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2.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33462001

RESUMO

A 75-year-old man was admitted with a 3-month history of worsening diarrhoea and weight loss. He was on long-term immunosuppression following cardiac transplantation. Investigations revealed herpes simplex oesophagitis and stool samples were positive for norovirus. Treatment with acyclovir and nitazoxanide resulted in a complete resolution of symptoms. Norovirus is a common cause of infectious gastroenteritis, but immunosuppressed patients may present with chronic diarrhoea rather than an acute illness. This case highlights the importance of a low clinical threshold for testing for norovirus infection in immunocompromised patients.


Assuntos
Infecções por Caliciviridae/imunologia , Diarreia/virologia , Gastroenterite/imunologia , Hospedeiro Imunocomprometido , Norovirus/isolamento & purificação , Complicações Pós-Operatórias/imunologia , Perda de Peso , Idoso , Infecções por Caliciviridae/complicações , Infecções por Caliciviridae/diagnóstico , Doença Crônica , Diarreia/imunologia , Gastroenterite/complicações , Gastroenterite/diagnóstico , Transplante de Coração , Humanos , Masculino , Complicações Pós-Operatórias/diagnóstico , Perda de Peso/imunologia
3.
Am J Trop Med Hyg ; 103(2): 887-893, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32588795

RESUMO

Increasing access to rapid diagnostic tests for malaria (mRDTs) has raised awareness of the challenges healthcare workers face in managing non-malarial febrile illnesses (NMFIs). We examined NMFI prevalence, clinical diagnoses, and prescribing practices in outpatient clinics across different malaria transmission settings in Malawi. Standardized facility-based malaria surveillance was conducted at three facilities one of every 4 weeks over 2 years. Information on demographics, presenting symptoms, temperature, clinical diagnosis, and treatment were collected from outpatients presenting with malaria-like symptoms. Of the 25,486 patients with fever, 69% had NMFI. Non-malarial febrile illness prevalence was lower in 5- to 15-year-old patients (55%) than in children < 5 years (72%) and adults > 15 years of age (77%). The most common clinical diagnoses among febrile patients with negative mRDTs in all age-groups and settings were respiratory infections (46%), sepsis (29%), gastroenteritis (13%), musculoskeletal pain (9%), and malaria (5%). Antibiotic prescribing was high in all age-groups and settings. Trimethoprim-sulfamethoxazole (40%) and amoxicillin (29%) were the most commonly prescribed antibiotics and were used for nearly all clinical diagnoses. In these settings with minimal access to diagnostic tools, patients with fever and a negative mRDT received a limited number of clinical diagnoses. Many were likely to be inaccurate and were associated with the inappropriate use of the limited range of available antibiotics. Prescription and diagnostic practices for NMFIs in the facilities require research and policy input. Resource-limited malaria-endemic countries urgently need more point-of-care diagnostic tools and evidence-based diagnosis and treatment algorithms to provide effective and cost-efficient care.


Assuntos
Antibacterianos/uso terapêutico , Febre/epidemiologia , Gastroenterite/epidemiologia , Malária/epidemiologia , Dor Musculoesquelética/epidemiologia , Infecções Respiratórias/epidemiologia , Sepse/epidemiologia , Adolescente , Assistência Ambulatorial , Amoxicilina/uso terapêutico , Criança , Pré-Escolar , Gerenciamento Clínico , Doenças Endêmicas , Feminino , Febre/etiologia , Gastroenterite/complicações , Gastroenterite/tratamento farmacológico , Humanos , Malária/complicações , Malária/diagnóstico , Malaui/epidemiologia , Masculino , Dor Musculoesquelética/complicações , Dor Musculoesquelética/tratamento farmacológico , Prevalência , Infecções Respiratórias/complicações , Infecções Respiratórias/tratamento farmacológico , Sepse/complicações , Sepse/tratamento farmacológico , Infecções dos Tecidos Moles/complicações , Infecções dos Tecidos Moles/tratamento farmacológico , Infecções dos Tecidos Moles/epidemiologia , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Adulto Jovem
4.
Pediatrics ; 146(1)2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32487592

RESUMO

OBJECTIVES: Management decisions for patients with gastroenteritis affect resource use within pediatric emergency departments (EDs), and algorithmic care using evidence-based guidelines (EBGs) has become widespread. We aimed to determine if the implementation of a dehydration EBG in a pediatric ED resulted in a reduction in intravenous (IV) fluid administration and the cost of care. METHODS: In a single-center quality improvement initiative between 2010 and 2016, investigators aimed to decrease the percentage of patients with gastroenteritis who were rehydrated with IV fluids. The EBG assigned the patient a dehydration score with subsequent rehydration strategy on the basis of presenting signs and symptoms. The primary outcome was proportion of patients receiving IV fluid, which was analyzed using statistical process control methods. The secondary outcome was cost of the episode of care. Balancing measures included ED length of stay, admission rate, and return visit rate within 72 hours. RESULTS: A total of 7145 patients met inclusion criteria with a median age of 17 months. Use of IV fluid decreased from a mean of 15% to 9% postimplementation. Average episode of care-related health care costs decreased from $599 to $410. For our balancing measures, there were improvements in ED length of stay, rate of admission, and rate of return visits. CONCLUSIONS: Implementation of an EBG for patients with gastroenteritis led to a decrease in frequency of IV administration, shorter lengths of stay, and lower health care costs.


Assuntos
Desidratação/economia , Serviço Hospitalar de Emergência/economia , Hidratação/economia , Gastroenterite/economia , Recursos em Saúde/tendências , Custos Hospitalares/estatística & dados numéricos , Melhoria de Qualidade , Algoritmos , Criança , Pré-Escolar , Desidratação/etiologia , Desidratação/terapia , Feminino , Hidratação/métodos , Gastroenterite/complicações , Gastroenterite/terapia , Humanos , Lactente , Masculino , Estudos Retrospectivos
5.
J Psychosom Res ; 134: 110136, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32417692

RESUMO

OBJECTIVE: The association between gastroenteritis exposure and schizophrenia (SCZ) onset has been investigated, but the findings were inconsistent. This study aimed to determine whether gastroenteritis would increase the risk of SCZ onset. METHODS: We performed a systematic literature search in PubMed, Cochrane Library and the Web of Science database up to 23 November 2019. The pooled relative risk (RR) with 95% confidence interval (CI) was used to estimate the effect of gastroenteritis on SCZ. Stratified analysis was conducted by study design, diagnostic criteria, region, adjustment for confounders, gastroenteritis sub-classification and data source. RESULTS: This meta-analysis included nine published articles with 13,830,871 subjects. Overall, there was no significant relationship between gastroenteritis and SCZ onset (N [number of studies] = 11, RR = 1.06, 95% CI: 0.81-1.39). However, pooled results from cohort studies suggested that gastroenteritis significantly increased the risk of SCZ (N = 7, RR = 1.27, 95% CI = 1.05-1.53). Increased risk of SCZ was observed in America (N = 3) and Australia (N = 2), whereas no association was found in Europe (N = 1) and Asia (N = 5). The pooled RR, adjusting for ≥2 confounders (N = 5), was higher than those adjusting for <2 confounders (N = 6). The effects also varied in diagnostic criteria, gastroenteritis sub-classification and data source. CONCLUSION: Based on current research evidence, it is not yet certain that gastroenteritis is a risk factor for SCZ, and more research on the association between specific gastroenteritis and SCZ is needed.


Assuntos
Gastroenterite/complicações , Esquizofrenia/complicações , Estudos de Coortes , Humanos , Fatores de Risco
6.
Pediatrics ; 145(4)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32132152

RESUMO

CONTEXT: Several antiemetics have been used in children with acute gastroenteritis. However, there is still controversy over their use. OBJECTIVE: To determine the effectiveness and safety of antiemetics for controlling vomiting in children with acute gastroenteritis. DATA SOURCES: Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Latin America and the Caribbean Literature on Health Sciences, and gray literature, until December 2018. STUDY SELECTION: We selected randomized clinical trials comparing metoclopramide, ondansetron, domperidone, dexamethasone, dimenhydrinate, and granisetron. DATA EXTRACTION: Two reviewers independently screened abstracts and full texts, extracted the data, and assessed the risk of bias. We performed pairwise and network meta-analysis using the random-effects model. RESULTS: Twenty-four studies were included (3482 children). Ondansetron revealed the largest effect in comparison to placebo for cessation of vomiting (odds ratio = 0.28 [95% credible interval = 0.16 to 0.46]; quality of evidence: high) and for hospitalization (odds ratio = 2.93 [95% credible interval = 1.69 to 6.18]; quality of evidence: moderate). Ondansetron was the only intervention that reduced the need for intravenous rehydration and the number of vomiting episodes. When considering side effects, dimenhydrinate was the only intervention that was worse than placebo. LIMITATIONS: Most treatment comparisons had low- or very low-quality evidence, because of risk of biases and imprecise estimates. CONCLUSIONS: Ondansetron is the only intervention that revealed an effect on the cessation of vomiting, on preventing hospitalizations, and in reducing the need for intravenous rehydration. Ondansetron was also considered a safe intervention.


Assuntos
Antieméticos/uso terapêutico , Gastroenterite/complicações , Vômito/tratamento farmacológico , Doença Aguda , Antieméticos/efeitos adversos , Criança , Pré-Escolar , Dexametasona/uso terapêutico , Diarreia/induzido quimicamente , Dimenidrinato/uso terapêutico , Domperidona/uso terapêutico , Hidratação/estatística & dados numéricos , Granisetron/uso terapêutico , Hospitalização , Humanos , Lactente , Metoclopramida/uso terapêutico , Metanálise em Rede , Ondansetron/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Análise de Regressão , Vômito/complicações
7.
Am Fam Physician ; 101(5): 294-300, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-32109037

RESUMO

Upper gastrointestinal (GI) bleeding is defined as hemorrhage from the mouth to the ligament of Treitz. Common risk factors for upper GI bleeding include prior upper GI bleeding, anticoagulant use, high-dose nonsteroidal anti-inflammatory drug use, and older age. Causes of upper GI bleeding include peptic ulcer bleeding, gastritis, esophagitis, variceal bleeding, Mallory-Weiss syndrome, and cancer. Signs and symptoms of upper GI bleeding may include abdominal pain, lightheadedness, dizziness, syncope, hematemesis, and melena. Physical examination includes assessment of hemodynamic stability, presence of abdominal pain or rebound tenderness, and examination of stool color. Laboratory tests should include a complete blood count, basic metabolic panel, coagulation panel, liver tests, and type and crossmatch. A bolus of normal saline or lactated Ringer solution should be rapidly infused to correct hypovolemia and to maintain blood pressure, and blood should be transfused when hemoglobin is less than 7 g per dL. Clinical prediction guides (e.g., Glasgow-Blatchford bleeding score) are necessary for upper GI bleeding risk stratification and to determine therapy. Patients with hemodynamic instability and signs of upper GI bleeding should be offered urgent endoscopy, performed within 24 hours of presentation. A common strategy in patients with failed endoscopic hemostasis is to attempt transcatheter arterial embolization, then proceed to surgery if hemostasis is not obtained. Proton pump inhibitors should be initiated upon presentation with upper GI bleeding. Guidelines recommend high-dose proton pump inhibitor treatment for the first 72 hours post-endoscopy because this is when rebleeding risk is highest. Deciding when to restart antithrombotic therapy after upper GI bleeding is difficult because of lack of sufficient data.


Assuntos
Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/terapia , Adulto , Antibacterianos/uso terapêutico , Anti-Inflamatórios não Esteroides/efeitos adversos , Anticoagulantes/efeitos adversos , Transfusão de Sangue , Endoscopia Gastrointestinal , Fibrinolíticos/uso terapêutico , Gastroenterite/complicações , Hemorragia Gastrointestinal/etiologia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/tratamento farmacológico , Humanos , Síndrome de Mallory-Weiss/complicações , Úlcera Péptica/complicações , Inibidores da Agregação de Plaquetas/efeitos adversos , Inibidores da Bomba de Prótons/uso terapêutico , Fatores de Risco , Inibidores de Captação de Serotonina/efeitos adversos
9.
Diagn Microbiol Infect Dis ; 96(2): 114927, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31740171

RESUMO

Vibrio-related gastroenteritis in the United States is mostly associated with the consumption of raw or improperly cooked seafood. We describe a case of a stage IV lung adenocarcinoma patient who became ill after eating crab while visiting Upstate New York. Molecular testing and culture confirmed a coinfection with V. parahaemolyticus and a nontoxigenic strain V. cholera.


Assuntos
Cólera/complicações , Cólera/microbiologia , Coinfecção , Gastroenterite/complicações , Gastroenterite/microbiologia , Neoplasias/complicações , Vibrioses/complicações , Vibrioses/microbiologia , Adenocarcinoma de Pulmão/complicações , Adenocarcinoma de Pulmão/diagnóstico , Idoso , Cólera/diagnóstico , Coinfecção/diagnóstico , Comorbidade , Gastroenterite/diagnóstico , Humanos , Masculino , Estadiamento de Neoplasias , Neoplasias/diagnóstico , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Vibrioses/diagnóstico , Vibrio cholerae/classificação , Vibrio parahaemolyticus/classificação
10.
Clin Lab ; 65(12)2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31850714

RESUMO

BACKGROUND: Viral gastroenteritis is one of the most common illnesses in humans worldwide, and different viral agents have been shown to be associated with the disease. Among these, rotaviruses and adenoviruses are the responsible causative agents of acute gastroenteritis and causing numerous outbreaks. Therefore, a simple and rapid diagnostic tool, such as an immunochromatographic (IC) test, is required for rapid diagnosis, especially during an outbreak of these pathogens. METHODS: The efficiency of two commercial IC kits were evaluated for simultaneous detections of rotavirus and adenovirus in clinical stool specimens by a single test kit. RESULTS: The data demonstrated that both IC test kits could detect either adenovirus or rotavirus positive alone, as well as mixed infections of both viruses in a single stool specimen. In addition, a wide variety of rotavirus genotypes, including G1-P[8]-I1, G2-P[4]-I2, G3-P[8]-I2, G8-P[8]-I2, and G9-P[8]-I1 could be detected by both IC kits. The detection limit of the kits for the detection of rotavirus and adenovirus were comparable to those of real-time PCR at 105 copies/mL. CONCLUSIONS: These two IC test kits could be used as an alternative choice for rapid screening of rotavirus and adenovirus in the stool specimens, especially during the seasonal outbreak of acute gastroenteritis.


Assuntos
Infecções por Adenoviridae/diagnóstico , Adenoviridae/genética , Cromatografia/métodos , Imunoensaio/métodos , Infecções por Rotavirus/diagnóstico , Rotavirus/genética , Adenoviridae/fisiologia , Infecções por Adenoviridae/complicações , Infecções por Adenoviridae/virologia , Pré-Escolar , Fezes/virologia , Gastroenterite/complicações , Gastroenterite/diagnóstico , Genótipo , Humanos , Lactente , Kit de Reagentes para Diagnóstico/normas , Reprodutibilidade dos Testes , Rotavirus/fisiologia , Infecções por Rotavirus/complicações , Infecções por Rotavirus/virologia , Sensibilidade e Especificidade
11.
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
12.
Rev. esp. enferm. dig ; 111(12): 914-920, dic. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-190533

RESUMO

Background: PI-IBS prevalence is around 10.1%-14.5% ≥ 12 months after infectious gastroenteritis in North America, Europe and Asia. However, there are no studies from Latin America. Two previous studies in Mexico suggest a low incidence of 5%. Aims: to determine the prevalence of PI-IBS in patients attended in a tertiary-care center, as well as IBS subtypes, severity, other digestive symptoms and red flags vs nPI-IBS. Methods: seventy IBS patients screened for immunological research completed the Rome III, Spiller's for PI-IBS and IBS-SSS questionnaires. PI-IBS prevalence was determined according to three criteria sets. C1: ≥ 2 episodes of sudden onset, onset while traveling, initial illness with any of the following symptoms, fever, vomiting, bloody diarrhea and a positive stool culture. C2: sudden onset and > 2 episodes of fever, diarrhea, vomiting and bloody diarrhea. C3: sudden onset after an infectious episode such as a positive culture or onset with ≥ 2 episodes of fever, vomiting, diarrhea, rectal bleeding and foreign travel. Items were dichotomized as present or absent and compared using the Fisher's exact and Mann-Whitney U tests. Results: PI-IBS prevalence was as follows. C1: 5.7%, C2: 0 and C3: 1.4%. There were no IBS-C or IBS-M cases. In the C1 group, one case was mild and three were moderate IBS, which was similar to the non PI-IBS group. One case in the C3 group had mild IBS. There were no differences in the frequency of esophageal, gastroduodenal, anorectal, bloating/distension and red flags between PI-IBS and non PI-IBS groups (analyzed only for C3). Conclusions: in Mexico, there is a very low prevalence of PI-IBS in patients from a tertiary-referral center. However, it varies according to the surrogate-criteria used. The later needs to be taken into account when performing PI-IBS studies


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Doenças Inflamatórias Intestinais/etiologia , Gastroenterite/complicações , Enteropatias Parasitárias/complicações , Infecções Bacterianas/complicações , Viroses/complicações , Atenção Terciária à Saúde/estatística & dados numéricos , Doenças Inflamatórias Intestinais/epidemiologia , México/epidemiologia , Medidas de Resultados Relatados pelo Paciente , Doenças Transmissíveis/complicações
13.
Nutrients ; 11(11)2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31739457

RESUMO

The effectiveness of Lactobacillus reuteri DSM 17938 (L. reuteri) for the management of acute gastroenteritis (AGE) has been recently questioned. We performed a systematic review to update evidence on L. reuteri for treating AGE in children. We searched MEDLINE, EMBASE, the Cochrane Library databases, and additional data sources from January 2016 (end of search for our 2016 systematic review) to August 2019. The primary outcomes were stool volume and duration of diarrhea. Four RCTs were included. None of them evaluated stool volume. Compared with placebo or no treatment, L. reuteri reduced diarrhea duration (four RCTs, n = 347, mean difference, MD -0.87 days, 95% CI [-1.43, -0.31]). L. reuteri use was also associated with a reduced duration of hospitalization (three RCTs, n = 284, MD -0.54 days, 95% CI [-1.09, 0.0]). The small effect sizes of limited clinical relevance and methodological limitations of the included trials should be noted when interpreting these findings.


Assuntos
Diarreia/prevenção & controle , Gastroenterite/tratamento farmacológico , Lactobacillus reuteri , Probióticos/uso terapêutico , Pré-Escolar , Defecação , Diarreia/etiologia , Fezes , Gastroenterite/complicações , Hospitalização , Humanos , Lactente , Lactobacillus reuteri/classificação , Especificidade da Espécie
14.
Ned Tijdschr Geneeskd ; 1632019 11 18.
Artigo em Holandês | MEDLINE | ID: mdl-31769637

RESUMO

BACKGROUND: Rotavirus is a common cause of gastroenteritis in children. It is much less known that rotavirus infections can lead to encephalitis with convulsions in neonates. CASE DESCRIPTION: A premature boy (36 weeks + 5 days) developed neonatal convulsions 17 days post-partum. His sister had symptoms of gastroenteritis. Cerebral MRIs showed extensive white matter abnormalities in diffusion-weighted images and, a few weeks later, cystic white matter abnormalities. There were no gastrointestinal phenomena or pleocytosis in the cerebrospinal fluid. Rotavirus was detected in the stools, using molecular diagnostics (PCR). CONCLUSION: Rotavirus infection at a neonatal age can have serious consequences. Due to the absence of gastrointestinal phenomena, pleocytosis and demonstrability of rotavirus in faeces and not in CSF, this clinical picture has long remained undiagnosed. Instructions on hand hygiene during the post-partum period contributes to the prevention of rotavirus infection in neonates. Herd immunity through rotavirus vaccination for all neonates could lead to significant risk reduction.


Assuntos
Gastroenterite/diagnóstico , Infecções por Rotavirus/diagnóstico , Convulsões/etiologia , Imagem de Difusão por Ressonância Magnética , Fezes/virologia , Gastroenterite/complicações , Humanos , Recém-Nascido , Imagem por Ressonância Magnética/efeitos adversos , Masculino , Rotavirus , Infecções por Rotavirus/complicações
15.
Indian J Pediatr ; 86(12): 1142-1145, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31701427

RESUMO

The objective of the present study was to identify risk factors for mortality at admission in children admitted to the Pediatric Intensive Care Unit (PICU) with acute gastroenteritis (AGE) with severe dehydration and shock. This was a retrospective chart review of all cases of AGE with severe dehydration and shock admitted to the PICU from 2012 to 2017. Children who died during hospital stay were compared with those who survived. A total of 62 children were admitted with AGE to the PICU during this period. Twenty-four children (39%) died. The following variables were found to be significantly associated with death on univariate analysis: clinical pallor (p = 0.01), thrombocytopenia (p = 0.018), elevated leucocyte count (p = 0.02), hypoalbuminemia (p = 0.02) and severe acute malnutrition (SAM) (p = 0.04). On multivariate analysis, only hypoalbuminemia {RR [95% CI: 2.6 (1.27 to 9.21)]; 0.039} and SAM {RR [95% CI: 4.9 (1.12 to 10)]; 0.045} remained statistically significant. Children admitted with severe dehydration and shock had high mortality rates. These children were a sicker subset with probable sepsis. Severe acute malnutrition and hypoalbuminemia were associated with increased risk of death in these patients.


Assuntos
Criança Hospitalizada , Desidratação/complicações , Desidratação/mortalidade , Gastroenterite/complicações , Gastroenterite/mortalidade , Hospitalização , Adolescente , Criança , Pré-Escolar , Desidratação/fisiopatologia , Feminino , Gastroenterite/fisiopatologia , Humanos , Hipoalbuminemia/epidemiologia , Índia/epidemiologia , Lactente , Unidades de Terapia Intensiva Pediátrica , Tempo de Internação , Masculino , Desnutrição/epidemiologia , Mortalidade , Análise Multivariada , Estudos Retrospectivos , Fatores de Risco , Sepse , Choque , Trombocitopenia/epidemiologia
16.
Trop Med Int Health ; 24(12): 1427-1433, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31627250

RESUMO

OBJECTIVE: To evaluate the clinical severity of diarrhoea associated to viral co-infection in children with acute gastroenteritis. METHODS: About 461 children under five years hospitalised with acute diarrhoea (266 males and 187 females) were enrolled in the study. Using stool samples, rotavirus and adenovirus infections were investigated by ELISA, and norovirus infections by nested duplex RT-PCR. We assessed social, demographic, clinical and behavioural conditions that might influence the occurrence of rotavirus, adenovirus and norovirus infections. RESULTS: Mono-viral infection was detected in 49% and mixed viral infection in 12% of patients. The prevalence of mixed infection was neither dependent on age nor sex. Three samples were infected with all three viruses. A significant association was found between fever (axillary temperature> 37.5 °C) and rotavirus-norovirus dual infection (aOR (CI 95%) = 2.1 (1.14-3.84), P = 0.016; aOR (CI 95%) = 0.37 (0.19-0.73), P = 0.004). Mixed infection was the most common during the dry season from June to October (71.4% versus 54.7%, P = 0.023). CONCLUSION: Co-infection with both rotavirus and norovirus is common in under-five hospitalised children but does not contribute to the severity of the disease.


Assuntos
Infecções por Caliciviridae/epidemiologia , Criança Hospitalizada , Gastroenterite/epidemiologia , Infecções por Rotavirus/epidemiologia , Adolescente , Infecções por Caliciviridae/complicações , Criança , Serviços de Saúde da Criança , Pré-Escolar , Comorbidade , Congo/epidemiologia , Feminino , Gastroenterite/complicações , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Infecções por Rotavirus/complicações
17.
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
18.
BMC Res Notes ; 12(1): 699, 2019 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-31655628

RESUMO

OBJECTIVES: The present study aims to investigate the etiology, clinical profile and resistance pattern of the isolated pathogens in Nepalese adults with acute gastroenteritis. This cross-sectional study was conducted at Sukraraj Tropical and Infectious Disease Hospital, from April 2016 to Sep 2017. Subjects' ages 14 or above, presenting with gastroenteritis with positive stool culture were enrolled for analysis. RESULTS: Of total 153 patients, 47.72% subjects confirmed the presence of bacterial infection. Vibrio cholerae spp and Shigella spp were detected in 36.6% and 23.28% respectively. The most common resistance among Vibrio cholerae was to nitrofurantoin (92.8%), cotrimoxazole (92.8%) and nalidixic acid (92.8%). Among 17 isolates of Shigella spp, the most frequent drug resistant was observed in ampicillin (64.7%), nalidixic acid (58.8%), ceftriaxone (47%). Chloramphenicol (94.1%), tetracycline (88.2%), and cotrimoxazole (82.3%) were found to be the most sensitive towards this pathogen. High rate of diarrhea due to bacterial infection, especially Shigella spp and Vibrio spp and their high rate of drug resistance emphasize an urgent need of designing a surveillance system for antimicrobial resistance in Nepalese setting.


Assuntos
Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Gastroenterite/complicações , Shigella/efeitos dos fármacos , Centros de Atenção Terciária , Vibrio/efeitos dos fármacos , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Bacterianas/complicações , Infecções Bacterianas/microbiologia , Estudos Transversais , Diarreia/epidemiologia , Diarreia/etiologia , Diarreia/microbiologia , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana/métodos , Pessoa de Meia-Idade , Nepal/epidemiologia , Shigella/isolamento & purificação , Vibrio/isolamento & purificação , Adulto Jovem
19.
Pediatr Infect Dis J ; 38(12): e326-e328, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31634298

RESUMO

Autopsy investigation of a fatal case of rotavirus severe acute gastroenteritis and multiple organ failure in a 16-month boy with previous intrauterine growth retardation showed colocalization of nonstructural and structural rotavirus proteins within viroplasms in nephrons. This case brings new insights into extraintestinal rotavirus infection and new clues to its abilities to bind to human histo-blood group antigens.


Assuntos
Gastroenterite/complicações , Gastroenterite/virologia , Insuficiência de Múltiplos Órgãos/virologia , Infecções por Rotavirus/complicações , Infecções por Rotavirus/patologia , Lesão Renal Aguda/virologia , Autopsia , Evolução Fatal , Retardo do Crescimento Fetal , Gastroenterite/patologia , Humanos , Lactente , Masculino , Néfrons/virologia , Rotavirus , Infecções por Rotavirus/diagnóstico , Choque Séptico/virologia
20.
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
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