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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent studies have suggested that Plesiomonas shigelloides is a cause of diarrhea. The present study addresses the clinical features, epidemiology, and response to antimicrobial therapy of P. shigelloides diarrhea. Thirty cases of P. shigelloides infection were defined by isolation of the organism from stool specimens, and 30 age-matched control patients were identified by detection of other enteric pathogens. Clinical and epidemiological information was obtained by interviewing the referring physicians and the patients. Of the P. shigelloides-infected patients, 71% had a history of recent tropical travel, but 29% acquired their infections locally in association with the consumption of seafood or untreated water or both. Seventy-eight percent of the P. shigelloides-infected patients had findings suggestive of colitis, and P. shigelloides-infected patients had a history of tropical travel, acute illness, abdominal pain, and prolonged symptoms significantly more often than did the control patients. Antimicrobial therapy significantly reduced the duration of illness in patients with Plesiomonas diarrhea. These results suggest that P. shigelloides is a significant cause of both locally acquired and traveler's diarrhea that may respond to antimicrobial therapy.
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PMID:Clinical features, epidemiology, and treatment of Plesiomonas shigelloides diarrhea. 274 7

To evaluate factors which might contribute to treatment failure in children with chronic constipation and soiling, we evaluated the history, physical findings, defecation dynamics, and anorectal function in 97 patients. We treated them with milk of magnesia, high fibre diet, and bowel training techniques and evaluated outcome at one year when 43% had recovered. Recovery rates were similar for boys and girls. Fifty seven per cent of the patients had not recovered. This group at the outset had more frequent soiling episodes, more severe constipation, were less likely to defecate water filled rectal balloons and to relax the external sphincter during defecation. In general girls had more severe constipation, abdominal pain, and a previous urinary tract infection than boys. Girls were more compliant during treatment and had less frequent soiling episodes at one year. Stepwise logistic regression showed that severe constipation, abnormal contraction of the external sphincter and pelvic floor during attempted defecation, and inability to defecate the 100 ml balloon in less than or equal to 1 min was significantly related to treatment failure. Defecation of smaller balloons, volumes for threshold of rectal sensation, critical volume and rectal contraction, and compliance with treatment could not predict treatment failure.
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PMID:Factors determining outcome in children with chronic constipation and faecal soiling. 275 95

Diarrhoea, abdominal pain, malaise and fever affected 75 of the 88 conscript soldiers in Utti, Finland after an outdoors infantry drill. Campylobacter jejuni, heat-stable serotype 3/43/59, was isolated from 37 out of 63 men investigated. A clear serological response was evident in the risk group and negligible in the control group. The entire population at risk was interviewed. The outbreak was associated with the consumption of untreated surface water. C. jejuni, heat-stable serotype 3/43/59, was isolated on two occasions from the water source.
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PMID:Waterborne outbreak of Campylobacter enteritis after outdoors infantry drill in Utti, Finland. 277 48

Thirteen patients with Aeromonas species septicemia were seen at Westmead Hospital between 1983 and 1987. In 10 patients (77%) septicemia was caused by A. sobria, and in 3 (23%) by A. hydrophila, A. caviae was not isolated. Chronic underlying illness was present in 10 patients (77%), hematological malignancy being the most common (46%). The average age of the patients was 65.8 years. Seven patients (54%) presented with clinical sepsis, diarrhea and abdominal pain. The biliary tract, lung and soft tissue were other primary sites of infection. Nosocomial infection occurred in 5 patients (38%). Cross-infection was not seen. Contact with fresh water or fish was observed in only 2 patients (15%). The majority of cases occurred in the warmer months of the year. The overall mortality was 46%. All isolates of Aeromonas species were resistant to ampicillin 8 mg/L. Ten isolates were resistant to tobramycin 1 mg/L, and 3 to tobramycin 4 mg/L. In contrast, 3 isolates were resistant to gentamicin 1 mg/L, and none to 4 mg/L. The isolates showed a varied pattern of resistance to other antibiotics tested, but all were susceptible to piperacillin 64 mg/L, imipenem 4 mg/L, ciprofloxacin 1 mg/L, and amikacin 16 mg/L.
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PMID:Aeromonas septicemia: relationship of species and clinical features. 281 70

Meconium ileus equivalent (MIE) can be defined as a clinical manifestation in cystic fibrosis (CF) patients caused by acute intestinal obstruction by putty-like faecal material in the cecum or terminal ileum. A broader definition includes a more chronic condition in CF patients with abdominal pain and a coecal mass which may eventually pass spontaneously. The condition occurs only in CF patients with exocrine pancreatic insufficiency (EPI). It has not been seen in other CF patients nor in non-CF patients with EPI. The frequency of these symptoms has been reported as 2.4%-25%. Pathophysiologically, MIE is probably caused by a combination of EPI, increased intestinal transit time, and abnormal intestinal mucus. The treatment should primarily be non-operative. Specific treatment with N-acetylcysteine, administrated orally and/or as an enema is recommended. Enemas with the water soluble contrast medium, meglucamine diatrizoate (Gastrografin), provide an alternative form for treatment and can also serve diagnostic purposes. It is important that the physician is familiar with this disease entity and the appropriate treatment with the above mentioned drugs. Non-operative treatment is often effective, and dangerous complications following surgery can thus be avoided.
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PMID:[Meconium ileus equivalent]. 291 55

A phase I study was carried out on a new water-soluble nitrosourea, 6-deoxy-3,5 di-O-methyl 6-(3 methyl-3-nitrosoureido)-alpha-D-glucofuranoside (EDMN, CGP 6809), given every 2 weeks. A total of 18 patients received doses of 1, 2, 3, and 3.75 g/m2 as a 2- to 5-h infusion. Toxicity principally involved nausea and vomiting, hepatotoxicity, and abdominal pain. There was no evidence of cumulative toxicity. The dose of 3.75 g/m2 was not exceeded because in a previous phase I study, 4.5 g/m2 every 6 weeks was not tolerated; the recommended dose for phase II studies is 3.75 g/m2 every 2 weeks.
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PMID:Phase I trial of a new nitrosourea, CGP 6809, given every 2 weeks. 292 83

A retrospective review of 108 consecutive patients with perforated typhoid enteritis managed operatively over a 4-year period at Baptist Medical Centre, Ogbomoso, Nigeria is presented. There were 75 males and 33 females with an average age of 19.7 years. Presenting symptoms were fever, abdominal pain, vomiting, and either diarrhea or constipation. One hundred patients (93 percent) underwent debridement of the perforation and two-layer bowel closure. Postoperative morbidity included intraabdominal abscess, wound dehiscence, and subsequent bowel perforation. Most of the 35 deaths (32 percent mortality) were attributed to overwhelming sepsis which progressed despite aggressive operative management and antibiotic administration. The key to improved survival in this deadly disease lies not in a better operation or improved perioperative care but in the prevention of typhoid fever by providing safe drinking water and improved sanitation methods for all of the global community.
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PMID:Perforated typhoid enteritis: operative experience with 108 cases. 292 66

In July 1982, an outbreak of pharyngitis caused by adenovirus type 7a occurred among children in a small town in western Oklahoma. Predominant symptoms were fever and sore throat (by case definition), headache (83%), abdominal pain (64%), and conjunctivitis (51%). At least 77 persons were identified whose symptoms met the case definition for illness. Onsets of illness peaked during the week of July 5 to 12, and the outbreak resolved within three weeks. A systematic telephone survey of the town revealed that persons who had swum at the community swimming pool were more likely to be ill than those who had not (P less than .001). A second survey of families with season passes to the pool showed that among swimmers, illness was directly related to average number of hours of exposure to the pool each week (P less than .001 by chi-square for trend). In addition, swimmers who reported swallowing pool water were more likely to be ill (29 of 56, 52%) than persons who did not (ten of 41, 24%) (P = .01). Throat-swab specimens from five of seven ill persons (71%) grew adenovirus 7a compared with one of 12 well persons (8%) (P = .01). The pool chlorinator had reportedly malfunctioned during early July. The outbreak resolved with proper operation of the chlorination system. Swimming pools continue to be a potential source of community-wide outbreaks of adenovirus infections.
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PMID:Community outbreak of adenovirus type 7a infections associated with a swimming pool. 303 27

For evaluation of the efficacy of early treatment with ampicillin on the clinical course of Yersinia pseudotuberculosis infection in children, 136 patients were randomly assigned to receive either ampicillin or placebo. Subjects were those who were diagnosed as having Kawasaki syndrome and those who satisfied three of the following four criteria: fever; rash; abdominal symptoms; and a history of ingestion of untreated drinking water. Fifty-six patients had evidence of Y. pseudotuberculosis infection bacteriologically and/or serologically. Twenty-six were assigned to placebo and 28 to ampicillin. Ampicillin therapy did not show a significant benefit in shortening the duration of fever, diarrhea and abdominal pain or in preventing rash, erythema nodosum and acute renal failure. After 5 days of treatment none of the patients in the ampicillin group excreted the organism in the stool whereas 19 (90%) of 21 in the placebo group did (P less than 0.001). Ampicillin did not show a clinical benefit but reduced the fecal excretion of the organism.
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PMID:Ampicillin vs. placebo for Yersinia pseudotuberculosis infection in children. 305 77

It is a common clinical practice to initiate enteral hyperalimentation using low flow rates or diluted formula. These adjustments are made in an effort to minimize patient intolerance. Using complex and elemental enteral formulas, we investigated whether various flow rates or osmolalities effected clinical intolerance or carbohydrate malabsorption in 20 healthy volunteers. Our infusion rates ranged between 50 and 150 kcal/hr and the osmolalities ranged between 325 and 690 mOsm/Kg of water. Even at the maximal flow rate and osmolality, our results show that both types of enteral formulas were well tolerated as assessed by the frequency of abdominal pain, bloating, passage of rectal gas and stooling. No carbohydrate malabsorption was detected as measured by breath hydrogen. In well nourished subjects, our findings do not support the common clinical practice of initiating alimentation with low flow rates or diluted formula.
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PMID:Effect of enteral formula infusion rate, osmolality, and chemical composition upon clinical tolerance and carbohydrate absorption in normal subjects. 309 2


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