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https://www.readbyqxmd.com/read/29243878/predictive-value-of-c-reactive-protein-for-tuberculosis-bloodstream-infection-or-death-among-hiv-infected-individuals-with-chronic-non-specific-symptoms-and-negative-sputum-smear-microscopy
#1
Richard A Bedell, Monique van Lettow, Christopher Meaney, Elizabeth L Corbett, Adrienne K Chan, Robert S Heyderman, Suzanne T Anderson, Ann Åkesson, Moses Kumwenda, Rony Zachariah, Anthony D Harries, Andrew R Ramsay
BACKGROUND: To determine whether C-reactive protein (CRP) is an inflammatory biomarker that may identify patients at risk of infections or death. Mortality among HIV-infected persons commencing antiretroviral therapy (ART) is often attributed to tuberculosis (TB) or bloodstream infections (BSI). METHODS: In two district hospitals in southern Malawi we recruited HIV-infected adults with one or more unexplained symptoms present for at least one month (weight loss, fever, or diarrhea), and negative expectorated sputum microscopy for TB...
December 15, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29237784/low-yield-of-filmarray-gi-panel-in-hospitalized-patients-with-diarrhea-an-opportunity-for-diagnostic-stewardship-intervention
#2
Matthew M Hitchcock, Carlos A Gomez, Niaz Banaei
FilmArray GI Panel (BioFire Diagnostics, Salt Lake City, UT) is a multiplex, on-demand, sample-to-answer, real-time PCR assay for the syndromic diagnosis of infectious gastroenteritis that has become widely adopted and, in some instances, replaced conventional stool culture and parasite exams. Conventional testing has historically been restricted among hospitalized patients due to low diagnostic yield, but it is not known whether use of the FilmArray GI Panel should be circumscribed. Cary-Blair stool samples submitted for FilmArray GI Panel in adult patients admitted to an academic hospital from August 2015 to January 2017 were included in this study...
December 13, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29236651/recognizing-a-rare-phenomenon-of-angiotensin-converting-enzyme-inhibitors-visceral-angioedema-presenting-with-chronic-diarrhea-a-case-report
#3
Joseph Gabriel Gabriel, Venkatasriharsha Vedantam, Aaysha Kapila, Kailash Bajaj
INTRODUCTION: Peripheral angioedema of the face and upper airways is a well-known phenomenon of angiotensin-converting enzyme inhibitors occurring in only 0.1% to 0.7% of patients. We describe a case of the even less-common manifestation of visceral angioedema, which causes symptoms of chronic and intractable diarrhea. CASE PRESENTATION: A 68-year-old white woman presented with large-volume diarrhea, caused by visceral angioedema secondary to lisinopril therapy...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29234568/long-term-quality-of-life-of-retroperitoneal-sarcoma-patients-treated-with-pre-operative-radiotherapy-and-surgery
#4
Philip Wong, Zahra Kassam, Amanda N Springer, Rebecca Gladdy, Peter Chung, Jolie Ringash, Charles Catton
PURPOSE: Retroperitoneal sarcomas (RPS) are connective tissue cancers that are often large and anatomically in close proximity to critical and radiation-sensitive normal structures and organs within the abdomen and pelvis. The management of RPS may include preoperative radiotherapy (RT) and surgery. We aimed to examine how treatment-related toxicities affect patient quality of life (QOL).  Methods and materials: Within two prospective cohort studies, 48 RPS patients who were treated with preoperative RT from 1998-2012 were recruited and assessed for QOL (EORTC-QLQ-C30) and to determine toxicities potentially related to RT and surgery (graded using CTCAE V...
October 11, 2017: Curēus
https://www.readbyqxmd.com/read/29230146/microscopic-colitis-a-review-of-collagenous-and-lymphocytic-colitis
#5
Karen Boland, Geoffrey C Nguyen
Microscopic colitis (MC) is a chronic inflammatory bowel disease characterized by chronic watery diarrhea and diagnosed with the histologic hallmarks of disease despite a macroscopically normal large bowel. Although 2 distinct disease phenotypes exist, their clinical presentations and epidemiologic characteristics have overlapping features. This article summarizes evidence regarding the pathogenesis of MC, mechanisms of diarrhea in this cohort, and associations with medications. In addition, currently recommended and novel therapeutic approaches to achieving remission in this patient population are reviewed...
November 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29227466/morbidity-and-mortality-of-a-cohort-of-peruvian-hiv-infected-children-2003-2012
#6
Amira N Baker, Angela M Bayer, Rolando M Viani, Lenka Kolevic, Myung-Shin Sim, Jaime G Deville
BACKGROUND: Data on pediatric HIV in Peru is limited. The National Institute of Child Health (Instituto Nacional de Salud del Niño: INSN) cares for the most HIV-infected children under age 18 in the country. We describe the outcomes of children seen at INSN's HIV clinic over the 10 years when antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) interventions became available in 2004. METHODS: We conducted a retrospective review of INSN HIV clinic patients between 2003-2012...
December 8, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29218485/apical-membrane-alterations-in-non-intestinal-organs-in-microvillus-inclusion-disease
#7
Cameron Schlegel, Victoria G Weis, Byron C Knowles, Lynne A Lapierre, Martin G Martin, Paul Dickman, James R Goldenring, Mitchell D Shub
OBJECTIVES: Microvillus inclusion disease (MVID) is a severe form of neonatal diarrhea, caused mainly by mutations in MYO5B. Inactivating mutations in MYO5B causes depolarization of enterocytes in the small intestine, which gives rise to chronic, unremitting secretory diarrhea. While the pathology of the small intestine in MVID patients is well described, little is known about extraintestinal effects of MYO5B mutation. METHODS: We examined stomach, liver, pancreas, colon, and kidney in Navajo MVID patients, who share a single homozygous MYO5B-P660L (1979C>T p...
December 7, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29217957/evaluation-of-parasitological-methods-for-the-detection-of-strongyloides-stercoralis-among-individuals-in-selected-health-institutions-in-addis-ababa-ethiopia
#8
Tamirat Hailegebriel, Beyene Petros, Tekola Endeshaw
Background: Strongyloides stercoralis causes chronic intestinal infection that may lead to disseminated disease during immunosuppression. Therefore, efficient diagnostic methods are essential to detect silent and latent infections. The present study was aimed to compare the efficacy of parasitological methods for the detection of S. stercoralis infection. Methods: A cross-sectional study was conducted on 351 subjects (226 HIV positive and 125 HIV negative) from October 2005 to May 2006...
September 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29217892/bowel-migration-of-dormant-chronic-ambulatory-peritoneal-dialysis-catheter-a-vexed-problem-not-avoided-by-flushing
#9
P Vincent, J Gopinathan, R Narayanan
Delayed bowel erosion by peritoneal dialysis catheter is rare with fewer than thirty cases having been reported in the literature. This complication is usually encountered when the catheter is kept dormant. Two cases have also been reported with catheters in active use. The risk factors for bowel erosion include immunosuppression, diverticulosis, and amyloidosis. An 80-year-old male with chronic kidney disease Stage 5 due to hypertensive nephrosclerosis underwent chronic ambulatory peritoneal dialysis catheter insertion...
November 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29212102/-conservative-treatment-of-an-aseptic-abscess-syndrome-with-splenic-abscesses-in-crohn-s-disease
#10
Thomas Göbel, Jutta Rauen-Vossloh, Hubert Georg Hotz, Andree Boldt, Andreas Erhardt
A 24-year old woman with a history of Crohn's disease developed bloody diarrhea and multiple abdominal abscesses, daily fever, leukocytosis, and elevated CRP several months after her immunosuppressive therapy with azathioprine was stopped. Recurrent abscess punctures did not detect any pathogenic germs and neither clinical nor serological response was achieved by administration of different antimicrobial therapies. Additionally, new splenic abscesses arose despite ongoing therapy. Under the suspicion of the rare aseptic abscess syndrome, representing an auto-inflammatory, extra-intestinal manifestation of Crohn's disease, the antimicrobial therapy was stopped and an intravenous therapy with prednisolone was initiated...
December 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29211811/challenges-in-the-diagnosis-of-ulcerative-colitis-with-concomitant-bacterial-infections-and-chronic-infectious-colitis
#11
Wei-Chen Lin, Chen-Wang Chang, Ming-Jen Chen, Cheng-Hsin Chu, Shou-Chuan Shih, Tzu-Chi Hsu, Horng-Yang Wang
Ulcerative colitis (UC) is a chronic inflammation of the large bowel characterized by diarrhea and a negative stool culture. However, several enteropathogens have been implicated as causative agents in UC. The differentiation between chronic infectious colitis (IC) and UC with concurrent infection is difficult owing to their similar clinical presentations. The study aimed to explore the presentations and diagnostic clues that enable differentiation between UC with concomitant infections and chronic IC. The study included 17 UC patients with a bacterial infection and 46 with chronic IC...
2017: PloS One
https://www.readbyqxmd.com/read/29210625/evaluation-of-oral-serum-derived-bovine-immunoglobulins-in-hiv-infected-patients-with-chronic-idiopathic-diarrhea
#12
David M Asmuth, John E Hinkle, Anthony LaMarca, Carl J Fichtenbaum, Ma Somsouk, Netanya S Utay, Audrey L Shaw, Bryon W Petschow, Christopher J Detzel, Eric M Weaver
Objectives To evaluate serum-derived bovine immunoglobulin/protein isolate (SBI) for safety and impact on gastrointestinal (GI) symptoms in HIV patients with chronic idiopathic diarrhea. Methods A multi-center trial comprised of a double-blind, placebo (PBO)-controlled lead-in phase, (participants received PBO or SBI at 2.5 or 5.0 g BID for 4 weeks) followed by a 20-week, PBO-free phase (SBI at either 2.5 or 5.0 g BID). Participants included HIV-infected patients who were virologically suppressed with a history of chronic idiopathic diarrhea, defined as > 3 loose stools per day for ≥ 3 months without an identifiable cause...
November 2017: HIV Clinical Trials
https://www.readbyqxmd.com/read/29210011/n-of-1-randomized-trials-of-ultra-micronized-palmitoylethanolamide-in-older-patients-with-chronic-pain
#13
Federico Germini, Anna Coerezza, Luca Andreinetti, Alessandro Nobili, Paolo Dionigi Rossi, Daniela Mari, Gordon Guyatt, Maura Marcucci
BACKGROUND: Ultra-micronized palmitoylethanolamide (um-PEA) represents an attractive option for chronic pain control in complex older patients at higher risk of adverse effects with traditional analgesics. OBJECTIVE: The aim of this study was to determine the effectiveness of um-PEA versus placebo on chronic pain intensity and function in individual geriatric patients. DESIGN: We performed randomized, blinded N-of-1 trials with two 3-week um-PEA versus placebo comparisons, separated by 2-week washout periods...
December 5, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29204849/human-intestinal-spirochetosis-mimicking-ulcerative-colitis
#14
Shin Nishii, Masaaki Higashiyama, Sho Ogata, Shunsuke Komoto, Suguru Ito, Akinori Mizoguchi, Hisato Terada, Hirotaka Furuhashi, Takeshi Takajo, Kazuhiko Shirakabe, Chikako Watanabe, Kengo Tomita, Shigeaki Nagao, Soichiro Miura, Ryota Hokari
Human intestinal spirochetosis (HIS) is a colorectal infection caused by the Brachyspira species of intestinal spirochetes, whose pathogenicity in humans remains unclear owing to the lack of or mild symptoms. We monitored the 5-year clinical course of a woman diagnosed with HIS in whom ulcerative colitis (UC) had been suspected. Following a positive fecal occult blood test, she underwent a colonoscopic examination at a local clinic where she was diagnosed with "right-sided" UC concomitant with incidentally detected HIS, and was referred to our hospital...
December 4, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29194677/chronic-inflammatory-demyelinating-polyneuropathy-and-malignancy-a-systematic-review
#15
REVIEW
Yusuf A Rajabally, Shahram Attarian
A systematic review of the literature was performed on the association of chronic inflammatory demyelinating polyneuropathy (CIDP) with malignancy. Hematologic disorders are the most common association, particulalry non-Hodgkin's lymphoma. CIDP frequently precedes the malignancy diagnosis, and there is a favorable CIDP response to treatment more than 70% of the time. Melanoma is the second most common association, and may be accompanied by antiganglioside antibodies; the CIDP shows a good response to immunotherapy...
December 1, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/29191916/duvelisib-a-novel-oral-dual-inhibitor-of-pi3k-%C3%AE-%C3%AE-is-clinically-active-in-advanced-hematologic-malignancies
#16
Ian W Flinn, Susan O'Brien, Brad Kahl, Manish Patel, Yasuhiro Oki, Francine F Foss, Pierluigi Porcu, Jeffrey Jones, Jan A Burger, Nitin Jain, Virginia M Kelly, Kerstin Allen, Mark Douglas, Jennifer Sweeney, Patrick Kelly, Steven Horwitz
Duvelisib (IPI-145) is a novel, oral, dual inhibitor of phosphoinositide 3-kinase (PI3K)-δ and PI3K-γ in late-stage clinical development for treatment of hematologic malignancies. This Phase 1 study (registered as NCT01476657 at ClinicalTrials.gov) evaluated the maximum tolerated dose (MTD), pharmacokinetics (PK), pharmacodynamics (PD), efficacy, and safety of duvelisib in 210 patients with advanced hematologic malignancies. In the Dose Escalation Phase (n=31), duvelisib 8 to 100 mg BID was administered, with MTD determined to be 75 mg BID...
November 30, 2017: Blood
https://www.readbyqxmd.com/read/29187397/the-spirochete-brachyspira-pilosicoli-enteric-pathogen-of-animals-and-humans
#17
REVIEW
David J Hampson
Brachyspira pilosicoli is a slow-growing anaerobic spirochete that colonizes the large intestine. Colonization occurs commonly in pigs and adult chickens, causing colitis/typhlitis, diarrhea, poor growth rates, and reduced production. Colonization of humans also is common in some populations (individuals living in village and peri-urban settings in developing countries, recent immigrants from developing countries, homosexual males, and HIV-positive patients), but the spirochete rarely is investigated as a potential human enteric pathogen...
January 2018: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/29186198/safety-and-efficacy-of-ferric-citrate-in-patients-with-nondialysis-dependent-chronic-kidney-disease
#18
Glenn M Chertow, Geoffrey A Block, John F Neylan, Pablo E Pergola, Katrin Uhlig, Steven Fishbane
Two randomized, placebo-controlled trials conducted in patients with nondialysis-dependent (NDD) chronic kidney disease (CKD), iron deficiency anemia, and normal or elevated serum phosphorus demonstrated that ferric citrate (FC) significantly increased hemoglobin and decreased serum phosphate concentrations. Pooling these trial results could provide a more robust evaluation of the safety and efficacy of FC in this population. We pooled results of a phase 2 (n = 149) and 3 trial (n = 233) of patients randomized and treated for up to 12 and 16 weeks, respectively...
2017: PloS One
https://www.readbyqxmd.com/read/29182206/-mckrittick-wheelock-syndrome-report-of-one-case
#19
Alejandro Kral, Jorge Vega
McKittrick-Wheelock syndrome is caused by chronic water and electrolyte hypersecretion from an intestinal tumor, usually a villous adenoma, located in the rectum or sigmoid. Patients often have dehydration, hypovolemic shock and kidney failure associated with hypokalemia, hyponatremia, hypochloremia and metabolic acidosis. We report a 62-year-old male, suffering chronic diarrhea for eight years who was admitted after a syncope. He had severe hypokalemia, hyponatremia, metabolic acidosis, hypovolemia and acute renal failure...
July 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29181956/infectious-diseases-in-poland-in-2015
#20
Małgorzata Sadkowska-Todys, Andrzej Zieliński, Mirosław P. Czarkowski
PURPOSE OF THE STUDY: This is the next annual analysis of the situation of infectious and parasitic diseases in Poland in 2015 within the framework of the Epidemiological Chronicle of Przegląd Epidemiologiczny - Epidemiological Review. Its purpose is to identify potential threats to the health of populations from infectious diseases occurring in Poland with reference to other parts of the globe. MATERIAL AND METHODS: This paper is an introduction to more detailed studies of the epidemiological situation of selected infectious diseases and summarizes the results of the surveillance of infectious diseases in Poland in 2015...
2017: Przegla̧d Epidemiologiczny
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