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1.
Yakugaku Zasshi ; 139(12): 1553-1556, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31787644

RESUMO

The skin is the largest human organ, comprising the epidermis that is composed of epithelial tissue, the dermis composed of connective tissue, and the innermost subcutaneous tissue. Generally, skin conditions are due to aging and the influence of the external environment, but empirically patients with gastrointestinal diseases are more prone to pruritus and inflammation caused by dry skin. A decrease in the skin barrier function, involving immunocompetent mast cells and oxidative stress, was noted in indomethacin-induced small intestine inflammation, dextran sodium sulfate (DSS)-induced ulcerative colitis, and azoxymethane+DSS-induced colorectal cancer. A possible correlation was found to exist between inflammatory gastrointestinal diseases and the skin, and this correlation was investigated using a rheumatoid arthritis model as representative of inflammatory diseases. Similar to previously reported results, deterioration of the skin barrier function was observed, and new information was obtained by analyzing changes in inflammatory markers in the blood and skin tissues. Understanding the underlying mechanism of decreased skin barrier function will help in establishing effective prophylaxis and treatment methods and clarify the importance of crosstalk between organs. It will also help accelerate drug development.


Assuntos
Artrite Reumatoide/complicações , Gastroenterite/complicações , Dermatopatias/etiologia , Fenômenos Fisiológicos da Pele , Pele/fisiopatologia , Animais , Modelos Animais de Doenças , Humanos , Camundongos , Envelhecimento da Pele
2.
BMC Infect Dis ; 19(1): 910, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664944

RESUMO

BACKGROUND: On September 4, 2018, a boarding school in the Shunyi District of Beijing, China reported an outbreak of acute gastroenteritis. At least 209 suspected students caused of diarrhea and vomiting. The case was investigated, and control measures were taken to prevent further spread. METHODS: A retrospective cohort study was conducted among the school students and staff in order to test hypothesis that high risk of food served at the school canteen. We collected information on demographics, refectory records, person to person transmission by uniform epidemiological questionnaire. Risk ratios (RR) and 95% confidence intervals (CI) were calculated. Stool specimens of cases and canteen employees, retained food, water, and environmental swabs were investigated by laboratory analysis. RESULTS: We identified 209 cases (including 28 laboratory-confirmed cases) which occurred from August 29 to September 10. All cases were students, and the average age was 20, 52% were male. The outbreak lasted for 13 days, and peaked on September 5. Consumption of Drinks stall and Rice flour stall on September 1 (RR:3.4, 95%CI:1.5-7.8, and RR:7.6, 95%CI:2.8-20.2), Rice flour stall and Fish meal stall on September 2 (RR:4.0, 95%CI:1.2-13.6, and RR:4.6, 95%CI:1.7-12.5), muslim meal stall on September 4 (RR:2.7, 95%CI:1.3-5.4), Barbeque stall on September 5 (RR:3.0, 95%CI:1.2-7.0) were independently associated with increased risk of disease within the following 2 days. Among 35 specimens of rectal swabs or feces from students, 28 specimens were positive. Norovirus GI.6 alone was detected in 23 specimens, Bacillus cereus alone in 3 specimens and both norovirus GI.6 and Bacillus cereus in 2 specimens. Ten specimens of rectal swabs from canteen employees were positive for norovirus GI, and 2 specimens were positive for Bacillus cereus. Four retained food specimens were positive for Bacillus cereus, and environmental samples were negative for any viruses or bacteria. CONCLUSION: Our investigation indicated that canteen employees were infected by two pathogens (norovirus and Bacillus cereus) and transmission may have been possible due to unhygienic practices. Student consumption of food or drink at high-risk stalls was determined as the probable cause of the outbreak.


Assuntos
Bacillus cereus/isolamento & purificação , Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Doenças Transmitidas por Alimentos/microbiologia , Gastroenterite/epidemiologia , Norovirus/isolamento & purificação , Adolescente , Pequim/epidemiologia , Infecções por Caliciviridae/complicações , Diarreia/complicações , Fezes/microbiologia , Fezes/virologia , Feminino , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/virologia , Gastroenterite/complicações , Higiene das Mãos , Humanos , Masculino , Razão de Chances , Estudos Retrospectivos , Inquéritos e Questionários , Universidades , Vômito/complicações , Adulto Jovem
3.
Pol Merkur Lekarski ; 47(278): 76-79, 2019 Aug 30.
Artigo em Polonês | MEDLINE | ID: mdl-31473758

RESUMO

Acute gastroenteritis is one of the most common infection among children. An estimated 500 million children suffer from the condition worldwide each year. In developed countries the course of acute infectious diarrhea is relatively mild, symptoms usually resolve spontaneously within few days. Unfortunately high mortality rate is still a heavyweight problem in countries with low economic development. Acute diarrhea is defined as a change of the consistency of stools to loose or liquid and/ or increase of an amount of defecations to more than 3 during a day. Other symptoms of gastroenteritis include fever, nausea and vomiting. The most common cause of AGE are viruses, with rotavirus being the most frequent agent. The diagnose is based on medical interview, that include mainly precise information about duration and characteristic of occurred symptoms and epidemiological data. The most important part of diagnostic and therapeutic management is dehydration's assessment, which determine the severity of AGE and is used as one of the factors that decide about hospital admission. The majority of patients can be treated in an outpatients settings, hospitalization should be reserved for those requiring enteral or parenteral rehydration. Oral rehydration with hypoosmolar fluids is standard first-line treatment. Other effective procedures include administration of probiotics (Lactobacillus GG , Saccharomyces boulardii), racecadotril and diosmectite as antidiarrheals and ondansetron reducing the intensity of nausea and vomiting. Antibiotherapy should be only considered in exceptional situations. Acute diarrhea is commonly known medical problem, which can be easily treated by following simple, well-defined rules.


Assuntos
Hidratação , Gastroenterite , Probióticos , Vômito , Doença Aguda , Criança , Diarreia , Gastroenterite/complicações , Gastroenterite/terapia , Humanos , Lactente , Probióticos/uso terapêutico , Vômito/etiologia
4.
Medicine (Baltimore) ; 98(35): e16540, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464891

RESUMO

Antibiotics during infancy, delivery, and breastfeeding affect the intestinal microbiota in early life and is associated with allergic disease. Gastroenteritis (GE) during infancy also affects intestinal microbiota in early life, however, its relationship to allergic disease has not been investigated.Data of 45,499 males and 49,430 females, from birth to 5 years of age, were collected from a national database in Taiwan. Subjects were categorized into early GE (GE within 0-6 months) and non-early GE group (no GE within 0-6 months). The rates of asthma (AS), allergic rhinitis (AR), and atopic dermatitis (AD) over 5 years were evaluated and compared between the groups. In patients with AS, AR, and AD, the number of clinical visits and drug prescriptions for the allergic disease was also evaluated to assess the effect of early GE on allergic disease.After adjusting for the effect of GE in later life and other factors, the rates of AS [OR (odds ratio) 1.54, 95% confidence interval (CI) 1.48-1.60], AR [OR 1.49, 95% CI 1.45-1.54], and AD [OR 1.40, 95% CI 1.33-1.47] were higher in the early GE group than in the non-early GE group. The magnitude of the increase was higher in females than in males. In those with AS, AR, and AD, the number of clinical visits and drug prescriptions was not different between the early GE and non-early GE groups. In children with early GE, good control of GE in the following years lowered the rate of allergic disease.Early-life GE was associated with increased rates of AS, AR, and AD in later life and this was trend more prominent in females.


Assuntos
Asma/epidemiologia , Dermatite Atópica/epidemiologia , Gastroenterite/complicações , Rinite Alérgica/epidemiologia , Asma/etiologia , Estudos de Casos e Controles , Pré-Escolar , Dermatite Atópica/etiologia , Feminino , Gastroenterite/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Rinite Alérgica/etiologia , Caracteres Sexuais , Taiwan/epidemiologia
5.
PLoS One ; 14(7): e0219299, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31276475

RESUMO

Acute moderate to severe gastroenteritis is traditionally associated with hypernatremia but recent observations suggest that hypernatremia is currently less common than hyponatremia. The latter has sometimes been documented also in children with acute community-acquired diseases, such as bronchiolitis and pyelonephritis. We investigated the prevalence of dysnatremia in children with acute moderate severe gastroenteritis, bronchiolitis and pyelonephritis. This prospective observational study included 400 consecutive previously healthy infants ≥4 weeks to ≤24 months of age (232 males and 168 females): 160 with gastroenteritis and relevant dehydration, 160 with moderate-severe bronchiolitis and 80 with pyelonephritis admitted to our emergency department between 2009 and 2017. Circulating sodium was determined by means of direct potentiometry. For analysis, the Kruskal-Wallis test and the Fisher's exact test were used. Hyponatremia was found in 214 of the 400 patients. It was common in gastroenteritis (43%) and significantly more frequent in bronchiolitis (57%) and pyelonephritis (68%). Patients with hyponatremia were significantly younger than those without hyponatremia (3.9 [1.6-13] versus 7.5 [3.4-14] months). The gender ratio was similar in children with and without hyponatremia. Hyponatremia was associated with further metabolic abnormalities (hypokalemia, hyperkalemia, metabolic acidosis or metabolic alkalosis) in gastroenteritis (71%) and pyelonephritis (54%), and always isolated in bronchiolitis. In conclusion, hyponatremia is common at presentation among previously healthy infants with gastroenteritis, bronchiolitis or pyelonephritis. These data have relevant consequences for the nutrition and rehydration management in these conditions.


Assuntos
Infecções Comunitárias Adquiridas/metabolismo , Hiponatremia/epidemiologia , Doença Aguda , Bronquiolite/complicações , Infecções Comunitárias Adquiridas/complicações , Infecções Comunitárias Adquiridas/epidemiologia , Feminino , Gastroenterite/complicações , Hospitalização , Humanos , Hipernatremia/epidemiologia , Hipernatremia/metabolismo , Hiponatremia/complicações , Hiponatremia/metabolismo , Lactente , Recém-Nascido , Masculino , Potenciometria , Prevalência , Estudos Prospectivos , Pielonefrite/complicações , Sódio/sangue , Sódio/metabolismo
6.
Indian Pediatr ; 56(6): 468-471, 2019 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-31278225

RESUMO

OBJECTIVE: To evaluate the efficacy of ondansetron for the treatment of vomiting and thus reducing the need for intravenous (IV) rehydration in children with gastroenteritis. DESIGN: Double-blind, placebo-controlled, randomized trial. SETTING: Pediatric ward of An Giang General Hospital, South Vietnam, between December 2013 and June 2014. PARTICIPANTS: 61 inpatient children (age 11-60 mo) suffering from gastroenteritis with vomiting. Exclusion criteria were: underlying chronic conditions, immunodeficiency, malnutrition or history of allergy to ondansetron. INTERVENTION: Single bolus of IV ondansetron at a dose of 0.2 mg/kg or placebo. OUTCOME MEASURES: Proportion of patients who needed IV rehydration, proportion of patients with cessation of vomiting, amount of oral rehydration solution intake, duration of diarrhea and the length of hospital stay. RESULTS: After drug administration, 22 (73%) of the 30 patients in the ondansetron group had complete cessation of vomiting compared with 7 (23%) of the 31 patients in the placebo group (RR 0.32; 95% CI 0.16 to 0.63, P<0.001). 3 (10%) patients in the ondansetron group required IV rehydration as compared with 12 (39%) in the placebo group (RR 0.51; 95% CI 0.33 to 0.79, P=0.009). The median amount of oral rehydration solution intake in 24 hours was significantly greater in the ondansetron group (450 mL vs 350 mL, P=0.019).The duration of diarrhea and the length of hospital stay were not different between the two groups. CONCLUSIONS: In hospitalized children having gastro-enteritis associated with emesis, ondansetron is effective in the cessation of episodes of vomiting and in lowering the rates of IV rehydration, without reducing the duration of diarrhea and hospital stay.


Assuntos
Antieméticos/uso terapêutico , Desidratação/prevenção & controle , Gastroenterite/complicações , Ondansetron/uso terapêutico , Vômito/tratamento farmacológico , Pré-Escolar , Desidratação/etiologia , Desidratação/terapia , Diarreia/etiologia , Método Duplo-Cego , Esquema de Medicação , Feminino , Hidratação/estatística & dados numéricos , Gastroenterite/terapia , Humanos , Lactente , Injeções Intravenosas , Tempo de Internação/estatística & dados numéricos , Masculino , Resultado do Tratamento , Vômito/etiologia
7.
J Infect Chemother ; 25(11): 913-916, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31189503

RESUMO

Rotavirus infection is a major cause of gastroenteritis, which occurs mainly in children. Liver dysfunction due to rotavirus gastroenteritis has been reported; however, acute hepatitis due to this disease is very rare. We present a rare case in which rotavirus gastroenteritis led to sequential diagnosis of acute hepatitis and systemic primary carnitine deficiency (CDSP) in a 1-year-old girl. The patient's symptoms (hypoglycemia, hepatomegaly, and elevated levels of serum transaminases and creatinine kinase) suggested a steatosis causing liver dysfunction. She was initially considered to have a beta oxygenation defect or secondary carnitine deficiency caused by pivalic acid-containing antibiotics; however, repetitive carnitine analysis and free carnitine clearance measurement confirmed primary carnitine deficiency (carnitine transporter deficiency). Children with severe liver dysfunction due to rotavirus infection and presenting with liver steatosis should undergo blood acyl carnitine analysis to detect potential carnitine or other beta oxidation deficiencies, especially if newborn screening for these diseases is not available.


Assuntos
Cardiomiopatias/etiologia , Carnitina/deficiência , Gastroenterite/complicações , Gastroenterite/etiologia , Hepatite/etiologia , Hiperamonemia/etiologia , Doenças Musculares/etiologia , Infecções por Rotavirus/complicações , Doença Aguda , Cardiomiopatias/virologia , Feminino , Gastroenterite/virologia , Hepatite/virologia , Humanos , Hiperamonemia/virologia , Lactente , Doenças Musculares/virologia , Rotavirus/patogenicidade
8.
Seizure ; 70: 20-24, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31238195

RESUMO

PURPOSE: The aim of the present study was to compare the clinical features of campylobacter-associated benign convulsions with mild gastroenteritis (BCWG) with rotavirus-associated BCWG in China. METHODS: The medical records of BCWG patients admitted to Children's Hospital of Jiangxi Province in China between January 2015 and January 2017 were reviewed in this retrospective study. RESULTS: Ultimately, 318 patients were diagnosed with BCWG. Two hundred and two cases were tested for Campylobacter jejuni antigen, and seven (3.47%) were positive. A total of 248 cases were tested for rotavirus antigen, and 44 (17.74%) were positive. Campylobacter-associated BCWG occurred in summer and autumn. In contrast, rotavirus-associated BCWG mainly occurred in winter. In the campylobacter-associated BCWG group, five patients (71.43%) had two or more seizures. In one patient(14.29%), the seizure occurred on the first day of gastroenteritis; three patients (42.86%) had seizures on the second day, and three (42.86%) had seizures on the third day or later. Thirteen seizures were observed in the campylobacter-associated BCWG group; of these, 11 (84.62%) lasted less than 5 min, and 11 (84.62%) were generalized seizures. Phenobarbital (5 mg/kg/time) was effective in all 6 cases (100%) in which it was used. Other than the different seasonal distributions, the clinical features of campylobacter-associated BCWG and rotavirus-associated BCWG may be similar. CONCLUSIONS: Campylobacter is one of the pathogens responsible for BCWG, especially in summer and autumn. Other than the different seasonal distributions, the clinical features of campylobacter-associated BCWG and rotavirus-associated BCWG may be similar.


Assuntos
Infecções por Campylobacter/complicações , Gastroenterite/complicações , Infecções por Rotavirus/complicações , Convulsões/etiologia , Infecções por Campylobacter/diagnóstico , Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/terapia , Diagnóstico Diferencial , Feminino , Seguimentos , Gastroenterite/diagnóstico , Gastroenterite/epidemiologia , Gastroenterite/terapia , Humanos , Lactente , Masculino , Estudos Retrospectivos , Infecções por Rotavirus/diagnóstico , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/terapia , Estações do Ano , Convulsões/diagnóstico , Convulsões/epidemiologia , Convulsões/terapia
10.
Artigo em Inglês | MEDLINE | ID: mdl-31083597

RESUMO

Shiga toxin-producing Escherichia Coli (STEC) infections routinely run as a common gastroenteritis, but in many cases they may evolve towards hemolytic uremic syndrome (HUS). HUS is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Gut microorganisms have a fundamental impact on human physiology, because they modulate normal intestinal functions and play a pivotal role in influencing the local and systemic immune responses. Despite surveillance established in many countries and major progresses in the understanding of STEC-HUS mechanisms, no specific treatment is currently available. Targeting the gut microbiota could represent a new potential therapeutic strategy in STEC infection. In this paper, we reviewed the current knowledge about microbiota characteristics of patients with STEC infections, as well as in vitro and in vivo evidence of probiotic supplementation in managing STEC gastroenteritis and in HUS onset prevention.


Assuntos
Infecções por Escherichia coli/tratamento farmacológico , Gastroenterite/tratamento farmacológico , Microbioma Gastrointestinal , Síndrome Hemolítico-Urêmica/tratamento farmacológico , Probióticos/uso terapêutico , Escherichia coli Shiga Toxigênica/fisiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Gastroenterite/complicações , Gastroenterite/epidemiologia , Gastroenterite/microbiologia , Síndrome Hemolítico-Urêmica/epidemiologia , Síndrome Hemolítico-Urêmica/microbiologia , Humanos , Incidência
11.
World J Gastroenterol ; 25(15): 1899-1906, 2019 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-31057303

RESUMO

BACKGROUND: Cytomegalovirus (CMV) remains a critical complication after solid-organ transplantation. The CMV antigenemia (AG) test is useful for monitoring CMV infection. Although the AG-positivity rate in CMV gastroenteritis is known to be low at onset, almost all cases become positive during the disease course. We treated a patient with transverse colon perforation due to AG-negative CMV gastroenteritis, following a living donor liver transplantation (LDLT). CASE SUMMARY: The patient was a 52-year-old woman with decompensated liver cirrhosis as a result of autoimmune hepatitis who underwent a blood-type compatible LDLT with her second son as the donor. On day 20 after surgery, upper and lower gastrointestinal endoscopy (GE) revealed multiple gastric ulcers and transverse colon ulcers. The biopsy tissue immunostaining confirmed a diagnosis of CMV gastroenteritis. On day 28 after surgery, an abdominal computed tomography revealed transverse colon perforation, and simple lavage and drainage were performed along with an urgent ileostomy. Although the repeated remission and aggravation of CMV gastroenteritis and acute cellular rejection made the control of immunosuppression difficult, the upper GE eventually revealed an improvement in the gastric ulcers, and the biopsy samples were negative for CMV. The CMV-AG test remained negative, therefore, we had to evaluate the status of the CMV infection on the basis of the clinical symptoms and GE. CONCLUSION: This case report suggests a monitoring method that could be useful for AG-negative CMV gastroenteritis after a solid-organ transplantation.


Assuntos
Doenças do Colo/diagnóstico , Infecções por Citomegalovirus/complicações , Gastroenterite/complicações , Perfuração Intestinal/diagnóstico , Transplante de Fígado/efeitos adversos , Antígenos Virais/sangue , Antígenos Virais/imunologia , Colo/diagnóstico por imagem , Colo/virologia , Doenças do Colo/etiologia , Citomegalovirus/imunologia , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/sangue , Infecções por Citomegalovirus/imunologia , Infecções por Citomegalovirus/virologia , Doença Hepática Terminal/imunologia , Doença Hepática Terminal/patologia , Doença Hepática Terminal/cirurgia , Endoscopia Gastrointestinal , Feminino , Gastroenterite/sangue , Gastroenterite/imunologia , Gastroenterite/virologia , Hepatite Autoimune/imunologia , Hepatite Autoimune/patologia , Hepatite Autoimune/cirurgia , Humanos , Perfuração Intestinal/etiologia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
12.
Indian J Pediatr ; 86(7): 642-644, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31020591

RESUMO

Rotavirus is a common cause of acute gastroenteritis in children. Manifestations of rotavirus gastroenteritis beyond gastrointestinal tract are rare. Rotavirus has been reported to be associated with encephalopathy, myositis and elevated liver enzymes; but simultaneous presentation of all these conditions in the same child is extremely rare. The authors report a case of 17-mo-old girl who presented with acute rotavirus gastroenteritis with G3 + G9P[8] strain associated with hypernatremia, encephalopathy, myositis, transaminitis and hypoalbuminemia. Child had complete recovery with no neurological sequalae on follow-up, and liver enzymes and albumin returned to normal. The authors suggest that rotavirus infection should be considered in the differential diagnosis of a child with encephalopathy or myositis, particularly if associated with acute diarrhea.


Assuntos
Encefalopatias/complicações , Gastroenterite/complicações , Gastroenterite/virologia , Hipoalbuminemia/complicações , Miosite/complicações , Infecções por Rotavirus/complicações , Albuminas , Encefalopatias/diagnóstico , Encefalopatias/fisiopatologia , Diarreia/complicações , Fezes/virologia , Feminino , Gastroenterite/diagnóstico , Gastroenterite/fisiopatologia , Humanos , Hipoalbuminemia/diagnóstico , Hipoalbuminemia/fisiopatologia , Lactente , Rotavirus/isolamento & purificação , Infecções por Rotavirus/diagnóstico , Infecções por Rotavirus/fisiopatologia , Infecções por Rotavirus/virologia
13.
Indian J Gastroenterol ; 38(2): 134-142, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30949908

RESUMO

BACKGROUND AND AIM: Post-infection irritable bowel syndrome (PI-IBS) can occur following acute gastroenteritis (AGE). This study was designed to evaluate the incidence and risk factors of PI-IBS following AGE and to validate a PI-IBS risk score. METHODS: This prospective study was performed between September 2014 and October 2016 on AGE patients by documenting their AGE severity and following up after 3 and 6 months to study the development of IBS (ROME III criteria). The risk score was calculated for all the subjects, and its discrimination ability was tested. RESULTS: Out of 136 hospitalized AGE patients, 35 developed PI-IBS after 6 months. The factors associated with PI-IBS were younger age, longer duration of AGE, anxiety, depression, abdominal pain, bloody stool, vomiting, fever, family history of IBS, and positive stool culture (univariate analysis); however, on multivariate analysis, younger age (adjusted odds ratio [AOR] 0.5; p 0.03), prolonged duration of AGE (AOR 8.6; p 0.01), and abdominal cramps (AOR 2.1; p 0.02) were the independent factors influencing its occurrence. PI-IBS occurred even after infection with Vibrio cholerae. The PI-IBS risk score was significantly higher in patients who developed PI-IBS (72.4 ± 14.48 vs. 31.56 ± 20.4, p-value < 0.001); score > 50 had a sensitivity and specificity of 91.4% and 84.2%, respectively. CONCLUSION: One fourth of AGE patients developed PI-IBS after 6 months. Factors influencing its development were younger age, long duration of AGE, and abdominal pain. The PI-IBS risk score had good predictive accuracy in our population.


Assuntos
Gastroenterite/complicações , Síndrome do Intestino Irritável/epidemiologia , Síndrome do Intestino Irritável/etiologia , Doença Aguda , Fatores Etários , Infecções por Escherichia coli , Feminino , Gastroenterite/microbiologia , Humanos , Incidência , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Risco , Fatores de Risco , Fatores de Tempo , Vibrio
14.
Brain Dev ; 41(7): 600-603, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30954360

RESUMO

OBJECTIVE: This study was performed to evaluate the efficacy and safety of intravenous phenobarbital (PB) for benign convulsions with mild gastroenteritis (CwG). METHODS: A randomized, single-blind, placebo-controlled trial involving patients with CwG was conducted at the Japanese Red Cross Society Himeji Hospital. Patients with CwG who had experienced two or more seizures were eligible. Patients were excluded if any anticonvulsant was used before enrollment. Patients who were allocated to the PB group were administered 10 mg/kg of PB intravenously. Patients who were allocated to the placebo group were administered 20 ml of normal saline. RESULTS: From April 2016 to October 2018, 13 of 24 patients with CwG were randomized (PB group, n = 7; placebo group, n = 6; age, 1-3 years). Five of six patients in the placebo group had seizures after administration of placebo. However, patients in the PB group had no seizures after administration of PB, with a significant difference in efficacy between the two groups (P = 0.005). Five patients who had seizures after administration of normal saline were administered 10 mg/kg of PB, and no patients had a seizure thereafter. No significant differences were found in heart rate, blood pressure, or saturation of percutaneous oxygen between the two groups. CONCLUSION: This is the first randomized controlled trial to evaluate the efficacy of an anticonvulsant for CwG. Intravenous PB at 10 mg/kg is effective and well tolerated for CwG.


Assuntos
Fenobarbital/uso terapêutico , Convulsões/tratamento farmacológico , Administração Intravenosa , Anticonvulsivantes/uso terapêutico , Pré-Escolar , Feminino , Gastroenterite/complicações , Gastroenterite/dietoterapia , Humanos , Lactente , Masculino , Efeito Placebo , Método Simples-Cego , Resultado do Tratamento
15.
J Infect Dis ; 220(2): 213-218, 2019 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-30816414

RESUMO

Despite rotavirus vaccination, diarrhea remains a leading cause of child mortality. We collected stool specimens from 684 children <5 years of age hospitalized with diarrhea (cases) and 527 asymptomatic community controls for 4 years after rotavirus vaccine introduction in Malawi. Specimens were tested for 29 pathogens, using polymerase chain reaction analysis. Three or more pathogens were detected in 71% of cases and 48% of controls. Pathogens significantly associated with diarrhea included rotavirus (in 34.7% of cases and 1.5% of controls), enteric adenovirus (in 29.1% and 2.7%, respectively), Cryptosporidium (in 27.8% and 8.2%, respectively), heat-stable enterotoxin-producing Escherichia coli (in 21.2% and 8.5%, respectively), typical enteropathogenic E. coli (in 18.0% and 8.3%, respectively), and Shigella/enteroinvasive E. coli (in 15.8% and 5.7%, respectively). Additional interventions are required to prevent diarrhea due to rotavirus and other common causal pathogens.


Assuntos
Diarreia/etiologia , Diarreia/imunologia , Infecções por Rotavirus/imunologia , Vacinas contra Rotavirus/imunologia , Rotavirus/imunologia , Estudos de Casos e Controles , Criança Hospitalizada , Criptosporidiose/complicações , Cryptosporidium/patogenicidade , Diarreia/microbiologia , Diarreia/virologia , Escherichia coli/patogenicidade , Fezes/microbiologia , Fezes/virologia , Feminino , Gastroenterite/complicações , Humanos , Lactente , Malaui , Masculino
17.
Am Fam Physician ; 99(3): 159-165, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30702253

RESUMO

Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each year. Evaluation of a child with acute gastroenteritis should include a recent history of fluid intake and output. Significant dehydration is unlikely if parents report no decrease in oral intake or urine output and no vomiting. The physical examination is the best way to evaluate hydration status. The four-item Clinical Dehydration Scale can be used to determine severity of dehydration based on physical examination findings. In children with mild illness, stool microbiological tests are not routinely needed when viral gastroenteritis is the likely diagnosis. Mild gastroenteritis in children can be managed at home. Oral rehydration therapy, such as providing half-strength apple juice followed by the child's preferred liquids, is the mainstay of treatment for mild dehydration and is as effective as intravenous rehydration for preventing hospitalization and return to the emergency department. Oral rehydration solutions are recommended for moderate dehydration. Ondansetron may be prescribed if needed to prevent vomiting and improve tolerance of oral rehydration solutions. Hospitalization and intravenous fluids are recommended for children who do not respond to oral rehydration therapy plus an antiemetic and patients with severe dehydration (i.e., signs of shock or more than 10% dehydration). Handwashing, breastfeeding, and rotavirus vaccination reduce the incidence of acute gastroenteritis in young children.


Assuntos
Desidratação/terapia , Gastroenterite/terapia , Adolescente , Antieméticos/uso terapêutico , Bicarbonatos/administração & dosagem , Criança , Pré-Escolar , Desidratação/diagnóstico , Desidratação/etiologia , Hidratação/métodos , Gastroenterite/complicações , Gastroenterite/diagnóstico , Glucose/administração & dosagem , Humanos , Lactente , Ondansetron/uso terapêutico , Cloreto de Potássio/administração & dosagem , Índice de Gravidade de Doença , Cloreto de Sódio/administração & dosagem , Vômito/etiologia , Vômito/terapia
19.
BMC Public Health ; 19(1): 69, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30646867

RESUMO

BACKGROUND: In 2016, the Government of India introduced the oral rotavirus vaccine (ROTAVAC, Bharat Biotech, India) in 4 states of India as part of the Universal Immunization Programme, and expanded to 5 more states in 2017. We report four years of data on rotavirus gastroenteritis in hospitalized children < 5 years of age prior to vaccine introduction. METHODS: Children from 7 sites in southern and northern India hospitalized for diarrhoea were recruited between July 2012 and June 2016. Stool samples were screened for rotavirus using enzyme immunoassay (EIA). The EIA positive samples were genotyped by reverse-transcription polymerase chain reaction. RESULTS: Of the 5834 samples from the 7 sites, 2069 (35.5%) were positive for rotavirus by EIA. Genotyping was performed for 2010 (97.1%) samples. G1P[8](56.3%), G2P[4](9.1%), G9P[4](7.6%), G9P[8](4.2%), and G12P[6](3.7%) were the common genotypes in southern India and G1P[8](36%), G9P[4](11.4%), G2P[4](11.2%), G12P[6](8.4%), and G3P[8](5.9%) in northern India. CONCLUSIONS: The study highlights the high prevalence of rotavirus gastroenteritis in India and the diversity of rotavirus genotypes across different geographical regions. Pre- vaccine surveillance data is necessary to evaluate the potential change in admission rates for gastroenteritis and circulating rotavirus genotypes after vaccine introduction, thus assessing impact.


Assuntos
Diarreia/virologia , Fezes/virologia , Gastroenterite/virologia , Genótipo , Infecções por Rotavirus/virologia , Vacinas contra Rotavirus , Rotavirus/genética , Pré-Escolar , Diarreia/epidemiologia , Diarreia/etiologia , Infecções por Enterovirus , Feminino , Gastroenterite/complicações , Gastroenterite/epidemiologia , Hospitalização , Humanos , Programas de Imunização , Índia/epidemiologia , Lactente , Masculino , Prevalência , Características de Residência , Rotavirus/crescimento & desenvolvimento , Infecções por Rotavirus/complicações , Infecções por Rotavirus/epidemiologia , Vacinação
20.
Medicine (Baltimore) ; 98(2): e14082, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30633216

RESUMO

Benign convulsions with mild gastroenteritis have a high incidence in the North China, previous reports it has been caused by rotavirus infection, which is a non-febrile convulsion. In recent years, we observed that norovirus infection gradually increased all the years round and most of them are febrile convulsion.Retrospective analysis was performed on 55 pediatric patients with benign convulsions with mild gastroenteritis (CWG) who were admitted between January 2010 and January 2015.The median age of the norovirus infection group was greater than that of the rotavirus infection group. Norovirus infection has no obvious seasonality. The peak age of benign CWG onset was less than 3 years (74.5%). In 69.1% of all cases, the temperature was less than 38 °C. In 70.9% of cases, children had experienced more than 2 episodes. In 96.4% of all cases, convulsive episodes were shorter than 5 min. Convulsions mostly occurred within the first 2 days (78.2%) after gastroenteritis tract symptoms. Most episodes featured generalized tonic-clonic seizure (87.3%). Serum Na+ levels were lower while other biochemical test results were normal. Follow-up 2 years attack again (16.8%), intelligence quotient was not reduced.CWG febrile or afebrile occurs most frequently among young children. In addition to the rotavirus, the norovirus might also cause this syndrome. The prognosis is favorable and long-term anti-seizure treatment is considered to be unnecessary.


Assuntos
Infecções por Caliciviridae/complicações , Gastroenterite/complicações , Infecções por Rotavirus/complicações , Convulsões/diagnóstico , Convulsões/etiologia , Infecções por Caliciviridae/diagnóstico , Criança , Pré-Escolar , China , Feminino , Seguimentos , Gastroenterite/diagnóstico , Gastroenterite/virologia , Humanos , Incidência , Lactente , Masculino , Prognóstico , Estudos Retrospectivos , Infecções por Rotavirus/diagnóstico , Convulsões/epidemiologia , Índice de Gravidade de Doença , Síndrome
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