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At least 415 records · Page 23Linked to original sources
PubMed1996

In postmeiotic male germ cells poly (A) shortening accompanies translation of mRNA encoding gamma enteric actin but not cytoplasmic beta and gamma actin mRNAs.

In the mammalian testis the cytoplasmic beta and gamma actins are expressed in all stages of germ-cell differentiation, whereas gamma enteric actin is expressed in germ cells solely in postmeiotic stages. Northern blot analysis of mouse testicular RNAs reveals actin mRNAs of about 2.1, 1.5, and 1.4 kB. The 2.1-kB mRNAs encode the cytoplasmic beta and gamma actins, whereas the two faster-migrating actin mRNAs encode gamma enteric actin. When postmitochondrial mouse testis extracts are fractionated by sucrose gradient centrifugation, the 1.5-kB gamma enteric actin mRNA is primarily found in the nonpolysomal fraction, whereas the 1.4-kB gamma enteric actin is polysomal. When the poly (A) tails are removed, the nonpolysomal and polysomal gamma enteric actin mRNAs both migrate at 1.3 kB, indicating that the difference in electrophoretic mobilities of the two gamma enteric actin mRNAs is caused by poly (A) length differences. The nonpolysomal and polysomal forms of the cytoplasmic beta and gamma actins show similar electrophoretic mobilities before and after deadenylation. Sequence comparison of the 3' untranslated region of the mouse gamma enteric actin to the 3' untranslated regions of other testicular mRNAs that undergo partial deadenylation reveals three highly-conserved sequence elements. These data demonstrate that the poly (A) shortening of polysomal mRNAs previously seen only with testis-specific mRNAs that are stored as mRNPs also occurs with mRNAs of widely-expressed genes that are expressed in postmeiotic male germ cells. The mRNAs all contain specific conserved sequence elements in their 3' untranslated regions.

Actins↗
PubMed1977

Enteric-coated pellets: theoretical analysis of effect of dispersion in the stomach on blood level profiles.

The advantages of encapsulated enteric-coated pellets as dosage forms are discussed theoretically and compared to enteric-coated tablets. An enteric-coated tablet may take from approximately 0.5 to more than 8 hr to pass from the stomach to the duodenum. On the other hand, enteric-coated pellets are subjected to dispersion in the stomach, but they pass through the pyloric sphincter after a mean residence time in the stomach that would not be different from that exhibited by a suspension dosage form. The dispersion effect causes a theoretical reduction in peak blood level over that of an enteric-coated tablet of equivalent potency while maintaining bioavailability. It is hypothesized that enteric-coated pellets will reduce intestinal side effects that may occur with enteric-coated tablet preparations.

Capsules↗
PubMed1994

Impact of enteral nutrition on intestinal bacterial translocation and mortality in burned mice.

The aim of these experiments was to study the effect of early enteral nutrition with either standard or enriched (arginine, n-3 fatty acids, RNA) enteral formulas on translocation of bacteria from the gut and acute mortality rate following thermal injury. In the first experiment 60 Balb c mice were gavaged with 10(10)Escherichia coli and received a 20% burn injury. In 40 mice enteral nutrition (20 standard, 20 enriched) was started immediately after injury and stopped 36 h later. In the control group (n = 20) aliquotes of Ringer's solution was administered intragastrically. Mortality rate was observed for 10 days post-injury. In the second experiment 60 Balb c mice were gavaged with 10(10)E. coli labelled with biotin(111) Indium and then burned. In 40 mice enteral nutrition (20 standard, 20 enriched) was started immediately after burn. The control group (n = 20) received aliquotes of Ringer's solution. 4 h after injury all animals were sacrificed and liver, lungs, kidneys, spleen and systemic blood were harvested, and radionuclide counts were measured. No animal died after day 3 post-burn. The mortality rate was significantly lower at day 1 in the groups infused with both enteral solutions (15%) compared to controls (30%; p = 0.05). At day 3 the animals fed with the enriched diets showed a lower mortality (5%) versus the standard and control groups (10%). Bacterial translocation to the liver and lungs was significantly higher in Ringer's group than in both enterally fed groups. Early post-burn enteral nutrition reduces both translocation and acute mortality. Supplementation of the diets with specific nutrients appears to exert additional advantages on outcome.

Journal Article↗
PubMed2004

Proteinase inhibitors TPCK and TLCK prevent Entamoeba histolytica induced disturbance of tight junctions and microvilli in enteric cell layers in vitro.

Tight junctions and microvilli constitute an anti-invasive barrier at the luminal side of enteric cell layers. Both subcellular structures are disrupted following adhesion of Entamoeba histolytica trophozoites to enteric cell layers in vitro. It was our aim to analyse the molecular mechanism underlying this disruption. Therefore, we cocultured enteric T84 cell layers established on filter inserts with E. histolytica trophozoites and tested various modulators of enteric molecules, involved in the functional regulation of tight junctions, as well as inhibitors of trophozoite virulence factors on their capacity to maintain the transepithelial electrical resistance. Pretreatment of trophozoites with the proteinase inhibitor N-Tosyl-Phenylalanine chloromethyl ketone or N-Tosyl-l-Lysine chloromethyl ketone prevented the decrease in transepithelial electrical resistance whereas none of the modulators used to pretreat enterocytes were successful. Moreover, zymography and Western blot analysis revealed that both N-Tosyl-Phenylalanine chloromethyl ketone and N-Tosyl-l-Lysine chloromethyl ketone inhibited E. histolytica cysteine proteinases and prevented proteolysis of tight junction molecules ZO-1 and ZO-2 and of villin, the major actin bundling molecule in microvilli. Immunocytochemistry with an antibody against ezrin, an actin-binding molecule in microvilli, and phase contrast microscopy demonstrated that pretreatment of trophozoites with N-Tosyl-Phenylalanine chloromethyl ketone or N-Tosyl-l-Lysine chloromethyl ketone also prevented disturbance of microvilli and destruction of Caco-2 enteric cell layers in cocultures. Taken together, our results indicate that trophozoites use their proteinases to overcome microvilli and tight junction barriers during the invasion of enteric cell layers, that these phenomena could be prevented by pretreatment of trophozoites with N-Tosyl-Phenylalanine chloromethyl ketone or N-Tosyl-l-Lysine chloromethyl ketone, and that such pretreatment disabled trophozoites to destroy enteric cell layers in vitro.

Animals↗
PubMedDate not supplied

Non-radioisotopic glucose turnover in children with falciparum malaria and enteric fever.

To determine whether glucose turnover is increased in acute falciparum malaria compared to enteric fever in children, steady-state 6,6-D2-glucose turnover was measured in 9 Malaysian children with uncomplicated malaria (6 males and 3 females; median age 10 years, body weight 22 kg) and in 12 with uncomplicated enteric fever (8 males and 4 females; median age 10 years, body weight 24 kg) in acute illness, after quinine (5 malaria patients) and in convalescence. Baseline plasma glucose concentrations in malaria and enteric fever were similar (all values are medians [ranges in brackets]) 5.6 [3.2-11.3] vs. 5.5 [4.2-8.0] mmol/L), as were serum insulin levels (5.6 [0.4-26.5] vs. 6.8 [1.1-22.5] milliunits/L; P > 0.4). Glucose turnover in the malaria patients was higher than in patients with enteric fever (6.27 [2.71-6.87] vs. 5.20 [4.50-6.08] mg/kg.min; P = 0.02) and in convalescence (4.74 [3.35-6.79] mg/kg.min; P = 0.05 vs. acute malaria study), and fell after quinine together with a rise in serum insulin (P = 0.03). Basal plasma lactate concentrations were higher in enteric fever than in malaria (3.4 [1.8-6.4] vs. 0.8 [0.3-3.8] mmol/L; P < 0.0001) and correlated inversely with glucose turnover in this group (rs = -0.60; n = 12; P = 0.02). These data suggest that glucose turnover is 20% greater in malaria than in enteric fever. This might reflect increased non-insulin-mediated glucose uptake in falciparum malaria and/or impaired gluconeogenesis in enteric fever, and may have implications for metabolic complications and their clinical management in both infections.

Adolescent↗
PubMed1996

Is enteral nutrition optimally used in hospitalized patients? A study of the practice of nutrition in a Swedish hospital.

Thirty patients with parenteral nutrition were studied in order to evaluate if they could be given enteral nutrition instead. Based upon absolute and relative contraindications for enteral nutrition, we calculated that 80% of the patients were possible candidates for enteral nutrition. Long-term use of parenteral nutrition may cause complications. Besides metabolic and other advantages when enteral nutrition is used, economical gains are also important. We have calculated an estimated annual net profit of US$ 357,000 in our hospital, if enteral instead of parenteral feeding is used in patients suitable for the former type of feeding. This implies that it is really cost-beneficial to consider enteral nutrition in hospitalized patients. Although parenteral nutrition will continue to have its place in the management of different occasions, increased use of enteral nutrition may result in improved patient outcomes and improved cost-effectiveness.

Journal Article↗
PubMed1996

Does percutaneous endoscopic gastrostomy prevent gastro-oesophageal reflux during the enteral feeding of elderly patients?

Percutaneous endoscopic gastrostomy (PEG) is reported to be a safe method for enteral feeding, although its ability to prevent gastro-oesophageal reflux (GOR) during enteral feeding remains controversial. In 12 elderly patients fed enterally to avoid the risk of tracheal aspiration, we have compared two 24-h oesophageal pH profiles, one recorded when enteral feeding was delivered at first via a nasogastric tube (NGT), and the other via a PEG. The second recording was always performed at least 8 days after gastrostomy placement. Enteral nutrition consisted of 500 ml of a polymeric diet delivered 3 times a day at 08:00, 13:00 and 18:00. After gastrostomy placement, enteral feeding was associated with a pathological acid reflux in 8 out of 12 patients. In all of these 8 patients, GOR was mostly related to a high number of reflux episodes. In 4 out of 8 patients, GOR occurred only during the 3 h following the administration of the nutritive diet. In 4 of the patients, GOR did not occur any more after removal of the NGT, whilst gastrostomy placement was followed by GOR in 5 patients. GOR during enteral feeding via PEG is common in elderly subjects. We have shown that a chronological relationship existed in some patients between the endoscopic procedure and the onset of a pathological GOR.

Journal Article↗
PubMed1999

Factors associated with coercion in entering treatment for alcohol problems.

Although the importance of coercion in entry to treatment for alcohol problems is recognized, few studies have focused on different types and levels of coercion among heterogeneous groups of clients entering treatment agencies. This paper describes demographic and problem characteristics associated with various sources and levels of coercion. More than 40% (n = 377) of individuals entering a representative sample of a county's HMO, public, and private indemnity-based non-DUI alcohol treatment services (n = 927) indicated they received an ultimatum to enter treatment from at least one person. The most common source of an ultimatum to enter treatment was from family members (n = 222), followed by the legal system (n = 78), and healthcare professionals (n = 55). Respondents experiencing pressure to enter treatment reported that ultimatums from more than one source were common. Individuals entering treatment who were most likely to report being coerced were white, young adults (age 18-39), and married or living with a partner. When controlling for demographic characteristics and problem severity, family problem severity and legal problem severity predicted having received an ultimatum to enter treatment. Alcohol and drug problem severity were not related to receiving a treatment ultimatum.

Adolescent↗
PubMed1999

Enteric viral infections as a cause of diarrhoea in the acquired immunodeficiency syndrome.

BACKGROUND AND AIMS: The role of non-cytomegalovirus (CMV) enteric viral infection in causing diarrhoea in patients with human immunodeficiency virus (HIV) is poorly understood. We aimed to investigate the prevalence of these infections in acute and chronic diarrhoea. METHODS: Stool specimens from 377 HIV-infected patients presenting with diarrhoea were studied prospectively for evidence of non-CMV enteric viral infection. Patients with diarrhoea underwent investigation for gastrointestinal pathogens, including electron microscopic examination of stool for enteric viruses. We collected data on patients in whom enteric virus was identified and examined the association of enteric virus infection with diarrhoeal symptomatology. RESULTS: Eighty-nine (10.3%) stool specimens from 60 (15.9%) HIV+ individuals were positive for coronavirus (n = 13, 22%), rotavirus (n = 11, 18%), adenovirus (n = 30, 50%) and small round structured viruses (n = 5, 8%) or dual infection (n = 2, 3%). Thirty-four of 52 (65%) patients available for analysis had acute diarrhoea, and 18/52 (35%) had chronic diarrhoea. Twenty-three of 52 (44%) patients had a concurrent gut pathogen. After exclusion of concurrent pathogens enteric viral infections were found to be significantly associated with acute as opposed to chronic diarrhoea (P = 0.004). The presence of adenovirus colitis was significantly more likely to be associated with chronic diarrhoea (15/21 cases) than adenovirus isolated from stool alone (9/23 cases) (P = 0.03). There was a trend towards an association between adenovirus colitis and colonic cytomegalovirus infection (P = 0.06). CONCLUSION: Enteric viral infection is strongly associated with acute diarrhoea in patients with HIV. Light microscopic examination of large bowel biopsies can identify adenovirus colitis which is significantly associated with chronic diarrhoea, and in addition may facilitate gastrointestinal co-infection with CMV.

AIDS-Related Opportunistic Infections↗
PubMed2006

The use of enteral naloxone to treat opioid-induced constipation in a pediatric intensive care unit.

OBJECTIVE: To describe the effects of enteral naloxone used to treat opioid-induced constipation in pediatric intensive care patients. DESIGN: Retrospective chart review. SETTING: Pediatric intensive care unit. PATIENTS: Twenty-three patients who received opioid therapy and enteral naloxone in our institution from January 2003 to February 2004 were compared with a randomly sampled control group matched for age, weight, sex, and length of stay who received opioids but had not received enteral naloxone. INTERVENTIONS: None. MEASUREMENTS: Daily stool output, daily opiate usage, nutrition, adjuvant laxative use, and side effects were assessed. RESULTS: Patients stayed an average of 5 days (range, 0-13 days) in the pediatric intensive care unit before enteral administration of naloxone was instituted and received it for an average of 9 consecutive days (range, 3-30 days). Mean stool output for study patients before administration of enteral naloxone was 0.14 +/- 0.38 stools per day, whereas after its initiation it was 1.60 +/- 1.14 stools per day (p < .001). However, two patients developed significant opiate withdrawal symptoms after receiving enteral naloxone. The average stool output for control patients was 0.53 +/- 1.21 stools per day. CONCLUSIONS: Enteral naloxone may be effective in increasing stool output in opioid-induced constipation but carries the risk of introducing withdrawal symptoms. Further studies are needed to evaluate this agent for opioid-induced constipation in the intensive care unit.

Adolescent↗
PubMed1994

Differential elimination of enteric bacteria by protists in a freshwater system.

The short-term (1 h) and long-term (3 d) elimination of low and high densities of five enteric bacteria, Klebsiella pneumoniae, Aeromonas hydrophila, Escherichia coli, Enterococcus faecalis and Staphylococcus epidermidis, by flagellate and ciliate protists were measured in a freshwater system. In addition, the two processes, ingestion and digestion, which cause the disappearance of those enteric bacteria as time passes, were quantified. The results showed that the elimination of these enteric bacteria by protists depends on their initial density, which confirms that the lower the bacterial density the more difficult is their elimination. On the other hand, the short-term and long-term elimination rates of each enteric bacteria were different, and moreover, the order of priority for elimination in the two cases was not the same. Escherichia coli showed the highest elimination rate in short-term experiments, while Aer. hydrophila disappeared at highest rates in long-term experiments. This different order of priority in the elimination rates and the different digestion rates on the five enteric bacteria by phagotrophic protists indicated that the elimination in time is very much influenced by the digestive capacity on each enteric bacteria of those protists. Thus, the low digestion rates of Ent. faecalis and Staph. epidermidis by flagellates and ciliates as well as their low disappearance percentages in the long-term experiments confirm that enteric Gram-positive bacteria are eliminated from the aquatic systems at lower rates, because their digestion is difficult.

Aeromonas hydrophila↗
PubMed2006

Enteral fluid therapy in large animals.

Enteral fluids administered alone, or in conjunction with intravenous fluids, are reported to be useful for the treatment of dehydration and electrolyte loss associated with diarrhoea in a number of species, following exercise in horses and for feed impaction of the large intestine of horses. Enteral fluids are suitable for treatment of mild to moderately dehydrated patients with some intact intestinal epithelium and motile small intestine. In patients that will drink voluntarily or tolerate nasal intubation the use of enteral fluids may avoid the complications associated with intravenous fluid administration. However the labour costs associated with repeated nasal intubation in intensively managed patients requiring large volumes of fluids may make the use of enteral fluids less economical than intravenous fluid administration. Enteral fluid use alone is contraindicated in patients that are severely dehydrated and/or in hypovolaemic shock, however, if used in conjunction with intravenous fluids, the effects of villous atrophy and malnutrition may be ameliorated and the duration of hospitalisation shortened. There is a variety of commercially available enteral fluids available to veterinary practitioners. While the key components of these fluids are sodium, chloride and carbohydrates, the amounts of ions and other ingredients such as potassium, alkalising agents, amino acids and shortchain fatty acids may vary. The species of the animal, the underlying condition, and the constituents of the fluid, should influence the choice of an enteral fluid.

Animals↗
PubMedDate not supplied

Profile and expectations of students entering general practice residency programs.

Although various studies have attempted to evaluate the success of general practice residency (GPR) programs in providing postdoctoral training, little work has investigated the motivation for senior dental students opting for such training compared with entering directly into private practice. Questionnaires were administered to 58 seniors at the State University of New York at Buffalo School of Dental Medicine 1 month before graduation to determine possible differences between those entering GPR programs and those planning to enter private practice. The survey also examined the goals of dentists about to enter GPR programs and compared them with the training goals determined by the Commission on Dental Accreditation. Although 75% of those entering GPR programs cited additional clinical experience as the reason for choosing this step in their careers, the most frequent response from those entering directly into private practice concerned the financial benefits. Also, of the respondents about to enter GPR programs, only one student indicated a desire for training in hospital dentistry. Although this survey was relatively limited in size, it appears that advanced instruction in the management of patients with complex health care problems is not one of the primary motivating factors for students considering residencies. This may indicate a need at the predoctoral level for greater instruction in changing health care demographics and in the training goals of general practice residencies, to continue to attract qualified dental graduates with goals compatible with those of GPR programs.

Attitude↗
PubMed1998

Enteric beta-defensin: molecular cloning and characterization of a gene with inducible intestinal epithelial cell expression associated with Cryptosporidium parvum infection.

A growing body of evidence suggests that endogenous antibiotics contribute to the innate defense of mammalian mucosal surfaces. In the cow, beta-defensins constitute a large family of antibiotic peptides whose members have been previously isolated from the respiratory and oral mucosa, as well as circulating phagocytic cells. A novel bovine genomic clone with beta-defensin-related sequence [corrected] related to those of these alpha-defensins was isolated and characterized. The corresponding cDNA was isolated from a small intestinal library; its open reading frame predicts a deduced sequence of a novel beta-defensin, which we designate enteric beta-defensin (EBD). Northern blot analysis of a variety of bovine tissues revealed that EBD mRNA is highly expressed in the distal small intestine and colon, anatomic locations distinct from those for previously characterized beta-defensins. EBD mRNA was further localized by in situ hybridization to epithelial cells of the colon and small intestinal crypts. Infection of two calves with the intestinal parasite Cryptosporidium parvum induced 5- and 10-fold increases above control levels of EBD mRNA in intestinal tissues. An anchored-PCR strategy was used to identify other beta-defensin mRNAs expressed in the intestine. In addition to that of EBD, several low-abundance cDNAs which corresponded to other beta-defensin mRNAs were cloned. Most of these clones encoded previously characterized beta-defensins or closely related isoforms, but two encoded a previously uncharacterized prepro-beta-defensin. Northern blot evidence supported that all of these other beta-defensin genes are expressed at levels lower than that of the EBD gene in enteric tissue. Furthermore, some of these beta-defensin mRNAs were abundant in bone marrow, suggesting that in enteric tissue their expression may be in cells of hematopoietic origin. Extracts of small intestinal mucosa obtained from healthy cows have numerous active chromatographic fractions as determined by an antibacterial assay, and one peptide was partially purified. The peptide corresponded to one of the low-abundance cDNAs. This study provides evidence of beta-defensin expression in enteric tissue and that the mRNA encoding a major beta-defensin of enteric tissue, EBD, is inducibly expressed in enteric epithelial cells. These findings support the proposal that beta-defensins may contribute to host defense of enteric mucosa.

Amino Acid Sequence↗
PubMed1983

Rapid method for detection, identification, and susceptibility testing of enteric pathogens.

Three hundred and seven colonies believed to be enteric pathogens were selected from primary plates of MacConkey, xylose desoxycholate, or salmonella-shigella agar for inoculation to lactose-sucrose broth, urea-41 motility medium, modified Andrade glucose broth with inverted Durham tube, pregrowth broth, triple sugar iron agar, lysine iron agar (LIA), and Christensen urea agar. The rapid screen consisted of interpreting the lactose-sucrose, urea-41 motility, and modified Andrade glucose broth gas reactions after 4 to 6 h at 35 degrees C. These rapid screening biochemicals plus LIA were incubated for 24 h if further interpretation was required. Reference biochemicals (triple sugar iron, LIA, and Christensen urea agars) were interpreted at 24 h. Of 307 isolates, 49 (16%) were reported as negative for enteric pathogens after 4 to 6 h because their biochemical profiles were not compatible with those for enteric pathogens. A total of 87 (28.3%) isolates produced biochemical profiles at 4 to 6 h that were presumptive for enteric pathogens. The 87 presumptive pathogens were inoculated into the AutoMicrobic system Gram-Negative General Susceptibility Card and the AutoMicrobic system Enterobacteriaceae-Plus Biochemical Card (AMS-EBC+) after 4 to 6 h of growth in pregrowth broth. Of these isolates, 63 were confirmed to be enteric pathogens, of which 61 (96.8%) were correctly identified by the AMS-EBC+. One isolate was identified as Shigella dysenteriae by AMS-EBC+ but confirmed as Shigella flexneri biotype 6 by a reference laboratory. The other isolate was identified as Arizona hinshawii by AMS-EBC+ but was confirmed as Salmonella enteritidis. Of the 307 isolates, 166 (54.1%) required further interpretation of the rapid screening biochemicals plus LIA at 24 h; 5 of these were detected as enteric pathogens. The same 68 enteric pathogens were detected by both the rapid method and the reference method. The results from the general susceptibility card agreed with agar diffusion results at 99.2%. One Salmonella enteritidis and four Shigella spp. showed minor discrepancies with tetracycline. No very major or major discrepancies were observed.

Bacteriological Techniques↗
PubMed2003

Feeding the hypotensive patient: does enteral feeding precipitate or protect against ischemic bowel?

Although the enteral route of enteral feeding is the preferred method of nutrition support for critically ill patients, this important therapeutic strategy is not without risk. In human subjects, the digestion and absorption of nutrients induce typical hemodynamic changes, consisting of an increase in mesenteric blood flow at the expense of reduced systemic blood pressure. On rare occasion when providing aggressive enteral nutrition to critically ill patients, common symptoms of gastrointestinal intolerance may progress to a syndrome of abdominal distention, hypotension, and shock, with the development of small bowel ischemia or necrosis. Although the incidence of small bowel ischemia secondary to enteral feeding is low, the overall clinical outcome is still poor and carries a high mortality rate. Enteral feeding is well tolerated and is probably beneficial in most critically ill patients before and after a period of hypotension. Although enteral nutrition may be used with caution during the period of hypotension, evidence of poor gastrointestinal function (increased nasogastric tube output, unexplained abdominal pain, and abdominal distention), or development of dilated loops of bowel or intramural gas (pneumatosis intestinalis) on radiographic studies should be interpreted as potential indicators of gut ischemia. With progress in our understanding of the pathophysiology, diagnosis, and prevention of ischemic injury to the intestinal mucosa, the strategy of aggressive enteral feeding for critically ill patients may result in a reduction in this major complication and enhanced functional recovery from severe illness.

Journal Article↗
PubMed2001

Concomitant blunt enteric injuries with injuries of the liver and spleen: a dilemma for trauma surgeons.

Prompt identification of enteric injuries after blunt trauma remains problematic. With the increased utilization of nonoperative management of blunt abdominal trauma gastrointestinal disruptions may escape timely detection and repair. The purpose of this study was to evaluate blunt enteric injuries requiring operative repair in adult patients and the association of concomitant hepatic and/or splenic injuries. Over a 10-year period (January 1990 through December 1999) 1648 patients suffered blunt liver, spleen, and/or enteric injuries, with 87 (5.3%) of these requiring operative repairs of the enteric injury. These patients had enteric injury only (EI) (60.9%; 53 of 87), concomitant enteric/splenic injury (ESI) (10.3%; 9 of 87), concomitant enteric/hepatic injury (EHI) (13.8%; 12 of 87), and enteric/hepatic/splenic injury (EHSI) 14.9% (13 of 87). A delay in treatment of >8 hours from presentation of EI compared with either EHI or ESI was not significantly different between the two groups. EHSI had exploratory laparotomy more expeditiously related to hemodynamic instability. Mortality rates were higher with EHI related to hemorrhagic shock and/or severe traumatic brain injury. Morbidity was not related to a delay in diagnosis until the period of delay was greater than 24 hours. The nonoperative management of blunt solid organ injury does not delay the detection and treatment of concomitant bowel injuries compared with isolated blunt enteric injuries. Occult enteric injury with solid organ injury has a low incidence and represents a continuing challenge to the clinical acumen of the trauma surgeon.

Adult↗
PubMed2003

Enteric virions and microbial biofilms--a secondary source of public health concern?

Through their many sorption sites, microbial biofilms can accumulate both organic and inorganic particulate and colloidal material from bulk water environments. An application of such first principles to the ecology of "biocolloidal" enteric virions would suggest that they too may be concentrated by biofilms in a similar way. Though previous studies have isolated human gastrointestinal (enteric) virions from microbial biofilms, the exact human health significance of this has been neither fully investigated nor completely understood. Through an assessment of the location, accumulation and persistence of model enteric virion (phiX174, MS2 and B40-8 bacteriophages as well as 20 nm fluorescent latex microspheres) within biofilms, the aim of the current study was to investigate whether the interaction of enteric virions with distribution pipe biofilms could provide a secondary source of public health concern to consumers. Model enteric virions were found to be incorporated into biofilms at concentrations representing 1% of those present in the adjacent bulk water environment. A sub-population (0.01%) of these persisted throughout an experimental period of 30 days, inferring their potential to accumulate over time. Furthermore, model enteric virions were partitioned into bacterial microcolonies, environments where biofilm bacteria can persist and re-grow, even in the presence of "acceptable" levels of disinfection. A risk model for enteric virion accumulation and release from distribution pipe biofilms suggested that associated risks may exceed USEPA benchmark values. These findings could have wide-reaching implications in water treatment and distribution strategies, and necessitate a re-appraisal of current water guideline values.

Bacteria↗