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diarrhea and transplant

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https://www.readbyqxmd.com/read/28101911/comparison-of-cbv-beam-and-beac-high-dose-chemotherapy-followed-by-autologous-hematopoietic-stem-cell-transplantation-in-non-hodgkin-lymphoma-efficacy-and-toxicity
#1
Youwu Shi, Peng Liu, Shengyu Zhou, Jianliang Yang, Xiaohong Han, Xiaohui He, Changgong Zhang, Lin Gui, Yan Qin, Sheng Yang, Liya Zhao, Jiarui Yao, Bo Jia, Shuxiang Zhang, Yan Sun, Yuankai Shi
AIM: Limited data are available to guide the choice of conditioning regimen before autologous hematopoietic stem cell transplantation (AHSCT) for patients with lymphoma. METHODS: We analyzed 129 non-Hodgkin lymphoma patients who underwent AHSCT from 1996 to 2013 using the most common regimens: CBV (cyclophosphamide, carmustine and etoposide; n = 16), BEAM (carmustine, etoposide, cytarabine and melphalan; n = 36) and BEAC (carmustine, etoposide, cytarabine and cyclophosphamide; n = 77)...
January 19, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28097735/autoimmune-enteropathy-and-hepatitis-in-pediatric-heart-transplant-recipient
#2
Kimberly Lewis, Ryan Butts, J Antonio Quiros, Michelle Hudspeth, Katherine Twombley, Andrew Savage, Sally Self, Ali Burnette, Shaoli Sun
AIE is a rare disorder in children that presents with severe diarrhea and malabsorption, caused by immune-mediated damage to intestinal mucosa. AIE is often associated with various syndromes of immunodeficiency including IPEX syndrome (immune dysregulation, polyendocrinopathy and enteropathy, X-linked). Dysfunctional T regulatory cells are the source of pathology in both IPEX syndrome and AIE as they are essential in maintaining tolerance to self-antigens and eliminating autoreactive B cells. This case report describes a 10-year-old cardiac transplant and total thymectomy patient on chronic immunosuppression with tacrolimus that presented with AIE and extraintestinal manifestations of cyclical hepatitis...
January 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28093134/management-of-clostridium-difficile-infection-in-inflammatory-bowel-disease-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#3
REVIEW
Sahil Khanna, Andrea Shin, Ciarán P Kelly
The purpose of this expert review is to synthesize the existing evidence on the management of Clostridium difficile infection in patients with underlying inflammatory bowel disease. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current practice guidelines. This review is a summary of expert opinion in the field without a formal systematic review of evidence. Best Practice Advice 1: Clinicians should test patients who present with a flare of underlying inflammatory bowel disease for Clostridium difficile infection...
February 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28067684/diarrhea-after-allogeneic-stem-cell-transplantation-beyond-graft-versus-host-disease
#4
Katarzyna Robak, Joanna Zambonelli, Jaroslaw Bilinski, Grzegorz W Basak
Diarrhea constitutes a frequent and often debilitating complication of allogeneic hematopoietic cell transplantation (alloHCT). Especially when accompanied by jaundice, skin rash, and symptoms of the upper gastrointestinal tract, diarrhea strongly suggests emergence of acute graft-versus-host disease (GvHD), which is a serious immune complication of the procedure, with possible fatal consequences. However, especially when diarrhea occurs as an isolated symptom, the other causes must be excluded before initiation of GvHD treatment with immune-suppressive drugs...
January 6, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28063938/brincidofovir-for-asymptomatic-adenovirus-viremia-in-pediatric-and-adult-allogeneic-hematopoietic-cell-transplant-recipients-a-randomized-placebo-controlled-phase-ii-trial
#5
Michael S Grimley, Roy F Chemaly, Janet A Englund, Joanne Kurtzberg, Gregory Chittick, Thomas M Brundage, Andrew Bae, Marion E Morrison, Vinod K Prasad
Adenovirus infection in immunocompromised patients contributes to significant morbidity and mortality, especially after allogeneic hematopoietic cell transplantation (HCT). Brincidofovir (BCV, CMX001) is an orally bioavailable lipid conjugate of cidofovir that has in vitro activity against adenoviruses and other double-stranded DNA viruses. This randomized placebo-controlled phase II trial evaluated pre-emptive treatment with BCV for the prevention of adenovirus disease in pediatric and adult allogeneic HCT recipients with asymptomatic adenovirus viremia...
January 5, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28060108/diagnostic-utility-of-complement-immunohistochemical-studies-in-post-stem-cell-transplant-intestinal-thrombotic-microangiopathy-case-report
#6
Jenna E Rossoff, Jennifer Schneiderman, Sonali Chaudhury, Nicoleta C Arva
Thrombotic complications are a significant source of morbidity and mortality following hematopoietic stem cell transplants. Among them, transplant-associated thrombotic microangiopathy (TA-TMA) is a well-recognized syndrome that can affect various organ systems. Its etiology is related to endothelial injury accompanied by complement activation. As many of the signs and symptoms of the disease are also encountered in other complications following hematopoietic stem cell transplant, it can often be difficult to establish the diagnosis based on clinical data alone...
January 5, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28032203/antioxidant-properties-of-mesenchymal-stem-cells-against-oxidative-stress-in-a-murine-model-of-colitis
#7
Fabiany da Costa Gonçalves, Mateus Grings, Natália Schneider Nunes, Fernanda Otesbelgue Pinto, Tuane Nerissa Alves Garcez, Fernanda Visioli, Guilhian Leipnitz, Ana Helena Paz
OBJECTIVE: To investigate the effects of oxidative stress injury in dextran sulfate sodium (DSS)-induced colitis in mice treated with mesenchymal stem cells (MSC). RESULTS: Mice exposed to oral administration of 2% DSS over 7 days presented a high disease activity index and an intense colonic inflammation. Systemic infusion of MSC protected from severe colitis, reducing weight loss and diarrhea while lowering the infiltration of inflammatory cells. Moreover, toxic colitis injury increased oxidative stress...
December 28, 2016: Biotechnology Letters
https://www.readbyqxmd.com/read/28030354/phylogenetic-analysis-of-genetically-distinct-enterocytozoon-bieneusi-infecting-renal-transplant-recipients
#8
Sonali Khanduja, Ujjala Ghoshal, Uday C Ghoshal
Enterocytozoon bieneusi (E. bieneusi), infecting renal transplant (RT) recipients may be transmitted anthroponotically or zoonotically. Accordingly, we aimed to, a) evaluate genotypes of E. bieneusi ínfecting RT recipients, and b) infer phylogenetic interpretation on transmission of different genotypes among infected hosts. Stool samples of 22 RT recipients infected with microsporidia (identified using modified trichrome staining) were subjected to species identification. All E. bieneusi positive samples were subjected to genotyping...
March 1, 2017: Acta Parasitologica
https://www.readbyqxmd.com/read/28028357/can-probiotics-benefit-children-with-autism-spectrum-disorders
#9
REVIEW
Fernando Navarro, Yuying Liu, Jon Marc Rhoads
Children with autism are commonly affected by gastrointestinal problems such as abdominal pain, constipation and diarrhea. In recent years, there has been a growing interest in the use of probiotics in this population, as it hypothetically may help to improve bowel habits and the behavioral and social functioning of these individuals. The gut microbiome plays an important role in the pathophysiology of organic as well as functional gastrointestinal disorders. Microbial modification with the use of antibiotics, probiotics, and fecal transplantation have been effective in the treatment of conditions such as recurrent Clostridium difficile infection, pouchitis, and irritable bowel syndrome...
December 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28025783/idelalisib-induced-colitis-and-skin-eruption-mimicking-graft-versus-host-disease
#10
Muhammad Bader Hammami, Ahmad Al-Taee, Marshall Meeks, Mark Fesler, M Yadira Hurley, Dengfeng Cao, Jin-Ping Lai
INTRODUCTION: Idelalisib is a selective inhibitor of the delta isoform of phosphatidylinositol 3-kinase which was approved by the United States Federal Drug Administration in 2014 for the treatment of relapsed chronic lymphocytic leukemia and indolent non-Hodgkin lymphoma. Drug-induced injury of the gastrointestinal tract is a relatively frequent but usually under-recognized disease entity. CASE PRESENTATION: We report the case of a 56-year-old male with a history of relapsed follicular lymphoma status post allogenic bone marrow transplant who developed severe diarrhea with a skin eruption mimicking graft-versus-host disease (GVHD) 6 months after starting idelalisib...
December 26, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27997854/the-emerging-metabolic-view-of-clostridium-difficile-pathogenesis
#11
REVIEW
Andrew J Hryckowian, Kali M Pruss, Justin L Sonnenburg
It is widely accepted that Clostridium difficile exploits dysbiosis and leverages inflammation to thrive in the gut environment, where it can asymptomatically colonize humans or cause a toxin-mediated disease ranging in severity from frequent watery diarrhea to pseudomembranous colitis or toxic megacolon. Here, we synthesize recent findings from the gut microbiota and enteric pathogenesis fields to inform the next steps toward a better understanding of C. difficile infection (CDI). In this review, we present a model in which the lifestyle of C...
December 17, 2016: Current Opinion in Microbiology
https://www.readbyqxmd.com/read/27995486/clostridium-difficile-infection-updates-in-management
#12
REVIEW
Raseen Tariq, Sahil Khanna
Clostridium difficile was first identified in 1978 as a diarrhea-causing bacterium in humans. In the last three decades, C. difficile infection (CDI) has reached an epidemic state, both in health care and community settings worldwide. There has been substantial progress in the field of CDI, including identification of novel risk factors, presence of CDI in individuals not considered at risk previously, and treatment options including new drugs, monoclonal antibodies, and fecal microbiota transplantation. This review discusses epidemiology, novel and traditional risk factors, and updates in management for CDI...
December 20, 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/27984397/donor-screening-experience-for-fecal-microbiota-transplantation-in-patients-with-recurrent-c-difficile-infection
#13
Raseen Tariq, Renee Weatherly, Patricia Kammer, Darrell S Pardi, Sahil Khanna
GOALS: To evaluate our experience with stool donor recruitment, screening, retention, and donor perception for fecal microbiota transplantation (FMT). BACKGROUND: Multiply recurrent Clostridium difficile infection is being increasingly managed with FMT from donor stools. However, donor selection and recruitment is challenging due to lack of standard evidence-based guidelines, donor exclusion criteria, frequency of screening and donor commitment. METHODS: Data on donors screened using institutional guidelines with history, blood and stool testing and their perspectives on donation were analyzed...
December 14, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27903231/new-analogues-of-mycophenolic-acid
#14
Agnieszka Głowacka, Michal Prejs, Grzegorz Cholewinski, Krystyna Dzierzbicka
Mycophenolic acid (MPA) possesses antibacterial, antifungal, antiviral, immunosuppressive and anticancer properties. It is a non-competitive and reversible inhibitor of dehydrogenase inosine-5'-monophosphate (IMPDH) [1,2]. This compound belongs to the immunosuppressive drugs used for the prevention of both acute and chronic transplant rejection [3]. Until now clinically have been used two derivatives of MPA: mycophenolate mofetil (MMF, CellCept) and mycophenolate sodium (MPS, Myfortic). They cause, similar to MPA, although at lower degree, the side effects such as vomiting, abdominal pain, diarrhea, nausea, gastrointestinal, urogenital tract, blood or nervous system disorders...
November 29, 2016: Mini Reviews in Medicinal Chemistry
https://www.readbyqxmd.com/read/27896624/autologous-bone-marrow-stem-cell-transplantation-for-the-treatment-of-ulcerative-colitis-complicated-with-herpes-zoster-a-case-report
#15
Hang Xiang, Xiaomei Zhang, Chao Yang, Wenhuan Xu, Xin Ge, Rong Zhang, Ya Qiu, Wanjun Sun, Fan Li, Tianyuan Xiang, Haixu Chen, Zheng Wang, Qiang Zeng
Ulcerative colitis (UC) is a chronic inflammatory bowel disease with continuous or recurrent symptoms. A 42-year-old male patient with intermittent diarrhea accompanied by bloody mucopurulent stools was admitted to our hospital. The diagnosis of UC was confirmed by a combination of laboratory examination, colonoscopy, and histological assay. The patient developed herpes zoster in the hospital, which challenged traditional treatments. Therefore, we performed an autologous bone marrow cells to modulate the immune system with his permission...
November 28, 2016: Frontiers of Medicine
https://www.readbyqxmd.com/read/27881814/chronic-norovirus-infections-in-cardiac-transplant-patients-considerations-for-evaluation-and-management
#16
Paul T Jurgens, Larry A Allen, Amrut V Ambardekar, Colleen K McIlvennan
Norovirus is a common self-limiting gastrointestinal infection, but in transplant recipients, symptoms can last for months and result in serious health complications. As there is currently no established treatment for chronic norovirus infection in transplant patients, management has been directed at symptom control, trial of various antivirals, and ultimately reductions in immunosuppression. We present 3 cases of chronic norovirus infection in cardiac transplant patients to illustrate various approaches to diagnosis, the prolonged nature of disease symptoms, and treatment options...
November 23, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27879593/triptolide-reduces-the-required-dose-of-tacrolimus-by-attenuating-inflammation-enhancing-immunosuppression-and-increasing-donor-chimerism-in-a-heterotopic-hindlimb-transplantation-model
#17
Chuan Gu, Fei Liu, Xusong Luo, Xianyu Zhou, Jun Yang, L Scott Levin
BACKGROUND: Induction of tolerance and minimizing the toxicity of immunosuppression are two fundamental goals in vascularized composite allotransplantation. Accumulating data indicate that triptolide is an agent that may have the capacity to suppress inflammation and immunologic rejection. METHODS: A heterotopic hindlimb allotransplantation model from Brown Norway to Lewis rats was established and treated with different doses of tacrolimus combined with or without triptolide...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27876339/diagnosis-and-treatment-of-clostridium-difficile-c-diff-colitis-review-of-the-literature-and-a-perspective-in-gynecologic-oncology
#18
REVIEW
Kristin N Taylor, Michael T McHale, Cheryl C Saenz, Steven C Plaxe
Clostridium difficile infection (CDI) is a major cause of nosocomial diarrhea with the potential for significant morbidity and mortality. Colonization in a susceptible individual, with risk factors such as prior antibiotic use, advanced age, or medical comorbidities, may result in symptomatic infection. Although patients with a gynecologic malignancy may be at a higher risk of developing CDI due to an increased likelihood of having one or more risk factors, data do not consistently support the idea that chemotherapy or cancer itself are independently associated with CDI...
November 19, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27862714/de-novo-inflammatory-bowel-disease-after-pediatric-kidney-or-liver-transplant
#19
Melissa A Fernandes, Hillary J Braun, Kim Evason, Sue Rhee, Emily R Perito
A subset of children who receive a liver and/or kidney transplant develop de novo inflammatory bowel disease-like chronic intestinal inflammation, not explained by infection or medications, following transplant. We have conducted a single-center, retrospective case series describing the unique clinical and histologic features of this IBD-like chronic intestinal inflammation following solid organ transplant. At our center, nine of 327 kidney or liver recipients developed de novo IBD following transplant (six liver, two kidney, one liver-kidney)...
November 11, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27849236/treatment-of-short-bowel-syndrome-in-children-value-of-the-intestinal-rehabilitation-program
#20
Uenis Tannuri, Fabio de Barros, Ana Cristina Aoun Tannuri
The main cause of acute intestinal failure is short bowel syndrome, generally as a result of resection of extensive segments of small intestine. As a result, the main symptoms are watery diarrhea, malabsorption syndrome, chronic malnutrition, and death, if the patient is not properly treated. If the length of the remaining intestine is greater than 30 cm, complete adaptation is possible and the patient may not require parenteral nutrition. The currently recommended treatment includes the use of prolonged parenteral nutrition and enteral nutrition, always aimed at constant weight gain, in conjunction with surgeries aimed at elongating the dilated bowel...
September 2016: Revista da Associação Médica Brasileira
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