Symptoms Of Diarrhea Research Articles

Clinical efficacy and safety evaluation of Buzhongyiqi pills on appetite improvement in patients with colorectal cancer receiving chemotherapy: a pilot randomized cross-over clinical trial.

To evaluate the clinical efficacy and safety of Buzhongyiqi pills (BZYQP, ) in improving the appetite of patients with colorectal cancer (CRC) receiving chemotherapy. A pilot, randomized, single-blind cross-over clinical trial was conducted on diagnosed stage II-IV CRC patients receiving chemotherapy. Patients were randomly assigned to either the BZYQP-placebo or placebo-BZYQP groups. The BZYQP-placebo group received BZYQP for 1-2 d before the first cycle of chemotherapy and continued until the end of the third cycle. A 7-day washout followed, after which they received a placebo until the end of the sixth cycle. The placebo-BZYQP group followed the opposite treatment order. The oral dose of BZYQP and placebo was ten pills three times daily. A total of 12 visit points were scheduled in this study, with each visit point carried out before and after each of the six cycles of chemotherapy. The Simplified Nutrition Appetite Questionnaire (SNAQ), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, version 3.0), and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE, V5.0) were used to evaluate patient appetite, quality of life, and drug safety. Totally 62 patients completed the study, and baseline characteristics were balanced between the BZYQP-placebo and placebo-BZYQP groups. The primary outcome, as assessed by SNAQ scores, demonstrates a statistically significant difference between the two groups during the first three cycles of chemotherapy, with the mean SNAQ score of the BZYQP-placebo group consistently higher than that of the placebo-BZYQP group from V1 (P < 0.001). After the washout period, the SNAQ score of the BZYQP-placebo group decreased from V7, and the difference in SNAQ scores between the two groups gradually became more significant after the intersection at V9. Secondary outcomes showed that during the first three cycles of chemotherapy, the BZYQP-placebo group had significantly lower scores in physical, role, emotional, cognitive, and social functioning domains, as well as in fatigue, loss of appetite, and diarrhea symptoms, compared to the placebo-BZYQP group (P < 0.001). Scores for physical, role, emotional, cognitive, and social functioning in the BZYQP-placebo group remained lower (P < 0.05) at V11. The chemotherapy-induced adverse events (AEs) in the BZYQP-placebo group were significantly lower than those in the placebo-BZYQP group at V5, mainly in nausea and vomiting (9.1% vs 62.1%, P < 0.001), diarrhea (12.1% vs 44.8%, P = 0.004), and anemia (15.2% vs 41.4%, P = 0.021). No drug-related events were reported in this study. BZYQP is feasible and safe to effectively improve the appetite of patients with CRC receiving chemotherapy and help them with better quality of life.

Laparoscopic management of necrotizing granulomatous appendicitis: a diagnostic challenge

We present a case report of necrotizing granulomatous appendicitis, a rare condition that poses significant diagnostic challenges due to its atypical presentation, often mimicking more common conditions like acute appendicitis or inflammatory bowel disease. A 29-year-old female was admitted with a one-month history of abdominal pain, diarrhea, vomiting, and recent urinary symptoms. Laboratory tests revealed leukocytosis, elevated C-reactive protein, and anemia. A CT scan indicated an inflamed appendix, prompting a laparoscopic appendectomy. Intraoperatively, findings raised the suspicion of inflammatory bowel disease; however, histopathological analysis confirmed necrotizing granulomatous appendicitis. Further microbiological testing excluded bacterial and fungal infections, while the IGRA test was positive for tuberculosis. This case emphasizes the dual role of laparoscopic surgery in both diagnosing and treating necrotizing granulomatous appendicitis. It highlights the importance of considering rare etiologies, such as tuberculosis, especially in patients presenting with atypical symptoms. Early recognition and appropriate management are crucial for improving patient outcomes.

Biosafety Training and Introduction to Livestock Diseases Using Participatory Rural Appraisal Method in Pade Angen Livestock Group East Lombok Regency

The community service aims to introduce the application of biosafety and biosecurity and provide the ability to recognize livestock diseases simply with the participatory rural appraisal (PRA) method in reducing the transmission of livestock diseases in East Lombok Regency. The implementation methods of the activities include a survey of the service location to identify problems, socialization of the program activity to the target community, education about biosecurity and biosafety, and an introduction to simple livestock disease detection based on community participation with PRA, then continued with training on applying simple biosecurity and biosafety and simple livestock disease detection methods with PRA proportional piling and matrix scoring methods. The data of PRA proportional piling and matrix scoring based on disease symptom data will be mapped and ranked using descriptive analysis. The results of this community service were obtained from members of The Pade Angen II Livestock Group could use personal protective equipment (PPE) correctly by 80%. The detection of disease based on symptoms using the proportional piling and matrix scoring methods obtained repeat breeding events with symptoms of repeated mating of 21%, helminthiasis with symptoms of worms of 14%, itching of 4%, diarrhea of 4%, and scabies with symptoms of itching of 8%. Foot and mouth disease was also still found with symptoms of wounds on the feet and salivation of 11%, miscarriage of 4% and fever of 1%, coccidiosis with symptoms of bloody diarrhea of 10%, colibacillosis with symptoms of diarrhea of 6%, bloat with symptoms of bloating of 3% and fever of 1%.

Neuroendoscopic Lavage in Hydrocephalus with Ventricular Empyema: A Case Report

Introduction: Ventricular empyema, or pyogenic ventriculitis, is a severe condition characterized by pus accumulation in the cerebral ventricles due to intracranial infection, often caused by Gram-negative bacteria. Early diagnosis and treatment are crucial to prevent fatal neurological damage. Case Report: A 3-month-old infant with severe hydrocephalus and ventricular empyema was admitted with symptoms of seizures, fever, and diarrhea. Initial examination showed decreased consciousness and significant leukocytosis. CT scans confirmed severe hydrocephalus and ventricular empyema. Despite resistance to standard antibiotics, neuroendoscopic lavage (NEL) and bilateral external ventricular drainage (EVD) were performed, leading to substantial improvement. Discussion: The patient’s condition improved significantly post-surgery, with a decrease in leukocyte count and resolution of empyema as shown in follow-up imaging. This case demonstrates the efficacy of NEL in treating complex pediatric neurosurgical conditions. Conclusion: NEL proves to be an effective treatment for intraventricular empyema in pediatric patients, improving clinical outcomes and reducing hospital stays. The success of this approach emphasizes the need for tailored neurosurgical interventions and regular follow-ups to ensure patient recovery and prevent recurrence.

Baseline gut microbiome alpha diversity predicts chemotherapy-induced gastrointestinal symptoms in patients with breast cancer

Chemotherapy frequently causes debilitating gastrointestinal symptoms, which are inadequately managed by current treatments. Recent research indicates the gut microbiome plays a role in the pathogenesis of these symptoms. The current study aimed to identify pre-chemotherapy microbiome markers that predict gastrointestinal symptom severity after breast cancer chemotherapy. Fecal samples, blood, and gastrointestinal symptom scores were collected from 59 breast cancer patients before, during, and after chemotherapy. Lower pre-chemotherapy microbiome alpha diversity and abundance of specific microbes (e.g., Faecalibacterium) predicted greater chemotherapy-induced gastrointestinal symptoms. Notably, tumor and diet characteristics were associated with lower pre-chemotherapy alpha diversity. Lower baseline alpha diversity also predicted higher chemotherapy-induced microbiome disruption, which was positively associated with diarrhea symptoms. The results indicate certain cancer patients have lower microbiome diversity before chemotherapy, which is predictive of greater chemotherapy-induced gastrointestinal symptoms and a less resilient microbiome. These patients may be strong candidates for pre-chemotherapy microbiome-directed preventative interventions (e.g., diet change).

Recent Outbreaks and Factsheet of Future Global Pandemic Marburg Virus: A Looming Threat

Abstract: The Marburg virus (MARV), which belongs to the family Filoviridae, is the cause of Marburg virus disease (MVD), a disease that can be fatal. Laboratories employees of Marburg and Frankfurt cities of Germany, and Belgrade city of Yugoslavia (now Serbia), contracted an infection caused by a hitherto unidentified infectious pathogen in August 1967. According to the World Health Organization (WHO), MARV is one of the most im-portant issues in the world. With a case fatality rate ranging from 24.0 to 88.0%, the virus is very dangerous, underscoring the need for public awareness. This outbreak was deter-mined to be caused by the MARV, one of the deadliest viruses that infect humans. However, African green monkeys (Chlorocebus aethiops), which were imported from Uganda and transported to all three locations, were discovered to be the virus's primary source, while fruit bats (Rosettus aegyptiacus), which belong to the Pteropodidae family, act as the MARV's natural hosts. The disease's pathophysiology indicates significant antiviral suppression as a result of alter-ations in gene expression and the synthesis of interferon-stimulated genes in the hepatic cells. Along with the advent of hemorrhagic manifestations, which can result in a patient's death, the condition may worsen and cause abdominal discomfort, nausea, vomiting, phar-yngitis, diarrhea, and other symptoms. The countermeasures against MVD are outlined in this article, with an emphasis on the ecology, traits, virion proteins, pathology, and trans-mission of MARV clinical aspects along with diagnostic, patient therapy, and management.

Factors Associated with the Use of Medicinal Plants for Treating Diseases and Symptoms in Honduras

ABSTRACT A cross-sectional analytical design was set up to collect data about medicinal plants’ use through a Google Forms survey. Out of the 16,379 individuals surveyed in Honduras, treatment for anxiety and dermatological problems was more frequent at an older age. Treatments for symptoms of fever, cough, diarrhea, abdominal pain, and joint pain were more common at an older age and those residing in rural areas received treatment for asthmatic problems. The population chose the use of medicinal plants as an alternative for the treatment of symptoms or illnesses due to economic factors or limited access to health-care service.

Factors Associated with Medical Care-Seeking and Stool Sample Submission for Diarrheal Illness, FoodNet, United States, 2018-2019.

Laboratory-based surveillance for enteric pathogens causing diarrhea is foundational for monitoring foodborne diseases in the United States. However, diarrheal illnesses are not always confirmed by laboratory testing, so estimates of the true number of illnesses must adjust for underdiagnosis, including underdiagnosis due to ill persons not seeking medical care or submitting a stool sample for laboratory testing. We assessed these factors among persons with an acute diarrheal illness who responded to the most recent Foodborne Diseases Active Surveillance Network (FoodNet) Population Survey (2018-2019). Multiple modes of administration (telephone, web-based) and multiple sampling frames were used to ask survey respondents in English or Spanish about diarrhea and other symptoms experienced in the 30 days before the interview and to ask if they had sought medical care or submitted a stool sample. Of 1018 respondents with an acute diarrheal illness, 22.0% had sought medical care and 4.7% submitted a stool sample. On multivariable analysis, older adults (aged 65 years and over), male respondents, and persons with a household income of ≥$40,000 per annum were significantly more likely to seek medical care, as were respondents reporting cough, fever, vomiting, recent international travel, or duration of diarrhea for ≥3 days. Older adults and persons with five or more loose stools in 24 h who sought medical care were significantly more likely to submit a stool sample. Ill respondents with a concurrent cough were less likely to submit a stool sample. Sociodemographic characteristics, symptoms, and international travel influence whether a patient with an acute diarrheal illness will seek care or submit a stool specimen. Accounting for these factors when analyzing surveillance data will likely produce more precise estimates of the true number of foodborne illnesses.

OA13 Trust your gut: it has the answer

Abstract Introduction We report the case of a 51-year-old man who presented over seven years to multiple specialities, including rheumatology on several occasions, with arthralgia, fevers and weight loss. He was found to have raised inflammatory markers, lymphadenopathy and pericardial and pleural effusions but despite extensive investigation over this time, the cause for his presentation remained elusive. After many years, he developed gastrointestinal symptoms, which led us to the unifying diagnosis of Whipple’s disease. Case description This patient initially presented to rheumatology in 2017 with left ankle pain. His only medical history was renal calculi. He was diagnosed with gout and osteoarthritis and was discharged. Two years later, he presented with fevers. Investigations revealed raised inflammatory markers, small pericardial and pleural effusions and small-volume upper abdominal lymphadenopathy. He was treated with colchicine for pericarditis with some improvement. He presented again in 2021 with chest and flank pain and breathlessness. CTPA revealed an ongoing small pericardial effusion and small-volume intrathoracic and intra-abdominal lymphadenopathy. Inflammatory markers remained raised (CRP 30-50, ESR 20-30). He had now begun to lose weight. He was referred to the cancer of unknown primary service, who monitored his lymphadenopathy. In January 2022, he underwent an open biopsy of a mesenteric lymph node, which revealed non-caseating granulomas and no evidence of malignancy. He was referred again to rheumatology due to ongoing migratory joint pains in his wrists, ankles and knees. Rheumatoid factor, anti-CCP, antinuclear antibody and serum ACE had been negative on several occasions. He underwent a PET scan that revealed persistent lymphadenopathy with low to moderate avidity, borderline splenomegaly and a slightly prominent marrow signal. He then had a bone marrow biopsy that showed no significant abnormality. In December 2023, we settled on a probable diagnosis of sarcoidosis. He was treated with a trial of steroid without much symptomatic improvement and there was a plan to initiate Methotrexate. However, he then developed nausea and vomiting and was noted to have a new iron deficiency anaemia. He was referred to gastroenterology and underwent an upper endoscopy, which was macroscopically normal, but microscopically showed findings in keeping with Whipple’s disease (WD) with PAS-positive staining. Duodenal biopsy PCR confirmed this. He is now awaiting input from the infectious diseases team and long-term antibiotic treatment. Discussion WD is caused by the bacterium Tropheryma whipplei. There are four commonly recognised manifestations of T. whipplei infections: 1) classic WD, 2) localised chronic infections, 3) acute infections and 4) asymptomatic carriage. Our patient has classic WD, and his case exemplifies the disease course and diagnostic challenges. Classic WD is a rare, chronic, multisystem infectious disease. It is reported as most often affecting middle-aged white males of European ancestry. It can be divided into an early phase with intermittent arthralgias or arthritis and fever, a middle phase with gastrointestinal symptoms and weight loss, and a late phase with predominant neurological symptoms. Arthritis is the presenting symptom in 60-70% of cases and occurs in 90% of all cases. Given this, around half of patients are initially misdiagnosed as having an inflammatory rheumatic disease. As in the case of our patient, joint manifestations do not correlate with intestinal symptoms and can precede intestinal manifestations by a mean interval of six years. Joint involvement in WD is typically a migratory oligo- or polyarthritis or arthralgia primarily involving large and medium joints, most commonly the knees, ankles and wrists. Less commonly affected joints are elbows, hips and shoulders. WD should be considered in all patients with the four cardinal symptoms of arthralgias, diarrhoea, abdominal pain, and weight loss after more common differentials have been excluded. In patients without gastrointestinal symptoms, having suspicion of the disease is more difficult; however, consideration should be made in patients with seronegative arthritis, who do not respond to immunosuppressive treatment. Other clinical syndromes in which WD should be considered include fever of unknown origin, chronic serositis, generalised lymphadenopathy, progressive central nervous system disease or early onset cognitive deficits. Although histology revealing non-caseating granulomas is the hallmark of sarcoidosis, they are non-specific and can be found in many other diseases. Key learning points • WD has a reputation as a great mimicker of many diseases and there is still often a considerable delay to diagnosis, even in typical cases, given the natural history of the disease and its rarity. WD should be considered in patients with seronegative arthritis not following a typical disease course, particularly if they develop gastrointestinal symptoms. WD is also a pertinent differential in patients with persistent constitutional upset with unexplained lymphadenopathy or serositis. It should be remembered that non-caseating granulomas can be found in many diseases and that sarcoidosis remains a diagnosis of exclusion among granulomatous disorders.

Enteric Adenovirus Gastroenteritis in Under-Five Children, Kano-Nigeria

Abstract Context: Adenoviruses have been implicated in many outbreaks and sporadic cases of pediatric gastroenteritis. Aim: This study aimed to determine the prevalence and circulating serotype(s) of enteric adenoviruses among under-five children with diarrheal diseases in Kano, Nigeria. Settings and Designs: This was a multicentered hospital-based cross-sectional study involving 250 under-five children recruited from Murtala Muhammad Specialist Hospital, Muhammad Abdullahi Wase Teaching Hospital and Hasiya Bayero Paediatric Hospital. Materials and Methods: Enteric adenovirus F40/F41 were checked in the stools of children exhibiting symptoms of gastroenteritis, diarrhea, and/or vomiting by nested PCR amplification of the adenovirus Hexa/E1B regions and positive samples characterized by sequencing and phylogenetic analysis. Statistical Analysis Used: Data generated were analyzed using descriptive statistics, and the association between the variables was checked by the Chi-square test. A P value &lt;0.05 was considered statistically significant. Results: The nested PCR result shows that 7 (2.8%) out of the 250 stools were positive for enteric adenovirus (group F), with only serotype F41 detected within the cohort examined. The isolates were more closely related to KJ425126 from Gabon. The results highlighted that fever and vomiting are prominent features of adenovirus F41 gastroenteritis and children 1–2 years especially males were mostly affected. Conclusion: The study improved our knowledge and understanding of the role of enteric adenovirus in under-five gastroenteritis and suggests that EAdeV-F41 is an important cause of gastrointestinal infections, particularly in infants and young children in Kano, Nigeria. This may call for routine screening of the stools of children with diarrhea for future management guidelines.

Co-frequency or contrary? The effects of Qiwei Baizhu Powder and its bioactive compounds on mucosa-associated microbiota of mice with antibiotic-associated diarrhea.

Qiwei Baizhu Powder (QWBZP) has been proven effective in treating antibiotic-associated diarrhea (AAD), and the mechanism is associated with regulating the gut microbiota. However, the role of the bioactive compounds of QWBZP in regulating the gut microbiota is still unclear. In this study, 24 mice were divided into a normal control group (N), a model group (R), a QWBZP decoction group (TW), and a QWBZP-TG group (TG). AAD mouse models were established by mixed antibiotic administration. After modeling, mice in the TW group and TG group were treated with QWBZP decoction and QWBZP-TG, respectively. Mice in the N group and R group were gavaged with sterile water. 16S rRNA gene sequencing was used to investigate the changes of mucosa-associated microbiota (MAM) in the small intestine of mice. Moreover, the levels of diamine oxidase (DAO), D-Lactate, secretory immunoglobulin A (sIgA), interleukin 6 (IL-6), IL-10, and tumor necrosis factor-α (TNF-α) were detected using enzyme-linked immunosorbent assay (ELISA) kits. The results showed that QWBZP-TG significantly altered the diversity, structure, and abundance of MAM in the AAD mice. QWBZP-TG exerted a stronger suppression effect on Escherichia and Clostridium compared with QWBZP decoction. Meanwhile, QWBZP-TG downregulated the abundance of Lactobacillus, which elicited an opposite effect to QWBZP decoction. Prevotella was the signature bacteria that responded to the QWBZP-TG intervention. Furthermore, both QWBZP decoction and QWBZP-TG decreased the levels of DAO, D-Lactate, sIgA, IL-6, and TNF-α in the AAD mice. The role of glycosides is to help QWBZP ameliorate diarrhea symptoms by inhibiting the proliferation of diarrhea-associated bacteria, reducing inflammation and regulating immunity.

Pancreatic exocrine carcinoma in a lohmann brown chicken

A 23-month-old lohmann brown breed chicken showed symptoms of anorexia, depression and diarrhea before dying. It presented to the pathology laboratory for necropsy. The necropsy confirmed serosal, white and nodular widespread tumor infiltrations in different sizes in the intestines and periton adjacent to the pancreas. In the histological examination, poorly differentiated epithelial cells were seen to form tubular structures in the pancreatic tissue located between the duodenum. According to pathology, this case was diagnosed as pancreatic exocrine carcinoma. This case report provides histologic descriptions of the pancreatic exocrine carcinoma in a chicken that have been reported extremely rare in poultry and pet birds.

The Effect of Colesevelam on the Microbiome in Postoperative Crohn's Disease.

While surgery plays a pivotal role in the management of ileal Crohn's disease, the risk of endoscopic recurrence following an ileocaecal resection can be greater than 65% within 12 months of surgery. More than 90% of patients with Crohn's disease have a concomitant diagnosis of bile acid diarrhea following an ileal resection. This pilot study aimed to assess whether the use of bile acid sequestrants in patients with Crohn's disease who have undergone a primary terminal ileal resection with concomitant bile acid diarrhea can alter the microbiome and prevent disease recurrence. Patients with Crohn's disease who underwent a primary terminal ileal resection and had symptoms of diarrhea within 1-3 months of surgery underwent 75SeHCAT testing for bile acid diarrhea. If positive (75SeHCAT ≤ 15%), patients were treated with colesevelam and stool samples were collected at 4 weeks, 8 weeks, and 6-12 months posttreatment. If negative (75SeHCAT > 15%), treatment was not given and were reviewed in the clinic as per local guidelines. All patients underwent a 6-12 month postoperative colonoscopy where further stool samples and mucosal biopsies were taken. Disease activity was established using the endoscopic Rutgeert's score, with disease remission defined as Rutgeert's score <i2 and disease recurrence ≥i2. 16S ribosomal RNA gene analysis was undertaken for the collected fecal and mucosal samples to assess α/β-diversity and microbial composition. A total of 14 patients who completed the study, 10 of whom had a 75SeHCAT positive diagnosis of bile acid diarrhea and were started on treatment with colesevelam. Four patients did not require treatment as 3 were asymptomatic and 1 had a negative 75SeHCAT scan. Three of the fourteen patients had disease recurrence at their 6-12 month postoperative colonoscopy assessment, of which 1 patient was taking colesevelam and 2 patients were not taking colesevelam. A total of 44 fecal samples and 44 mucosal biopsies underwent 16S ribosomal RNA gene analysis to assess α/β-diversity and microbial composition. In the colesevelam treated patients there was no significant difference in α/β-diversity pre- and posttreatment. Pretreatment, the 3 most abundant bacterial classes in all patients were Bacteroidia, Clostridia, and Gammaproteobacteria. Following 6-12 months of treatment, out of the 9 patients on colesevelam, 5/9 (55.6%) had a reduction in Bacteroidia, 9/9 (100%) had an increase in Clostridia, and 7/9 (77.8%) had a reduction in Gammaproteobacteria. Of the 2 patients not given colesevelam, one showed a reduction in Bacteroidia, increase in Clostridia and a reduction in Gammaproteobacteria. This small pilot study demonstrated that patients who were given colesevelam, were more likely to be in disease remission at their 6-12 months colonoscopy review compared with those not treated. Furthermore, treatment with colesevelam may have a role in altering the microbiome to help maintain remission states in postoperative Crohn's disease. Larger mechanistic studies are now needed to confirm these findings and demonstrate statistical significance as well as investigate whether this benefit may be present even in those patients with 75SeHCAT negative disease.

Effect of Vaccination Against E. coli, C. perfringens Type A/C on Piglet Productive and Clinical Parameters Under Field Conditions.

Background: One of the main strategies to control neonatal porcine diarrhoea (NPD) is through vaccination of the sows. This study aimed to compare the efficacy of two commercial vaccination schemes under field conditions on a farm where a C. perfringens type A cpb2-positive strain was implicated in NPD. Methods: This study was performed in a farrow-to-wean herd with 5500 sows, already using an E. coli and C. perfringens vaccine but still suffering NPD. Where the presence of a C. perfringens type A cpb2-positive strain was confirmed, Enteroporc Coli AC® (Ceva) was administrated to the sows in group A according to the manufacturer's instructions. Sows in group B were vaccinated using two other combined commercial vaccines. In each group, piglets from 10 litters were ear-tagged and individually weighed at birth and at 8 and 22 days of age. The incidence of diarrhoea, general piglet body condition, and antimicrobial treatment were recorded within 10 consecutive days after birth. Results: A total of 234 piglets (119 in group A and 115 in group B) were included. The mean weight gain of piglets from birth to 22 days of age was significantly higher in group A (4.99 kg) than in group B (4.66 kg) (p = 0.039). The rest of the recorded parameters such as the presence of diarrhoea, the piglet's body condition score, and the number of days with antimicrobial treatment did not differ significantly between groups. Conclusions: This study confirmed the efficiency of the Enteroporc Coli AC® vaccine in reducing clinical symptoms of diarrhoea in piglets, which was comparable with the other vaccines used in the study. The positive effect on piglets' productive performance during the lactation phase was observed.

Lactiplantibacillus argentoratensis AGMB00912 alleviates diarrhea and promotes the growth performance of piglets during the weaning transition

BackgroundPreventing post-weaning diarrhea (PWD) in weaned piglets is a crucial challenge in the swine production industry. The stress of weaning, dietary shifts from maternal milk to solid feed, and environmental changes lead to decreased microbial diversity, increased pathogen abundance, and compromised intestinal integrity. We have previously identified Lactiplantibacillus argentoratensis AGMB00912 (LA) in healthy porcine feces, which demonstrated antimicrobial activity against pathogens and enhanced short-chain fatty acid production. This research aimed to evaluate the efficacy of LA strain supplementation as a strategy to inhibit PWD and enhance overall growth performance in weaned piglets.ResultsLA supplementation in weaned piglets significantly increased body weight gain, average daily gain, and average daily feed intake. It also alleviated diarrhea symptoms (diarrhea score and incidence). Notably, LA was found to enrich beneficial microbial populations (Lactobacillus, Anaerobutyricum, Roseburia, Lachnospiraceae, and Blautia) while reducing the abundance of harmful bacteria (Helicobacter and Campylobacter). This not only reduces the direct impact of pathogens but also improves the overall gut microbiota structure, thus enhancing the resilience of weaned piglets. LA treatment also promotes the growth of the small intestinal epithelial structure, strengthens gut barrier integrity, and increases short-chain fatty acid levels in the gut.ConclusionsThe study findings demonstrate the promising potential of LA in preventing PWD. Supplementation with the LA strain offers a promising feed additive for improving intestinal health and growth in piglets during the weaning transition, with the potential to significantly reduce the incidence and severity of PWD.

Effect of Adopting a Gluten-Free Diet on Exposure to Arsenic and Other Heavy Metals in Children With Celiac Disease: A Prospective Cohort Study.

Lifelong adherence to a gluten-free diet (GFD) is the primary treatment of celiac disease (CeD), a gluten-driven enteropathy. Concerns have been raised about increased exposure to arsenic from a GFD because rice, which naturally bioaccumulates arsenic, is commonly used as a substitute for gluten-containing grains such as wheat. We hypothesize that arsenic exposure increases in newly diagnosed children with CeD after they adopt a GFD. This is a single-center prospective longitudinal cohort study of children (age 2-18 years) with elevated celiac serology who underwent a diagnostic endoscopy before initiation of a GFD between January and May 2022. The primary outcome was change in urinary arsenic concentration between endoscopy and after 6 months on a GFD. Of the 67 recruited participants, 50 had a biopsy diagnostic of CeD and were invited to continue the study. Thirty-five participants completed sample collection. Participants were from a middle-class, well-educated population that was predominantly White with presenting symptoms of abdominal pain (51%) and diarrhea (29%). After 6 months on a GFD, there was a significant increase in the median urinary arsenic concentration (3.3 µg/L vs 13.6 µg/L, P = 0.000004). In regression models, family history of CeD and Hispanic ethnicity were associated with having a higher urinary arsenic concentration after 6 months on a GFD. Children with newly diagnosed CeD have increased arsenic exposure shortly after transitioning to a GFD. While the arsenic levels were well below acutely toxic concentrations, the clinical impact of chronic exposure to mildly elevated arsenic levels is unknown.

Prevalence and Outcomes of Gastrointestinal Manifestations in an Australian Scleroderma Cohort.

The gastrointestinal tract (GIT) is the most commonly affected internal organ in systemic sclerosis (SSc). We sought to determine the prevalence and impact of GIT symptoms on survival and patient-reported outcomes. A total of 907 consecutive patients from the Australian Scleroderma Cohort Study who had prospectively completed the University of California, Los Angeles, Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.0 Questionnaire (UCLA GIT) between 2015 and 2021 were included. The associations between UCLA GIT scores and physical function (Scleroderma Health Assessment Questionnaire), quality of life (QoL; Short Form 36), mood (Patient-Reported Outcomes Measurement Information System [PROMIS] anxiety and depression domains), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue score), and employment were investigated using multivariable population-averaged panel models using generalized estimating equations (GEEs). Kaplan-Meier curves and multivariable Cox proportional hazard regression models were used to evaluate survival according to total UCLA GIT scores. GIT symptoms were reported in 87% of participants, with 46% to 52% reporting moderate to very severe symptoms of reflux, distension, diarrhea, and constipation. Higher total UCLA GIT scores were associated with worse QoL, physical function, fatigue, anxiety, and depression (P < 0.001). In the multivariable GEE analysis, moderate and severe to very severe total scores, reflux scores, and distension scores were associated with worse physical function, QoL, fatigue, anxiety, and depression compared to mild scores (P < 0.05). Patients with severe total scores and diarrhea scores were more likely to be unemployed compared to those with mild scores (P < 0.05). UCLA GIT total scores were not independently associated with death in our cohort. GIT manifestations are common in SSc and negatively impact QoL, physical function, and employment but are not directly associated with increased death.

Decreasing of Trimethylamine N-Oxide by Cecal Microbiota and Choline-Trimethylamine Lyase are Associated with Sishen Pill on Diarrhea with Kidney-Yang Deficiency Syndrome.

Sishen Pill (SSP) is a traditional Chinese medicine prescription commonly used to treat diarrhea with kidney-yang deficiency syndrome. The aim was to investigate the underlying mechanisms of SSP's therapeutic effects, providing experimental evidence for its mechanism of action. A mouse model of diarrhea with kidney-yang deficiency syndrome was induced using adenine combined with Folium sennae. After successful model replication, SSP decoction was administered. CutC activity, TMAO, IL-6, TNF-α levels, and cecal content microbiota were measured. SSP significantly improved the general behavioral characteristics of diarrhea mice, and reduced CutC activity, TMAO and IL-6 levels. Sequencing results indicated significant changes at the phylum and genus levels. Correlation analysis revealed a positive correlation between CutC activity and Faecalibaculum (p<0.05) and Chryseobacterium (p<0.05), and a significant negative correlation with Prevotellaceae UCG-001, Rikenella (p<0.05), Acinetobacter (p<0.05), Parasutterella (p<0.05), and Lacticaseibacillus (p<0.05). TNF-α levels showed a significant negative correlation with Lacticaseibacillus (p<0.05), Prevotellaceae UCG-001 (p<0.01), Parasutterella (p<0.05), and Candidatus Saccharimonas (p<0.05). IL-6 levels exhibited a significant negative correlation with Rikenella (p<0.05), Acinetobacter (p<0.05), Prevotellaceae UCG-001 (p<0.05), Lacticaseibacillus (p<0.01), and Parasutterella (p<0.05), and a significant positive correlation with Faecalibaculum (p<0.05), Chryseobacterium (p<0.01), and A2. Serum TMAO levels showed a significant positive correlation with Faecalibaculum (p<0.05) and Chryseobacterium (p<0.01), and hepatic TMAO levels exhibited a significant positive correlation with Chryseobacterium (p<0.05). SSP significantly alleviated the symptoms of diarrhea with kidney-yang deficiency syndrome by modulating the cecal microbiota, downregulating CutC activity, and reducing TMAO and inflammatory factor levels. The cecal microbiota-CutC-TMAO-inflammatory cytokine axis may be a key mechanism underlying the therapeutic effects of SSP.

Molecular detection of bacteria causing diarrhea in human

This study aimed to detect bacteria causing diarrhea in human by molecular method. During 2021 and 2022, around 150 patients (both sexes) with chronic diarrhoea or similar symptoms were registered at a private clinic. After collecting all of the necessary patient data, a sterile cotton swab was used to collect faecal samples, which were then put in a peptone water broth and sent off to the lab within an hour, then cultured on different media. Multiple biochemical assays and serotyping led to positive identifications of the bacterial isolates. The molecular study includes three primers uidA, invA, 16s rRNA. The current study showed that female 55% was highly infected than male 45% and the total percentage of infection was 40%. The present study exhibited that the age group of 1-5 years had higher infectivity than other age groups. In comparison to other bacteria, this research found that E. coli was the most common cause of diarrhoea in patients.

Prevalence and associated factors of norovirus infections among patients with diarrhea in the Amhara national regional state, Ethiopia

BackgroundNoroviruses (NoVs) are the leading cause of diarrheal disease among all age groups worldwide, with an increased burden in developing countries. As there is no surveillance, epidemiological data is limited in Ethiopia. Hence, this study aimed to investigate the prevalence and associated factors of NoV infection among patients with diarrhea in the Amhara National Regional State, Ethiopia.MethodsA prospective health facility-based cross-sectional study was conducted from May 2021 to November 2021. A total of 550 study participants of all age groups with symptoms of diarrhea were proportionately assigned to the four study areas, area with three health facilities. Study participants were systematically sampled in each health facility. A fecal sample from each case was collected. The RNA was extracted and tested for NoV by one-step RT-PCR. Sociodemographic and other variables were gathered using a pre-tested questionnaire. A descriptive analysis was performed. Both binary and multiple logistic regressions were utilized to identify factors associated with NoV infection. Variables with a p-value < 0.05 in the final model were considered statistically significant.ResultsFive hundred nineteen out of 550 samples were analyzed (94.4% response rate). The overall prevalence of NoV was 8.9% (46/519). The positivity rates were higher among the elderly (33.3%) and under-5 children (12.5%). Both genogroup I and genogroup II (GII) were identified, with GII being the predominant, at 82.6% (38/46). Of all participants, only 20% reported a history of vomiting. Norovirus infection was more prevalent among participants from Debre Tabor (AOR = 4, 95%CI: 1.2–14) and Bahir Dar areas (AOR = 3.6, 95%CI: 1.04–11) compared to Debre Markos. Additionally, older adults (AOR = 7, 95% CI: 2–24) and under-5 children (AOR = 3.5, 95% CI: 2.8–12) were disproportionately affected compared to adults. The previous history of diarrhea (AOR = 3.6, 95% CI: 1.7–7) was a significant factor contributing to NoV infections. Moreover, the odds of NoV infection were higher among individuals with a high frequency of diarrhea (AOR = 15.3, 95%CI: 7.6–43) and vomiting (AOR = 3.5, 95%CI: 1.5-8).ConclusionsThe prevalence of NoV was considerably high, with the predominance of NoV-GII. The positivity rate was higher among the extreme age groups and varied across the study areas. To obtain a comprehensive understanding of the virus`s epidemiology and its genetic diversity, further research is warranted.