveal a severe to moderately severe architectural disturbance showing crypt epithelial hyperplasia with increased numbers of epithelial cell mitotic figures along with villous "flattening", increased numbers of lamina propria plasma cells and lymphocytes and increased numbers of intra-epithelial lymphocytes in untreated disease...
2018: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/30001340/clinical-environmental-and-behavioral-characteristics-associated-with-cryptosporidium-infection-among-children-with-moderate-to-severe-diarrhea-in-rural-western-kenya-2008-2012-the-global-enteric-multicenter-study-gems
#14
Miranda J Delahoy, Richard Omore, Tracy L Ayers, Katharine A Schilling, Anna J Blackstock, J Benjamin Ochieng, Feny Moke, Peter Jaron, Alex Awuor, Caleb Okonji, Jane Juma, Tamer H Farag, Dilruba Nasrin, Sandra Panchalingam, James P Nataro, Karen L Kotloff, Myron M Levine, Joseph Oundo, Dawn M Roellig, Lihua Xiao, Michele B Parsons, Kayla Laserson, Eric D Mintz, Robert F Breiman, Ciara E O'Reilly
BACKGROUND: Cryptosporidium is a leading cause of moderate-to-severe diarrhea (MSD) in young children in Africa. We examined factors associated with Cryptosporidium infection in MSD cases enrolled at the rural western Kenya Global Enteric Multicenter Study (GEMS) site from 2008-2012. METHODOLOGY/PRINCIPAL FINDINGS: At health facility enrollment, stool samples were tested for enteric pathogens and data on clinical, environmental, and behavioral characteristics collected...
July 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29998055/dysphonia-and-dyspnea-in-idiopathic-hypereosinophilic-syndrome-treated-with-mepolizumab
#15
Dana Kay, Ali Ataya, Xiuli Liu, Jena Auerbach, Dan Urbine
Hypereosinophilic syndrome (HES) is characterized by a persistently elevated eosinophil count associated with eosinophil-related end-organ damage and thromboembolic events, in the absence of an identifiable cause. We present a case of idiopathic HES with evidence of peripheral and tissue eosinophilia while on high dose prednisone, associated with muscle tension dysphonia, colitis, and jackhammer esophagus. The patient was treated with the interleukin-5 inhibitor, Mepolizumab, with resolution of symptoms including dyspnea, diarrhea and dysphonia...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29997755/a-survey-of-the-frequency-of-cytomegalovirus-associated-diarrhea-in-immunocompromised-patients-using-a-non-invasive-method
#16
Mahmoud Agholi, Akbar Safaei, Mani Ramzi, Gholam Reza Hatam, Jamal Sarvari
Background and Objectives: Cytomegalovirus (CMV) infection is the most common viral opportunistic infection causing gastrointestinal diseases such diarrhea and colitis in immunocompromised patients. The development and performance of a robust and sensitive PCR assay are usually evaluated to detect CMV DNA in human fecal specimens. In this study, our aim was to detect CMV DNA in stool samples taken from patients with HIV/AIDS, cancer, and transplant recipient patients with chronic and persistent diarrhea using a non-invasive method...
April 2018: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/29991893/eosinophilic-gastrointestinal-disorder-is-it-what-it-seems-to-be
#17
Stefania Chetcuti Zammit, Monique Cachia, Karen Sapiano, Julia Gauci, Stephen Montefort, Pierre Ellul
Background: Eosinophilic gastroenteropathy is an uncommon condition whose causes can be numerous and non-specific. The aim of the study was to characterize the presence of gastrointestinal disorders in the adult Maltese population and assess the degree of association with atopic diseases. Methods: Adult patients with gastrointestinal eosinophilia in the gastrointestinal tract on histology were identified and their clinical case notes were reviewed. Patients were interviewed and asked questions regarding asthma, allergic rhinitis, and eczema...
July 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29970024/antibiotic-resistance-and-molecular-characterization-of-the-hydrogen-sulfide-negative-phenotype-among-diverse-salmonella-serovars-in-china
#18
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
https://www.readbyqxmd.com/read/29930899/laboratory-diagnosis-of-cryptosporidiosis
#19
REVIEW
Sumeeta Khurana, Preeti Chaudhary
Cryptosporidiosis is a major etiology of persistent and chronic diarrhea in children and immunocompromised patients. In addition, it is also one of the important pathogens causing zoonotic or waterborne outbreaks. A number of conventional and molecular tests are available, but each test is riddled with few limitations. Further, there is a need to develop point of care tests and multiplexed tests for simultaneous detection of multiple pathogens.
January 2018: Tropical Parasitology
https://www.readbyqxmd.com/read/29905160/-the-significance-of-cryptosporidiosis-for-the-health-of-calves-in-switzerland
#20
P Olias, I Dettwiler, A Hemphill, P Deplazes, A Steiner, M Meylan
Diarrhea in calves is one of the most important cattle diseases in Switzerland. The diagnosis and treatment of calf diarrhea represent a major challenge. Single-celled Cryptosporidium parasites are the most prevalent causative agents of calf diarrhea besides rotavirus in the first weeks of life, and are responsible for about 50% of diarrheal cases. Cryptosporidium parvum has been described as a cause of diarrhea in one to three weeks old calves since the 1970s. Oral ingestion of persistent environmental oocysts results in severe diarrhea lasting four to six days and shedding of large numbers of infectious oocysts...
June 2018: Schweizer Archiv Für Tierheilkunde
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