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PubMedDate not supplied

[Protein changes in the jejunal juice and endointestinal exudation of albumin-I 131 in acute infectious enterocolitis].

The phenomenon of endointestinal protein exudation in acute infectious enterocolitis is studied. Total proteins were determined in 30 cases of acute enterocolitis and 50 of bacillary dysentery in the acute stages of the disease and convalescence. The proteinogram of the jejunal juice was performed in the acute stage and convalescence in 20 patients. In 16 patients and 5 controls endointestinal albumin elimination was determined quantitatively by means of 131I labeled albumin. The results showed increase in the total protein content in the jejunal juice in the course of acute infectious enterocolitis and bacillary dysentery and a return to normal values in convalescence. Electrophoresis of the jejunal juice in acute infectious enterocolitis showed the absence of fraction III with alpha1-globulin migration, and increased fractions I, II and IV probably due to the loss of endointestinal albumin, also confirmed by quantitative albumin determinations with 131I labeled albumin. In conclusion, patients with acute infectious enterocolitis present a marked loss of endointestinal albumins in the acute stage of the disease, with a return to normal values in convalescence.

Albumins↗
PubMed1978

Bowel stenosis as a late complication of acute necrotizing enterocolitis.

Bowel stricture as a late complication of acute necrotizing enterocolitis in 10 neonates is discussed with respect to time interval to development, number of strictures, location, sexual and racial distribution and possible contributing factors. This is compared with previous reports in the literature. Differences in the distribution of acute and late sites of involvement are discussed.

Colonic Diseases↗
PubMed1982

[Clinical evaluation of ceftizoxime in the pediatric infections (author's transl)].

Ceftizoxime (FK 749, CZX) was evaluated in 24 children with a suspicion of bacterial infection. Of the 17 confirmed bacterial infections, 16 were shown to be effective (effective rate, 94.1%). The diagnosis included acute pharyngitis (2), pneumonia (6), staphylococcal empyema (1), cervical purulent lymphadenitis (2), acute enterocolitis (2), acute pyelonephritis (1), SSSS (1) and suspected septicemia (2). The etiological pathogens recovered were Streptococcus anginosus (1), Streptococcus pneumoniae (1), Staphylococcus aureus (2), Haemophilus influenzae (3), enteropathogenic Escherichia coli (1) etc. A case of suspected Pseudomonas aeruginosa septicemia was not effectively treated with CZX. The serum half-life of CZX was 1.36 hours after intravenous bolus infection. A cerebrospinal fluid level of CZX was 6.2 mcg/ml 1 hour after intravenous bolus injection of 1 g (23.8 mg/kg) in a child with inflamed meninges. No severe adverse reaction was encountered with the CZX therapy. The data suggest that CZX is an excellent candidate for the first choice parenteral antibiotic in the pediatric infections.

Age Factors↗
PubMed1982

[Clinical evaluation of cefsulodin in Pseudomonas infections in children].

Cefsulodin (CFS) was evaluated for its safety and efficacy in 14 children with Pseudomonas aeruginosa infections. The diagnoses included pneumonia (4), sepsis (1), presumed sepsis (4), acute postoperative ascending cholangitis (1), acute postoperative peritonitis with wandering pneumonia (1), acute enterocolitis with acute UTI (1), recurrent UTI (1), and acute cystitis (1). CFS was administered intravenously with a daily dose of 93 to 299 mg/kg in the cases with normal renal functions. CFS was effective in all but one case both clinically and bacteriologically. A case of pneumonia whose isolate was resistant to CFS responded poorly. Mild transient eosinophilia was observed in 3 cases, but no severe adverse reactions were encountered. Peak MIC values of 18 clinical isolates of P. aeruginosa were 1.56 mcg/ml, 0.39 to 0.78 mcg/ml and 12.5 mcg/ml for CFS, gentamicin, and sulbenicillin, respectively. A half life of the serum CFS levels was 1.09 hours after intravenous bolus injection of 20 to 25 mg/kg of CFS (n = 2). A cerebrospinal-fluid level and biliary levels measured in cases with inflamed meninges or with cholangitis were well above the MIC value. From the present study, CFS appeared to be a safe and effective antibiotic when used in children with susceptible Pseudomonas infections. Combined use of another antibiotic should be considered in the case with polymicrobial infections because of the CFS's very narrow spectrum.

Adolescent↗
PubMed2005

Necrotizing enterocolitis in acute lymphoblastic leukemia patients: department experience.

Necrotizing enterocolitis is a severe complication of high-dose chemotherapy in patients with hematopoietic malignancies. Some patients with severe mucositis may develop necrosis of the intestine, leading to typhlitis and perforation of the intestinal tract. The patients have few obvious symptoms; thus, early diagnosis and prompt treatment of intestinal necrosis or bowel perforation seem critical for a good overall treatment outcome. We present 5 cases of intraabdominal complications in patients with acute lymphoblastic leukemia. All patients who underwent surgery survived the postoperative period. We also present a suggested algorithm for treatment of acute abdomen complications in leukemic patients.

Adult↗
PubMed1980

Indications for operation in acute necrotizing enterocolitis of the neonate.

A study to evaluate criteria for operation was carried out in 61 infants with acute necrotizing enterocolitis (NEC). A total of 10 clinical, roentgenographic, and laboratory criteria were considered. Each proposed operative criterion was correlated with the documented presence or absence of intestinal gangrene in these infants. Indications for operation verified by this study were (1) pneumoperitoneum, (2) paracentesis findings positive for gangrenous intestine, (3) erythema of the abdominal wall, (4) a fixed abdominal mass, and (5) a persistently dilated loop of intestine on serial abdominal radiographs. The first two signs occurred frequently; the latter three were rare. Operative indications which proved to be invalid in this study were (1) clinical deterioration, (2) persistent abdominal tenderness, (3) profuse lower gastrointestinal hemorrhage, (4) the roentgenographic finding of gasless abdomen with ascites, and (5) severe thrombocytopenia. Twenty-four of the infants were operated on. The mortality rate among the infants operated on after free intestinal perforation had occurred (64%) was double that of infants operated on for intestinal gangrene without perforation (30%). Paracentesis may identify infants with intestinal gangrene prior to the development of perforation and may permit advantagenous timing of operation. This analysis of the frequency and reliability of proposed operative criteria may aid the surgical decision.

Ascites↗
PubMed1983

[Clinical evaluation of T-1982 (cefbuperazone) in the pediatric infections].

T-1982 (cefbuperazone) was evaluated in 25 children with a suspicion of bacterial infections, of the 21 confirmed bacterial infections, 18 were shown to be effective (efficacy rate, 85.7%). The diagnosis included pneumonia (4), bronchopneumonia (3), acute bronchitis (4), acute pharyngitis (1), acute laryngitis (1), acute epiglottitis (1), acute enterocolitis (3), cervical lymphadenitis (1), acute pyelonephritis (1) and suspected septicemia (2). The etiologic pathogens recovered were Haemophilus influenzae (4), Staphylococcus aureus (2), Salmonella typhimurium (1), Salmonella subgenus (1), and enteropathogenic Escherichia coli (2). Among these strains, 7 strains were eradicated after treatment. A case of suspected septicemia and 2 cases of acute enterocolitis with Salmonella infection were not effectively treated with T-1982. The serum half-life of T-1982 was 1.2 hours after an intravenous bolus injection. No severe adverse reaction was encountered with the T-1982 therapy. The data suggest that T-1982 is an effective and safe parenteral antibiotic in the treatment of susceptible pediatric bacterial infections.

Anti-Bacterial Agents↗
PubMed2001

Intestinal cytokine gene expression in infants with acute necrotizing enterocolitis: interleukin-11 mRNA expression inversely correlates with extent of disease.

BACKGROUND/PURPOSE: The authors have shown previously that surgical specimens from infants with acute necrotizing enterocolitis (NEC) show upregulation of inducible nitric oxide (NO) synthase (iNOS) and interferon-gamma mRNA. However, the contribution of other inflammatory cytokines such as interleukin-8 (IL-8), IL-11, and IL-12 has not been defined. Likewise, the role of GTP-cyclohydrolase, the rate-limiting enzyme in tetrahydrobiopterin synthesis, and thus NO production by iNOS is unclear. In this study, the authors sought to further define the pattern of cytokine expression seen in infants with acute NEC. METHODS: The authors measured intestinal cytokine mRNA expression by semiquantitative reverse transcriptase polymerase chain reaction in 21 infants with histologically confirmed NEC, 18 with other inflammatory conditions, and in 9 patients without intestinal inflammation. Guanosine triphosphate-cyclohydrolase (GTP-CH) activity was measured by specific enzyme assay. Univariate exact logistic regression analysis was performed to identify predictors of outcome. RESULTS: IL-8 and IL-11 mRNA were upregulated in patients with acute NEC compared with those with other inflammatory conditions or those without disease; these levels returned to baseline at the time of stoma closure. Increased IL-11 mRNA decreased the likelihood of pan-necrosis (odds ratio, 0.93; P =.002). Increased IL-12 levels (but not IL-8) seemed to protect against pan-necrosis (odds ratio, 0.70; P =.06). CONCLUSIONS: Local upregulation of IL-11 may represent an adaptive response designed to limit the extent of intestinal damage in NEC. Decreased IL-12 levels may contribute to the pathogenesis of NEC by allowing bacteria to escape host defenses.

Acute Disease↗
PubMed1978

Necrotizing enterocolitis in acute leukemia: radiographic findings.

Acute gangrenous appendicitis or right lower quadrant necrotizing enterocolitis occurs with a high incidence in patients undergoing treatment for acute leukemia. In a series of 81 fully documented cases with complete charts and follow-up we identified seven surgically or pathologically proved cases of this syndrome. Plain radiographs of the abdomen were available in five of the seven cases, and a barium enema was performed on one. In three of the five cases the radiographic examination suggested or confirmed the nature of the right lower quadrant syndrome. Two of the seven patients were sucessfully treated by appropriate surgery. The radiographic findings in this series are reviewed and re-emphasized since an accurate diagnosis becomes important in appropriate management of this formerly uniformly fatal complication of acute leukemia and/or its therapy.

Acute Disease↗
PubMedDate not supplied

Acute hemorrhagic enterocolitis in ratites: isolation of eastern equine encephalomyelitis virus and reproduction of the disease in ostriches and turkey poults.

Two emus died with acute hemorrhagic enterocolitis. Eastern equine encephalomyelitis (EEE) virus was isolated in Vero cells from non-pooled samples of brain and intestine. Enterocolitis with splenic and hepatic necrosis was reproduced by intramuscular or oral inoculation of this isolate in two ostriches and three turkey poults.

Animals↗
PubMed1988

Methyldopa hypersensitivity can mimic acute toxic enterocolitis.

The most widely known hypersensitivity reaction of methyldopa, a drug commonly used in the treatment of hypertension, is seroconversion to a positive result of a direct Coombs' test that may lead to a hemolytic anemia. The authors report a case of an infrequently noted, but serious, hypersensitivity reaction to methyldopa, manifesting primarily as acute toxic enterocolitis. A 63-year-old woman was admitted to hospital and underwent aggressive and prolonged investigation of enterocolitis. Withdrawal of methyldopa gave immediate relief of intestinal problems. Rechallenge precipitated a return of symptoms within 14 hours. It is recommended that periodic blood counts and liver function tests be done on patients treated with methyldopa for hypertension. If any abnormalities are noted the drug should be discontinued.

Acute Disease↗
PubMedDate not supplied

[The blood circulation of the rectal mucosa and the functional status of the rectal sphincter in acute infectious enterocolitis].

Significant decrease in the tone of the rectal mucosa venules was to be seen at the climax of acute Proteus and Klebsiella enterocolitis, as evidenced by examinations with the aid of rheorectograph and an analyzer of intracavitary motor activity, general blood supply to the intestinal segment under study being not compromised. The tone of the rectal mucous membrane arterioles is raised at the climax of acute dysentery caused by a Flexner type of organism in erosive and haemorrhagic proctosigmoiditis. With the clinical recovery being set in, the blood supply to this area fails to return to normal. The excitability of the inner anal sphincter was noted to be on the increase at the climax of acute S. flexneri dysentery, this showing up predominantly in erosive and haemorrhagic proctosigmoiditis, ceasing to reveal itself in the period of reconvalescentia.

Acute Disease↗
PubMed1989

Peritoneal drainage and ileostomy as a treatment for the acute necrotising enterocolitis.

Between 1982 and 1987, in the "Centre néonatal" of Rocourt (Belgium), 18 cases of necrotising enterocolitis have been operated upon during the acute stage of the disease. The authors explain the advantages and the disadvantages of the classical surgical procedures: laparotomy with exploration of the colon and resection of the necrotic segments followed by immediate reanastomosis or by enterostomy above the resected area. They recommend, however, a minimal laparotomy in the right lower quadrant with ileostomy on the terminal ileum without exploration of the colon or resection of the necrotic segments. The advantages of this technique are: minimal impairment of the general condition which increases the chances of survival; possibility to perform the resection later on when general and local conditions have improved; possibility for the lesions to heal spontaneously with short stenotic segments. Only 1 death among the 18 patients during the acute stage and none during the secondary procedures. In most of the cases, an economical resection could be performed with preservation of as much as possible of the normal bowel.

Drainage↗