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https://www.readbyqxmd.com/read/29781761/prevention-and-treatment-of-clostridium-difficile-associated-diarrhea-by-reconstitution-of-the-microbiota
#1
Noa Eliakim-Raz, Jihad Bishara
This review summarizes the latest advances in treating and preventing Clostridium difficile infection (CDI), the most common infectious disease cause of nosocomial diarrhea in adults in developed countries. As customary antibiotic therapies against C. difficile, metronidazole and vancomycin, are broad spectrum, they affect greatly the gut microbiota, which result in very high recurrence rates. Therefore, new strategies are researched intensively. New therapies focus on limiting further destruction of the gut microbiota or restoring the microbiota to its pre-destructed state...
May 21, 2018: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29780607/renal-cell-carcinoma-in-a-cat-with-polycystic-kidney-disease-undergoing-renal-transplantation
#2
Daniel J Adams, Jolie A Demchur, Lillian R Aronson
Case summary: A 10-year-old spayed female American Shorthair cat underwent renal transplantation due to worsening chronic kidney disease secondary to polycystic kidney disease. During transplantation, the right kidney grossly appeared to be more diseased than the left and was firmly adhered to the surrounding tissues. An intraoperative fine-needle aspirate of the right native kidney revealed inflammatory cells but no evidence of neoplasia. To create space for the allograft, a right nephrectomy was performed...
January 2018: JFMS Open Reports
https://www.readbyqxmd.com/read/29765165/detection-of-cytomegalovirus-dna-in-fecal-samples-as-a-method-for-cmv-enterocolitis-diagnosis-after-allogeneic-stem-cell-transplantation
#3
Alzbeta Zavrelova, Jakub Radocha, Lenka Pliskova, Pavla Paterova, Eva Vejrazkova, Jiri Cyrany, Filip Gabalec, Miroslav Podhola, Pavel Zak
BACKGROUND: Cytomegalovirus enterocolitis is a rare but potentially life threatening complication after allogeneic stem cell transplantation. Its early diagnosis and treatment are essential for a successful outcome. OBJECTIVE: To determine the potential benefit of fecal CMV DNA detection in the diagnosis of CMV colitis among stem cell transplant recipients. STUDY DESIGN: Biopsies from the lower gastrointestinal tract, taken during 69 episodes of diarrhea, were compared with fecal samples previously examined for CMV DNA in 45 patients after allogeneic stem cell transplantation...
May 16, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29761168/outcomes-of-surgical-management-of-familial-intrahepatic-cholestasis-1-and-bile-salt-export-protein-deficiencies
#4
Laura N Bull, Ludmila Pawlikowska, Sandra Strautnieks, Irena Jankowska, Piotr Czubkowski, Jennifer L Dodge, Karan Emerick, Catherine Wanty, Sami Wali, Samra Blanchard, Florence Lacaille, Jane A Byrne, Albertien M van Eerde, Kaija-Leena Kolho, Roderick Houwen, Steven Lobritto, Vera Hupertz, Patricia McClean, Giorgina Mieli-Vergani, Etienne Sokal, Philip Rosenthal, Peter F Whitington, Joanna Pawlowska, Richard J Thompson
Progressive familial intrahepatic cholestasis (PFIC) with normal circulating gamma-glutamyl transpeptidase levels can result from mutations in the ATP8B1 gene (encoding familial intrahepatic cholestasis 1 [FIC1] deficiency) or the ABCB11 gene (bile salt export protein [BSEP] deficiency). We investigated the outcomes of partial external biliary diversion, ileal exclusion, and liver transplantation in these two conditions. We conducted a retrospective multicenter study of 42 patients with FIC1 deficiency (FIC1 patients) and 60 patients with BSEP deficiency (BSEP patients) who had undergone one or more surgical procedures (57 diversions, 6 exclusions, and 57 transplants)...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29748558/the-gastroenterologist-s-guide-to-management-of-the-post-liver-transplant-patient
#5
REVIEW
David M Chascsa, Hugo E Vargas
The management of the post-liver transplant patient is complex and involves a large interdisciplinary team. After referral to a transplant center, evaluation and listing, and eventual transplantation, the patient is cared for closely by the transplant center. Once deemed ready for discharge, the patient returns to the primary care provider for ongoing management of the various issues that increase in incidence post transplant such as osteoporosis, cardiovascular, and renal diseases, as well as metabolic syndrome...
May 11, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29742710/fecal-microbiota-transplantation-treatment-for-refractory-ulcerative-colitis-with-allergy-to-5-aminosalicylic-acid-a-case-report
#6
Hong-Gang Wang, Shi-Peng Liu, Tian-Heng Ma, Wei Yan, Jing-Fang Zhou, Yun-Tao Shi, Peng Shen, Xiao-Zhong Yang, Shang-Nong Wu
INTRODUCTION: Fecal microbiota transplantation (FMT) is currently being explored as a potential therapy for ulcerative colitis (UC). Here, we report the first case of a UC patient with allergy to 5-aminosalicylic acid (5-ASA) who underwent FMT and achieved clinical remission. CASE PRESENTATION: This patient had a 9-year history of UC and was allergic to 5-ASA. He suffered from gradually aggravated abdominal pain and frequent bloody diarrhea. There was a continuous distribution of superficial erosion and ulceration by colonoscopy...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29742694/association-between-histopathological-alterations-and-diarrhea-severity-in-acute-intestinal-graft-versus-host-disease
#7
Loredana Nilkenes Gomes da Costa, Carolina Costa-Lima, Luciana Rodrigues de Meirelles, Rita B Carvalho, Marcos Paulo Colella, Francisco Jose Penteado Aranha, Afonso Celso Vigorito, Erich Vinicius De Paula
Gastrointestinal (GI) acute graft-versus-host disease (aGVHD) remains one of the most important complications of allogeneic hematopoietic cell transplantation (allo-HCT). The diagnosis of this complication is largely dependent on clinical symptoms, but GI biopsies are warranted in most cases, due to the multitude of potential causes that coexist in patients with a clinical suspicion of this complication. In addition, several lines of evidence support that the GI is not only a target organ in aGVHD, but also a key mediator of the pathogenesis of this condition...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29738579/baicd-gene-cluster-abundance-is-negatively-correlated-with-clostridium-difficile-infection
#8
Philipp Solbach, Patrick Chhatwal, Sabrina Woltemate, Evelina Tacconelli, Michael Buhl, Markus Gerhard, Christoph K Thoeringer, Maria J G T Vehreschild, Nathalie Jazmati, Jan Rupp, Michael P Manns, Oliver Bachmann, Sebastian Suerbaum
BACKGROUND: Clostridium difficile infection (CDI) is a major cause of hospital-acquired diarrhea. Secondary bile acids were shown to confer resistance to colonization by C. difficile. 7α-dehydroxylation is a key step in transformation of primary to secondary bile acids and required genes have been located in a single bile acid-inducible (bai) operon in C. scindens as well as in C. hiranonis, two Clostridium sp. recently reported to protect against C. difficile colonization. AIM: To analyze baiCD gene abundance in C...
2018: PloS One
https://www.readbyqxmd.com/read/29707621/improved-glucose-tolerance-in-a-kidney-transplant-recipient-with-type-2-diabetes-mellitus-after-switching-from-tacrolimus-to-belatacept-a-case-report-and-review-of-potential-mechanisms
#9
Gretchen N de Graav, Marieke van der Zwan, Carla C Baan, Joop A M J L Janssen, Dennis A Hesselink
The introduction of immunosuppressant belatacept, an inhibitor of the CD28-80/86 pathway, has improved 1-year outcomes in kidney transplant recipients with preexistent diabetes mellitus and has also reduced the risk of posttransplant diabetes mellitus. So far, no studies have compared a tacrolimus-based with a belatacept-based immunosuppressive regimen with regard to improving glucose tolerance after kidney transplantation. Here, we present the case of a 54-year-old man with type 2 diabetes mellitus who was converted from belatacept to tacrolimus 1 year after a successful kidney transplantation...
March 2018: Transplantation Direct
https://www.readbyqxmd.com/read/29703246/clostridium-difficile-cure-with-fecal-microbiota-transplantation-in-a-child-with-pompe-disease-a-case-report
#10
D E Dow, P C Seed
BACKGROUND: Recurrent Clostridium difficile infection is a growing problem among children due to both the increasing survival of medically fragile children with complicated chronic medical conditions resulting in prolonged antibiotic exposure and hospitalization and the emergence of strains of Clostridium difficile that are hypervirulent and associated with high rates of relapse. CASE PRESENTATION: This case describes a medically complex 21-month-old Hispanic girl with Pompe disease and B cell immunodeficiency with recurrent Clostridium difficile infection refractory to antimicrobial management...
April 28, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29699418/role-of-early-palliative-care-interventions-in-hematological-malignancies-and-bone-marrow-transplant-patients-barriers-and-potential-solutions
#11
Marco Ruiz, Patrick Reynolds, Regina Marranzini, Alina Khan, Jessica Ketterer, Amanda Brahim
INTRODUCTION: Despite advances in palliative care management of physical, psychological, and emotional symptoms along the spectrum of chronic conditions, early palliative care interventions are not used frequently and comprehensively in bone marrow transplant units. METHODS: The literature review of PubMed articles in English published until December 2017. RESULTS: Patients with hematologic malignancies and bone marrow transplant interventions are a heterogeneous group...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29684865/the-effect-of-fecal-microbiota-transplantation-on-psychiatric-symptoms-among-patients-with-irritable-bowel-syndrome-functional-diarrhea-and-functional-constipation-an-open-label-observational-study
#12
Shunya Kurokawa, Taishiro Kishimoto, Shinta Mizuno, Tatsuhiro Masaoka, Makoto Naganuma, Kuo-Ching Liang, Momoko Kitazawa, Moeko Nakashima, Chie Shindo, Wataru Suda, Masahira Hattori, Takanori Kanai, Masaru Mimura
BACKGROUNDS: The intestinal microbiota is considered as a potential common underpinning pathophysiology of Functional Gastrointestinal Disorders (FGIDs) and psychiatric disorders such as depression and anxiety. Fecal Microbiota Transplantation (FMT) has been reported to have therapeutic effects on diseases related to dysbiosis, but few studies have evaluated its effect on psychiatric symptoms. METHODS: We followed 17 patients with either Irritable Bowel Syndrome (IBS), Functional Diarrhea (FDr) or Functional Constipation (FC) who underwent FMT for the treatment of gastrointestinal symptoms and observation of psychiatric symptoms...
April 12, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29682370/fatal-pneumococcus-sepsis-after-treatment-of-late-antibody-mediated-kidney-graft-rejection
#13
Gunilla Einecke, Jan Hinrich Bräsen, Nils Hanke, Hermann Haller, Anke Schwarz
Antibody-mediated rejection (ABMR) is a major cause of late renal allograft dysfunction and graft loss. Risks and benefits of treatment of late ABMR have not been evaluated in randomized clinical trials. We report on a 35-year-old patient with deterioration in renal function and progressive proteinuria 15 years after transplantation. Recurrent infections after a splenectomy following traumatic splenic rupture 3 years earlier had led to reduction of immunosuppression. Renal transplant biopsy showed glomerular double contours, 40% fibrosis/tubular atrophy, peritubular capillaritis, and positive C4d staining indicating chronic-active ABMR...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29670776/-kit-d816v-positive-acute-mast-cell-leukemia-associated-with-normal-karyotype-acute-myeloid-leukemia
#14
Marta Lopes, Maria Dos Anjos Teixeira, Cláudia Casais, Vanessa Mesquita, Patrícia Seabra, Renata Cabral, José Palla-García, Catarina Lau, João Rodrigues, Maria Jara-Acevedo, Inês Freitas, Jose Ramón Vizcaíno, Jorge Coutinho, Luis Escribano, Alberto Orfao, Margarida Lima
Introduction: Mast cell (MC) leukemia (MCL) is extremely rare. We present a case of MCL diagnosed concomitantly with acute myeloblastic leukemia (AML). Case Report: A 41-year-old woman presented with asthenia, anorexia, fever, epigastralgia, and diarrhea. She had a maculopapular skin rash, hepatosplenomegaly, retroperitoneal adenopathies, pancytopenia, 6% blast cells (BC) and 20% MC in the peripheral blood, elevated lactate dehydrogenase, cholestasis, hypoalbuminemia, hypogammaglobulinemia, and increased serum tryptase (184  μ g/L)...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29582552/efficacy-and-tolerability-of-magnesium-plus-protein-for-managing-hypomagnesemia-in-pediatric-kidney-transplant-patients
#15
Teresa V Lewis, Stephen Neely, Martin A Turman
We sought to investigate whether magnesium oxide bound to soy protein (MGP) increases serum magnesium concentrations with less diarrhea compared to commonly prescribed magnesium salts. Subjects were switched to MGP at a near-equivalent daily elemental magnesium dose. Mean serum magnesium levels were compared. If magnesium levels remained <1.7 mg/dL after switching to MGP, subjects were enrolled into Part 2 and received a one-time MGP dose adjustment. The MGP daily dose was increased by 266 mg. For both parts 1 and 2, subjects recorded the number and quality of their stools to assess gastrointestinal (GI) tolerability of MGP...
March 27, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29570132/xanthomatous-cells-in-cutaneous-graft-versus-host-disease-biopsies-a-clue-for-the-diagnosis-of-hepatic-graft-versus-host-disease
#16
Denise Gamé, Lucia López, Concepción Román, Ángel Santos-Briz
Graft-versus-host disease (GVHD) is one of the most common and serious complications of hematopoietic stem-cell transplantation that mainly affects the skin, gastrointestinal tract, and liver. Hepatic GVHD is associated with high morbidity and mortality, and its diagnosis can be especially challenging because of nonspecific clinical signs and symptoms. It must be suspected in patients with elevated liver enzymes and cholestasis, especially in those with a history of preceding skin rash and diarrhea. We describe 3 patients with cutaneous and hepatic GVHD that presented with severe hypercholesterolemia and hypertriglyceridemia, and no xanthomatous macular lesions, in which cutaneous biopsies revealed the presence of xanthomatous dermal histiocytes...
March 21, 2018: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/29564854/-nursing-care-of-older-people-with-clostridium-difficile-infection
#17
Ya-Ting Chuang, Yueh-Juen Hwu
The global incidence of Clostridium difficile infection (CDI) has increased in recent decades. The etiology of CDI includes aging as well as the misuse of antibiotics. This highly infectious disease requires that healthcare workers be vigilant and take isolation precautions, particularly in long-term facilities. CDI contributes to the development of severe diarrhea, which may cause imbalance of electrolytes, malabsorption of nutrients, physical disabilities, and psychosocial impacts in older patients. This article explores the pathophysiology, impacts, treatments (e...
April 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29552005/intrahost-norovirus-evolution-in-chronic-infection-over-5-years-of-shedding-in-a-kidney-transplant-recipient
#18
Andrej Steyer, Tilen Konte, Martin Sagadin, Marko Kolenc, Andrej Škoberne, Julija Germ, Tadeja Dovč-Drnovšek, Miha Arnol, Mateja Poljšak-Prijatelj
Noroviruses are the leading cause of acute gastroenteritis, and they can affect humans of all age groups. In immunocompromised patients, norovirus infections can develop into chronic diarrhea or show prolonged asymptomatic virus shedding. Chronic norovirus infections are frequently reported for solid organ transplant recipients, with rapid intrahost norovirus evolution seen. In this report, we describe a case of chronic norovirus infection in an immunocompromised patient who was followed up for over 5 years...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29534657/role-of-endoscopic-findings-and-biopsies-in-renal-transplant-recipients-with-gastrointestinal-complications-a-tertiary-care-experience
#19
Rajesh Kumar Wadhwa, Aisha Nazeer, Ayesha Aslam Rai, Nasir Hassan Luck
OBJECTIVES: We investigated the incidence of gastrointestinal disorders requiring endoscopic and histopathologic diagnoses in renal transplant recipients. MATERIALS AND METHODS: In this retrospective analysis, we examined records of patients seen at the Department of Hepato-Gastroenterology and Transplantation Sciences, Sindh Institute of Urology and Trans?lantation (Karachi, Pakistan) from January 2010 to December 2014. Renal transplant recipients with gastrointestinal disorders who required endoscopy, including proctoscopy and upper and lower gastrointestinal endoscopy as per indication, were included...
March 9, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29518863/-clinical-study-of-low-cytomegalovirus-viral-load-thresholds-for-preemptive-antiviral-therapy-in-hematopoietic-cell-transplant-recipients
#20
L Li, Y Wang, C H Yan, X J Huang
Objective: To investigate the threshold of cytomegalovirus (CMV) DNAemia for preemptive antiviral therapy in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: Viral load between 1×10(3) copies/ml and 5×10(3) copies/ml was defined as low viral load by real time Q-PCR. Clinical data and outcome were collected. Results: A total of 95 allo-HSCT recipients with low viral load from September 2014 to February 2015 were recruited in this study. The control group included 37 patients who received preemptive initial antiviral therapy...
March 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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