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https://www.readbyqxmd.com/read/29890556/-management-of-clostridium-difficile-infections-at-german-intensive-care-units-results-from-a-survey-among-intensivists
#1
Jan Bruensing, Lukas Buendgens, Christoph Jochum, Ulf Herbers, Ali Canbay, Georg Braun, Christian Trautwein, Wolfgang Huber, Alexander Koch, Frank Tacke
BACKGROUND:  Clostridium difficile associated colitis is a frequent cause of nosocomial diarrhea at the intensive care unit (ICU) and is associated with poor prognosis in critically ill patients. Few studies have evaluated the efficacy of treatment options or adherence to guideline recommendations of Clostridium difficile infections at the ICU. METHODS:  Therefore, on behalf of the Gastroenterology Intensive Care Medicine working group of the DGVS, we have conducted an online-based survey among leading intensivists in Germany...
June 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29888965/current-updates-in-management-of-clostridium-difficile-infection-in-cancer-patients-review
#2
Muhammad Aziz, Rawish Fatima, Lindsey N Douglass, Omar Abughanimeh, Shahzad Raza
Clostridium difficile infection (CDI) is a significant health burden now recognized as the leading cause of acquired diarrhea in patients receiving antibiotic therapy. Complications of infection with this pathogen include severe diarrhea causing electrolyte imbalances, dehydration, hemodynamic instability, toxic megacolon, shock and death, hence it is extremely paramount to stay updated on management options for this infection especially in cancer patients. This article presents an in-depth review of literature on the treatment modalities available for CDI in cancer patients...
June 11, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29858434/-clostridium-difficile-infection-and-antibiotic-associated-diarrhoea
#3
Benjamin H Mullish, Horace Rt Williams
Antibiotic-associated diarrhoea is among the most common adverse events related to antibiotic use. Most cases are mild, but Clostridium difficile infection causes a spectrum of disease, ranging from occasional diarrhoea to colitis, toxic megacolon, and potentially death. Recent developments in our understanding of the biology of the gut microbiota have provided new insights into the pathogenesis of these conditions, and have revealed a role for manipulation of the gut microbiota as a novel therapeutic approach...
June 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29783140/congenital-diaphragmatic-disease-an-unusual-presentation-in-adulthood-case-report
#4
Angela Gurrado, Roberta Maria Isernia, Alessandro De Luca, Valentina Ferraro, Daniela Virgintino, Anna Napoli, Giuseppe Cavallaro, Eugenio Maiorano, Angela Pezzolla, Mario Testini
INTRODUCTION: Congenital diaphragmatic disease is a quite common condition that usually occurs in the neonatal period, and the diagnosis of congenital diaphragmatic disease in adulthood is rare. CASE PRESENTATION: A 64-years-old Caucasian woman was admitted in emergency at our Department, due to a bowel obstruction and dyspnea. A CT-scan showed a diaphragmatic herniation in the left area, with malposition of dilated transverse and descending colon in the chest. An emergency laparatomy was performed, showing a toxic megacolon, in the absence of a true diaphragmatic hernia, and a left diaphragm and left liver hypoplasia...
May 7, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29768720/bis-cyclic-guanidine-as-a-novel-class-of-compounds-potent-against-clostridium-difficile
#5
Chunhui Li, Peng Teng, Zhong Peng, Peng Sang, Xingmin Sun, Jianfeng Cai
Clostridium difficile infection (CDI) symptoms range from diarrhea to severe toxic megacolon and even death. Due to its rapid acquisition of resistance, C. difficile is listed as an urgent antibiotic-resistant threat, and has surpassed methicillin-resistant Staphylococcus aureus (MRSA) as the most common hospital-acquired infections in the USA. To combat the pathogen, the new structural class of pseudo peptides that exhibit antimicrobial activities could play an important role. Herein, we report that bis-cyclic guanidine compounds that exhibit potent antibacterial activity against C...
May 16, 2018: ChemMedChem
https://www.readbyqxmd.com/read/29692762/-clostridium-difficile-from-colonization-to-infection
#6
REVIEW
Holger Schäffler, Anne Breitrück
Clostridium difficile is the most frequent cause of nosocomial antibiotic-associated diarrhea. The incidence of C. difficile infection (CDI) has been rising worldwide with subsequent increases in morbidity, mortality, and health care costs. Asymptomatic colonization with C. difficile is common and a high prevalence has been found in specific cohorts, e.g., hospitalized patients, adults in nursing homes and in infants. However, the risk of infection with C. difficile differs significantly between these cohorts...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29691261/serum-vancomycin-concentrations-after-oral-and-intracolonic-vancomycin-administration-in-a-patient-with-colonic-discontinuity-and-severe-clostridium-difficile-infection
#7
Katja Wilke, Sina Helbig, Katja de With
PURPOSE: A case of detectable systemic vancomycin levels after oral vancomycin administration but not after intracolonic administration in a patient with colonic discontinuity and severe Clostridium difficile infection (CDI) is reported. SUMMARY: A 63-year-old woman who had recently undergone pancreas-kidney transplantation developed severe CDI after 13 days of meropenem therapy for presumed urosepsis. Meropenem was stopped immediately, and treatment with oral vancomycin (250 mg every 6 hours) was started...
May 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29685027/clinical-course-of-severe-colitis-a-comparison-between-crohn%C3%A2-s-disease-and-ulcerative-colitis
#8
E Sinagra, A Orlando, F Mocciaro, V Criscuoli, L Oliva, S Maisano, M Giunta, F La Seta, G Solina, A G Rizzo, A Leone, G Tomasello, F Cappello, M Cottone
Few data are available about the clinical course of severe colonic Crohn’s disease (CD). The aim of this study is to describe the clinical course of severe Crohn’s colitis in a patient cohort with isolated colonic or ileocolonic CD, and to compare it with the clinical course of patients with severe ulcerative colitis (UC). Thirty-four patients with severe Crohn’s colitis were prospectively identified in our cohort of 593 consecutive hospitalized patients through evaluation of the Crohn’s Disease Activity Index score and the Harvey-Bradshaw Index...
March 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29668894/endoscopic-treatment-of-ileal-pouch-sinus
#9
Nan Lan, Bo Shen
Background and aims: Pouch sinus is a serious complication in patients undergoing ileal pouch-anal anastomosis. The aim of this study was to verify the efficacy and safety of endoscopic needle knife sinusotomy (NKSi) in the management of pouch sinus. Methods: All consecutive patients with a pouch sinus treated with NKSi from 2008 to 2016 were identified. The primary outcomes were complete healing of the sinus and pouch survival. Results: A total of 109 patients were included...
June 8, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29617039/closure-of-gastrointestinal-incisions-using-skin-staples-alone-and-in-combination-with-suture-in-29-cats
#10
Z Schwartz, B R Coolman
OBJECTIVE: To report the use of skin staples alone, and in combination with sutures, for closure of gastrointestinal incisions in cats and to describe outcomes. MATERIALS AND METHODS: Retrospective study of cats that underwent gastrotomy, jejunotomy, jejunal or colonic anastomosis using skin staples alone or in combination with sutures to close the enteric wounds at one referral hospital between 2001 and 2016. Data regarding patient signalment, duration of clinical signs, indication for surgery, diagnosis, haematological and biochemical values, surgical time, procedure, complications and outcome were collected...
May 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29589457/-hirschsprungs-disease-in-adults-two-case-reports-and-review-of-the-literature
#11
R Škába, J Hoch, Z Jech, M Kynčl, V Campr
Hirschsprungs disease (HD) in adults is extremely rare, only three publications in Czech and Czechoslovak journals making reference to the condition after childhood. We present two cases of adult patients with HD. The first case is a 46-year-old male patient suffering from chronic constipation since childhood and diagnosed with megacolon at the age of 16; however, no further detailed diagnosis was done. At the age of 41, he developed a sigmoid perforation due to fecaloma and underwent urgent rectosigmoid resection and colostomy...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29569002/mast-cells-and-serotonin-synthesis-modulate-chagas-disease-in-the-colon-clinical-and-experimental-evidence
#12
Vinicius Kannen, Juliana Y Sakita, Zumira A Carneiro, Michael Bader, Natalia Alenina, Regina R Teixeira, Enio C de Oliveira, Mariângela O Brunaldi, Bianca Gasparotto, Daniela C Sartori, Cleverson R Fernandes, João S Silva, Marcus V Andrade, Wilson A Silva, Sergio A Uyemura, Sérgio B Garcia
BACKGROUND: Trypanosoma cruzi (T. cruzi) infects millions of Latin Americans each year and can induce chagasic megacolon. Little is known about how serotonin (5-HT) modulates this condition. Aim We investigated whether 5-HT synthesis alters T. cruzi infection in the colon. MATERIALS AND METHODS: Forty-eight paraffin-embedded samples from normal colon and chagasic megacolon were histopathologically analyzed (173/2009). Tryptophan hydroxylase 1 (Tph1) knockout (KO) mice and c-KitW-sh mice underwent T...
June 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29545782/regulatory-lymphoid-and-myeloid-cells-determine-the-cardiac-immunopathogenesis-of-trypanosoma-cruzi-infection
#13
REVIEW
Manuel Fresno, Núria Gironès
Chagas disease is a multisystemic disorder caused by the protozoan parasite Trypanosoma cruzi , which affects ~8 million people in Latin America, killing 7,000 people annually. Chagas disease is one of the main causes of death in the endemic area and the leading cause of infectious myocarditis in the world. T. cruzi infection induces two phases, acute and chronic, where the infection is initially asymptomatic and the majority of patients will remain clinically indeterminate for life. However, over a period of 10-30 years, ~30% of infected individuals will develop irreversible, potentially fatal cardiac syndromes (chronic chagasic cardiomyopathy [CCC]), and/or dilatation of the gastro-intestinal tract (megacolon or megaesophagus)...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29513802/radiological-study-of-megacolon-in-trypanosoma-cruzi-infected-rats
#14
Carlos Edmundo Rodrigues Fontes, Ana Paula de Abreu, Aretuza Zaupa Gasparim
BACKGROUND: Researches on Chagas disease still use several animals and rats, due to size and susceptibility were preferred by many authors. AIM: To develop an experimental model of megacolon in rats inoculated with the strain Y of Trypanosoma cruzi. METHODS: Thirty male Wistar rats were distributed in three groups inoculated with different inoculants: Group A: 600000, Group B: 1000000 and Group C: 1500000 blood trypomastigotes of T. cruzi...
March 1, 2018: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29501836/shigellosis-and-toxic-megacolon-secondary-to-shigella-flexneri-serotype-3a-the-challenges-of-laboratory-diagnosis
#15
Emma McGuire, Simon Tiberi, Holly Ciesielczuk, Mark Melzer
We present a rare case of Shigella flexneri bacteraemia and toxic megacolon, and discuss the challenges of conventional laboratory techniques versus molecular PCR platforms in differentiating between Shigella species and Escherichia coli.
May 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29470711/mast-cell-nerve-interaction-in-the-colon-of-trypanosoma-cruzi-infected-individuals-with-chagasic-megacolon
#16
Patrícia Rocha Martins, Rodolfo Duarte Nascimento, Aline Tomaz Dos Santos, Enio Chaves de Oliveira, Patricia Massara Martinelli, Débora d'Avila Reis
Chagas disease is an infection caused by the parasite Trypanosoma cruzi that affects millions of people worldwide and is endemic in Latin America. Megacolon is the most frequent complication of the digestive chronic form and happens due to lesions of the enteric nervous system. The neuronal lesions seem to initiate in the acute phase and persist during the chronic phase, albeit the mechanisms involved in this process are still debated. Among the cells of the immune system possibly involved in this pathological process is the mast cell (MC) due to its well-known role in the bi-directional communication between the immune and nervous systems...
April 2018: Parasitology Research
https://www.readbyqxmd.com/read/29459800/-andean-megacolon-and-sigmoid-volvulus-in-the-high-altitude-presentation-of-418-cases-between-2008-2012-at-c-monge-hospital-puno-peru
#17
Luis A Borda Mederos, Eduardo Junior Kcam Mayorca, Percy Alarcon Aguilar, Luis Miguel Miranda Rosales
OBJECTIVE: The present study describes the medical and surgical management of sigmoid volvulus due to Andean dolicomegacolon in a hospital at an altitude above 3000 m. MATERIAL AND METHODS: A descriptive, observational, crosssectional study of 418 patients diagnosed with sigmoid volvulus; Admitted initially due to intestinal obstruction, in the Hospital of Juliaca Carlos Monge. Puno-Perú, during the period 2008-2012. The data were processed through the SPSS software version 21...
October 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/29413206/gastrointestinal-motility-problems-in-critically-ill-patients
#18
REVIEW
Christine Frazer, Leslie Hussey, Mary Bemker
Gastrointestinal (GI) motility problems are common complications in critical care patients. GI problems contribute to an increased risk of morbidity and mortality. Toxic megacolon (TM) is a type of acquired megacolon categorized as a medical emergency and includes severe inflammation affecting all layers of the colon wall. The high incidence of GI complications in critically ill patients requires the critical care nurse to provide close monitoring of patients at risk and an acute awareness of the causation, signs and symptoms, and treatment of various GI motility disorders, including gastroparesis, ileus, and TM...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29393463/bmp4-knockdown-of-ncscs-leads-to-aganglionosis-in-the-middle-embryonic-stage
#19
Hong-Bo Li, Xian-Qing Jin, Xin Jin, Zheng-Hua Guo, Xiong-Hui Ding, Quan Wang, Rui-Zhuo Liu
Transplacental bone morphogenetic protein (BMP)4 RNA interference (RNAi) is a technique used to knockdown genes in embryos. BMP4 are essential for the development of nervous system in the differentiation of neural crest stem cells (NCSCs). The failure of differentiation and migration of NCSCs may lead to aganglionosis. In the present study, pregnant mice were divided into three groups: Ringer's group, pSES group and RNAi‑BMP4 group. In order to silence the BMP4 gene in the first generation (F1), 11.5 day pregnant mice were injected with the small interfering RNA BMP4 plasmid, pSES or Ringer's solution via the tail vein...
April 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29385992/symptoms-and-diagnostic-criteria-of-acquired-megacolon-a-systematic-literature-review
#20
Tahleesa Cuda, Ronny Gunnarsson, Alan de Costa
BACKGROUND: Acquired Megacolon (AMC) is a condition involving persistent dilatation and lengthening of the colon in the absence of organic disease. Diagnosis depends on subjective radiological, endoscopic or surgical findings in the context of a suggestive clinical presentation. This review sets out to investigate diagnostic criteria of AMC. METHODS: The literature was searched using the databases - PubMed, Medline via OvidSP, ClinicalKey, Informit and the Cochrane Library...
January 31, 2018: BMC Gastroenterology
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