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https://www.readbyqxmd.com/read/28511188/calprotectin-in-daily-practice-where-do-we-stand-in-2017
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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...
March 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28330075/a-novel-multiplex-pcr-method-for-the-detection-of-virulence-associated-genes-of-escherichia-coli-o157-h7-in-food
#16
Vo Van Giau, Thuy Trang Nguyen, Thi Kim Oanh Nguyen, Thi Thuy Hang Le, Tien Dung Nguyen
Shiga toxin-producing Escherichia coli O157:H7 (E. coli O157:H7) strains are foodborne infectious agents that cause a number of life-threatening diseases, including hemorrhagic colitis (HC) and hemolytic uremic syndrome (HUS). Shiga toxin 1 (stx1), shiga toxin 2 (stx2), or a combination of both are responsible for most clinical symptoms of these diseases. Hence, various diagnostic methods have been developed so far to detect shiga toxins such as cell culture, ELISA, Rapid Latex Agglutination (RPLA) and hybridization, but due to high costs and labor time in addition to low sensitivity, they have not received much attention...
June 2016: 3 Biotech
https://www.readbyqxmd.com/read/28326205/shigella-sonnei-bacteremia-presenting-with-profound-hepatic-dysfunction
#17
Oluwaseun Shogbesan, Andrew Rettew, Bilal Shaikh, Abdullateef Abdulkareem, Anthony Donato
Worldwide, Shigellosis is a significant public health issue, associated with nearly one million deaths annually. About half a million cases of Shigella infection are reported annually in the United States. Shigella bacteremia is uncommon and generally seen in children and immunocompromised adults. We present a case of a Shigella sonnei bacteremia with marked hepatic derangement in a 27-year-old previously healthy homosexual male with history of Roux-en-Y gastric bypass, who presented to the emergency room with a 4-day history of loose watery stool, abdominal cramps, nausea and vomiting, and yellow skin of 2-day duration...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28321153/p-glycoprotein-multidrug-transporter-in-inflammatory-bowel-diseases-more-questions-than-answers
#18
EDITORIAL
Elke Cario
The gastrointestinal barrier is constantly exposed to numerous environmental substrates that are foreign and potentially harmful. These xenobiotics can cause shifts in the intestinal microbiota composition, affect mucosal immune responses, disturb tissue integrity and impair regeneration. The multidrug transporter ABCB1/MDR1 p-glycoprotein (p-gp) plays a key role at the front line of host defence by efficiently protecting the gastrointestinal barrier from xenobiotic accumulation. This Editorial discusses how altered expression and function of ABCB1/MDR1 p-gp may contribute to the development and persistence of chronic intestinal inflammation in inflammatory bowel diseases (IBD)...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28304317/early-onset-necrotizing-enterocolitis-nec-in-premature-twins
#19
B Afzal, V Elberson, C McLaughlin, V H S Kumar
Twin infants born at 34 week gestation had frank blood in stools on day three of life on mixed feeds of formula and maternal breast milk. Sepsis work up was negative in these relatively well appearing infants with pneumatosis in the colon on abdominal x-ray. Blood in stools recurred on reintroduction of breast milk in Twin A. Both infants recovered from episodes of bloody stools on amino-acid based formula and were thriving at discharge. Early necrotizing enterocolitis in both twins is rare and has not been reported...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28267992/clostridium-difficile-disease-diagnosis-pathogenesis-and-treatment-update
#20
REVIEW
Lena M Napolitano, Charles E Edmiston
Clostridium difficile infections are the leading cause of health care-associated infectious diarrhea, posing a significant risk for both medical and surgical patients. Because of the significant morbidity and mortality associated with C difficile infections, knowledge of the epidemiology of C difficile in combination with a high index of suspicion and susceptible patient populations (including surgical, postcolectomy, and inflammatory bowel disease patients) is warranted. C difficile infections present with a wide spectrum of disease, ranging from mild diarrhea to fulminant colitis or small bowel enteritis and recurrent C difficile infections...
March 3, 2017: Surgery
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