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1.
Methods Mol Biol ; 2414: 151-169, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34784037

RESUMO

Vaccines are regarded as the most cost-effective countermeasure against infectious diseases. One challenge often affecting vaccine development is antigenic diversity or pathogen heterogeneity. Different strains produce immunologically heterogeneous virulence factors, therefore an effective vaccine needs to induce broad-spectrum host immunity to provide cross-protection. Recent advances in genomics and proteomics, particularly computational biology and structural biology, establishes structural vaccinology and highlights the feasibility of developing effective and precision vaccines. Here, we introduce the epitope- and structure-based vaccinology platform multiepitope-fusion-antigen (MEFA), and provide instructions to generate polyvalent MEFA immunogens for vaccine development. Conceptually, MEFA combines epitope vaccinology and structural vaccinology to enable a protein immunogen to present heterogeneous antigenic domains (epitopes) and to induce broadly protective immunity against different virulence factors, strains or diseases. Methodologically, the MEFA platform first identifies a safe, structurally stable and strongly immunogenic backbone protein and immunodominant (ideally neutralizing or protective) epitopes from heterogeneous strains or virulence factors of interest. Then, assisted with protein modeling and molecule dynamic simulation, MEFA integrates heterogeneous epitopes into a backbone protein via epitope substitution for a polyvalent MEFA protein and mimics epitope native antigenicity. Finally, the MEFA protein is examined for broad immunogenicity in animal immunization, and assessed for potential application for multivalent vaccine development in preclinical studies.


Assuntos
Vacinas Combinadas , Animais , Biologia Computacional , Diarreia , Escherichia coli Enterotoxigênica/imunologia , Epitopos/genética , Infecções por Escherichia coli , Vacinologia , Fatores de Virulência/genética
2.
Rev Med Chil ; 149(6): 888-898, 2021 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-34751348

RESUMO

Neuroendocrine Tumors (NETs) encompass a wide variety of tumors arising from neuroendocrine cells, which produce bioactive substances. The incidence of NETs increased significantly lately, becoming one of the most common tumors of the digestive tract. Their clinical presentation is as diverse as their capacity for hormone production. Carcinoid syndrome is the most common hormonal syndrome produced by NETs and is characterized by diarrhea, flushing and cardiac valvular lesions. New research brought multiple changes in the classification of these neoplasms and a new understanding about their diagnosis and treatment, promoting a multidisciplinary approach. Somatostatin analogues, radiation, biological, and cytotoxic drugs have improved the prognosis of these patients, which entails a great challenge for healthcare providers.


Assuntos
Antineoplásicos , Tumores Neuroendócrinos , Antineoplásicos/uso terapêutico , Diarreia , Humanos , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/terapia , Somatostatina/uso terapêutico
3.
Artigo em Inglês | MEDLINE | ID: mdl-34770125

RESUMO

The influence of natural environmental factors and social factors on children's viral diarrhea remains inconclusive. This study aimed to evaluate the short-term effects of temperature, precipitation, air quality, and social attention on children's viral diarrhea in temperate regions of China by using the distribution lag nonlinear model (DLNM). We found that low temperature affected the increase in children's viral diarrhea infection for about 1 week, while high temperature and heavy precipitation affected the increase in children's viral diarrhea infection risk for at least 3 weeks. As the increase of the air pollution index may change the daily life of the public, the infection of children's viral diarrhea can be restrained within 10 days, but the risk of infection will increase after 2 weeks. The extreme network search may reflect the local outbreak of viral diarrhea, which will significantly improve the infection risk. The above factors can help the departments of epidemic prevention and control create early warnings of high-risk outbreaks in time and assist the public to deal with the outbreak of children's viral diarrhea.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Criança , China/epidemiologia , Diarreia/epidemiologia , Humanos , Internet , Meteorologia
4.
Pol J Vet Sci ; 24(3): 323-333, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34730310

RESUMO

Diarrhea caused by parasitic agents is common in neonatal calves and leads to significant economic losses in cattle farms worldwide. Cryptosporidium spp. is one of the most frequently detected parasitic agents causing diarrhea in neonatal calves. The aim of this study was to investigate the presence of Cryptosporidium spp. on a dairy farm which a has major diarrhea problem. Samples were collected from calves, cows, drinking bowls, and two different artesian water sources, as well as from the environment. All fecal samples were investigated using Kinyoun acid-fast stained slides and real-time PCR targeting the Cryptosporidium spp. COWP gene. In addition, species identification was performed by nested PCR targeting the Cryptosporidium spp. COWP gene and sequencing. Cryptosporidium spp. was detected in 11 calves (30.55%; 11/36) by real-time PCR and the cows were negative. Among real-time PCR positive samples, only five were also found positive by microscopy. Moreover, Cryptosporidium spp. was found in one of the two artesian water sources and five environmental samples by real-time PCR. Among these positive samples, eight were sequenced. According to the RFLP pattern, BLAST and, phylogenetic analyses, all sequenced samples were Cryptosporidium parvum. These findings show the importance of C. parvum as a cause of calf diarrhea on dairy farms.


Assuntos
Doenças dos Bovinos/parasitologia , Criptosporidiose/parasitologia , Cryptosporidium parvum/isolamento & purificação , Água/parasitologia , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Criptosporidiose/epidemiologia , Indústria de Laticínios , Diarreia/parasitologia , Diarreia/veterinária , Surtos de Doenças/veterinária , Fezes/parasitologia , Feminino
5.
Biomed Res Int ; 2021: 5778455, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34796233

RESUMO

Background: Bovine rotavirus (BRV) and bovine coronavirus (BCoV) are the most common viral agents in neonatal calf diarrhea and result in serious economic consequences. The aim of the study was to determine the epidemiology of those viruses in randomly selected dairy farms of Addis Ababa. Methods: A cross-sectional study was conducted from November 2018 to April 2019 using a probability proportional to size (PPS) sampling technique. A total of 110 calves, less than 30 days of age, from 57 dairy herds were involved in the study. Associated factors of herds and calves were collected using semistructured interviews from farm owners and through physical observation of selected calves. Fecal samples were collected and analyzed using the sandwich ELISA method. Data generated from both semistructured interviews and laboratory investigation were analyzed using STATA_MP version 15. Results: From the total 110 calves, 42 (38.18%) had diarrhea during the survey. The prevalence of bovine rotavirus and coronavirus was 3.64% (4/110) and 0.91% (1/110), respectively. Diarrhea, feeding colostrum timing, and sex of the neonatal calves had statistically significant association with bovine rotavirus infection (p < 0.05). All rotavirus-positive neonatal calves were identified in small scale dairy farms and in dairy farms that reported mortality though they lack statistically significant association. Only one coronavirus case was detected among the neonatal calves. The case was identified among small scale herds and in a herd with diarrheal cases. The sex of the coronavirus calf was female, diarrheic, and among 11-20 days old. Conclusion: The prevalence of rotavirus and coronavirus infections in neonatal calves was seldom in dairy farms of the study area. Rotavirus was more common than coronavirus, and further studies should be initiated on other (infectious and noninfectious) causes of neonatal calf diarrhea in the area.


Assuntos
Doenças dos Bovinos/epidemiologia , Infecções por Coronavirus/veterinária , Infecções por Rotavirus/veterinária , Animais , Animais Recém-Nascidos , Bovinos , Doenças dos Bovinos/virologia , Infecções por Coronavirus/epidemiologia , Coronavirus Bovino/isolamento & purificação , Estudos Transversais , Diarreia/epidemiologia , Diarreia/veterinária , Diarreia/virologia , Etiópia/epidemiologia , Fazendas/estatística & dados numéricos , Fezes/virologia , Feminino , Masculino , Mortalidade , Prevalência , Rotavirus/isolamento & purificação , Infecções por Rotavirus/epidemiologia
6.
Medicine (Baltimore) ; 100(41): e27528, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731146

RESUMO

ABSTRACT: Diarrhea is one of the manifestations of the novel coronavirus disease (COVID-19), but it also develops as a complication of massive antibiotic therapy in this disease. This study aimed to compare these types of diarrhea.We included patients with COVID-19 in a cohort study and excluded patients with chronic diarrhea, laxative use, and those who died during the first day of hospitalization.There were 89 (9.3%), 161 (16.7%), and 731 (75.7%) patients with early viral, late antibiotic-associated, and without diarrhea, respectively. Late diarrhea lasted longer (6 [4-10] vs 5 [3-7] days, P < .001) and was more severe. Clostridioides difficile was found in 70.5% of tested patients with late diarrhea and in none with early diarrhea. Presence of late diarrhea was associated with an increased risk of death after 20 days of disease (P = .009; hazard ratio = 4.7). Patients with late diarrhea had a longer hospital stay and total disease duration, and a higher proportion of these patients required intensive care unit admission. Oral amoxicillin/clavulanate (odds ratio [OR] = 2.23), oral clarithromycin (OR = 3.79), and glucocorticoids (OR = 4.41) use was a risk factor for the development of late diarrhea, while ceftriaxone use (OR = 0.35) had a protective effect. Before the development of late diarrhea, decrease in C-reactive protein levels and increase in lymphocyte count stopped but the white blood cell and neutrophil count increased. An increase in neutrophils by >0.6 × 109 cells/L predicted the development of late diarrhea in the coming days (sensitivity 82.0%, specificity 70.8%, area under the curve = 0.791 [0.710-0.872]).Diarrhea in COVID-19 is heterogeneous, and different types of diarrhea require different management.


Assuntos
Antibacterianos/efeitos adversos , COVID-19/epidemiologia , Diarreia/induzido quimicamente , Diarreia/virologia , Idoso , Diarreia/classificação , Diarreia/epidemiologia , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
7.
Schweiz Arch Tierheilkd ; 164(10): 661-671, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34758958

RESUMO

INTRODUCTION: Three outbreaks of fatal diarrhoea occurred in bush dog (Speothos venaticus) groups at two zoological collections in the United Kingdom between 2009 and 2017. In all cases, the predominant clinical signs were diarrhoea, anorexia and severe loss of condition. Despite supportive treatment, a number of fatalities occurred during each outbreak. Common gross post mortem findings were emaciation, with erythema, mucosal haemorrhage, and ulceration of the gastrointestinal tract. Histopathological features included villus blunting and fusion, crypt epithelial loss and lymphoid depletion, supporting a viral aetiology and canine coronavirus was suspected. Diagnosis was confirmed on the basis of serology (rising antibody titres) and the detection of viral nucleic acid using polymerase chain reaction. The canine coronavirus was subtyped as type 2a, which is known to cause systemic fatal disease in immature domestic dogs. To the authors' knowledge, these are the first reported cases of fatal diarrhoea associated with canine coronavirus type 2a in bush dogs. These outbreaks suggest that adult bush dogs are highly susceptible to canine coronavirus infection and may succumb to viral enteritis.


Assuntos
Canidae , Coronavirus Canino , Doenças do Cão , Animais , Diarreia/epidemiologia , Diarreia/veterinária , Surtos de Doenças/veterinária , Doenças do Cão/epidemiologia , Cães , Reino Unido
8.
Rev Saude Publica ; 55: 82, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34816983

RESUMO

OBJECTIVE: To evaluate the prevalence of reports of symptoms of COVID-19 among individuals with and without antibodies and identify those with greater capability to predict the presence of antibodies against SARS-CoV-2. METHODS: The study uses data collected in phases 5 to 8 of Epicovid-19-RS. The presence of antibodies against SARS-CoV-2 was evaluated by a rapid test. The occurrence of cough, fever, palpitations, sore throat, difficulty breathing, changes in taste and smell, vomiting, diarrhea, body pain, shaking, and headache since March 2020 was also evaluated. Then, the capability to predict the evaluated symptoms concerning the presence of antibodies was calculated. RESULTS: A total of 18,000 individuals were interviewed and 181 had antibodies against COVID-19 in phases 5 to 8. The proportion of asymptomatic individuals was 19.9% among participants with antibodies and 49.7% among those without antibodies. All symptoms were reported more frequently by individuals with antibodies. The division of the prevalence of symptoms among individuals with antibodies by the prevalence among individuals without antibodies showed the following prevalence ratios: for changes in smell or taste (9.1), fever (4.2), tremors (3.9), breathing difficulty (3.2) and cough (2.8 times). Anosmia and fever were the symptoms with a greater capability to predict the presence of antibodies. CONCLUSION: The prevalence of symptoms was higher among individuals with antibodies against SARS-CoV-2. The proportion of asymptomatic individuals was low. Altered smell or taste and fever were the symptoms that most predict the presence of antibodies. These results can help to identify probable cases, contributing to the clinical diagnosis and screening of patients for testing and isolation guidance in positive cases, especially in scenarios of the scarcity of diagnostic COVID-19 tests.


Assuntos
COVID-19 , Brasil/epidemiologia , Diarreia , Humanos , Prevalência , SARS-CoV-2
9.
Sci Rep ; 11(1): 21725, 2021 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-34741071

RESUMO

SARS-CoV-2 enters the intestine by the spike protein binding to angiotensin-converting enzyme 2 (ACE2) receptors in enterocyte apical membranes, leading to diarrhea in some patients. Early treatment of COVID-19-associated diarrhea could relieve symptoms and limit viral spread within the gastrointestinal (GI) tract. Diosmectite, an aluminomagnesium silicate adsorbent clay with antidiarrheal effects, is recommended in some COVID-19 management protocols. In rotavirus models, diosmectite prevents pathogenic effects by binding the virus and its enterotoxin. We tested the trapping and anti-inflammatory properties of diosmectite in a SARS-CoV-2 model. Trapping effects were tested in Caco-2 cells using spike protein receptor-binding domain (RBD) and heat-inactivated SARS-CoV-2 preparations. Trapping was assessed by immunofluorescence, alone or in the presence of cells. The effect of diosmectite on nuclear factor kappa B (NF-kappaB) activation and CXCL10 secretion induced by the spike protein RBD and heat-inactivated SARS-CoV-2 were analyzed by Western blot and ELISA, respectively. Diosmectite bound the spike protein RBD and SARS-CoV-2 preparation, and inhibited interaction of the spike protein RBD with ACE2 receptors on the Caco-2 cell surface. Diosmectite exposure also inhibited NF-kappaB activation and CXCL10 secretion. These data provide direct evidence that diosmectite can bind SARS-CoV-2 components and inhibit downstream inflammation, supporting a mechanistic rationale for consideration of diosmectite as a management option for COVID-19-associated diarrhea.


Assuntos
COVID-19/tratamento farmacológico , Quimiocina CXCL10/metabolismo , Subunidade p50 de NF-kappa B/metabolismo , SARS-CoV-2 , Silicatos/química , Adsorção , Compostos de Alumínio/química , Enzima de Conversão de Angiotensina 2/metabolismo , Anti-Inflamatórios , Sítios de Ligação , Células CACO-2 , Cromatografia Líquida , Argila , Diarreia/etiologia , Diarreia/terapia , Enterócitos/metabolismo , Gastroenterologia , Humanos , Compostos de Magnésio/química , Espectrometria de Massas , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Ligação Proteica/efeitos dos fármacos , Domínios Proteicos , Rotavirus , Silicatos/metabolismo
10.
BMC Gastroenterol ; 21(1): 417, 2021 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-34742228

RESUMO

BACKGROUND: Gastrointestinal endoscopy is frequently recommended for chronic diarrhea assessment in Western countries, but its benefit in the Southeast Asia region is not well established. METHODS: Medical records of consecutive patients undergoing esophagogastroduodenoscopy (EGD), colonoscopy, and small bowel endoscopy for chronic diarrhea from 2008 to 2018 were reviewed. Small bowel endoscopy included push enteroscopy, balloon-assisted enteroscopy (BAE), and video capsule endoscopy (VCE). The diagnostic yield of each endoscopic modality and predictors for positive small bowel endoscopy were analyzed. RESULTS: A total of 550 patients were included. The mean age was 54 years, and 266 (46.3%) patients were male. The mean hemoglobin and albumin levels were 11.6 g/dL and 3.6 g/dL, respectively. EGD and colonoscopy were performed in 302 and 547 patients, respectively, and the diagnostic yield was 24/302 (7.9%) for EGD and 219/547 (40.0%) for colonoscopy. EGD did not reveal positive findings in any patients with normal colonoscopy. Fifty-one patients with normal EGD and colonoscopy underwent small bowel endoscopy. Push enteroscopy, BAE, and VCE were performed in 28, 21, and 19 patients with a diagnostic yield of 5/28 (17.9%), 14/21 (66.7%), and 8/19 (42.1%), respectively. Significant weight loss, edema, and hypoalbuminemia were independent predictors for the positive yield of small bowel endoscopy. CONCLUSION: Colonoscopy was an essential diagnostic tool in identifying the cause of chronic diarrhea in Thai patients, whereas EGD provided some benefits. Small bowel endoscopy should be performed when colonoscopy and EGD were negative, particularly in patients with significant weight loss, edema, and hypoalbuminemia.


Assuntos
Endoscopia por Cápsula , Endoscopia Gastrointestinal , Adulto , Colonoscopia , Diarreia/etiologia , Endoscopia do Sistema Digestório , Hemorragia Gastrointestinal , Humanos , Masculino , Pessoa de Meia-Idade , Tailândia
11.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(11): 1316-1320, 2021 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-34749475

RESUMO

Objective: We aimed to analyze the the genotyping of norovirus infectious diarrhea epidemic in Songjiang district, Shanghai, and explored the experience in handling the epidemic to provide a scientific basis for formulating prevention and treatment strategies. Methods: The epidemiological data and related samples of 69 outbreaks of infectious diarrhea caused by norovirus was collected from 2017 to 2019 in Songjiang district, Shanghai. Sequencing and type identification were performed by the method of gene sequencing for the junction region of Norovirus ORF1 and ORF2. Results: From 2017 to 2019, 69 outbreaks of norovirus infections diarrhea were reported in Songjiang district, Shanghai. A total of 1 767 samples were tested, including 619 case samples (positive rate 19.9%), 343 practitioner samples (positive rate 1.1%), 505 environmental samples (positive rate 0.5%) and 300 food samples (not detected). 141 sequences were obtained, and the genotype analysis showed that the genotype that mainly caused infectious diarrhea in 2017 and 2018 was GII.P16-GII.2 (50.98%, 26/51). In 2019, the genotypes that mainly caused infectious diarrhea were GII.P16-GII.2 (13.73%, 7/51) and GII.Pe-GII.4 (9.80%, 5/51). Conclusion: The main genotype of the 69 outbreaks of nororirus infectious diarrhea epidemic in Songjiang district, Shanghai from 2017 to 2019 was GII.P16-GII.2, which showed obvious peaks in spring, autumn and winter. There were more infections in kindergartens and schools. The surveillance of norovirus infection should be strengthened.


Assuntos
Infecções por Caliciviridae , Gastroenterite , Norovirus , Infecções por Caliciviridae/epidemiologia , China/epidemiologia , Diarreia/epidemiologia , Surtos de Doenças , Gastroenterite/epidemiologia , Genótipo , Humanos , Norovirus/genética , Filogenia
12.
Korean J Parasitol ; 59(5): 497-499, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34724769

RESUMO

Trichinellosis (trichinosis) is a parasitic infection caused by nematodes of the genus Trichinella. Pigs are the most common source of human infection. We describe a case of a 47-year-old woman presented with a wide range of intermittent symptoms including prolonged fever, dry cough, diarrhea, rash, myalgias and arthralgias. The patient was attended by physicians with various medical specialties such as dermatologists, rheumatologists and allergiologists, but they did not establish a certain diagnosis because of the gradual onset of symptoms, raising the suspicion of a systematic disease. After extensive work up, the diagnosis of trichinosis was established with femoral muscle biopsy compatible with inflammatory myopathy of parasitic etiology with trichinosis to be the predominant diagnosis. Despite the significant delay of diagnosis for almost three months, patient was treated successfully with no further complications. Trichinellosis is a food-borne treatable infection. Preventive measures include community education especially in zones where parasite prevalence is increased, improvement of farming and cooking techniques.


Assuntos
Doenças Transmitidas por Alimentos/diagnóstico , Triquinelose , Animais , Biópsia , Diagnóstico Diferencial , Diarreia , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Suínos , Trichinella , Triquinelose/diagnóstico
13.
BMJ Case Rep ; 14(11)2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34753719

RESUMO

Liver involvement in Graves' disease can be seen as a part of autoimmune process or rarely, due to the direct effects of thyrotoxicosis on liver. Hyperthyroidism can also have gastrointestinal manifestations like frequent bowel movements, diarrhoea, even malabsorption with steatorrhoea. We report a 36-year-old man with hyperthyroidism, presenting with cholestatic jaundice and persistent small bowel diarrhoea. He was diagnosed to have Graves' disease and after ruling out more common causes, the cause of cholestatic jaundice was supposed to be Graves' disease. Considering this possibility, the patient was started on treatment with carbimazole. As patient's thyroid function tests started improving, he showed significant clinical and biochemical improvement from liver point of view as well.


Assuntos
Doença de Graves , Icterícia Obstrutiva , Tireotoxicose , Adulto , Carbimazol/uso terapêutico , Diarreia/etiologia , Doença de Graves/complicações , Doença de Graves/diagnóstico , Doença de Graves/tratamento farmacológico , Humanos , Icterícia Obstrutiva/etiologia , Masculino
14.
J Korean Med Sci ; 36(44): e301, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34783217

RESUMO

We used serial rectal swabs to investigate the amount and duration of virus secretion through the gastrointestinal tract and assessed the association between fecal shedding and gastrointestinal symptoms and to clarify the clinical usefulness testing rectal swabs. We enrolled ten adult patients hospitalized with symptomatic coronavirus disease 2019 (COVID-19). Respiratory and stool specimens were collected by physicians. The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed using real-time reverse-transcription polymerase chain reaction. All ten patients had respiratory symptoms, six had diarrhea, and seven were positive for SARS-CoV-2 on rectal swabs. The viral loads in the respiratory specimens was higher than those in the rectal specimens, and no rectal specimens were positive after the respiratory specimens became negative. There was no association between gastrointestinal symptoms, pneumonia, severity, and rectal viral load. Rectal swabs may play a role in detecting SARS-CoV-2 in individuals with suspected COVID-19, regardless of gastrointestinal symptoms.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/virologia , Reto/virologia , SARS-CoV-2/isolamento & purificação , Eliminação de Partículas Virais , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/complicações , COVID-19/transmissão , Diarreia/etiologia , Diarreia/virologia , Fezes/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nasofaringe/virologia , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Índice de Gravidade de Doença , Fatores de Tempo , Carga Viral
15.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(5): 535-539, 2021 Mar 26.
Artigo em Chinês | MEDLINE | ID: mdl-34791856

RESUMO

Blastocystis hominis is a common intestinal protozoan parasite. Most individuals with B. hominis infections have no apparent clinical symptoms; however, a few patients, notably those with co-infections or impaired immune system function may present abdominal pain, diarrhea, nausea, vomiting, and even death. This paper reviews the co-infections of B. hominis and other pathogens and comorbidity of B. hominis infections and other diseases, so as to provide insights into the management of B. hominis infections.


Assuntos
Infecções por Blastocystis , Blastocystis hominis , Infecções por Blastocystis/epidemiologia , Comorbidade , Diarreia/epidemiologia , Fezes , Humanos
17.
Artigo em Inglês | MEDLINE | ID: mdl-34770204

RESUMO

The relationship between environmental factors and child health is not well understood in rural Pakistan. This study characterized the environmental factors related to the morbidity of acute respiratory infections (ARIs), diarrhea, and growth using geographical information systems (GIS) technology. Anthropometric, address and disease prevalence data were collected through the SEEM (Study of Environmental Enteropathy and Malnutrition) study in Matiari, Pakistan. Publicly available map data were used to compile coordinates of healthcare facilities. A Pearson correlation coefficient (r) was used to calculate the correlation between distance from healthcare facilities and participant growth and morbidity. Other continuous variables influencing these outcomes were analyzed using a random forest regression model. In this study of 416 children, we found that participants living closer to secondary hospitals had a lower prevalence of ARI (r = 0.154, p < 0.010) and diarrhea (r = 0.228, p < 0.001) as well as participants living closer to Maternal Health Centers (MHCs): ARI (r = 0.185, p < 0.002) and diarrhea (r = 0.223, p < 0.001) compared to those living near primary facilities. Our random forest model showed that distance has high variable importance in the context of disease prevalence. Our results indicated that participants closer to more basic healthcare facilities reported a higher prevalence of both diarrhea and ARI than those near more urban facilities, highlighting potential public policy gaps in ameliorating rural health.


Assuntos
Diarreia , Infecções Respiratórias , Criança , Atenção à Saúde , Diarreia/epidemiologia , Instalações de Saúde , Humanos , Lactente , Morbidade , Paquistão/epidemiologia , Infecções Respiratórias/epidemiologia
18.
PLoS One ; 16(10): e0250681, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34673776

RESUMO

Induction of remission is easily achieved with dietary treatment in dogs diagnosed with Food Responsive Chronic Diarrhea (FRD). Administration of prebiotics and glycosaminoglycans (GAGs) may improve epithelial cell integrity and therefore be useful as adjunct treatment. This study evaluated whether the relapse rate of FRD dogs that are switched back to a normal diet can be influenced using supplemental treatment with prebiotics and GAGs. A randomized, controlled clinical trial (RCCT) was performed in dogs diagnosed with FRD. Dogs were diagnosed based on clinical exclusion diagnosis, endoscopic biopsies showing predominantly lymphoplasmacytic infiltration, and response to dietary treatment. Dogs were randomized to be fed a combination of prebiotics and GAGs (group 1) or placebo (group 2) in addition to a hydrolyzed diet. At week 10, a second endoscopy was performed and dogs were switched back to normal diet. Relapse rate was monitored every 2 weeks after that until week 18. Statistical analysis was performed for each outcome (Canine Chronic Enteropathy Clinical Activity Index (CCECAI), clinicopathological data, endoscopic scoring, mWSAVA histological scoring index (mWSAVA), and number of relapses following switch to normal diet) using a linear mixed effects model for group comparison. Time, group, and their interactions were included as a fixed effect, whereas each dog was treated as a random effect. Of the 35 dogs enrolled into the clinical trial, 10 in each group reached the point of second endoscopy. A total of 13 dogs (n = 8 in group 1 and n = 5 in group 2) reached the trial endpoint of 18 weeks. After switching back to normal diet, none of the dogs in either group relapsed. No significant differences were found over time or between groups for CCECAI, endoscopy scoring and histological scoring. Although there was a clinical worsening in the placebo group after switching back to the original diet, this was not statistically significant (CCECAI p = 0.58). Post-hoc power calculation revealed that 63 dogs per group would have been needed to detect statistically significant differences in CIBDAI between treatment groups. Standard dietary treatment induced rapid clinical response in all cases, however, additional supplementation with prebiotics and GAGs did not significantly improve clinical outcome within 4 months after switching back to normal diet. Since there are very few RCCT published in CE in dogs, this pilot study provides important power analyses for planning of further studies.


Assuntos
Doenças do Cão/tratamento farmacológico , Glicosaminoglicanos/administração & dosagem , Prebióticos/administração & dosagem , Animais , Diarreia/tratamento farmacológico , Dieta/métodos , Cães , Feminino , Masculino , Projetos Piloto
19.
Int J Hyg Environ Health ; 238: 113850, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34673353

RESUMO

Diarrheal disease remains a leading cause of child mortality, globally. In the Democratic Republic of the Congo (DRC), each year there are an estimated 45 million episodes of diarrhea in children under five years of age. The Reducing Enteropathy, Diarrhea, Undernutrition, and Contamination in the Environment (REDUCE) program seeks to develop theory-driven, evidence-based approaches to reduce diarrheal diseases among young children. The REDUCE prospective cohort study in Walungu Territory in Eastern DRC took guidance from the risks, attitudes, norms, abilities, and self-regulation model, the integrated behavioral model for water, sanitation, and hygiene (WASH), and other behavior change theories to identify psychosocial factors associated with WASH behaviors. Psychosocial factors were measured among 417 caregivers at baseline and caregiver responses to child mouthing of dirty fomites and handwashing with soap was assessed by 5-hour structured observation at the 6-month follow-up. Caregivers who agreed that their child could become sick if they put dirt in their mouth (perceived susceptibility) and caregivers that agreed they could prevent their child from playing with dirty things outside (self-efficacy) were significantly more likely to stop their child from mouthing a dirty fomite. Higher perceived susceptibility, self-efficacy, and disgust, and lower dirty reactivity, were associated with higher handwashing with soap behaviors. This study took a theory-driven and evidence-based approach to identify psychosocial factors to target for intervention development. The findings from this study informed the development of the REDUCE Baby WASH Modules that have been delivered to over 1 million people in eastern DRC.


Assuntos
Saneamento , Água , Criança , Pré-Escolar , Diarreia/epidemiologia , Diarreia/prevenção & controle , Humanos , Higiene , Lactente , Estudos Prospectivos
20.
PLoS One ; 16(10): e0257851, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34669729

RESUMO

BACKGROUND: Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia, diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds. METHODS: We conducted a cross-sectional survey in 110 LLPHFs and 129 health workers in Mbarara District, Uganda between May and December 2019. Structured questionnaires and observation forms were used to collect data on availability of treatment guidelines, vital medicines, diagnostics, and equipment; health worker qualifications; and knowledge of management of common childhood infections. RESULTS: Amoxicillin was available in 97%, parental ampicillin and gentamicin in 77%, zinc tablets and oral rehydration salts in >90% while artemether-lumefantrine was available in 96% of LLPHF. About 66% of facilities stocked loperamide, a drug contraindicated in the management of diarrhoea in children. Malaria rapid diagnostic tests and microscopes were available in 86% of the facilities, timers/clocks in 57% but only 19% of the facilities had weighing scales and 6% stocked oxygen. Only 4% of the LLPHF had integrated management of childhood illness (IMCI) booklets and algorithm charts for management of common childhood illnesses. Of the 129 health workers, 52% were certificate nurses/midwives and (26% diploma nurses/clinical officers; 57% scored averagely for knowledge on management of common childhood illnesses. More than a quarter (38%) of nursing assistants had low knowledge scores. No notable significant differences existed between rural and urban LLPHFs in most parameters assessed. CONCLUSION: Vital first-line medicines for treatment of common childhood illnesses were available in most of the LLPHFs but majority lacked clinical guidelines and very few had oxygen. Majority of health workers had low to average knowledge on management of the common childhood illnesses. There is need for innovative knowledge raising interventions in LLPHFs including refresher trainings, peer support supervision and provision of job aides.


Assuntos
Infecções Bacterianas/diagnóstico , Diarreia/diagnóstico , Malária/diagnóstico , Pneumonia/diagnóstico , Ampicilina/uso terapêutico , Antimaláricos/uso terapêutico , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/terapia , Pré-Escolar , Estudos Transversais , Diarreia/epidemiologia , Diarreia/microbiologia , Diarreia/terapia , Feminino , Hidratação/normas , Gentamicinas/uso terapêutico , Humanos , Lactente , Recém-Nascido , Malária/epidemiologia , Malária/parasitologia , Malária/terapia , Masculino , Pneumonia/epidemiologia , Pneumonia/microbiologia , Pneumonia/terapia , Instalações Privadas/tendências , Uganda/epidemiologia , Zinco/uso terapêutico
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