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Paula Ferrada, Rachael Callcut, Martin D Zielinski, Brandon Bruns, Daniel Dante Yeh, Tanya L Zakrison, Jonathan P Meizoso, Babak Sarani, Richard D Catalano, Peter Kim, Valerie Plant, Amelia Pasley, Linda A Dultz, Asad J Choudhry, Elliott R Haut
OBJECTIVES: The mortality of patients with Clostridum Dificile Associated Disease (CDAD) requiring surgery continues to be very high. Loop ileostomy (LI) was introduced as an alternative procedure to total colectomy (TC) for CDAD by a single center study. To date, no reproducible results have been published. The objective of this study is to compare these two procedures in a multicentric approach to help the surgeon decide what procedure is best suited for the patient in need. METHODS: This was a retrospective multicenter study conducted under the sponsorship of the Eastern Association for the Surgery of Trauma (EAST)...
April 20, 2017: Journal of Trauma and Acute Care Surgery
Feng Wang, Sha Ha, Richard R Rustandi
Clostridium difficile is a gram-positive intestine bacterium that causes a severe diarrhea and could eventually be lethal. The main virulence factor is related to the release of two major exotoxins, toxin A (TcdA) and toxin B (TcdB). Recent C. difficile-associated disease (CDAD) outbreaks have been caused by hypervirulent strains which secrete an additional binary toxin (CDTa/CDTb). Vaccination against these toxins is considered the best way to combat the CDAD. Recently, a novel tetravalent C. difficile vaccine candidate containing all four toxins produced from a baculovirus expression system has been developed...
March 21, 2017: Journal of Chromatography. A
Velliyur Viswesh, Ana L Hincapie, Marie Yu, Linda Khatchatourian, Michael A Nowak
PURPOSE: A scoring system for identifying patients at high or low risk for recurrent Clostridium difficile-associated diarrhea (CDAD) is described. METHODS: A retrospective cohort study was performed using data on adults with CDAD admitted to a 3-hospital system from 2009 to 2014. The primary endpoint was the rate of recurrent CDAD within 60 days of clinical cure of CDAD. Risk factors for CDAD recurrence were identified, and a risk prediction tool was developed using multivariate logistic regression...
April 1, 2017: American Journal of Health-system Pharmacy: AJHP
Johannes Bogner
No abstract text is available yet for this article.
March 2017: MMW Fortschritte der Medizin
Richard L Nelson, Katie J Suda, Charlesnika T Evans
BACKGROUND: Clostridium difficile (C. difficile) is recognized as a frequent cause of antibiotic-associated diarrhoea and colitis. This review is an update of a previously published Cochrane review. OBJECTIVES: The aim of this review is to investigate the efficacy and safety of antibiotic therapy for C. difficile-associated diarrhoea (CDAD), or C. difficile infection (CDI), being synonymous terms. SEARCH METHODS: We searched MEDLINE, EMBASE, CENTRAL and the Cochrane IBD Group Specialized Trials Register from inception to 26 January 2017...
March 3, 2017: Cochrane Database of Systematic Reviews
Shima Lotfian, Masoumeh Douraghi, Amir Aliramezani, Sedighe Ghourchian, Abdolfatah Sarrafnejad, Hojjat Zeraati
BACKGROUND: The available data regarding Clostridium difficile infections (CDIs) in developing countries are scarce. This may be related in part to the complexity of anaerobic bacterial culture and/or cytotoxicity assays of C. difficile. Here, we evaluated the diagnostic efficacy of PCR in comparison with toxigenic culture for direct detection of conserved genes as well as toxin genes of C. difficile in fecal specimens of patients with clinical symptoms of CDI. METHODS: Loose or soft feces from 171 patients suspected of having C...
October 1, 2016: Clinical Laboratory
S Wong, P Santullo, J O'Driscoll, A Jamous, S P Hirani, M Saif
BACKGROUND: This was a retrospective audit, with the aims being to (1) record the use of antibiotics; (2) establish the prevalence of antibiotic-associated diarrhoea (AAD) and Clostridium difficile-associated diarrhoea (CDAD); and (3) assess if there was any seasonal variation in antibiotic use and incidence of AAD. METHODS: The study was performed at a single spinal cord injury (SCI) centre in the UK. Data were collected using a standardised questionnaire during October 2014 to June 2015...
January 31, 2017: Spinal Cord
Guo Ya-Nan, Wang Jun, Zhang Hao-Jun, Jia Hong-Bing, Li Ping, Liu Xin-Zhu
Traditional Chinese medicine QPYF has a good effect for treating antibiotic-associated diarrhea in clinical practice. The aim of this study is to test its efficacy to prevent Clostridium difficile associated diarrhea (CDAD) in a mouse model. C57BL/6 mice were infected with Clostridium difficile VPI 10463 after exposure to antimicrobial mixture. QPYF was administered from 7 days prior to Clostridium difficile infection to 20 days after infection, and its effect was compared with no treatment and receiving placebo...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Bao-Zhong Zhang, Jianpiao Cai, Bin Yu, Yanhong Hua, Candy Choiyi Lau, Richard Yi-Tsun Tsun Kao, Kong-Hung Sze, Kwok-Yung Yuen, Jian-Dong Huang
BACKGROUND: Clostridium difficile-associated disease (CDAD) constitutes a great majority of hospital diarrhea cases in industrialized countries and is induced by two types of large toxin molecules: toxin A (TcdA) and toxin B (TcdB). Development of immunotherapeutic approaches, either active or passive, has seen a resurgence in recent years. Studies have described vaccine plasmids that express either TcdA and/or TcdB receptor binding domain (RBD). However, the effectiveness of one vector encoding both toxin RBDs against CDAD has not been evaluated...
October 22, 2016: BMC Infectious Diseases
Asada Leelahavanichkul, Wimonrat Panpetch, Navaporn Worasilchai, Poorichaya Somparn, Wiwat Chancharoenthana, Sumanee Nilgate, Malcolm Finkelman, Ariya Chindamporn, Somying Tumwasorn
Gastrointestinal (GI) leakage in Clostridium difficile-associated diarrhea (CDAD) is well known but is not routinely assessed in clinical practice. Serum (1→3)-β-D-glucan (BG), a fungal cell wall component used as a biomarker for invasive fungal disease, was tested in a CDAD mouse model with and without probiotics. Higher serum fluorescein isothiocyanate-dextran (FITC-dextran) and spontaneous gram-negative bacteremia, GI leakage indicators, were frequently found in CDAD mice, which died compared with those which survived...
September 2016: FEMS Microbiology Letters
Nitipong Permpalung, Sikarin Upala, Anawin Sanguankeo, Suthanya Sornprom
Objective. Clostridium difficile infection is a leading cause of nosocomial diarrhea in developed countries. Studies evaluating the associations of increased risk of community-acquired CDAD and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) have yielded inconclusive results. We conducted a systematic review and meta-analysis to compare the odds of NSAID exposure in patients with CDAD versus patients without CDAD in both community-based and healthcare-associated settings. Methods. Relevant observational studies indexed in PubMed/MEDLINE and EMBASE up to February 2015 were analyzed and data were extracted from nine studies...
2016: Canadian Journal of Gastroenterology & Hepatology
Jenine R Leal, Steven J Heitman, John M Conly, Elizabeth A Henderson, Braden J Manns
OBJECTIVE To conduct a full economic evaluation assessing the costs and consequences related to probiotic use for the primary prevention of Clostridium difficile-associated diarrhea (CDAD). DESIGN Cost-effectiveness analysis using decision analytic modeling. METHODS A cost-effectiveness analysis was used to evaluate the risk of CDAD and the costs of receiving oral probiotics versus not over a time horizon of 30 days. The target population modeled was all adult inpatients receiving any therapeutic course of antibiotics from a publicly funded healthcare system perspective...
September 2016: Infection Control and Hospital Epidemiology
Yongqiang Li, Yi Huang, Yuyuan Li, Yuqiang Nie
OBJECTIVE: This study investigated the incidence, risk factors, and clinical characteristics of Clostridium difficile-associated diarrhea (CDAD) in Chinese patients. METHODS: Fecal specimens of patients with antibiotic-associated diarrhea (AAD) were collected to test C. difficile toxin A and B using enzyme-linked fluorescent assay to identify CDAD. By adopting a nested case-control design, the matched people (ratio 1:3) without AAD were included as controls. RESULTS: Out of 56,172 inpatients, 39,882 (71...
May 2016: Pakistan Journal of Medical Sciences Quarterly
G Domeniconi, S Serafino, M Migone De Amicis, S Formica, M Lanzoni, A Maraschini, F Sisto, D Consonni, M D Cappellini, G Fabio, S Castaldi
BACKGROUND: Clostridium difficile-associated disease (CDAD) is the most common infectious antibiotic-associated diarrhea and is a growing health care problem. Prevention of Clostridium difficile infection focuses on clinical and epidemiologic infection control measures. METHODS: Between 2008 and 2009, we conducted a retrospective study that showed an incidence of CDAD among the highest reported in the literature. Subsequently, we developed a preventive protocol that was adopted in our hospital in 2010...
November 1, 2016: American Journal of Infection Control
Kazuhito Yuhashi, Yuka Yagihara, Yoshiki Misawa, Tomoaki Sato, Ryoichi Saito, Shu Okugawa, Kyoji Moriya
PURPOSE: The enzyme immunoassay (EIA) has lower sensitivity for Clostridium difficile toxins A and B than the polymerase chain reaction in the diagnosis of C. difficile-associated diarrhea (CDAD). Furthermore, toxin positivity with EIA performed on C. difficile isolates from stool cultures may be observed even in patients with EIA glutamate dehydrogenase (GDH)-positive and toxin-negative stool specimens. It is unclear whether such patients should be treated as having CDAD. METHODS: The present study retrospectively compared patient characteristics, treatment, and diarrhea duration among three groups of patients who underwent stool EIA testing for CDAD diagnosis: a toxin-positive stool group (positive stool group; n=39); a toxin-negative stool/toxin-positive isolate group (discrepant negative/positive group, n=14); and a dual toxin-negative stool and isolate group (dual negative group, n=15)...
2016: Infection and Drug Resistance
Bo-Yang Tsai, Wen-Chien Ko, Ter-Hsin Chen, Ying-Chen Wu, Po-Han Lan, Yi-Hsuan Chen, Yuan-Pin Hung, Pei-Jane Tsai
Clostridium difficile is the major cause of nosocomial diarrhea. We have previously demonstrated that in southern Taiwan, severe C. difficile-associated diarrhea (CDAD) cases were due to the C. difficile RT 126 strain infection, indicating the arrival of an epidemic C. difficile clone in southern Taiwan. RT126 has a close genetic relationship with RT078. However, the RT078 family is the predominant strain of C. difficile in animals worldwide, particularly in swine. In this study, we surveyed C. difficile strains isolated from swine at several farms in Taiwan from August 2011 to March 2015...
October 2016: Anaerobe
A Chakraborty, A Kar, S Roy
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Prakaithip Thongkoom, Suwattana Kanchanahareutai, Suriwan Chantrakooptungkul, Somsak Rahule
BACKGROUND: In recent years, toxigenic Clostridium difficile infection (CDI) has been the cause of C. difficile-associated diseases (CDAD), resulting in increasing hospitalization, community infection outbreak and mortality all over the world. OBJECTIVE: To investigate the prevalence of toxigenic C. difficile strains in Rajavithi Hospital. MATERIAL AND METHOD: This was a retrospective study of data from C. difficile toxin tests at Rajavithi Hospital's microbiology laboratory from January 1, 2009 to June 30, 2015...
February 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Jeffrey Kirby
A provocative question has emerged since the Supreme Court of Canada's decision on assisted dying: Should Canadians who request, and are granted, an assisted death be considered a legitimate source of transplantable organs? A related question is addressed in this paper: is controlled organ donation after assisted death (cDAD) more or less ethically-problematic than standard, controlled organ donation after circulatory determination of death (cDCDD)? Controversial, ethics-related dimensions of cDCD that are of relevance to this research question are explored, and morally-relevant distinctions between cDAD and cDCD are identified...
December 2016: Medicine, Health Care, and Philosophy
Noah Wiedel, Jorge Gilbert, Brett Baloun, Chelsea Nelson
Clostridium difficile associated diarrhea (CDAD) is increasingly important in primary care, and associated with high cost, significant morbidity and mortality. As the preferred treatment for different groups of patients varies considerably, it is important to stratify CDAD patients into mild versus severe and uncomplicated versus complicated. While treatment with either metronidazole or oral vancomycin cures a majority of patients, and despite improvement in early diagnosis and therapy, recurrence continues to be a significant problem...
March 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
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