Hyperimmune yolk extract with Immunoglobulin Y basic active principle as a possible adjuvant treatment in patients who need/benefit from neurorehabilitation, with Clostridium difficile (Clostridioides difficile) enterocolitis as intercurrent comorbidity - a systematic literature review.

The study aims to add a new and beneficial perspective using Immunoinstant G food supplement as an adjuvant treatment. It is essential to study the bibliographic resources in the field to identify the current stage of knowledge on this topic. For this purpose, we have prepared a systematic literature review, focusing on the possibilities of improving the treatment of Clostridium difficile (Clostridioides difficile) enterocolitis in patients who need/benefit from neurorehabilitation. The systematic literature review was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We obtained a number of 6 articles that were considered in the elaboration of our systematic literature review. We identified that this field is insufficiently studied and needs additional clinical trials. Our study contributes to increasing this understanding based on the thorough theoretical and practical approach of this topic.

Multiple thrombosis associated with Cytomegalovirus enterocolitis in an immunocompetent patient: a case report.

BACKGROUND: Cytomegalovirus (CMV) is reported to have thrombogenic characteristics that activate factor X in vitro and stimulate the production of factor VIII and von Willebrand factor (vWF). Thrombosis associated with CMV infection is prevalent among immunocompromised patients and predominantly presents as a solitary large thrombus in the deep vein, pulmonary artery, splanchnic arteriovenous ducts, or other similar sites. Multiple thrombi, however, are rarely observed in such cases. Here, we report about an immunocompetent man with multiple microthrombi associated with CMV infection. CASE PRESENTATION: A 72-year-old Japanese man who complained of abdominal pain was hospitalized with multiple colonic stenosis. He was later diagnosed with CMV enterocolitis and treated with ganciclover from Day 27 post-admission. During hospitalization, the patient developed thrombi in his fingers. He was initially treated with anticoagulant therapy (rivaroxaban); however, the therapy was discontinued owing to a prolonged activated thromboplastin time and an elevated international normalized ratio of prothrombin time. Instead, vitamin K and fresh-frozen plasma were administered. Nevertheless, his coagulation profile remained abnormal. Eventually, he developed colonic perforation and had to undergo emergency surgery. An intraoperative specimen showed several microthrombi in the middle and small arteriovenous ducts of his small and large intestines. The patient's coagulopathy improved preoperatively, and his overall condition improved postoperatively. Since the activation of ADAMTS13 was reduced remarkably, the thrombotic tendency was determined to be a thrombotic microangiopathy-like condition owing to increased vWF. We could not attribute the coagulopathy to any other cause except CMV infection; therefore, we concluded that this was a case of multiple thrombosis associated with CMV. CONCLUSIONS: We present an extremely rare case of a patient with multiple thrombotic microangiopathy-like microthrombosis caused by CMV infection. Our findings suggest that CMV infection may be considered as a differential diagnosis for immunocompetent individuals who present with thrombosis of unspecified cause.

Literature Review: Herbal Medicine Treatment after Large-Scale Disasters.

Large-scale natural disasters, such as earthquakes, tsunamis, volcanic eruptions, and typhoons, occur worldwide. After the Great East Japan earthquake and tsunami, our medical support operation's experiences suggested that traditional medicine might be useful for treating the various symptoms of the survivors. However, little information is available regarding herbal medicine treatment in such situations. Considering that further disasters will occur, we performed a literature review and summarized the traditional medicine approaches for treatment after large-scale disasters. We searched PubMed and Cochrane Library for articles written in English, and Ichushi for those written in Japanese. Articles published before 31 March 2016 were included. Keywords "disaster" and "herbal medicine" were used in our search. Among studies involving herbal medicine after a disaster, we found two randomized controlled trials investigating post-traumatic stress disorder (PTSD), three retrospective investigations of trauma or common diseases, and seven case series or case reports of dizziness, pain, and psychosomatic symptoms. In conclusion, herbal medicine has been used to treat trauma, PTSD, and other symptoms after disasters. However, few articles have been published, likely due to the difficulty in designing high quality studies in such situations. Further study will be needed to clarify the usefulness of herbal medicine after disasters.

Protective effect of Blumea lacera DC aerial parts in indomethacin-induced enterocolitis in rats.

Traditionally Blumea lacera DC is used to treat inflammation and bowel ailments. Lack of specific, curative treatment for IBD enticed us to investigate the therapeutic efficacy of ethanolic extract of aerial parts of Blumea lacera DC (EEBL) against indomethacin-induced enterocolitis. Male Wistar rats were divided into six groups (n = 5) and different doses of EEBL (100 and 200 mg/kg, p.o) and sulphasalazine (100 mg/kg, p.o) were administered for seven days. Enterocolitis was induced by two subsequent doses of indomethacin (7.5 mg/kg, s.c) on 7th and 8th day. Treatments were continued up to 12th day and sacrificed. The protective effect was assessed on the basis of macroscopic scores of ileum strips, changes in biochemical parameters such as serum lactate dehydrogenase (LDH), tissue myeloperoxidase (MPO), lipid peroxidation (LPO), and total thiols (TT). Further, activity was ascertained by histopathological evaluations. HPLC fingerprinting profiling of EEBL was also carried out. Pre-treatment with EEBL or sulphasalazine significantly attenuated the indomethacin-induced proximal ileal damage, elevated levels of serum LDH, tissue MPO, LPO and lower levels of TT. Further, observed activity of EEBL was well correlated with histopathological alterations. The results revealed the protective action of the title plant against the indomethacin-induced enterocolitis in rats, which might be attributed by its antioxidant, anti-inflammatory, antimicrobial, and membrane-stabilizing properties.

Effects of curcumin on growth performance, jejunal mucosal membrane integrity, morphology and immune status in weaned piglets challenged with enterotoxigenic Escherichia coli.

The aim of this study was to evaluate the effect of dietary curcumin supplementation on growth performance and intestinal mucosal barrier function of weaned piglets. Fifty piglets, weaned at 21±2 days of age, were randomly allotted to five treatments for 21 days. The dietary treatments were the control (basal diet), and the basal diet supplemented with 50mg/kg quinocetone, or 200 mg/kg, 300 mg/kg or 400mg/kg curcumin. The piglets were housed in individual pens and orally challenged with enterotoxigenic Escherichia coli (ETEC) during the preliminary trial period. The jejunal morphology and histology analysis were detected under light microscope. The plasma D-lactate and diamine oxidase (DAO) were determined by using enzymatic spectrophotometric assay. Immunohistochemistry assays were used to examine secretory immunoglobulin (sIgA) protein expression. Real-time PCR was used to determine mRNA levels of cytokine and Toll-like receptor 4 (TLR4) in jejunal mucosa. The results showed that, compared with the control, dietary addition of 300 mg/kg or 400 mg/kg curcumin decreased (P<0.05) feed/gain ratio and crypt depth, improved (P<0.05) villus height and villus height:crypt depth ratio, reduced (P<0.05) plasma D-lactate and DAO activity, up-regulated the protein expression of sIgA (P<0.05), increased (P<0.05) the number of goblet cells (GCs) and reduced (P<0.05) the number of intraepithelial lymphocytes (IELs). The mRNA levels of interleukin 1ß (IL-1ß) and TLR4 and tumor necrosis factor α (TNF-α) were also decreased (P<0.05), but mRNA level of interleukin 10 (IL-10) was increased (P<0.05). There was no difference in the above parameters between the 300 mg/kg and 400 mg/kg curcumin groups. Pigs fed with 50 mg/kg quinocetone also decreased (P<0.05) feed/gain ratio, increased villus height:crypt depth ratio (P<0.05), and reduced (P<0.05) crypt depth and mRNA levels of TLR4. In conclusion, curcumin and the quinocetone have similar effects in improving piglet growth, but dietary addition of 300 mg/kg or 400 mg/kg curcumin was more effective than quinocetone in improving intestinal mucosal barrier integrity, morphology, and immune status of weaned pigs. This indicates that curcumin could be used as a potential feed additive replacing quinocetone in weaned piglets.

A mineral extract from red algae ameliorates chronic spontaneous colitis in IL-10 deficient mice in a mouse strain dependent manner.

Inflammatory bowel disease is an urgent public health problem with a high incidence in developed countries. Alterations of lifestyle or dietary interventions may attenuate the disease progression and increase the efficacy of current therapies. Here we tested the effect of chronic supplementation with a mineral extract from red marine algae - rich in calcium (34%), magnesium, phosphorus, selenium and other trace minerals - in a clinically relevant model of spontaneous enterocolitis, interleukin (IL)-10(-/-) mice. The mineral extract was administered in the drinking water of Il10(-/-) mice on C57BL/6 J and BALB/c strain backgrounds for 25 weeks commencing from 3 to 4 weeks of age. The mineral extract ameliorated the spontaneous development of colitis and severity of disease in Il10(-/-) mice on a C57BL/6 J background. Mineral extract-treated Il10(-/-) C57BL/6 J strain mice had significantly reduced mortality, circulating levels of serum Amyloid A and reduced colonic tissue damage. In contrast, comparable treatment of Il10(-/-) mice on a BALB/c background with the mineral extract did not alter the course of colitis. These data demonstrate that chronic supplementation with a natural mineral extract selectively ameliorates spontaneous mild-moderate colitis in Il10(-/-) mice on a C57BL/6 J, but does not attenuate more moderate-severe colitis in BALB/c strain animals.

American Journal of Gastroenterology Lecture: Intestinal microbiota and the role of fecal microbiota transplant (FMT) in treatment of C. difficile infection.

The vital roles that intestinal flora, now called microbiota, have in maintaining our health are being increasingly appreciated. Starting with birth, exposure to the outside world begins the life-long intimate association our microbiota will have with our diet and environment, and initiates determination of the post-natal structural and functional maturation of the gut. Moreover, vital interactions of the microbiota with our metabolic activities, as well as with the immunological apparatus that constitutes our major defense system against foreign antigens continues throughout life. A perturbed intestinal microbiome has been associated with an increasing number of gastrointestinal and non-gastrointestinal diseases including Clostridium difficile infection (CDI). It has become recognized that fecal microbiota transplantation (FMT) can correct the dysbiosis that characterizes chronic CDI, and effect a seemingly safe, relatively inexpensive, and rapidly effective cure in the vast majority of patients so treated. In addition, FMT has been used to treat an array of other gastrointestinal and non-gastrointestinal disorders, although experience in these other non-CDI diseases is in its infancy. More work needs to be done with FMT to ensure its safety and optimal route of administration. There is a conceptual sea change that is developing in our view of bacteria from their role only as pathogens to that of being critical to health maintenance in a changing world. Future studies are certain to narrow the spectrum of organisms that need to be given to patients to cure disease. FMT is but the first step in this journey.

Protective effect of aqueous extract of Spinacia oleracea leaves in experimental paradigms of inflammatory bowel disease.

The present study was aimed to assess the protective effect of aqueous extract of Spinacia oleracea leaves (AESO 250, 500, and 1,000 mg/kg, p.o.) in inflammatory bowel disease using acetic acid- and ethanol-induced colitis in mice and indomethacin-induced enterocolitis in rats. The preliminary phytochemical analysis and further high performance thin layer chromatographic (HPTLC) analysis and phytochemical tests of HPTLC bands confirmed the presence of flavonoids and tannins in AESO. In acute oral toxicity study, administration of AESO (5,000 mg/kg, p.o.) did not show any sign of toxicity and mortality. The treatment with AESO significantly increased body weight, decreased diarrhea with bloody stools, increased blood hemoglobin and plasma total protein, and decreased serum and ileum or colon malondialdehyde content and attenuated the extent of lesions and ameliorated the histological injury of mucosa in all paradigms. The most prominent effects were evident for AESO 1,000 mg/kg. The results of the present study revealed that AESO was effective in attenuating almost all the symptoms of IBD in experimental paradigms. The effect might be due to the antioxidant activity of the flavonoids present in the AESO.

Polysaccharides derived from Yamoa (Funtumia elastica) prime gammadelta T cells in vitro and enhance innate immune responses in vivo.

Yamoa (ground bark of Funtumia elastica tree) is marketed and sold as a dietary supplement with anecdotal therapeutic effects in the treatment of asthma and hay fever. We determined that Yamoa and Yamoa-derived polysaccharides affected innate immunity, in part, by priming gammadelta T cells. Gene expression patterns in purified bovine gammadelta T cells and monocytes induced by Yamoa were similar to those induced by ultrapure lipopolysaccharide (uLPS). In the presence of accessory cells, Yamoa had priming effects that were similar to those of LPS on bovine and murine gammadelta T cells, but much more potent than LPS on human gammadelta T cells. The bioactive component of Yamoa was delineated to a complex polysaccharide fraction (Yam-I). Intraperitoneal injection of Yamoa and Yam-I in mice induced rapid increases in peritoneal neutrophils directed by changes in chemokine expression. In support of a unique agonist found in Yam-I, similar peritonitis responses were also observed in TLR4- and MyD88-deficient mice. Therapeutic treatment with Yam-I resulted in decreased bacterial counts in feces from mice with Salmonella enterica serotype typhimurium (ST)-induced enterocolitis. This characterization of the immune stimulatory properties of polysaccharides derived from Yamoa suggests mechanisms for the anecdotal positive effects of its ingestion and that these polysaccharides show potential for application in innate protection from disease.

[The use of therapeutic/prophylactic dragee "honey laminolact" in radiotherapy of uterine tumors]. / Opyt primeneniia lechebno-profilakticheskogo drazhe "laminolakt medovyi" pri luchevom lechenii bol'nykh rakom tela matki.

The study deals with the effect of a newly-developed food product--Honey Laminolact, containing live lactic acid bacteria, amino acids, trace elements, fruit pectine and immunomodulators-on the degree of response to radiation in 44 patients who received radiotherapy for uterine tumors. It was shown to lower response of the intestinal tract to radiation when the small pelvis was exposed.

Collagenous and microscopic colitis: clinical importance.

Minimal-change colitis and microscopic colitis are clinicopathological terms for diarrhoea with normal endoscopic or barium enema findings. Some controversy about the exact definitions and terminology still exists. Some forms of minimal-change colitis may overlap with "self-limited" colitis (infectious colitis) or may be due to (surreptitious) use of laxatives or other drugs. In recent years it has become clear however that some genuine forms of chronic colitis can be diagnosed only by microscopic examination of multiple colonic biopsies while macroscopy is negative and hence can be called "microscopic colitis". Collagenous colitis and lymphocytic colitis are at present two forms of this type of colitis which are more or less well defined both clinically and pathologically. Chronic watery diarrhoea is the main symptom for both. The symptoms of collagenous colitis appear most commonly in the sixth decade. Women are affected about 4 times more frequently than men. The major microscopic characteristic is a thickened collagen layer underneath the intercryptal surface epithelium. The major characteristic of lymphocytic colitis is an increase in number of interepithelial lymphocytes. Both conditions are characterized by signs of mucosal inflammation. Clinically, collagenous colitis is characterized by long-lasting diarrhoea. In patients with lymphocytic colitis the period of chronic diarrhoea is usually shorter and female predominance is less apparent. Although the natural history of these forms of colitis is not precisely known, it appears from the data thus far published that the long-term consequences are unlikely to be dire. The true incidence, aetiology and pathogenesis are unknown for both conditions and treatment is unclear.(ABSTRACT TRUNCATED AT 250 WORDS)

[Chemotherapy of Campylobacter infections]. / Khimioterapiia kampilobakterioza.

A total of 600 patients with suspected alimentary food poisoning were hospitalized. The ++clinico-laboratory findings showed that 27 (4.5 per cent) of them had Campylobacter infection. The cultures of Campylobacter jejuni and Campylobacter coli were isolated from 24 and 3 patients, respectively. The patients underwent complex pathogenetic treatment with oral rehydration saline solutions, symptomatic agents, enzymatic preparations and diet (the basic therapy) supplemented with biological bacterial preparations in less severe cases (8 patients). Antibacterial drugs such as furazolidone (roxytromycin), gentamicin and levomycetin, as well as fluoroquinolones such as ofloxacin and ciprofloxacin were additionally used in the treatment of both the patients with the generalized infection and those with more severe processes of the disease, pronounced diarrhea with blood traces and persisting isolation of Campylobacter (12 patients). The most favourable results in the treatment of more severe patients with Campylobacter infection were obtained with the fluoroquinolones used after inadequately efficient therapy with furazolidone or antibiotics especially in the cases with repeated isolation of campylobacteria.

Misoprostol accelerates colonic mucosal repair in acetic acid-induced colitis.

The objectives of this study were 1) to determine whether misoprostol (MISO) (prostaglandin E1 analog) pretreatment protects the colonic mucosa from the injurious effects of acetic acid by attenuating the initial injury or by enhancing the rate of repair and 2) to assess the relationship between the protective effect of MISO pretreatment and mucosal ornithine decarboxylase activity in the inflamed colon. We found that the intrarectal administration of acetic acid caused rapid and extensive injury to the colonic mucosa, such that mucosal permeability increased 88-, 75-, 26-, 7.5- and 9.3-fold at 1, 2, 6, 24 and 48 hr after the enema, respectively. Intrarectal pretreatment with 50 micrograms of MISO for 30 min did not attenuate the increase in mucosal permeability at 1 hr after enema; however, it did significantly reduce mucosal permeability by 50 to 60% at 2, 6 and 48 hr after enema. We also demonstrated that acetic acid produced an 8.4-fold increase in colonic myeloperoxidase activity and a 1.8-fold increase in colonic weight at 48 hr after enema. MISO significantly reduced the increases in both myeloperoxidase activity and colon weight. Ornithine decarboxylase activity in the descending colon of vehicle-pretreated animals increased significantly only at 24 hr after the acetic acid enema. In addition, MISO pretreatment followed by acetic acid enema resulted in significantly higher ornithine decarboxylase activities in the descending colon at 2 and 6 hr, compared with the vehicle plus acetic acid and MISO plus saline groups.(ABSTRACT TRUNCATED AT 250 WORDS)

[Immunomodulating properties of pectin from seawater grass Zostera]. / Immunomoduliruiushchie svoistva pektina iz morskoi travy Zostera.

Immunomodulating activity of zosterin was studied. Zosterin is a pectin from sea grass belonging to Zostera with pronounced antibacterial activity and therapeutic efficacy in experimental infections. It was shown that parenteral administration of the drug 24 hours before the antigenic irritation stimulated the humoral and cellular immunity in F1 (CBA X C 57 BL/6) mice: an increase in the number of the antibody cells in the spleen, the DTH and the index of the splenocyte spontaneous proliferation. In the animals treated with injections of zosterin and infected intraperitoneally with a virulent strain of S. enteritidis there was observed a marked increase in migration of polymorphonuclear leukocytes to the abdominal cavity accompanied by an increase in their phagocytic activity. The results suggested the possible use of zosterin as a drug with associated antibacterial and immunomodulating activities.

[Nigedase in the combined treatment of patients with chronic pancreatitis and enterocolitis]. / Nigedaza v kompleksnom lechenii bol'nykh khronicheskim pankreatitom i énterokolitom.

The authors examined the efficacy of a new native agent of lipolytic action (nigedase, made in the USSR) used for the treatment of digestive disorders in 62 patients with chronic diseases of the pancreas and enterocolitis. Nigedase should be taken 1-2 tablets daily for 3-4 weeks. By its lipolytic action nigedase is more active than festal.

Ciprofloxacin in the treatment of acute bacterial diarrhea: a double blind study.

In a double-blind, randomized, placebo-controlled trial 50 adult patients with acute diarrhea received either 500 mg ciprofloxacin b.i.d. or a placebo for five days. Results were evaluated in 21 patients in the ciprofloxacin group (10 with Salmonella spp., 11 with Campylobacter jejuni) and 25 patients in the placebo group (16 with Salmonella spp., 5 with Campylobacter jejuni, 4 with Shigella spp.). The duration of fever in patients treated with ciprofloxacin was 1.5 days versus 2.3 days in the placebo group; the difference was not statistically significant. The duration of diarrhea in the ciprofloxacin group was 1.4 days versus 2.6 days in the placebo group (p less than 0.01); the corresponding figures in patients with salmonellosis were 1.6 versus 3.2 (p = 0.01). In the ciprofloxacin group all stool cultures became negative 48 h after start of treatment and remained negative during the follow-up period of three weeks. In the placebo group only one of the 25 patients had negative stool cultures during therapy and only seven after the treatment period (p less than 0.001). Ciprofloxacin was very well tolerated and was found to be a safe compound without major adverse effects.

[Bactericidal and immunocorrective properties of plant extracts]. / Bakteritsidnye i immunokorrigiruiushchie svoistva nekotorykh rastitel'nykh ékstraktov.

Extract from oak cork, St. John's wort leaves and flowers and pine buds possess more pronounced bactericidal properties with respect to staphylococci, shigellae, Escherichia coli than decoctions from these medicinal plants. Such extracts may be included into complexes for the treatment of otorhinolaryngological diseases, enterocolitis in children and bacterial eczema. As a medicinal form, extract prepared from medicinal plants are more convenient for storage and permit more exact dosage.

Clinical evaluation of mezlocillin in neonates.

Single-dose pharmacokinetic studies were performed in 64 infants, ranging in age from less than 1 day to 6 days, after intravenous infusion or intramuscular injection of approximately 75 mg/kg of mezlocillin. Mean serum concentrations at one hour were 107 micrograms/ml and 82.5 micrograms/ml for neonates less than or equal to 1 day of age and greater than or equal to 6 days of age, respectively. The serum clearance ranged from 3.0 to 6.4 hours. Based on data from the study, it is recommended that mezlocillin be administered to neonates with gram-negative bacterial infections in a single dose of 75 mg/kg, either as an intravenous infusion over 30 minutes or as an intramuscular injection, every 12 hours during the first week of life. Mezlocillin alone or in conjunction with penicillin was used in treating 165 neonates with suspected sepsis. Gram-negative organisms were recovered from 18 of the 27 neonates from whom pathogens were isolated. Three of these 18 strains, a Klebsiella oxytoca, an Acinetobacter anitratum, and a Haemophilus influenzae, were resistant to mezlocillin in vitro. Twenty-four of the 27 patients who satisfied criteria for evaluation achieved a bacteriological and a clinical cure. Cerebrospinal fluid permeation after multiple doses ranged from 18% to 45% of serum levels. No significant local or systemic side effects were seen. The results indicate that mezlocillin is an effective ureidopenicillin for the treatment of gram-negative bacterial infections.