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Toxins ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 62
Author(s):  
Erika N. Biernbaum ◽  
Indira T. Kudva

Foodborne diseases affect an estimated 600 million people worldwide annually, with the majority of these illnesses caused by Norovirus, Vibrio, Listeria, Campylobacter, Salmonella, and Escherichia coli. To elicit infections in humans, bacterial pathogens express a combination of virulence factors and toxins. AB5 toxins are an example of such toxins that can cause various clinical manifestations, including dehydration, diarrhea, kidney damage, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). Treatment of most bacterial foodborne illnesses consists of fluid replacement and antibiotics. However, antibiotics are not recommended for infections caused by Shiga toxin-producing E. coli (STEC) because of the increased risk of HUS development, although there are conflicting views and results in this regard. Lack of effective treatment strategies for STEC infections pose a public health threat during outbreaks; therefore, the debate on antibiotic use for STEC infections could be further explored, along with investigations into antibiotic alternatives. The overall goal of this review is to provide a succinct summary on the mechanisms of action and the pathogenesis of AB5 and related toxins, as expressed by bacterial foodborne pathogens, with a primary focus on Shiga toxins (Stx). The role of Stx in human STEC disease, detection methodologies, and available treatment options are also briefly discussed.


BMC Urology ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Hideki Ban ◽  
Kenichiro Miura ◽  
Rika Tomoeda ◽  
Katsuki Hirai ◽  
Motoshi Hattori

Abstract Background Adenovirus gastroenteritis is a common cause of diarrhea and vomiting in infants, resulting in prerenal acute kidney injury (AKI). However, postrenal AKI due to urinary stones associated with adenovirus gastroenteritis is extremely rare. Here, we describe postrenal AKI due to obstructive ammonium acid urate stones associated with adenovirus gastroenteritis. Case presentation A previously healthy 6-month-old boy had an 11-day history of severe diarrhea and a 5-day history of vomiting. His stool was positive for adenovirus antigens. We initiated fluid replacement therapy. On the second hospital day, he suddenly developed anuria. Abdominal computed tomography revealed bilateral hydronephrosis, left ureteral stones, and right bladder ureteral junction stones. Laboratory data showed that the creatinine level increased to 1.00 mg/dL. We diagnosed postrenal AKI due to obstructive bilateral urinary stones. Urination with stable urine volume resumed spontaneously after hydration. A few stones were found in the urine, which consisted of ammonium acid urate (> 98%). The serum creatinine level improved to 0.25 mg/dL. He was discharged nine days after admission. Conclusions We suggest that adenovirus gastroenteritis be considered in pediatric patients with postrenal AKI due to urinary stones.


Author(s):  
Archana Dhengare ◽  
Savita Pohekar ◽  
Prerana Sakharwade ◽  
Sheetal Sakharkar ◽  
Samrudhi Gujhar ◽  
...  

Typhoid fever is a major health problem globally. Typhoid fever is an enteric fever characterized by systemic illness along with abdominal pain and fever in a "step-ladder" pattern. Typhoid fever is one of the major causes of mortality and morbidity in overcrowded and unhygienic areas though comprehensive research and public health interventions have decreased the occurrence. Patient is having sign symptoms as gastrointestinal symptoms, malaise, hepatomegaly, and high liver enzymes presented with a two-week fever. As a differential diagnosis, a Widal test  is done and two blood cultures were requested; both came out positive, confirming the diagnosis of typhoid fever caused by Salmonella typhi. Treatment with ceftriaxone and metronidazole was stared prior to confirmation of the diagnosis, with a partial response; later, pharmacological therapy was altered based on ciprofloxacin susceptibility testing, with a satisfactory clinical response. We look at how to diagnose and treat enteric fever, with an importance to typhoid fever. Symptoms or important clinical finding:- A 6 year old male was admitted in A.V.B.R.H on date 12/03/2021 with chief complaint of abdominal discomfort, malaise, problems such as  fever since 2 weeks, gastrointestinal symptoms, lethargy, hepatomegaly, and an increased liver enzyme. Diagnosis therapeutic intervention and outcome: A case is diagnosed as Typhoid Fever. After physical examination and investigation, doctor was detected a case of 6 week. Therapeutic intervention and outcome: Also provide a calcium supplements and iron supplements present case was stable but according to ultrasonography finding. Outcome- Good sanitation, improved water supply, and a suitable sewage waste matter system, as well as the successful use of existing typhoid vaccinations, can all help to avoid typhoid fever. Nursing Perspective: Administration fluid replacement .i.e DNS and RL monitored vital signs per hourly. Maintained temperature chart 2 hourly strictly, maintained intake output chart properly. Tablet paracetamol, antibiotics given as per doctor’s order. Conclusion: Good sanitation, improved water supply, and a suitable sewage waste matter  system, as well as the successful use of existing typhoid vaccinations, can all help to avoid typhoid fever.


Author(s):  
Sonali Wawre ◽  
Archana Dhengare ◽  
Pranali Wagh ◽  
Kanchan Bikade ◽  
Aarti Raut ◽  
...  

Background: Little is known about acute and transient psychotic disorders (ATPD), a diagnostic category introduced with ICD-10. Case Presentation: Acute transient psychotic disorder is a heterogeneous group of disorders characterised by the acute onset of psychotic symptoms such as delusion, hallucination and perceptual disturbances, and by the severe disruption of ordinary behaviour. Patient history: The Male patient 48 year old who was apparently admitted in AVBRH on date 08/05/2021 with chief complaint was Abnormal behaviour( taking clothes off in public ), irritability, aggressive, muttering and smiling to self from 10 days back. His parents once locked him in a room as they fear he might hurt him. He was taken to a faith healer in Pandarkawda twice by his parents. The Baba gave him some mysterious beats like bracelet to wear which eventually decreased his symptoms for 3 days but the symptoms persisted from the fourth day. This time, the Baba mixed a lemon juice, turmeric powder & kumkuma (a powder made from dried turmeric with a bit of slaked lime) and applied all over him eyes which severely inflamed & burnt his eyes. His eye injury elevated his psychotic symptoms which is why his parents took him to psychiatric OPD in AVBRH. Past History: Patient was apparently asymptomatic 2 yrs back. He was married to a woman of his parent’s choice. His marriage life was stressful and unhealthy. He was underestimated by his wife due to his low qualification and health problem. Clinical Finding: The patient has been undergone with various investigations like culture, blood tests, Physical examination and mental status examination symptomatically with antipsychotic agent and anticonvulsant such as Tab Olanzapine 10mg- HS, Tab Clonazepam 0.5mg – SOS. Medical Management: Antibiotic eye drop homatropine and eye ointment ciprofloxacin. Nursing Management: Administered fluid replacement i.e DNS and RL, eye care was done with betadine and Normal Saline solutions, eye care by administering eye drops and monitored all vital signs hourly. Conclusion: Patient was admitted to hospital with the chief complaint of muttering to self, irritability and eye injury, blisters, pus discharge from eyes and his condition was very critical and patient was admitted in AVBR Hospital ,immediate treatment was started by health team member and all possible treatment were given and now the patient condition is satisfactory.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Martin A. Schick ◽  
Jonas Pippir ◽  
Manuel F. Struck ◽  
Jürgen Brugger ◽  
Winfried Neuhaus ◽  
...  

Abstract Objective Colloid solutions are commonly used to maintain perioperative fluid homeostasis. In regard to perioperative infant-centered care, data about the impact of colloids are rare. New data suggest a possible positive effect of hydroxyethyl starch (HES) concerning blood brain barrier. Therefore we conduct a retrospective single center study of children scheduled for neurosurgery, age < five with a blood loss > 10% of body blood volume, receiving either 6% HES 130/0.4 or 5% human albumin (HA). Results Out of 913 patients, 86 were included (HES = 30; HA = 56). Compared to HES [16.4 ± 9.2 ml/kg body weight (mean ± SD)] HA group received more colloid volume (25.7 ± 11.3), which had more blood loss [HA 54.8 ± 45.0; HES 30.5 ± 30.0 (%) estimated blood volume] and higher fluid balances. Fibrinogen was decreased and activated partial thromboplastin time was elevated in HA group. Urinary output, creatinine and urea levels did not differ between the two groups. Serum calcium, total protein levels were lower in HES group. HA treated infants tended to have shorter ICU and hospital stays. We conclude that none of the investigated colloid solutions were without leverage to infants. Consequently randomized controlled trials about perioperative goal-directed fluid replacement of children undergoing (neuro)-surgery with major blood loss are needed.


Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4073
Author(s):  
Haresh T. Suppiah ◽  
Ee Ling Ng ◽  
Jericho Wee ◽  
Bernadette Cherianne Taim ◽  
Minh Huynh ◽  
...  

There are limited data on the fluid balance characteristics and fluid replenishment behaviors of high-performance adolescent athletes. The heterogeneity of hydration status and practices of adolescent athletes warrant efficient approaches to individualizing hydration strategies. This study aimed to evaluate and characterize the hydration status and fluid balance characteristics of high-performance adolescent athletes and examine the differences in fluid consumption behaviors during training. In total, 105 high-performance adolescent athletes (male: 66, female: 39; age 14.1 ± 1.0 y) across 11 sports had their hydration status assessed on three separate occasions—upon rising and before a low and a high-intensity training session (pre-training). The results showed that 20–44% of athletes were identified as hypohydrated, with 21–44% and 15–34% of athletes commencing low- and high-intensity training in a hypohydrated state, respectively. Linear mixed model (LMM) analyses revealed that athletes who were hypohydrated consumed more fluid (F (1.183.85)) = 5.91, (p = 0.016). Additional K-means cluster analyses performed highlighted three clusters: “Heavy sweaters with sufficient compensatory hydration habits,” “Heavy sweaters with insufficient compensatory hydration habits” and “Light sweaters with sufficient compensatory hydration habits”. Our results highlight that high-performance adolescent athletes with ad libitum drinking have compensatory mechanisms to replenish fluids lost from training. The approach to distinguish athletes by hydration characteristics could assist practitioners in prioritizing future hydration intervention protocols.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohamed Rishard ◽  
Thalagala Kossinnage Maheeka Kossinna ◽  
Mohamed Nazar Latiff ◽  
Susantha De Silva ◽  
Mohamed Hilmy Mohamed Asmath

Abstract Background Constipation during pregnancy is not uncommon. Usually, this does not warrant extensive evaluation and settles with minor interventions or lifestyle modifications. Severe fecal impaction in chronically constipated patients can rarely lead to obstructive uropathy. Relief of obstruction can result in a diuretic phase which may be self-limiting or pathological. However, occurrence of pathological post-obstructive diuresis as a result of severe constipation is an extremely rare complication during pregnancy and puerperium which can even be fatal if not promptly diagnosed and adequately monitored and timely intervened. We describe the management of a pathological post-obstructive diuresis which occurred in the immediate postpartum period after treatment of severe constipation and obstructive uropathy. Case presentation A woman who had undergone an emergency caesarean section due to deep transverse arrest 1 week ago, presented with fecal impaction and anuria. On relief of urinary obstruction which had developed secondary to fecal impaction, she developed pathological post-obstructive diuresis. Careful and timely monitoring with exact fluid replacement, correction of electrolyte imbalances and multidisciplinary care ensured complete recovery of the patient. Conclusions Despite obstructive uropathy being uncommon in obstetric practice, clinicians need to have a high index of suspicion to monitor and promptly manage the potentially life-threatening condition of post-obstructive diuresis in pregnant and puerperal women undergoing urinary tract decompression. Due to unreliability of laboratory cutoff values in pregnancy and puerperium, a more vigilant and multidisciplinary approach with lower threshold for intervention is more prudent in the management of these patients.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shenglan Zhou ◽  
Dongmei Tang ◽  
Sumei Wei ◽  
Zhengchang Hu ◽  
Xuemei Wang ◽  
...  

Abstract Background Ralstonia mannitolilytica, a newly emerging opportunistic pathogen worldwide, has been reported to be responsible for human pneumonia, septicemia and meningitis. This is the first report of a case of Ralstonia mannitolilytica sepsis after elective cesarean delivery. Case presentation A 25-year-old woman, gravida 1 para 0, was scheduled for an elective cesarean delivery at 39+ 1 weeks of gestation. Sudden high fever and decreased blood pressure occurred a short time after the operation. Ralstonia mannitolilytica was identified in her blood culture 5 days after the operation. Based on the presence of sepsis and septic shock, massive fluid replacement, blood transfusion, vasoactive agents, imipenem/cilastatin and cefoperazone sulbactam sodium were applied. She was discharged after intensive care without complications. Conclusions Although the incidence of sepsis due to Ralstonia mannitolilytica is relatively low, once infection occurs in a puerpera, severe symptoms develop abruptly. Thus, prompt diagnosis and appropriate treatment are key to the cure.


2021 ◽  
Vol 14 (3) ◽  
pp. 1454-1459
Author(s):  
Noriaki Ito ◽  
Takeshi Masuda ◽  
Kakuhiro Yamaguchi ◽  
Shinjiro Sakamoto ◽  
Yasushi Horimasu ◽  
...  

Pneumatosis intestinalis (PI) is a rare disease that forms emphysema lesions under the mucosa and serosa of the gastrointestinal tract. We present the first case of PI following radiation-induced esophagitis during chemoradiotherapy (CRT) for lung cancer. A 74-year-old man with severe chronic obstructive pulmonary disease (COPD) was treated with CRT for lung cancer. During the treatment, he presented with vomiting and abdominal distention. CT showed pneumatosis from the esophagus to the small intestine. Severe radiation-induced esophagitis was observed, and gastrointestinal endoscopy revealed a circumferential esophageal ulcer. From these observations, this case was diagnosed as PI following severe esophagitis. A nasogastric tube was inserted, and conservative treatment with fasting, fluid replacement, and antibiotic was performed. Four days after the onset of PI, CT showed marked improvement of the pneumatosis. When CRT is performed for lung cancer patients, we should not only consider esophagitis but also PI. The presence of COPD may be considered a specific factor for the development of severe esophagitis and the consequent PI in this case.


2021 ◽  
Vol 14 (3) ◽  
pp. 1460-1465
Author(s):  
Shugo Yajima ◽  
Yasukazu Nakanishi ◽  
Shunya Matsumoto ◽  
Naoya Ookubo ◽  
Kenji Tanabe ◽  
...  

Hyperchloremic metabolic acidosis can be a problem in urinary diversion using the ileum. A 73-year-old Japanese male was hospitalized in emergency due to anorexia and malaise 3 weeks after being discharged from the hospital after getting robot-assisted radical cystoprostatectomy and intracorporeal ileal conduit urinary diversion. The blood analysis revealed metabolic acidosis, elevated chloride ions, and marked hyperglycemia: he was diagnosed with hyperchloremic metabolic acidosis and hyperglycemic hyperosmolar syndrome. We started administering insulin and large amounts of fluid replacement; besides, we inserted a large-diameter open tip catheter into the ileal conduit in hopes of inhibiting urine reabsorption in the intestinal mucosa. His general condition gradually improved, and he was discharged 10 days after his hospitalization.


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