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https://www.readbyqxmd.com/read/28625250/-fulminant-clostridium-difficile-colitis-new-challenges-in-critical-care-medicine
#1
Bin Liu
Fulminant Clostridium difficile colitis (FCDC) means severe Clostridium difficile colitis (CDC), which often manifested with severe diarrhea, fever, abdominal distention, electrolyte disorder, hypoalbuminemia, and it can lead to pseudo membrane colonitis, toxic megacolon, bowel perforation, septic shock, and multiple organ dysfunction. Now Clostridium difficile (CD) becomes one of the most important medical institutions related infectious pathogens. In particular, the recently discovered mutant CD strain NAP1/BI/ribotype 027 has high pathogenicity in the global epidemic and its outbreak...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28580600/secretory-diarrhea-and-hypokalemia-associated-with-colonic-pseudo-obstruction-a-case-study-and-systematic-analysis-of-the-literature
#2
REVIEW
F Bazerbachi, S Haffar, L A Szarka, Z Wang, L J Prokop, M H Murad, M Camilleri
BACKGROUND: Colonic pseudo-obstruction (CPO) is characterized by colonic distention in the absence of mechanical obstruction or toxic megacolon. Concomitant secretory diarrhea (SD) with hypokalemia (SD-CPO) due to gastrointestinal (GI) loss requires further characterization. AIM: To perform a systematic review of SD-CPO, report a case study, and compare SD-CPO with classical CPO (C-CPO). METHODS: We performed a search of MEDLINE, EMBASE, Cochrane, and Scopus for reports based on a priori criteria for CPO, SD and GI loss of potassium...
June 5, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28554765/evaluation-of-the-immunohistochemical-expression-of-gal-1-gal-3-and-gal-9-in-the-colon-of-chronic-chagasic-patients
#3
Marcela Beghini, Márcia Fernandes de Araújo, Viviane Oliveira Severino, Renata Margarida Etchebehere, Denise Bertulucci Rocha Rodrigues, Sanívia Aparecida de Lima Pereira
OBJECTIVE AND DESIGN: The aim of the present study was to evaluate the immunohistochemical expression of Gal-1, Gal-3 and Gal-9 in the colon of chronic chagasic patients compared to biopsied non-chagasic patients. MATERIAL OR SUBJECTS: Thirty-two colon fragments were selected from chagasic patients with megacolon (n=25) and nonchagasic patients without megacolon (n=7). METHODS: Immunohistochemistry for Gal-1, Gal-3 and Gal-9 was performed using a common light microscope and the results were scored 0-3 according to labeling intensity...
April 20, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28536228/clostridium-difficile-extraintestinal-abscess-a-rare-complication
#4
Vamsi Krishna Kantamaneni, Krishna C Gurram, Abhijit Kulkarni
Extraintestinal Clostridium difficile is rare. A 74-year-old man with a history of ulcerative colitis presented after a fall. Trauma work-up showed liver cirrhosis. Two days later he developed abdominal pain, distension, diarrhoea and leucocytosis. Stool tested positive for C. difficile CT abdomen showed pancolitis with toxic megacolon. Total abdominal colectomy and ileostomy with a rectal stump was performed. He was discharged, but was readmitted with sepsis. CT abdomen showed a 10.4×7.2 cm fluid collection in the pelvis...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28524628/myenteric-neuroprotective-role-of-aspirin-in-acute-and-chronic-experimental-infections-with-trypanosoma-cruzi
#5
J Y Oda, M O Belém, T M Carlos, R Gouveia, B F C Luchetti, N M Moreira, C L Massocatto, S M Araújo, D M G Sant Ana, N C Buttow, P Pinge-Filho, E J A Araújo
BACKGROUND: Experimental and clinical studies have shown that myenteric neuron cell death during infection with Trypanosoma cruzi mainly occurs in the esophagus and colon, resulting in megaesophagus and megacolon, respectively. Evidence suggests that the cyclooxygenase enzyme (COX) is involved in the T. cruzi invasion process. The use of low-dose aspirin (ASA), a COX-1/COX-2 inhibitor, has been shown to reduce infection with T. cruzi. Therefore, in this study, we evaluated the effects of treatment with low-dose ASA on myenteric colonic neurons during murine infection with T...
May 19, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28516109/serum-derived-bovine-immunoglobulin-as-novel-adjunct-in-complicated-clostridium-difficile-colitis-treatment
#6
Samson Ferm, Nims Varadi, Constantine Fisher, Ellen Gutkin
Clostridium difficile infection (CDI) is a well-known complication of antibiotic therapy. It is associated with significant morbidity, mortality, and cost in the hospital setting. The main symptoms include watery diarrhea, abdominal pain, and distension, but CDI can also present as toxic megacolon, bowel perforation with peritonitis, sepsis and renal failure. Therapy includes metronidazole and oral vancomycin, with rectal vancomycin and fecal transplant reserved for more complicated cases. Adjunctive treatments such as probiotics have been tried with mixed results...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28502864/chagas-disease-in-europe-a-review-for-the-internist-in-the-globalized-world
#7
REVIEW
Spinello Antinori, Laura Galimberti, Roberto Bianco, Romualdo Grande, Massimo Galli, Mario Corbellino
Chagas disease (CD) or American trypanosomiasis identified in 1909 by Carlos Chagas, has become over the last 40years a global health concern due to the huge migration flows from Latin America to Europe, United States, Canada and Japan. In Europe, most migrants from CD-endemic areas are concentrated in Spain, Italy, France, United Kingdom and Switzerland. Pooled seroprevalence studies conducted in Europe show an overall 4.2% prevalence, with the highest infection rates observed among individuals from Bolivia (18...
May 11, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28460206/supergiant-fecaloma-as-manifestation-of-chronic-constipation
#8
G Currò, C Lazzara, S Latteri, M Bartolotta, G Navarra
Fecaloma is common in patients with damage to the autonomic nervous system in the large bowel associated with Chagas disease (inflammatory and neoplastic) or Hirschprung's disease, in psychiatric patients and, more commonly, in elderly patients suffering with chronic constipation. Symptoms of fecaloma are usually nonspecific. Clinical examination can give the appearance of an abdominal tumor. Most cases of fecaloma are treated conservatively with digital evacuation and enemas. In severe and unremitting cases, surgery is required to prevent significant complications...
January 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28435929/megacolon-as-an-atypical-presentation-of-cervical-myelopathy
#9
Jacob Y L Oh, Kevin J H Kwek, Seh-Wee Tee, Mark Tan
A 61-year-old gentleman was admitted with progressive symptoms of cervical myelopathy. An MRI performed showed severe compression from C3-6 with cord signal changes. He was offered surgical intervention but the operation had to be delayed because of worsening abdominal distension. X-rays performed showed a severely dilated colon measuring >12 cm. A CT did not show any obstructive cause. He was managed conservatively for more than 2 weeks but did not improve. As his symptoms continued to worsen, a decision was made to proceed with a C3-6 posterior decompression and fusion, despite the theoretical risk of bacterial translocation predisposing him to infection...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28414798/correction-enteric-neuronal-damage-intramuscular-denervation-and-smooth-muscle-phenotype-changes-as-mechanisms-of-chagasic-megacolon-evidence-from-a-long-term-murine-model-of-tripanosoma-cruzi-infection
#10
Camila França Campos, Silvia Dantas Cangussú, Ana Luiza Cassin Duz, Christiane Teixeira Cartelle, Maria de Lourdes Noviello, Vanja Maria Veloso, Maria Terezinha Bahia, Camila Megale Almeida-Leite, Rosa Maria Esteves Arantes
[This corrects the article DOI: 10.1371/journal.pone.0153038.].
2017: PloS One
https://www.readbyqxmd.com/read/28403672/toxic-megacolon-as-a-rare-complication-following-atropine-therapy-due-to-organophosphate-poisoning-a-case-report
#11
Babak Mostafazadeh, Esmaeil Farzaneh, Maryam Paeezi, Farahnaz Nikkhah
The main therapeutic basis for a case of organophosphate poisoning is a combination therapy which includes atropine as an anticholinergic drug and pralidoxime. If the poisoning is severe, a high dose of this combination of medicines may be needed, but this may cause serious side effects: paralytic ileus or even megacolon; however, these gastrointestinal events are very rare. Here, we report a case of organophosphate poisoning where atropine therapy was given and led to drug-associated toxic megacolon.
January 1, 2017: Medico-legal Journal
https://www.readbyqxmd.com/read/28396132/clostridium-difficile-infection
#12
REVIEW
Luis Alcalá Hernández, Elena Reigadas Ramírez, Emilio Bouza Santiago
Clostridium difficile infection (CDI) is the main cause of nosocomial diarrhea in industrialized countries and the source of a growing number of cases of diarrhea in the community. The outbreak of the hypervirulent strain belonging to ribotype 027 has increased the incidence and severity of CDI in some countries. Although CDI usually courses as a mild diarrhea it can lead to severe forms such as toxic megacolon or septic shock. One of every 2 episodes of CDI is not diagnosed in Spanish hospitals due to a lack of clinical suspicion or the use of insensitive diagnostic methods...
April 8, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28393975/-management-of-severe-ulcerative-colitis-an-up-to-date
#13
Cristian Hernández-Rocha, Patricio Ibáñez, María Elena Molina, Julieta Klaassen, Andrea Valenzuela, Roberto Candia, Felipe Bellolio, Álvaro Zúñiga, Rodrigo Miguieles, Juan Francisco Miquel, José Chianale, Manuel Álvarez-Lobos
Ulcerative Colitis (UC) is a chronic inflammatory disease involving the colon, with alternating periods of remission and activity. Exacerbations can be severe and associated with complications and mortality. Diagnosis of severe UC is based on clinical, biochemical and endoscopic variables. Patients with severe UC must be hospitalized. First line therapy is the use of intravenous corticoids which achieve clinical remission in most patients. However, 25% of patients will be refractory to corticoids, situation that should be evaluated at the third day of therapy...
January 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28357579/epithelial-cell-types-and-their-proposed-roles-in-maintaining-the-mucosal-barrier-in-human-chagasic-megacolonic-mucosa
#14
Christian Koch, Alexandre B M da Silveira, Enio C de Oliveira, Karl Quint, Winfried Neuhuber, Axel Brehmer, Samir Jabari
Patients suffering from chagasic megacolon must have an intact mucosal barrier as they survive this chronic disease for decades. A key structure of the mucosal barrier are epithelial cells. Vasoactive-intestinal-peptide (VIP)-positive nerve fibres are involved in influencing, e.g., epithelial cell proliferation, mucus secretion (e.g., mucin 2 and trefoil factor 3 of goblet cells) and inflammation or autoimmunity, all putative and/or known factors altered in chagasic megacolon. We analyzed qualitatively and quantitatively goblet cells, their specific markers, such as mucin 2 (MUC2) and trefoil factor 3 (TFF3) and enterocytes, the relation of VIP-immunoreactive nerve fibres to the epithelia, the distribution of gelsolin, a protein involved in chronic inflammation processes in the epithelia, and the proliferation rate of epithelial cells by combined 4',6-diamidino-2-phenylindole (DAPI) and phosphohistone-H3 (PHH3) staining...
March 29, 2017: Histochemistry and Cell Biology
https://www.readbyqxmd.com/read/28357400/intra-abdominal-hypertension-causes-bacterial-growth-in-lungs-an-animal-study
#15
Eleni Papakrivou, Demosthenes Makris, Efstratios Manoulakas, Magda Mitroudi, Konstantinos Tepetes, Konstantinos Papazoglou, Epaminondas Zakynthinos
To study the effect of intra-abdominal hypertension (IAH) on the frequency of pneumonia with an experimental study, thirteen Sprague-Dawley rats were included. Eight out of thirteen animals were randomly assigned to receive 10 ml of benzalkonium chloride 0.2% (megacolon group) and five animals received 10 ml NaCl 0.9% (controls). Animals were anaesthetized by intramuscular delivery of ketamine. The incidence of positivity for bacteria lung tissue cultures and mesenteric lymph node cultures was assessed at the 21st day after animals' sacrification, or before in case of death...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28348903/successful-treatment-of-clostridium-difficile-bacteremia-with-aortic-mycotic-aneurysm-in-a-patient-with-prior-endovascular-aortic-aneurysm-repair
#16
Kairav Shah, Rebecca Brauch, Kartikeya Cherabuddi
The clinical spectrum of Clostridium difficile infection can range from benign gastrointestinal colonization to mild diarrhea and life threatening conditions such as pseudomembranous colitis and toxic megacolon. Extraintestinal manifestations of C. difficile are rare. Here, we report a patient with a history of an endovascular aortic aneurysm repair (EVAR) presenting with an endovascular leak complicated by C. difficile bacteremia and a mycotic aneurysm. He was successfully treated with an explant of the EVAR, an aorto-left renal bypass, and aorto-bi-iliac bypass graft placement along with a six-week duration of intravenous vancomycin and oral metronidazole...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28342760/correction-of-hirschsprung-associated-mutations-in-human-induced-pluripotent-stem-cells-via-clustered-regularly-interspaced-short-palindromic-repeats-cas9-restores-neural%C3%A2-crest-cell-function
#17
Frank Pui-Ling Lai, Sin-Ting Lau, John Kwong-Leong Wong, Hongsheng Gui, Reeson Xu Wang, Tingwen Zhou, Wing Hon Lai, Hung-Fat Tse, Paul Kwong-Hang Tam, Maria-Mercedes Garcia-Barcelo, Elly Sau-Wai Ngan
BACKGROUND & AIMS: Hirschsprung disease is caused by failure of enteric neural crest cells (ENCCs) to fully colonize the bowel, leading to bowel obstruction and megacolon. Heterozygous mutations in the coding region of the RET gene cause a severe form of Hirschsprung disease (total colonic aganglionosis). However, 80% of HSCR patients have short-segment Hirschsprung disease (S-HSCR), which has not been associated with genetic factors. We sought to identify mutations associated with S-HSCR, and used the clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 gene editing system to determine how mutations affect ENCC function...
March 23, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28238313/-laparoscopic-lateral-suspension-another-way-to-treat-genital-prolapse
#18
J B Dubuisson, N Veit-Rubin, J M Wenger, J Dubuisson
The laparoscopic sacrocolpopexy is the treatment of choice of pelvic organ prolapses since more than twenty years. The laparoscopic lateral suspension with mesh is an alternative technique. Its originality is the subperitoneal passing of the lateral arm of the mesh in the lateral abdominal wall, leaving the skin above the iliac crest, in a place without risks of vascular, nerve, bowel injuries. We report in this article the results of the three main publications on the subject. The indications are cystocele and apical descent...
January 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28238232/is-abdominal-ct-scan-useful-for-the-management-of-patients-with-severe-acute-colitis-complicating-inflammatory-bowel-disease-a-study-in-54-consecutive-patients
#19
Diane Mege, Marie Monsinjon, Magaly Zappa, Carmen Stefanescu, Xavier Treton, Léon Maggiori, Yoram Bouhnik, Yves Panis
AIM: To evaluate the contribution of CT scanning to the management of patients with severe acute exacerbation of colitis (SAC) complicating inflammatory bowel disease (IBD), in particular, its contribution to surgical decision making. METHOD: All patients who were admitted to our institution for SAC complicating IBD, were divided into Group A (surgical treatment) and B (medical treatment). Admission CT scan results were compared between the 2 groups. RESULTS: From 2006 to 2015, 54 patients (26 males, median age= 39 (17-71) years) presented with SAC were divided into Group A (n=41, 76%) and B (n=13, 24%)...
February 26, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28208866/fatal-toxic-megacolon-in-a-child-of-hirschsprung-disease
#20
Shiwani R Garg, Pragati A Sathe, Annapurna C Taware, Ketaki M Surve
Hirschsprung disease (HD) in late childhood is uncommon and often undiagnosed or misdiagnosed. However, in a patient with Hirschsprung disease, of greater significance is the occurrence of life threatening enterocolitis. In its more severe form, this is associated with gross dilatation of the colon and profound toxaemia, the combination being termed toxic megacolon. Because of its relative rarity, we report a case of 10-year-old child who had a history of chronic constipation for nine years. He later developed complications and presented to the emergency department with toxic megacolon, a rare occurrence due to neglected constipation...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
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