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Persistent Diarrhea

Xiao Hu, Wei Cao, Min Zhao
Vasoactive intestinal peptide-producing tumors (VIPoma) usually originate in the pancreas and are characterized by diarrhea, hypokalemia, and achlorhydria (WDHA syndrome). In adults, nonpancreatic VIPoma is very rare. Herein, we report an unusual case of VIP-producing pheochromocytoma marked by persistent shock, flushing, and watery diarrhea and high sensitivity to octreotide. A 53-year-old woman was hospitalized for sudden-onset hypertension with convulsions, which then rapidly evolved to persistent shock, flushing, and watery diarrhea...
November 26, 2018: World Journal of Clinical Cases
Takafumi Shima, Maiko Ozeki, Takashi Kinoshita, Kotaro Honda, Hitoshi Inoue, Shinsho Morita
RATIONALE: Nonocclusive mesenteric ischemia (NOMI) is a life-threatening disorder; prompt diagnosis is vital. Surgical treatment is often required, but some cases can be treated conservatively. We herein report an extremely rare case wherein protein-losing enteropathy (PLE) developed after conservative treatment of NOMI. PATIENT CONCERNS: The patient was a 66-year-old man. He underwent laparoscopic super low anterior resection and temporary ileostomy for sigmoid colon cancer and rectum cancer...
November 2018: Medicine (Baltimore)
Amandeep Kaur, Gabriëlla A M Ten Have, Bernadette Hritzo, Nicolaas E P Deutz, Cara Olsen, Maria Moroni
PURPOSE: Göttingen minipig (G-MP) displays classic gastrointestinal acute radiation syndrome (GI-ARS) following total body irradiation (TBI) at GI doses which are lethal by 10-14 days. In collaboration with BARDA, we are developing a hemi-body/partial body irradiation (PBI) model by exposing only the abdomen and lower extremities to study GI structure/function impairment, natural history of injury and recovery, as well as correlative biomarkers out to 30 days. MATERIALS AND METHODS: Twenty-four G-MP were exposed to either 12 or 16 Gy (LINAC Elekta); head, forelimbs, and thorax were outside the irradiation field, sparing ∼50% of the bone marrow...
November 26, 2018: International Journal of Radiation Biology
Nilima, Asha Kamath, Karthik Shetty, B Unnikrishnan, Siddharth Kaushik, Shesh N Rai
BACKGROUND: Spatial analysis has been vital in mapping the spread of diseases and assisting in policy making. Targeting diarrhea transmission hotspots is one of the potential strategies for reducing diarrhea cases. This study aimed to examine the spatial-temporal variations and to identify the modifiable determinants of diarrhea while controlling for the spatial dependence in the data. METHODS: An ecological study on diarrhea data from DLHS-3 and NFHS- 4 in India...
November 23, 2018: BMC Public Health
Xing-Jie Shen, Liang Liu, Jing-Yu Zhu
RATIONALE: Radiation enteritis (RE) is one of the serious complications caused by the radiotherapy and it can occur in any segment of the intestine, including small intestine, colon, and rectum. It can cause a number of serious problems of the intestine, such as chronic ulcers, bleeding, intestinal stenosis, intestinal fistula, and perforation. At present, there is no standard treatment guideline for the RE. PATIENT CONCERNS: A 54-year-old male patient received surgery and chemotherapy for rectal cancer and radiofrequency ablation (RFA) for a single metastatic carcinoma of the liver...
November 2018: Medicine (Baltimore)
Alina Kurolap, Orly Eshach Adiv, Tova Hershkovitz, Adi Tabib, Netanel Karbian, Tamar Paperna, Adi Mory, Arcadi Vachyan, Nadav Slijper, Ran Steinberg, Yaniv Zohar, Dror Mevorach, Hagit Baris Feldman
OBJECTIVES: Loss of the complement inhibitor CD55 leads to a syndrome of early-onset protein-losing enteropathy (PLE), associated with intestinal lymphangiectasia and susceptibility to large-vein thrombosis. The in vitro and short-term treatment benefits of eculizumab (C5-inhibitor) therapy for CD55-deficiency have been previously demonstrated. Here we present the 18-months treatment outcomes for 3 CD55-deficiency patients with sustained therapeutic response. METHODS: Three CD55-deficiency patients received off-label eculizumab treatment...
November 8, 2018: Journal of Pediatric Gastroenterology and Nutrition
S C Ring, D A Graham, M M Kelleher, M L Doherty, D P Berry
Genetic selection is an inexpensive and complementary strategy to traditional methods of improving animal health and welfare. Nonetheless, endeavors to incorporate animal health and welfare traits in international breeding programs have been hampered by the availability of informative phenotypes. The recent eradication program for bovine viral diarrhea (BVD) in the Republic of Ireland has provided an opportunity to quantify the potential benefits that genetic selection could offer BVD eradication programs elsewhere, as well as inform possible eradication programs for other diseases in the Republic of Ireland...
November 9, 2018: Journal of Animal Science
Svetlana Vakkilainen, Riikka Mäkitie, Paula Klemetti, Helena Valta, Mervi Taskinen, Eystein Sverre Husebye, Outi Mäkitie
Background: Mutations in RMRP , encoding a non-coding RNA molecule, underlie cartilage-hair hypoplasia (CHH), a syndromic immunodeficiency with multiple pathogenetic mechanisms and variable phenotype. Allergy and asthma have been reported in the CHH population and some patients suffer from autoimmune (AI) diseases. Objective: We explored AI and allergic manifestations in a large cohort of Finnish patients with CHH and correlated clinical features with laboratory parameters and autoantibodies. Methods: We collected clinical and laboratory data from patient interviews and hospital records...
2018: Frontiers in Immunology
Fernando Merwaiss, Cecilia Czibener, Diego E Alvarez
After initiation of an infective cycle, spread of virus infection can occur fundamentally in two different ways: (i) viral particles can be released into the external environment and diffuse through the extracellular space until they interact with a new host cell, or (ii) virions can remain associated with infected cells promoting the direct passage between infected and uninfected cells that is referred to as direct cell-to-cell transmission. Although evidence for cell-associated transmission has accumulated for many different viruses, the ability of members of the genus pestivirus to use this mode of transmission has not been reported...
November 7, 2018: Journal of Virology
Mauro Larghi
Bovine viral diarrhea virus (BVDV) is an important infectious agent affecting herd productivity and reproduction, and leading to massive economic losses. As such, BVD is the subject of a number of control and eradication schemes globally. The key elements of such schemes are: diagnosis and removal of persistently infected animals from herds; implementation of biosecurity practices aimed at preventing the introduction or re-introduction of BVDV in free herds; and ongoing surveillance to monitor the progress of the program and to detect new infections...
October 23, 2018: Animal Health Research Reviews
Giselle Volney, Michael Tatusov, Andy C Yen, Nune Karamyan
Naphthalene poisoning is a rare form of toxicity that may occur after ingestion, inhalation, or dermal exposure to naphthalene-containing compounds such as mothballs. Clinically, patients present with acute onset of dark brown urine, watery diarrhea, and non-bloody bilious vomiting 48-96 hours after exposure. Vital sign abnormalities include fever, tachycardia, hypotension, and persistent pulse oximetry readings of 84%-85% despite oxygen supplementation. Laboratory workup demonstrates hyperbilirubinemia with indirect predominance, hemolytic anemia, methemoglobinemia, and renal dysfunction...
August 15, 2018: Curēus
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 also 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 the adherence of such strains to intestinal cells and promoting their bacterial growth using generated sialic acid as an energy source...
December 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
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