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Query: UMLS:C0017536 (giardiasis)
 1,714 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clostridium difficile has been associated with diarrhea in hospitalized patients receiving antibiotic therapy, and may be nosocomially acquired. Rehabilitation hospital inpatients may require frequent antibiotic intervention and are thus at risk, though few reports of epidemics at such centers have been published. This study describes the evaluation and prevalence of C difficile-related disease, among rehabilitation hospital inpatients. A retrospective review was conducted of all diarrhea evaluations performed among inpatients in two freestanding rehabilitation hospitals over a two-year period. A total of 303 laboratory tests were performed among the 115 patients evaluated. C difficile was determined to be the etiologic agent of diarrhea in 25% of patients undergoing enteric evaluation, and in 39% of patients specifically assayed for C difficile toxin B. Giardiasis was detected in one patient, and no evidence of Salmonella, Shigella, Campylobacter, or Yersinia infection was found. The estimated prevalences for diarrhea and C difficile-related disease were 3.7% and 1.1%, respectively. Thus, C difficile is an important cause of diarrhea among rehabilitation hospital inpatients, though its true prevalence may be underestimated due to inadequate diagnostic evaluation. Enteric bacterial pathogens such as Campylobacter, Salmonella, Shigella, Yersinia, and Giardia are insignificant causes of diarrhea among these patients. Elimination of routine testing for these pathogens would reduce costs without compromising diagnostic utility. Diagnostic evaluation should include C difficile toxin assay, and if positive, appropriate therapy instituted.
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PMID:Clostridium difficile-related disease: evaluation and prevalence among inpatients with diarrhea in two freestanding rehabilitation hospitals. 826 89

Acute diarrhoeal diseases are an important cause of morbidity and mortality, particularly in children. Acute diarrhoea may be watery, where features of dehydration are more prominent or dysenteric, where the stools contain blood and mucous. Rehydration therapy is the key to the management of acute watery diarrhoea, whereas antibiotics play a vital role in the management of acute invasive diarrhoea, particularly shigellosis. Rehydration may be done either by the oral or intravenous routes depending upon the degree of dehydration. Oral rehydration salt solution of WHO formula is recommended for oral rehydration therapy (ORT). Ringer's lactate is the ideal intravenous fluid for correction of severe dehydration due to diarrhoea. Antibiotic therapy is beneficial for cholera and shigellosis only. Antiparasitic agents are indicated only if amoebiasis or giardiasis is present. Antidiarrhoeals are of no benefit for the treatment of acute diarrhoea. Appropriate feeding during diarrhoea is recommended with beneficial outcome.
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PMID:Management of acute diarrhoea. 878 11

We review the pathophysiology of intestinal water and electrolyte transport leading to diarrhoea, the currently available pharmacological strategies for its treatment, and the economic implications of such treatments. Diarrhoea occurs most frequently and is associated with highest mortality in children under 5. Oral rehydration therapy (ORT) is the cornerstone of its management. The safety and efficacy of ORT in the prevention of death from dehydration, both in field and also in hospital settings, are now well established. Because it is also inexpensive, ORT is widely applicable worldwide. More recently, rice-based ORT has emerged, based on well known traditional remedies for diarrhoea in southeast Asia and the Far East. Rice-based ORT has the advantage of being more culturally acceptable, readily available even in rural homes in developing countries, and is more effective in reducing stool output and the duration of diarrhoea, compared with conventional glucose-electrolyte solutions such as World Health Organization ORT. For infants, the well known antidiarrhoeal properties of human milk needs emphasis for a variety of reasons including economic ones. Data concerning the economic benefits to a nations' health budget as a result of nationwide implementation of oral rehydration solution (ORS) use are limited. Available data from individual centres in developing countries, if projected to national level, would incur considerable economic advantage. Except for a few notable infections such as shigellosis, cholera, amoebiasis and giardiasis, the widespread use of antibiotics in acute diarrhoea, still a common practice in many developing countries, has no proven value and may be detrimental. The economic implications of antibiotic abuse in the treatment of diarrhoea in developing countries is enormous. Despite the availability of a wide spectrum of pharmacological agents for diarrhoea reviewed in this article, only a few such agents are of proven clinical efficacy: corticosteroids, aminosalicylates and immunosuppressants in the treatment of inflammatory bowel disease and opioid derivatives such as loperamide which may be useful in protracted diarrhoea in children and in disorders where rapid gastrointestinal transit is the main cause of diarrhoea. Opioids are not recommended for acute infective diarrhoea in childhood. Octreotide, a somatostatin analogue, is reported to be useful in the treatment of secretory diarrhoea due to noninfective causes and in the treatment of intractable diarrhoea associated with AIDS. Its high cost and need for parenteral administration prevent its wider application.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pharmacoeconomics of the therapy of diarrhoeal disease. 1015 Jan 56

Diarrheal diseases remain an important cause of childhood morbidity and death in developing countries, although diarrheal deaths have significantly declined in recent years, mostly due to successes in the implementation of oral rehydration therapy (ORT), which is the principal treatment modality. Diarrhea may occur for varied reasons; however, most episodes of diarrhea in developing countries are infectious in origin. Three clinical forms of diarrhea (acute watery diarrhea, invasive diarrhea, and persistent diarrhea) have been identified to formulate a management plan. Acute diarrhea may be watery (where features of dehydration are prominent) or dysenteric (where stools contain blood and mucus). Rehydration therapy is the key to management of acute watery diarrhea, whereas antimicrobial agents play a vital role in the management of acute invasive diarrhea, particularly shigellosis and amebiasis. In persistent diarrhea, nutritional therapy, including dietary manipulations, is a very important aspect in its management, in addition to rehydration therapy. Rehydration may be carried out either by the oral or intravenous route, depending upon the degree of dehydration. Oral rehydration salts (ORS) solution (World Health Organization formula) is recommended for ORT. Intravenous fluid is recommended for initial management of severe dehydration due to diarrhea, followed by ORT with ORS solution for correction of ongoing fluid losses. Antimicrobial therapy is beneficial for cholera and shigellosis. Antiparasitic agents are indicated only if amebiasis and giardiasis are present. Appropriate feeding during diarrhea is recommended for nutritional recovery and to prevent bodyweight loss. Antidiarrheal agents do not provide additional benefit in the management of infectious diarrhea. Although some probiotics have been shown to be beneficial in the treatment of acute diarrhea due to rotavirus, their use in the treatment of diarrhea is yet to be recommended, even in developed countries. The children of developing countries might benefit from zinc supplementation during the diarrheal illness, but its mode of delivery and cost effectiveness are yet to be decided.
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PMID:Treatment of infectious diarrhea in children. 1260 80

Swimming is the second most popular exercise activity in the United States, with approximately 360 million annual visits to recreational water venues (1). This exposure increases the potential for the spread of recreational water illnesses (RWIs) (e.g., cryptosporidiosis, giardiasis, and shigellosis). Since the 1980s, the number of reported RWI outbreaks has increased steadily (2). Local environmental health programs inspect public and semipublic pools periodically to determine compliance with local and state health regulations. During inspections for regulatory compliance, data pertaining to pool water chemistry, filtration and recirculation systems, and management and operations are collected. This report summarizes pool inspection data from databases at six sites across the United States collected during May 1--September 1, 2002. The findings underscore the utility of these data for public-health decision making and the need for increased training and vigilance by pool operators to ensure high-quality swimming pool water for use by the public.
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PMID:Surveillance data from swimming pool inspections--selected states and counties, United States, May--September 2002. 1280 97

The health impact of utilization of raw domestic sewage for vegetable cultivation in the suburbs of Asmara, Eritrea, was assessed. Results showed heavy contamination of vegetables by fecal coliforms and Giardia cysts as well as other pathogenic bacteria such as Shigella and Salmonella. Stool samples from 75 occupationally exposed farmers revealed that 45% of them were harboring Giardia cysts. Dietary intake of raw greens (lettuce, cabbage) grown on the raw sewage appears to cause giardiasis, amebiasis, and diarrhea in the farming community as well as in the surrounding area. Comparison of hospital data from the affected area with data from other areas of Eritrea indicated that agriculture use of untreated wastewater was the major cause of the increase in giardiasis and other gastrointestinal diseases.
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PMID:Health effects of wastewater reuse for agriculture in the suburbs of Asmara city, Eritrea. 1547 82

Men who have sex with men (MSM) are a priority population for HIV care and prevention programs. This report describes HIV and other sexually transmitted disease (STD) trends among MSM in metropolitan Atlanta by analyzing nine databases. We describe the use of the male-to-female (M:F) ratio, a surrogate marker for MSM in databases without standardized MSM variables that is recommended as an indirect measure of HIV risk behavior in the CDC/HRSA Integrated Guidelines for Developing Epidemiologic Profiles. During 1997 to 2001, there were increases among MSM for reported syphilis (from 9% to 17%), anti-biotic-resistant gonorrhea (from 4.8% to 8.6%), and HIV seroprevalence (from 33% to 43%). During 1998 to 2001, the M:F ratio for cases peaked at 12:1 during a hepatitis A outbreak among MSM, increased for shigellosis (from 1:0 to 18:1) and giardiasis (from 1.7 to 2.1), and did not appreciably change for hepatitis B, salmonellosis, or chlamydia. HIV and several other STDs appear to have increased among MSM in metropolitan Atlanta. When standardized MSM variables are not available, an M:F ratio is useful.
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PMID:Trends in infectious diseases and the male to female ratio: possible clues to changes in behavior among men who have sex with men. 1640 Nov 82

In the less developed nations, hygiene and sanitation remain overriding factors in population health and the burden of waterborne disease. Both morbidity and mortality from diseases, such as cholera, remain high, but the overwhelming burden of diarrhoeal diseases inevitably goes undiagnosed. Enterotoxic E. coli, shigellosis and campylobacteriosis are prevalent amongst bacterial diseases and giardiasis is often diagnosed among protozoan diseases. In terms of viral diseases, hepatitis A is frequently associated with water and rotavirus, and more recently norovirus, infections are suspected to be major causes of gastroenteritis, although they are seldom diagnosed. From the perspective of research and training, and despite the efforts of major international organizations, effective programs that teach basic hygiene and sanitation remain elusive.
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PMID:Emerging issues in water and health research. 1649

Large outbreaks of giardiasis caused by person-to-person transmission, or a combination of transmission routes, have not previously been reported. A large, prolonged giardiasis outbreak affected families belonging to a country club in a suburb of Boston, Massachusetts, during June-December 2003. We conducted a retrospective cohort study to determine the source of this outbreak. Giardiasis-compatible illness was experienced by 149 (25%) respondents to a questionnaire, and was laboratory confirmed in 97 (65%) of these cases. Of the 30 primary cases, exposure to the children's pool at the country club was significantly associated with illness (risk ratio 3.3, 95% confidence interval 1.7-6.5). In addition, 105 secondary cases probably resulted from person-to-person spread; 14 cases did not report an onset date. This outbreak illustrates the potential for Giardia to spread through multiple modes of transmission, with a common-source outbreak caused by exposure to a contaminated water source resulting in subsequent prolonged propagation through person-to-person transmission in the community. This capacity for a common-source outbreak to continue propagation through secondary person-to-person spread has been reported with Shigella and Cryptosporidium and may also be a feature of other enteric pathogens having low infectious doses.
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PMID:Prolonged outbreak of giardiasis with two modes of transmission. 1656 69

Surveillance of imported infectious diseases is important because of the need for early detection of outbreaks of international concern as well as information of risk to the travelers. This paper attempts to review how the Japanese surveillance system deals with imported infectious diseases and reviews the trend of these diseases. The cases of acquired infection overseas were extracted from the surveillance data in 1999-2008. The incidence and rate of imported cases of a series of infectious diseases with more than one imported case were observed by the year of diagnosis and place of acquired infection. During the period 10,030 cases that could be considered to be imported infectious diseases were identified. Shigellosis ranked as the most common imported disease, followed by amebiasis, malaria, enterohemorrhagic Escherichia coli infection and the acquired immunodeficiency syndrome, typhoid fever, dengue fever, hepatitis A, giardiasis, cholera, and paratyphoid fever. The annual trends of these diseases always fluctuated but not every change was investigated. The study reveals that the situation of imported infectious diseases can be identified in the current Japanese surveillance system with epidemiologic features of both temporal and geographic distribution of cases of imported infectious diseases. However, further timely investigation for unusual increase in infectious diseases is needed.
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PMID:Imported infectious diseases and surveillance in Japan. 1898 79


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