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1.
Acta Scientiae Veterinariae ; 50, 2022.
Article in English | EMBASE | ID: covidwho-1818984

ABSTRACT

Background: Diarrhea induced by infectious factors may lead to significant health problems in dogs. Canine parvovirus (CPV), canine coronavirus (CCV), canine distemper virus (CDV), Giardia spp., Escherichia coli (E. coli), and Salmonella spp. are the important infectious agents that may induce diarrhea in dogs. The present study aimed to investigate the effect of CPV, CCV, CDV, Giardia spp., E. coli, and Salmonella spp. infections on the change in serum calprotectin (Calp) concentration. Materials, Methods & Results: A total of 30 dogs were enrolled in the study. The study dogs were divided into 3 groups. Healthy animals as confirmed by clinical examination and animals negative for the specified pathogens were placed in Group 1. Animals infected by one or more agents, including CPV, CCV, CDV, and Giardia spp., but negative for E. coli or Salmonella spp. were placed in Group 2. Finally, animals positive for E. coli or Salmonella spp. and infected or not infected by one or more agents, including CPV, CCV, CDV, and Giardia spp., were placed in Group 3. Stool samples and rectal and conjunctival swab samples were collected to investigate the etiologic agents that induced diarrhea. Blood samples were collected through vena cephalica antebrachii for hematological and biochemical examinations. The samples were obtained via routine clinical examinations at the Prof. Dr. Servet Sekin outpatient clinic at Dicle University Veterinary Faculty. CPV, CCV, CDV, and Giardia spp. diagnoses were made based on immunochromatographic test kits. The bacteriological analysis of stool samples was used to diagnose E. coli and Salmonella spp. infection. Serum Calp concentrations were measured by Enzyme-Linked Immunosorbent Assay (ELISA). The analysis of swab and stool samples by immunochromatographic rapid diagnosis kits and microbiological methods showed that 5 animals were infected with CPV, 10 with CCV, 6 with CDV, 3 with Giardia spp., 12 with E. coli, and 2 with none of the specified agents. Total leukocyte count (WBC), lymphocyte (Lym - %), and granulocyte (Gra - %) values were higher in the diarrheal dogs when compared with the control group. In the biochemical examination of serum samples, total bilirubin (TBIL) and phosphorus (P) levels were higher and sodium (Na) levels were lower in Group 3 when compared to the control group (P = 0.025, 0.024, and 0.018, respectively). Total protein (TP) and albumin (Alb) values were lower in Group 2 compared to Groups 1 and 3 [P = 0.001 and 0.019 for TP, P = 0.000 and 0.01 for Alb, respectively]. There was a statistically significant difference in creatine kinase (CK) levels between Group 1 and Group 2 (P = 0.013). Serum Calp level was higher in the E. coli infected group (Group 3) compared to the other groups, no significant differences were noted between the groups (P > 0.05). Discussion: In conclusion, to the best of authors knowledge, this study is the first to evaluate serum Calp levels in dogs with diarrhea induced by viral, bacterial, and protozoan infections. The Calp level was higher in the sick dogs that were infected by at least one agent, including CPV, CCV, CDV, and Giardia spp., and were at the same time E. coli positive when compared with the control group and the group without E. coli infections. It was concluded that new studies could be useful to reveal the diagnostic importance of serum Calp concentration in dogs with diarrhea and that these results may contribute to future studies in this area.

2.
Biochemical and Cellular Archives ; 21(2):1-2, 2021.
Article in English | EMBASE | ID: covidwho-1812557
3.
Viruses ; 14(4):722, 2022.
Article in English | ProQuest Central | ID: covidwho-1810314

ABSTRACT

The chicken astrovirus (CAstV) is a ubiquitous enteric RNA virus that has been associated mainly with conditions, such as the runting-stunting syndrome, severe kidney disease, visceral gout, and white chick syndrome, in broiler-type chickens worldwide. Sequence analysis of the capsid genes’ amino acids of the strains involved in these conditions reveals a genetic relationship and diversity between and within the CAstV genogroups and subgroups based on phylogenetic analysis, genetic distance (p-dist), and pathogenicity. While the two genogroups (A and B) are demarcated phylogenetically, their pairwise amino acid sequence identity is 39% to 42% at a p-dist of 0.59 to 0.62. Group-A consists of three subgroups (Ai, Aii, and Aiii) with an inter- and intra-subgroup amino acid identity of 78% to 82% and 92% to 100%, respectively, and a p-dist of 0.18 to 0.22. On the other hand, the six subgroups (Bi, Bii, Biii, Biv, Bv, and Bvi) in Group-B, with a p-dist of 0.07 to 0.18, have an inter- and intra-subgroup amino acid identity of 82% to 93% and 93% to 100%, respectively. However, these groupings have little to no effect on determining the type of CAstV-associated pathology in chickens.

4.
BMC Veterinary Research ; 18:1-8, 2022.
Article in English | ProQuest Central | ID: covidwho-1808371

ABSTRACT

Background Porcine epidemic diarrhea virus (PEDV) is one of the most important enteric viruses causing diarrhea in pigs. The establishment of a rapid detection method applicable in field conditions will be conducive to early detection of pathogen and implementation of relevant treatment. A novel nucleic acid amplification method, recombinase polymerase amplification (RPA), has been widely used for infectious disease diagnosis. Results In the present study, a reverse transcription (RT)-RPA assay combined with lateral flow dipstrip (LFD) was established for the visual detection of PEDV by targeting the N gene. The RT-RPA-LFD assay detected as low as 102 copies/µL of PEDV genomic RNA standard. Moreover, the novel RT-RPA-LFD assay did not show cross-reactivity with common swine pathogens, demonstrating high specificity. The performance of the assay for detection of clinical samples was also evaluated. A total number of 86 clinical samples were tested by RT-RPA-LFD and RT-PCR. The detection results of RT-RPA-LFD were compared with those of RT-PCR, with a coincidence rate of 96.5%. Conclusion The newly established RT-RPA-LFD assay in our study had high sensitivity and specificity, with a potential to use in resource-limited areas and countries.

5.
Journal of Medical Virology ; n/a(n/a), 2022.
Article in English | Wiley | ID: covidwho-1802453

ABSTRACT

BackgroundPrecise prevention and control measures have been adopted to impede the transmission of COVID-19 in China. This study was performed to investigate the effect of protective measures on gastrointestinal infection in children during the COVID-19 pandemic.MethodsThe data on the rotavirus and adenovirus antigen tests were collected in outpatient children due to gastroenteritis from January 1, 2019, to December 31, 2020, at the Children's Hospital of Zhejiang University School of Medicine. According to age and month distribution, the positive number and rate of rotavirus and adenovirus in 2020 were compared with 2019.ResultsA 3.8-fold and 4-fold reduction in the number of rotavirus- and adenovirus-positive patients in 2020 were found, respectively. The overall positive rate of rotavirus and adenovirus infection was drastically decreased in 2020 (rotavirus 2020: 18.18% vs 2019: 9.75%, P < 0.001;adenovirus 2020: 3.13% vs 2019: 1.58%, P < 0.001). The proportions of rotavirus and adenovirus in all age groups in 2020 decreased compared with those in 2019. The highest frequency of rotavirus infection occurred among children aged 1?3 years both in 2019 and 2020 (2019: 27.95% vs 2020: 17.19%, P < 0.001), while adenovirus infection was detected in children aged 3?5 years, which had the highest percent positivity (2019: 8.19% vs 2020: 4.46%;P < 0.001). An obvious peak prevalence of rotavirus incidence was found during December-April, and the percent positivity of rotavirus significantly decreased in 2020 (December 2019: 24.26% vs 2020: 8.44%, P < 0.001;January 2019: 40.67% vs 2020: 38.18%, P < 0.05;February 2019: 40.73% vs 2020: 15.04%, P < 0.001;March 2019: 31.47% vs 2020: 7.88%, P < 0.001;April 2019: 15.52% vs 2020: 4.78%, P < 0.001). The positive rate of adenovirus distributed throughout 2019 was 1.91%-4.86%, while the percent positivity during 2020 in the same period was much lower (0.00%-3.58%).ConclusionsOur results confirmed that the preventive and control measures adopted during the COVID-19 pandemic and the collateral benefit of these interventions have significantly decreased the transmission of rotavirus or adenovirus.This article is protected by copyright. All rights reserved.

6.
Transactions on Maritime Science-Toms ; : 13, 2021.
Article in English | Web of Science | ID: covidwho-1791932

ABSTRACT

Background: Due to nature of their profession, seafarers visit many ports in different parts of the world and are thus exposed to various infectious diseases. And yet, chronic non-communicable diseases, malignant illnesses and accidents have lately become an important cause of death among the seafarers. Although before the COVID-19 pandemic outbreak the communicable disease outbreaks were becoming less common, their share in seafarer morbidity remains significant. The aim of this research is to determine the most common infectious risks/contagious diseases on ships. Materials and methods: The Medline and Scopus databases have been searched using the following key words: seafarers, infectious diseases, morbidity, mortality. The information sources include relevant literature, as well as national and international regulations on preventive measures against infectious diseases. Results: At the global level no national or international surveillance systems exist on infectious disease occurrences on ships. There are only a few exceptions. However, based on some available individual and group research, conclusions may be drawn concerning the most important diseases in seafarer pathology. Of communicable/infectious diseases on ships, the most important ones are the acute respiratory illnesses, including the COVID-19 disease, followed by food poisoning/acute gastroenteritis, vector-borne diseases and HIV as the most common sexually transmitted disease in the past 20 years. Conclusion: Estimating the threat from infectious diseases in seafarers depends on the type and trade of vessels. For COVID 19 and other respiratory infections, as well as food poisoning, risks are higher on cruise ships and passenger ships than on cargo ships. For better understanding of the issue, we need internationally co-ordinated studies and well organised surveillance systems.

7.
Journal of Physical Education and Sport ; 22(2):289-296, 2022.
Article in English | ProQuest Central | ID: covidwho-1786259

ABSTRACT

Introduction. The purpose of the work was to determine the antiviral and bactericidal action of the steam-water mixture containing ozone created by the POS-1 apparatus on models of the transmissible gastroenteritis virus of pigs of the coronavirus family and multi-resistant clinical strains of bacteria, as well as the selection of optimal parameters for the supply of ozone in the composition of the gas mixture, which does not cause pathological changes on the part of organs and body systems. Materials and methods. To create a gas mixture containing ozone, the POS-1 apparatus created by the team of NMC Medinteh LLC was used. Virological studies were conducted on the basis of the Institute of Epidemiology and Infectious Diseases named after L.V. Gromashevsky. As a working material, models of the vector-borne gastroenteritis virus of pigs of the coronavirus family were used. A series of bacteriological and experimental studies were performed on the basis of the State Institution of the National Institute of Surgery and Transplantology named after A.A. Shalimov of the National Academy of Medical Sciences of Ukraine. For bacteriological studies, polyresistant cultures at a concentration of 108 CCU/ml were used. To study the effects of an ozone-containing mixture of gases on living biological tissues, studies on white rats were performed in the experiment. Results. Virological studies have shown that at an exposure of 20 minutes in contact with an extracellular virus, the infectious titer decreased by 100,000 times, and at an exposure of 30 minutes, complete deactivation of the virus occurred. Bacteriological studies revealed a complete absence of culture growth after treatment with an ozone-containing mixture for 20 minutes. The results of swimming tests and behavioral reaction of white rats of the control and experimental groups did not differ from each other. Histological studies of the tissues of the respiratory system, as well as the spleen, thyroid gland, kidneys and adrenal glands did not reveal signs of pathological effects. Conclusions. 1. The parameters of ozone generation and supply in the composition of the steam-water mixture of gases were studied and optimally selected. 2. Studies of the effect of the ozone-containing mixture on the strain of the virus of the coronavirus family, as well as bacteriological studies on multi-resistant clinical bacterial cultures confirm the pronounced virocidal and bactericidal properties of the developed method. 3. The use of an ozone-containing mixture does not cause any pathological changes on the part of the organs and systems of a living organism. 4. The gas mixture can be used to prevent and treat infectious diseases of the respiratory system, both viral and bacterial genesis.

8.
Chinese Journal of Animal Nutrition ; 34(1):159-176, 2022.
Article in Chinese | CAB Abstracts | ID: covidwho-1771309

ABSTRACT

This experiment was conducted to investigate the effects of recombinant porcine Lactobacillus reuteri secreting bovine lactoferrin peptide (LFCA) on growth performance of newborn piglets and the protective effect on porcine transmissible gastroenteritis virus (TGEV)infection which caused piglet diarrhea. Experiment 1:thirty-six one-day-old newborn piglets with an average body weight of about 1.5 kg were randomly divided into 3 groups, which were pPG-LFCA/LR-CO21 group, pPG/LR-CO21 group and control group, each group with 12 piglets. Piglets in each group were orally administered recombinant porcine Lactobacillus reuteri expressing LFCA pPG-LFCA/LR-CO21, containing empty vector plasmid PPG/LR-CO21 and equal volume phosphate buffer (PBS);oral administration continued for 3 days, and the observation time after oral administration was 14 d. During the period, piglets were fed freely, and the changes of body weight and diarrhea were recorded. Experiment 2:thirty one-day-old newborn piglets with an average body weight of about 1.5 kg were randomly divided into 5 groups and given TGEV with a half tissue culture infection dose (TCID50) of 10-7.50/mL by oral administration of 1, 3, 6, 9 and 12 mL, respectively. The observation period of 7 d was set to analyze the conditions of half lethal dose. Experiment 3:another thirty-two newborn piglets with an average body weight of about 1.5 kg were selected as experimental animals and randomly divided into 4 groups, with 8 piglets in each group. The groups were pPG-LFCA/LR-CO21 group, pPG/LR-CO21 group, control group and TGEV infect group. There were 8 replicates in each group and 1 piglet in each replicate. Each head of the experimental group was orally fed ppG-LFCA/LR-CO21, pPG/LR-CO21 and equal volume of PBS at a dose of 2..1010 CFU per day for 1 consecutive week. At 8 days of age, TGEV was infected by oral administration at half lethal dose, and samples were collected after 7 days of infection. The weight change and diarrhea of each group of piglets were recorded;hematoxylin-eosin staining was used to detect the length of intestinal villi and the depth of crypts;enzyme linked immunosorbent assay (ELISA) was used to determine total serum total immunoglobulin G (IgG) and total secretory immunoglobulin A (sIgA) antibody contents. RT-qPCR was used to detect the mRNA relative expression levels of Claudin-1, Occludin, tight junction protein-1 (ZO-1), inflammatory cytokines interleukin-6 (IL-6), interleukin-8 (IL-8), interferon-P (IFN-P), tumor necrosis factor-a (TNF-a) and Toll-like receptor 2 (TLR2). The flora structure of the contents of the piglet's cecum was analyzed. After oral recombinant porcine Lactobacillusreuteri, compared with the control group, the average daily gain of newborn piglets in the pPG-LFCA/LR-CO21 group was significantly increased (P < 0.01), while the diarrhea rate was significantly decreased (P < 0.01). Compared with TGEV infection group, the average daily gain of piglets in pPG-LFCA/LR-CO21 group was increased and diarrhea rate was decreased, and the differences were significant (P < 0.05). Villus height and the ratio of villus height to crypt depth in jejunum and ileum were significantly increased (P < 0.05). The contents of total IgG and intestinal mucosal total sIgA antibody in serum of piglets were significantly increased (P < 0.05);the mRNA relative expression levels of tight junction protein-related genes Claudin-1, Occludin and ZO-1 in intestinal mucosal tissue were extremely significantly increased (P < 0.01), and the serum TNF-a content was extremely significantly decreased (P < 0.01). Serum IFN-P, IL-6, IL-8 and TLR2 contents were significantly increased (P < 0.01), and the survival rate of piglets was improved. The analysis of the bacterial diversity in the contents of the piglets' cecum showed that the proportion of normal intestinal flora of piglets decreased after TGEV infection. Compared with the TGEV infect group, the proportion of pathogenic bacteria Bacteroides in piglet's intestinal flora decreased by o

9.
Emerg Infect Dis ; 28(3): 713-716, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1770993

ABSTRACT

A rapid decrease in viral gastroenteritis during winter 2019-20 and a return of norovirus and rotavirus activity during winter 2020-21 were observed while multiple nonpharmaceutical interventions for coronavirus disease were in effect in Hong Kong. The initial collateral benefit of coronavirus disease countermeasures that reduced the viral gastroenteritis burden is not sustainable.


Subject(s)
COVID-19 , Caliciviridae Infections , Norovirus , Rotavirus Infections , Rotavirus , Caliciviridae Infections/epidemiology , Caliciviridae Infections/prevention & control , China/epidemiology , Feces , Humans , Infant , Norovirus/genetics , Rotavirus/genetics , Rotavirus Infections/epidemiology , Rotavirus Infections/prevention & control , SARS-CoV-2
10.
Plasma Medicine ; 11(3):1-18, 2021.
Article in English | Scopus | ID: covidwho-1745247

ABSTRACT

Wearing a mask population-wide is an important preventive measure in address-ing COVID-19 and potential future pandemics. We showed how a household microwave oven, a coat-hanger, and a coffee cup can generate plasma that can be used to decontaminate N95 respirators in less than 1 minute. We proved that microwave-generated plasma can reduce infectivity of the Tulane virus and the transmissible gastroenteritis virus (TGEV) on N95 respirators by > 3-log10. We further studied the Tulane virus by molecular assays to understand inactivation mech-anisms, and we found that the plasma damages both viral proteins and genomes. Spectroscopy of the plasma revealed OH and C-containing radicals as the most prevalent active species expected to cause virus inactivation. The respirators still maintained filtration and fit even after 10 cycles of the plasma treatment. We believe that microwave-generated plasma is an easily accessible respirator decontamination technique that everyone could use for safe respirator reuse. © 2021 by Begell House, Inc.

11.
Eur Heart J Case Rep ; 6(2): ytac043, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1722376

ABSTRACT

Background: Myocarditis is caused by inflammation affecting the heart muscle. The usual aetiological factor is viral, especially in immunocompetent hosts and developed countries. Campylobacter jejuni is a common cause of bacterial gastroenteritis but has rarely been associated with myocarditis. Case summary: We report a case of a 22-year-old male admitted with pleuritic chest pain and a diarrhoeal illness. Thorough evaluation of the patient history did not reveal any sources for contracting the diarrhoea. Stool cultures confirmed that the patient had C. jejuni infection as well as myopericarditis confirmed on cardiac magnetic resonance imaging (cardiac MRI). Treatment with colchicine 0.5 mg BD, ibuprofen 600 mg TDS, and ciprofloxacin 500 mg BD orally for 5 days was started, together with an intravenous infusion of 0.9% normal saline 1 L TDS. The patient showed signs of improvement over a span of three days and the ST changes on electrocardiogram resolved. Discussion: Although C. jejuni-associated myopericarditis is uncommon, it can be potentially life-threatening if not considered in the differential. Its diagnosis involves good history taking, examination, and investigation with electrocardiography, troponins and inflammatory markers, echocardiography, and cardiac MRI. Several mechanisms of infection have been suggested, including direct insult by toxin or bacterium as well as an immune-mediated response. Both supportive and causative treatments are important to ensure recovery while reducing the risk of complications. It is therefore crucial to ensure that the patient receives adequate follow-up to ascertain patient progress and to mitigate any complications that may arise as well as tackle patient concerns. The patient had a rapid recovery.

12.
J Med Virol ; 2021 Oct 29.
Article in English | MEDLINE | ID: covidwho-1718375

ABSTRACT

Norovirus, an enteric virus primarily responsible for gastroenteritis outbreaks worldwide, is currently causing outbreaks around the United Kingdom during the COVID-19 pandemic. With an already exhausted health care system, the significant burden norovirus can have on the National Health Service, including economic and social burdens, is immense and cannot be tolerated. Primary challenges and priorities to be focused on due to the increase in norovirus outbreaks include a further depletion of health care services, increase cases in schools, nurseries, and care facilities, underreporting of the cases, and no effective vaccine being available. Therefore, it is essential to increase awareness about norovirus and its transmission in public, take necessary precautions, and increase reporting of cases. This article discusses the impact norovirus has during the COVID-19 pandemic, and the challenges, and recommendations to achieve control before it reaches epidemic levels.

13.
Vaccines (Basel) ; 10(2)2022 Jan 20.
Article in English | MEDLINE | ID: covidwho-1715799

ABSTRACT

Routine infant immunization with live, oral rotavirus vaccines (LORVs) has had a major impact on severe gastroenteritis disease. Nevertheless, in high morbidity and mortality settings rotavirus remains an important cause of disease, partly attributable to the sub-optimal clinical efficacy of LORVs in those settings. Regardless of the precise immunological mechanism(s) underlying the diminished efficacy, the introduction of injectable next-generation rotavirus vaccines (iNGRV), currently in clinical development, could offer a potent remedy. In addition to the potential for greater clinical efficacy, precisely how iNGRVs are delivered (multiple doses to young infants; alongside LORVs or as a booster; co-formulated with Diphtheria-Tetanus-Pertussis (DTP)-containing vaccines), their pricing, and their storage and cold chain characteristics could each have major implications on the resultant health outcomes, on cost-effectiveness as well as on product preferences by national stakeholders and healthcare providers. To better understand these implications, we critically assessed whether there is a compelling public health value proposition for iNGRVs based on potential (but still hypothetical) vaccine profiles. Our results suggest that the answer is highly dependent on the specific use cases and potential attributes of such novel vaccines. Notably, co-formulation of iNGRVs with similar or greater efficacy than LORVs with a DTP-containing vaccine, such as DTP-Hib-HepB, scored especially high on potential impact, cost-effectiveness, and strength of preference by national stakeholders and health care providers in lower and middle income countries.

14.
Journal of Investigative Medicine ; 70(2):589, 2022.
Article in English | EMBASE | ID: covidwho-1707355

ABSTRACT

Case Report Multi-system inflammatory syndrome in children (MIS-C) is a recently described clinical syndrome in children that continues to progress in its manifestations. The syndrome is associated with the novel coronavirus disease 2019 (COVID-19), and can affect any organ system in the body, leading to a wide variety of symptoms. This syndrome is often misdiagnosed in its initial presentation, and many families require multiple evaluations before finally being diagnosed and admitted for the appropriate treatment. Symptoms are caused by overwhelming inflammation and often involve the gastrointestinal, integumentary, cardiac, and hematologic systems. A high index of suspicion at the time of initial presentation should be maintained to obtain an accurate diagnosis of MIS-C. Patient Case We report the case of a previously healthy 11-year-old male who presents with acute cervical lymphadenitis that did not respond to appropriate outpatient antibiotic therapy. He has a history of testing positive for SARS-CoV-2 via PCR, associated with mild cough and rhinorrhea, about three weeks prior to the onset of current symptoms. Upon initial presentation physical exam and laboratory results were not consistent with MIS-C, however inflammatory markers were slightly elevated which was consistent with a diagnosis of cervical lymphadenitis. Over the course of the next several days, the patient developed gastrointestinal symptoms including abdominal pain, vomiting and diarrhea. He also developed non-purulent conjunctivitis, and a generalized erythematous rash, associated with significant leukocytosis, transaminitis, and elevated coagulation markers. His electrocardiogram (EKG), and echocardiogram (ECHO) remained within normal limits despite elevated pro-BNP levels, and he later developed significant hypotension, hypoxemia, and bilateral pleural effusions requiring a short course of diuretics. The patient remained febrile despite receiving a normal saline bolus, treatment with intravenous immune globulin (IVIG), and intravenous steroids. He had ongoing symptoms, and the erythematous rash reappeared. His steroid dose was increased, and the patient had a good response in both labs, and clinical status. Leukocytosis has continued, but there is significant improvement in all other inflammatory markers, and the patient is on course to be discharged home safely. Conclusion Many patients are unfortunately misdiagnosed after multiple evaluations before the final diagnosis of MIS-C is made. Multi-system inflammatory syndrome in children (MISC) may mimic other conditions such as gastroenteritis, acute appendicitis, Kawasaki Disease, sepsis, or even lymphadenitis. Clinicians should be alert to subtle signs of inflammation, such as lymphadenitis, that may progress to more classic symptoms of MIS-C such as persistent fever, abdominal pain, and a rash.

15.
Kidney International Reports ; 7(2):S77, 2022.
Article in English | EMBASE | ID: covidwho-1701542

ABSTRACT

Introduction: Acute kidney injury (AKI) requiring dialysis is an important health care burdenand is associated with very high in-hospital mortality. As no specific treatment is available toreverse AKI, the management remains supportive, including optimized fluid, electrolyte andacid-base balance, adjusting the dose of potentially nephrotoxic medications or avoidingsecondary haemodynamic and nephrotoxic kidney injury with timely initiation of dialysis.Timely initiation of dialysis in AKI is fundamental to achieve treatment goals and to providesolute clearance and removal of excess fluid while awaiting recovery of kidney function. Ifkidney function remains inadequate after a period of discontinuation from dialysis, it should bereinstituted by the foresight of the treating physician. The primary outcome of interest of thestudy was recovery of sufficient kidney function to discontinue haemodialysis therapy andcomplete recovery of renal function. Methods: This prospective observational study has beenconducted in the Department of Nephrology, Mymensingh Medical College Hospital,Bangladesh from September 2019 to February 2021. All adult patients in whom conventionalintermittent haemodialysis was initiated in the dialysis ward were included in the study. Allpatients were followed up till death or complete recovery or for a maximum period of six month.A structured data collection sheet was used to collect patients detail and recorded data wereanalyzed by IBM SPSS version 23. Results: A total of 134 patients of AKI requiring dialysiswere included in the study with the mean age of 42.3±15.7 years. Male (54.5%) were slightlymore than female with a male to female ratio of 1.2:1. Diabetes was present in 16 (11.9%)patients and hypertension was present in 47 (35.1%) patients. The causes of AKI weresepticaemia (35.1%), urinary tract infection (34.3%), surgery (18.7%), vomiting (16.4%),leptospirosis (11.2%), obstetric (10.4%), acute watery diarrhoea (9.7%), malignancy (8.2%), postrenal obstruction (8.2%), drugs (7.5%), rapidly progressive glomerulonephritis (6%), COVID-19(5.2%), rhabdomyolysis (4.5%), intestinal obstruction (3.7%), acute gastroenteritis (2.2%), waspbite (2.2%), organophosphorus compounds (OPC) poisoning (1.5%), starfruit toxicity (1.5%),haemolytic uremic syndrome (0.7%) and unknown (1.5%). Mean number of dialysis requirementwas 5.9±8.6 and length of hospital stay was 15.4±10.5 days. Out of 134 patients, 95 (70.9%)were discharged from hospital and 39 (29.1%) died in hospital. Total death of patients during thestudy period were 49 (36.6%) including home death of 10 (7.5%) patients. Complete recovery ofkidney function was achieved in 70 (52.2%) patients and partial recovery of kidney function whocan survive without dialysis were observed in 12 (9%) patients. 3 (2.2%) patients remain ondialysis and total survival during the study period was observed in 85 (63.4%) patients. Survivalrate was significantly higher in patients with ≤ 40 years (72.6%) and significantly lower inpatients with malignancy (18.2%) and post renal obstruction (27.3%). Conclusions: Outcomes ofacute kidney injury in patients requiring dialysis remains poor. Early detection, optimization offluid and electrolyte balance and timely initiation of haemodialysis are the keys to improvesurvival and overall mortality. No conflict of interest

16.
Foodborne Pathog Dis ; 19(4): 290-292, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1621512

ABSTRACT

The rate of enteric infections reported to public health surveillance decreased during 2020 amid the coronavirus disease 2019 (COVID-19) pandemic. Changes in medical care-seeking behaviors may have impacted the diagnosis of enteric infections contributing to these declines. We examined trends in outpatient medical care-seeking behavior for acute gastroenteritis (AGE) in Colorado during 2020 compared with the that of previous 3 years using electronic health record data from the Colorado Health Observation Regional Data Service (CHORDS). Outpatient medical encounters for AGE were identified using diagnoses codes from the International Classification of Diseases 10th Revision and aggregated by year, quarter, age group, and encounter type. The rate of encounters was calculated by dividing the number of AGE encounters by the corresponding total number of encounters. There were 9064 AGE encounters in 2020 compared with an annual average of 18,784 from 2017 to 2019 (p < 0.01), representing a 52% decrease. The rate of AGE encounters declined after the first quarter of 2020 and remained significantly lower for the rest of the year. Moreover, previously observed trends, including seasonal patterns and the preponderance of pediatric encounters, were no longer evident. Telemedicine modalities accounted for 23% of all AGE encounters in 2020. AGE outpatient encounters in Colorado in 2020 were substantially lower than during the previous 3 years. Decreases remained stable over the second, third, and fourth quarters of 2020 (April-December) and were especially pronounced for children <18 years of age. Changes in medical care-seeking behavior likely contributed to declines in the number of enteric disease cases and outbreaks reported to public health. It is unclear to what extent people were ill with AGE and did not seek medical care because of concerns about the infection risk during a health care visit or to what extent there were reductions in certain exposures and opportunities for disease transmission resulting in less illness.

17.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617063

ABSTRACT

Background: Whilst the Irish Health Service Executive (HSE) currently recommends COVID-19 screening for all adult hospital admissions, current guidelines state that the screening of asymptomatic paediatric admissions is not necessarily required. However, clinically determining who requires testing can be difficult and subject to inter-carer variability. We sought to audit our acute admissions and swab results to determine rates of testing, characteristics of those being tested, and rates of positivity in a busy Irish tertiary paediatric unit. Methods: We reviewed the charts of 122 patients admitted acutely to our unit over the course of July 2021 to determine whether or not they had undergone COVID-19 screening using a nasopharyngeal PCR test and the clinical indication for testing. The clinical presentation of these admissions was analysed to try to determine positive predictive factors for COVID-19 screening and better streamline surveillance criteria. Results: A total of 122 admissions were analysed, with 74 (60.7%) having had a COVID-19 PCR test performed at the point of admission. Of these, 1 patient was found to be COVID-19 positive, giving an overall positivity rate of 0.8% amongst admissions analysed and 1.4% for admissions screened. The patient who returned a positive result was febrile at presentation but did not have any respiratory symptoms. Respiratory symptoms were documented for 45 of the 122 admissions (36.9%), and 42 of these underwent COVID-19 screening (93.3%). All swabs were negative. A total of 59 out of 122 were febrile at presentation, 55 (93.2%) of whom underwent screening. As above, 1 case tested positive. Of the afebrile patients, 19 out of 64 underwent COVID-19 screening. COVID-19 screening was performed in 12 patients who did not have a fever or respiratory symptoms at the time of presentation. In terms of non-respiratory presentations, screening was performed in 12 out of 14 (85.7%) presenting with gastritis/gastroenteritis, and 9 out of 12 (75%) presenting with a history and examination consistent with a UTI/pyelonephritis. Of 18 patients who were admitted with primarily psychiatric presentations, none had either a fever or respiratory symptoms at presentation, and none underwent COVID-19 screening. Conclusion: Our results reflect the existing data that COVID-19 appears to be less pathogenic in paediatric populations than in adult ones. Our low positivity rate compared to a high swab rate has repercussions in terms of bed allocation and isolation status. There is variation in terms of clinical criteria being viewed as sufficient to justify screening. Further study is required to determine consensus guidelines for COVID-19 surveillance in acute paediatric hospital admissions.

18.
Gastroenterology ; 160(6):S-609, 2021.
Article in English | EMBASE | ID: covidwho-1591792

ABSTRACT

Introduction Post-Infectious Irritable Bowel Syndrome May Occur After 10% Of Acute Gastrointestinal (Gi) Infections And Can Cause Significant Long-Term Morbidity. Covid-19 Frequently Presents With Acute Gi Symptoms, But It Is Unclear How Often These Persist After Recovery. The Purpose Of This Study Was To Estimate The Prevalence Of Persistent Gi Symptoms After Covid-19 And To Identify Risk Factors For This. Methods Adult Patients Who Were Hospitalized With Covid-19 At Columbia University Medical Center Between March 1 And June 30, 2020 And Had A Primary Care Appointment 30 To 180 Days After Discharge Were Reviewed For The Presence Or Absence Of Documented Gi Symptoms (Diarrhea, Abdominal Pain, Nausea/Vomiting, Or Constipation) At Initial Presentation With Covid-19 And At Primary Care Follow Up. Patients Were Excluded If They Had A Pre Existing History Of Irritable Bowel Syndrome, Other Chronic Gi Conditions, Or Acute Enteric Infections During Hospitalization With Covid-19 (E.G., Clostridioides Difficile Infection). The Prevalence Of Persistent Gi Symptoms After Covid-19 Hospitalization Was Estimated, And Risk Factors Were Assessed. Results 187 Patients Hospitalized With Covid-19 Met Study Inclusion Criteria. Of These, 37 Were Excluded For Pre-Existing Gi Symptoms And 3 For C. Difficile Infection, Leaving 147 Patients In The Cohort. The Most Common Gi Symptoms At Initial Presentation With Covid-19 Were Diarrhea (23%), Nausea/Vomiting (21%), And Abdominal Pain (6.1%). After A Median Follow-Up Time Of 106 Days (Iqr 78-141), 16% Of Patients Had Persistent Gi Symptoms (95% Confidence Interval 11 To 23%). An Additional 5% Of Patients Experienced Transient Gi Symptoms Which Resolved. At The Time Of Most Recent Follow-Up, 7.5% Of Patients Had New Abdominal Pain, 6.8% New Constipation, 4.1% New Diarrhea, And 4.1% New Nausea/ Vomiting (Table 1). The Prevalence Of Persistent Gi Symptoms After Covid-19 Was Significantly Higher Than The Estimated Prevalence Of Post-Infectious Irritable Bowel Syndrome After Acute Gastroenteritis (16% Vs. 10%, P=0.01) But May Decline Over Time (Figure 1). The Presence Of Gi Symptoms At The Time Of Initial Presentation Was A Risk Factor For Persistent Symptoms After Hospitalization For Covid-19 (22% Vs. 14%, P=0.21). Prior History Of Depression Was Also A Risk Factor For Persistent Gi Symptoms (28% Vs. 13%, P=0.04). Conclusion At A Median Of 106 Days After Discharge Following Hospitalization For Covid-19, 16% Of Patients Reported Persistent New Gi Symptoms. The Long-Term Gi Effects Of Covid-19 Should Be Further Studied.

19.
Gastroenterology ; 160(6):S-610, 2021.
Article in English | EMBASE | ID: covidwho-1591118

ABSTRACT

Introduction: Rome IV irritable bowel syndrome (IBS) is characterized by abdominal pain and altered bowel habits, and meta-analysis reveals a global prevalence of 3.8%. Using data from the “National GI Survey II”—a nationwide audit of gastrointestinal (GI) symptoms in nearly 90,000 adult Americans—we aimed to determine the prevalence, burden of illness, and healthcare seeking behavior of those who met Rome IV IBS criteria. Methods: We conducted the National GI Survey II from 5/3-6/24/20, a period coinciding with the peak of the initial COVID-19 wave in the U.S. A representative adult sample based on U.S. Census age, sex, and region data was recruited. The self-administered survey guided participants through the Rome IV IBS questionnaire, NIH GI PROMIS symptom scales, and questions on comorbidities and demographics. A primary outcome was prevalence of IBS based on Rome IV criteria;we also determined the presence and severity of non-cardinal IBS symptoms and healthcare seeking for abdominal pain, constipation, or diarrhea in those with IBS. We used multivariable logistic regression to adjust for confounding variables. Results: Of the 88,969 individuals who completed the survey, 6,543 (7.4%) met Rome IV IBS criteria: mixed IBS (IBS-M), 34.0%;IBS with constipation (IBS-C), 32.1%;IBS with diarrhea (IBS-D), 29.6%;unsubtyped IBS, 4.4%. Females, non-Hispanic Whites, and those 30-49yo and with comorbidities (e.g., prior gastroenteritis, fibromyalgia, inflammatory bowel disease) had statistically higher odds for meeting Rome IV IBS criteria (all p<.001). Differences in pain severity, as measured by PROMIS, were not evident among the subtypes (p>.05). Table 1 presents the presence and severity of symptoms beyond the cardinal IBS symptoms;those with IBS-D or IBS-M were more likely to report excess gas, heartburn, regurgitation, nausea/vomiting, pelvic pain, or bowel incontinence vs. those with IBS-C, but symptom severity scores were largely similar among groups. Those with IBS reported the following healthcare seeking behaviors for their cardinal IBS symptoms: ever sought care, 73.8%;ever sought care via telehealth, 19.4%;sought care in past 12 months, 59.7%. Table 2 presents the healthcare seeking data stratified by subtype;those with IBS-D and IBS-M were less likely to have sought care vs. those with IBS-C. Discussion: In this nationwide U.S. survey, we found that Rome IV-positive IBS is more prevalent (7.4%) vs. prior estimates. Additional research is needed to understand if this higher prevalence is in part due to the COVID-19 pandemic, as social distancing may have levied a psychological toll on many individuals, leading to alterations in the gut-brain axis and a propensity to develop IBS or gain greater awareness of symptoms. We also noted that people with IBS commonly experience other symptoms on top of their cardinal IBS symptoms.(Table presented) (Table presented)

20.
Gastroenterology ; 160(6):S-9, 2021.
Article in English | EMBASE | ID: covidwho-1598955

ABSTRACT

Introduction: Management of intractable Functional Constipation (FC) can include antegrade enemas, transanal irrigation and in some cases sacral nerve stimulation (SNS). SNS is expensive, invasive and not available in all centers. Although the mechanism of action of SNS in the treatment of FC is unclear, one of its effects is through direct modulation of nerve activity. Percutaneous tibial nerve stimulation (PTNS) allows transmission of electronic impulses and retrograde stimulation to the sacral nerve plexus in a simple and non-invasive fashion. Methods: Single-center, prospective interventional study. Children between the ages of 4-14 with Rome IV diagnosis of FC. Exclusion criteria: Neurological problems or organic causes of fecal or urinary incontinence. Over a 2-week period, children received 10 daily sessions of PTNS (30 min/day) during weekdays. Electrodes were placed over the skin of the ankle posteriorly. Placement of electrodes on the anatomic route of the posterior tibial nerve was confirmed through visualization of rhythmic flexion of toes during initial stimulation. Strength of the stimulus was below pain threshold. Children recorded characteristics of bowel movements (BMs) daily during the intervention and the following 7 days. Consistency was assessed through Bristol scale and quality of life (QOL) via PedsQL GI questionnaire. Results: 23 children were enrolled. One child was excluded for acute gastroenteritis (on the 7th session of PTNS) and one child for COVID-19 exposure. 20 patients completed the study (4-14 years) (8,4+/-3,2years, 71.4 % female) day 1 (n=21) to day 17(n=20). By the end of the trial, there was a significant improvement in consistency of BMs, fecal incontinence (FI) (no episodes of FI), presence and intensity of abdominal pain and a trend for improvement in blood in the stools (no children had blood in the stools) (Table 1). In PedsQL GI questionnaire, there was a 91.3% improvement of incomplete BM and 86.3% improvement in abdominal pain. Only one child required rescue therapy (no BM for 3 days). This child was the only treatment failure. Two children reported leg cramps that resolved by changing the side of PTNS application. At 7 days follow-up, there was persistently significant improvement in presence and intensity of abdominal pain and no children had FI or blood in the stools. Conclusion We found an improvement in stool consistency, FI, blood in stools and QOL at the end of the trial with sustained benefits in abdominal pain, blood in stools and FI at follow-up. The study suggests that PTNS may be a promising noninvasive treatment for FC in children. Larger studies with long-term follow-up should confirm our findings. Controlled randomized clinical trials with various protocols are recommended. (Table Presented)

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