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PubMed1982

[Acinetobacter colcoaceticus: its properties, identification key and a study of its role in acute intestinal diseases].

The authors present their new scheme for the identification of Acinetobacter calcoaceticus, requiring a lesser number of test, and the characterstics of 84 strains isolated from patients with acute intestinal diseases and from the environment. Some strains are atypical. Acinetobacter has been detected in 7.8 +/- 1.0% of patients with acute intestinal diseases. The authors' observations confirm that the detection of Acinetobacter in washings from such patients is more convincing for etiological diagnosis than its detection on feces.

Acinetobacter↗
PubMed1997

Intestinal disease in acquired immunodeficiency: evaluation by CT.

Intestinal symptoms affect most AIDS patients at some point in their disease. The purpose of this study was to evaluate the use of CT in this setting. A total of 339 abdominal CT exams were reviewed for signs of intestinal disease. Abdominal CT scans of 45 patients with intestinal symptoms were compared with colonoscopy and histologic data. The CT results were correlated with CD4( +) T-lymphocyte counts and patient survival. More than 14 % of all abdominal CT exams displayed signs of enteric disease. Of the 45 patients studied with both CT and colonoscopy, 35 (78 %) had signs of intestinal disease by CT. Of these 35 patients, colonoscopic signs of an intestinal lesion were found in 29 and histologic proof of disease was established in 30 cases. Colonoscopy and histology detected 8 lesions missed by CT. There were 14 cases of unspecific colitis, 15 cases of cytomegalovirus (CMV) colitis, and 4 cases of enteric tuberculosis as per biopsy. Five patients presented with Kaposi's sarcoma and 1 with a non-Hodgkin's lymphoma. Neither colonoscopic nor CT signs of intestinal disease did reliably distinguish between histologic subgroups. Specifically, CMV colitis could not be distinguished from unspecific colitis. CD4( +) T-lymphocyte counts for histologic subgroups were not significantly different, either. No colonoscopic or histologic feature predicted survival, whereas low CD4 counts and ascites on CT indicated a poor prognosis. Whereas CT detects signs of intestinal disease in most AIDS patients, these signs remain largely unspecific. Colonoscopy and biopsies provide no consistently valid standard with which to compare CT because of controversial sensitivity and specificity of these methods. The CT technique detects small bowel as well as extraintestinal disease. Therefore, CT is an important diagnostic modality in abdominal disease of immunocompromised patients.

AIDS-Related Opportunistic Infections↗
PubMed1986

Digestion of bentiromide and absorption of xylose in healthy cats and absorption of xylose in cats with infiltrative intestinal disease.

The digestion of bentiromide and the absorption of D-xylose was measured in 17 clinically healthy cats. The plasma xylose concentrations of the healthy cats were compared with values from 9 cats with diffuse infiltrative intestinal disease. The cats were administered 16.7 mg of bentiromide/kg and 0.5 g of xylose/kg via a stomach tube. Plasma samples were obtained before administration and 30, 60, 90, and 120 minutes after administration. The maximum mean plasma p-aminobenzoic acid concentration occurred at 60 minutes, with a value of 386 +/- 134 micrograms/dl (mean +/- SD). The maximum mean plasma xylose concentration also occurred at 60 minutes, with a value of 26.0 +/- 9.2 mg/dl. Plasma concentrations of p-aminobenzoic acid and xylose were lower in healthy cats than those reported for healthy dogs. There was no significant difference between xylose concentrations in healthy cats and cats with infiltrative intestinal disease.

4-Aminobenzoic Acid↗
PubMed1997

Five-year results of the treatment of 23 patients with immunoproliferative small intestinal disease: a Turkish experience.

BACKGROUND: Currently, there is no agreement regarding optimal treatment strategies for immunoproliferative small intestinal disease (IPSID). In this article, the authors report the treatment outcomes of a group of 23 Turkish patients with IPSID. METHODS: Between December 1988 and July 1993, 23 consecutive patients with IPSID, including 5 with secretory type, were included in the study. Seven patients with Stage A disease (according to the criteria of Galien et al.) received tetracycline (1 g/day, orally) for a median duration of 7 months (range, 6-11 months) initially, whereas the remaining patients (9 Stage B patients and 7 Stage C patients) received combination chemotherapy (cyclophosphamide, vincristine, procarbazine, and prednisolone [COPP regimen]) followed by tetracycline at a dose of 1 g/day for 6 more months in patients with complete response (CR) after the COPP regimen. RESULTS: The median follow-up was 68 months (range, 38-89 months). As first-line therapy in Stage A patients, tetracycline yielded a 71% CR and 43% disease free survival (DFS) rate. Eleven of 16 patients (69%) with Stage B or C disease who received the COPP regimen achieved CR and only 2 patients had a recurrence (DFS rate of 56%). The 5-year overall survival (OAS) rate for the entire group was 70%, and the 5-year DFS rate for patients with CR was 75%. However, the median OAS for 3 patients with immunoblastic lymphoma was only 7 months. CONCLUSIONS: The COPP regimen, with its acceptable toxicity, appears to be a good alternative as a first-line treatment for patients with Stage B or C IPSID with low grade lymphoma whereas tetracycline appears to be the initial treatment of choice for patients with Stage A disease.

Adolescent↗
PubMed1990

[The use of parietal pH-metry in the diagnosis of intestinal diseases].

Parietal measurements of pH values in patients with various intestinal diseases and in normal subjects have revealed that alkaline medium with gradual elevation of the values in the caudal direction is characteristics of the normal large intestine; acid pH values were registered in patients with lactase insufficiency, nonspecific ulcerative colitis, in contrast to those with post-dysentery colitis and tumors of the large intestine. Lactulose and sodium sulfate were found the factors that significantly influence the large intestine parietal pH values, the effects of wheat bran were lower; magnesium sulfate and sodium hydrocarbonate mineral water with medium mineral content had no effect on parietal pH values.

Colitis, Ulcerative↗
PubMed1987

Immunoglobulin gene rearrangement in immunoproliferative small intestinal disease (IPSID).

Analysis of DNA from the mucosal tissue of three patients with immunoproliferative small intestinal disease (IPSID) and alpha chain disease, two of whom had early stage disease responsive to antibiotics, showed monoclonal heavy and light chain gene rearrangements in all cases. These findings suggest that IPSID is neoplastic even in its early stages, but that the neoplastic cells respond to normal stimuli. Monoclonal lymphoid populations could not be detected in circulating lymphocytes from these patients, which raises the possibility that the circulatory pathways of lymphocytes derived from human gut associated lymphoid tissue may not necessarily parallel those in experimental animals.

Adolescent↗
PubMed1989

[Changes of the liver and bile ducts in patients with acute intestinal diseases].

Patients with acute intestinal infections, in particular, salmonellosis showed in 1/3 during the acute period an insignificant increase of bilirubin and alaninaminotransferase. During early reconvalescence the majority of patients revealed functional changes of the biliary tract, mainly, in the form of hypotensive-hypokinetic type of dyskinesia.

Acute Disease↗
PubMed2000

Amelioration of intestinal disease severity in cystic fibrosis mice is associated with improved chloride secretory capacity.

The variability in intestinal disease severity in patients with cystic fibrosis (CF) has been associated with the expression of secondary modifier genes. The locus containing these modifier genes in CF patients is syntenic with a modifier locus previously associated with survival in CF transmembrane conductance regulator-knockout mice. These previous studies showed that the proportion of CF mice that survive weaning (mildly affected mice) versus those that succumb to obstruction of the small intestine (severely affected) is related to their genetic background and the expression of modifier genes. In the present work, we show that the basal transepithelial chloride transport measured across jejuna obtained from mice of mixed genetic backgrounds segregates into two groups, some mice having low and others having high, near normal chloride transport. Further, we report that the segregation of mice with respect to intestinal chloride transport correlates with their predicted segregation on the basis of genotype at the "modifier locus." These findings support the hypothesis that intestinal disease modification in CF mice correlates with improved chloride transport through non-CF transmembrane conductance regulator chloride channels.

Animals↗
PubMed1987

The enzymology of intestinal disease.

The role of enzyme estimations is reviewed. Serum levels of most enzymes do not alter significantly in intestinal diseases because dying mucosal cells slough off into the lumen. Similarly, biopsy material may provide misleading results because of lack of homogeneity between diseased and normal segments of bowel, whether in inflammatory or neoplastic conditions. Lactase deficiency is the most common intestinal enzyme deficiency. The once popular lactose tolerance test is lately giving way to the breath hydrogen test, which generally reflects unabsorbed carbohydrate reaching the colon. This test and its clinical usefulness are reviewed in some detail, and the use of lactulose as an indicator of intestinal transit is also discussed.

Breath Tests↗
PubMed1998

Immunoproliferative small intestinal disease in a 16-year-old boy presenting as severe malabsorption with excellent response to tetracycline treatment.

Immunoproliferative small intestinal disease (IPSID) is a rare lympho-proliferative disorder of the upper small intestine. It is considered a special form of MALT lymphoma with propensity to malignant transformation. This disorder is rare in pediatric literature. We report a case of IPSID in a 16-year-old boy with low-grade malignant transformation, presenting as severe malnutrition and a possible association with Helicobacter pylori. The patient responded well to an extended treatment with tetracycline and eradication of H. pylori.

Adolescent↗
PubMed1975

[Data on the biological characteristics of serological group O4 Escherichia isolated in acute intestinal diseases].

A study was made of 155 strains of E. coli of the O4 serological group isolated from sick children and adults during group and sporadic acute intestinal diseases), from persons who came in contact with them, and also from healthy persons during prophylactic examination; three standard cultures were examined as well. Along with strains with a typical enzymatic activity there were strains which produced retarded lactose fermentation and also gas-free, immobile and lysin-negative strains resembling Shigellae. Eight biochemical types were determined among E. coli 04. A study of the antigenic structure by cross agglutinin adsorption indicated identicity of the strains by O-antigen and their difference by the K- and H-antigens. Circulation of E. coli of serological types O4: K12(L): H1,O4: K3(L): H5,O4: K3(L): H12,04: K12(L): H40,04: K52(L): H4, and O4: K12(L) HII was revealed; the first two serological types prevailed. Serological types of O4: K3(L):H12, O4: K12(L): HI and O4: K12(L): H40, isolated in cases of group and sporadic acute intestinal diseases were described for the first time.

Acute Disease↗
PubMed2003

[Surgical management of abdominal aortic aneurysms with coexistent intestinal disease].

The management of patients suffering from abdominal aortic aneurysms with concomitant intestinal disease is demanding. Surgical procedures have to be evaluated meticulously with regard to morbidity and priority. We retrospectively investigated early and late results of nine patients (eight males, one female) with coincidental aortic and intestinal surgery during the last 9.5 years. The average age was 77 years (range 67-85). One-stage procedures were undertaken twice with implantation of aortic grafts to replace abdominal aortic aneurysms (AAA). During these emergency procedures, an aortoduodenal fistula was repaired in one case and resection of an ischemic segment of the sigmoid colon was resected in another. Seven two-stage procedures were performed as elective surgery. Five AAA were excluded before the intestinal repair. In two cases of urgent visceral pathologies, colon resection was done first, followed by elimination of the AAA. In case of elective surgery, two-stage procedures seem to be safe and effective. However, in certain emergent cases, one-stage procedures with implantation of vascular grafts in combination with colon or bowel surgery might also be justified.

Adenoma, Villous↗
PubMed1993

[Crohn disease: morphologic findings of extra-intestinal disease manifestations].

Extraintestinal manifestations occur frequently in patients with Crohn's disease. The spectrum of extraintestinal symptoms reported associated with Crohn's disease involves many organ systems. Commonly recognized extraintestinal manifestations include dermatologic, oral, ocular, skeletal, vascular, hepatobiliary, pancreatic, and pulmonary. Morphological findings on extraintestinal manifestations (erythema nodosum, pyoderma gangrenosum, erythrodermia--granulomatous periostitis and synovitis--granulomatous sialadenitis, aphthous stomatitis--fibrous alveolitis) in Crohn's disease are reported and discussed.

Biopsy↗
PubMed2001

General outbreaks of infectious intestinal disease linked with poultry, England and Wales, 1992-1999.

Between 1992 and 1999, 1426 foodborne general outbreaks of infectious intestinal disease (IID) were reported to the Public Health Laboratory Service Communicable Disease Surveillance Centre. A fifth were associated with the consumption of poultry. Chicken was implicated in almost three quarters of these outbreaks, turkey in over a fifth and duck in 2% of outbreaks. The organisms most frequently reported were Salmonella (30% of outbreaks), Clostridium perfringens (21%) and Campylobacter (6%). Over 7000 people were affected, with 258 hospital admissions and 17 deaths. During the summer, outbreaks were mainly of salmonellosis and attributed to the consumption of chicken. In December, C. perfringens and turkey were the organism and vehicle most often implicated. Most outbreaks occurred on commercial catering premises (56%) or in private houses (21%). The highlight of this surveillance period was the fall in outbreaks of salmonellosis linked with poultry products, probably due, at least in part, to the vaccination of poultry flocks.

Animals↗
PubMed1997

Outbreaks of infectious intestinal disease in residential institutions in England and Wales 1992-1994.

Data from the surveillance scheme of all general outbreaks of infectious intestinal disease in England and Wales reported to or otherwise identified, by the Public Health Laboratory Service Communicable Disease Surveillance Centre (CDSC) in 1992 and 1994 were used to describe the epidemiology of outbreaks of infectious intestinal disease in residential institutions. Outbreaks in residential institutions accounted for 22% (282/1275) of all outbreaks with most, 95% (268/282), occurring in homes for the elderly. The commonest pathogens in these 282 outbreaks were small round structured viruses 48% (132), salmonellas 17% (49). Clostridium perfringens 8% (23), rotavirus 5% (15) and Shigella sonnei 2% (6). The mode of transmission was described as mainly person to person in 71% (200 outbreaks) and mainly foodborne in 21% (58 outbreaks). The mean duration of outbreaks was 9 days. Duration of outbreaks varied with both the mode of transmission and the pathogen involved. The mean attack rate was 37%. Illness was reported in 5872 people. One or more individuals were admitted to hospital in 22% of outbreaks. Twenty-six deaths were reported, of which 18 were attributed to salmonellosis. Outbreaks in residential institutions are common. Attack rates are high and outbreaks are often prolonged, with high morbidity and mortality. There is a need for effective infection control policies which include appropriate training of staff, simple surveillance systems and readily available expert advice to ensure outbreaks are rapidly controlled.

Aged↗