Systematic review and Meta-analysis of efficacy and safety of Fengliao Changweikang prescription in treatment of acute gastroenteritis / 中国中药杂志

This study systematically evaluated the clinical efficacy and safety of Fengliao Changweikang prescription for treating acute gastroenteritis(AGE). The databases of CNKI, Wanfang, VIP, SinoMed, Medline, Cochrane Library and two clinical trial registration platforms were retrieved from inception to August 30, 2022, to collect randomized controlled trial(RCT) on Fengliao Changweikang prescription treating AGE. Two researchers independently conducted literature screening, data extraction, and risk of bias assessment according to pre-established inclusion and exclusion criteria. RevMan 5.4.1 was used for data analysis. Finally, 18 RCTs were included, involving 3 489 patients. Meta-analysis showed that compared with conventional western medicine, Fengliao Changweikang prescription improved the relief rate of abdominal pain(RR=1.27, 95%CI[1.17, 1.38],P<0.000 01); Fengliao Changweikang prescription + conventional western medicine increased the cure rate(RR=1.43, 95%CI[1.12, 1.82], P=0.004), shortened the duration of diarrhoea(RR=-1.65, 95%CI[-2.44,-0.86], P<0.000 1), abdominal pain(RR=-1.46, 95%CI[-2.00,-0.92], P<0.000 01), vomiting(RR=-2.16, 95%CI[-2.51,-1.81], P<0.000 01) and fever(RR=-2.61, 95%CI[-4.00,-1.23], P=0.000 2), down-regulated the level of interleukin-8(IL-8)(RR=-1.07, 95%CI[-1.26,-0.88], P<0.000 01), IL-6(RR=-8.24, 95%CI[-8.99,-7.49], P<0.000 01) and hypersensitive C-reactive protein(hs-CRP)(RR=-3.04, 95%CI[-3.40,-2.69], P<0.000 01) and recurrence of AGE(RR=0.20, 95%CI[0.05, 0.90], P<0.04). In conclusion, Fengliao Changweikang prescription was safe in clinical application. It was beneficial to alleviate the clinical symptoms of diarrhea, abdominal pain, vomiting, and fever, and down-regulate the levels of some serum inflammatory factors in AGE patients. However, considering that few high-quality studies have evaluated the efficacy and safety of Fengliao Changweikang prescription in treatment of AGE, further evidence is needed in the future.

La administración de ondansetrón no mejora la evolución de los niños con gastroenteritis aguda sin deshidratación / Administration of ondansetron does not improve the course of children with acute gastroenteritis without dehydration

Sobre la base de una viñeta clínica de un niño con gastroenteritis aguda sin deshidratación, el autor de este artículo realiza una búsqueda bibliográfica para revisar la evidencia que avala el uso de ondansetrón para tratar sus vómitos, práctica bastante común en instituciones con acceso a este fármaco en sus centrales de emergencia. Luego de dicha búsqueda, el autor concluye que en niños con gastroenteritis aguda sin deshidratación, la administración de ondansetrón no reduce la necesidad de hidratación intravenosa ni la frecuencia ni la severidad de los vómitos. (AU)

Based on a clinical vignette of a child with acute gastroenteritis without dehydration, the author of this article performs a literature search to review the evidence supporting the use of ondansetron to treat his vomiting, a fairly common practice in institutions with access to this drug in their emergency rooms. After this search, the author concludes that in children with acute gastroenteritis without dehydration, the administration of ondansetron does not reduce the need for intravenous hydration or the frequency or severity of vomiting. (AU)

Development, characterization and evaluation of the dissolution profile of sulfasalazine suspensions / Desenvolvimento, caracterização e avaliação do perfil de dissolução de suspensões sulfasalazina

This paper reports the development, characterization and in vitrodissolution behavior of sulfasalazine suspensions for treatment of chronic intestinal inflammatory diseases. Three formulations were developed, from powdered sulfasalazine obtained from different suppliers. The sulfasalazine was characterized regarding concentration, Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC), X-Ray Diffraction (XRD), particle size distribution, polydispersion and solubility. The suspensions were developed and characterized regarding pH, viscosity, density, particle size, sedimentation volume, concentration and dissolution. The pH values were slightly acidic. The method of preparing the suspensions reduced the particle sizes and made the size distribution more homogeneous. The dissolution studies showed that the sulfasalazine suspensions had low solubility in acidic media, but dissolve quickly, reaching levels of 85%, in neutral media or media containing 0.5% of surfactants such as polysorbate 80. Besides this, the sulfasalazine suspensions were classified as having immediate dissolution because they reached dissolution levels near 100% in 20 minutes...

O trabalho reporta o desenvolvimento, caracterização e estudo in vitro de dissolução de suspensões de sulfassalazina para uso em doenças inflamatórias crônicas intestinais. Desenvolveram-se três formulações baseadas em fornecedores diferentes de pó de sulfassalazina. A sulfassalazina foi caracterizada quanto a Teor, Infravermelho por Transformada de Fourier (FTIR), Calorimetria Diferencial de Varredura (DSC), Difração de Raios-X (XRD), distribuição de tamanho das partículas, índice de polidispersão e solubilidade. A suspensão foi desenvolvida e caracterizada quanto a pH, viscosidade, densidade, tamanho de partícula, volume de sedimentação, teor e estudo de dissolução. Os valores de pH determinados foram levemente ácidos. O método de preparo das suspensões reduziu o tamanho das partículas e tornou a distribuição de tamanho mais homogênea. Os estudos de dissolução mostraram que a suspensão de sulfassalazina tem problemas de solubilidade em meios de caráter ácido, entretanto, sofre dissolução rápida acima de 85% em meios neutros ou contendo 0,5% de tensoativos como Polissobato 80. Além disso, as suspensões de sulfassalazina foram classificadas como formulações de dissolução imediata porque a partir de 20 minutos sofrem dissolução em torno de 100%...

Gastrenterite eosinofílica / Eosinophilic gastroenteritis

A gastrenterite eosinofílica é uma doença rara com apresentação heterogênea caracterizada pela presença de intenso infiltrado de eosinófilos em um ou em múltiplos segmentos do trato gastrin- testinal. Foi realizada revisão da literatura com ênfase em diag- nóstico, diagnóstico diferencial e tratamento, com o objetivo de divulgá-la entre a comunidade médica e viabilizar diagnóstico e tratamento precoces dessa entidade clínica, a fim de evitar complicações.(AU)

Eosinophilic gastroenteritis is a rare disease with heterogeneous presentation characterized by intense eosinophilic infiltration in one or multiple segments of the gastrointestinal tract. This review of the literature emphasized diagnosis, differential diagnosis and treatment in order to disseminate this clinical entity among the medical community and facilitate early diagnosis and treatment in order to avoid complications.(AU)

Emprego de probióticos em infecções gastrointestinais e em terapias com antibióticos / Use of probiotics in gastrointestinal infections and antibiotic therapy

São considerados probióticos alguns micro-organismos, principalmente bactérias, que atuam na regulação da microflora intestinal e conferindo ao hospedeiro alguns benefícios, como a melhoria do sistema imunológico, proteção contra colonização de patógenos e controle da flora intestinal em tratamentos com antibióticos. Esta revisão objetiva discorrer sobre algumas funções destes micro-organismos bem como relatar alguns resultados encontrados em experimentos realizados visando à compreensão a ação dos probióticos em infecções gastrointestinais. Os trabalhos realizados nesta área indicam que os probióticos podem ser considerados como uma possibilidade na prevenção e no tratamento de infecções gastrointestinais, bem como coadjuvante em terapias com antibióticos.

Gastroenteritis aguda causada por Vibrio cholerae no-O1, no-O139 que porta una región homologa a la isla de patogenicidad VpaI-7 / Acute gastroenteritis caused by a Vibrio cholerae non-O1, non-O139 strain harboring a genetic region homologous to the VpaI-7 pathogenicity island

Pathogenic Vibrio cholerae isolates, the etiologic agents of cholera, generally express one of two O antigens (O1 or O139). Most environmental isolates are nonpathogenic and are referred to as "non-O1, non-O139". However some V. cholerae non-O1, non-O139 strains are clearly pathogenic and have caused outbreaks or sporadic cases of gastroenteritis and extraintestinal infections in humans. We report a case of acute gastroenteritis by a V. cholerae non-O1, non-O139 harboring a genetic region homologous to a segment of the VpaI-7 V. parahaemolyticus pathogenicity island.

Cepas patogénicas de Vibrio cholerae, el agente causal del cólera, expresan generalmente uno de dos antígenos O (denominados O1 u O139). La mayoría de las cepas ambientales son no patogénicas y corresponden al tipo denominado "no-O1, no-O139". Sin embargo, algunas cepas de este tipo son claramente patogénas y han causado brotes de gastroenteritis e infecciones extra-intestinales en humanos. Se reporta un caso clínico de gastroenteritis aguda causado por una cepa de V. cholerae no-O1, no-O139 que contiene en su genoma una región homóloga a un segmento de la isla de patogenicidad VpaI-7 descrita previamente en V. parahaemolyticus.

[ case report of eosinophilic gastroenteritis presenting with abdominal pain and ascitis]

Eosinophilic gastroenteritis is a heterogeneous disorder affecting both children and adults, and is characterized by the presence of an intense eosinophilic infiltrate on histopathology of one or multiple segments from the esophagus to the rectum. Eosinophilic gastroenteritis which may involve more than one layer of the gastrointestinal tract. Clinical features depend on the layer and location to be involved. Involvement of the serosal layer occurs in 10% of cases of eosinophilic gastroenteritis and is typically presented as ascites. The patient in our report was as likely as those who refer with full thickness involvement and presenting ascite, and was completely improved after steroid treatment. The patient was presented a 14-year-old boy that referred to the physician with progressive abdominal pain and ascites. After recognition of eosinophilia in blood and ascite fluid, he was suspected to have Eosinophilic gastroenteritis. Ultimately, following serial examinations and after laparascopic full thickness biopsy Eosinophilic gastroenteritis was closely diagnosed. The patient was treated with prednisolone. The abdominal pain and ascites subsided soon after initiation of steroid treatment

Non-rotavirus infection causing apnea in a neonate.

Apnea in a premature infant is not always due to immaturity and caffeine is not always the answer. We report a case of apnea in a preterm infant who presented at two weeks of life with increase in frequency of apnea that did not respond to caffeine. Family history was significant for diarrhea in a sibling. Stool PCR was positive for Norovirus Genogroup II. Enteric isolation was instituted and the apnea resolved spontaneously with conservative management. Re-emergence of apnea or persistent apnea necessitates further investigation to elucidate the etiology.

Eosinophilic gastrointestinal disorders

Eosinophilic gastrointestinal disorders are rare inflammatory diseases of unknown origin defined as disorders that selectively affect the gastrointestinal tract with eosinophil-rich inflammation in the absence of known causes for eosinophilia [eg, drug reactions, parasitic infections, and malignancy]. Eosinophil levels fluctuate, predating presentation by years and may be absent at presentation. Allergic mechanism has been suggested in at least a subset of patients. Indeed, increased total IgE and food-specific IgE levels have been detected in the majority of patients. A majority of patients have positive skin test responses to a variety of food antigens but do not have typical anaphylactic reactions, which is consistent with a delayed-type of food hypersensitivity syndrome. A male preponderance in the third to fifth decades of life has been reported. 25% have a history of atopy. Presentation may vary from a single organ affected by eosinophilic infiltrate to that of multisystem involvement. The gastric antrum and proximal small bowel are the most affected sites, commonly presenting with obstruction. Frank ulceration and haemorrhage are unusual. Symptoms are non-specific with nausea, vomiting, dyspepsia, abdominal pain, and weight loss. Approximately 80% have symptoms for several years before diagnosis. Eosinophilic gastroenteritis can present with protein-losing enteropathy. Serosal inflammation is the most likely cause of the exudative ascites. Biliary obstruction is a rare presentation of eosinophilic gastroenteritis. Presentation can mimic malignancy. Ultrasound, computed tomography and contrast studies may show nonspecific features of thickened mucosa and bowel wall. The histology is characteristic with mucosal oedema, a dense eosinophilic infiltrate, muscle bundle hypertrophy, and fibrosis. The submucosa is most commonly affected and full thickness biopsies may be needed for diagnosis. Treatments are often unsatisfactory, and long-term outcomes are uncertain. Prednisolone 20-40 mg per day remains an empirical treatment. Elimination diets and sodium cromoglycate are successful in rare cases where the causative antigen is isolated. Drugs such as montelukast, ketotifen, suplatast tosilate, mycophenolate mofetil, and alternative Chinese medicines have been advocated but are generally not successful. Spontaneous resolution may occur. It is hoped that a better understanding of the pathogenesis and treatment of EG will emerge by combining holistic clinical and research approaches involving experts in the fields of allergy, gastroenterology, nutrition, and pathology

Gastroenterite eosinofílica com ascite e sem i-obstrução intestinal: relato de caso e revisão da literatura / Eosinophilic gastroenteritis with ascites and intestinal pseudo-obstruction: report of a case and literature review

A gastroenterite eosinofílica (GE) é considerada uma doença pouco comum, com menos de 300 casos relatados na literatura. É caracterizada por infiltração eosinofílica das camadas da parede do tubo digestivo. A patogênese não é bem conhecida. Há algumas evidências da participação de fatores imunológicos ou alérgicos. Em geral, o prognóstico é favorável, embora a doença tenha caráter recorrente. Relata-se o caso de paciente, 21 anos, sexo masculino/ que apresentou quadro de dor abdominal, náusea, vômitos, emagrecimento e eliminação reduzida de flatos e fezes. Ao exame físico, foram observadas distensão abdominal, dor à palpação e ascite tensa. Os exames laboratoriais demonstraram eosinofilia no sangue periférico, variando de 15 a 60%. Exames parasitológicos de fezes seriados não mostraram ovos ou larvas. Ao estudo radiológico, identificaram-se espessamento da parede do intestino delgado e redução do lume. Infiltração eosinofílica da mucosa do cólon distal foi verificada pelo exame anatomopatológico. Com base nesses achados, o diagnóstico de GEfoi realizado e instituído o tratamento com prednisona, ocorrendo remissão da doença. Apesar de ser considerada doença rara e de causa ainda desconhecida, a GEdeve ser incluída no diagnóstico diferencial dos quadros de eosinofilia periférica com comprometimento do trato gastrintestinal (TGI).

Use of mannanoligosacharides as an adjuvant treatment for gastrointestinal diseases and this effects on E. coli inactivated in dogs

PURPOSE: To evaluate the effects of mannanoligosacharides on dogs showing gastroenteritis. METHODS: Sixteen dogs, 2-6 month-old, distributed into two groups: T1 - animals with gastroenteritis receiving treatment for the disease + mannanoligosacharides (2 g/animal).; and T2 - animals with gastroenteritis receiving just treatment for the disease. The animals were randomly included in the sample and all of them were submitted to blood and feces collection for coproculture. In the treatment for gastroenteritis antibiotic, antihemetic, vermifuge, vitamins and sorotheraphy were used. The parameters evaluated were the numbers of leucocytes, neutrophils, lymphocytes and the presence of enteropathogenic bacteria in feces. RESULTS: The mannanoligosacharides was effective in eliminating pathogenic E. coli in 85.71 percent of the animals, while in the no-treated group only 25 percent of the animals were negative to E. coli. CONCLUSION: The mannanoligosacharides is effective in the control of pathogenic E. coli and it can be indicated as an adjuvant treatment for gastroenteritis in dogs.

OBJETIVO: Avaliar os efeitos da adição de mananoligossacarídeos fosforilados (MOS) que apresentavam gastroenterite , pacientes de uma Clínica Veterinária. MÉTODOS: foram estudados 16 cães de 2 a 6 meses de idade, de várias raças. Os animais foram distribuídos em 2 grupos, sendo o grupo T1 composto por animais com gastroenterite, que receberam o tratamento para a doença e Mos (2,0 g/animal) e o grupo T2, animais com gastroenterite, que somente receberam o tratamento para a doença sem o MOS. Os animais foram incluídos aleatoriamente na amostra e todos eles foram submetidos à coleta de sangue e de fezes para coprocultura.O tratamento para a gastroenterite constituiu-se de antibiótico,antiemético,vermífugo,vitaminas e soroterapia. No experimento, foram avaliados os leucócitos, neutrófilos, linfócitos e a presença de bactérias enteropatogênicas nas fezes. RESULTADOS: Constatou-se a efetividade do Mos no grupo tratado, quando houve a eliminação da Escherichia coli patogênica em 85,71 por cento dos animais,enquanto que, no grupo sem o Mos, só 25 por cento, não apresentaram o microorganismo. CONCLUSÃO: O Mos é efetivo no controle da E. coli patogênica, sendo indicado como tratamento adjuvante nas gastroenterites.

Plasmid-mediated high-level ceftriaxone resistance in a Salmonella enterica serotype typhimurium isolate

We evaluated ion exchange chromatography [IEC] on the Jeol Aminotac 500 analyzer for total homocysteine [tHcy] determination and compared it with an immunoassay method using fluorescence polarization on an Abbott IMx analyzer. IEC method validation [linearity, limit of detection, precision, interference] was made according to the French Biology Society guidelines [Societe Fran‡aise de Biologie Clinique]. Moreover, during a 2-month period, 55 plasma samples from patients scheduled for routine tHCy measurement were assayed by both methods for determining correlation. The IEC method was found linear up to at least 190 micro mol/l, and the limit of detection was 1.6 micro mol/l. Precision was studied with 3 controls at 6, 15 and 30 micro mol/l. Intra-assay coefficients of variation [n = 14] were 8.3, 3.1 and 2.3%, respectively, and inter-assay coefficients of variation [n = 15] were 9.6, 5.1 and 4.9%, respectively. No interference was found with other sulfur-containing amino acids [methionine, cysteine]. An excellent agreement was found between IEC and fluorescence polarization [Deming regression; y = 0.99x - 1.23; r = 0.97; p < 0.001]. The IEC method for tHcy measurement shows adequate precision and correlates highly with the IMx assay. The IEC method is more time-consuming but less expensive in reagent cost and allows simultaneous determination of plasma methionine concentration which may help to explain the underlying mechanism responsible for hyperhomocysteinemia

Revisión y recomendaciones para el manejo de diarrea por Vibrio parahaemolyticus / Review and guidelines for treatment of diarrhea caused by Vibrio parahaemolyticus

A contar del año 1998 se han presentado en Chile tres brotes epidémicos por Vibrio parahaemolyticus, el último de ellos durante el verano del 2005, que afectó a más de 10.000 personas. Los afectados presentaron un cuadro clínico caracterizado por diarrea, náuseas, vómitos, dolor abdominal y fiebre; 6 por ciento de los casos tuvo leucocitos fecales positivos y un paciente falleció. La cepa predominante en los tres brotes ha sido la pandémica O3: K6. El diagnóstico de V. parahaemolyticus se realizó con la confirmación microbiológica de las cepas y tipificación o por asociación epidemiológica. Las cepas fueron susceptibles in vitro a tetraciclina, cefalosporinas de tercera generación, quinolonas y cloranfenicol no observándose susceptibilidad a ampicilina. Todos los casos se asociaron al consumo de mariscos crudos o insuficientemente cocidos. Por la repercusión de este brote, el Ministerio de Salud impulsó la formación de una comisión multidisciplinaria para actualizar los aspectos epidemiológicos, clínicos y microbiológicos, y elaborar una guía de recomendaciones en el manejo de esta infección.

Pattern of parenteral antimicrobial prescription among pediatric patients in Al Watani government Hospital in Palestine

No studies were carried out in Palestine to investigate the antimicrobial prescribing among hospitalized pediatric patients. The objective of this study was to audit and therapeutically analyze the pattern of parenteral antimicrobial prescriptions among pediatric patients in Al-Watani government hospital in Palestine. Such audit will be of great value to clinician and health policy makers. Data on antimicrobial prescribing were collected for 30 consecutive days for all pediatric patients admitted to Al-Watani government hospital. Data on antimicrobial prescribing were entered and analyzed using Statistical Package for Social Sciences [SPSS] program. Analysis was done for age, sex, diagnosis, site of infection, number of antimicrobial agents given, how many times have the drug regimen been changed and the frequency of individual drug use. Three hundred and forty pediatric patients were admitted to Al-Watani government hospital during the study period. Gastroenteritis was the most common cause of hospitalization, while upper respiratory tract infection [URTI] was the most common cause of parenteral antimicrobial agent administration. Two hundred and ten [61.8%] patients received parenteral antimicrobial agents while 16 [4.7%] received both parenteral and oral antimicrobial agents. Single antimicrobial agent was prescribed for 172 [76.1%] patients. Cefuroxime was the main single antimicrobial agent used, it was administered to 70/226 [31%] patients. Treatment patterns used for most patients were nearly according to current therapeutic recommendations. However, improving the availability of rapid diagnostic methods to differentiate between viral and bacterial infections is suggested to reduce empiric therapy numbers by antimicrobial agents so as to decrease chance for drug resistance

Estudio de la eficacia y seguridad de brodimoprim vs. trimetoprim-sulfametoxazol en niños con gastroenteritis bacteriana / Study brodimoprim vs. trimetoprim-sulfatoxasol security and effectiveness in children with bacterial gastroenteritis

Se realizó un estudio comparativo de brodimoprim contra trimetoprim/sulfametoxazol para el tratamiento de niños con diarrea aguda bacteriana. Se estudiaron 30 pacientes en cada grupo. El grupo l recibió trimetoprim/sulfametoxazol en suspensión por vía oral, a dosis de 8 mg/kg/día cada 12 horas por 5 días. El grupo ll recibió brodimoprim en suspensión con dosis única inicial de 10 mg/kg de peso, seguida de 5 mg/kg cada 24 horas por 5 días. En ambos grupos, los resultados mostraron remisión de la sintomatología en todos los pacientes, y negativización en la mayoría de los coprocultivos. En efectos colaterales un paciente presentó cefalea y otros dos presentaron diarrea por brodimoprim; la diferencia no fue significativa. Se concluye que brodimoprim es una buena alternativa para tratar a niños con diarrea aguda.

Antibioticoterapia em Pediatria / Antibiotic therapy in Pediatrics

O trabalho destaca a necessidade do emprego criterioso de antibióticos em Pediatria, ressaltando suas principais indicaçöes a saber: infecçöes dos tratos respiratórios alto e baixo, do trato urinário, gastroenterites, infecçöes da pele e de partes moles e meningites

Gastroenteritis eosinofílica / Eosinophilic gastroenteritis

Se presenta una revisión del compromiso eosinofílico del aparato digestivo, compromiso que puede afectar desde el esófago hasta el recto pero que es más común en el estómago y el intestino delgado. La infiltración eosinofílica puede comprometer la mucosa y submucosa (síndrome diarreico, vómitos y dolores abdominales), la capa muscular (síndrome pilórico, obstrucción o suboclusión intestinal) o la serosa (ascitis). El diagnóstico se establece generalmente al estudiar la etiología de una eosinofilia periférico y luego de descartar una enteroparasitosis, una parasitosis tisular o un cuadro alérgico. La confirmación diagnóstico se fundamenta en la demostración histológica de una infiltración eosinofílica. El tratamiento se basa en la administración de prednisona (dosis de ataque inicial por 15 días y luego de mantención por varios meses). En los caos refractarios o recurrentes: azatioprina, ciclosporima o ciclofosfamida. Cirugía sólo para las complicaciones, perforaciones, obstrucciones intestinales o sangramientos importantes

Hallazgos ultrasonograficos en la gastroenteriris eosinofilica / Ultrasonographic findings in eosinophilic gastroenteritis

We evaluated radiologic and ultrasonographic findings in 2 patients with eosinophilic gastroenteritis with gastrointestinal afectation and their tratment results.

Contribution a l'etude chimique et microbiologique de Nauclea latifolia sm. (Rubiaceae) : possibilite d'utilisation des feuilles comme succedane des racines dans le traitement traditionnel de gastro-enterites

Nauclea latifolia Sm. est une Rubiaceae medicinale tres utilisee dans la therapeutique medico-traditionnelle au Burkina-Faso. Elle est preconisee dans le traitement d'un certain nombre d'affections et plus particulierement les gastro-enterites infantiles. Ce travail presente les resultats d'une etude sur la mise en evidence d'une activite antibacterienne des extraits hydro-alcooliques et alcaloidiques (feuilles et ecorces de racines) vis-a-vis de quatre germes pathogenes testes in vitro. L'effet antimicrobien engendre par les extraits des feuilles de la drogue offre une opportunite de proposer l'utilisation des feuilles comme substitut aux racines. Cette substitution des feuilles aux racines contribue a la sauvegarde de cette plante dont l'exploitation traditionnelle des racines compromet la survie