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1.
Acta Med Indones ; 52(3): 283-289, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33020339

RESUMO

Coronavirus disease 2019 (COVID-19) is a new infectious disease that spreads very rapidly and therefore, WHO has declared it as a global pandemic disease. The main clinical symptoms found in COVID-19 patients are cough and fever; however, in some cases, diarrhea can be one of the early symptoms. The present case report describes a patient who came with a complaint of diarrhea without fever and she was later confirmed to be positive for COVID-19 during hospitalization. The presence of unspecified initial symptoms calls for greater vigilance from health workers in establishing diagnosis patients with COVID-19.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/complicações , Diarreia/etiologia , Pandemias , Pneumonia Viral/complicações , RNA Viral/análise , Idoso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Diarreia/diagnóstico , Feminino , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Fatores de Tempo
2.
Rev Med Suisse ; 16(710): 1916-1919, 2020 Oct 14.
Artigo em Francês | MEDLINE | ID: mdl-33058577

RESUMO

Probiotics are a big food and pharmaceutical industry today. The most widely used probiotics are Lactobacillus spp, Bifidobacterium spp, strains of Enterococcus spp, Streptococcus spp and yeasts such as Saccharomyces pp. Among the best-known indications are Clostridioides difficile colitis and diarrhea due to antibiotics, but probiotics are also proposed as adjuvants for atopic syndromes, autoimmune diseases, prevention and treatment of obesity, diabetes and cystic fibrosis, where dysbiosis play an important role. However, their use remains debated due to a lack of powerful data proving their effectiveness and their often-overlooked side effects.


Assuntos
Probióticos/efeitos adversos , Probióticos/uso terapêutico , Antibacterianos/efeitos adversos , Diarreia/microbiologia , Diarreia/terapia , Disbiose/microbiologia , Disbiose/terapia , Humanos
3.
BMC Infect Dis ; 20(1): 741, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33036564

RESUMO

BACKGROUND: Cholera remains a major global health challenge. Uvira, in the Democratic Republic of the Congo (DRC), has had endemic cholera since the 1970's and has been implicated as a possible point of origin for national outbreaks. A previous study among this population, reported a case confirmation rate of 40% by rapid diagnostic test (RDT) among patients at the Uvira Cholera Treatment Centre (CTC). This study considers the prevalence and diversity of 15 enteric pathogens in suspected cholera cases seeking treatment at the Uvira CTC. METHODS: We used the Luminex xTAG® multiplex PCR to test for 15 enteric pathogens, including toxigenic strains of V. cholerae in rectal swabs preserved on Whatman FTA Elute cards. Results were interpreted on MAGPIX® and analyzed on the xTAG® Data Analysis Software. Prevalence of enteric pathogens were calculated and pathogen diversity was modelled with a Poisson regression. RESULTS: Among 269 enrolled CTC patients, PCR detected the presence of toxigenic Vibrio cholerae in 38% (103/269) of the patients, which were considered to be cholera cases. These strains were detected as the sole pathogen in 36% (37/103) of these cases. Almost half (45%) of all study participants carried multiple enteric pathogens (two or more). Enterotoxigenic Escherichia coli (36%) and Cryptosporidium (28%) were the other most common pathogens identified amongst all participants. No pathogen was detected in 16.4% of study participants. Mean number of pathogens was highest amongst boys and girls aged 1-15 years and lowest in women aged 16-81 years. Ninety-three percent of toxigenic V. cholerae strains detected by PCR were found in patients having tested positive for V. cholerae O1 by RDT. CONCLUSIONS: Our study supports previous results from DRC and other cholera endemic areas in sub-Sahara Africa with less than half of CTC admissions positive for cholera by PCR. More research is required to determine the causes of severe acute diarrhea in these low-resource, endemic areas to optimize treatment measures. TRIAL REGISTRATION: This study is part of the impact evaluation study entitled: "Impact Evaluation of Urban Water Supply Improvements on Cholera and Other Diarrheal Diseases in Uvira, Democratic Republic of Congo" registered on 10 October 2016 at clinicaltrials.gov Identification number: NCT02928341 .


Assuntos
Cólera/epidemiologia , Criptosporidiose/epidemiologia , Cryptosporidium/genética , Diarreia/epidemiologia , Surtos de Doenças , Escherichia coli Enterotoxigênica/genética , Infecções por Escherichia coli/epidemiologia , Vibrio cholerae/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Cólera/microbiologia , Criptosporidiose/parasitologia , República Democrática do Congo/epidemiologia , Testes Diagnósticos de Rotina , Diarreia/microbiologia , Doenças Endêmicas , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Prevalência , Microbiologia da Água , Adulto Jovem
4.
Wei Sheng Yan Jiu ; 49(5): 724-730, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-33070812

RESUMO

OBJECTIVE: To identify the relationship between fever and diarrhea 2-week prevalence and Yingyangbao(YYB) effective consumption among infants and young children. METHODS: A total of 2952 infants and young children aged from 6 to 24 month in 10 impoverished counties of Henan province were selected by multi-stage random sampling between June and September 2017. To acquire 2-week prevalence information of infants and young children, their caregivers were investigated by self-made questionnaire. The structural equation model was utilized in multi-factor analysis. RESULTS: After adjusting potential confounders, YYB effective consumption reduced2-week prevalence of fever(ß=-0. 279, P=0. 001) and diarrhea(ß=-0. 182, P=0. 042) among infants and young children. Nutrition knowledge and YYB benefit cognition of caregivers reduced2-week prevalence of fever(γ=-0. 002, 95%CI-0. 004~-0. 001, P=0. 003) and diarrhea(γ=-0. 001, 95%CI-0. 003~0. 000, P=0. 049) indirectly through chain mediation path of "nutrition knowledge-YYB benfit cognition-YYB effective consumption-fever/diarrheal". CONCLUSION: YYB effective consumption can reduce 2-week prevalence of fever and diarrhea among infants and young children. Nutrition knowledge and YYB benefit cognition can improve YYB effective consumption and thus reduce 2-week prevalence of fever and diarrhea indirectly.


Assuntos
Suplementos Nutricionais , População Rural , Criança , Pré-Escolar , Diarreia/epidemiologia , Diarreia/prevenção & controle , Alimentos Fortificados , Humanos , Lactente , Prevalência
5.
Rev Saude Publica ; 54: 90, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33027343

RESUMO

OBJECTIVE: To analyze factors associated with diarrheal disease in the rural Caribbean region of Colombia. METHOD: A cross-sectional study conducted in the rural area of the Cesar Department, Colombia, between November 2017 and June 2018. Self-reported cases of diarrheal disease were surveyed, and water samples from 42 households were collected and analyzed. Descriptive statistics were employed in the analysis of socioeconomic status, environmental and sanitary conditions, and we evaluated their association with the diarrheal disease using the Poisson regression models. Each model was adjusted with variables suggested by specific directed acyclic graphs. RESULTS: Poor water supply conditions, hygiene and basic sanitation were reported in the study area. All water samples were classified either as high risk for health problems or unfit for human consumption. The diarrheal disease had a prevalence of 7.5% across all ages and of 23.5% in children under five years old. The variables rainy season (PR = 0.24; 95%CI 0.07-0.85), children under five years old (PR = 4.05; 95%CI 1.70-9.68), water from deep wells (PR = 16.90; 95%CI 2.45-116.67), water from artificial ponds (PR = 11.47; 95%CI 1.27-103.29), toilets availability (PRA = 0.23; 95%CI 0.06-0.96), and swine presence (PR = 0.20; 95%CI 0.05-0.74) were significantly associated with the occurrence of diarrheal disease. CONCLUSION: Water supply, hygiene and basic sanitation conditions have been associated with the diarrheal disease, affecting almost a quarter of the population under five years old. There is an urge for the design of effective policies that improve environmental and sanitation conditions in rural areas.


Assuntos
Diarreia/epidemiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Colômbia/epidemiologia , Estudos Transversais , Inquéritos Epidemiológicos , Humanos , Lactente , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
6.
Medicine (Baltimore) ; 99(40): e22641, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019489

RESUMO

RATIONALE: Rotavirus is routinely diagnosed by the detection of antigens or the viral genome. However, these tests have limitations, in that they do not detect all rotavirus strains. PATIENT CONCERNS: We present a case of a 27-month-old girl who was hospitalized for 4 days with severe gastroenteritis, including high fever, vomiting, diarrhea, mild dehydration, and periumbilical pain. Notably, the patient previously received the Rotarix vaccine. DIAGNOSES: The laboratory tests were negative for rotavirus, astrovirus, adenovirus, and norovirus as well as common diarrhea-causing bacteria. Human-bovine recombinant rotavirus was detected by MinION sequencing. INTERVENTIONS: To investigate the cause agents from the unexplained severe gastroenteritis infant, the stool sample was prepared by random amplification for Nanopore MinION sequencing. OUTCOMES: Treatment through the administration of ORS solution and galtase powder with probiotics was successful after the diagnosis of unusual rotavirus infection. LESSONS: This case report is the first detection of an unusual human-bovine recombinant rotavirus in an idiopathic gastroenteritis using Nanopore MinION sequencing.


Assuntos
Gastroenterite/virologia , Sequenciamento por Nanoporos/métodos , Infecções por Rotavirus/diagnóstico , Vacinas contra Rotavirus/efeitos adversos , Rotavirus/genética , Dor Abdominal , Doença Aguda , Pré-Escolar , Desidratação/etiologia , Diarreia/etiologia , Fezes/virologia , Feminino , Febre/etiologia , Hidratação/métodos , Gastroenterite/patologia , Gastroenterite/terapia , Humanos , Probióticos/uso terapêutico , Rotavirus/isolamento & purificação , Infecções por Rotavirus/complicações , Infecções por Rotavirus/virologia , Índice de Gravidade de Doença , Resultado do Tratamento , Vacinação/efeitos adversos , Vacinas Atenuadas/efeitos adversos , Vômito/etiologia
7.
Medicine (Baltimore) ; 99(35): e21920, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871927

RESUMO

INTRODUCTION: Collagen colitis (CC) is a microscopic colitis diagnosed by mucosal biopsy and is extremely rare in children. PATIENT CONCERNS: We reported a child with severe persistent diarrhea that could not be relieved with traditional diarrheal treatment. No abnormalities were found after multiple colonoscopies. DIAGNOSES: A significant increase in total IgE levels was found in the patient's blood. He had a history of mild chronic allergic rhinitis and slightly intermittent wheezing. However, we found that the child had a hyperallergic reaction to multiple respiratory antigens and had mild pulmonary dysfunction. Finally, colonoscopy with biopsy identified the diagnosis of CC. INTERVENTION: Considering that a respiratory allergic reaction was one of the causes of diarrhea, anti-allergic treatment was given to the child, and his severe diarrhea was soon relieved. Corticosteroid treatment was suggested to the patient, but his parents firmly refused steroid therapy. According to the patient's specific allergic reaction to mites, desensitization treatment was finally chosen for him. OUTCOMES: After 1 year of desensitization for dust mites, the patient's respiratory symptoms improved, total IgE levels decreased, autoantibodies declined, and diarrhea did not reoccur. Colonoscopy with biopsy showed a significant improvement in pathology. CONCLUSION: CC in children is rare, and childhood CC induced by a respiratory allergic reaction has not been previously reported. Therefore, this is a special case of CC in a patient who was cured with anti-allergy treatments and desensitization instead of steroid therapy.


Assuntos
Colite Colagenosa/diagnóstico , Colite Colagenosa/etiologia , Diarreia/etiologia , Hipersensibilidade Respiratória/complicações , Antialérgicos/uso terapêutico , Biópsia , Criança , Doença Crônica , Colite Colagenosa/terapia , Colonoscopia , Dessensibilização Imunológica , Diarreia/terapia , Humanos , Masculino , Hipersensibilidade Respiratória/terapia
8.
Benef Microbes ; 11(5): 477-488, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32877228

RESUMO

Neonatal calf diarrhoea is one of the challenges faced by intensive farming, and probiotics are considered a promising approach to improve calves' health. The objective of this study was to evaluate the effect of potential probiotic lactobacilli on new-born dairy calves' growth, diarrhoea incidence, faecal score, cytokine expression in blood cells, immunoglobulin A (IgA) levels in plasma and faeces, and pathogen abundance in faeces. Two in vivo assays were conducted at the same farm in two annual calving seasons. Treated calves received one daily dose of the selected lactobacilli (Lactobacillus reuteri TP1.3B or Lactobacillus johnsonii TP1.6) for 10 consecutive days. A faecal score was recorded daily, average daily gain (ADG) was calculated, and blood and faeces samples were collected. Pathogen abundance was analysed by absolute qPCR in faeces using primers directed at Salmonella enterica, rotavirus, coronavirus, Cryptosporidium parvum and three Escherichia coli virulence genes (eae, clpG and Stx1). The faecal score was positively affected by the administration of both lactobacilli strains, and diarrhoea incidence was significantly lower in treated calves. No differences were found regarding ADG, cytokine expression, IgA levels and pathogen abundance. Our findings showed that oral administration of these strains could improve gastrointestinal health, but results could vary depending on the calving season, which may be related to pathogen seasonality and other environmental effects.


Assuntos
Doenças dos Bovinos/terapia , Diarreia , Lactobacillus johnsonii/metabolismo , Lactobacillus reuteri/metabolismo , Probióticos/uso terapêutico , Animais , Animais Recém-Nascidos , Bovinos , Doenças dos Bovinos/microbiologia , Doenças dos Bovinos/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/veterinária , Criptosporidiose/prevenção & controle , Citocinas/sangue , Indústria de Laticínios , Diarreia/prevenção & controle , Diarreia/terapia , Diarreia/veterinária , Infecções por Escherichia coli/prevenção & controle , Infecções por Escherichia coli/veterinária , Fezes/virologia , Trato Gastrointestinal/microbiologia , Imunoglobulina A/sangue , Infecções por Rotavirus/prevenção & controle , Infecções por Rotavirus/veterinária , Salmonelose Animal/prevenção & controle
9.
Mil Med Res ; 7(1): 45, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32962760

RESUMO

BACKGROUND: Gastrointestinal symptoms are not rare among coronavirus disease 2019 (COVID-19) patients, but there have been no reports regarding convalescent plasma therapy for the recovery of gastrointestinal problems in COVID-19 patients. CASE PRESENTATION: We present two cases of patients with COVID-19-associated recurrent diarrhea and positive fecal occult blood who successfully recovered after a one-time convalescent plasma administration. CONCLUSION: When COVID-19 patients develop recurrent or refractory gastrointestinal symptoms and fail to respond to the available treatment, alternative therapy with convalescent plasma administration may be considered.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Diarreia/terapia , Hemorragia Gastrointestinal/terapia , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Idoso , Infecções por Coronavirus/diagnóstico , Diarreia/etiologia , Feminino , Seguimentos , Hemorragia Gastrointestinal/etiologia , Humanos , Imunização Passiva/métodos , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Recidiva , Amostragem , Índice de Gravidade de Doença , Taiwan , Resultado do Tratamento
10.
N Engl J Med ; 383(13): 1231-1241, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32966722

RESUMO

BACKGROUND: The World Health Organization recommends 20 mg of zinc per day for 10 to 14 days for children with acute diarrhea; in previous trials, this dosage decreased diarrhea but increased vomiting. METHODS: We randomly assigned 4500 children in India and Tanzania who were 6 to 59 months of age and had acute diarrhea to receive 5 mg, 10 mg, or 20 mg of zinc sulfate for 14 days. The three primary outcomes were a diarrhea duration of more than 5 days and the number of stools (assessed in a noninferiority analysis) and the occurrence of vomiting (assessed in a superiority analysis) within 30 minutes after zinc administration. RESULTS: The percentage of children with diarrhea for more than 5 days was 6.5% in the 20-mg group, 7.7% in the 10-mg group, and 7.2% in the 5-mg group. The difference between the 20-mg and 10-mg groups was 1.2 percentage points (upper boundary of the 98.75% confidence interval [CI], 3.3), and that between the 20-mg and 5-mg groups was 0.7 percentage points (upper boundary of the 98.75% CI, 2.8), both of which were below the noninferiority margin of 4 percentage points. The mean number of diarrheal stools was 10.7 in the 20-mg group, 10.9 in the 10-mg group, and 10.8 in 5-mg group. The difference between the 20-mg and 10-mg groups was 0.3 stools (upper boundary of the 98.75% CI, 1.0), and that between the 20-mg and 5-mg groups was 0.1 stools (upper boundary of the 98.75% CI, 0.8), both of which were below the noninferiority margin (2 stools). Vomiting within 30 minutes after administration occurred in 19.3%, 15.6%, and 13.7% of the patients in the 20-mg, 10-mg, and 5-mg groups, respectively; the risk was significantly lower in the 10-mg group than in the 20-mg group (relative risk, 0.81; 97.5% CI, 0.67 to 0.96) and in the 5-mg group than in the 20-mg group (relative risk, 0.71; 97.5% CI, 0.59 to 0.86). Lower doses were also associated with less vomiting beyond 30 minutes after administration. CONCLUSIONS: Lower doses of zinc had noninferior efficacy for the treatment of diarrhea in children and were associated with less vomiting than the standard 20-mg dose. (Funded by the Bill and Melinda Gates Foundation; ZTDT ClinicalTrials.gov number, NCT03078842.).


Assuntos
Antidiarreicos/administração & dosagem , Diarreia/tratamento farmacológico , Zinco/administração & dosagem , Antidiarreicos/efeitos adversos , Antidiarreicos/sangue , Pré-Escolar , Diarreia Infantil/tratamento farmacológico , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Lactente , Masculino , Adesão à Medicação , Vômito/induzido quimicamente , Vômito/epidemiologia , Zinco/efeitos adversos , Zinco/sangue
11.
BMC Infect Dis ; 20(1): 716, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993540

RESUMO

BACKGROUND: A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age. CASE PRESENTATION: The patient presented with 1 week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5. CONCLUSION: MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Síndrome de Resposta Inflamatória Sistêmica/complicações , Adulto , Aspirina/administração & dosagem , Aspirina/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/virologia , Tosse/complicações , Diarreia/complicações , Dispneia/complicações , Feminino , Febre/complicações , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Imunoglobulinas Intravenosas/uso terapêutico , Pandemias , Faringite/complicações , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase , Síndrome de Resposta Inflamatória Sistêmica/tratamento farmacológico , Síndrome de Resposta Inflamatória Sistêmica/virologia , Resultado do Tratamento , Vômito/complicações
12.
BMC Infect Dis ; 20(1): 659, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32894092

RESUMO

BACKGROUND: Diarrheagenic Escherichia coli (DEC) are among the leading pathogens associated with endemic diarrhea in low income countries. Yet, few epidemiological studies have focused the contribution of enterohemorrhagic E. coli (EHEC), enteroinvasive E. coli (EIEC) and diffusely adherent E. coli (DAEC). METHODS: We assessed the contribution of EHEC, EIEC and DAEC isolated from stool samples from a case-control study conducted in children aged < 5 years in Southern Mozambique between December 2007 and November 2012. The isolates were screened by conventional PCR targeting stx1 and stx2 (EHEC), ial and ipaH (EIEC), and daaE (DAEC) genes. RESULTS: We analyzed 297 samples from cases with less-severe diarrhea (LSD) matched to 297 controls, and 89 samples from cases with moderate-to-severe diarrhea (MSD) matched to 222 controls, collected between November 3, 2011 and November 2, 2012. DEC were more common among LSD cases (2.7%, [8/297] of cases vs. 1.3% [4/297] of controls; p = 0.243]) than in MSD cases (0%, [0/89] of cases vs. 0.4%, [1/222] of controls; p = 1.000). Detailed analysis revealed low frequency of EHEC, DAEC or EIEC and no association with diarrhea in all age strata. Although the low frequency, EIEC was predominant in LSD cases aged 24-59 months (4.1% for cases vs. 0% for controls), followed by DAEC in similar frequency for cases and controls in infants (1.9%) and lastly EHEC from one control. Analysis of a subset of samples from previous period (December 10, 2007 and October 31, 2011) showed high frequency of DEC in controls compared to MSD cases (16.2%, [25/154] vs. 11.9%, [14/118], p = 0.383, respectively). Among these, DAEC predominated, being detected in 7.7% of cases vs. 17.6% of controls aged 24-59 months, followed by EIEC in 7.7% of cases vs. 5.9% of controls for the same age category, although no association was observed. EHEC was detected in one sample from cases and two from controls. CONCLUSIONS: Our data suggests that although EHEC, DAEC and EIEC are less frequent in endemic diarrhea in rural Mozambique, attention should be given to their transmission dynamics (e.g. the role on sporadic or epidemic diarrhea) considering that the role of asymptomatic individuals as source of dissemination remains unknown.


Assuntos
Diarreia/epidemiologia , Escherichia coli Êntero-Hemorrágica/genética , Infecções por Escherichia coli/epidemiologia , Saúde da População Rural , Estudos de Casos e Controles , Pré-Escolar , Diarreia/microbiologia , Doenças Endêmicas , Escherichia coli Êntero-Hemorrágica/isolamento & purificação , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Moçambique/epidemiologia , Reação em Cadeia da Polimerase , Prevalência , População Rural
13.
Yonsei Med J ; 61(10): 901-903, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32975066

RESUMO

In this report, we describe the case of a SARS-CoV-2 infection (COVID-19) in an infant with mild fever and diarrhea in the absence of respiratory distress. A 45-day-old male infant with COVID-19 was transferred to our pediatric department. He had mild fever and diarrhea at admission. Positive-to-negative nasal swab conversion occurred on the 21st day from the onset of symptoms. However, stool swab positivity persisted during the 6-week admission period and for 7 weeks during follow-up at an outpatient clinic after discharge. Negative conversion in a stool specimen occurred on the 142nd day from the onset of symptoms. This case highlights the potential of fecal virus shedding as an important feature of viral transmission in infants and young children.


Assuntos
Infecções por Coronavirus/diagnóstico , Fezes/virologia , Pneumonia Viral/diagnóstico , Eliminação de Partículas Virais , Betacoronavirus , Diarreia/etiologia , Febre/etiologia , Humanos , Lactente , Masculino , Pandemias
14.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(5): 560-564, 2020 May 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879107

RESUMO

OBJECTIVES: To analyze the clinical characteristics of fecal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid-positive in patients with coronavirus dasease 2019 (COVID-19) and to provide a scientific basis for the prevention and control of this disease. METHODS: The clinical data of 16 patients with fecal SARS-CoV-2 nucleic acid positive, who hospitalized in the North Branch of the First Hospital of Changsha (Changsha Public Health Rescue Center) from January to February 2020, were retrospectively analyzed. Their clinical manifestations, laboratory data and imaging data were summarized. RESULTS: Among the 16 patients, there were 9 males (56.25%) and 7 females (43.75%), the ratio of males to females was 1∶1.29. The age of onset was (43.3±14.6) years. There were 15 patients with contact history of Wuhan, 1 patient with contact history of local patient.Twelve patients were common type (75%), and 4 patients were severe type (25%). Clinical symptoms included fever in 14 patients (87.5%), cough in 12 patients (75%), shortness of breath in 5 patients (31.25%), pharyngalgia in 10 patients (62.5%), fatigue in 7 patients (43.75%), and diarrhea in 4 patients (25%). There were 14 patients (87.5%) with normal or decreased white blood cell count, 11 patients (68.75%) with decreased lymphocyte count, 15 patients (93.75%) with increased erythrocyte sedimentation rate, 13 patients (81.25%) with increased hypersensitivity C-reactive protein, 5 patients (31.25%) with increased procalcitonin, and 8 patients (50%) with increased serum ferritin in peripheral blood, and stool routine was basically normal. Compared with the common type, there was significant difference in the white blood cell and lymphocyte counts in the severe type (P<0.01); the infection indicators, such as hypersensitivity C-reactive protein and serum ferritin, were significantly increased, with significant difference (all P<0.01); but the procalcitonin and erythrocyte sedimentation rate was not significantly different (both P>0.05). Chest CT mainly showed patchy shadows and interstitial changes. According to imaging examination, 4 patients (25%) showed unilateral pneumonia and 12 patients (75%) showed bilateral pneumonia. CONCLUSIONS: The patients have the clinical symptoms of COVID-19, but gastrointestinal symptoms (such as diarrhea) are more common, and the changes of white blood cell count, lymphocyte count, hypersensitivity C-reactive protein, ferritin are more obvious in severe patients.The positivity of fecal nucleic acid suggests the possibility of digestive tract transmission of SARS-CoV-2, and fecal nucleic acid testing can be used as a routine testing method in clinical practice.


Assuntos
Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Adulto , Betacoronavirus/isolamento & purificação , Proteína C-Reativa/análise , China , Infecções por Coronavirus/fisiopatologia , Diarreia/virologia , Fezes/virologia , Feminino , Ferritinas/análise , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/fisiopatologia , Estudos Retrospectivos
15.
Sci Total Environ ; 741: 140189, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32886968

RESUMO

Childhood diarrhea has been one of the major public health concerns in countries that have limited resources like Ethiopia. Understanding the association between childhood diarrhea and meteorological factors would contribute to safeguard children from adverse health effects through early warning mechanisms. Thus, this study aimed at exploring the association between childhood diarrhea and meteorological factors to enable reducing health risks. A retrospective study design was used to explore the association between meteorological factors and childhood diarrhea in southwestern Ethiopia from 2010 to 2017. Mann Kendall trend test and Spearman's correlation were computed to test the association of childhood diarrhea and meteorological factors. The space-time permutation model was used to identify the risky periods, seasons with most likely clusters, and high childhood diarrhea. Similarly, a negative binomial regression model was fitted to determine the predictability of meteorological factors for childhood diarrhea. The highest childhood diarrhea morbidity was 92.60 per 1000 per under five children. The risk of childhood diarrhea increased by 16.66% (RR: 1.1666; 95% CI: 1.164-1.168) per increase in 1 °C temperature. Furthermore, rainfall was found to be a significant risk factor of childhood diarrhea, with 0.16% (RR: 1.00167; 95% CI: 1.001306-1.001928) per 1 mm increase in rainfall. The temperature was positively correlated with the occurrence of childhood diarrhea. But the association with rainfall showed spatial variability. The space-time permutation model revealed that dry season was found to be a high-risk period with excess childhood diarrhea. The results showed that the observed association between meteorological factors and childhood diarrhea could be used as evidence for early warning systems for the prevention of childhood diarrhea.


Assuntos
Diarreia , Conceitos Meteorológicos , Criança , Etiópia , Humanos , Estudos Retrospectivos , Fatores de Risco
16.
Rev Soc Bras Med Trop ; 53: e20200494, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876320

RESUMO

Diagnosing cases of coronavirus disease (COVID-19) with only non-respiratory symptoms has been challenging. We reported the diagnosis of a child who tested positive for COVID-19 with abdominal pain/diarrhea and tracked his family cluster. One member of the family tested positive for COVID-19 on real-time reverse-transcription polymerase chain reaction assay and three other family members had anti-SARS-CoV-2 antibodies.


Assuntos
Infecções por Coronavirus/diagnóstico , Coronavirus/isolamento & purificação , Diarreia/diagnóstico , Pandemias , Pneumonia Viral/diagnóstico , Dor Abdominal/etiologia , Betacoronavirus , Pré-Escolar , Técnicas de Laboratório Clínico , Análise por Conglomerados , Busca de Comunicante , Diarreia/etiologia , Febre/etiologia , Humanos , Masculino , Faringite/etiologia
17.
J Infect Dev Ctries ; 14(8): 844-846, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32903227

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China, on Jan 7, 2020. Over the following months, the virus rapidly spread throughout the world. Coronavirus Disease 2019 (COVID-19) can involve the gastrointestinal tract, including symptoms like nausea, vomiting and diarrhea and shedding of the SARS-CoV-2 in feces. Angiotensin-converting enzyme 2 (ACE2) protein, which has been proven to be a cell receptor for SARS-CoV-2, is expressed in the glandular cells of gastric, duodenal, and rectal epithelia, supporting the entry of SARS-CoV-2 into the host cells. According to the literature, rates of COVID-19 patients reporting diarrhea were between 7 - 14%. Diarrhea in the course of COVID-19 disease can cause dehydration and hospitalization. Although no antiviral drug was specifically designed for the treatment of diarrhea, several molecules could have beneficial effects by reducing viral replication. In this letter, we discussed the Levamisole, which is an anthelmintic agent with immunomodulatory effects, could be used effectively both for antiviral therapy and especially in COVID-19 patients with diarrhea.


Assuntos
Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Diarreia/tratamento farmacológico , Fatores Imunológicos/uso terapêutico , Levamisol/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Infecções por Coronavirus/complicações , Humanos , Pandemias , Pneumonia Viral/complicações
18.
Medicine (Baltimore) ; 99(38): e21617, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957305

RESUMO

BACKGROUND: The study aims to evaluate the efficacy and safety of probiotic therapy for coronavirus disease 2019 with diarrhea. METHODS: The following electronic bibliographic databases will be searched to identify relevant studies from December 2019 to December 2020: MEDLINE, PubMed, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Technical Periodicals, Wan-fang data, Chinese Biological Medicine Database, and other databases. The search results will not be restricted by language, all included articles were randomized controlled trial. Two independent researchers will conduct article retrieval, de-duplication, filtering, quality assessment, and data analysis through the Review Manager (V.5.3). Meta-analysis, subgroup analysis and/or descriptive analysis were performed on the included data. RESULTS: High-quality synthesis and/or descriptive analysis of current evidence will be provided from outcomes. CONCLUSION: This study will provide the evidence of whether probiotics is an effective and safe intervention for coronavirus disease 2019 with diarrhea.PROSPERO registration number: CRD42020192657.


Assuntos
Betacoronavirus , Infecções por Coronavirus/microbiologia , Diarreia/terapia , Pneumonia Viral/microbiologia , Probióticos/uso terapêutico , Infecções por Coronavirus/complicações , Diarreia/microbiologia , Humanos , Metanálise como Assunto , Pandemias , Pneumonia Viral/complicações , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
19.
Medicine (Baltimore) ; 99(38): e22227, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957362

RESUMO

BACKGROUND: Diarrheal disease currently claims the lives of approximately 500,000 children each year. Rotaviruses are the pathogens primarily responsible for more severe cases and more than one-third of diarrhea-associated deaths in children under 5 years old globally. At present, commonly used drug therapies for rotavirus diarrhea in Western medicine, such as oral rehydration salts, montmorillonite, probiotics, and nitazoxanide, often cannot achieve satisfactory curative effects. Moreover, infants' and children's compliance with drugs and injections is often lower than their compliance with acupoint application therapy. A large number of studies have shown that acupoint application can increase the clinical cure rate and shorten the duration of diarrhea. However, there is a lack of systematic reviews on the safety and efficacy of acupoint application in the treatment of rotavirus diarrhea. Therefore, we will conduct a study to evaluate the safety and efficacy of acupoint application for rotavirus diarrhea in infants and children. METHODS: We will search the relevant medical literature using PubMed, EMBASE, Web of Science, Cochrane CENTRAL, China National Knowledge Infrastructure, the Wanfang Database, the Chinese Biomedical Literature Database, and the Chinese Scientific Journal Database from inception to August 2020. Both MeSH and free text terms will be utilized to obtain the maximum numbers of papers. No language restrictions will be applied, and the publication type will be limited to randomized controlled trials. Two teams will independently review and assess the studies for inclusion in the review. RevMan V 5.0 software will be applied for data extraction. The methodological quality of the included studies will be evaluated according to the Cochrane Handbook. RESULTS: The results of this study will be published in a peer-reviewed journal. CONCLUSION: The conclusion of this systematic review will provide evidence regarding whether acupoint application is an effective intervention for infants and children with rotavirus diarrhea. INPLASY REGISTRATION NUMBER: INPLASY202070123.


Assuntos
Pontos de Acupuntura , Diarreia/terapia , Medicina Tradicional Chinesa/métodos , Infecções por Rotavirus/terapia , Criança , Diarreia/virologia , Humanos , Lactente , Metanálise como Assunto , Infecções por Rotavirus/complicações , Revisões Sistemáticas como Assunto
20.
J Korean Med Sci ; 35(37): e333, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32959547

RESUMO

BACKGROUND: There is limited information on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who are asymptomatic or have mild symptoms. METHODS: We performed a retrospective case series of patients with COVID-19 enrolled from February 22 to March 26, 2020. Forty cases of COVID-19 were confirmed using real-time reverse-transcription polymerase chain reaction among patients who underwent screening tests and were consecutively hospitalized at Ulsan University Hospital, Ulsan, Korea. The final follow-up date was May 19, 2020. All COVID-19 cases in Ulsan were included. Demographic and epidemiological information, comorbidities, clinical signs and symptoms, laboratory and radiologic findings, medications, treatments, outcomes, and main durations of patients with COVID-19 were compared according to supplemental oxygen requirement. RESULTS: Forty patients were included (median age, 30 years; interquartile range [IQR], 25-57 years; 58% female). Six (15%) patients required supplemental oxygen. The prevalence of asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was 5% and that of presymptomatic infection was 13%. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea were the screening criteria for diagnosing symptomatic and presymptomatic SARS-CoV-2 infections. Sputum production, chest discomfort, a large number of symptoms, abnormal procalcitonin and C-reactive protein levels, and abnormal chest X-ray or chest computed tomography findings were more common in patients requiring supplemental oxygen than in those not requiring supplemental oxygen. Overall mortality rate was 3% (1/40). Four patients (10%) were readmitted after testing positive by reverse-transcription polymerase chain reaction again. Incubation period was 5 days (IQR, 4-6 days), and the duration of viral shedding was 21 days (IQR, 14-28 days; maximum, 51 days). CONCLUSION: The prevalence of asymptomatic SARS-CoV-2 infection was 5%, which is much lower than that previously reported. This finding suggests that careful interviews and follow-ups should be performed to identify SARS-CoV-2 infections. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea are adequate screening criteria for covering all symptoms of SARS-CoV-2 infection. Further evaluation is required to create representative screening criteria for COVID-19.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Idoso , Betacoronavirus , Comorbidade , Tosse/epidemiologia , Diarreia/epidemiologia , Feminino , Febre/epidemiologia , Hospitalização , Humanos , Coreia (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Mialgia/epidemiologia , Pandemias , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Avaliação de Sintomas , Resultado do Tratamento
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