Small Intestinal Bacterial Overgrowth Syndrome Prevalence in Romanian Patients with Inflammatory Bowel Disease.

BACKGROUND: small intestinal bacterial overgrowth (SIBO) is an entity commonly associated with digestive disease. Recently, its association with inflammatory bowel diseases (IBD) made the object of an increasing number of investigations. Sometimes symptoms of excessive bacterial populations may overlap or mimic flares of inflammatory disease. METHOD: patients with IBD (CD - Crohn disease and UC - ulcerative colitis) in remission underwent screening for the presence of SIBO using the hydrogen breath test. RESULTS: of the 75 patients tested, the breath test was positive for SIBO in 25.3% (30.77% of patients with CD and 19.4% of patients with UC). The risk factors associated with the presence of this syndrome were identified as: pancolonic impairment in UC, perianal and ileo-colonic involvement in CD, postoperative absence of the ileocecal valve. Patients in remission with bacterial overgrowth tend to present more frequently: a higher daily average of stools, a lower BMI (body mass index) and much more frequent complaints of persistent flatulence. CONCLUSIONS: patients with Crohn's disease suffer from small intestinal bacterial overgrowth syndrome more frequently than those with ulcerative colitis. The hydrogen breath test may be used, along with other laboratory methods, to distinguish between an inflammatory bowel disease and an overlap of small intestinal bacterial overgrowth.

Intestinal Microbiome, Small Intestinal Bacterial Overgrowth and Inflammatory Bowel Diseases - What are the Connections?

IBD (inflammatory bowel diseases) represent chronic idiopathic inflammatory diseases, prone to relapse in the digestive tract; it is estimated that they result from the interaction of the intestinal microbiome with the intestinal immune system. The inflammatory microbiome exerts multiple beneficial roles. Perhaps the central element to developing IBD is dysbiosis; there is still an incompletely established association between intestinal microbiome changes in patients with IBD and SIBO (small intestinal bacterial overgrowth). Influencing the intestinal microbiome may play an adjuvant therapeutic role in the treatment of IBD. We present a synthesis of the connections between the entities mentioned above.

[The epidemiological characteristics of influenza in a large urban center (B.) of Romania in 1991]. / Caractéristiques épidémiologiques de la grippe dans un grand centre urbain (B.) de Roumanie, en 1991.

The peculiarities of the 1991 influenza epidemics in a big urban centre (B.) of Romania were evaluated through clinical and epidemiological active survey and laboratory assays. The results revealed the low rate of endemic morbidity and its significant risk during the fourth trimester as compared to the first, the important implication of the infant population in maintaining the endemic morbidity and of the less than one year old children in the seasonal peaks of the first and fourth trimesters. The laboratory assays revealed the simultaneous circulation but with variable intensity of type A(H3N2), A(H1N1) and B influenza viruses, inducing a high humoral specific protection level in the population. So the risk is low of an important epidemics during 1992. The opportunity is discussed of the prophylactic vaccination with type A(H3N2), A(H1N1) and B circulating strains of all high risk groups, especially of the preschool children from collectivities.

[The evolutionary characteristics of an influenza epidemic in a large urban center (B.) of Romania between 1988 and 1990]. / Caractéristiques de l'évolution de l'épidémie de grippe dans un grand centre urbain (B.) de Roumanie dans l'intervalle 1988 à 1990.

The report presents the peculiar characteristics of influenza epidemics in a big urban centre (B.) of Romania, between 1988 and 1990, surveyed by clinical, epidemiological and laboratory methods. Among the peculiarities of the epidemics: the low rate of endemic morbidity, the seasonal and preseasonal peaks, the very high implication of infantile population in influenza A(H3N2), A(H1N1) and B virus circulation, as well as the high level of mass specific humoral protection against these viruses. Elements of epidemiologic prognosis are suggested for 1991. Opportunity of vaccine prophylaxis using WHO recommended virus strains of the three types: A(H3N2), A(H1N1) and B, for risk groups is discussed.

Epidemiological aspects of the evolution of influenza infections in a large urban centre (B.) in Romania in 1988.

The study describes the peculiarities of the influenza infection evolution, in 1988, in a large urban centre, B., in Romania, as they result from the active surveillance of the epidemiological process of influenza and other viral respiratory tract infections, by means of a complex methodology based on clinical-epidemiological and laboratory techniques. The low endemic morbidity, the evolution of these seasonally ascendant specific incidence, the endemic aspect of influenza infection being maintained as a consequence of its predominance in infants and children, the clinically mild form of the outbreaks, all these are specific elements of the epidemiologic impact in the surveyed territory. They are discussed in accordance with the results of laboratory tests (seroepidemiologic and diagnostic) that confirmed the permanent circulation of influenza virus types A(H1N1), A(H3N2) and B in all age groups.

Epidemiologic features of influenza in a large urban centre (B.) in Romania, in 1987.

The study presents the peculiarities of influenza evolution in 1987 in a large town in Romania. These features were defined by a complex methodology, based on clinical, epidemiologic and laboratory investigations, used in the active control of the epidemiologic process kinetics. The influenza viruses type A (H1N1 and H3N2) had a major role in the infecting and immunizing contacts in all age groups whereas the influenza virus type B had a reduced circulation. The epidemiologic influenza impact in 1987 is discussed from the point of view of the complex relationships between the antigenic structure of circulating influenza viruses and the anti-influenza immune profile of the population under the influence of extremely complex economic, social and natural factors.

Epidemiologic particularities of influenza in 1986 in a large urban centre of Romania.

The study presents the evolutive peculiarities of the epidemiologic influenza process in 1986 in a large urban centre in Romania, inferrable from the active control by a complex methodology based on clinical, epidemiologic and laboratory investigations. The prevalent part of A (H1N1 and H3N2) and B influenza viruses in causing seasonal morbidity risings is being stressed. A (H3N2) and B influenza viruses determined an epidemic rising during the first trimester and A (H1N1) and A (H3N2) during the fourth trimester in 1986. The epidemiologic influenza impact in 1986 is discussed from the point of view of the complex relationships between the antigenic structure of circulating influenza viruses and the antiinfluenza immune structure of the population.

Epidemiological features of influenza in a large town of Romania during 1983.

Data supplied by the active influenza surveillance - including clinical, epidemiological and laboratory investigations - allowed the characterization of the particularities of an influenza outbreak caused by A(H3N2) virus in a large town of Romania in March 1983. The epidemiological impact of influenza in 1983 is discussed in the light of the complex relationships between the antigenic structure of circulating influenza strains and the profile of antiinfluenza immunity of the population.

Epidemiological particularities of influenza in a town of Romania during 1982.

The particularities of influenza evolution in a large town of Romania during 1982 are outlined on the ground of the data obtained by a complex methodology of active influenza surveillance. The epidemiological features of influenza are discussed within the complex framework of the relationships between the antigenic structure of circulating influenza viruses and the profile of antiinfluenza immunity among the population.

Investigations on the involvement of swine influenza A virus (Hsw1N1) in the influenza outbreak recorded in a town of Romania during the 1976--1977 winter season.

Seroepidemiological investigations performed with 1,620 serum samples and serodiagnostic tests with 166 paired sera demonstrated that swine influenza virus type A/New Jersey 8/76 (Hsw1N1) played no role in the epidemiology of human influenza in a large town of Romania during 1977.

Epidemioligical particularities of influenza outbreaks in a town of Romania during 1975.

Results are presented of the complex epidemiological influenza surveillance in a large town of Romania during 1975. The comprehensive and unitary methodology including systematic laboratory, clinical and epidemiological investigations supplied data on the influenza type A outbreak recorded during the first term of 1975. The factors of importance for epidemiological prognosis -- seroepidemiological indicators of the immunological profile of the population according to age groups, serodiagnostic and virological investigation clinically diagnosed influenza cases, complex epidemiological surveys in representative foci, study of the antigenic structure of the influenza strains isolated -- are outlined. The importance of a continuous, complex influenza surveillance for the differential orientation of prophylaxis and control steps is emphasized.

[Details of the evolution of the influenza epidemic process in the city of Bucharest in 1974]. / Particularitati de evolutie a procesului epidemic gripal în Municipiul Bucuresti în anul 1974

The present paper reports on the results of a complex epidemiologic survey of the epidemiologic potential of influenza in Bucharest in 1974, conducted on the basis of a complete, unitary methodology including; (a) Dynamic survey of the morbidity and mortality from influenza, with statistical-mathematical processing of the data per age group and total population; (b) Monthly sero-epidemiologic survey of the antiinfluenza immunologic profile of the population, determined in lots of 540 sera (annual total 7020 serum samples), with statistical-mathematical processing of the serograms; (c) Serodynamic determinations of 67 paired serum smaples collected from patients presenting influenza syndromes during ascension of the epidemic morbidity from influenza; (d) Complex epidemiologic surveys in representative influenza foci in children, adolescent and adult communities. Based upon the result obtained the authors discuss the evolutive particularities of the epidemiologic process in Bucharest, particularly during the epidemic ascension of the first trimester of 1974, caused by the intensified circulation of influenza virus type B. The orientative value of certain elements for the epidemiologic prognosis is emphasized, such as: the immunologic profile of the population per age group with regard to the circulating influenza virus strains (autochtonous or imported strains), active control of the incidence of influenza in communities (technical schools etc.) or enterprises with a large number of employees, laboratory etiologic determinations in cases of a clinical diagnosis of influenza in a preepidemic season. The authors' ten years experience in the active survey of the active epidemiologic potential of influenza in the town of Bucharest shows that the methodology applied was efficient both for scientific assessing of the epidemiologic situation and for an orientation in the choice of preventive and control measures.