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1.
Ann Saudi Med ; 41(5): 293-298, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34618605

RESUMO

BACKGROUND: Cryptosporidium spp. is a protozoan parasite that infects many vertebrate animals, including humans. Since Cryptosporidium spp. can cause chronic life-threatening diarrhea and severe malabsorption in immunocompromised patients, we investigated the prevalence of this parasite among patients undergoing chemotherapy for malignant solid tumors. OBJECTIVE: Investigate the prevalence of Cryptosporidium spp. in stool samples. DESIGN: Cross-sectional. SETTING: Tertiary care. PATIENTS AND METHODS: Stool samples were collected from adult patients with malignant solid tumors receiving chemotherapy and diarrhea. Cryptosporidium spp. prevalence was determined using Ziehl-Neelsen staining, ELISA, and real-time PCR targeting of the COWP gene. MAIN OUTCOME MEASURE: The prevalence of Cryptosporidium spp. in patients undergoing chemotherapy for malignant solid tumors. SAMPLE SIZE: 94 RESULTS: The prevalence was 2.1% (2/94), 5.3% (5/94), and 5.3% (5/94) as detected by Ziehl-Neelsen staining, real-time PCR and ELISA, respectively. The prevalence reached 8.5% (8/94) using all results obtained from the three methods. Among eight positive stool samples, four were positive by at least two different methods (Ziehl-Neelsen staining-ELISA or ELISA-real-time PCR) whereas the remaining four were positive by either ELISA or real-time PCR. CONCLUSION: These findings show the risk of cryptosporidiosis in cancer patients and the necessity to use at least two diagnostic methods during the diagnosis of cryptosporidiosis to reach more accurate and trustworthy results. LIMITATIONS: Further studies with a larger sample size are recommended. CONFLICT OF INTEREST: None.


Assuntos
Criptosporidiose , Cryptosporidium , Neoplasias , Animais , Estudos Transversais , Criptosporidiose/epidemiologia , Cryptosporidium/genética , Diarreia/epidemiologia , Humanos , Neoplasias/tratamento farmacológico , Neoplasias/epidemiologia
2.
Chaos ; 31(9): 093129, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34598439

RESUMO

Bovine viral diarrhea (BVD) is a disease in cattle with complex transmission dynamics that causes substantial economic losses and affects animal welfare. The infection can be transient or persistent. The mostly asymptomatic persistently infected hosts are the main source for transmission of the virus. This characteristic makes it difficult to control the spreading of BVD. We develop a deterministic compartmental model for the spreading dynamics of BVD within a herd and derive the basic reproduction number. This epidemiological quantity indicates that identification and removal of persistently infected animals is a successful control strategy if the transmission rate of transiently infected animals is small. Removing persistently infected animals from the herd at birth results in recurrent outbreaks with decreasing peak prevalence. We propose a stochastic version of the compartmental model that includes stochasticity in the transmission parameters. This stochasticity leads to sustained oscillations in cases where the deterministic model predicts oscillations with decreasing amplitude. The results provide useful information for the design of control strategies.


Assuntos
Diarreia , Surtos de Doenças , Animais , Número Básico de Reprodução , Bovinos , Diarreia/epidemiologia
3.
J Nepal Health Res Counc ; 19(2): 417-420, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34601542

RESUMO

Cronkhite-Canada syndrome first described in 1955, is a rare clinical syndrome of unknown etiology. Since then, more than 500 cases have been reported worldwide in the literature. The disease is characterized by diffuse gastrointestinal polyposis, dystrophic changes of the fingernails, cutaneous hyperpigmentation, alopecia, diarrhea, weight loss, and abdominal pain. A 84-year-old woman was admitted in our hospital with severe dehydration following diarrhea and epigastric discomforts. She also had dystrophic change of fingernails, and pigmentation of the palm and alopecia, all of which began several months ago. Endoscopy showed numerous, dense, tiny red polyps throughout the stomach, and duodenum. Her clinical manifestations and endoscopy were consistent with Cronkhite-Canada syndrome. We prescribed oral corticosteroids, which dramatically improved her condition. We here report rare case of Cronkhite-Canada syndrome who presented to our hospital. Keywords: Cronkhite-canada syndrome; gastrointestinal polyposis; onychodystrophy nail.


Assuntos
Hiperpigmentação , Polipose Intestinal , Idoso de 80 Anos ou mais , Alopecia , Diarreia , Feminino , Humanos , Polipose Intestinal/diagnóstico , Polipose Intestinal/tratamento farmacológico , Nepal
4.
Sci Rep ; 11(1): 19713, 2021 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-34611200

RESUMO

The novel coronavirus disease 2019 (COVID-19) presents with non-specific clinical features. This may result in misdiagnosis or delayed diagnosis, and lead to further transmission in the community. We aimed to derive early predictors to differentiate COVID-19 from influenza and dengue. The study comprised 126 patients with COVID-19, 171 with influenza and 180 with dengue, who presented within 5 days of symptom onset. All cases were confirmed by reverse transcriptase polymerase chain reaction tests. We used logistic regression models to identify demographics, clinical characteristics and laboratory markers in classifying COVID-19 versus influenza, and COVID-19 versus dengue. The performance of each model was evaluated using receiver operating characteristic (ROC) curves. Shortness of breath was the strongest predictor in the models for differentiating between COVID-19 and influenza, followed by diarrhoea. Higher lymphocyte count was predictive of COVID-19 versus influenza and versus dengue. In the model for differentiating between COVID-19 and dengue, patients with cough and higher platelet count were at increased odds of COVID-19, while headache, joint pain, skin rash and vomiting/nausea were indicative of dengue. The cross-validated area under the ROC curve for all four models was above 0.85. Clinical features and simple laboratory markers for differentiating COVID-19 from influenza and dengue are identified in this study which can be used by primary care physicians in resource limited settings to determine if further investigations or referrals would be required.


Assuntos
COVID-19/patologia , Dengue/patologia , Influenza Humana/patologia , Adulto , Área Sob a Curva , COVID-19/complicações , COVID-19/virologia , Estudos de Coortes , Dengue/complicações , Dengue/virologia , Diagnóstico Diferencial , Diarreia/etiologia , Feminino , Febre/etiologia , Humanos , Influenza Humana/complicações , Influenza Humana/virologia , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , RNA Viral/análise , RNA Viral/metabolismo , Curva ROC , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Vômito/etiologia , Adulto Jovem
5.
BMC Cancer ; 21(1): 1083, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620124

RESUMO

BACKGROUND: The aim of the study was to estimate the minimally important difference (MID) for interpreting group-level change over time, both within a group and between groups, for the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scores in patients with prostate cancer. METHODS: We used data from two published EORTC trials. Clinical anchors were selected by strength of correlations with QLQ-C30 scales. In addition, clinicians' input was obtained with regard to plausibility of the selected anchors. The mean change method was applied for interpreting change over time within a group of patients and linear regression models were fitted to estimate MIDs for between-group differences in change over time. Distribution-based estimates were also evaluated. RESULTS: Two clinical anchors were eligible for MID estimation; performance status and the CTCAE diarrhoea domain. MIDs were developed for 7 scales (physical functioning, role functioning, social functioning, pain, fatigue, global quality of life, diarrhoea) and varied by scale and direction (improvement vs deterioration). Within-group MIDs ranged from 4 to 14 points for improvement and - 13 to - 5 points for deterioration and MIDs for between-group differences in change scores ranged from 3 to 13 for improvement and - 10 to - 5 for deterioration. CONCLUSIONS: Our findings aid the meaningful interpretation of changes on a set of EORTC QLQ-C30 scale scores over time, both within and between groups, and for performing more accurate sample size calculations for clinical trials in prostate cancer.


Assuntos
Deterioração Clínica , Diarreia , Inquéritos Epidemiológicos , Neoplasias da Próstata , Qualidade de Vida , Índice de Gravidade de Doença , Idoso , Dor do Câncer , Ensaios Clínicos Fase III como Assunto/estatística & dados numéricos , Reembasadores de Dentadura , Europa (Continente) , Fadiga , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Desempenho Físico Funcional , Interação Social , Fatores de Tempo
6.
Pan Afr Med J ; 39: 225, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34630837

RESUMO

Systemic sclerosis is a rare condition that has not been well reported in Africa, and several multisystemic manifestations, including gastrointestinal ones, have not been well documented locally. We present an unusual case of persistent gastro-oesophageal reflux and diarrhoea in a 74-year-old Kenyan female, who progressively developed abdominal distention, dysphagia and Raynaud´s phenomenon. Stool tests were unremarkable, whereas antinuclear antibody, ribonucleoproteins antibody (anti-nRNP/Sm) and anti-Sjögren's-syndrome-related antigen A autoantibody (anti-SSA) tests were positive. Endoscopic and imaging investigations revealed features of gastrointestinal dysmotility including reflux oesophagitis, gastroparesis and chronic intestinal pseudo-obstruction. A diagnosis of systemic sclerosis was made, and she responded well to medical treatment. We present this case to contribute to the limited literature of a disease associated with high morbidity and mortality, as well as encourage fellow clinicians to have a high level of suspicion in their differentials of persistent gastrointestinal dysmotility.


Assuntos
Diarreia/etiologia , Refluxo Gastroesofágico/etiologia , Escleroderma Sistêmico/diagnóstico , Idoso , Transtornos de Deglutição/etiologia , Feminino , Humanos , Quênia , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/terapia
7.
J Glob Health ; 11: 13008, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484715

RESUMO

Backgound: The global community recognizes the urgent need to end preventable child deaths, making it an essential part of the third Sustainable Development Goal. Pneumonia, diarrhoea, and malaria still remain the leading causes of deaths among children under five years, especially in one of the poorest geographic regions of the world - West and Central Africa. This region carries a disproportionately high share of the global burden, both in terms of morbidity and mortality. The study aims to assess levels and trends of the prevalence of these three childhood diseases in West and Central Africa to better inform ongoing and future programmes to improve child survival. Methods: Demographic and Health Surveys and Multiple Indicator Cluster Surveys available from 1995 to 2017 for 23 countries in West and Central Africa were analysed. We estimated the prevalence of diarrhoea, acute respiratory infections (ARI), malaria, and fever as a proxy for malaria, and split the data into three time periods to assess these trends in disease prevalence over time. Further analyses were done to assess the variations by geographic location (urban and rural) and gender (boys and girls). Results: In West and Central Africa, the reduction of the prevalence rates of diarrhoea, acute respiratory infections, malaria, and fever has decelerated over time (1995-2009), and little improvements occurred between 2010 and 2017. The reduction within the region has been uneven and the prevalence rates either increased or stagnated for diarrhoea (nine countries), ARI (four countries), and fever (six countries). The proportion of affected children was high in emergency or fragile settings. Disaggregated analyses of population-based data show persistent gaps between the prevalence of diseases by geographic location and gender, albeit not significant for the latter. Conclusions: Without intensified commitment to reducing the prevalence of pneumonia, malaria, and diarrhoea, many countries will not be able to meet the SDG goal to end preventable child deaths. Evidence-driven programmes that focus on improving equitable access to preventive health care information and services must be fostered, especially in complex emergency settings. This will be an opportunity to strengthen primary health care, including community health programmes, to achieve universal health coverage.


Assuntos
Malária , Infecções Respiratórias , África Central , Criança , Pré-Escolar , Diarreia/epidemiologia , Diarreia/prevenção & controle , Feminino , Saúde Global , Humanos , Malária/epidemiologia , Malária/prevenção & controle , Masculino , Prevalência , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controle
8.
Zhongguo Zhen Jiu ; 41(9): 984-90, 2021 Sep 12.
Artigo em Chinês | MEDLINE | ID: mdl-34491647

RESUMO

OBJECTIVE: To compare the clinical therapeutic effect on diarrhea-predominant irritable bowel syndrome (IBS-D) of spleen deficiency and damp excess among fire needling therapy with filiform needle combined with acupoint application therapy, simple acupoint application therapy and pinaverium bromide tablets, and explore the mechanism on the improvements in IBS-D. METHODS: A total of 150 patients with IBS-D of spleen deficiency and damp excess were randomized into a combined treatment group (50 cases, 14 cases dropped off), an acupoint application group (50 cases, 16 cases dropped off ) and a western medication group (50 cases, 13 cases dropped off ). In the western medication group, pinaverium bromide tablets were prescribed for oral administration, 50 mg per time, three times a day. In the acupoint application group, the herbal plaster of shenling baizhu powder mixed with fresh ginger juice was placed on Shenque (CV 8), once every two days. In the combined treatment group, on the base of the treatment as the acupoint application group, the fire needling therapy with filiform needle was exerted at Tianshu (ST 25), Shangjuxu (ST 37), Yinlingquan (SP 9) and Dachangshu (BL 25), once every two days. The duration of treatment in each group was 4 weeks. Separately, before treatment and after 7 and 28 days of treatment, the score of clinical symptoms and the score of quality of life scale for IBS (IBS-QOL) were observed in each group. Before treatment and after 28 days of treatment, the levels of , and T lymphocytes, and the ratio of / in peripheral blood of patients were detected successively; as well as the expressions of 5-HT3R mRNA and 5-HT4R mRNA in colon mucosal tissues in each group separately. RESULTS: Except the score for abdominal pain in the acupoint application group and the scores for abdominal pain and abdominal distention in the western medication group after 7 days of treatment, the scores for abdominal pain, abdominal distention, defecation frequency, stool form and incomplete bowel movement after 7 and 28 days of treatment were all reduced as compared with those before treatment in each group separately (P<0.05). After 7 days of treatment, the scores for abdominal distention, defecation frequency and stool form in the combined treatment group were all lower than those in the western medication group (P<0.05). After 28 days of treatment, the score of each clinical symptom in the combined treatment group was lower than either of the rest two groups respectively (P<0.05); and the scores for abdominal pain, abdominal distention and incomplete bowel movement in the acupoint application group were lower than those in the western medication group separately (P<0.05). After 7 and 28 days of treatment, the score of each item in IBS-QOL was increased as compared with that before treatment in each group (P<0.05). After 7 days of treatment, except the scores for heterosexual relationship and human relations, scores of the other items, other scores of IBS-QOL in the combined treatment group were higher than those in the western medication group separately (P<0.05); while the scores of anxiety and behavior disorder in the acupoint application group were higher than those in the western medication group (P<0.05). After 28 days of treatment, the each score of IBS-QOL in the combined treatment group was higher than the other two groups respectively (P<0.05), while the scores of anxiety, behavior disorder, dietary control, social reaction and human relations in the acupoint application group were all higher than the western medication group (P<0.05). After treatment, the levels of and T lymphocytes and the ratio of /in peripheral blood, as well as the expressions of 5-HT4R mRNA in colon tissue were all increased in each group (P<0.05), but the levels of T lymphocyte and 5-HT3R mRNA expressions in colon tissue were reduced in each group (P<0.05). After treatment, regarding the levels of and T lymphocytes and the ratio of /in peripheral blood, as well as the expressions of 5-HT4R mRNA in colon tissue, the values in the combined treatment group were all higher than either of the rest two groups respectively (P<0.05), while the values in the acupoint application group were higher than the western medication group (P<0.05). Concerning to the level of T lymphocytes and 5-HT3R mRNA expression, the values in the combined treatment group were lower than the rest two groups respectively (P<0.05), and the values in the acupoint application group were lower than the western medication group (P<0.05). CONCLUSION: The combined treatment with the fire needling therapy with filiform needle and the acupoint application therapy effectively relieves the clinical symptoms, improves the quality of life and strengthens the immunity in the patients with IBS-D. The therapeutic effect of this combined regimen is better than either simple acupoint application therapy or the oral medication of pinaverium bromide. The mechanism may be related to the regulation of the levels of T lymphocyte subsets and the modulation of the expressions of 5-HT3R and 5-HT4R mRNA in colon tissue.


Assuntos
Terapia por Acupuntura , Síndrome do Intestino Irritável , Pontos de Acupuntura , Diarreia/etiologia , Diarreia/terapia , Humanos , Síndrome do Intestino Irritável/terapia , Qualidade de Vida , Baço , Resultado do Tratamento
9.
Ann Palliat Med ; 10(8): 9249-9258, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34488410

RESUMO

BACKGROUND: Tongxie Yaofang is commonly used in the treatment of IBS-D. Many systematic reviews have confirmed its efficacy and safety, but the methodology and quality of evidence need to be further evaluated. METHODS: The databases of Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature (CBM), Wanfang, VIP, Web of Science (SCI), PubMed, Cochrane Library, and Embase were searched to gather systematic evaluations of TXYF in treating IBS-D. The search time was from inception to January 2021. The search was performed independently by 2 researchers who screened the literature and extracted data. Methodological quality of the studies included in the systematic evaluation was evaluated by the A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) scale. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used to categorize the evidence quality of outcome indicators, and the curative effect evaluation was summarized. RESLUTS: A total of 10 systematic evaluations were included, and the results of AMSTAR-2 evaluation showed that 6 reports were relatively complete, 4 reports were poor, and the overall quality was not high. DISCUSSION: It was revealed that TXYF can improve the total clinical effective rate and symptoms of patients with IBS-D, but the GRADE evaluation results showed that the quality of evidence was low to extremely low. It is suggested that further high-quality clinical research should be conducted to provide more reliable evidence-based medical evidence for the application of TXYF in the treatment of irritable bowel syndrome.


Assuntos
Síndrome do Intestino Irritável , Diarreia/tratamento farmacológico , Humanos , Síndrome do Intestino Irritável/tratamento farmacológico , Resultado do Tratamento
10.
Praxis (Bern 1994) ; 110(11): 619-620, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34465197

RESUMO

CME/Answers: Mushroom Poisoning in the Family Practice Abstract. In the general medical practice, it is not trivial to distinguish between banal intolerances after consumption of edible mushrooms and the initial symptoms of poisoning with potentially fatal outcome. Nevertheless, there are some criteria that can be used as clinical guidance: A latency of six hours or more between the consumption of gilled mushrooms that have not been checked by experts and the onset of mostly severe vomiting and diarrhea is indicative of poisoning with amatoxins, the toxins i.e. in death caps (Amanita phalloides). Although the therapeutic options are controversial, prompt antidotal treatment with silibinin has proven to be effective.


Assuntos
Intoxicação Alimentar por Cogumelos , Amanita , Diarreia , Medicina de Família e Comunidade , Humanos , Intoxicação Alimentar por Cogumelos/diagnóstico , Intoxicação Alimentar por Cogumelos/terapia
11.
JNMA J Nepal Med Assoc ; 59(235): 303-304, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-34506443

RESUMO

"Three more hours", I tell myself as I find my way to the exam hall. I see a bunch of my classmates cramming for the last minute, and here I am, in a corner, reminding myself that it's just three more hours till I get away from this horror. Irritable Bowel Syndrome is a gastrointestinal disorder in which there is dull achy lower abdominal pain associated with either diarrhea or constipation. Though it has high prevalence, it is still an underrated disease which can be easily missed in clinical settings.


Assuntos
Síndrome do Intestino Irritável , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Constipação Intestinal/etiologia , Diarreia/etiologia , Humanos , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/diagnóstico , Prevalência
12.
J Glob Health ; 11: 13009, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484716

RESUMO

Background: While the prevalence of childhood diseases and related mortality have been decreasing over the past decades, progress has been unequally distributed. The poorest households often carry the highest disease burden. As morbidity and mortality also decline most slowly among children of the poorest households, socioeconomic status may become a more relevant risk factor for childhood diseases. Methods: We analysed the association between socioeconomic status and highly prevalent childhood diseases, specifically diarrhoea, acute respiratory infections (ARI), and malaria, and how this association changed over time. For this observational study, we used repeated cross-sectional data, namely all available Demographic and Health Surveys as well as Multi-Indicator Cluster Surveys from Western and Central Africa between 1995 and 2017. We estimated the predicted prevalence of each disease for the entire region in three time periods. We repeated the analysis separately for each country to highlight heterogeneity between countries. Results: A notable wealth gradient can be seen in the prevalence rates of diarrhoea, ARI, and malaria in Western and Central Africa. Children in the poorest quartile have a much higher morbidity than children in the richest quartile and have experienced a considerably slower decline in prevalence rates. In the period 2010-2017, predicted prevalence of diarrhoea was 17.5% for children in the poorest quartile and 12.5% for children in the richest quartile. Similarly, the predicted prevalence was 11.1% and 8.6% for ARI, and 54.1% and 24.4% for malaria in endemic countries. The pattern does not differ between boys and girls. While exact prevalence rates vary between countries, only few countries have seen a decline in the wealth gradient for childhood diseases. Conclusions: The increasing wealth gradient in health raises concerns of increasing inequality that goes beyond wealth. It suggests a need to further improve targeting of health programmes. Moreover, these programmes should be adapted to address the interlinked challenges which burden the poorest households.


Assuntos
Malária , Infecções Respiratórias , África Central , Criança , Estudos Transversais , Diarreia/epidemiologia , Feminino , Humanos , Lactente , Malária/epidemiologia , Masculino , Prevalência , Infecções Respiratórias/epidemiologia , Fatores Socioeconômicos
13.
Trop Anim Health Prod ; 53(5): 449, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34533637

RESUMO

Bovine viral diarrhea virus (BVDV) is an important pathogen correlated with reproductive, respiratory, and gastrointestinal disorders in cattle. Furthermore, it causes endemic infections and significant economic losses in cattle herds worldwide. This review was performed to determine the pooled seroprevalence of BVDV infection and related risk factors among cattle in Iran. Data were systematically gathered without time limitation until 1 December 2020 in the Islamic Republic of Iran from the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Elmnet, Magiran, Irandoc, Scientific Information Database (SID), and Civilica. According to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and inclusion criteria, 28 eligible studies were obtained from various Iran areas. In total, the pooled seroprevalence of BVDV infection, using random-effect model, was estimated 52% (95% CI, 40.1-63.9) in cattle. According to serological detection methods, pooled seroprevalence was as follows: based on ELISA 53.9% and SVN 25.1%. The highest pooled seroprevalence of BVDV infection was in the southeast provinces of Iran (78.4%) and lowest pooled seroprevalence was in Southwest provinces of the country (28.5%). The pooled seroprevalence of BVDV infection in cattle ≤ 2 years was significantly lower than cattle > 2 years (OR = 0.606; 95% CI, 0.397-0.925), whereas the pooled seroprevalence had no significant difference according to other factors such as gender, herd size, and herd types. In conclusion, the pooled seroprevalence of BVDV infection among cattle in Iran is relatively high. The seroprevalence was different among geographical regions of the country. These results are desirable for managing the control programs of this infection in Iran.


Assuntos
Doença das Mucosas por Vírus da Diarreia Viral Bovina , Doenças dos Bovinos , Vírus da Diarreia Viral Bovina , Animais , Doença das Mucosas por Vírus da Diarreia Viral Bovina/epidemiologia , Bovinos , Diarreia/veterinária , Irã (Geográfico)/epidemiologia , Estudos Soroepidemiológicos
14.
MMW Fortschr Med ; 163(16): 30, 2021 09.
Artigo em Alemão | MEDLINE | ID: mdl-34533719
15.
BMC Infect Dis ; 21(1): 983, 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34548008

RESUMO

BACKGROUND: The inappropriate use of antimicrobials for acute infectious diarrhea is widespread and leads to the problem of antimicrobial resistance. To improve the use of antimicrobials, it is first necessary to understand the actual situation of diarrheal disease and to identify potential targets for intervention. This study aimed to investigate the recent epidemiological characteristics of and antimicrobial prescriptions for acute infectious diarrhea in Japan. METHODS: This was a retrospective observational study of outpatients aged 0-65 years, separated into children (age 0-17 years) and adults (age 18-65 years), diagnosed with acute infectious diarrhea, using the administrative claims database of the Japan Medical Data Center from 2013 to 2018. We evaluated the number of eligible visits/number of database registrants (defined as the visit rate). The analysis of the antimicrobial prescription rate was restricted to otherwise healthy individuals diagnosed with acute infectious diarrhea alone by excluding patients with multiple disease diagnoses and with medical backgrounds of chronic bowel diseases or immunocompromised conditions. We further classified them by diagnosis of bacterial or nonbacterial acute infectious diarrhea. RESULTS: The total number of eligible visits for acute infectious diarrhea was 2,600,065. The visit rate, calculated based on the number of eligible visits by database registrants, was higher in children (boys, 0.264; girls, 0.229) than in adults (men, 0.070; women, 0.079), with peaks in early summer and winter. The peaks for visits in adults lagged those of children. In total, 482,484 visits were analyzed to determine the antimicrobial prescription rate; 456,655 (94.6%) were diagnosed with nonbacterial acute infectious diarrhea. Compared with children (boys, 0.305; girls, 0.304), the antimicrobial prescription rate was higher in adults, and there were differences between sexes in adults (men, 0.465; women, 0.408). Fosfomycin and fluoroquinolone were most frequently used for nonbacterial acute infectious diarrhea in children (44.1%) and adults (50.3%), respectively. CONCLUSIONS: These results revealed overprescription of antimicrobials for acute infectious diarrhea in this administrative claims database in Japan and contribute to the development of antimicrobial stewardship strategies and the identification of targets for efficiently reducing inappropriate antimicrobial use.


Assuntos
Antibacterianos , Anti-Infecciosos , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Atenção à Saúde , Diarreia/tratamento farmacológico , Diarreia/epidemiologia , Prescrições de Medicamentos , Feminino , Humanos , Lactente , Recém-Nascido , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
16.
Trop Anim Health Prod ; 53(5): 471, 2021 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-34550482

RESUMO

Bovine viral diarrhea (BVD) is an economically important cattle disease with worldwide distribution and characterized mainly by suboptimal fertility in the affected herds. The objectives of this study were to estimate the seroprevalence of BVDV within dairy cattle, to identify potential risk factors, and to assess the association with occurrence of reproductive problems. Sera (n = 954) collected from dairy cattle from 98 herds in southern and central Ethiopia were tested for BVDV antibodies using a commercial ELISA. Among screened sera samples, 20.9% (95% CI, 18.4, 23.6) tested positive to BVDV antibodies. The herd prevalence was 50% (95% CI, 40.1, 59.9) and the intra-herd prevalence ranged between 2.6 and 100% (mean = 31.4%) in positive herds. Geographic region, herd size, and animal arrangement in the farm had significant association with serostatus (p < 0.05). Cattle from southern Ethiopia and herds of large size had 2.8 (95% CI, 1.9, 4.2) and 2.6 (95% CI, 1.5, 4.6) times higher odds of being seropositive compared to their counterparts, respectively. Serostatus to BVDV was associated with history of anestrus, repeat breeding (RB), mastitis, and extended calving interval (CI) (p < 0.05). Animals with history of extended CI and mastitis were 1.7 (95% CI, 1.0, 2.7) and 2.2 (95% CI, 1.5, 3.2) times more likely to be seropositive compared with those with normal CI and no history of mastitis, respectively. On the other hand, animals with history of anestrus and RB were less likely to be seropositive to BVDV compared to cattle with no such history. Sera from 26 selected cattle were also examined using reverse transcription (RT)-PCR for detection of BVDV RNA; however, all samples tested were negative for the presence of BVDV nucleic acid. Our study highlights the variation in BVDV status within Ethiopian dairy herds, and association with some important reproductive performance traits and potential risk factors.


Assuntos
Doença das Mucosas por Vírus da Diarreia Viral Bovina , Vírus da Diarreia Viral Bovina , Animais , Anticorpos Antivirais , Doença das Mucosas por Vírus da Diarreia Viral Bovina/epidemiologia , Bovinos , Diarreia/veterinária , Etiópia/epidemiologia , Feminino , Estudos Soroepidemiológicos
17.
BMC Gastroenterol ; 21(1): 350, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34556042

RESUMO

BACKGROUND: Olmesartan, which is an angiotensin II receptor blocker, reportedly causes spruelike enteropathy, with intestinal villous atrophy as its typical histopathological finding. Interestingly, collagenous and/or lymphocytic gastritis and colitis occur in some patients. We report the case of a 73-year-old Japanese man with a 2-month clinical history of severe diarrhea and weight loss. There were few reports in which spruelike enteropathy and collagenous colitis were both observed and could be followed up. CASE PRESENTATION: We report a case of a 73-year-old man with a 2-month clinical history of severe diarrhea and weight loss. He had taken olmesartan for hypertension treatment for 5 years. Endoscopic examination with biopsies revealed intestinal villous atrophy and collagenous colitis. Suspecting enteropathy caused by olmesartan, which was discontinued on admission because of hypotension, we continued to stop the drug. Within 3 weeks after olmesartan discontinuation, his clinical symptoms improved. After 3 months, follow-up endoscopy showed improvement of villous atrophy but not of the thickened collagen band of the colon. However, the mucosa normalized after 6 months, histologically confirming that the preexistent pathology was finally resolved. CONCLUSIONS: This report presents a case in which spruelike enteropathy and collagenous colitis were both observed and could be followed up. In unexplained cases of diarrhea, medication history should be reconfirmed and this disease should be considered a differential diagnosis.


Assuntos
Colite Colagenosa , Colite , Idoso , Colite/induzido quimicamente , Colite/diagnóstico , Colite Colagenosa/induzido quimicamente , Colite Colagenosa/diagnóstico , Diarreia/induzido quimicamente , Humanos , Imidazóis/efeitos adversos , Masculino , Tetrazóis/efeitos adversos
18.
Lancet Glob Health ; 9(10): e1402-e1410, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34534487

RESUMO

BACKGROUND: The odds ratio (OR) comparing pathogen presence in diarrhoeal cases versus asymptomatic controls is a measure for diarrhoeal disease cause that has been integrated into burden of disease estimates across diverse populations. This study aimed to estimate the OR describing the association between pathogen detection in stool and diarrhoea for 15 common enteropathogens by age group and child mortality setting. METHODS: We did a systematic review to identify case-control and cohort studies published from Jan 1, 1990, to July 9, 2019, which examined at least one enteropathogen of interest and the outcome diarrhoea. The analytical dataset included data extracted from published articles and supplemented with data from the Global Enteric Multicenter Study and the Malnutrition and Enteric Disease study. Random effects meta-analysis models were fit for each enteropathogen, stratified by age group and child mortality level, and adjusted for pathogen detection method and study design to produce summary ORs describing the association between pathogen detection in stool and diarrhoea. FINDINGS: 1964 records were screened and 130 studies (over 88 079 cases or diarrhoea samples and 135 755 controls or non-diarrhoea samples) were available for analysis. Heterogeneity (I2) in unadjusted models was substantial, ranging from 27·6% to 86·6% across pathogens. In stratified and adjusted models, summary ORs varied by age group and setting, ranging from 0·4 (95% CI 0·2-0·6) for Giardia lamblia to 54·1 (95% CI 7·4-393·5) for Vibrio cholerae. INTERPRETATION: Incorporating effect estimates from diverse data sources into diarrhoeal disease cause and burden of disease models is needed to produce more representative estimates. FUNDING: WHO, Bill & Melinda Gates Foundation, and National Institutes of Health.


Assuntos
Mortalidade da Criança , Desnutrição , Estudos de Casos e Controles , Criança , Estudos de Coortes , Diarreia/epidemiologia , Humanos
19.
Trop Biomed ; 38(3): 360-365, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34508344

RESUMO

COVID-19, caused by the SARS-CoV-2 virus, can lead to massive inflammation in the gastrointestinal tract causing severe clinical symptoms. SARS-CoV-2 infects lungs after binding its spike proteins with alveolar angiotensin-converting enzyme 2 (ACE2), and it also triggers inflammation in the gastrointestinal tract. SARS-CoV-2 invades the gastrointestinal tract by interacting with Toll-like receptor-4 (TLR4) that induces the expression of ACE2. The influx of ACE2 facilitates cellular binding of more SARS-CoV-2 and causes massive gastrointestinal inflammation leading to diarrhea. Diarrhea prior to COVID-19 infection or COVID-19-induced diarrhea reportedly ends up in a poor prognosis for the patient. Flavonoids are part of traditional remedies for gastrointestinal disorders. Preclinical studies show that flavonoids can prevent infectious diarrhea. Recent studies show flavonoids can inhibit the multiplication of SARS-CoV-2. In combination with vitamin D, flavonoids possibly activate nuclear factor erythroid-derived-2-related factor 2 that downregulates ACE2 expression in cells. We suggest that flavonoids have the potential to prevent SARS-CoV-2 induced diarrhea.


Assuntos
COVID-19/complicações , Diarreia/prevenção & controle , Flavonoides/uso terapêutico , SARS-CoV-2 , Enzima de Conversão de Angiotensina 2/fisiologia , Diarreia/etiologia , Humanos
20.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 33(8): 903-917, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34590555

RESUMO

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.


Assuntos
Estado Terminal , Nutrição Enteral , China , Consenso , Diarreia , Nutrição Enteral/efeitos adversos , Humanos
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