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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In an outbreak of small round structured virus (SRSV) gastroenteritis at an international AIDS conference 67 people were ill with diarrhoea or vomiting, one requiring admission to hospital. Epidemiological investigations demonstrated that the vehicle of infection was food prepared by a foodhandler who was recovering from a mild gastrointestinal illness. The food most strongly associated with illness, coronation chicken, was prepared by the food handler on the second day after symptoms ceased. The investigation confirms the view that foodhandlers may contaminate food with SRSVs after cessation of symptoms and should remain off work until at least 48 h after recovery.
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PMID:Outbreak of SRSV gastroenteritis at an international conference traced to food handled by a post-symptomatic caterer. 839 41

There is considerable mortality in sub-Saharan Africa relative to other regions in the world. No country in Africa, however, has a system of vital registration capable of providing reliable national data on mortality. Accurate information on the causes of adult mortality is therefore very limited. This lack of knowledge is becoming especially important in light of the impact HIV infection and AIDS are having in many sub-Saharan African countries. The authors documented the pattern of adult medical deaths in Queen Elizabeth Central Hospital, Blantyre, Malawi between April 1992 and March 1993. Their findings were then compared with data on mortality collected from the same wards in 1973, before the AIDS pandemic. Tuberculosis (TB) and AIDS together accounted for 49% of all medical deaths in 1992-93, with 82% of deaths occurring among individuals aged 13-49 years. TB, AIDS, gastroenteritis, pneumonia, pyogenic meningitis, and septicemia were the most important causes of death. In 1973, TB was responsible for 13% of deaths and there were no deaths due to AIDS. The authors note that the predicted upsurge in the level of AIDS-related mortality in sub-Saharan Africa during the 1990s will have grave consequences for the health sector, as well as for the social and economic fabric of the countries concerned.
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PMID:The changing pattern of mortality in an African medical ward. 856 May 90

We report the microbiological characteristics of two Rahnella aquatilis strains isolated in the faeces of two patients with acute gastroenteritis, one of whom is an AIDS patient. The biochemical behaviour was studied with different automated identification systems, and the few clinical cases to be found in the literature were reviewed. Of the nine strains isolated in clinical samples, two were obtained from blood cultures, two from respiratory samples, one from urine, one from a burn wound, one from a surgical wound, and two (our strains) from faeces. In almost all cases the patient presented an underlying condition facilitating infection by opportunistic microorganisms. The majority of strains are characterized by their resistance to ampicillin, cephalothin and cefoxitin. Due to the rarity of the isolation of R. aquatilis in human samples it is not yet possible to establish, with any degree of certainty, its true pathogenic capacity.
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PMID:Clinical and microbiological characteristics of Rahnella aquatilis strains isolated from children. 889 4

The prevalence of enteric viruses associated with gastroenteritis was determined in 125 stool samples from patients infected with the human immunodeficiency virus (HIV), with or without diarrhea. Diagnostic assays included enzyme immunoassays for the identification of rotavirus, adenovirus, and Norwalk virus; polyacrylamide gel electrophoresis for atypical rotaviruses and picobirnaviruses and polymerase chain reaction for astrovirus. Enteric viruses were detected in 6.4% (8 of 125) of the stools collected: five (4.0%) samples positive for adenoviruses, and three (2.3%) samples positive for picobirnaviruses were detected. No rotavirus, astrovirus, or Norwalk virus were observed. Only one of the viruses identified (adenovirus) was found in a sample from a patient with diarrhea. Viruses were detected in 10% of the patients with AIDS, 14% of the symptomatic patients, and none of the asymptomatic persons. These results do not support a major role for enteric viruses in the diarrhea suffered by HIV-infected patients.
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PMID:Prevalence of enteric viruses in human immunodeficiency virus seropositive patients in Venezuela. 966 37

Nutrition is a final common pathway in chronic disease, and weight loss is a major manifestation of acquired immunodeficiency syndrome (AIDS). In sub-Saharan Africa, studies have shown that 25% of children with malnutrition have human immunodeficiency virus (HIV) infection, although patterns of malnutrition are indistinguishable from those who are HIV negative. Breast-feeding increases the risk of vertical transmission, and the overall risk versus benefit needs continuing careful consideration in relation to local mortality from gastroenteritis and malnutrition. Chronic diarrhea is much more common in HIV-infected children in Africa and may have a multiplicity of causes, including infection with adherent forms of Escherichia coli, protozoa, and even direct HIV infection of intestinal mucosal cells. The HIV wasting syndrome produces reduction in bioelectrical impedence, fat, lean body mass, and body cell mass, but the changes can be predicted from equations used in starvation states. Micronutrients may be important, but observed changes may be due to immune mediator activation, rather than malnutrition. Calorie supplementation is beneficial when delivered by any route, but is likely to produce the greatest positive change when CD4 counts are highest in relation to calorie intake. Paradoxically, HIV-infected children may be obese early in the disease until AIDS develops. There is an inextricable link between disease and nutritional status. In children with AIDS wasting syndrome, a low CD4 count and high viral load are likely so that effective antiviral treatment may ultimately produce the greatest improvement in health, including nutritional status.
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PMID:Global issues in pediatric nutrition: AIDS. 978 58

To evaluate the applicability of disability adjusted life-years (DALYs) as a measure to compare positive and negative health effects of drinking water disinfection, we conducted a case study involving a hypothetical drinking water supply from surface water. This drinking water supply is typical in The Netherlands. We compared the reduction of the risk of infection with Cryptosporidium parvum by ozonation of water to the concomitant increase in risk of renal cell cancer arising from the production of bromate. We applied clinical, epidemiologic, and toxicologic data on morbidity and mortality to calculate the net health benefit in DALYs. We estimated the median risk of infection with C. parvum as 10(-3)/person-year. Ozonation reduces the median risk in the baseline approximately 7-fold, but bromate is produced in a concentration above current guideline levels. However, the health benefits of preventing gastroenteritis in the general population and premature death in patients with acquired immunodeficiency syndrome outweigh health losses by premature death from renal cell cancer by a factor of > 10. The net benefit is approximately 1 DALY/million person-years. The application of DALYs in principle allows us to more explicitly compare the public health risks and benefits of different management options. In practice, the application of DALYs may be hampered by the substantial degree of uncertainty, as is typical for risk assessment.
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PMID:Balancing the risks and benefits of drinking water disinfection: disability adjusted life-years on the scale. 1075 89

Adenovirus infections have been reported in as many as one-fifth of bone marrow transplant (BMT) recipients and patients with acquired immunodeficiency syndrome (AIDS), and in a lesser, though still prominent, proportion of organ transplant recipients. The relative contributions of primary infections versus reactivations from latency in immunocompromised patients remain unclear. Compared with adult BMT recipients, pediatric BMT recipients appear to be infected by adenovirus more frequently and earlier in the post-transplant period. The diagnosis of adenovirus infection is complicated by the existence of > 40 viral serotypes, although certain subgroups are more likely to be involved in certain patient populations. Adenoviruses are responsible for a broad range of clinical diseases that may be associated with high mortality, including pneumonia, hepatitis, encephalitis, hemorrhagic cystitis, and gastroenteritis. The clinical and histopathologic features of adenovirus disease may resemble those of cytomegalovirus disease, potentially complicating the diagnosis. Risk factors for clinical adenovirus disease include the number of sites from which the virus is cultured and, in BMT recipients, the presence of moderate to severe acute graft-versus-host disease.
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PMID:Adenovirus infections in immunocompromised patients. 1086 46

There is a continuous change in viral epidemics with respect to clinical symptoms, their duration or disappearance and the emergence of new diseases. This can be observed both in human and animal diseases. This evolution of virus diseases is mainly related to three factors: etiological agent, host and environment. As far as genetic alterations of the virus are concerned, two major mechanisms are involved: 1) mutations such as recombination and reassortment; 2) selection for resistance or susceptibility. The epidemiology of newly emerged virus diseases in man and animals, such as AIDS and hemorrhagic fevers, and bovine spongiform encephalopathy (BSE), canine hemorrhagic gastroenteritis or respiratory syndrome in horses will be discussed.
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PMID:Recent developments in the epidemiology of virus diseases and BSE. 1088 27

Cytomegalovirus (CMV) can be an important opportunistic infection in HIV-1-infected patients, particularly when the CD4+ T-cell count drops below 50 lymphocytes/mm3. CMV-associated disease, including retinitis, pneumonitis, gastroenteritis, and encephalitis, is estimated to affect up to 40% of AIDS patients. We have studied the cellular immune response to CMV in gut-associated lymphoid tissue (GALT) of HIV-1-infected patients. Two patients with chronic diarrhea of unknown etiology were examined by flexible sigmoidoscopy and upper endoscopy. Biopsy specimens were obtained from lymphoid-associated tissue sites in rectum and duodenum. Both patients were seropositive for CMV IgG, but had not been treated with ganciclovir, and neither had clinical signs of CMV disease. Mononuclear cell cultures were established from GALT and blood and assayed for the presence of CMV-specific CD8+ T cells. CD8+ T-cell phenotype and function were assessed by MHC Class I tetramer staining, using an HLA-A*0201 tetramer complex specific for peptide 495-503 (NLVPMVATV) of CMV lower matrix protein pp65, and by a standard 51Cr release assay. CMV pp65-specific cytotoxic lymphocytes (CTL) were detected in GALT and blood MNC from both patients. These results demonstrate that HIV-1-infected subjects seropositive for CMV, but without active CMV gastrointestinal disease, harbor CMV-specific CTL in intestinal lymphoid tissue. This is the first report of isolation of CMV-specific CTL in GALT and will lead to greater understanding of the pathogenesis of CMV disease in human mucosal tissue.
AIDS Res Hum Retroviruses 2000 Aug 10
PMID:Isolation of cytomegalovirus-specific cytotoxic T-lymphocytes from gut-associated lymphoid tissue (GALT) of HIV type 1-infected subjects. 1095 91

Acute gastroenteritis is common in adults. It can occur in institutional epidemics or epidemics of food-borne illness; in these cases, caliciviruses are the major cause of the condition. When acute gastroenteritis occurs in nonepidemic form, its causes are less clear. It may be due to caliciviruses or to the less common serotypes of childhood gastroenteritis viruses, such as rotavirus, astrovirus, and adenovirus. The pathogenesis of acute viral gastroenteritis is not completely understood. Old evidence suggests that mild villus damage is responsible, but new evidence indicates that active secretion and motility disturbance may be involved in the production of symptoms. Five common viruses can remain latent in gastrointestinal tissues and produce disease many years after initial infection. Two major herpesviruses, cytomegalovirus and herpes simplex virus, cause ulcerative disease of the gastrointestinal tract. This disease occurs in healthy persons but is more common and more severe in immunocompromised patients. Three other viruses--Epstein-Barr virus, human papilloma virus, and human herpesvirus-8--are implicated in benign and malignant proliferative diseases of the gastrointestinal tract. Epstein-Barr virus has been associated with immunoproliferative disease after transplantation and may also cause small-bowel and colonic lymphoma in healthy adults. It causes most AIDS-related lymphomas. Human papillomaviruses cause anorectal condyloma and anal cancer. Human herpesvirus-8 causes gastrointestinal Kaposi sarcoma.
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PMID:Viral infections of the gastrointestinal tract. 1098 Sep 63


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