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At least 1,405 records · Page 78Linked to original sources
PubMed2002

Prevalence of gastrointestinal disease caused by Clostridium difficile in a university hospital in Hungary.

A one-year survey was undertaken to investigate the frequency of diarrhoea caused by Clostridium difficile among patients in a 1200-bed university hospital in Hungary. The VIDAS (bioMérieux) toxin A detection kit was used for screening specimens for the presence of C. difficile toxin. For all other diarrhoeal specimens selected according to special criteria, cytotoxin testing was used to determine the presence of 'free toxin' in the faeces. During the study period, a total of 945 diarrhoeal faecal samples were tested for the presence of C. difficile toxin. Of 375 requested samples, 58 (18.3%) were toxin-A positive. Of the 570 remaining faecal samples selected by the laboratory, 120 (21%) proved to be toxin positive. The results showed that patients from the surgical (33.3%), internal (24%) and haematological (12.8%) wards had the greatest frequency of diarrhoea attributable to C. difficile.

Adult↗
PubMed1998

Future aspects of functional gastrointestinal disease: how should treatments be evaluated.

Evaluation can only be approached when groups to receive any form of therapy are well defined. To make progress in an area now confused, the best strategy would seem to involve separating from the mass of FGD patients, sub-groups which are well defined by tight diagnostic criteria, and initially limiting all research, including clinical trials, to such groups. Overlapping syndromes can be studied later. Clearly defined psychiatric illnesses should be diagnosed by DSM criteria and excluded from study. While research and long-term clinical trials should be limited to tightly defined groups, short-term responses to specific therapies could be used to define the groups, following which clinical clusters for that group could be re-evaluated. In broad terms, across-the-board attention to visceral sensitivity, nervous function and psychosocial factors seem more likely to yield insights in IBS than in NUD, but at present no confident statements can be made about pathogenesis in either group. Further clinical trials performed as in the past, are largely inappropriate at this time.

Algorithms↗
PubMed1989

Detection of HIV-1 RNA in the lamina propria of patients with AIDS and gastrointestinal disease.

Thirty formaldehyde-fixed, paraffin-embedded endoscopic biopsy specimens from the colon and rectum of 25 patients with acquired immunodeficiency syndrome were examined using a [35S]HIV-RNA in situ hybridization procedure. Nine of the specimens contained cells that bound significant amounts of probe. Cells were considered positive if more than 50 grains of silver (over background) per 200 micron 2 were seen over cells that did not stain with eosin. Most of the positive cells resembled macrophages, although cells with condensed nuclei resembling lymphocytes were found. No epithelial cells expressing viral RNA were detected. Formaldehyde-fixed eosinophils gave spurious signals that could be reduced with sulfhydryl modifying agents. HIV-1 may be disseminated in the lamina propria of the gut at low concentrations in some patients but may not be detectable in others. The lower gut lining may be both a portal of initial infection with HIV and a target of disseminated HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Factors associated with the development of post-infectious functional gastrointestinal diseases: does smoking play a role?

OBJECTIVES: Irritable bowel syndrome (IBS) is associated with psychological stress, alterations in gut motor function and/or visceral perception. Previous studies suggest 7-32% of people develop IBS after bacterial gastroenteritis but the exact mechanisms underlying post-infectious IBS are not clear. The present study's aim was to examine the role of possible causative factors in the development of post-infectious functional gastro-intestinal disorders (FGIDs), including IBS. METHODS: A prospective cohort study where 122 people without a prior FGID under study and with stool-positive bacterial gastroenteritis consented to participate. The presence or not of IBS, functional dyspepsia or functional diarrhoea was diagnosed at the start and on 6-month follow-up using self-complete Rome II modular questionnaires. Demographic data, smoking, alcohol use, anxiety and depression (using the Hospital Anxiety and Depression Scale), and life events and impact (using the Life Events Survey) were collected at the start of the study. RESULTS: One hundred and seven questionnaires were returned with 25 participants (23.4%) developing a FGID and 16 participants presenting symptoms consistent with IBS (15%). Smoking was significantly associated with the development of a post-infectious FGID (odds ratio = 4.8, 95% confidence interval = 1.5-15.2) on regression analysis. CONCLUSIONS: Post-infectious FGIDs appear to be associated with smoking. Smoking is known to moderate gut immunity in other disorders such as ulcerative colitis and Crohn's disease. This study adds to increasing evidence for an organic basis to post-infectious FGIDs, perhaps moderated via inflammatory pathways.

Adolescent↗
PubMed1994

Role of somatostatin and somatostatin analogues in the treatment of gastrointestinal diseases: prevention of complications after pancreatic surgery.

Morbidity and mortality related to pancreatic surgery are still high: 30-40% and 3-10% respectively. As most complications are probably related to exocrine pancreatic secretion, its inhibition could improve the postoperative course. In 1979, Klempa saw a low complication rate after Whipple resection in a small number of patients treated with somatostatin, a powerful inhibitor of pancreatic exocrine secretion. The long acting somatostatin analogue, octreotide, also inhibits pancreatic exocrine secretion and can be given by subcutaneous injections. Two double blind, placebo controlled, multicentre studies with randomisation into parallel groups were recently performed to find out if peri and postoperative administration of octreotide (100 micrograms thrice daily subcutaneously) reduces the rate of complications specifically related to pancreatic surgery. Both trials consistently showed that octreotide can reduce substantially (over 40%) the risk of complications in these patients; the treatment acceptability was good.

Clinical Trials as Topic↗