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https://www.readbyqxmd.com/read/28732397/combined-sewer-overflow-events-and-childhood-emergency-department-visits-a-case-crossover-study
#1
Cole Brokamp, Andrew F Beck, Louis Muglia, Patrick Ryan
In localities with combined sewer systems, combined sewer overflow (CSO) events frequently occur following high precipitation and can result in the release of untreated sewage and industrial wastewater into surface waters. We hypothesized that either direct contact with or proximity to aerosolized CSO effluent would increase the risk for childhood emergency department (ED) visits for asthma, gastrointestinal (GI) illnesses, and skin and soft tissue infections (SSTIs) in Cincinnati, OH, USA. ED visits for 2010-2014 due to GI diseases, asthma, and SSTIs were extracted from the Cincinnati Children's Hospital Medical Center electronic health records...
July 17, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28729921/an-outbreak-of-foodborne-norovirus-gastroenteritis-linked-to-a-restaurant-in-melbourne-australia-2014
#2
Shaun P Coutts, Kaye Sturge, Karin Lalor, John A Marshall, Leesa D Bruggink, Nela Subasinghe, Marion Easton
INTRODUCTION: In May 2014 an outbreak of norovirus occurred among patrons of a restaurant in Melbourne, Australia. Investigations were conducted to identify the infectious agent, mode of transmission and source of illness, and to implement controls to prevent further transmission. METHODS: A retrospective case-control study was conducted to test the hypothesis that food served at the restaurant between 9 and 15 May 2014 was the vehicle for infection. A structured questionnaire was used to collect demographic, illness and food exposure data from study participants...
April 2017: Western Pacific Surveillance and Response Journal: WPSAR
https://www.readbyqxmd.com/read/28729860/burn-injury-leads-to-increase-in-relative-abundance-of-opportunistic-pathogens-in-the-rat-gastrointestinal-microbiome
#3
Guangtao Huang, Kedai Sun, Supeng Yin, Bei Jiang, Yu Chen, Yali Gong, Yajie Chen, Zichen Yang, Jing Chen, Zhiqiang Yuan, Yizhi Peng
The gastrointestinal microbiome is crucial in human health. With greater than 10 times the cell count of an individual, the gastrointestinal microbiome provides many benefits to the host. It plays an important role in chronic illnesses and immune diseases and also following burns and trauma. This study aimed to determine whether severe burns affect the gastrointestinal microbiome during the early stages of after burn injury and the extent to which the microbiome is disturbed by such burns. We used a rat burn model to investigate any changes occurring in the microbiome after the burn trauma using 16S rRNA sequencing and downstream α-diversity, β-diversity, and taxonomy analysis...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28726122/beta-ketothiolase-deficiency-presenting-with-metabolic-stroke-after-a-normal-newborn-screen-in-two-individuals
#4
Monica H Wojcik, Klaas J Wierenga, Lance H Rodan, Inderneel Sahai, Sacha Ferdinandusse, Casie A Genetti, Meghan C Towne, Roy W A Peake, Philip M James, Alan H Beggs, Catherine A Brownstein, Gerard T Berry, Pankaj B Agrawal
Beta-ketothiolase (mitochondrial acetoacetyl-CoA thiolase) deficiency is a genetic disorder characterized by impaired isoleucine catabolism and ketone body utilization that predisposes to episodic ketoacidosis. It results from biallelic pathogenic variants in the ACAT1 gene, encoding mitochondrial beta-ketothiolase. We report two cases of beta-ketothiolase deficiency presenting with acute ketoacidosis and "metabolic stroke." The first patient presented at 28 months of age with metabolic acidosis and pallidal stroke in the setting of a febrile gastrointestinal illness...
July 20, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28722594/fatal-leptospira-spp-zika-virus-coinfection-puerto-rico-2016
#5
Paige Neaterour, Aidsa Rivera, Renee L Galloway, Myriam Garcia Negrón, Brenda Rivera-Garcia, Tyler M Sharp
Coinfection with pathogens that cause acute febrile illness (AFI) can complicate patient diagnosis and management. This report describes a fatal case of Leptospira spp./Zika virus (ZIKV) coinfection in Puerto Rico. The patient presented with a 5-day history of AFI; reported behavioral risk factors for leptospirosis; was diagnosed with possible leptospirosis, dengue, chikungunya, or ZIKV disease; and received appropriate treatment of leptospirosis and dengue. Following a 3-day hospitalization, the patient died due to acute gastrointestinal hemorrhage, and kidney and liver failure...
June 26, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28720723/profile-and-outcomes-of-critically-ill-children-in-a-lower-middle-income-country
#6
Muhammad Irfan Habib, Khalid Mehmood A Khan
OBJECTIVE: To determine the clinical profile and outcome of critically ill children presenting to a paediatric ED in a lower middle-income country. METHODS: We performed a retrospective analysis of children (<14 years) presenting to the ED of the National Institute of Child Health, Karachi, between January and December 2014 who were assigned to acuity 1 (requiring immediate life-saving interventions) according to the Emergency Severity Index. Data included demographic variables, presenting complaints, interventions and outcomes in the ED...
July 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28719282/travelers-diarrhea-and-other-gastrointestinal-symptoms-among-boston-area-international-travelers
#7
Rhett J Stoney, Pauline V Han, Elizabeth D Barnett, Mary E Wilson, Emily S Jentes, Christine M Benoit, William B MacLeod, Davidson H Hamer, Lin H Chen
AbstractThis prospective cohort study describes travelers' diarrhea (TD) and non-TD gastrointestinal (GI) symptoms among international travelers from the Boston area, the association of TD with traveler characteristics and dietary practices, use of prescribed antidiarrheal medications, and the impact of TD and non-TD GI symptoms on planned activities during and after travel. We included adults who received a pre-travel consultation at three Boston-area travel clinics and who completed a three-part survey: pre-travel, during travel, and post-travel (2-4 weeks after return)...
June 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28716445/feeding-systems-and-the-gut-microbiome-gut-brain-interactions-with-relevance-to-psychiatric-conditions
#8
REVIEW
Brittany L Mason
BACKGROUND: Physical and mental health is dependent on the environment, and feeding is a prime example of this environmental exchange. While the hypothalamus controls both feeding behavior and the stress response, the integration of the neural control centers and the peripheral gut allows for disruption in the gastrointestinal systems and dysfunctional communication to the brain. OBJECTIVE: The purpose of this review is to familiarize clinicians with the physiology controlling feeding behavior and its implications for psychiatric conditions, such as anorexia nervosa and depression...
June 8, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28716290/yarsagumba-fungus-health-problems-in-the-himalayan-gold-rush
#9
Pranawa Koirala, Bidur Pandit, Pratibha Phuyal, Ken Zafren
INTRODUCTION: Seasonal migration of people in search of Yarsagumba fungus creates a population of collectors that faces hardship and health risks in austere high-altitude settings. METHODS: In 2016, our 4-person team performed a 2-day health-needs survey of people collecting Yarsagumba fungus near the village of Yak Kharka (4020 m) in the Manang District of Nepal. RESULTS: There were approximately 800 people, both male and female, from age 10 to over 60, collecting Yarsagumba fungus...
July 14, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28715976/astrovirus-biology-and-pathogenesis
#10
Valerie Cortez, Victoria A Meliopoulos, Erik A Karlsson, Virginia Hargest, Cydney Johnson, Stacey Schultz-Cherry
Astroviruses are nonenveloped, positive-sense single-stranded RNA viruses that cause gastrointestinal illness. Although a leading cause of pediatric diarrhea, human astroviruses are among the least characterized enteric RNA viruses. However, by using in vitro methods and animal models to characterize virus-host interactions, researchers have discovered several important properties of astroviruses, including the ability of astrovirus capsid to act as an enterotoxin, disrupting the gut epithelial barrier. Improved animal models are needed to study this phenomenon, along with the pathogenesis of astroviruses, particularly in those strains that can cause extraintestinal disease...
July 17, 2017: Annual Review of Virology
https://www.readbyqxmd.com/read/28714426/suicide-following-acute-admissions-for-physical-illnesses-across-england-and-wales
#11
S E Roberts, A John, U Kandalama, J G Williams, R A Lyons, K Lloyd
BACKGROUND: The study aim was to establish and quantify suicide risk following acute admissions for all major physical illnesses, for confirmatory purposes, from two independent information sources from different countries. METHODS: Record linkage of inpatient and death certificate data for 11 004 389 acute admissions for physical illnesses in England and 713 496 in Wales. The main outcome measure was standardised mortality ratios (SMRs) for suicide at 1 year following discharge from hospital...
July 17, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28712987/the-tailored-study-a-randomized-controlled-trial-to-improve-surrogate-decision-making
#12
Daniel P Sulmasy, Mark T Hughes, Gayane Yenokyan, Joan Kub, Peter B Terry, Alan B Astrow, Julie A Johnson, Grace Ho, Marie T Nolan
CONTEXT: Patients with terminal illnesses often require surrogate decision makers. Prior research has demonstrated high surrogate stress, and that despite standards promoting substituted judgment, most patients do not want their surrogates to make pure substituted judgments for them. It is not known how best to help loved ones fulfill the surrogate role. OBJECTIVES: To test the effectiveness of an intervention to help surrogate decision makers. METHODS: 166 patients (41% with ALS and 59% with gastrointestinal cancers) and their surrogates at 2 university medical centers were randomized to an intensive nurse-directed discussion of the end of life Decision Control Preferences of the patient (TAILORED) or a discussion of nutrition (CONTROL); 163 completed baseline interviews and underwent the intervention...
July 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28712662/enteropathogen-detection-in-children-with-diarrhoea-or-vomiting-or-both-comparing-rectal-flocked-swabs-with-stool-specimens-an-outpatient-cohort-study
#13
Stephen B Freedman, Jianling Xie, Alberto Nettel-Aguirre, Bonita Lee, Linda Chui, Xiao-Li Pang, Ran Zhuo, Brendon Parsons, James A Dickinson, Otto G Vanderkooi, Samina Ali, Lara Osterreicher, Karen Lowerison, Phillip I Tarr
BACKGROUND: Enteropathogen detection traditionally relies on diarrhoeal stool samples, but these are inconvenient to collect if they are not immediately available, leading to suboptimum return rates of samples and delayed or missed diagnostic opportunities. We sought to compare the enteropathogen yields of rectal swabs and stool specimens in children with diarrhoea or vomiting, or both. METHODS: The Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE) did a study in three outpatient cohorts in Calgary and Edmonton (AB, Canada)-children enrolled in the Pediatric Emergency Research Canada emergency departments, children receiving routine vaccinations at a Calgary health clinic, and symptomatic children who met criteria for treatment at home...
July 13, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28709443/severity-of-acute-gastrointestinal-injury-grade-is-a-predictor-of-all-cause-mortality-in-critically-ill-patients-a-multicenter-prospective-observational-study
#14
Bangchuan Hu, Renhua Sun, Aiping Wu, Yin Ni, Jingquan Liu, Feng Guo, Lijun Ying, Guoping Ge, Aijun Ding, Yunchao Shi, Changwen Liu, Lei Xu, Ronglin Jiang, Jun Lu, Ronghai Lin, Yannan Zhu, Weidong Wu, Bo Xie
BACKGROUND: In 2012, the European Society of Intensive Care Medicine proposed a definition for acute gastrointestinal injury (AGI) based on current medical evidence and expert opinion. The aim of the present study was to evaluate the feasibility of using the current AGI grading system and to investigate the association between AGI severity grades with clinical outcome in critically ill patients. METHODS: Adult patients at 14 general intensive care units (ICUs) with an expected ICU stay ≥24 h were prospectively studied...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28702908/water-quality-and-health-in-northern-canada-stored-drinking-water-and-acute-gastrointestinal-illness-in-labrador-inuit
#15
Carlee J Wright, Jan M Sargeant, Victoria L Edge, James D Ford, Khosrow Farahbakhsh, Inez Shiwak, Charlie Flowers, Sherilee L Harper
One of the highest self-reported incidence rates of acute gastrointestinal illness (AGI) in the global peer-reviewed literature occurs in Inuit communities in the Canadian Arctic. This high incidence of illness could be due, in part, to the consumption of contaminated water, as many northern communities face challenges related to the quality of municipal drinking water. Furthermore, many Inuit store drinking water in containers in the home, which could increase the risk of contamination between source and point-of-use (i...
July 12, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28701844/effect-of-calories-delivered-on-clinical-outcomes-in-critically-ill-patients-systemic-review-and-meta-analysis
#16
Legese Chelkeba, Mojtaba Mojtahedzadeh, Zeleke Mekonnen
INTRODUCTION: International guidelines are promoting early enteral nutrition (EN) as a means of feeding critically ill adult patients to improve clinical outcomes. The question of how much calorie intake is enough to improve the outcomes still remained inconclusive. Therefore, we carried out a meta-analysis to evaluate the effect of low calorie (LC) versus high calorie (HC) delivery on critically ill patients' outcomes. METHODS: We included randomized clinical trials (RCTs) that compared LC EN with or without supplemental parenteral nutrition with HC delivery in this meta-analysis irrespective of the site of nutritional delivery in the gastrointestinal tract...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28700476/peripheral-monocytosis-as-a-predictive-factor-for-adverse-outcome-in-the-emergency-department-survey-based-on-a-register-study
#17
Mathias Hensel, Lena Grädel, Alexander Kutz, Sebastian Haubitz, Andreas Huber, Beat Mueller, Philipp Schuetz, Thomas Hügle
Monocytosis is associated with chronic infections such as tuberculosis or endocarditis as well as rheumatic and myeloproliferative disorders. Monocytes are also involved in the pathogenesis of atherosclerosis, coronary artery disease, and stroke. The value of monocytosis as a prognostic marker in different diagnostic groups in the emergency setting, however, has not been investigated so far.The aim of the article is to study monocytosis as an outcome factor in the emergency setting.In a Swiss register study, we analyzed monocyte counts in 4238 patients aged >18 years who were admitted to the emergency department of a regional tertiary care hospital...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28698051/effects-of-pituitary-adenylate-cyclase-activating-polypeptide-on-small-intestinal-int-407-cells
#18
A Illes, B Opper, D Reglodi, M Kerenyi, P Czetany, A Boronkai, E Schafer, G Toth, E Fabian, G Horvath
Pituitary adenylate cyclase activating polypeptide (PACAP) is an endogenous neuropeptide having a widespread distribution both in the nervous system and peripheral organs including the gastrointestinal tract. It has been shown to exert actions on intestinal functions, mainly affecting glandular secretion and motility. PACAP has several different effects on cell survival depending on the cell type and the applied stimulus. Its influences on small intestinal epithelial cells are not yet elucidated, therefore the aim of the present study was to investigate the effects of PACAP on intestinal epithelial cells having high turnover (INT 407) against different harmful stimuli, such as oxidative stress, in vitro hypoxia and gamma radiation...
July 4, 2017: Neuropeptides
https://www.readbyqxmd.com/read/28693557/prevalence-of-giardia-infection-in-households-of-giardia-cases-and-risk-factors-for-household-transmission
#19
Alison Waldram, Roberto Vivancos, Catherine Hartley, Kenneth Lamden
BACKGROUND: Giardia is a leading but neglected cause of infectious gastroenteritis worldwide and is treatable. There is a substantial burden of undetected Giardia in the UK and for every one case of Giardia reported to national surveillance there are 14 cases in the community. We aimed to ascertain the prevalence of, and risk factors associated with secondary household Giardia infections to assess the burden of infection and inform control measures. METHODS: We identified all giardiasis cases notified in nine local authorities in Lancashire between June 2014 and June 2015, and invited their household contacts to submit faecal specimens for Giardia testing and complete a risk factor questionnaire...
July 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28691768/microbiome-inflammation-epigenetic-alterations-and-mental-diseases
#20
REVIEW
Reza Alam, Hamid M Abdolmaleky, Jin-Rong Zhou
Major mental diseases such as autism, bipolar disorder, schizophrenia, and major depressive disorder are debilitating illnesses with complex etiologies. Recent findings show that the onset and development of these illnesses cannot be well described by the one-gene; one-disease approach. Instead, their clinical presentation is thought to result from the regulative interplay of a large number of genes. Even though the involvement of many genes are likely, up regulating and activation or down regulation and silencing of these genes by the environmental factors play a crucial role in contributing to their pathogenesis...
July 10, 2017: American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics
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