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Chronic diarrhoea is described as diarrhoea lasting more than 4 weeks. The underlying causes are multiple and the diagnostic orientation depends on several anamnestic and clinical elements. The basic work-up includes biology and stool analysis. We present the case of a 14-year-old adolescent with chronic diarrhoea and weight loss for several months. Extensive complementary analyses were performed, all being totally negative. A careful repeated clinical history revealed that the patient had a significant nicotine intake, confirmed by a urine cotinine test. Withdrawal led to a resolution of the symptomatology. Nicotine consumption in the form of nicotine replacement products among young people is increasing rapidly. Nicotine has multiple health effects, including neurological, gastrointestinal and immune adverse effects.
La diarrhée chronique est décrite comme une diarrhée qui dure plus de 4 semaines. Les étiologies sont multiples et l'orientation diagnostique dépend de plusieurs éléments anamnestiques et cliniques. La mise au point de base comprend une biologie et une analyse de selles. Nous présentons le cas d'un adolescent de 14 ans avec diarrhée chronique et perte pondérale depuis plusieurs mois. Un bilan complémentaire extensif est réalisé et revient totalement négatif. C'est en répétant l'anamnèse qu'une consommation nicotinique non négligeable est mise en évidence chez le patient, confirmée par un dosage élevé de cotinine urinaire. Le sevrage a permis une résolution de la symptomatologie. La consommation de nicotine sous forme de produits de substitution nicotinique chez les jeunes est en forte augmentation. La nicotine a de multiples effets négatifs sur la santé, notamment neurologiques, gastrointestinaux et immunitaires.
Asunto(s)
Nicotina , Cese del Hábito de Fumar , Adolescente , Humanos , Nicotina/efectos adversos , Nicotina/orina , Dispositivos para Dejar de Fumar Tabaco , Diarrea/inducido químicamente , Pérdida de PesoRESUMEN
BACKGROUND: Native valves infective endocarditis due to Escherichia coli is still a rare disease and a particular virulence of some E.coli isolate may be suspected. CASE PRESENTATION: A 79-year-old woman presented during the post-operative period of an orthopedic surgery a urinary tract infection following obstructive ureteral lithiasis. E. coli was isolated from a pure culture of urine and blood sampled simultaneously. After evidence of sustained E.coli septicemia, further investigations revealed acute cholecystitis with the same micro-organism in biliary drainage and a native valve mitral endocarditis. E.coli was identified as O2:K7:H6, phylogenetic group B2, ST141, and presented several putative and proven virulence genes. The present isolate can be classified as both extra-intestinal pathogenic E.coli (ExPECJJ) and uropathogenic E. coli (UPECHM). CONCLUSIONS: The relationship between the virulent factors present in ExPEC strains and some serotypes of E. coli that could facilitate the adherence to cardiac valves warrants further investigation.
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Endocarditis/diagnóstico , Escherichia coli Patógena Extraintestinal/aislamiento & purificación , Anciano , Animales , Endocarditis/microbiología , Escherichia coli Patógena Extraintestinal/clasificación , Escherichia coli Patógena Extraintestinal/patogenicidad , Femenino , Humanos , Procedimientos Ortopédicos/efectos adversos , Filogenia , Periodo Posoperatorio , Infecciones Urinarias/microbiología , Infecciones Urinarias/patología , Urolitiasis/cirugía , Virulencia/genéticaRESUMEN
OBJECTIVES: The use of semielemental diets concerns a small proportion of children on enteral nutrition whose characteristics have never been reported. Our aim was to describe a cohort of patients on home enteral nutrition with Peptamen Junior, including the tolerance and nutritional efficacy of this product. METHODS: We performed a retrospective multicenter survey on a cohort of patients receiving this semielemental diet at home between 2010 and 2015 in 14 tertiary pediatric French centers. We recorded at baseline, 3, 6, and 12 months, and then every year the anthropometric characteristics of the patients, indications and modalities of administration of the diet, and the tolerance and adverse events. RESULTS: We recruited 136 patients ages 9.8â±â4.4 years at baseline. Mean body mass index z score was -1.0â±â1.8; mean height z score was -1.1â±â1.9. The main underlying diseases were digestive (35.3%), neurological (33.1%), and hematological (19.9%). The indications for a semielemental diet were failure of another diet in 70 patients (51.9%), severe malnutrition in 19 (14.1%), cystic fibrosis in 11 (8.1%), and switch from parenteral nutrition in 11 (8.1%). Side effects were observed in 39.2% of the patients, and required medical attention in 8.2%. Body mass index improved or remained normal in 88.3% of children. CONCLUSIONS: This semielemental diet seems to be well tolerated and efficient in the setting of home enteral nutrition in children with complex diseases featuring malabsorption and/or after failure of polymeric diet.
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Nutrición Enteral , Alimentos Formulados , Niño , Estudios de Cohortes , Estudios Transversales , Femenino , Francia , Servicios de Atención de Salud a Domicilio , Humanos , Masculino , Estudios Retrospectivos , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
Wastewater microbiota represents important actors of organic depollution. Nowadays, some species used as bioindicators of the effluent quality are still identified by microscopy. In the present study, we investigated eukaryotic diversity at the different steps of the treatment process of a wastewater treatment plant (aerobic, anaerobic, clarifier basins and anaerobic digester) using the 18S rRNA gene sequencing approach. Of the 1519 analysed sequences, we identified 160 operational taxonomic units. Interestingly, 56.9% of the phylotypes were assigned to novel phylogenetic molecular species since they show <97% sequence identity with their nearest affiliated representative within public databases. Peritrichia ciliates were the most predominant group, with Epistylis as the most common genus. Although anaerobic, the digester appears to harbor many unclassified phylotypes of protozoa species. Novel lineages such as LKM11 and LKM118 were widely represented in the digester. Diversity values given by Shannon indexes show that the clarifier is the most diversified. This work will help designing molecular tools that are fast, reliable, and reproducible for monitoring wastewater depollution and studying phylogenetic relationships among the wonderful world of protists within this anthropogenic ecosystem.
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Eucariontes/clasificación , Eucariontes/genética , Aguas Residuales/microbiología , Alveolados/clasificación , Alveolados/genética , Secuencia de Bases , Biodiversidad , Cilióforos/clasificación , Cilióforos/genética , Monitoreo del Ambiente , Hongos/clasificación , Hongos/genética , Variación Genética , Microbiota/genética , Filogenia , ARN Ribosómico 18S/genética , Análisis de Secuencia de ADN , Aguas del Alcantarillado/microbiología , Purificación del AguaRESUMEN
The SARS-CoV-2 pandemic was characterized by a significant increase in the endorsement of conspiracy theories. Conspiracy theories are narratives that can enable and accentuate distrust toward health professionals and authorities. As such, they can lead to violent radicalization and should be considered a public health issue. This perspective article aims to further the understanding of professionals on conspiracy theories via the 3N model of radicalization and self-determination theory. Based on empirical research, theory, and existing interventions, potential initiatives intended to tackle the issue of conspiracy theories during pandemics are also presented.
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[This corrects the article DOI: 10.3389/fpsyg.2021.682931.].
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OBJECTIVE: Numerous professions are considered at risk of developing work-related posttraumatic stress disorder (PTSD), as per DSM-5. This study sought to identify the prevalence of PTSD among lawyers and its associated work and non-work-related risk and moderating factors. METHOD: A cross-national sample of Canadian lawyers (N = 169) completed two online surveys 8 months apart. RESULTS: Seven percent of lawyers working with trauma-related cases met the criteria for probable PTSD at study entry only, 7.0% met them at study endpoint only, and an additional 3.5% of the sample met the criteria at both time points, yielding a current (past-month) prevalence of 10.4% and an 8-month cumulative prevalence of 17.5%. Beyond a past diagnosis of PTSD, the most important risk factor was the number of years on the job. Parenthood represented a mitigating factor. Ultimately, the more time spent working on trauma-related cases, the more severe were the PTSD symptoms, although this relationship was moderated by perceived quality of life and work-family balance. CONCLUSIONS: Lawyers exposed to trauma-related cases represent an at-risk group for PTSD. The findings highlight the powerful impacts that interpersonal relationships and self-care may have in buffering this health hazard. (PsycInfo Database Record (c) 2022 APA, all rights reserved).