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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...
June 29, 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...
June 9, 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...
June 4, 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
Rachael V McCaleb, Arpita S Gandhi, Stephen Michael Clark, Amber B Clemmons
BACKGROUND: Acid suppressive therapy (AST)-namely, proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs)-is routinely prescribed to hospitalized patients for stress ulcer prophylaxis (SUP). OBJECTIVE: To identify the incidence of and indications for AST use in the hematology/oncology population as well as to identify the occurrence of the following PPI-associated adverse events: pneumonia and Clostridium difficile-associated diarrhea (CDAD)...
July 2016: Annals of Pharmacotherapy
Shinsmon Jose, Rajat Madan
Clostridium difficile is the most important cause of nosocomial infectious diarrhea in the western world. C. difficile infections are a major healthcare burden with approximately 500,000 new cases every year and an estimated annual cost of nearly $1 billion in the U.S. Furthermore, the infections are no longer restricted to health care facilities, and recent studies indicate spread of C. difficile infection to the community as well. The clinical spectrum of C. difficile infection ranges from asymptomatic colonization to severe diarrhea, fulminant colitis and death...
April 5, 2016: Anaerobe
S N Thitaram, J F Frank, G R Siragusa, J S Bailey, D A Dargatz, J E Lombard, C A Haley, S A Lyon, P J Fedorka-Cray
Clostridium difficile is commonly associated with a spectrum of disease in humans referred to as C. difficile-associated disease (CDAD) and use of antimicrobials is considered a risk factor for development of disease in humans. C. difficile can also inhabit healthy food animals and transmission to humans is possible. As a result of the complexity and cost of testing, C. difficile is rarely tested for antimicrobial susceptibility. A total of 376 C. difficile strains (94 each from swine and dairy feces, and 188 from beef cattle feces) were isolated from healthy food animals on farms during studies conducted by the National Animal Health Monitoring System...
June 16, 2016: International Journal of Food Microbiology
Celeste C Finnerty, David N Herndon, Jong O Lee, Noe A Rodriguez, Iman H Al-Haj, Paul Wurzer, Brendan R Calhoun, Marc G Jeschke
BACKGROUND: Clostridium difficile is a key culprit underlying nosocomial infectious diarrhea. We investigated the effect of C difficile-associated diarrhea (CDAD) on morbidity and mortality in severely burned children and CDAD risk factors. METHODS: After review of 2,840 records, 288 pediatric burn patients were identified as having stool output of >10 mL•kg(-1)•min(-1) for ≥2 successive days and had stool samples immunoassayed for toxins A and B. A case control analysis was performed by matching cases to controls via logistic regression and propensity scores so that age, admission time, and time of occurrence could be controlled; the endpoints were mortality and hospitalization time...
June 2016: Surgery
Stephan Ehrhardt, Nan Guo, Rebecca Hinz, Stefanie Schoppen, Jürgen May, Markus Reiser, Maximilian Philipp Schroeder, Stefan Schmiedel, Martin Keuchel, Emil C Reisinger, Andreas Langeheinecke, Andreas de Weerth, Marcus Schuchmann, Tom Schaberg, Sandra Ligges, Maria Eveslage, Ralf M Hagen, Gerd D Burchard, Ansgar W Lohse
Background.  Antibiotic-associated diarrhea (AAD) and Clostridium difficile-associated diarrhea (CDAD) are common complications of antibiotic use. Data on the efficacy of probiotics to prevent AAD and CDAD are unclear. We aimed to evaluate the efficacy of Saccharomyces boulardii to prevent AAD and CDAD in hospitalized adult patients. Methods.  We conducted a multicenter, phase III, double-masked, randomized, placebo-controlled trial in hospitalized patients who received systemic antibiotic treatment in 15 hospitals in Germany between July 2010 and October 2012...
January 2016: Open Forum Infectious Diseases
Cristian Hernández-Rocha, Paola Pidal, M Cristina Ajenjo, Rodrigo Quera, Marcela Quintanilla, Jaime Lubascher, M Irene Jemenao, Patricio Ibáñez, Manuel Álvarez-Lobos, Alexis Diomedi, Alejandra Marcotti, Mirta Acuña, Juan P Arab, Arnoldo Riquelme, Roberto Candía, Sergio Carvajal
BACKGROUND: Clostridium dijfficile-associated diarrhea (CDAD) has become very important due to the increase in its incidence, severity, recurrence and the associated economic burden. Having a national consensus guideline is essential to improve its management. OBJECTIVE: To build a multidisciplinary and evidence-based consensus in prevention, diagnosis and treatment of CDAD. METHODS: We convened a panel of experts in the field of infectious diseases, gastroenterology, evidence-based medicine and consensus methodology...
February 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Christine Sm Lau, Ronald S Chamberlain
INTRODUCTION: Clostridium difficile infection (CDI) is the leading cause of antibiotic-associated diarrhea. CDI has increased in incidence and severity over the past decade, and is a growing worldwide health problem associated with substantial health care costs and significant morbidity and mortality. This meta-analysis examines the impact of probiotics on the incidence of Clostridium difficile-associated diarrhea (CDAD) among children and adults, in both hospital and outpatient settings...
2016: International Journal of General Medicine
Karn Wijarnpreecha, Suthanya Sornprom, Charat Thongprayoon, Parkpoom Phatharacharukul, Wisit Cheungpasitporn, Kiran Nakkala
BACKGROUND/OBJECTIVES: Clostridium difficile-associated diarrhea (CDAD) is a major concern of public health worldwide. The risk of CDAD in patients with nasogastric tube (NGT) insertion is controversial. The aim of this study was to assess the risk of incidence of CDAD in patients with NGT insertion. METHODS: A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through August 2015. Studies that reported relative risks, odds ratios, or hazard ratios comparing the risk of CDAD in patients with NGT insertion versus those who did not were included...
May 2016: Digestive and Liver Disease
Chanife Memet, Demet Menekse Gerede, Metin Ozenci, Irem Muge Akbulut, Aynur Acibuca, Mustafa Kiliçkap, Cetin Erol
BACKGROUND AND AIM OF THE STUDY: Calcific and degenerative aortic diseases (CDADs) are a group of disorders that mostly affect the elderly population and may progress and warrant aortic valve replacement. It is believed that oxidative stress plays a role in the progression of the diseases. Several markers of oxidative stress were evaluated in a small cohort of patients with CDADs, and a control group with similar characteristics. METHODS: Thirty patients with aortic stenosis (AS) and 30 healthy subjects were included in the study...
July 2015: Journal of Heart Valve Disease
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