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1.
PLoS One ; 16(12): e0262032, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34972156

RESUMO

Diseases from food of animal origin are common health problems in Ethiopia. A cross-sectional study was carried out to estimate health and economic burden, and to identify demographic factors associated with community awareness of foodborne zoonotic diseases in Amhara region, Ethiopia. Data was collected from 435 households in three towns: Gondar, Lalibela and Debark. A retrospective data was also collected from health records in each town. The health burden due to zoonotic diseases was estimated at 0.2, 0.1 and 1.3 DALYs per household per year and at 73.2, 146.6 and 1,689.5 DALYs out of 100,000 populations per year in Gondar, Lalibela and Debark, respectively. The overall health burden due to foodborne zoonotic diseases (aggregated over the 435 households in the three towns) was estimated to be 89.9 DALYs per 100,000 populations per year. The economic impact of foodborne zoonotic diseases in the three towns of Amhara regional state was 278.98 Ethiopian Birr (ETB) (1ETB = 0.025 US Dollar) per household per year and 121,355.68 ETB per year. Costs of preventive measures followed by costs of patients' time made the highest contribution while costs of diagnosis made the lowest contribution to the total economic burden of foodborne zoonotic diseases. From a total of 435 respondents, 305 (70.1%) had known the presence of zoonotic diseases. Level of education, number of families in the house and income were highly associated with awareness of zoonosis. Although majority of respondents had known zoonotic diseases exists (70.1%) and disease can be acquired from animal source food (63.2%), the health and economic burden associated to foodborne zoonotic diseases are still high. Therefore, changing mindset and practical training aiming in controlling foodborne zoonotic diseases may be suggested to the community in the health improvement extension service.


Assuntos
Doenças Transmitidas por Alimentos/fisiopatologia , Zoonoses/fisiopatologia , Adolescente , Adulto , Idoso , Animais , Criança , Efeitos Psicossociais da Doença , Estudos Transversais , Demografia , Diarreia/epidemiologia , Diarreia/fisiopatologia , 50308 , Etiópia/epidemiologia , Características da Família , Comportamento Alimentar , Feminino , Estresse Financeiro , Alimentos , Doenças Transmitidas por Alimentos/economia , Doenças Transmitidas por Alimentos/prevenção & controle , Custos de Cuidados de Saúde , Humanos , Expectativa de Vida , Masculino , Carne , Pessoa de Meia-Idade , Modelos Econômicos , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem , Zoonoses/economia , Zoonoses/prevenção & controle
2.
Vet Microbiol ; 263: 109263, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34749283

RESUMO

Transmissible gastroenteritis (TGE) and porcine epidemic diarrhea (PED) are highly transmissible intestinal infections caused by transmissible gastroenteritis virus (TGEV) and porcine epidemic diarrhea virus (PEDV), respectively. They are clinically associated with vomiting, diarrhea, and dehydration in piglets. An imbalance in Na+ uptake by intestinal epithelial cells causes TGEV/PEDV-induced diarrhea. However, the mechanism by which TGEV/PEDV-infection in piglets causes Na+ imbalance diarrhea has not been elucidated. In the present study, we demonstrated that specific inhibition of NHE3 activity caused small intestinal bulging, intestinal wall thinning and severe diarrhea in piglets, consistent with the signs of TGEV/PEDV infection. This study further elucidated the role of NHE3 in TGEV/PEDV-induced diarrhea. In this study, small intestinal epithelial cells (IPEC-J2) were used as a model of infection. The results showed that TGEV/PEDV infection reduced NHE3 activity and Na+ uptake in IPEC-J2 cells. Further studies revealed that the use of NHE3-specific inhibitors could reduce the amount of cell membrane NHE3, thereby decreasing Na+ uptake and ultimately leading to diarrhea. Transcriptomic studies performed on obtained jejunal tissues were also consistent with pre-laboratory results. This study will provide a basis for understanding Na+ imbalance diarrhea caused by TGEV/PEDV, as well as for elucidating the diarrheal pathogenesis of other members of α-animal coronaviruses.


Assuntos
Infecções por Coronavirus , Diarreia , Gastroenterite Suína Transmissível , Trocador 3 de Sódio-Hidrogênio , Doenças dos Suínos , Animais , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/veterinária , Diarreia/fisiopatologia , Diarreia/veterinária , Células Epiteliais/patologia , Células Epiteliais/virologia , Gastroenterite Suína Transmissível/fisiopatologia , Vírus da Diarreia Epidêmica Suína , Trocador 3 de Sódio-Hidrogênio/metabolismo , Suínos , Vírus da Gastroenterite Transmissível
3.
Biomarkers ; 26(8): 737-746, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34634977

RESUMO

PURPOSE: Psidium guajava L. (Family, Myrtaceae) is reportedly used in ethnomedicine for the treatment of diarrhoea, inflammation, and gastroenteritis. OBJECTIVE: This study evaluated the gastrointestinal function of Psidium guajava leaf extract (PGLE) in rats and rabbits. MATERIALS AND METHODS: Crude ethanolic PGLE was subjected to phytochemical and toxicity tests (acute and sub-acute). Standard analytical procedures were employed to evaluate the in vivo gastrointestinal motility, and gastroprotective effect of PGLE against aspirin-induced ulcers. RESULTS: In the phytochemical analysis, phenols were the highest (48.32 mg) followed by flavonoids (32.74 mg) and least in tannins (7.31 mg). The acute toxicity of PGLE was >6000 mg/kg. Administration of PGLE decreased significantly (p < 0.05) the body weight, while the liver biomarkers were not significantly altered (p > 0.05) when compared to the control. PGLE significantly increased extractible mucus weight and lowered gastric acid secretion in rats (p < 0.05). PGLE decreased significantly (p < 0.05) ulcer scores and indexes, and increased percentage ulcer inhibition in a dose-dependent manner compared to the negative and omeprazole-treated groups. PGLE dose-dependently inhibited basal amplitudes of contractions, and significantly inhibited acetylcholine-induced contractions, terminating them completely at higher doses. CONCLUSION: PGLE may be a good anti-ulcer and anti-diarrhoeal agent, raising the prospect of novel drug development for such applications.


Assuntos
Diarreia/prevenção & controle , Trato Gastrointestinal/efeitos dos fármacos , Extratos Vegetais/farmacologia , Folhas de Planta/química , Psidium/química , Úlcera/prevenção & controle , Alcaloides/isolamento & purificação , Alcaloides/farmacologia , Animais , Peso Corporal/efeitos dos fármacos , Peso Corporal/fisiologia , Diarreia/patologia , Diarreia/fisiopatologia , Flavonoides/isolamento & purificação , Flavonoides/farmacologia , Motilidade Gastrointestinal/efeitos dos fármacos , Motilidade Gastrointestinal/fisiologia , Trato Gastrointestinal/fisiologia , Humanos , Fitoterapia/métodos , Extratos Vegetais/isolamento & purificação , Coelhos , Ratos Wistar , Saponinas/isolamento & purificação , Saponinas/farmacologia , Úlcera/patologia , Úlcera/fisiopatologia
4.
Pharm Biol ; 59(1): 1452-1463, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34711130

RESUMO

CONTEXT: Wei Chang An (WCA) is a commercial prescription developed for the coordination of gastrointestinal movement. OBJECTIVE: To investigate the role of WCA in the regulation of diarrhoea and constipation in rats. MATERIAL AND METHODS: The diarrhoea and constipation models were prepared by gavage of Folium senna and diphenoxylate hydrochloride. Rats were randomized equally (n = 6) into the normal group given saline daily, the positive group given Pinaverium Bromide (13.5 mg/kg) or Sennoside A (0.1 mg/kg) and three WCA-treated groups (22, 44, and 88 mg/kg) by gavage daily for 7 consecutive days. The effects of WCA were assessed by a series of faecal symptoms and histopathology. Gastrointestinal parameters were determined by ELISA. The effect of WCA on gastrointestinal tissues was evaluated by strip assay. Expression of ROCK-1 and MLCK was measured by RT-PCR and Western blotting. RESULTS: Data from Bristol stool form scale, diarrhoea index, visceral sensitivity, defaecation time, and intestinal propulsive rate showed that WCA protected rats against diarrhoea and constipation (p < 0.01). The up-regulation of Substance P and 5-hydroxytryptamine in diarrhoea rats and down-regulation of Substance P and vasoactive intestinal polypeptide in constipation rats were inhibited by WCA (p < 0.05). WCA stimulated the gastrointestinal strip contractions but inhibited ACh-induced contractions (p < 0.01). The decreased ROCK-1 and MLCK expression in diarrhoea rats and increased in constipation rats were suppressed by WCA (p < 0.01). CONCLUSIONS: WCA has both antidiarrhea and anti-constipation effects, suggesting its bidirectional role in gastrointestinal modulation, and providing evidence of WCA for irritable bowel syndrome treatment.


Assuntos
Constipação Intestinal/tratamento farmacológico , Diarreia/tratamento farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Motilidade Gastrointestinal/efeitos dos fármacos , Animais , Constipação Intestinal/fisiopatologia , Diarreia/fisiopatologia , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Medicamentos de Ervas Chinesas/administração & dosagem , Síndrome do Intestino Irritável/tratamento farmacológico , Síndrome do Intestino Irritável/fisiopatologia , Masculino , Quinase de Cadeia Leve de Miosina/genética , Ratos , Ratos Wistar , Quinases Associadas a rho/genética
5.
Nutrients ; 13(7)2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34371976

RESUMO

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (LFD) improves both gastrointestinal (GI) symptoms and the psychological profile of patients with irritable bowel syndrome with diarrhea (IBS-D). The effects of 12 weeks of LFD on GI symptom and psychological profiles in relation to inflammation and the involvement of the intestinal barrier were studied in twenty IBS-D patients. The IBS Severity Scoring System, the Symptom Checklist-90-Revised, the Italian version of the 36-Item Short-Form Health Survey, the IBS-Quality of Life (QoL) questionnaire, and the Psychophysiological questionnaire were administered. The GI barrier function was assessed by sugar absorption test, the serum and fecal zonulin levels, and the serum levels of intestinal fatty-acid binding protein and diamine oxidase. Interleukins (ILs) and lipopolysaccharide (LPS) serum levels were evaluated along with dysbiosis. At the end of LFD, GI symptoms, psychological state (mainly anxiety, somatization, psychoticism, and interpersonal sensitivity), and QoL significantly improved in these patients. Simultaneously, an improvement in small intestinal permeability and intestinal mucosal integrity occurred, while IL-6, Il-10, LPS, and fermentative dysbiosis significantly decreased. The LFD can modify the immune-inflammatory features and enhance intestinal permeability and mucosal integrity, thus determining a concurrent improvement in the clinical and psychological conditions.


Assuntos
Dieta com Restrição de Carboidratos , Fermentação , Trato Gastrointestinal/fisiopatologia , Intestinos/fisiopatologia , Síndrome do Intestino Irritável/dietoterapia , Síndrome do Intestino Irritável/psicologia , Adulto , Diarreia/fisiopatologia , Dissacarídeos , Feminino , Humanos , Inflamação/fisiopatologia , Absorção Intestinal/fisiologia , Mucosa Intestinal/fisiopatologia , Síndrome do Intestino Irritável/fisiopatologia , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Monossacarídeos , Oligossacarídeos , Polímeros/administração & dosagem , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários
6.
Am J Trop Med Hyg ; 105(3): 794-800, 2021 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-34252051

RESUMO

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease worldwide. It can be transmitted from person to person, and the fatality rate is very high. During this study, three SFTS clusters including 12 associated cases were identified in three counties in Zhejiang Province from 2018 to 2020. The median age of the three index patients was 70 years, and that of secondary case patients was 59 years. Of note, the mortality rate of the index patients was 100%. The mortality rate of secondary case patients was 11%. The total secondary attack rate (SAR) was 30% (9/30). The SARs of cluster A, cluster B, and cluster C were 38% (3/8), 21% (3/14), and 38% (3/8), respectively. Additionally, the interval from onset to diagnosis was 4 days. The intervals from disease onset to confirmation of the index cases and secondary cases were 7 days and 4 days, respectively. All secondary case patients had a history of close contact with blood or body fluids of the index patients. These results indicate that SFTS patients should not be discharged until recovery. When SFTS patients die, the corpses should be transferred directly from the hospital to the crematorium for cremation by persons wearing proper protective equipment to prevent virus transmission.


Assuntos
Hotspot de Doença , Febre Grave com Síndrome de Trombocitopenia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Calafrios/fisiopatologia , China/epidemiologia , Diarreia/fisiopatologia , Fadiga/fisiopatologia , Feminino , Febre/fisiopatologia , Cefaleia/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Febre Grave com Síndrome de Trombocitopenia/fisiopatologia , Febre Grave com Síndrome de Trombocitopenia/transmissão , Adulto Jovem
7.
Food Funct ; 12(16): 7402-7414, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34190232

RESUMO

Niacin deficiency leads to inflammation of mucous membranes and diarrhoea. There are few reports on the effects of niacin on the intestinal health of weaned piglets. The present study was conducted to analyse the effects of niacin in weaned piglets along with its underlying mechanism. A total of 48 25-day-old weaned piglets (24 females and 24 males) were randomly allotted into four groups, each treatment were supplemented with 22.5, 30, 45, and 75 mg kg-1 niacin for a period of 14 days, with 12 piglets per diet and 1 piglet per pen. Six piglets (3 males and 3 females) were randomly selected from each treatment group and euthanised for intestinal tissue sampling on days 7 and 14 after the weaning day (day 0), respectively. Dietary niacin did not affect the growth performance of weaned piglets but quadratically affected (P < 0.05) the diarrhoea rate from days 7 to 14. The duodenal villus height and width and crypt depth in the 30 mg kg-1 niacin group were greater than those in the 45 mg kg-1 niacin group on day 7, and the jejunal crypt depth, ileal crypt depth, villus height and villus width decreased (linear, P < 0.05) with the increase in dietary niacin. However, the dietary supplementation with niacin increased (linear, P < 0.001) the jejunal villus height, crypt depth and villus width on day 14. Dietary niacin increased (linear, P < 0.05) the alkaline phosphatase activity in the jejunal mucosa of weaned piglets on day 7 but decreased (linear, P < 0.05) its activity on day 14. The number of Ki67 positive cells per crypt was decreased (linear, P < 0.05) with the dietary niacin on day 7 but increased (linear, P < 0.05) with dietary niacin contents on day 14. Moreover, dietary niacin altered (P < 0.05) SLC5A1, SLC15A1, SLC6A19, TJP-1, occludin and claudin-1 mRNA expression in the small intestine. These results indicate that dietary niacin has different effects on intestinal morphology and functions in the first and second weeks postweaning and that the dietary supplementation with niacin may, by modulating intestinal cell proliferation, affect the intestinal health.


Assuntos
Peso Corporal/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Intestinos/efeitos dos fármacos , Intestinos/fisiopatologia , Niacina/farmacologia , Animais , Diarreia/fisiopatologia , Dieta , Suplementos Nutricionais , Feminino , Masculino , Modelos Animais , Niacina/administração & dosagem , Suínos , Desmame
8.
J Virol ; 95(15): e0075121, 2021 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-33980599

RESUMO

Rotavirus infection is highly prevalent in children, and the most severe effects are diarrhea and vomiting. It is well accepted that the enteric nervous system (ENS) is activated and plays an important role, but knowledge of how rotavirus activates nerves within ENS and to the vomiting center is lacking. Serotonin is released during rotavirus infection, and antagonists to the serotonin receptor subtype 3 (5-HT3 receptor) can attenuate rotavirus-induced diarrhea. In this study, we used a 5-HT3 receptor knockout (KO) mouse model to investigate the role of this receptor in rotavirus-induced diarrhea, motility, electrolyte secretion, inflammatory response, and vomiting reflex. The number of diarrhea days (P = 0.03) and the number of mice with diarrhea were lower in infected 5-HT3 receptor KO than wild-type pups. In vivo investigation of fluorescein isothiocyanate (FITC)-dextran transit time showed that intestinal motility was lower in the infected 5-HT3 receptor KO compared to wild-type mice (P = 0.0023). Ex vivo Ussing chamber measurements of potential difference across the intestinal epithelia showed no significant difference in electrolyte secretion between the two groups. Immediate early gene cFos expression level showed no difference in activation of the vomiting center in the brain. Cytokine analysis of the intestine indicated a low effect of inflammatory response in rotavirus-infected mice lacking the 5-HT3 receptor. Our findings indicate that the 5-HT3 receptor is involved in rotavirus-induced diarrhea via its effect on intestinal motility and that the vagus nerve signaling to the vomiting center occurs also in the absence of the 5-HT3 receptor. IMPORTANCE The mechanisms underlying rotavirus-induced diarrhea and vomiting are not yet fully understood. To better understand rotavirus pathophysiology, characterization of nerve signaling within the ENS and through vagal efferent nerves to the brain, which have been shown to be of great importance to the disease, is necessary. Serotonin (5-HT), a mediator of both diarrhea and vomiting, has been shown to be released from enterochromaffin cells in response to rotavirus infection and the rotavirus enterotoxin NSP4. Here, we investigated the role of the serotonin receptor 5-HT3, which is known to be involved in the nerve signals that regulate gut motility, intestinal secretion, and signal transduction through the vagus nerve to the brain. We show that the 5-HT3 receptor is involved in rotavirus-induced diarrhea by promoting intestinal motility. The findings shed light on new treatment possibilities for rotavirus diarrhea.


Assuntos
Diarreia/fisiopatologia , Sistema Nervoso Entérico/fisiopatologia , Motilidade Gastrointestinal/fisiologia , Receptores 5-HT3 de Serotonina/metabolismo , Infecções por Rotavirus/patologia , Vômito/fisiopatologia , Animais , Células Enterocromafins/metabolismo , Motilidade Gastrointestinal/genética , Mucosa Intestinal/metabolismo , Mucosa Intestinal/virologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Receptores 5-HT3 de Serotonina/genética , Rotavirus/fisiologia , Serotonina/metabolismo , Antagonistas do Receptor 5-HT3 de Serotonina/farmacologia
9.
Am J Gastroenterol ; 116(8): 1720-1726, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34003175

RESUMO

INTRODUCTION: Patients with disorders of gut-brain interaction (DGBIs) are high users of health care. Past studies exploring predictors of utilization have lacked patient-level clinical data. The aim of the current study is to identify demographic, clinical, and psychological predictors of health care utilization in patients with irritable bowel syndrome (IBS), functional constipation (FC), and functional diarrhea (FDr). METHODS: Consecutive new patients diagnosed with IBS, FC, and FDr (using Rome IV criteria) completed questionnaires assessing health care utilization as well as clinical and psychological symptoms. Health care utilization was assessed using a 13-item measure inquiring about the previous 6 months. Patient-Reported Outcome Measures Information System (PROMIS) was used to assess severity of abdominal pain, constipation, diarrhea, anxiety, depression, and sleep disturbance. RESULTS: Of the 507 patients diagnosed with IBS, FC, or FDr, 434 completed the health care utilization questionnaire (mean age of 44 years, 79.5% female, and 73.5% IBS). In the final multivariable models, more severe abdominal pain and higher depression scores were significantly associated with increased utilization of (i) total outpatient visits, (ii) outpatient visits for gastrointestinal (GI) symptoms, and (iii) number of medications for GI symptoms. More severe abdominal pain was also significantly predictive of GI-related emergency department visits. Altered bowel habits were not consistent predictors of health care utilization. DISCUSSION: Severity of abdominal pain and depressive symptoms, but not bowel habits, is a primary driver of increased care-seeking behavior in patients with IBS, FC, and FDr.


Assuntos
Dor Abdominal/fisiopatologia , Dor Abdominal/psicologia , Depressão/psicologia , Síndrome do Intestino Irritável/fisiopatologia , Síndrome do Intestino Irritável/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Ansiedade/psicologia , Constipação Intestinal/fisiopatologia , Diarreia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Gravidez , Índice de Gravidade de Doença , Transtornos do Sono-Vigília/fisiopatologia , Transtornos do Sono-Vigília/psicologia , Inquéritos e Questionários
10.
Saudi Med J ; 42(4): 391-398, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33795494

RESUMO

OBJECTIVES: To determine the demographic and clinical characteristics, underlying comorbidities, and outcomes of children with coronavirus disease 2019 (COVID-19) infection. METHODS: In this retrospective study, we reported 62 pediatric patients (age <14 years) with confirmed COVID-19 between March 2 and July 1, 2020, at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. RESULTS: Comorbid conditions, including cardiac, neurological, respiratory, and malignant disorders, were reported in 9 patients (14.5%). The most prominent presenting complaints were fever (80.6%) and cough (48.4%). Most of our patients (80.6%) had mild disease, 11.3% had moderate disease, and 8.1% exhibited severe and critical illness. Twenty-one patients (33.9%) were hospitalized, with 4 patients (6.5%) admitted to the pediatric intensive care unit, and 3 (4.8%) patients died. CONCLUSION: All pediatric age groups are susceptible to COVID-19, with no gender difference. COVID-19 infection may result in critical illness and even mortality in subsets of pediatric patients.


Assuntos
COVID-19/fisiopatologia , Dor Abdominal/fisiopatologia , Adolescente , Asma/epidemiologia , Atrofia , Encéfalo/patologia , Bronquiolite Obliterante/epidemiologia , COVID-19/sangue , COVID-19/epidemiologia , COVID-19/terapia , Criança , Pré-Escolar , Comorbidade , Tosse/fisiopatologia , Diarreia/fisiopatologia , Dispneia/fisiopatologia , Feminino , Febre/fisiopatologia , Cardiopatias Congênitas/epidemiologia , Mortalidade Hospitalar , Hospitalização , Humanos , Hidrocefalia/epidemiologia , Lactente , Unidades de Terapia Intensiva Pediátrica , Masculino , Faringite/fisiopatologia , Respiração Artificial , Insuficiência Respiratória/fisiopatologia , Insuficiência Respiratória/terapia , Estudos Retrospectivos , Rinorreia/fisiopatologia , SARS-CoV-2 , Arábia Saudita/epidemiologia , Índice de Gravidade de Doença , Vômito/fisiopatologia
11.
Epidemiol Infect ; 149: e92, 2021 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-33814027

RESUMO

Case identification is an ongoing issue for the COVID-19 epidemic, in particular for outpatient care where physicians must decide which patients to prioritise for further testing. This paper reports tools to classify patients based on symptom profiles based on 236 severe acute respiratory syndrome coronavirus 2 positive cases and 564 controls, accounting for the time course of illness using generalised multivariate logistic regression. Significant symptoms included abdominal pain, cough, diarrhoea, fever, headache, muscle ache, runny nose, sore throat, temperature between 37.5 and 37.9 °C and temperature above 38 °C, but their importance varied by day of illness at assessment. With a high percentile threshold for specificity at 0.95, the baseline model had reasonable sensitivity at 0.67. To further evaluate accuracy of model predictions, leave-one-out cross-validation confirmed high classification accuracy with an area under the receiver operating characteristic curve of 0.92. For the baseline model, sensitivity decreased to 0.56. External validation datasets reported similar result. Our study provides a tool to discern COVID-19 patients from controls using symptoms and day from illness onset with good predictive performance. It could be considered as a framework to complement laboratory testing in order to differentiate COVID-19 from other patients presenting with acute symptoms in outpatient care.


Assuntos
Assistência Ambulatorial , Teste para COVID-19/métodos , COVID-19/diagnóstico , Dor Abdominal/fisiopatologia , Adolescente , Adulto , COVID-19/fisiopatologia , Estudos de Casos e Controles , Regras de Decisão Clínica , Tosse/fisiopatologia , Diarreia/fisiopatologia , Progressão da Doença , Dispneia/fisiopatologia , Feminino , Febre/fisiopatologia , Cefaleia/fisiopatologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Mialgia/fisiopatologia , Razão de Chances , Seleção de Pacientes , Faringite/fisiopatologia , Rinorreia/fisiopatologia , SARS-CoV-2 , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Adulto Jovem
12.
Biomed Pharmacother ; 138: 111426, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33762124

RESUMO

WangShiBoChiWan (WSBCW) is a commonly used Chinese herbal medicine for the treatment of functional gastrointestinal disorders. However, its preclinical efficacy and the mechanisms of action have not been adequately studied. The goals of this study were to evaluate the effects of WSBCW on gastrointestinal health and modulation of related biomarkers. Female C57BL mice were randomly assigned into one of the experimental groups consisting of the control, drug controls, and WSBCW at 40, 120, and 360 mg/kg BW. Whole gut transit, small intestinal motility, and intestinal barrier permeability were determined. The castor oil-induced diarrhea mouse model was used to determine the effect of WSBCW on the diarrhea type of irritable bowel syndrome (IBS-D). WSBCW increased whole gut transit and intestinal motility, improved intestinal permeability in healthy animals and alleviated diarrhea symptoms in IBS-D mice. WSBCW upregulated intestinal junction proteins, increased the abundance of Bifidobacterium genus, Desulfovibrio genus and inhibited Bacteroides fragillis group in the gut microbiota, increased intestinal villi lengths, and decreased blood levels of inflammatory cytokines. Our study provided preclinical evidence to verify the effectiveness of WSBCW in gastrointestinal health and elucidate mechanistic insights. The results warrant further investigations to evaluate the therapeutic efficacy of WSBCW on gastrointestinal disorders, such as IBS and IBD.


Assuntos
Medicamentos de Ervas Chinesas/farmacologia , Microbioma Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/efeitos dos fármacos , Medicina Herbária/métodos , Mediadores da Inflamação/antagonistas & inibidores , Junções Íntimas/efeitos dos fármacos , Animais , Diarreia/tratamento farmacológico , Diarreia/fisiopatologia , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Microbioma Gastrointestinal/fisiologia , Motilidade Gastrointestinal/efeitos dos fármacos , Motilidade Gastrointestinal/fisiologia , Trato Gastrointestinal/fisiologia , Mediadores da Inflamação/fisiologia , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/fisiologia , Síndrome do Intestino Irritável/tratamento farmacológico , Síndrome do Intestino Irritável/fisiopatologia , Camundongos , Camundongos Endogâmicos C57BL , Junções Íntimas/fisiologia
13.
J Med Case Rep ; 15(1): 171, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33771221

RESUMO

BACKGROUND: The pandemic of this century has overwhelmed the healthcare systems of affected countries, and all resources have been diverted to coronavirus disease 2019. At the onset, coronavirus disease 2019 can present as any other acute febrile undifferentiated illness. In tropical regions, clinicians are increasingly challenged to differentiate these febrile illnesses without the use of diagnostics. With this pandemic, many of these tropical diseases are neglected and go underreported. Dengue is holoendemic in the Maldives, and dengue viruses circulate throughout the year. Reports about coinfections with dengue virus and severe acute respiratory syndrome coronavirus 2 are scarce, and the outcome and the dynamics of the disease may be altered in the presence of coinfection. We have described the clinical manifestation and serial laboratory profile, and highlighted the atypical findings uncommon in dengue infection. CASE PRESENTATION: Case 1 was a 39-year old Asian male, presented on day 6 of dengue infection with warning signs. Reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 that was done as per hospital protocol was found to be positive. Case 2 was a 38-year old Asian male, was admitted on day 5 of illness with symptoms of acute respiratory infection with positive reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2. Evaluation of progressive leukopenia and thrombocytopenia showed positive dengue serology. CONCLUSION: Clinicians must be conscientious when working on the differential diagnosis of possible tropical diseases in cases of coronavirus disease 2019, specifically, when patients develop hemoconcentration, thrombocytopenia, and transaminitis with elevated expression of aspartate higher than alanine transaminase, which is frequently observed in dengue infection. Caution must be taken during the administration of intravenous fluids when treating patients with coronavirus disease 2019 and dengue coinfection, as coronavirus disease 2019 patients are more prone to develop pulmonary edema. Timely diagnosis and appropriate management are essential to avoid the devastating complications of severe forms of dengue infection. It is important to repeat and reconfirm the dengue serology in coronavirus disease 2019 patients to avoid false positivity. Diligence and care must be taken not to neglect other endemic tropical diseases in the region during the present pandemic.


Assuntos
COVID-19/complicações , Dengue/complicações , Leucopenia/sangue , Trombocitopenia/sangue , Dor Abdominal/fisiopatologia , Adulto , Anosmia/fisiopatologia , COVID-19/sangue , COVID-19/fisiopatologia , Teste de Ácido Nucleico para COVID-19 , Coinfecção , Tosse/fisiopatologia , Dengue/sangue , Dengue/fisiopatologia , Dengue/terapia , Diarreia/fisiopatologia , Disgeusia/fisiopatologia , Febre/fisiopatologia , Hidratação , Cefaleia/fisiopatologia , Humanos , Masculino , Mialgia/fisiopatologia , Faringite/fisiopatologia , SARS-CoV-2 , Vômito/fisiopatologia
14.
Eur J Gastroenterol Hepatol ; 33(5): 691-694, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33787540

RESUMO

BACKGROUND: Infection due to severe acute respiratory syndrome coronavirus 2 is typically associated with a respiratory syndrome, but gastrointestinal symptoms have been described in early reports from China. However, data from European centres are scarce. OBJECTIVES: We aimed to characterise the gastrointestinal manifestations of patients with coronavirus disease 2019 (COVID-19) and their disease course. METHODS: Patients admitted at our centre between March and April 2020 with diagnosis of COVID-19 were included. Asymptomatic patients or those without symptom information were excluded. Clinical features, laboratory data and disease severity (mechanical ventilation, intensive care admission or death) were analysed. RESULTS: Two-hundred one patients were included (median age 71 years; 56.2% male). Digestive symptoms were reported by 60 (29.9%) patients during the disease course, being part of the disease presentation in 34 (16.9%). The most frequent were diarrhoea in 36 patients (17.9%). Patients with gastrointestinal symptoms were younger (P = 0.032), had higher haemoglobin levels (P = 0.002) and lower C-reactive protein (P = 0.045) and potassium levels (P = 0.004). Patients with digestive symptoms had less severe disease (28.3 vs. 44.0%; P = 0.038). Regarding liver damage, aspartate aminotransferase (AST) was elevated in 65.2% of patients and alanine aminotransferase (ALT) in 62.7%, but these patients did not present a more severe disease (elevated AST P = 0.062; elevated ALT P = 0.276). CONCLUSION: A significant portion of COVID-19 patients have digestive symptoms, mostly at presentation. This should be taken into account in order to keep a high level of suspicion to reach an early diagnosis and setup infection control measures to control the transmission rate. This subgroup of patients appears to have a less severe disease course.


Assuntos
COVID-19/fisiopatologia , Diarreia/fisiopatologia , Vômito/fisiopatologia , Dor Abdominal/epidemiologia , Dor Abdominal/metabolismo , Dor Abdominal/fisiopatologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Ageusia/epidemiologia , Ageusia/metabolismo , Ageusia/fisiopatologia , Alanina Transaminase/metabolismo , Aspartato Aminotransferases/metabolismo , Proteína C-Reativa/metabolismo , COVID-19/metabolismo , Diarreia/epidemiologia , Diarreia/metabolismo , Feminino , Hemoglobinas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/epidemiologia , Náusea/metabolismo , Náusea/fisiopatologia , Portugal/epidemiologia , Estudos Retrospectivos , SARS-CoV-2 , Índice de Gravidade de Doença , Vômito/epidemiologia , Vômito/metabolismo , Adulto Jovem
15.
Sci Rep ; 11(1): 6060, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33723346

RESUMO

An experimental human challenge model with an attenuated diarrheagenic Escherichia coli (E. coli) strain has been used in food intervention studies aimed to increase resistance to E. coli infection. This study was designed to refine and expand this challenge model. In a double-blind study, healthy male subjects were orally challenged with 1E10 or 5E10 colony-forming units (CFU) of E. coli strain E1392/75-2A. Three weeks later, subjects were rechallenged with 1E10 CFU of E. coli. Before and after both challenges, clinical symptoms and infection- and immune-related biomarkers were analyzed. Subset analysis was performed on clinically high- and low-responders. Regardless of inoculation dose, the first challenge induced clinical symptoms for 2-3 days. In blood, neutrophils, CRP, CXCL10, and CFA/II-specific IgG were induced, and in feces calprotectin and CFA/II-specific IgA. Despite clinical differences between high- and low-responders, infection and immune biomarkers did not differ. The first inoculation induced protection at the second challenge, with a minor clinical response, and no change in biomarkers. The refined study design resulted in a larger dynamic range of symptoms, and identification of biomarkers induced by a challenge with the attenuated E. coli strain E1392/75-2A, which is of value for future intervention studies. Addition of a second inoculation allows to study the protective response induced by a primary infection.Clinicaltrials.gov registration: NCT02541695 (04/09/2015).


Assuntos
Diarreia , Infecções por Escherichia coli , Escherichia coli/metabolismo , Modelos Biológicos , Adolescente , Adulto , Anticorpos Antibacterianos/sangue , Biomarcadores/sangue , Proteína C-Reativa , Quimiocina CXCL1 , Diarreia/sangue , Diarreia/microbiologia , Diarreia/fisiopatologia , Método Duplo-Cego , Escherichia coli/patogenicidade , Infecções por Escherichia coli/sangue , Infecções por Escherichia coli/fisiopatologia , Humanos , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Complexo Antígeno L1 Leucocitário/metabolismo , Masculino , Pessoa de Meia-Idade
16.
Pediatr Rheumatol Online J ; 19(1): 29, 2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-33726806

RESUMO

BACKGROUND: There is mounting evidence on the existence of a Pediatric Inflammatory Multisystem Syndrome-temporally associated to SARS-CoV-2 infection (PIMS-TS), sharing similarities with Kawasaki Disease (KD). The main outcome of the study were to better characterize the clinical features and the treatment response of PIMS-TS and to explore its relationship with KD determining whether KD and PIMS are two distinct entities. METHODS: The Rheumatology Study Group of the Italian Pediatric Society launched a survey to enroll patients diagnosed with KD (Kawasaki Disease Group - KDG) or KD-like (Kawacovid Group - KCG) disease between February 1st 2020, and May 31st 2020. Demographic, clinical, laboratory data, treatment information, and patients' outcome were collected in an online anonymized database (RedCAP®). Relationship between clinical presentation and SARS-CoV-2 infection was also taken into account. Moreover, clinical characteristics of KDG during SARS-CoV-2 epidemic (KDG-CoV2) were compared to Kawasaki Disease patients (KDG-Historical) seen in three different Italian tertiary pediatric hospitals (Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste; AOU Meyer, Florence; IRCCS Istituto Giannina Gaslini, Genoa) from January 1st 2000 to December 31st 2019. Chi square test or exact Fisher test and non-parametric Wilcoxon Mann-Whitney test were used to study differences between two groups. RESULTS: One-hundred-forty-nine cases were enrolled, (96 KDG and 53 KCG). KCG children were significantly older and presented more frequently from gastrointestinal and respiratory involvement. Cardiac involvement was more common in KCG, with 60,4% of patients with myocarditis. 37,8% of patients among KCG presented hypotension/non-cardiogenic shock. Coronary artery abnormalities (CAA) were more common in the KDG. The risk of ICU admission were higher in KCG. Lymphopenia, higher CRP levels, elevated ferritin and troponin-T characterized KCG. KDG received more frequently immunoglobulins (IVIG) and acetylsalicylic acid (ASA) (81,3% vs 66%; p = 0.04 and 71,9% vs 43,4%; p = 0.001 respectively) as KCG more often received glucocorticoids (56,6% vs 14,6%; p < 0.0001). SARS-CoV-2 assay more often resulted positive in KCG than in KDG (75,5% vs 20%; p < 0.0001). Short-term follow data showed minor complications. Comparing KDG with a KD-Historical Italian cohort (598 patients), no statistical difference was found in terms of clinical manifestations and laboratory data. CONCLUSION: Our study suggests that SARS-CoV-2 infection might determine two distinct inflammatory diseases in children: KD and PIMS-TS. Older age at onset and clinical peculiarities like the occurrence of myocarditis characterize this multi-inflammatory syndrome. Our patients had an optimal response to treatments and a good outcome, with few complications and no deaths.


Assuntos
COVID-19/fisiopatologia , Doença da Artéria Coronariana/fisiopatologia , Hipotensão/fisiopatologia , Linfopenia/fisiopatologia , Síndrome de Linfonodos Mucocutâneos/fisiopatologia , Miocardite/fisiopatologia , Síndrome de Resposta Inflamatória Sistêmica/fisiopatologia , Distribuição por Idade , Antirreumáticos/uso terapêutico , Aspirina/uso terapêutico , Proteína C-Reativa/metabolismo , COVID-19/epidemiologia , COVID-19/metabolismo , COVID-19/terapia , Criança , Pré-Escolar , Tosse/fisiopatologia , Diarreia/fisiopatologia , Dispneia/fisiopatologia , Feminino , Glucocorticoides/uso terapêutico , Insuficiência Cardíaca/fisiopatologia , Humanos , Hiperferritinemia/metabolismo , Hiperferritinemia/fisiopatologia , Imunoglobulinas Intravenosas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Lactente , Unidades de Terapia Intensiva Pediátrica , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Itália/epidemiologia , Masculino , Síndrome de Linfonodos Mucocutâneos/epidemiologia , Síndrome de Linfonodos Mucocutâneos/metabolismo , Síndrome de Linfonodos Mucocutâneos/terapia , Inibidores da Agregação Plaquetária/uso terapêutico , SARS-CoV-2 , Choque/fisiopatologia , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/metabolismo , Síndrome de Resposta Inflamatória Sistêmica/terapia , Taquipneia/fisiopatologia , Troponina T/metabolismo , Vômito/fisiopatologia
17.
Chest ; 159(2): e107-e113, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33563452

RESUMO

CASE PRESENTATION: A 53-year-old man presented to the ED at a time of low severe acute respiratory syndrome coronavirus 2, also known as coronavirus disease 2019 (COVID-19), prevalence and reported 2 weeks of progressive shortness of breath, dry cough, headache, myalgias, diarrhea, and recurrent low-grade fevers to 39°C for 1 week with several days of recorded peripheral capillary oxygen saturation of 80% to 90% (room air) on home pulse oximeter. Five days earlier, he had visited an urgent care center where a routine respiratory viral panel was reportedly negative. A COVID-19 reverse transcriptase polymerase chain reaction test result was pending at the time of ED visit. He reported a past medical history of gastroesophageal reflux disease that was treated with famotidine. Travel history included an out-of-state trip 3 weeks earlier, but no recent international travel.


Assuntos
COVID-19/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Bacteriemia/complicações , COVID-19/complicações , COVID-19/fisiopatologia , Teste de Ácido Nucleico para COVID-19 , Doenças Cerebelares/complicações , Doenças Cerebelares/diagnóstico por imagem , Tosse/fisiopatologia , Diarreia/fisiopatologia , Progressão da Doença , Dispneia/fisiopatologia , Serviço Hospitalar de Emergência , Febre/fisiopatologia , Cefaleia/fisiopatologia , Humanos , AVC Isquêmico/complicações , AVC Isquêmico/diagnóstico por imagem , Linfopenia/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Mialgia/fisiopatologia , Oximetria , Pneumonia Estafilocócica/complicações , Radiografia Torácica , SARS-CoV-2 , Infecções Estafilocócicas/complicações , Tomografia Computadorizada por Raios X
18.
Medicine (Baltimore) ; 100(3): e24318, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33546062

RESUMO

RATIONALE: The immune dysregulation, polyendocrinopathy, enteropathy, and X-linked (IPEX) syndrome is a rare disorder that most often manifests in the early stages of life. IPEX syndrome with a late onset, presenting with severe gastritis has rarely been reported. PATIENT CONCERNS: Two male adolescents presented with recurrent vomiting, severe malnutrition, and growth retardation due to severe gastritis. DIAGNOSES: Esophagogastroduodenoscopy of the 2 patients revealed rare presentations of severe gastritis with multiple ulcers and stenosis of the pylorus. Next-generation sequencing revealed 2 novel variants in gene FOXP3 in the patients who were diagnosed with the IPEX syndrome. INTERVENTIONS: Both patients were treated with a high calorie formular enteral nutritional therapy. In addition, the pylorus of patient 1 was enlarged by balloon dilation, while patient 2 was treated with mercaptopurine and low dose prednisone. OUTCOMES: Symptoms and nutritional status of the patients improved after treatment. LESSONS: Chronic severe gastritis with stenosis of the pylorus could be an atypical manifestation of the IPEX syndrome. The use of next-generation sequencing is highly suitable for the diagnosis of atypical IPEX syndromes.


Assuntos
Diabetes Mellitus Tipo 1/congênito , Diarreia/complicações , Diarreia/diagnóstico , Gastrite/etiologia , Doenças Genéticas Ligadas ao Cromossomo X/complicações , Doenças Genéticas Ligadas ao Cromossomo X/diagnóstico , Doenças do Sistema Imunitário/congênito , Fatores de Tempo , Adolescente , China , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/fisiopatologia , Diarreia/fisiopatologia , Fatores de Transcrição Forkhead/genética , Gastrite/fisiopatologia , Doenças Genéticas Ligadas ao Cromossomo X/fisiopatologia , Humanos , Doenças do Sistema Imunitário/complicações , Doenças do Sistema Imunitário/diagnóstico , Doenças do Sistema Imunitário/fisiopatologia , Masculino , Desnutrição/etiologia
19.
Toxins (Basel) ; 13(2)2021 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-33525722

RESUMO

Bacillus cereus is a ubiquitous soil bacterium responsible for two types of food-associated gastrointestinal diseases. While the emetic type, a food intoxication, manifests in nausea and vomiting, food infections with enteropathogenic strains cause diarrhea and abdominal pain. Causative toxins are the cyclic dodecadepsipeptide cereulide, and the proteinaceous enterotoxins hemolysin BL (Hbl), nonhemolytic enterotoxin (Nhe) and cytotoxin K (CytK), respectively. This review covers the current knowledge on distribution and genetic organization of the toxin genes, as well as mechanisms of enterotoxin gene regulation and toxin secretion. In this context, the exceptionally high variability of toxin production between single strains is highlighted. In addition, the mode of action of the pore-forming enterotoxins and their effect on target cells is described in detail. The main focus of this review are the two tripartite enterotoxin complexes Hbl and Nhe, but the latest findings on cereulide and CytK are also presented, as well as methods for toxin detection, and the contribution of further putative virulence factors to the diarrheal disease.


Assuntos
Bacillus cereus/metabolismo , Proteínas de Bactérias/metabolismo , Diarreia/microbiologia , Enterotoxinas/metabolismo , Doenças Transmitidas por Alimentos/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Proteínas Hemolisinas/metabolismo , Vômito/microbiologia , Animais , Bacillus cereus/genética , Bacillus cereus/patogenicidade , Proteínas de Bactérias/genética , Depsipeptídeos/genética , Depsipeptídeos/metabolismo , Diarreia/diagnóstico , Diarreia/fisiopatologia , Enterotoxinas/genética , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/fisiopatologia , Regulação Bacteriana da Expressão Gênica , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/fisiopatologia , Proteínas Hemolisinas/genética , Interações Hospedeiro-Patógeno , Humanos , Virulência , Vômito/diagnóstico , Vômito/fisiopatologia
20.
Pediatr Rheumatol Online J ; 19(1): 21, 2021 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-33627147

RESUMO

IMPORTANCE: Active pediatric COVID-19 pneumonia and MIS-C are two disease processes requiring rapid diagnosis and different treatment protocols. OBJECTIVE: To distinguish active pediatric COVID-19 pneumonia and MIS-C using presenting signs and symptoms, patient characteristics, and laboratory values. DESIGN: Patients diagnosed and hospitalized with active COVID-19 pneumonia or MIS-C at Children's of Alabama Hospital in Birmingham, AL from April 1 through September 1, 2020 were identified retrospectively. Active COVID-19 and MIS-C cases were defined using diagnostic codes and verified for accuracy using current US Centers for Disease Control case definitions. All clinical notes were reviewed for documentation of COVID-19 pneumonia or MIS-C, and clinical notes and electronic medical records were reviewed for patient demographics, presenting signs and symptoms, prior exposure to or testing for the SARS-CoV-2 virus, laboratory data, imaging, treatment modalities and response to treatment. FINDINGS: 111 patients were identified, with 74 classified as mild COVID-19, 8 patients as moderate COVID-19, 8 patients as severe COVID-19, 10 as mild MIS-C and 11 as severe MIS-C. All groups had a male predominance, with Black and Hispanic patients overrepresented as compared to the demographics of Alabama. Most MIS-C patients were healthy at baseline, with most COVID-19 patients having at least one underlying illness. Fever, rash, conjunctivitis, and gastrointestinal symptoms were predominant in the MIS-C population whereas COVID-19 patients presented with predominantly respiratory symptoms. The two groups were similar in duration of symptomatic prodrome and exposure history to the SARS-CoV-2 virus, but MIS-C patients had a longer duration between presentation and exposure history. COVID-19 patients were more likely to have a positive SAR-CoV-2 PCR and to require respiratory support on admission. MIS-C patients had lower sodium levels, higher levels of C-reactive protein, erythrocyte sedimentation rate, d-dimer and procalcitonin. COVID-19 patients had higher lactate dehydrogenase levels on admission. MIS-C patients had coronary artery changes on echocardiography more often than COVID-19 patients. CONCLUSIONS AND RELEVANCE: This study is one of the first to directly compare COVID-19 and MIS-C in the pediatric population. The significant differences found between symptoms at presentation, demographics, and laboratory findings will aide health-care providers in distinguishing the two disease entities.


Assuntos
COVID-19/fisiopatologia , Síndrome de Resposta Inflamatória Sistêmica/fisiopatologia , Dor Abdominal/fisiopatologia , Adolescente , Afro-Americanos , Asma/epidemiologia , Proteína C-Reativa/metabolismo , COVID-19/epidemiologia , COVID-19/metabolismo , Estudos de Casos e Controles , Criança , Pré-Escolar , Comorbidade , Conjuntivite/fisiopatologia , Doença da Artéria Coronariana , Diabetes Mellitus/epidemiologia , Diarreia/fisiopatologia , Dilatação Patológica , Ecocardiografia , Exantema/fisiopatologia , Feminino , Febre/fisiopatologia , Cardiopatias Congênitas/epidemiologia , Humanos , Hiponatremia/metabolismo , Masculino , Náusea/fisiopatologia , Neoplasias/epidemiologia , Transtornos do Neurodesenvolvimento/epidemiologia , Obesidade/epidemiologia , SARS-CoV-2 , Índice de Gravidade de Doença , Distribuição por Sexo , Volume Sistólico , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/metabolismo , Fatores de Tempo , Vômito/fisiopatologia
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