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Persistent Diarrhea

Nhan T Ho, Fan Li, Kathleen A Lee-Sarwar, Hein M Tun, Bryan P Brown, Pia S Pannaraj, Jeffrey M Bender, Meghan B Azad, Amanda L Thompson, Scott T Weiss, M Andrea Azcarate-Peril, Augusto A Litonjua, Anita L Kozyrskyj, Heather B Jaspan, Grace M Aldrovandi, Louise Kuhn
Previous studies on the differences in gut microbiota between exclusively breastfed (EBF) and non-EBF infants have provided highly variable results. Here we perform a meta-analysis of seven microbiome studies (1825 stool samples from 684 infants) to compare the gut microbiota of non-EBF and EBF infants across populations. In the first 6 months of life, gut bacterial diversity, microbiota age, relative abundances of Bacteroidetes and Firmicutes, and predicted microbial pathways related to carbohydrate metabolism are consistently higher in non-EBF than in EBF infants, whereas relative abundances of pathways related to lipid metabolism, vitamin metabolism, and detoxification are lower...
October 9, 2018: Nature Communications
Kaihui Zhang, Yan Huang, Zhongtao Gai, Yi Liu
OBJECTIVE: To delineate the clinical and genetic characteristics of a girl featuring motor retardation, language retardation and regression, and light persisting diarrhea. METHODS: The patient was clinically examined and tested by tandem mass spectrometry and next generation sequencing. RESULTS: The proband could not stand and walk alone, and had light persisting diarrhea. She manifested language development retardation and regression. Laboratory tests were all normal, but the screening of metabolic disorders for urine and blood showed deficiency of short chain coenzyme A dehydrogenase due to elevated ethylmalonic acid and butyryl carnitine...
October 10, 2018: Zhonghua Yi Xue Yi Chuan Xue za Zhi, Zhonghua Yixue Yichuanxue Zazhi, Chinese Journal of Medical Genetics
Mauricio A Navarro, Jihong Li, Bruce A McClane, Eleonora Morrell, Juliann Beingesser, Francisco A Uzal
Clostridium perfringens type F (formerly enterotoxigenic C. perfringens type A) strains produce an enterotoxin (CPE) to cause acute cases of food poisoning and chronic nonfoodborne human gastrointestinal diseases (NFD), e.g. antibiotic-associated diarrhea (AAD). NFD strains produce NanI sialidase, an extracellular enzyme that releases sialic acids from sialyated host macromolecules. Recent in vitro studies suggested that NanI may contribute to NFD strain intestinal colonization by enhancing their adherence to intestinal cells and promoting their bacterial growth using generated sialic acid as an energy source...
October 8, 2018: Infection and Immunity
Katia Fettucciari, Lara Macchioni, Magdalena Davidescu, Paolo Scarpelli, Camilla Palumbo, Lanfranco Corazzi, Andrea Marchegiani, Matteo Cerquetella, Andrea Spaterna, Pierfrancesco Marconi, Gabrio Bassotti
Clostridium difficile infection (CDI) causes nosocomial/antibiotic-associated diarrhea and pseudomembranous colitis, with dramatic incidence/mortality worldwide. C. difficile virulence factors are toxin A and toxin B (TcdB) which cause cytopathic/cytotoxic effects and inflammation. Until now studies were focused on molecular effects of C. difficile toxins (Tcds) on different cells while unexplored aspect is the status/fate of cells that survived their cytotoxicity. Recently we demonstrated that enteric glial cells (EGCs) are susceptible to TcdB cytotoxicity, but several EGCs survived and were irreversibly cell-cycle arrested and metabolically active, suggesting that EGCs could became senescent...
October 6, 2018: Biochimica et biophysica acta. Molecular cell research
F P Wang, X Ma, D Zhu, Y Z Gong, H J Ning, X M Zhong
Objective: To analyze the clinical features and interleukin-10 receptor gene mutations in six infants with very early onset inflammatory bowel disease (VEO-IBD). Methods: Four girls and two boys with VEO-IBD admitted to Children's Hospital Affiliated to Capital Institute of Pediatrics from June 2016 to September 2017 were reviewed. The clinical data including general condition, clinical symptoms, laboratory tests, and colonoscopy and pathological results were collected and analyzed. Interleukin-10 receptor α subunit (IL-10RA) gene was examined in all patients...
October 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Mayuko Hida, Takatoshi Anno, Fumiko Kawasaki, Hideaki Kaneto, Kohei Kaku, Niro Okimoto
BACKGROUND: Pyosalpinx, which is one of the pelvic inflammatory diseases, is usually observed in young women; it is rarely found in older women. Possible causative agents are thought to be Chlamydia trachomatis and Neisseria gonorrhea in addition to some Enterobacteriaceae. On the other hand, type 2 diabetes is a disease with a lot of complications such as hyperglycemia, inflammation, and immune disorders. Therefore, patients with type 2 diabetes mellitus have an increased susceptibility to infection especially when glycemic control is poor...
October 6, 2018: Journal of Medical Case Reports
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
Sami Akbulut, Cemalettin Koc, Abuzer Dirican
Gardner's syndrome (GS) is a rare syndrome with autosomal dominant inheritance, which is characterized by multiple intestinal polyps, dental anomalies, desmoid tumors, and soft tissue tumors. All gastrointestinal symptoms seen in GS are associated with the underlying familial adenomatosis polyposis and abdominal desmoid tumors, with the most common symptoms being anemia, lower gastrointestinal bleeding, abdominal pain, diarrhea, obstruction, and mucous defecation. To our best knowledge, no case of GS that has presented with gastrointestinal perforation and bleeding has ever been reported in the English language medical literature...
September 26, 2018: World Journal of Clinical Cases
Yamuna T Krishna, Kristine L Griffin, Robert L Gates
Biliary dyskinesia (BD) is a motility disorder of the gallbladder that can result in right upper quadrant (RUQ) pain, nausea, vomiting, and diarrhea. Cholecystectomy is considered the standard of care for BD. Up to 23 per cent of pediatric patients who undergo surgery for BD have persistent symptoms postoperatively. We performed a retrospective review to identify preoperative factors significantly associated with symptom resolution after cholecystectomy. We retrospectively reviewed pediatric patients aged 10-17 years diagnosed with BD who underwent cholecystectomy between 2006 and 2016...
September 1, 2018: American Surgeon
Corinna Pietsch, Nora Ennuschat, Sabine Härtel, Uwe G Liebert
BACKGROUND: Noroviruses are a leading cause of acute gastroenteritis in all age groups. They generally cause a rapidly self-limiting illness. However, chronic norovirus diarrheal disease occurs in immunocompromised individuals, and is accompanied by persistent shedding of infectious norovirus in stool. OBJECTIVES: The study aims to characterize a novel GII.P26-GII.26 norovirus strain. Furthermore, it analyses viral mutations arising during chronic infection of an immunocompromised host...
September 19, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Buyi Zhang, Meghan L Verne, Jeremy Z Fields, G Nicholas Verne, QiQi Zhou
BACKGROUND: Well over 700,000 United States military personnel participated in the Persian Gulf War in which they developed chronic health disorders of undetermined etiology. Up to 25% of Veterans had persistent and chronic gastrointestinal (GI) symptoms, which they suspected were related to their military service in the Gulf. AIM: The overall aim of the current study was to evaluate intestinal permeability in previously deployed Gulf War Veterans who developed chronic GI symptoms during their tour in the Persian Gulf...
September 26, 2018: Journal of Clinical Gastroenterology
Vassilis Filiopoulos, Stratigoula Sakellariou, Konstantinos Papaxoinis, Christina Melexopoulou, Smaragdi Marinaki, John N Boletis, Ioanna Delladetsima
Background: Although colonic injury is a well-known complication of mycophenolic acid (MPA), the involvement of the upper gastrointestinal tract is less extensively documented. We present the occurrence of celiac-like duodenopathy manifested as a severe diarrhea syndrome in 2 renal transplant recipients on enteric-coated mycophenolate sodium. Methods: The patients belong to a setting of 16 renal transplant recipients under MPA suffering from chronic diarrhea in the absence of MPA-related colitis...
August 2018: Transplantation Direct
Lixia Sheng, Huarui Fu, Yamin Tan, Yongxian Hu, Qitian Mu, Yi Luo, Jianmin Shi, Zhen Cai, Guifang Ouyang, He Huang
RATIONALE: Basiliximab and etanercept have achieved promising responses in steroid-refractory graft versus host disease (SR-GVHD). However, the in vivo immune changes following the treatment have not been elucidated. PATIENT CONCERNS: A 14-year-old boy presented with skin rash and diarrhea 20 days after haploidentical hemotopoietic stem cell transplantation. DIAGNOSES: We made the diagnose of grade 3 acute GVHD with skin and gastrointestinal involvement...
September 2018: Medicine (Baltimore)
Tjede Funk, Karin Källander, Ayalkibet Abebe, Abreham Hailemariam, Helle Mölsted Alvesson, Tobias Alfvén
Different health-care management guidelines by the World Health Organization exist to help health workers in resource-limited settings treat patients. However, for children with unclassified fever and no danger signs, management guidelines are less clear and follow-up recommendations differ. Both "universal follow-up" for all children, irrespective of health status, and "conditional follow-up" only for children whose fever persists are recommended in different guidelines. It is unclear how feasible and acceptable these two different guidelines are among community health workers and caregivers of the sick child...
September 17, 2018: American Journal of Tropical Medicine and Hygiene
Matheus N Weber, Samuel P Cibulski, Simone Silveira, Franciele M Siqueira, Ana Cristina S Mósena, Mariana S da Silva, Juliana C Olegário, Ana Paula M Varela, Thaís F Teixeira, Matheus V Bianchi, David Driemeier, Saulo P Pavarini, Fabiana Q Mayer, Paulo M Roehe, Cláudio W Canal
Bovine viral diarrhea virus 1, reclassified as Pestivirus A, causes an economically important cattle disease that is distributed worldwide. Pestivirus A may cause persistent infection in that calves excrete the virus throughout their lives, spreading the infection in the herd. Many persistently infected (PI) calves die in the first 2 years of life from mucosal disease (MD) or secondary infections, probably as a consequence of virus-induced immune depression. Here, high-throughput sequencing (HTS) was applied for evaluation of the total virome in sera of (i) PI calves displaying clinically apparent MD (n = 8); (ii) PI calves with no signs of MD (n = 8); and (iii) control, Pestivirus A-free calves (n = 8)...
September 14, 2018: Virus Genes
Sangmin Lee, Junki Kim, Doo-Sung Cheon, Eun-A Moon, Dong Joo Seo, Soontag Jung, Hansaem Shin, Changsun Choi
A 3-month-old female Maltese puppy was hospitalized with persistent diarrhea in a local veterinary clinic. Blood chemistry and hematology profile were analyzed and fecal smear was examined. Diarrheal stools were examined in a diagnostic laboratory, using multiplex real-time polymerase chain reaction (PCR) against 23 diarrheal pathogens. Sequence analysis was performed using nested PCR amplicon of 18S ribosomal RNA. Coccidian oocysts were identified in the fecal smear. Although multiplex real-time PCR was positive for Cyclospora cayetanensis, the final diagnosis was Cystoisospora ohioensis infection, confirmed by phylogenetic analysis of 18S rRNA...
August 2018: Korean Journal of Parasitology
Nooreen Hussain, Faiz Hussain, Tulika Chatterjee, Jan N Upalakalin, Teresa Lynch
Enteropathy-associated T-cell lymphoma (EATL) is a rare disease found in the small bowel and is seen most commonly in patients with refractory celiac disease (RCD). We present a case of an elderly male with celiac disease (CD) diagnosed in childhood with months of abdominal pain and diarrhea despite attempting to avoid gluten in his diet. After persistent symptoms for months, the patient was admitted for an acute abdomen and was found to have small bowel perforation due to a jejunal mass that was diagnosed as an EATL...
2018: Journal of Community Hospital Internal Medicine Perspectives
Andrew M Evens, Ranjana H Advani, Irene B Helenowski, Michelle Fanale, Sonali M Smith, Borko D Jovanovic, Gregory R Bociek, Andreas K Klein, Jane N Winter, Leo I Gordon, Paul A Hamlin
Purpose To improve the curability of older patients with newly diagnosed Hodgkin lymphoma. Patients and Methods We conducted a multicenter phase II study that administered brentuximab vedotin (Bv) sequentially before and after standard doxorubicin, vinblastine, and dacarbazine (AVD) for untreated patients with Hodgkin lymphoma age 60 years or older. After two lead-in doses of single-agent Bv (1.8 mg/kg once every 3 weeks), patients received six cycles of AVD chemotherapy followed by four consolidative doses of Bv in responding patients...
September 4, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Lucia Carril-Ajuria, Elisabeth Jiménez-Aguilar, Carlos Gómez-Martín, Carmen Díaz-Pedroche
BACKGROUND: Immunotherapy treatment with immune-checkpoint blockade has become a new paradigm in cancer treatment. Despite its efficacy, it has also given rise to a new class of adverse events, immune-related adverse events, which may affect any organ, including the thyroid and the pituitary. CASE PRESENTATION: We present a case of a 77-year-old Caucasian man with metastatic renal cell carcinoma on immunotherapy treatment who was admitted to our hospital with a severe persistent headache of sudden onset...
September 4, 2018: Journal of Medical Case Reports
Rabab E El Hawary, Andrea A Mauracher, Safa S Meshaal, Alia Eldash, Dalia S Abd Elaziz, Radwa Alkady, Sohilla Lotfy, Lennart Opitz, Nermeen M Galal, Jeannette A Boutros, Jana Pachlopnik Schmid, Aisha M Elmarsafy
BACKGROUND: MHC class II deficiency leads to defective CD4+ T-cell function that results from impaired antigen presentation. A genetic disorder in 1 of 4 genes results in this syndrome that is associated with the clinical phenotype of combined immunodeficiency. OBJECTIVE: To describe the clinical, immunological, and molecular characteristics of 10 Egyptian patients from 9 different families having presented with MHC class II deficiency between 2012 and 2017. METHODS: An initial diagnosis based on the combination of clinical features and low HLA-DR expression by flow cytometry was confirmed by genetic analyses...
August 28, 2018: Journal of Allergy and Clinical Immunology in Practice
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