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

A 12-year review identified 21 patients with nontyphoidal, nonparatyphoidal salmonella septicemia. Eight of the patients had no predisposing factors. Factors identified included malignancy in five, recent surgery in four, alcoholism with aspiration pneumonia in two, chronic lung disease in two, diabetes in two, systemic lupus erythematosus in one and burns in one. Ten patients presented with gastroenteritis, two with localized abscesses, two with aspiration pneumonia and the remainder with nonspecific septicemia. Three patients died of underlying diseases and three died shortly after the septicemia of related causes. Six cases were nosocomial infection and were not related to hospital outbreaks. Salmonella septicemia with these serotypes is uncommon (1 per 14,000 admissions, 1 per 4000 blood cultures) and can occur in patients without diminished host resistance.
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PMID:Nontyphoidal, nonparatyphoidal salmonella septicemia in adults. 850 19

Water-soluble derivatives of camptothecin, and active topoisomerase I inhibitor, have shown a broad spectrum of activity against human tumors. Early clinical trials with the water-soluble sodium salt of camptothecin were hindered by significant cystitis, gastroenteritis, and leukopenia. Furthermore, the sodium salt of camptothecin has been shown to have significantly less activity than the water-insoluble lactone form of the compound. We describe a formulation of lipid-complexed CPT (LC-CPT; particle size range 20.8-208.1 nm) that is very easy to prepare and allows for intravenous administration in vivo in clinically relevant lipid-drug ratios (12.5:1 w/w). The lipid formulation had in vitro antitumor activity similar to that of CPT formulated without lipids and displayed similar cytotoxicity against MDR-1-negative and -positive tumor cells. The biodistribution of CPT was profoundly affected by lipid complexation; free CPT achieved the greatest concentration in the pulmonary parenchyma while LC-CPT achieved the highest concentration in the gastrointestinal tract. LC-CPT had significant antitumor activity in vivo against intraperitoneal L1210 and P338 leukemia and appeared to be more potent then free CPT.
Cancer Chemother Pharmacol 1996
PMID:Lipid-complexed camptothecin: formulation and initial biodistribution and antitumor activity studies. 861 6

The occurrence of chronic diarrhea in infants younger than three months suggests disaccharidase deficiency, cow's milk or soy protein intolerance, cystic fibrosis or an immunodeficiency state, while chronic diarrhea in children three to 18 years of age suggests celiac disease, late-onset primary lactose deficiency and inflammatory bowel disease. Gastrointestinal infection is the most common cause of chronic diarrhea in children of all ages. Diarrhea that develops after the introduction of cow's milk, cereals and fruits suggests an enzyme deficiency or protein intolerance. Watery, explosive stools suggest sugar intolerance, and foul-smelling, greasy, bulky stools suggest fat malabsorption. Marked weight loss suggests malabsorption, inflammatory bowel disease, hyperthyroidism or malignancy. The presence of neutrophils or red blood cells in the stool indicates bacterial gastroenteritis or inflammatory bowel disease, while the presence of eosinophils suggests protein intolerance or parasitic infestation. A toddler who is thriving and cheerful despite having diarrhea may have chronic nonspecific diarrhea of childhood.
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PMID:Evaluating the child with chronic diarrhea. 862 43

The authors describe the design of and statistical analyses involved in the Ambulatory Care Medical Audit Demonstration Project, which tested feasibility, cost, and effectiveness of cycles that met quality assurance requirements in eight pediatric and eight general medicine group practices at four teaching hospitals and six health centers. The authors used a concurrent crossover design using randomized cycles of quality assurance so that a practice was a control site for one guideline and an experimental site for another. For 12 months before and 18 months during and after quality assurance experimental interventions, the authors measured practitioner conformance to review criteria for patient-care guidelines believed to improve outcomes, including four internal medicine patient-care guidelines (ie, follow-up of low hematocrit, cancer screening for women, follow-up of high serum glucose, and monitoring of patients treated with digoxin) and four pediatric patient-care guidelines (ie, follow-up of positive urine cultures, screening for disease and immunizing infants, management of acute gastroenteritis, and management of acute ear infection). The authors distinguished review criteria whose performance depended on personal efforts of practitioners from those that concerned performance dependent on the practice's system for reporting test results and calling patients to return for care.
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PMID:The Ambulatory Care Medical Audit Demonstration Project. Research design. 879 86

The purpose of this article was to review the existing literature to define those groups of individuals who would be at the greatest risk of serious illness and mortality from water and foodborne enteric microorganisms. This group was found to include the very young, the elderly, pregnant women, and the immunocompromised. This segment of the population currently represents almost 20% of the population in the United States and is expected to increase significantly by the beginning of the next century, because of increases in life-span and the number of immunocompromised individuals. More than half of documented deaths from gastroenteritis and hepatitis A illness occur in the elderly in developed countries. The overall case fatality ratio for foodborne bacterial gastroenteritis outbreaks in nursing homes is 10 times greater than the general population. Pregnant mothers suffer from a case fatality ratio from hepatitis E infections ten times greater than the general population during waterborne disease outbreaks. Enteric diseases are most common and devastating among the immunocompromised. Cryptosporidium is a serious problem among patients with acquired immuno-deficiency syndrome (AIDS). Cancer patients undergoing chemotherapy and transplant patients, are also at significantly greater risk of dying from enteric viral infections than the general population. This review indicates the need for consideration of enhanced protection for certain segments of the population who will suffer the most from food and waterborne pathogens.
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PMID:Sensitive populations: who is at the greatest risk? 885 78

An enquiry has been made into the causes of admission in 1994 of African patients to Gelukspan Hospital, North West Province, South Africa. The study concerned 3791 patients of whom 3533 (93.2%) were classifiable. Two groups were not included in this number, namely, 1584 'lodgers' (e.g. mothers of infants), and 1868 females admitted for normal pregnancy. Of the 3533 patients, 940 (26.6%) were aged 14 years and younger; 545 (58.0%) these were boys and 395 (42.0%) were girls. The main causes of their admission were pneumonia, gastroenteritis, trauma, poisoning, and infections. Of the 2593 adults, 1418 (54.7%) were males and 1175 (45.3%) females. Among males, chief causes were pulmonary tuberculosis, trauma and accidents, congestive cardiac failure, psychosis, cancer and diabetes. Of the females, chief causes were pulmonary tuberculosis, trauma and accidents, pregnancy related disorders, gastroenteritis, anaemia and pneumonia. Regarding other diseases, 4.5% of adults were admitted for cancer, and 1.8% for diabetes. The general pattern of admissions is similar to that reported in other rural hospitals. The causes of admissions are discussed, regarding; (i) public health improvements occurring, and (ii) means of promoting further improvements by community self-help, and by help from State health and other services.
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PMID:Causes of admission of African patients to Gelukspan Hospital, North West Province, South Africa. 899 67

Over a 23-year period, 17 patients with hematologic diseases developed Aeromonas bacteremia while in our hematology ward. Male predominance (14 patients, 82%) was seen, with a predilection for the elderly. Hematologic malignancies, especially acute leukemia, accounted for 15 (88%) of all patients. Cancer chemotherapy and neutropenia (15 patients each) were the most common preceding host conditions. Aeromonas bacteremia generally occurred in the second half of the year (July-December), with no exposure to water or fish. Seven recent isolates comprised Aeromonas sobria (five isolates) and Aeromonas hydrophila (two isolates). Twelve patients (71%) showed a clinical picture ranging from mild gastroenteritis to severe enterocolitis. Anorectal and hepatobiliary infections were also noted in a few patients. The overall mortality rate was 35%. Ten (77%) of the 13 patients who were treated with aminoglycoside plus cephalosporin or carbapenem survived in association with marrow recovery.
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PMID:Aeromonas bacteremia in patients with hematologic diseases. 914 7

Total body irradiation is being used with increasing frequency for the treatment of lymphopoietic malignancies and in preparation for marrow transplantation. Acute toxicities include reversible gastroenteritis, mucositis, myelosuppression and alopecia. As the success of treatment improves and more patients become long-term survivors, manifestations of delayed and chronic toxicity become evident. These include impairment of growth and development, gonadal failure and sterility, cataract formation and possibly secondary malignancies. The contribution of total body irradition to the development of pneumonitis and pulmonary fibrosis is still poorly understood. Some of these changes are reversible or correctable, whereas others are permanent. Nevertheless, until equally effective but less toxic regimens become available, total body irradiation appears to be the treatment of choice to prepare patients with leukemia for marrow transplantation.
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PMID:Acute and delayed toxicities of total body irradiation. Seattle Marrow Transplant Team. 946 96

Salmonella infections are widespread particularly in tropical zones. Each year, 12.5 million cases of typhoid fever are reported with an incidence of 540 cases for every 100,000 inhabitants in developing countries versus 0.2 cases in industrialized countries. Pleuropulmonary manifestations constitute the most common extra-intestinal manifestation of salmonella infection. Counts are usually carried out in the digestive tract. Respiratory tract manifestations result from blood-borne diffusion from mesenteric lymph nodes, but gastroenteritis goes unnoticed in 2 of 3 cases. Predisposing factors are frequent including cancer, previous graft placement and immunosuppressant therapy, sickle cell disease, alcohol abuse, and pre-existing pulmonary disease. Clinical manifestations are usually acute but subacute forms cannot be ruled out. Cough is a common symptom observed in 25% of patients with typhoid fever. Pneumonia is uncommon overall (1%) but occurs in 50% of patients with pleural effusion, empyema, lung abscess, or bronchopleural fistula. A few cases of adult respiratory distress syndrome have been described in the literature. Recognition is important since these manifestations may signal previously unsuspected underlying pulmonary disease. Treatment requires appropriate antimicrobial therapy and close surveillance to prevent recurrence or complications.
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PMID:[Pleuropulmonary manifestations of salmonellosis]. 1039 2

A 49-year-old man, who had a 3-year history of liver dysfunction but had not been treated, was admitted to the hospital with a sudden onset of fever and generalized muscle pain. He subsequently developed generalized purpura with scattered hemorrhagic bullae of the skin and massive bloody stools. Aeromonas sobria was proven by culture of both blood and bullous fluid. In spite of the extensive treatment with antibiotics and other medications in the intensive care unit (ICU), the patient went into septic shock and died 2 days after admission. Pathological examination on autopsy revealed segmental necrotizing gastroenteritis with bacterial colonies and alcoholic liver cirrhosis, in addition to extensive severe soft tissue damage involving cellulitis and rhabdomyolysis and epidermolysis. Although the prognosis for Vibrio vulnificus infection with severe soft tissue damage in patients with liver cirrhosis, malignancy, diabetes mellitus or other pre-existing diseases is poor, the unfavorable progression of Aeromonas species, especially A. sobria infection is rare. This is thought to be the first report of an autopsied case.
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PMID:Aeromonas sobria infection with severe soft tissue damage and segmental necrotizing gastroenteritis in a patient with alcoholic liver cirrhosis. 1046 97


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