Gastrointestinal Infections Research Articles

Genetic diversity of enteric viruses responsible of gastroenteritis in urban and rural Burkina Faso.

Viral gastrointestinal infections remain a major public health concern in developing countries. In Burkina Faso, there are very limited updated data on the circulating viruses and their genetic diversity. This study investigates the detection rates and characteristics of rotavirus A (RVA), norovirus (NoV), sapovirus (SaV) and human astrovirus (HAstV) in patients of all ages with acute gastrointestinal infection in urban and rural areas. From 2018 to 2021, stool samples from 1,295 patients with acute gastroenteritis were collected and screened for RVA, NoV, SaV and HAstV. Genotyping and phylogenetic analyses were performed on a subset of samples. At least one virus was detected in 34.1% of samples. NoV and SaV were predominant with detection rates of respectively 10.5 and 8.8%. We identified rare genotypes of NoV GII, RVA and HAstV, recombinant HAstV strains and a potential zoonotic RVA transmission event. We give an up-to-date epidemiological picture of enteric viruses in Burkina Faso, showing a decrease in prevalence but a high diversity of circulating strains. However, viral gastroenteritis remains a public health burden, particularly in pediatric settings. Our data advocate for the implementation of routine viral surveillance and updated management algorithms for diarrheal disease.

Blended diet in enteral feeding: current guidance.

The practice of administering blended food via enteral feeding tubes has been growing in popularity in recent years. Concerns have been raised as this practice was perceived to increase risk of gastrointestinal intolerance, allergic reactions, nutritional insufficiency, tube blockages, and infection compared with using commercial enteral feed (CEF), the gold standard, as well as risk of litigation against the professional due to their support of practice that is not evidence-based. However, research has shown that the physical, social and emotional benefits from receiving blended diet may outweigh the previously suggested risks. Guidance has been updated to encourage discussions around blended diet while informing the tube-fed individuals, families and carers of potential risks, potential benefits, barriers, considerations for training, safety and contraindications.

Cation-π Interaction-Enhanced Self-Healing Injectable Hydrogels for Gastric Perforation Repair.

Surgical operations are the preferred treatment for gastric perforation (GP) but incur postoperative complications such as gastrointestinal adhesions and bacterial infections, leading to inefficient wound healing and serious complications that may even threaten the life of the patient. Developing hydrogel dressings capable of adapting to the gastric environment (acid) and decreasing visceral adhesions and bacterial infections after GP treatment is crucial. In this article, we developed an injectable, self-healing hydrogel using cation-π interactions between protonated amines and aromatic rings under acidic conditions and explored it for GP repair. The hydrogels demonstrate exceptional self-healing capabilities under acidic conditions and can be effectively tailored for the gastric environment. In addition, the hydrogel demonstrated significant efficacy in preventing gastrointestinal adhesion, reducing inflammation, promoting angiogenesis, and effectively facilitating wound healing in a rat GP model. This novel hydrogel demonstrates adaptability to the gastric environment, rendering it highly promising for potential applications in gastric trauma healing.

Living with parasites: exploiting tolerance of infection to reduce the impact of gastrointestinal nematodes in sheep

Gastrointestinal nematodes are among the most prevalent and damaging infections faced by ruminant livestock. Anthelmintic resistance means that sustainable control is essential and selective breeding has been part of this for decades. Breeding, however, has focused on promoting resistance to infection, yet almost no empirical work has been done on the other means by which hosts mitigate the impact of parasites, namely tolerance of infection. This review defines the concepts of resilience, resistance and tolerance, with particular attention to gastrointestinal nematode infections of sheep. How selection has thus far been implemented is discussed, and the pros and cons of each trait are evaluated. Tolerance has been almost completely neglected in livestock science, and its potential mechanisms with regard to gastrointestinal nematodes in sheep are discussed. The authors' work to understand more about tolerance to gastrointestinal nematodes and its potential role in sustainable control of gastrointestinal nematodes in the future is also disscussed.

Overview of the Efficacy of Using Probiotics for Neurosurgical and Potential Neurosurgical Patients.

This review delves into the emerging field of the gut microbiota-brain axis, emphasizing its bidirectional communication and implications for neurological health, particularly in trauma and neurosurgery. While disruptions in this axis can lead to dysbiosis and hinder neurological recovery, recent studies have highlighted the therapeutic potential of interventions like probiotics in targeting this axis. This review aims to focus on the efficacy of probiotic supplementation to support the gut microbiota-brain axis in trauma, neurosurgery, or pain based on the current clinical trials to assess the complex interplays among probiotics, the gut microbiota, and the central nervous system (CNS). This comprehensive literature review identified 10 relevant publications on probiotic interventions for various neurosurgical conditions across multiple countries. These studies demonstrated diverse outcomes, with significant improvements observed in gastrointestinal mobility, inflammatory responses, and infection rates, particularly in post-traumatic brain injury and spinal surgery. Probiotics also showed promise in mitigating antibiotic-associated diarrhea and modulating inflammatory cytokines. Despite the promising findings, the complex interplays among probiotics, the gut microbiota, and the central nervous system (CNS) call for cautious interpretation. Conflicting outcomes emphasize the need for better-designed trials to understand strain-specific and disease-specific effects accurately. In conclusion, probiotics offer a promising adjuvant therapy for neurosurgical patients, traumatic brain injuries, and post-spinal surgery. However, further well-designed randomized controlled trials are essential to elucidate the intricate relationship between microbiome-modulating interventions and the CNS via the gut microbiota-brain axis.

Water Scarcity and Risk of Acute Gastrointestinal Infections in Mexican Households: A Latent Class Analysis

Lack of access to piped water, as well as inadequate quantity and quality of water, are risk factors for acute gastrointestinal infections. In 2022, 4.9% of households in Mexico did not have piped water; 19.3% lacked, at some point, sufficient water for hygiene; and 18.9% perceived that the water was unfit for human consumption. During the same year, at least 1,441,226 people suffered from a gastrointestinal infection. Households without access to piped water and with insufficient water for hygiene were 27% more likely to suffer from a gastrointestinal infection than households with piped water and a sufficient supply for hygiene (odds ratio: 1.27; CI 95%: 1.26–1.28). The latent class analysis shows that 22% of households belong to the high-risk class of suffering gastrointestinal infections associated with a lack of piped water, insufficient quantity, and poor quality of water. These results provide elements for the design of public health programs through the supply of water for consumption and sanitation services.

Rheumatic diseases in the elderly: Challenges and management

Abstract The elderly demographic is seeing a gradual rise as a proportion of the overall global population, whilst also experiencing high rates of musculoskeletal issues, requiring specialized care. The management of rheumatic diseases in the elderly presents unique challenges due to the complex interplay among physiological changes, cognitive decline, and altered immune responses. Such conditions can be categorized into those progressing from earlier life stages (such as rheumatoid arthritis, systemic lupus erythematosus, spondyloarthritis, and gout) and those predominantly emerging in old age (such as polymyalgia rheumatica, giant cell arteritis, osteoarthritis, crystal arthropathies, and osteoporosis), each with distinct characteristics and management needs. These diseases often present atypically with nonspecific symptoms and altered serological markers, complicating diagnosis and management due to increased toxicity risks and comorbidities. Comprehensive, multidisciplinary care that includes cardiovascular health monitoring, bone density maintenance, gastrointestinal tolerance management, infection prevention, and mental health support are essential to improve outcomes and quality of life for elderly patients with rheumatic diseases.

Infections in residents of long- term care facilities in southern Poland, 12-month surveillance preliminary results

Long-Term Care Facility (LTCF) residents are particularly vulnerable to infections due to factors such as advanced age, co-morbidities, and regular medication use. Data from American and European sources indicate an anticipated occurrence rate of 2 to 11 infections per 1000 patient-days (pds) in LTCFs. The incidence rate of Clostridioides difficile infections (CDI) is reported at 0.52 per 10,000 resident days. The research objectives aimed to assess infection epidemiology in Polish LTCFs. An observational prospective study was conducted on residents from five LTCFs (2 residential homes and 3 nursing homes) in southern Poland between September 2022 and September 2023, utilizing the definition from the pan-European HALT study. The study received approval from the Bioethics Committee of the JU (1072.6120.73.2022) and was funded by the Polish NCN grant No.2021/41/B/NZ6/00749. CDI was defined by positive toxins A and B enzyme immunoassays (EIA) and positive glutamate dehydrogenase (DHA) EIA. Results from the study, involving 250 residents, revealed 157 cases of Healthcare-Associated Infections (HAIs) excluding gastrointestinal and CDI, with an incidence rate of 1.97/1000 pds. Lower respiratory tract infections dominated with 77 cases, including 36 pneumonia cases (47%). Additionally, 25 cases of gastrointestinal infections were reported, including only 7 CDI cases, resulting in an incidence rate of 0.88 CDI per 10,000 pds. Norovirus was detected in only one case, while the microbiological results were negative in the remaining cases. The incidence rate among Polish LTCF residents was lower than expected, contrasting with the CDI incidence that aligned with other research findings. Notably, the etiology of diarrhea remained undetermined in 68% of cases.

Evaluation of the prevalence of giardiasis and associated factors in Wardak province, center of Afghanistan

Introduction: Giardia intestinalis is a causative agent of gastrointestinal infections worldwide. Contaminated food, feces, drinking water (orofecal route), and factors like economic conditions, culture, and behavioral factors contribute to its transmission. Wardak province is located in the central region of Afghanistan, divided into eight districts, with a population of 656,720. Methods: A total of 274 patients with diarrhea referred to Wardak Hospital were studied, and among them, 17 individuals (10 males (58.8%) and 7 females (41.2%) tested positive for Giardia spp. by microscopy during 2023. In this cross-sectional study, socioeconomic, cultural, and symptomatology information were collected. The association between risk factors and intestinal parasitic infections was analyzed using Chi-Square and Fisher's exact tests with SPSS 26 and GraphPad Prism 8 software at a significance level of P ≤ 0.05. Results: More than half of the patients were under 30 years old. Most cases of the disease were observed in hot seasons (spring and summer). A significant correlation was found between the prevalence of giardiasis and factors such as close contact with animals, the use of unfiltered water, soil contact, and warmer seasons. No significant correlation was observed between economic status and travel history. 85% of patients had watery diarrhea, and 15% had bloody diarrhea. Conclusion: This is the first epidemiological study conducted in Wardak province, central Afghanistan. The findings reveal the prevalence of giardiasis and its interaction with multiple risk factors. This study suggests that giardiasis is an important causative factor for gastrointestinal diseases in the study region.

Prevalence of gastrointestinal helminth parasites of cattle in Kugiya Market, Bukuru, Jos South LGA, Plateau State, Nigeria

Gastrointestinal helminth infection in cattle caused by trematodes (flukes), cestodes (tapeworms), and nematodes (roundworms) causes significant diseases which may result to growth retardation and significant economic damage. An investigation of gastrointestinal parasites of cattle sold at Kugiya market Bukuru, Jos South LGA was carried out between January and April 2016. Faecal samples of 232 cattle were examined using floatation method (Saturated Salt Solution). All the samples had gastrointestinal parasites. Nineteen 19(100%) species of gastrointestinal parasites were encountered, 2(3.88%) of which are protozoans, while the remaining 17(96.12%) were helminths as follows: 5(17.67%) trematodes (including 1 amphistome), 1(12.07%) cestode and 11(17.67%) nematodes species. The most frequently encountered were nematodes with a prevalence of 66.38% (in 154 samples), followed by the trematodes in 41 samples with a prevalence of 17.67%, cestodes in 28(12.07%) and the least protozoa in 9(3.88%). The parasites encountered are Dicrocoelium dendrititcum 8(3.45%), Taenia saginata 28(12.07%), Ostertagia ostertagi 16(6.89%), Trichuris trichuiria 13(5.60%), Oesophagustomum radiatum 16(6.89%), Bunostomum phlebotomum 22(9.84%), Amphiostomes species 15(6.47%), Haemonchus contortus 16(6.89%), Cooperia pectinata 19(8.19%), Trichostrongylus axei 11(4.74%), Dicrocoelium hospes 5(2.16%), Strongyloides papillosus 11(4.74%), Fasciola hepatica 7(3.02%), Fasciola gigantica 6(2.59%), Oesophagustomum species 12 (5.17%), Dictyocaulus viviparous 7 (3.02%), Ascaris vitulorum 11(4.74%), Eimeria bovis 3(1.29%) and Eimeria zuernii 6 (2.59%). The cestode, T. saginata had the highest prevalence of 12.07% while the protozoa, E. bovis had the lowest 1.29%. Sex and age-related infection were not significantly different at P > 0.05. Likewise, the source, breed and stool consistency related infection were not significantly different.

Prevalence of Gastrointestinal Parasites among Student of Nasarawa State University, Keffi Nasarawa State, Nigeria

Gastrointestinal parasites are significant agents of intestinal infection with public health implications worldwide. This study aimed to ascertain intestinal parasites among students of Nasarawa State University, Keffi, Nasarawa State. A total of 138 Stool samples were collected from students in hostels and off campus and examined using the direct wet preparation and formol-ether concentration techniques. The overall prevalence of 18.84% was recorded with a higher prevalence of gastrointestinal parasites in samples collected from male subjects (23.61%) compared to the female individuals (13.63%) however, there was no statically significant difference (P>0.05) in prevalence between males and females subjects. The intestinal parasites species identified and their respective prevalence were: two species of nematodes; hookworm (26.92%) and Ascaris lumbricoides (46.15), a species of cestode- Taenia saginata (15.38%) and trematode- Schistosoma mansoni (11.58%). Gastrointestinal parasitic infection was higher in male hostel (50.00%) followed by female hostel (13.46%) and the least was recorded from the student village that is those students who live off campus (11.58%) although statistically, there is no significant difference between the location (P>0.05). The study showed that there is a high prevalence of gastrointestinal parasites in the study area (especially male hostel) therefore, there is a need to encourage adequate personal hygiene and sanitation. Also, further study should be carried out on the impact of parasitic infection on academic performance of the students.

Survey of Strongyloides infection in Maiduguri cattle abattoir, Nigeria

Gastro-intestinal infection constitutes major constraint to viable livestock industries. The study revealed information on the prevalence of Strongyloides infection in cattle in Maiduguri and environs with reference to sex, age and breeds of cattle in the study area. The result revealed the prevalence of 51 (25.5%) cases after examining 400 faecal samples using faecal sedimentation technique. The result of Strongyloides species infection recorded according to sex of cattle was higher in females with a prevalence of 40 (20.0%) compared to males with a prevalence of 11 (5.5%). The prevalence of infection based on age of cattle revealed higher percentage of 14 (7.0%) after examining 48 cattle in the age bracket of seven (7) years. A lower prevalence of 5 (2.5%) was recorded in cattle within the age bracket of 4 years after examining 36 samples. Breed-wise distribution of infected cattle indicated that Abore was more susceptible, followed by Ambala and Bakoloji breeds with prevalence of 20.5%, 4.5% and 0.5% respectively after examining 150, 36 and 11 faeces from respective breeds. Wadara appeared non-susceptible and therefore had no records of infection after examining low number of three samples from the breed. Bovine Strongyloides infection in Maiduguri and environs was established as a common finding and farmers should therefore be educated on proper use of antihelmintics and with emphasis on strategic antihelmintic medication. Good management practices including improved general hygiene and supplementary feeding of animals during periods of low grazing will have immunity boosting role in control of the parasite.

Epidemiological and Microbiological Characteristics of Nosocomial Infections in the Neurosurgery Department

Introduction. Healthcare-associated infections (HAIs) in neurosurgery departments are a serious problem, especially for patients in severe clinical condition. A high risk of HAIs is associated with medical interventions in the CNS, and brain injury itself is a particularly strong predictor of nosocomial infections. Aim. The aim of the study was to perform an epidemiological and microbiological analysis of the incidence of infections in the neurosurgery department. Material and Methods. Retrospective analysis was performed on the records of patients hospitalised in the neurosurgery department between 2019 and 2022. There were 4,267 patients, among whom 114 infections were found in 69 patients. The collected material was analysed statistically. Results. HAIs accounted for 1.6% of all hospitalised patients, occurring more frequently in men (42%). The infection incidence rate in 2019 was 3.7 and in 2022 — 2.5. The most commonly isolated pathogens were Enterobacterales. The most frequent diagnoses were respiratory tract infections (PN) — 24.56%, followed by bloodstream infections (BSI) — 20.18%, and surgical site infections (SSI) — 17% The percentage of PN (p=028) and SSI (p=0.027) infections decreased from year to year, and increased in BSI (p=0.022); statistically significant data. The mean for GCS differed significantly among patients with gastrointestinal infection (GI), p=0.021, and was highly statistically significant for BSI and PN, p<0.001. The mean for NRS 2002 differed significantly among patients with and without infection, p<0.05. Conclusions. Nosocomial infections occur in a small percentage of hospitalised patients, some of whom have more than one nosocomial infection. There is a need for epidemiological surveillance and collaboration between infection control specialists and neurosurgery staff to optimise HAI prevention and control. (JNNN 2024;13(2):69–77)

Analysis of the severity of symptoms of acute diarrhoea caused by rotaviruses in children and the level of parental knowledge about the prevention of this condition

Introduction. Gastrointestinal infections in young children in the form of acute diarrhoea of viral aetiology constitute a serious epidemiological and therapeutic problem. Aim. The aim of the study is to determine the severity of symptoms of acute rotavirus diarrhoea in children and to evaluate the level of parental knowledge about the factors predisposing to this condition and the preventive measures. Material and methods. A group of 100 individuals aged 18 to 40, parents of children under the age of 4 who were hospitalised due to acute diarrhoea, was surveyed. The questions concerned determining the severity of symptoms of acute diarrhoea in children of rotavirus aetiology and assess the level of parental knowledge about the factors predisposing to this condition and preventive measures. The study utilised the diagnostic survey method with a self-designed questionnaire, as well as a standardised questionnaire for assessing the child's condition on admission and the CDS scale. Results. The analysis of the results showed that parental knowledge about the course, management, and prevention of infectious diarrhoea in children is low. Parents tend to avoid seeking information from nurses and physicians, instead relying on media and Internet sources, which they consider as credible. The study identified sociodemographic factors that influence parental knowledge. Conclusions. Age, education, and place of residence significantly influence parental knowledge about the course, management, and prevention of infectious diarrhea in children. It was found that the gender of the parents does not have a significant impact on the level of knowledge regarding the disease in question.

Effect of Artemisia Vulgaris on Liver of Albino Mice Exposed to Cisplatin

The herb Arte(also known as Artemisia V.) is widely used to treat a variety of illnesses, including gastrointestinal disorders, infections, and fungal infections. The antibacterial component that makes this ingredient so beneficial and essential for treating septicemia is the prebiotic. This study looked at how Artemisia vulgaris L. protected rats' livers from the toxic treatment cisplatin. In virtual medicine, cisplatin is frequently employed. Numerous forms of human cancer, such as advanced cancer, uterine cancer, esophageal cancer, advanced privacy, and ovarian cancer, have been successfully treated with it. infection from other illnesses, like disease. In this experiment, thirty 25–30 g white secretive mice aged 12 weeks were used. 72 hours were spent soaking blood tissue samples in 4% paraformaldehyde before they were paraffin embedded. Hematoxylin-eosin (H, E) staining was applied after the sections were cut into 3-m pieces and embedded in paraffin wax. Establishing with the extraction of Artemisia vulgaris L 400 mg/kg/day of extract is the greatest efficiency technique, as the separated groups revealed. This proved the extract's efficiency. This finding offers thorough and widely reported support for the use of purifications like A. vulgaris in the medical treatment of systemic poisoning with additional benefits like definite therapeutic effects and potent histochemical in the treatment of cancerous tissues.

Gastrointestinal Helminths in Local (Black Bengal) and Jamunapari Goats of Barishal Sadar, Southern Bangladesh

Gastrointestinal helminths are important causes of hindering global goat production. To find the prevalence of gastrointestinal helminths of Black Bengal and Jamunapari breeds of goats, the current investigation was carried out at Barishal Sadar Upazilla of Barishal district, Bangladesh. The gastrointestinal helminths were identified through coprological examination. A total of 112 fecal samples were collected from household goats across different seasons, breeds, sexes, and ages. During the study period, four types of gastrointestinal helminths were identified based on the presence of helminth eggs in fecal samples. The overall prevalence of gastrointestinal helminths in goats was found to be 82.1%, while the prevalence rates of Fasciola gigantica (F. gigantica), Paramphistomum spp., Bunostomum spp., and Hemonchus spp. were 34.8% (95% CI: 1.4-2.5), 22.3% (95% CI: 0.7-1.8), 14.3% (95% CI: 0.1-1.5), and 10.7% (95% CI: 0.2-1.0), respectively. A significantly different prevalence was observed among different gastrointestinal helminths in goats. A significantly lower prevalence of F. gigantica and Paramphistomum spp. was observed in male goats, compared to females. A higher prevalence of F. gigantica was significantly observed during the winter, compared to the summer. The current study elucidates that F. gigantica was more prevalent in female goats. The current study indicated that F. gigantica was more prevalent in female goats. These findings underscore the importance of further research and control measures to manage gastrointestinal helminth infections in goats across southern Bangladesh and other regions with similar environmental conditions.

Beyond parasitism: Exploring the microbial profile of Haemonchus contortus and its predilection site (abomasum) in Kashmir Merino sheep

Gastrointestinal helminth infection, particularly by Haemonchus contortus, poses significant challenges to sheep farming worldwide. While anthelmintic drugs have been traditional control measures, the emergence of resistance calls for alternative strategies. Understanding the interaction between parasites, host, and their microbiome is crucial for management of helminth infection. This study intricately explores the interactions between microbial communities in Kashmir Merino sheep infected with H. contortus, to understand the complex interplay between host, parasite, and their microbiome. Sheep abomasal contents and H. contortus were collected from infected and control groups, processed for DNA extraction, and subjected to metagenomic sequencing of the 16 S rRNA gene. Downstream analysis unveils distinct microbial patterns, where Proteobacteria were dominant in H. contortus, while Bacteroidota and Firmicutes prevailed in the sheep abomasum. The revelation of unique genera and shifts in diversity indices underscored helminth-induced disruptions in the host. Beta diversity analysis further showed significant variations in bacterial profiles, providing insights into the intricate host, parasite, and microbiome dynamics. Additionally, this study elucidated the presence of pathogenic bacteria within H. contortus, accentuating their potential role in exacerbating sheep health issues. This finding underscores the complexity of the host-parasite-microbiome interaction showing helminth-induced microbiome alterations of the host.

Self-medication with antibiotics during the COVID-19 pandemic: A cross-sectional study among adults in Tema, Ghana.

Antibiotic self-medication is one of the common causes of antibiotic resistance of bacterial organisms. The COVID-19 pandemic introduced a new paradigm shift and significantly influenced healthcare behaviors, including an increase in antibiotic self-medication, which contributes to antibiotic resistance. This study was aimed at determining the prevalence of antibiotic self-medication and the possible associated factors during the peak of the COVID-19 pandemic among adult residents of Tema in Ghana from April to July 2021. Using a cross-sectional design, 400 adults were randomly selected and surveyed using a researcher-assisted questionnaire. Data were analyzed with IBM® SPSS® Statistics Version 22.0, considering associations significant at a 95% confidence interval (p < 0.05). Of the 400 respondents, (76%) 304 had practiced antibiotic self-medication within the previous 12 months during the COVID-19 pandemic. Significant factors associated with antibiotic self-medication included gender, age, marital status, education, occupation, and National Health Insurance Scheme subscription. Convenience and avoiding long hospital queues were primary non-medical reasons for antibiotic self-medication, while previous successful experience, easy access to antibiotics, treating symptoms, prophylaxis, and fear of hospital infection were the medical reasons for antibiotic self-medication. Commonly self-administered antibiotics were azithromycin (34%), amoxicillin/clavulanic acid (22%), and metronidazole (16%) for perceived respiratory tract and gastrointestinal tract infections. The high prevalence of antibiotic self-medication observed during the COVID-19 pandemic underscores the need for enhanced public education and stricter enforcement of regulations governing antibiotic sales. The non-medical and medical factors of convenience, avoiding long hospital queues, previous successful experience, easy access to antibiotics, treating symptoms, prophylaxis, and fear of hospital infection which motivated antibiotic self-medication practices require the implementation of antimicrobial stewardship interventions.

Clinical and epidemiological analysis of intestinal infections in a children's infectious diseases hospital, experience in using the PEWS scale

Purpose of the work: to conduct a clinical-epidemiological analysis of intestinal infections in a pediatric infectious diseases hospital and the effectiveness of the PEWS scale.Materials and methods: a retrospective study was conducted at the Moscow City Clinical Hospital «Communarka» and City Clinical Hospital No. 1 in the pediatric infectious disease departments from June 1, 2023, to August 31, 2023. Laboratory, clinical, and anamnestic data were obtained from the medical information system «EMIAS» and the laboratory information system (LIS) «ALISA». The study analyzed 838 medical records of children with acute respiratory infections.Results: when conducting a statistical analysis of indicators in two groups (group 1 — PEWS ≥ 3 points, recorded at least once during the entire period of hospitalization, group 2 — PEWS from 1 to 2 points, recorded at least once during hospitalization period) no significant differences were observed in terms of etiology, age, day of illness, blood test results, and length of hospital stay. All patients had a moderate form of acute respiratory infection, however, patients with PEWS ≥ 3 points required increased attention from medical staff and had a higher risk of deterioration without additional medical intervention, with the most significant risk in predicting deterioration being related to changes in the cardiovascular system. All children were discharged home in satisfactory condition with PEWS = 0.Conclusion: In our conducted research, for the first time in the Russian Federation, the experience of using the PEWS scale in pediatric practice for patients with gastrointestinal infections was applied with the aim of early detection of the risk of clinical deterioration. It can be assumed that the most significant risk in predicting deterioration in the condition of a child with acute gastrointestinal infection, as well as with acute respiratory infection, is predominantly due to disturbances in the cardiovascular system.

Serum 25-hydroxyvitamin D concentrations, vitamin D receptor polymorphisms, and risk of infections among individuals with type 2 diabetes: a prospective cohort study

BackgroundEvidence on the association between serum 25-hydroxyvitamin D [25(OH)D] and infections among patients with type 2 diabetes (T2D), a group susceptible to vitamin D deficiency and infections, is limited. ObjectivesWe aimed to examine this association in individuals with T2D, and to evaluate whether genetic variants in vitamin D receptor (VDR) would modify this association. MethodsThis study included 19,851 participants with T2D from United Kingdom Biobank. Infections were identified by linkage to hospital inpatient and death registers. Negative binomial regression models were used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs), with adjustment of potential confounders. ResultsIn patients with T2D, the incidence rate of infections was 29.3/1000 person-y. Compared with those with 25(OH)D of 50.0–74.9 nmol/L, the multivariable-adjusted IRRs and 95% CIs of total infections, pneumonia, gastrointestinal infections, and sepsis were 1.44 (1.31, 1.59), 1.49 (1.27, 1.75), 1.47 (1.22, 1.78), and 1.41 (1.14, 1.73), respectively, in patients with 25(OH)D <25.0 nmol/L. Nonlinear inverse associations between 25(OH)D concentrations and the risks of total infections (P-overall < 0.001; P-nonlinear = 0.002) and gastrointestinal infections (P-overall < 0.001; P-nonlinear = 0.040) were observed, with a threshold effect at ∼50.0 nmol/L. The vitamin D-infection association was not modified by genetic variants in VDR (all P-interaction > 0.050). ConclusionsIn patients with T2D, lower serum 25(OH)D concentration (<50 nmol/L) was associated with higher risks of infections, regardless of genetic variants in VDR. Notably, nonlinear inverse associations between 25(OH)D concentrations and the risks of infections were found, with a threshold effect at ∼50.0 nmol/L. These findings highlighted the importance of maintaining adequate vitamin D in reducing the risk of infections in patients with T2D.