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► Cryptosporidium viatorum n. sp. ► Cryptosporidium viatorum is associated with travel to the Indian subcontinent. ► Cryptosporidium viatorum is genetically and epidemiologically ...distinct from other Cryptosporidium spp.
A novel Cryptosporidium genotype was identified, among travellers with gastro-intestinal symptoms returning to Great Britain from the Indian subcontinent, for which we propose the name Cryptosporidium viatorum n. sp. The epidemiology of these cases was distinctly different from those with Cryptosporidium parvum and Cryptosporidium hominis. Of the 10 cases identified involving C. viatorum, most were in the first quarter of the year. One occurred in 2007, one in 2008, three in 2010 and five to end March 2011. The median age was 19years but most were in the 20–29years age group and seven were male. The symptoms included diarrhoea, abdominal pain, nausea, vomiting and fever. Compared with cases due to C. hominis and C. parvum, vomiting was reported less often, although the duration of gastro-intestinal symptoms was longer. The cases of C. viatorum were all travellers to the Indian subcontinent, whereas cases of C. hominis and C. parvum were more likely to have travelled elsewhere. Cryptosporidium viatorum isolates had indistinguishable sequences at each of the70kDa heat shock protein (HSP70), actin and ssrRNA loci which did not match any published previously and, although phylogenetically most similar to Cryptosporidium fayeri, they were distinct (<98% similarity) at the ssrRNA, HSP70 and actin genes. Morphologically, oocysts were typical of predominantly human-infecting species. Cryptosporidium viatorum n. sp. is proposed and work is warranted to investigate further the public health significance and occurrence elsewhere of this emerging parasite.
We compared viral load of emerging recombinant norovirus GII.P16-GII.2 with those for pandemic GII.Pe-GII.4 and epidemic GII.P17-GII.17 genotypes among inpatients in Hong Kong. Viral load of ...GII.P16-GII.2 was higher than those for other genotypes in different age groups. GII.P16-GII.2 is as replication competent as the pandemic genotype, explaining its high transmissibility and widespread circulation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Introduction:Vomiting is an important symptom that limits oral intake and may result in hospitalizations and prolonged hospital stays for intravenous fluid therapy. In our study, we aimed to compare ...the rates of hospital revisit and hospitalization due to vomiting within seven days of admission in children with acute gastroenteritis in two groups who received and did not receive intramuscular ondansetron.Methods:Files of patients aged 6 months-15 years (without dehydration) diagnosed with acute gastroenteritis (ICD A09) in our pediatric emergency clinic between December 2015-February 2016 (non-ondansetron period) and December 2019-February 2020 (intramuscular ondansetron period) were analyzed retrospectively. The patients included in the study were evaluated in two groups, the first group receiving a single dose of intramuscular ondansetron and the second group not receiving ondansetron treatment. Our primary aim was to determine the rates of readmission and hospitalization in the first 7 days of both groupsResults:It was determined that 21% of the patients who received ondansetron and 28% of the group who did not receive ondansetron were admitted to the emergency department due to vomiting in the first 7 days. In comparison of both groups, 5% of group I patients and 13% of group II patients needed intravenous fluids (odds ratio =0.3; 95% confidence interval =0.19-0.59) at repeated admission and required hospitalization in the emergency department.Conclusion:Intramuscular ondansetron treatment reduces the rate of hospital readmission, hospitalization and intravenous fluid requirement during re-admission in children with acute gastroenteritis with vomiting.
Rotavirus infection is a cause of considerable morbidity, with an estimated 500,000 deaths annually worldwide. This study in Vellore, India, showed that recurrent rotavirus infection in children was ...common, often with the same serotype.
Group A rotaviruses are the leading cause of dehydrating gastroenteritis in young children worldwide, and rotavirus gastroenteritis results in more than half a million deaths annually.
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Two rotavirus vaccines, Rotarix and RotaTeq, are licensed for use in the United States, Europe, and Latin America,
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and the World Health Organization has recommended their inclusion in national immunization programs in Africa and Asia on the basis of trials showing efficacy there.
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Naturally occurring rotavirus infection has been shown to confer protection against subsequent infection and disease in birth cohorts in Mexico and Guinea-Bissau, with each new infection reducing the severity . . .
Highlights ► We report the efficacy of the pentavalent rotavirus vaccine in Malian infants. ► Operational issues in the study design were recognized during the study. ► Case capture methods were ...adapted for local conditions and diarrhea reporting behaviors. ► The intention-to-treat analysis against severe rotavirus gastroenteritis was 42.9%.
Since human coronavirus (HCoV)–like particles were detected in the stool specimens of acute gastroenteritis and necrotizing enterocolitis children with electron microscopy, the relationship between ...HCoV and the pediatric gastrointestinal illness had been recognized. In recent years, the overall detection rates have been low and have varied by region. HCoVs have not been considered as the major pathogens in pediatric acute gastroenteritis. HCoVs detected in children with acute gastroenteritis have included 229E, OC43, HKU1, NL63, and severe acute respiratory syndrome coronavirus, Middle East Respiratory Syndrome Coronavirus and severe acute respiratory syndrome coronavirus-2 have also been associated with gastrointestinal symptoms in children. Although digestive tract has been recognized as an infection route, it has not been possible to fully investigate the association between HCoVs infection and the gastrointestinal symptoms because of the limited number of pediatric cases. Furthermore, pathologic features have not been clear. Till now, our knowledge of severe acute respiratory syndrome coronavirus-2 is limited. However, diarrhea and vomiting have been seen in pediatric cases, particularly in newborns and infants. It has been necessary to pay more attention on gastrointestinal transmission to identify the infected children early and avoid the children without apparent or mild symptoms becoming the sources of infection.
Objective
The overall prognosis of benign convulsions associated with mild gastroenteritis (CwG) is favorable, and the incidence of afebrile seizure recurrence with or without gastroenteritis (ASwGI ...and ASwoGI, respectively) is low. In this study we investigated the prognostic factors associated with afebrile seizure (AS) relapse after the first CwG episode.
Methods
A hospital‐based cohort with an initial CwG episode from January 2012 to October 2019 was followed for at least 19 months. The relapse types were divided into ASwGI and ASwoGI. Logistic regression analysis was performed to identify the independent prognostic factors for the recurrence of AS after the initial CwG episode. Furthermore, the clinical characteristics between ASwGI and ASwoGI were compared.
Results
Among the 868 patients enrolled, 67 (7.7%) experienced a second AS and 71% (48/67) showed gastroenteritis‐associated recurrence. Except for five patients with subsequent epilepsy (0.6%), only eight (0.9%) experienced three seizure episodes. The independent predictive factors for the subsequent recurrence of AS were age less than 18 months at onset (odds ratio OR: 2.93, 95% confidence interval CI: 1.53–5.63), repeated seizures over 24 h (OR: 4.09, 95% CI: 2.19–7.65), and absence of fever (OR: 2.33, 95% CI: 1.26–4.33) during the first CwG episode. The probability of recurrence of AS for those with one, two, and three predictive factors was 3.23%, 13.35%, and 22.85%, respectively. In addition, the age at onset was significantly lower in the ASwoGI group than in the ASwGI group during the first episode (p < .05).
Significance
The risk of AS relapse after the initial CwG episode is low, and the majority of patients presented with gastroenteritis. The risk can be predicted by age at onset, repeated seizures over 24 h, and absence of fever during the first CwG episode.
ABSTRACT
Objectives:
Eosinophilic esophagitis (EoE) is a chronic antigen‐mediated immune disorder of the esophagus. Consensus guidelines recommend obtaining esophageal, gastric, and duodenal biopsies ...at diagnostic endoscopy when EoE is suspected. The utility of repeated gastric and duodenal biopsies during follow‐up endoscopy in patients previously diagnosed with EoE is not established. The aim of the present study was to explore the role of gastric and duodenal biopsies in children with an established diagnosis of EoE undergoing repeat endoscopy to assess histological response to treatment.
Methods:
Retrospective chart review of children diagnosed with EoE at a tertiary care center was conducted. A total of 160 patients with EoE with demographic clinical, endoscopic, and histological data at diagnosis and follow‐up endoscopy were included. The frequency of gastric and duodenal biopsies at follow‐up endoscopy with abnormal histology and their correlation to endoscopic findings was determined.
Results:
At follow‐up endoscopy, 83% (132/160) of patients had gastric and 74% (118/160) had duodenal biopsies. Histology was normal in 81% of gastric and 92% of duodenal biopsies. The most frequent gastric abnormalities were chemical and inactive chronic gastritis. The most frequent duodenal abnormality was villous blunting with increased intraepithelial lymphocytes. Two patients with normal gastric and duodenal histology progressed to eosinophilic gastroenteritis at follow‐up endoscopy.
Conclusions:
Gastric and duodenal biopsies obtained in EoE patients during follow‐up endoscopy show pathology in a minority of patients, increase costs, and may add potential risk of adverse events. Large multicenter, prospective studies of endoscopic practice during follow‐up of EoE are warranted to provide evidence supporting best practices.
We compared the Allplex Gastrointestinal V/B1/B2 Assays and Seeplex Diarrhea V/B1/B2 ACE Detection Assays in patients with acute gastroenteritis (AGE). Of the total 432 specimens, 48.8% and 54.9% ...samples were positive for any bacterial or viral target using Seeplex and Allplex, respectively (P = 0.002). The overall percent agreement (OPA) between the two panels was >95% and the lowest OPA was 95.4% for CdB. Allplex identified 40 samples positive for Salmonella spp., while Seeplex and OBC identified only 27 (67.5%) and 8 (20%), respectively. Shigella spp. were detected by assays in six samples, but none were identified using culture. Clostridium perfringens with Seeplex was detected in 70 (16.2%). It remained an informative species in identifying AGE although cpe gene showed only 9.8% positivity. Pathogenic Escherichia coli with Allplex could be detected in 40 (9.3%) samples, which could provide valuable information for the diagnosis of AGE.
During 1997-2004, microbiologically confirmed gastrointestinal infections were reported for 101,855 patients in Sweden. Among patients who had Salmonella infection (n = 34,664), we found an increased ...risk for aortic aneurysm (standardized incidence ratio SIR 6.4, 95% confidence interval CI 3.1-11.8) within 3 months after infection and an elevated risk for ulcerative colitis (SIR 3.2, 95% CI 2.2-4.6) within 1 year after infection. We also found this elevated risk for ulcerative colitis among Campylobacter infections (n = 57,425; SIR 2.8, 95% CI 2.0-3.8). Within 1 year, we found an increased risk for reactive arthritis among patients with Yersinia enteritis (n = 5,133; SIR 47.0, 95% CI 21.5-89.2), Salmonella infection (SIR 18.2, 95% CI 12.0-26.5), and Campylobacter infection (SIR 6.3, 95% CI 3.5-10.4). Acute gastroenteritis is sometimes associated with disease manifestations from several organ systems that may require hospitalization of patients.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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