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https://www.readbyqxmd.com/read/28650734/clostridium-difficile-associated-colitis-post-transplant-is-not-associated-with-elevation-of-tacrolimus-concentrations
#1
Hugo J R Bonatti, Karim W Sadik, Elizabeth Krebs, Costi D Sifri, Timothy L Pruett, Robert G Sawyer
BACKGROUND: Diarrhea is a common condition after solid organ transplant (SOT); Clostridium difficile-associated colitis (CDAC) is one of the most common infections after SOT. We documented previously that some types of enteritis are associated with an elevation of tacrolimus (TAC) trough concentrations by interfering with the drug's complex metabolism. PATIENTS AND METHODS: Tacrolimus concentrations of 25 SOT recipients including 12 renal and 13 liver recipients before, during, and after CDAC were analyzed retrospectively...
June 26, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28625250/-fulminant-clostridium-difficile-colitis-new-challenges-in-critical-care-medicine
#2
Bin Liu
Fulminant Clostridium difficile colitis (FCDC) means severe Clostridium difficile colitis (CDC), which often manifested with severe diarrhea, fever, abdominal distention, electrolyte disorder, hypoalbuminemia, and it can lead to pseudo membrane colonitis, toxic megacolon, bowel perforation, septic shock, and multiple organ dysfunction. Now Clostridium difficile (CD) becomes one of the most important medical institutions related infectious pathogens. In particular, the recently discovered mutant CD strain NAP1/BI/ribotype 027 has high pathogenicity in the global epidemic and its outbreak...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28617889/erdheim-chester-disease-presenting-with-histiocytic-colitis-and-cytokine-storm
#3
George P Christophi, Yeshika Sharma, Quader Farhan, Umang Jain, Ted Walker, Gregory S Sayuc, Deborah C Rubin
BACKGROUND: Non-Langerhans histiocytosis is a group of inflammatory lymphoproliferative disorders originating from non-clonal expansion of hematopoietic stem cells into cytokine-secreting dendritic cells or macrophages. Erdheim-Chester Disease (ECD) is a rare type of non-Langerhans cell histiocytosis characterized by tissue inflammation and injury caused by macrophage infiltration and histologic findings of foamy histiocytes. Often ECD involves the skeleton, retroperitoneum and the orbits...
June 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28580210/immunosuppressive-medication-is-not-associated-with-surgical-site-infection-after-surgery-for-intractable-ulcerative-colitis-in-children
#4
Keiichi Uchida, Yoshikazu Ohtsuka, Atsushi Yoden, Hitoshi Tajiri, Hideaki Kimura, Takashi Isihige, Hiroyuki Yamada, Katsuhiro Arai, Takeshi Tomomasa, Kosuke Ushijima, Tomoki Aomatsu, Satoru Nagata, Kohei Otake, Kohei Matsushita, Mikihiro Inoue, Takahiro Kudo, Kenji Hosoi, Kazuo Takeuchi, Toshiaki Shimizu
Pediatric ulcerative colitis (UC) sometimes progresses to an intractable condition for medical therapy. The surgical management of UC is challenging because of difficult procedures and frequent infectious complications. The aim of this study was to survey surgical procedures and infectious complications in pediatric patients with UC in Japan and to assess the relationship between preoperatively administered immunosuppressive drugs and postoperative surgical site infection (SSI). A survey of pediatric patients treated from 2000 to 2012 was sent to 683 facilities nationwide...
May 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28566702/colitis-promotes-neuronal-differentiation-of-sox2-and-plp1-enteric-cells
#5
Jaime Belkind-Gerson, Hannah K Graham, Justin Reynolds, Ryo Hotta, Nandor Nagy, Lily Cheng, Michal Kamionek, Hai Ning Shi, Carol M Aherne, Allan M Goldstein
Mechanisms mediating adult enteric neurogenesis are largely unknown. Using inflammation-associated neurogenesis models and a transgenic approach, we aimed to understand the cell-source for new neurons in infectious and inflammatory colitis. Dextran sodium sulfate (DSS) and Citrobacter rodentium colitis (CC) was induced in adult mice and colonic neurons were quantified. Sox2GFP and PLP1GFP mice confirmed the cell-type specificity of these markers. Sox2CreER:YFP and PLP1creER:tdT mice were used to determine the fate of these cells after colitis...
May 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28511188/calprotectin-in-daily-practice-where-do-we-stand-in-2017
#6
Fabrizia D'Angelo, Christian Felley, Jean Louis Frossard
BACKGROUND: To make a distinction between organic and functional disease is essential for gastroenterologists in their daily practice, but it may be challenging, given the variety and aspecificity of gastrointestinal symptoms among the general population. The clinician aim is to avoid diagnostic delay and to restrict unnecessary invasive and expensive exams. SUMMARY: Faecal markers, in particular faecal calprotectin (FC), have given proof of being reliable markers of intestinal inflammation with good clinical sensitivity...
May 17, 2017: Digestion
https://www.readbyqxmd.com/read/28502929/multifocal-colonic-wall-abscesses-during-anti-tumor-necrosis-factor-tnf-%C3%AE-therapy-for-a-patient-with-ulcerative-colitis-a-very-rare-manifestation-of-infectious-complications
#7
Toshiro Fukui, Mio Takahashi, Takashi Okazaki, Takashi Tomiyama, Norimasa Fukata, Yugo Ando, Kazuichi Okazaki
A 24-year-old woman was transferred to our hospital under suspicion of an exacerbation of her known ulcerative colitis. Colonoscopy revealed an edematous swelling and multifocal discharge of pus throughout the descending colon, concurrent with active ulcerative colitis findings in the rectum and sigmoid colon. Computed tomography showed a thickened wall and multifocal abscesses within the wall of the descending colon. Two weeks after starting antimicrobial therapy, she was discharged home. This is the first case report of multifocal colonic wall abscesses...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28493071/nontraumatic-large-bowel-perforation-spectrum-of-etiologies-and-ct-findings
#8
REVIEW
Kunal Kothari, Barak Friedman, Gregory M Grimaldi, John J Hines
Large bowel perforation is an abdominal emergency that results from a wide range of etiologies. Computed tomography is the most reliable modality in detecting the site of large bowel perforation. The diagnosis is made by identifying direct CT findings such as extraluminal gas or contrast and discontinuity along the bowel wall. Indirect CT findings can help support the diagnosis, and include bowel wall thickening, pericolic fat stranding, abnormal bowel wall enhancement, abscess, and a feculent collection adjacent to the bowel...
May 10, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28458997/mesalamine-induced-eosinophilic-pneumonia
#9
Ankit Gupta, Swati Gulati
We present the case of a twenty two year old Caucasian male with ulcerative colitis on mesalamine who presented with dry cough, fever, malaise and dyspnea on exertion. He had peripheral eosinophilia and apical ground-glass opacities on computed tomography of the chest. He had no new exposures and his infectious workup was non diagnostic. Bronchoalveolar lavage showed eosinophilia raising the suspicion of mesalamine induced eosinophilic pneumonia. His symptoms improved after discontinuing mesalamine with a tapered dose of steroids...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28448580/sildenafil-normalizes-bowel-transit-in-preclinical-models-of-constipation
#10
Sarah K Sharman, Bianca N Islam, Yali Hou, Margaux Usry, Allison Bridges, Nagendra Singh, Subbaramiah Sridhar, Satish Rao, Darren D Browning
Guanylyl cyclase-C (GC-C) agonists increase cGMP levels in the intestinal epithelium to promote secretion. This process underlies the utility of exogenous GC-C agonists such as linaclotide for the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Because GC-C agonists have limited use in pediatric patients, there is a need for alternative cGMP-elevating agents that are effective in the intestine. The present study aimed to determine whether the PDE-5 inhibitor sildenafil has similar effects as linaclotide on preclinical models of constipation...
2017: PloS One
https://www.readbyqxmd.com/read/28427109/traveler-s-diarrhea-vision-abnormalities-and-unsteady-gait-in-a-young-woman
#11
Tobias Mühling, Felix Gundling, Thomas Helmberger, Wolfgang Schepp
We report on the course of disease in a young woman, originally admitted with suspected refractory infectious tropical traveler's diarrhea. However, symptoms did not resolve upon either symptomatic or subsequent antibiotic therapy. When neurologic deterioration was observed, imaging studies revealed a dramatic series of thromboembolic events, including intracranial hemorrhage caused by extensive sinus vein thrombosis as well as thrombi of the right cardiac ventricle. Colonic mucosal biopsy samples finally led to the histologic diagnosis of ulcerative colitis...
April 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28418397/bap180-baf180-is-required-to-maintain-homeostasis-of-intestinal-innate-immune-response-in-drosophila-and-mice
#12
Xiaomeng He, Junjing Yu, Min Wang, Yang Cheng, Yanan Han, Shuo Yang, Guizhi Shi, Lei Sun, Ying Fang, Si-Tang Gong, Zhong Wang, Yang-Xin Fu, Lei Pan, Hong Tang
Immune homeostasis is a prerequisite to protective immunity against gastrointestinal infections. In Drosophila, immune deficiency (IMD) signalling (tumour necrosis factor receptor/interleukin-1 receptor, TNFR/IL-1R in mammals) is indispensable for intestinal immunity against invading bacteria. However, how this local antimicrobial immune response contributes to inflammatory regulation remains poorly defined. Here, we show that flies lacking intestinal Bap180 (a subunit of the chromatin-remodelling switch/sucrose non-fermentable (SWI/SNF) complex) are susceptible to infection as a result of hyper-inflammation rather than bacterial overload...
April 18, 2017: Nature Microbiology
https://www.readbyqxmd.com/read/28407743/new-drugs-new-toxicities-severe-side-effects-of-modern-targeted-and-immunotherapy-of-cancer-and-their-management
#13
REVIEW
Frank Kroschinsky, Friedrich Stölzel, Simone von Bonin, Gernot Beutel, Matthias Kochanek, Michael Kiehl, Peter Schellongowski
Pharmacological and cellular treatment of cancer is changing dramatically with benefits for patient outcome and comfort, but also with new toxicity profiles. The majority of adverse events can be classified as mild or moderate, but severe and life-threatening complications requiring ICU admission also occur. This review will focus on pathophysiology, symptoms, and management of these events based on the available literature.While standard antineoplastic therapy is associated with immunosuppression and infections, some of the recent approaches induce overwhelming inflammation and autoimmunity...
April 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28401147/toxinotyping-and-sequencing-of-clostridium-difficile-isolates-from-patients-in-a-tertiary-care-hospital-of-northern-india
#14
Meenakshi Singh, Chetana Vaishnavi, Safrun Mahmood, Rakesh Kochhar
BACKGROUND: Clostridium difficile is an important cause of infectious colitis among hospitalized patients across the globe. The pathogenic potential of C. difficile in producing significant morbidity and mortality is mainly due to production of toxins A and B. The outbreaks of C. difficile infection (CDI) are due to changes in the genetic sequences of the organism. There is hardly any molecular study reported on the prevalent types of C. difficile strains in India. Toxinotyping and sequencing of locally circulating C...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28385287/mice-with-infectious-colitis-exhibit-linear-growth-failure-and-subsequent-catch-up-growth-related-to-systemic-inflammation-and-igf-1
#15
Mark D DeBoer, Vidhya Vijayakumar, Meiqing Gong, John L Fowlkes, Rachel M Smith, Fernando Ruiz-Perez, James P Nataro
In developing communities, intestinal infection is associated with poor weight gain and linear-growth failure. Prior translational animal models have focused on weight gain investigations into key contributors to linear growth failure have been lacking. We hypothesized that murine intestinal infection with Citrobacter rodentium would induce linear-growth failure associated with systemic inflammation and suppressed serum levels of insulin-like growth factor-1 (IGF-1). We evaluated 4 groups of mice infected or sham-infected on day-of-life 28: uninfected-controls, wild-type C rodentium-infected, partially-attenuated C rodentium-infected (with deletion of 3 serine protease genes involved in colonization), and pair-fed (given the amount of daily food consumed by the wild-type C rodentium group)...
March 2017: Nutrition Research
https://www.readbyqxmd.com/read/28380665/fcn-a-2-acting-as-a-new-regulator-of-macrophage-polarization-mediates-the-inflammatory-response-in-experimental-mouse-colitis
#16
Yi-Fei Yang, Yi-Dan Zhou, Jia-Chen Hu, Feng-Ling Luo, Yan Xie, Yan-Ying Shen, Wen-Xiu Bian, Zhi-Nan Yin, Hong-Liang Li, Xiao-Lian Zhang
Human ficolin-2 (FCN-2) and mouse ficolin-A (FCN-A, a ficolin-2-like molecule in mouse) are activators of the lectin complement pathway, present in normal plasma and usually associated with infectious diseases, but little is known about the role of FCN-A/2 in inflammatory bowel disease (IBD). In our present study, we found that IBD patients exhibited much higher serum FCN-2 levels than healthy controls. In the dextran sulfate sodium (DSS)-induced acute colitis mouse model, FCN-A knockout mice showed much milder disease symptoms with less histological damage, lower expression levels of pro-inflammatory cytokines (interleukin (IL)-6, IL-1β and tumor necrosis factor alpha (TNF-α)), chemokines (CXCL1/2/10 and CCL4) and higher levels of anti-inflammatory cytokine IL-10 compared to WT mice...
April 5, 2017: Immunology
https://www.readbyqxmd.com/read/28363097/gastrointestinal-emergencies-in-critically-ill-cancer-patients
#17
Delphine Lebon, Lucie Biard, Sophie Buyse, David Schnell, Etienne Lengliné, Camille Roussel, Jean-Marc Gornet, Nicolas Munoz-Bongrand, Laurent Quéro, Matthieu Resche-Rigon, Elie Azoulay, Emmanuel Canet
PURPOSE: To describe gastrointestinal emergencies in cancer patients. METHODS: All cancer patients admitted to the medical ICU of Saint-Louis Hospital for an acute abdominal syndrome during the study period (1997-2011) were included. RESULTS: A total of 164 patients were included. The most common diagnoses were: neutropenic enterocolitis (NE) (n=54, 33%), infectious colitis and peritonitis (n=51, 31%), bowel infiltration by malignancy (n=14, 9%), and mucosal toxicity of chemotherapy (n=12, 7%)...
March 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28361997/zinc-treatment-is-efficient-against-escherichia-coli-%C3%AE-haemolysin-induced-intestinal-leakage-in-mice
#18
Stephanie Wiegand, Silke S Zakrzewski, Miriam Eichner, Emanuel Schulz, Dorothee Günzel, Robert Pieper, Rita Rosenthal, Christian Barmeyer, André Bleich, Ulrich Dobrindt, Jörg-Dieter Schulzke, Roland Bücker
Zinc homoeostasis exerts protective effects in inflammatory intestinal diseases and zinc supplementation has been successfully used for treating infectious diarrhoea. This study aimed at a characterisation of zinc effects on focal leak induction by α-haemolysin (HlyA)-producing Escherichia coli (E. coli) as protective mechanism for colitis. We conducted in vivo experiments by oral challenge of gnotobiotic mice colonised with HlyA-expressing E. coli-536. Mice were either fed a defined normal or high zinc diet to analyse effects of zinc as a therapeutic regimen...
March 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28353200/asymptomatic-acute-hepatitis-e-in-a-female-patient-with-ulcerative-colitis
#19
Kazuyuki Suzuki, Ichiro Kumagai, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Ryoichi Kamiya, Kouryo Kondo, Akinobu Kato, Toshimi Chiba, Hiroaki Okamoto
We present a 60-year-old female patient with asymptomatic acute hepatitis E that was fortuitously detected during the course of ulcerative colitis (UC). She was admitted to hospital on October 30, 2015. Endoscopy and histological examination of the colon showed typical findings of UC. All parameters of liver function tests were normal on this date. Combination therapy with oral prednisolone and mesalazine was started and intravenous administration of infliximab once every 8 weeks was added later. Her symptoms gradually improved after these treatments, and she was discharged on February 7, 2016...
June 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28333760/antibiotic-associated-apoptotic-enterocolitis-in-the-absence-of-a-defined-pathogen-the-role-of-intestinal-microbiota-depletion
#20
Philipp Wurm, Walter Spindelboeck, Robert Krause, Johannes Plank, Gottfried Fuchs, Mina Bashir, Wolfgang Petritsch, Bettina Halwachs, Cord Langner, Christoph Högenauer, Gregor Gorkiewicz
OBJECTIVE: Antibiotic therapy is a major risk factor for the development of diarrhea and colitis with varying severity. Often the origin of antibiotic-associated gastrointestinal deterioration remains elusive and no specific infectious agents could be discerned. PATIENTS: We represent three cases of intractable high-volume diarrhea associated with combined antibiotic and steroid therapy in critically ill patients not fitting into established disease entities. Cases presented with severe apoptotic enterocolitis resembling acute intestinal graft-versus-host-disease...
June 2017: Critical Care Medicine
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