Control Of Diarrhea Research Articles

Effects of Shu Bu Wenshen Guchang recipe on intestinal injury and the TLR4/NF-κB signaling pathways in mice with irinotecan-induced delayed-type diarrhea.

BackgroundIrinotecan (also known as CPT-11) is a topoisomerase I inhibitor that is primarily used for the treatment of advanced colorectal cancer. CPT-11 and its active metabolite SN-38 can directly damage intestinal mucosal cells. In addition, CPT-11 can activate the Toll-like receptor 4 (TLR4) inflammasome/nuclear factor kappa-B p65 (NF-κB p65) pathway, ultimately leading to intestinal inflammation-related injury. Shu Bu Wenshen Guchang recipe (SBWGR) has the spleen and kidneys. Herein, we investigated the effects of SBWGR on intestinal injury and the TLR4/NF-κB signaling pathways in mice with CPT-11-induced delayed-type diarrhea, aiming to provide evidence for the treatment of CPT-11-induced delayed-type diarrhea.MethodsThirty tumor-bearing mice were divided into normal control, model control, octreotide, low dose SBWGR, and high dose SBWGR groups, with 6 mice in each group. After successful modelling of delayed diarrhea, the normal and model control groups were given equal amounts of saline for 5 consecutive days, and the other three groups gave the corresponding intra-drug administration. Body weight, tumor size, Chiu score, intestinal ischemia and reperfusion injury, and disease activity index (DAI) were recorded in each group. The levels of intestinal interleukin-1β (IL-1β), IL-18, and tumor necrosis factor-α (TNF-α) were measured by an enzyme-linked immunosorbent assay (ELISA). Intestinal TLR4 and NF-κB p65 levels were measured by reverse transcription-polymerase chain reaction (RT-PCR) and protein blotting.ResultsThe weight of octreotide and kidney was higher than the control group (P<0.05); The tumor volume comparison of the model control group, octreotide group, warm kidney intestine low dose group, and warm kidney intestine high dose group were not significantly different (P>0.05). Octreotide group, intestinal Chiu score, diarrhea score, DAI level, intestinal inflammatory cytokines, IL-1β, IL-18 and TNF-α intestinal level, intestinal TLR4, NF-κB p65 mRNA protein expression levels were significantly lower than those of the model control group (P<0.05), and the amount of the treatment group was increased (P<0.05).ConclusionsSBWGR exerts a prominent protective effect on intestinal damage caused by CPT-11-induced delayed-type diarrhea, which may be achieved by inhibiting the activation of the intestinal TLR4/NF-κB signaling pathway.

Household Baseline Survey on Indigenous Chicken Production Characteristics and Constraints in Busia and Machakos Counties of Kenya

Aims: To collect preliminary baseline data prior to validation of three climate-smart technologies.&#x0D; Study Design: A structured questionnaire was employed with participation of actors along the Indigenous Chicken value chain.&#x0D; Place and Duration of Study: Study was conducted from May 2019 to June 2020 within four (4) Sub-Counties in Busia and Machakos where high Indigenous Chicken populations are found.&#x0D; Methodology: A total of 160 households were surveyed. Targeted household information was recorded viz: distribution of respondents by village in the Counties; farmer socio-economic factors; flock structure and characteristics; disease and parasite constraints, management practices; disease reporting and communication amongst recruited farmers.&#x0D; Results: Results revealed that 56.5% of the respondents were male and 43.5% were female wit mean age of 50 years. Most farmers had formal education (97%) and practiced semi extensive poultry farming system (59%). Both indigenous and exotic chicken (62%) were kept for income purposes (82.6%) and only young chicks received feed supplements (55.8%). Newcastle (18.5%) and coccidiosis (16.4%) comprised the two major disease constraints reported. Prevalent bird disease symptoms were diarrhea (24.9%) and coughing (23.1%) while mites (27.9%) and fleas (22.3%) dominated the ecto-parasites. Disease control strategies comprised: vaccines (72.8%), dewormers (44.9%) and ethno-veterinary medicine. Aloe secundiflora and Aloe feroxin, were singled out as locally available and effective means of treating diarrhea (62.9%), respiratory infections (61.9%) and worm control (64.5%). Most Indigenous Chicken farmers (76.8%) failed to report illnesses among their flock and did not access to health services (72.1%). Farmers accessed health information through radio (26.5%) as opposed to mobile phones (1.65%).&#x0D; Conclusion: Findings of this survey reveal a low-grade free-range poultry system characterized by poor disease control. This scenario calls for targeted efforts by both government and private stakeholders to improve Indigenous Chicken management and help farmers adopt alternative climatic smart disease control interventions.

Evidence-Based Recommendations for Herd Health Management of Porcine Post-Weaning Diarrhea.

Simple SummaryIn this paper, you will find recommendations on how to prevent post-weaning diarrhea in pigs kept in indoor pig herds. The recommendations are based on the scientific knowledge that is currently available. The authors first validated that Danish veterinarians working with pigs demanded such recommendations. Then, we collected papers written by other researchers who had summarized the scientific knowledge on different topics related to post-weaning diarrhea. From the papers, we extracted and synthesized 79 specific recommendations that may help veterinarians and pig producers make good decisions for their pig herd. The paper exemplifies a novel approach to summarizing and transferring science into practice that may be of interest to people that are not involved with pigs and post-weaning diarrhea.Aided by their advising veterinarians, pig producers need to make difficult decisions regarding herd health management strategies. For instance, the preventive use of antimicrobials and medicinal zinc oxide must be substituted with more sustainable preventive approaches to porcine post-weaning diarrhea. Veterinarians and pig producers may find assistance in knowledge based on evidence in this regard; however, the overwhelming scientific literature is not always readily available. The overall aim of this paper is to suggest herd health management decision-support tools that can aid veterinary-assisted decision making in the control of porcine post-weaning diarrhea at a tactical level. The first objective was to validate the need for a herd health management concept, including two decision-support tools. The second objective was to develop evidence-based recommendations that can aid veterinary-assisted decision-making for the herd health management of post-weaning diarrhea. The first objective was investigated by a questionnaire-based study among veterinary pig practitioners in Denmark. For the second objective, we conducted a scientific summary based on scientific review papers identified through a systematic search in three databases. From the papers, we synthesized and extracted 79 specific recommendations. In this paper, we report comprehensive evidence-based recommendations for the herd health management of post-weaning diarrhea.

Control of Post-Bariatric Diarrhea by Intensive Treatment for Lymphedema

Control of Post-Bariatric Diarrhea by Intensive Treatment for Lymphedema

Improved Electrolyte and Fluid Balance Results in Control of Diarrhea with Crofelemer in Patient with Short Bowel Syndrome: A Case Report

Short bowel syndrome (SBS) is a rare malabsorptive disorder characterized by the inability to maintain a balance of fluids, electrolytes, and nutrients when taking a conventional diet. SBS can cause chronic, severe diarrhea and malnutrition, often requiring dependence on parenteral nutrition.

Epidemic and Evolutionary Characteristics of Swine Enteric Viruses in South-Central China from 2018 to 2021.

Swine enteric viruses are a major cause of piglet diarrhea, causing a devastating impact on the pork industry. To further understand the molecular epidemiology and evolutionary diversity of swine enteric viruses, we carried out a molecular epidemiological investigation of swine enteric viruses (PEDV, PDCoV, PoRVA, and TGEV) on 7107 samples collected from pig farms in south-central China. The results demonstrated that PEDV is the predominant pathogen causing piglet diarrhea, and its infection occurs mainly in relatively cold winter and spring in Hunan and Hubei provinces. The positive rate of PEDV showed an abnormal increase from 2020 to 2021, and that of PoRVA and PDCoV exhibited gradual increases from 2018 to 2021. PEDV-PoRVA and PEDV-PDCoV were the dominant co-infection modes. A genetic evolution analysis based on the PEDV S1 gene and ORF3 gene revealed that the PEDV GII-a is currently epidemic genotype, and the ORF3 gene of DY2020 belongs to a different clade relative to other GII-a strains isolated in this study. Overall, our results indicated that the variant PEDV GII-a is the main pathogen of piglet diarrhea with a trend of outbreak. G9 is the dominant PoRVA genotype and has the possibility of outbreak as well. It is therefore critical to strengthen the surveillance of PEDV and PoRVA, and to provide technical reserves for the prevention and control of piglet diarrhea.

Dahi (an immunonutrient) in India Culture

Indian dahi, its history of origin, uses and benefits are reviewed. Studies were undertaken to observe effects of fermented milk in control of diarrhoea in children. India with high prevalence and severity of malnutrition, overpopulation and mainly vegetarian society are in need to develop protein sources with richness of minerals and vitamins; thus dahi (made with- lactobacillus bulgaricus and streptococcus thermophilus) and other vegetable source Berseem leaves (Trifolium Alexandrium) were studied in children patients suffering from protein energy malnutrition needing hospitalization, for acceptability and improvement in health i.e. appetite, weight gain, increase in haemoglobin. Study patients had clinical or laboratory evidence of infection, but only 32% patients were CRP positive (blunted response). The T cell lymphocytes CD3, CD4 and CD8 were in normal range and supplementation did not alter the counts. The baseline cytokine levels (TNFα, IFNγ, IL-10 and IL-4) were high in malnourished children. On feeding dahi and LPC diets the serum proinflammatory (TNFα, IFNγ), and anti-inflammatory (IL-10) cytokine levels, increased. The increase in IL-10 was higher in children receiving dahi diet. On comparing dahi diet against milk diet IL-1, IL-6 levels increased significantly on day 15th and at 6 weeks (p&lt;0.001), in both the groups. However, IL-10 showed rise on day 15th and 6 weeks on dahi diet, in contrast milk diet patients showed fall on 15th day with subsequent rise at 6 weeks. The mean initial absolute lymphocyte counts were 3707±1551 and 4553±1776/ µl on dahi and milk diets, after 6weeks of treatment the corresponding values increased to 6312±1937 and 3493±1418 µl, respectively, (p=0.004). Similar, trend was observed for CD3+, CD4+, CD8+, CD19+ and CD56+ cells in two treatment groups. These observations demonstrate that dahi has immunonutrient properties.

Mothers' knowledge, attitude and home management of diarrhoea among children under five years old in Lagos, Nigeria.

BackgroundDiarrhoea is a leading cause of death among children under five years old globally. It remains a major cause of morbidity and mortality among this age group in Nigeria. Using simple home management, mothers play important roles in the prevention and control of diarrhoea among these children.AimThis study aimed to assess mothers’ knowledge, attitude and practice in the prevention and home management of diarrhoeal diseases among children under five years old in Lagos, Nigeria.SettingThis study was conducted within the communities of Kosofe local government area of Lagos State, Nigeria.MethodsA descriptive cross-sectional study design was conducted using a multistage sampling technique. Data were collected using a structured interviewer-administered questionnaire and analysed using EPI info version 7.2.1. Chi-square statistic was used to test the association between variable at the level of significance of 5%.ResultsA total of 360 respondents participated in this study. The mean age of the respondents was 32.5 ± 5.5 years. About 59.2% of respondents had good knowledge, 59.2% of them had positive attitude, and 53.1% of them had good practice towards prevention and home management of diarrhoea. Age (p = 0.007), occupation (p = 0.008) and level of education (p = 0.001) were significantly associated with practice of home management of diarrhoea among children under five years old.ConclusionEducated, employed, and married mothers were more likely to have good prevention and home management practices towards diarrhoea in their children under five years old.

Aichivirus C isolate is a diarrhoea-causing pathogen in goats.

Aichivirus C is an emerging virus in goats, but its biological significance remains unknown. In this study, 18 diarrheic and 16 non-diarrheic faecal samples of kids were collected from a farm with an on-going diarrheic outbreak in Sichuan Province, China in May 2021. Of these samples, 77.8% (14/18) of diarrheic samples were detected as Aichivirus C positive by RT-PCR, which was significantly higher than that of non-diarrheic faces (0%, p<.001); meanwhile, other common diarrhoea-causing pathogens in goats were not detected in diarrheic samples, except for two samples that were detected as caprine enterovirus positive, suggesting that Aichivirus C was associated with goat diarrhoea. Furthermore, five Aichivirus C strains were successfully isolated from positive samples using Vero cell lines and two isolates were further plaque-purified, named SWUN/F5/2021(10-6.7 TCID50 /0.1mL) and SWUN/F6/2021(10-7 TCID50 /0.1mL). Interestingly, Aichivirus C strain could cause systemic infection in experimental kids via oral administration, with the main clinical manifestation being severe watery diarrhoea. Histopathological changes observed in the duodenum and jejunum were characteristic, with shedding of mucosal epithelial cells. In addition, the virus was detected in tissues of diarrhoea kids naturally infected with Aichivirus C, exhibiting pathological changes similar to those of experimental infections. Overall, this study first isolated Aichivirus C and confirmed its pathogenicity in kids, with further study needed to better understand the virus pathogenicity. As Aichivirus C has been detected in South Korea, Italy and the USA and widely prevalent in southwest China, the results obtained here have significant implications for the diagnosis and control of diarrhoea in goats.

Cattle Review

Introduction: In this Cattle Review we consider open access papers, all from the Journal of Dairy Science, looking at farmers' attitudes towards bovine viral diarrhoea control, consumers' attitudes towards separating cows and calves, and pain control when disbudding.

Cangpu Oral Liquid as a Possible Alternative to Antibiotics for the Control of Undifferentiated Calf Diarrhea.

Antibiotics are essential in the prevention of calf diarrhea epidemics. As more antibiotics become ineffective due to drug-resistant bacteria, attention must be directed toward alternative treatments for calf diarrhea. Natural antibiotic alternatives, such as Chinese herbal medicine, have become a research hotspot in the clinical treatment of diseases such as calf diarrhea due to their characteristics of fewer side effects, low cost, little residue, and no drug resistance. The Cangpu Oral Liquid (CP) was modified from a traditional herbal formula that had been widely used in ancient China to treat gastrointestinal diseases in animals. In order to evaluate the treatment effect of CP on neonatal calf diarrhea, a randomized controlled field trial was performed. Two hundred and forty-six diarrheal Holstein calves of 2–15 days old were selected and randomly divided into two treatment groups receiving either apramycin or CP. 101 out of 123 calves recovered from diarrhea in the CP group, whereas 77 out of 123 calves showed recovery after antibiotic therapy. There were no differences in initial weight between both groups, while the final weight was significantly different (P = 0.892, P = 0.025, respectively). The mean average daily gain (ADG) of calves (211.45 gram/day) in the CP group was significantly higher compared to the antibiotic group (164.56 gram/day) (P = 0.001). The CP group also showed a shorter recovery time from diarrhea (3.90 days vs. 6.62 days, P = 0.001). The current results indicate that the CP has a beneficial clinical effect on the treatment of diarrhea in neonatal calves and is an effective alternative treatment option.

Molecular Variation between RT-PCR Detected Rotavirus Infection of Naturally Diarrheic Neonatal Calves and Rotavirus Strains of Commercial Vaccines

Neonatal diarrhea is the main cause of morbidity and mortality in calves, and Rotavirus is the main viral etiology. Rotavirus vaccines are one of the main important methods for control of diarrhea in neonates’ calves. In the current study, Deoxyribonucleic acid (DNA) sequencing and phylogenetic analysis of Bovine Rotavirus Group a (BRVA) were performed in our study. 1 Calf guard® vaccine genotype (G6P1) and 5 different field genotypes (2 G6P5, 1 G10P5, G10P? and 1 G10P11) were subjected to DNA sequencing. We observed that at the nucleotide level, G10P5 and G10P? Sequences were 100 % identical with each other, two G6P5 sequences were 100% identical with each other and there was no significant similarity between sequences of G10P11 with sequences of G6P5, G10P5, and G10P? The phylogenetic analysis of G10P5 and G10P? Isolates showed a close cluster with G10 isolates of Sharkia governorate, Egypt, phylogenetic analysis of two G6P5 and one G10P11 isolate showed a close cluster with the VP4 gene of Rotavirus isolates of Dakahlia Governorate, Egypt. Molecular comparison between detected and typed Rotaviruses’ genotypes with other genotypes of common vaccines indicated that there were genetically close or distance between field and vaccine Rotavirus strains. Our results can be concluded as the following, Molecular comparison between detected and typed Rotaviruses’ genotypes with other genotypes of common vaccines indicated that there was genetically close or distance between field and vaccinal Rotavirus strains. Also, we suggest that Rotavac vaccine containing G6P5 Rotavirus strain and Scour guard vaccine containing can be used in Assiut governorate due to circulating of G6P5 and G10P11 strains of Rotavirus in Assiut.

Exploring the effect of the primary care health workers number on infectious diarrhea morbidity and where the health resources should go

We aimed to explore the association between the number of primary healthcare workers and infectious diarrhea morbidity at community levels and to provide evidence-based implications for optimizing primary healthcare manpower resource allocations. We collected annual infectious diarrhea morbidity and relevant data of 4321 communities in Sichuan Province, China, from 2017 to 2019. Global and local Moran’s I were calculated to detect the spatial clustering of infectious diarrhea morbidity and to identify areas where increased primary healthcare manpower resources should be allocated. The spatial lag fixed effects panel data model was adopted to explore the association between the number of primary healthcare workers per 1000 residents and infectious diarrhea morbidity. Significantly high–high and low–low clusters of infectious diarrhea cases were found to be mainly distributed in underdeveloped and developed areas during the studied period years, respectively. The infectious diarrhea morbidity was found to be statistically negatively associated with the number of primary healthcare workers per 1000 residents with a coefficient of − 0.172, indicating that a 0.172 reduction of infectious diarrhea morbidity (1/10,000) was associated with doubled amounts of primary healthcare workers per 1000 residents. Our findings highlighted the role of primary healthcare in the process of infectious diarrhea prevention and control, and implied that constant efforts should be addressed to facilitate infectious diarrhea prevention and control, especially in the underdeveloped areas.

Spatiotemporal patterns of diarrhea incidence in Ghana and the impact of meteorological and socio-demographic factors.

Diarrhea remains a significant public health problem and poses a considerable financial burden on Ghana's health insurance scheme. In order to prioritize district-level hotspots of diarrhea incidence for effective targeted interventions, it is important to understand the potential drivers of spatiotemporal patterns of diarrhea. We aimed to identify the spatiotemporal heterogeneity of diarrhea incidence in Ghana and explore how meteorological and socio-demographic factors influence the patterns. We used monthly district-level clinically diagnosed diarrhea data between 2012 and 2018 obtained from the Centre for Health Information and Management of the Ghana Health Services. We utilized a hierarchical Bayesian spatiotemporal modeling framework to evaluate potential associations between district-level monthly diarrhea incidence and meteorological variables (mean temperature, diurnal temperature range, surface water presence) and socio-demographic factors (population density, Gini index, District League Table score) in Ghana. In addition, we investigated whether these associations were consistent across the four agro-ecological zones. There was considerable spatial heterogeneity in diarrhea patterns across the districts, with clusters of high diarrhea risk areas mostly found in the transition and savannah zones. The average monthly temporal patterns of diarrhea revealed a weak biannual seasonality with major and minor peaks in June and October, respectively, coinciding with the major and minor rainy seasons. We found a significant association between both meteorological and socio-demographic factors and diarrhea risk, but the strength and direction of associations differed across the four agro-ecological zones. Surface water presence demonstrated consistently positive, while diurnal temperature range and population density demonstrated consistently negative associations with diarrhea both overall and across the agro-ecological zones. Although overall diarrhea incidence is declining in Ghana, our results revealed high-risk districts that could benefit from district-specific tailored intervention strategies to improve control efforts. Ghana health sector policy-makers can use these results to assess the effectiveness of ongoing interventions at the district level and prioritize resource allocation for diarrhea control.

Reminder Message as an effort to Increase the Compliance of Mother Toddler Visits to Posyandu

Posyandu is a monthly routine activity designed to monitor the weight gain of toddlers by using the "Menuju Sehat" (KMS) card, providing nutrition counseling, and providing basic health services (immunization and diarrhea control). Reminder Message is a message that helps someone to remember something. Reminders can be more useful when contextual information is used to present information at the right time and in the right place. Reminder messages can be used to remind mothers of toddlers to schedule visits to their children's posyandu and increase the compliance of mothers with toddlers to posyandu. Objective: This study aims to determine the effectiveness of reminder messages on the compliance of mothers with toddlers visiting the posyandu in the working area of the Malaimsimsa Health Center Sorong City in 2021. Methods: The research design is a quasi-experimental approach with a one group pre-post test design. Sampling with purposive sampling technique, as many as 30 respondents consisting of 15 mothers and 15 toddlers. Data analysis was tested by Wilcoxon test. Results: there was an increase in the compliance of mothers toddlers to the posyandu where the p-value was 0.002 (&lt;0.05). Conclusion: reminder messages are effective in increasing compliance with visits by mothers toddlers visit to posyandu.

Probiotics and Health Benefits

Recently, the use of probiotics by human beings through different delivery routes is increased. These are those microorganisms that produce positive health benefits to the host. Different species of probiotics are used in human food matrices, but the commonly used probiotics are related to Bifido-bacteria and Lactobacillus genus. The health benefits attributed to probiotic consumption are investigated in numerous human and animal studies. These benefits are the improvement of metabolic disorders like control of diarrhea, improvement in lactose intolerance, prevention of colon cancer, treatment of H. pylori; decrement in blood cholesterol, alleviation in sensitivity and so forth. etc... The mentioned health benefits are species species-dependent. These microorganisms produce the benefits through several mechanisms such as competitive exclusion of pathogens and colonization resistance, normalization of altered microbiota, Anti Anti-proliferative effect, competition for nutrients, production of inhibitory substances, production of short chain fatty acids, and degradation of toxin receptors, immune effects, and regulation of intestinal transit. In this article, information and the results of recently conducted research concerning probiotics, its properties and mechanism of action, and health benefits of probiotics are gathered and discussed.

Investigating the development of diarrhoea through gene expression analysis in sheep genetically resistant to gastrointestinal helminth infection

Gastrointestinal helminths infect livestock causing health problems including severe diarrhoea. To explore the underlying biological mechanisms relating to development and control of diarrhoea, we compared 4 sheep that were susceptible to development of diarrhoea with 4 sheep that were diarrhoea-resistant. Transcriptomes in the tissues where the parasites were located were analyzed using RNASeq. By considering low-diarrhoea sheep as control, we identified 114 genes that were down-regulated and 552 genes that were up-regulated genes in the high-diarrhoea phenotype. Functional analysis of DEGs and PPI sub-network analysis showed that down-regulated genes in the high-diarrhoea phenotype were linked to biological processes and pathways that include suppression of ‘antigen processing and presentation’, ‘immune response’, and a list of biological functional terms related to ‘suppression in immune tolerance’. On the other hand, up-regulated genes in the high-diarrhoea phenotype probably contribute to repair processes associated with tissue damage, including ‘extracellular matrix organization’, ‘collagen fibril organization’, ‘tissue morphogenesis’, ‘circulatory system development’, ‘morphogenesis of an epithelium’, and ‘focal adhesion’. The genes with important roles in the responses to helminth infection could be targeted in breeding programs to prevent diarrhoea.

Randomized, parallel arm, phase II study of telotristat (Xermelo) in combination with lutetium Lu 177 dotatate (Lutathera) in well-differentiated neuroendocrine tumors (NETs).

TPS516 Background: PRRT using Lutetium Lu 177 Dotatate, has been approved by the FDA for metastatic, progressive gastroenteropancreatic neuroendocrine tumors (GEPNETs). Despite an impressive progression-free survival noted in NETTER-1 study, most patients will eventually progress after PRRT treatment. Increased serotonin secretion is found in a number of slow-growing NETs of the diffuse neuroendocrine system. Serotonin stimulates proliferation in cell lines of a typical (NCI-H727), an atypical (NCI-H720) bronchopulmonary NET, a small intestinal NET (KRJ-I), and a functioning human pancreatic carcinoid cell line (BON). This stimulation of growth by serotonin can be performed in an autocrine manner. Telotristat ethyl is a novel oral inhibitor of tryptophan hydroxylase (TPH), the rate-limiting enzyme in serotonin biosynthesis. In 2017, results of placebo-controlled phase III study (Telestar) evaluating Telotristat ethyl confirmed that among patients with carcinoid syndrome not adequately controlled by somatostatin analogs, treatment with Telotristat ethyl was generally safe and well tolerated and resulted in significant reductions in bowel movement frequency and urinary 5- hydroxy indoleacetic acid (u5-HIAA). Based on results of the Telestar trial, FDA approved 250 mg PO TID dosage of Telotristat for control of carcinoid syndrome diarrhea. Of note, 500 mg TID arm showed increased decline in urinary 5-HIAA as compared to 250 mg TID arm. Study Hypotheses: We hypothesize that inhibition of serotonin production will lead to cytostatic effect on neuroendocrine tumors and will complement anti-tumor activity of lutetium 177 dotatate. We anticipate our proposed combination will result in improved treatment efficacy as reflected by improved 20-month PFS as compared to historical control (NETTER-1). Methods: This is a single center, open label, randomized, parallel arm, phase II study evaluating two dose levels of Telotristat (Xermelo; 250 mg vs 500 mg) in combination with Lutetium Lu 177 Dotatate (Lutathera) in 70 well-differentiated neuroendocrine tumor patients. Study is currently enrolling patients and is expected to complete accrual in 3 years. Clinical trial information: NCT04543955.

Impact of colistin and colistin-loaded on alginate nanoparticles on pigs infected with a colistin-resistant enterotoxigenic Escherichia coli strain

Colistin is frequently used for the control of post-weaning diarrhoea in pigs. Colistin resistance caused by plasmidic genes is a public health issue. We evaluated, in experimental animal facilities, whether free colistin or colistin-loaded on alginate nanoparticles (colistin/Alg NPs) could select a colistin-resistant Enterotoxigenic Escherichia coli. The Alg NPs were produced by a simple top-down approach through ball milling of sodium alginate polymer precursor, and colistin loading was achieved through physical adsorption. Colistin loading on Alg NPs was confirmed using various tools such Fourier transform infrared spectroscopy and dynamic light scattering measurements. Thirty-four piglets were orally inoculated or not with a mcr-1-positive, rifampicin-resistant enterotoxigenic E. coli strain, and the inoculated pigs were either treated or not during five days with commercial colistin (100,000 IU/kg) or colistin/Alg NPs (40,415 IU/kg). Clinical signs were recorded. Fecal and post-mortem samples were analyzed by culture. The result clearly indicated that colistin/Alg NPs had a slightly better therapeutic effect. Both treatments led to a transitory decrease of the total E. coli fecal population with a majority of colistin-resistant E. coli isolates during treatment, but the dominant E. coli population was found susceptible at the end of the trial. Further studies are needed to evaluate, in diverse experimental or field conditions, the therapeutic efficacy of colistin/Alg NPs for post-weaning diarrhoea.

Home-based management practice of diarrhea in under 5 years old children and associated factors among caregivers in Ginchi town, Oromia region, west Ethiopia.

Objective:The study was aimed to assess the home-based management practice of diarrhea and associated factors among caregivers in children under 5 years old at Ginchi town, Oromia region, West Ethiopia.Methods:A community-based cross-sectional study was conducted among 335 caregivers in Ginchi town. Data were collected using face-to-face interviewing questionnaires by using a systematic sampling technique. Data were entered into Epi-data version 3.5.1 and exported to statically software package for social science version 23.0 for analysis. Descriptive analyses were carried out. Bivariable and multivariable logistic regressions were done to identify predictors of home-based management practice of diarrhea in children under 5 years old.Result:The study had a total of 326 participants, with a 97.3% response rate. Accordingly, 193 (59%) have a good home-based management practice of diarrhea in children under the age of 5 years. Attended elementary school (adjusted odds ratio (95% confidence interval), 0.17 (0.06, 0.47)), high school education (adjusted odds ratio (95% confidence interval), 0.04 (0.013, 0.126)), monthly income in second class (adjusted odds ratio (95% confidence interval), 0.19 (0.04, 0.94)), and being mother in child relationship (adjusted odds ratio (95% confidence interval), 1.27 (1.4, 4.20)) were the identified predictors of home-based management practice of diarrhea in children under 5 years old.Conclusion:More than half of the respondents have a good home-based management practice of diarrhea in children under 5 years old. Caregivers’ educational status, being mothers of the child, and monthly income were the identified predictors. As a result, health education and awareness programs for caregivers on diarrhea control, proper use of oral rehydration solution, home-based fluid preparation, and diarrhea prevention are critical.