Increasing evidence implicates prolonged intestinal transit (slow transit constipation) in the pathogenesis of conventional gallbladder stones (GBS), and that of gallstones induced by long term octreotide (OT) treatment. Both groups of GBS patients have multiple abnormalities in the lipid composition and physical chemistry of their gallbladder bile-associated with, and possibly due to, an increased proportion of deoxycholic acid (DCA) (percentage of total bile acids). In turn, this increase in the percentage of DCA seems to be a consequence of prolonged colonic transit. Thus, in acromegalic patients OT treatment significantly prolongs large bowel transit time (LBTT) and leads to an associated increase of the percentage of DCA in fasting serum (and, by implication, in gallbladder bile). LBTT is linearly related to the percentage of DCA in fasting serum and correlates significantly with DCA input (into the enterohepatic circulation) and DCA pool size. However, these adverse effects of OT can be overcome by the concomitant use of the prokinetic drug cisapride, which normalizes LBTT and prevents the rise in the percentage of serum DCA. Therefore, in OT-treated patients and other groups at high risk of developing stones, it may be possible to prevent GBS formation with the use of intestinal prokinetic drugs.

Cholelithiasis↗

PubMedDate not supplied

Occurrence of Salmonella enteritidis in unpasteurized liquid egg in the United States.

In order to gain a greater understanding of the occurrence and distribution of Salmonella enteritidis in the United States, a survey of unpasteurized liquid egg (collected at 20 egg-breaking plants across the United States) was conducted over a 52-week period. Weekly liquid egg samples were submitted for Salmonella culturing at the National Veterinary Services Laboratories. Group D positive salmonellae were serotyped and phage-typed. On a regional basis, the Northern Region of the United States had the highest S. enteritidis recovery, with 20% of the samples submitted from plants in that region culture-positive for this serotype. Salmonella enteritidis positives from the Southeast, Central, and Western regions were 10%, 15%, and 6% of the samples submitted, respectively.

Bacteriophage Typing↗