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PubMed1989

T-lymphocyte subsets in gut and blood of liver transplant recipients with and without cytomegalovirus gastroenteritis.

The effects of orthotopic liver transplantation (OLTx) and cytomegalovirus (CMV) gastroenteritis on the type of mononuclear cells within the upper gastrointestinal tract were determined. Nineteen liver transplant recipients were studied both before and after transplantation. Each underwent a pan-upper gastrointestinal endoscopy with biopsy of the antrum and duodenum before and four weeks following liver transplantation. A panel of monoclonal antibodies prepared against HLA-DR, NK, IL-2R, T11, T4, T8, and B1 cell surface antigens was used to examine the tissues. Before OLTx, none of the 19 subjects studied had clinical or histologic evidence for CMV gastroenteritis. Following OLTx, five of the 19 subjects had CMV gastroenteritis. The number of HLA-DR positive staining lymphocytes present in biopsies obtained post-OLTx was significantly greater (P less than 0.005) than those present in biopsies obtained pre-OLTx regardless of the presence or absence of CMV gastroenteritis. No difference in the intensity of HLA-DR antigen expression between pre- and post-OLTx biopsies and those with and without CMV gastroenteritis was evident. No difference in the number of natural killer (NK) cells and the number of cells expressing the interleukin-2 receptor (IL-2R) was evident between biopsies obtained pre- and post-OLTx. In contrast, the number of T lymphocytes bearing the T11, T4, and T8 markers and the calculated T4/T8 ratio differed between biopsies obtained pre- and post-OLTx and between those positive for CMV gastroenteritis post-OLTx and those without evidence for CMV gastroenteritis either before or after OLTx, although these changes were not consistent throughout the gastrointestinal tract.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2004

Recurrent gastroenteritis among infants in Western Australia: a seven-year hospital-based cohort study.

PURPOSE: To investigate factors that affect the frequency of recurrent gastroenteritis among infants in Western Australia (WA). METHODS: A 7-year retrospective cohort study was undertaken on all infants born in 1995 who were admitted for gastroenteritis during their first year of life (n=514). Linked hospitalization records of the cohort were retrieved to derive the number of readmissions, microbiologic diagnoses, patient demographics, and co-morbidities at the index episode. A negative binomial regression model adjusting for inter-hospital variations was used to determine the prognostic factors influencing recurrent gastroenteritis. RESULTS: Diarrhea with no specific etiology accounted for 54.7% of the cases presented at index admission and 55.8% of the total 676 admissions for the cohort. Of the 514 infants, 119 (23%) experienced repeated episodes of gastroenteritis. The lowest proportion of recurrences was 15.4% for patients initially admitted for bacterial or viral diarrhea. Over 85% of the recurrences from either bacterial and viral diarrhea or etiology unspecified were readmitted under the same category. Aboriginality and dehydration were significantly associated with the recurrence frequency, the adjusted incidence rate ratio being 2.86 (95% CI, 1.92-4.26) and 0.66 (95% CI, 0.49-0.88), respectively. Aboriginal infants contributed to 58% of those patients in the cohort who sustained repeated episodes of gastroenteritis. The proportion of patients with the recurrent disease was also significantly higher for Aboriginals (39%) than for non-Aboriginals (15%). The effect of dehydration was evident after accounting for within hospital correlations. CONCLUSIONS: Hospitalizations for recurrent gastroenteritis were more frequent among Aboriginal children than non-Aboriginal children in WA. Readmissions were also related to the presence of dehydration at the index episode. These findings have implications for preventive strategies to reduce the burden of gastroenteritis.

Cohort Studies↗

PubMed1999

Rotaviruses detected by reverse transcription polymerase chain reaction in acute gastroenteritis during a trial of rhesus-human reassortant rotavirus tetravalent vaccine: implications for vaccine efficacy analysis.

BACKGROUND: Rotaviruses are routinely diagnosed by detection of rotavirus antigen in stools using an enzyme immunoassay (EIA). A sensitive method, like reverse transcription polymerase chain reaction (RT-PCR), may reveal more rotaviruses, but the clinical significance of such findings is not well established. OBJECTIVES: To study whether RT-PCR can detect more episodes of rotavirus-associated gastroenteritis than EIA and to determine how rotavirus RT-PCR findings might change efficacy analysis of a rotavirus vaccine trial, in which the outcome measure was rotavirus gastroenteritis diagnosis with EIA. STUDY DESIGN: We applied RT-PCR for detection of rotaviruses in gastroenteritis episodes encountered in an efficacy trial of rhesus-human reassortant rotavirus tetravalent (RRV-TV) vaccine, in a total of 2398 infants. During a follow-up, covering two rotavirus epidemic seasons, 256 cases of rotavirus associated gastroenteritis were detected by EIA; 226 were in the primary efficacy analysis period that included children who had received three doses of vaccine or placebo. RESULTS: With RT-PCR, 84 (33%) more cases of rotavirus gastroenteritis were diagnosed than with EIA, 65 of these were in the primary efficacy analysis period. Clinically, cases of rotavirus gastroenteritis diagnosed by RT-PCR were much milder (median severity score 6 on a 20-point scale) than those diagnosed by EIA (median score 11), P < 0.0001. RT-PCR revealed proportionally more G2 and G4 rotaviruses than EIA. G1 rotaviruses detected by RT-PCR were almost equally divided between RRV-TV (25) vaccine and placebo (28) groups, whereas an apparent vaccine protective effect was seen in the distribution of G2 (one in the RRV-TV and eight in the placebo group) and G4 rotaviruses (six in the RRV-TV and 14 in the placebo group). CONCLUSION: RT-PCR is a useful tool in the diagnosis of rotavirus gastroenteritis, particularly for cases associated with other than the epidemiologically dominant G-type. Application of RT-PCR contributes to the overall appraisal of performance of rotavirus vaccine.

Acute Disease↗

PubMed2004

[Nosocomial gastroenteritis and asymptomatic rotavirus and astrovirus infection in hospitalized children].

BACKGROUND: Nosocomial gastroenteritis is frequent in pediatric hospital wards. Between 20% and 50% of gastroenteritis cases caused by rotavirus and astrovirus are of nosocomial origin. OBJECTIVE: To determine the incidence of nosocomial rotavirus and astrovirus gastroenteritis in our environment, the incidence of asymptomatic infection with these viruses, and to identify the G serotypes of the rotaviruses detected. METHODS: We performed a prospective study of all children under 2 years of age admitted to a neonatology unit over a 1-year period who were followed-up for the presence of diarrhea and periodic study of feces to detect the presence of rotavirus and astrovirus antigens by enzyme immunoassay (EIA). Patients with gastroenteritis also underwent bacteria stool culture, adenovirus detection by EIA, calcivirus detection by polymerase chain reaction, and analysis of rotavirus G serotypes by EIA with monoclonal antibodies. RESULTS: Of 666 children admitted without diarrhea, 60 presented nosocomial gastroenteritis (9 % of patients admitted and 1.75 per 100 days of hospital stay): 34 presented rotavirus (5 % of patients) and two presented astrovirus (0.3 % of patients). Of the 329 patients without diarrhea who were studied, viral elimination was detected in 27: rotavirus in 23 patients and astrovirus in four. Viral infection was detected on admission in 13 patients (4 %) and after 72 hours in 14 patients (4.2 %) (asymptomatic nosocomial infection). No differences in the distribution of rotavirus G serotypes were observed between community-acquired and nosocomial gastroenteritis. CONCLUSIONS: These data confirm the importance of viral etiology in nosocomial gastroenteritis and allow us to evaluate asymptomatic fecal elimination of rotavirus as one of the factors in the transmission of this infection.

Algorithms↗

PubMed2004

Costs of gastroenteritis in The Netherlands.

In order to target the most important cost components of gastroenteritis in The Netherlands and to indicate which change of policy yields the largest decrease in costs, the cost of illness of gastroenteritis and the number of Disability Adjusted Life Years (DALYs) in the Dutch population in 1999 were determined. The costs of gastroenteritis were estimated using data mainly from a community-based cohort study. For calculating DALYs, data on the number of deaths due to gastroenteritis were used from Statistics Netherlands. On average, the costs for gastroenteritis were 77 Euro (euros) per case. For all patients in The Netherlands, the costs were estimated at 345 million euros (ranging between 252 and 531 million euros). Indirect costs made up 82% of this total. An estimate of costs for patients with campylobacter, salmonella or norovirus infections was, in total, 10-17% of the costs of gastroenteritis. Gastroenteritis was associated with a loss of approximately 67,000 DALYs.

Adolescent↗

PubMed2003

Caesarean section increases the risk of hospital care in childhood for asthma and gastroenteritis.

OBJECTIVE: To investigate if caesarean section (CS) increases the risk for childhood asthma and gastroenteritis with reference made to children born with vaginal delivery (VD). METHODS: Retrospective study of data from linked Swedish medical service registers--Medical Birth Registry (MBR) and Hospital Discharge Registry (HDR). Data were obtained from women without any background/perinatal morbidity noted, and from children without any neonatal complications. Children that had reached at least 1 year of age and were found in the HDR were considered as cases, whereas children not found in the HDR or hospitalized for other causes than asthma or gastroenteritis were defined as controls. Odds ratios (OR) stratified for year of birth, maternal age, parity and smoking in early pregnancy were calculated. Investigations were made comparing the risk for in hospital treatment for asthma or gastroenteritis in CS children and in VD siblings of CS children. The overall inpatient morbidity in CS and VD children were also investigated. RESULTS: The OR for asthma in CS children was 1.31 [95% confidence interval (CI) 1.23-1.40]. The same OR, 1.31, was found for gastroenteritis (95% CI 1.24-1.38). The OR for CS children having experienced both asthma and gastroenteritis was further increased (1.74, 95% CI 1.36-2.23). The risk for asthma in VD siblings of CS children was not significantly increased, whereas VD siblings experienced a slightly increased risk for gastroenteritis. CS children had an increased overall in hospital morbidity when compared to VD children. CONCLUSION: There is a significant increase of the risk for developing symptoms of asthma and/or gastroenteritis that motivates admission for hospital care in CS children older than 1 year. It is speculated that a disturbed intestinal colonization pattern in CS children may be a common pathogenic factor.

Adult↗

PubMed2006

Acute gastroenteritis is followed by an increased risk of inflammatory bowel disease.

BACKGROUND & AIMS: Bacterial intestinal infections have been implicated as a possible cause of exacerbation of inflammatory bowel disease (IBD). We explored the relationship between infectious gastroenteritis and the occurrence of IBD using data from the General Practice Research Database. METHODS: A cohort of patients aged 20-74 years with an episode of acute infectious gastroenteritis (n = 43,013) was identified. From the same source population, an age-, sex-, and calendar time-matched control group free of gastroenteritis was sampled (n = 50,000). Both cohorts were followed up for a mean duration of 3.5 years. RESULTS: The estimated incidence rate of IBD was 68.4 per 100,000 person-years after an episode of gastroenteritis and 29.7 per 100,000 person-years in the control cohort. The hazard ratio of IBD was 2.4 (95% confidence interval [CI], 1.7-3.3) in the gastroenteritis cohort compared with the control cohort, and the excess risk was greater during the first year after the infective episode (hazard ratio, 4.1; 95% CI, 2.2-7.4). The relative risk of developing Crohn's disease in the gastroenteritis cohort was greater than that of ulcerative colitis, especially during the first year after the infective episode (hazard ratio, 6.6; 95% CI, 1.9-22.4). CONCLUSIONS: Our results are compatible with the hypothesis that infectious agents causing an episode of infectious gastroenteritis could play a role in the initiation and/or exacerbation of IBD.

Acute Disease↗

PubMed2006

Consumption of untreated tank rainwater and gastroenteritis among young children in South Australia.

BACKGROUND: Tank rainwater is a source of untreated drinking water in Australia and elsewhere. The aim of this study was to determine whether the risk of gastroenteritis among children who drank tank rainwater differed from that of children who drank treated public mains water. METHODS: A cohort study of 1,016 4- to 6-year old children who drank rainwater or treated mains water in rural South Australia was undertaken in 1999. Parents kept a daily diary of their child's gastrointestinal symptoms and water consumption for a period of 6 weeks. Data on respiratory illness and other risk factors for gastroenteritis were also collected. RESULTS: The incidence of gastroenteritis among children was 3.8-5.3 episodes per child-year, but most episodes (60%) lasted just 1 day. No increase in odds of gastroenteritis was observed among children who drank rainwater compared with treated mains water. The adjusted odds ratio for gastroenteritis associated with rainwater consumption compared with mains consumption was 0.84 (95% confidence interval 0.63-1.13). CONCLUSIONS: Gastroenteritis was found to be a significant cause of morbidity among young children. Young children, who were regular consumers of tank rainwater, were at no greater odds of gastroenteritis than those who drank treated public mains water.

Child↗

PubMed1992

Hospitalizations involving gastroenteritis in the United States, 1985: the special burden of the disease among the elderly.

While diarrheal disease is a well-recognized problem in children, its impact in the elderly has not been adequately assessed. Among the 4.06 million hospitalizations in 1985 in the McDonnell-Douglas Health Information System database, 98,185 hospitalizations, including 1,130 deaths, had gastroenteritis recorded as a discharge diagnosis. The authors analyzed the 87,181 hospitalizations and 514 deaths for which gastroenteritis was one of the top three diagnoses. Gastroenteritis was among the top three diagnoses in 9% of all hospitalizations of children 1-4 years of age, compared with 1.5% of hospitalizations throughout adulthood (greater than or equal to 20 years). Only 0.05% of hospitalizations involving gastroenteritis were fatal for children younger than 5 years, compared with 3% in individuals 80 years or older. While children aged less than 5 years and adults aged 60 years or more each comprised one-fourth of hospitalizations involving gastroenteritis, the older group represented 85% of diarrheal deaths. Age was the most important risk factor for death subsequent to a hospitalization involving gastroenteritis (odds ratio = 52.6, 95% confidence interval 37.0-76.9 for age greater than or equal to 70 years vs. less than 5 years). Gastroenteritis is a large, underemphasized public health problem among the elderly, among whom its case-fatality ratio is higher than in children.

Adolescent↗

PubMedDate not supplied

A clinical pathway for pediatric gastroenteritis.

Gastroenteritis is one of the most common reasons for hospitalization in the United States for children under the age of 5 years. Second only to respiratory problems, the cost of providing care for these children is estimated to exceed $2 billion dollars annually ( Burkhart, 1999; Prescilla, 2002). This article reviews the causes of gastroenteritis as well as the 1996 American Academy of Pediatrics Guidelines for treatment of gastroenteritis. These guidelines and more recently published literature were used to develop a clinical pathway to improve the care of pediatric patients admitted to the hospital with gastroenteritis. The article discusses the importance of clinical pathways and the process of implementation of a pathway for pediatric gastroenteritis. Additionally, the article provides a parent teaching tool to address recurrent questions parents have related to home management of a child with gastroenteritis. Useful web sites for resource information related to gastroenteritis are provided as well.

Child, Preschool↗

PubMed2001

International variation in disease burden of rotavirus gastroenteritis in children with community- and nosocomially acquired infection.

BACKGROUND: The great impact of rotavirus disease on morbidity and medical health care costs in industrialized countries together with the withdrawal of the live oral rotavirus vaccine have made a reassessment of rotavirus gastroenteritis necessary. Such a reassessment should provide sufficient data for developing alternative disease prevention strategies and for allocating resources efficiently. OBJECTIVES: To compare characteristics and management of community- and nosocomially acquired rotavirus disease in Austria, Germany and Switzerland. PATIENTS AND METHODS: In a prospective, population-based, trinational (Austria, Germany, Switzerland), multicenter (9 cities, 10 hospitals and 30 pediatric practices) study, a total of 174 552 children months and 78 516 hospital days were evaluated. Participants were all children 4 years of age and younger, who either presented at one of the pediatric practices with community-acquired gastroenteritis, or who had acquired gastroenteritis nosocomially. From December, 1997, to May, 1998, prospective antigen testing was done by enzyme-linked immunosorbent assay, and serotyping was done by reverse transcription polymerase chain reaction. Disease severity was scored by the Vesikari severity scale. RESULTS: Rotavirus was detected in 29.5, 27 and 37.5% of children with community-acquired gastroenteritis and in 57, 69 and 49% of children with nosocomial gastroenteritis in Austria, Germany and Switzerland, respectively. Severity of community-acquired rotavirus gastroenteritis was more pronounced in Austria (median severity score, 11) than in Germany (median score, 9) or Switzerland (median score, 10). However, only 2% of Austrian and Swiss children compared with 12% of German children presented to their pediatricians more than four times. Nosocomially acquired rotavirus gastroenteritis was mildest in Austria but occurred within the shortest median duration of hospitalization (4 days vs. 5 and 7 in Germany and Switzerland, respectively). In a multivariant analysis age, family size, day care, breast-feeding and nationality were not predictive factors for enhanced risk to contract rotavirus infection. Alimentation was changed frequently; diet was used between 23 and 83%; special formulas were used between 10 and 57%. CONCLUSION: The cumulative experience from three European countries suggest that rotavirus is an important cause of diarrhea in Central Europe, but significant local differences clearly demonstrate the need for obtaining national data as a reliable basis for control and prevention of the disease.

Child, Preschool↗

PubMed2006

Incidence, impact on the family and cost of gastroenteritis among 4 to 6-year-old children in South Australia.

BACKGROUND: Gastroenteritis is an important cause of morbidity in both adults and children worldwide. Although the burden of morbidity and mortality is highest in developing countries, gastroenteritis is still a significant cause of morbidity in Australia, particularly in young children. The aims of the present study were to determine the incidence of gastroenteritis among 4-6-year-old children in South Australia, to describe the impact on daily activities of the child and caregiver and estimate the cost of gastroenteritis in this population. METHODS: A diary study of drinking water consumption and gastrointestinal and respiratory symptoms was undertaken among 965 rural children in South Australia over a 6-week period during February-May 1999. Data on the response to gastrointestinal episodes were collected by telephone surveys midway and at the end of the 6-week period. Costing was based on the methods of Hellard et al. RESULTS: The incidence of community gastroenteritis among 4-6-year-old children was 5.53 episodes per child-year (95% confidence interval: 4.87-5.80). The costs associated with childhood gastroenteritis were estimated to be between 16,858,360 AU dollars and 22,477,814 AU dollars per annum. CONCLUSIONS: The incidence of community gastroenteritis among the 4-6-year-olds in the South Australian population is high and it costs the community a significant amount of money in terms of direct medical costs and time lost by parents and carers looking after their ill children.

Child↗

PubMed1985

Clinical features in hospitalised children with acute gastroenteritis. Does the rotavirus syndrome exist?

In a prospective study of children referred to hospital, rotavirus was identified in 37% of 128 patients with acute gastroenteritis. As compared with patients with non-rotavirus gastroenteritis, those with rotavirus gastroenteritis showed the following clinical characteristics: Age between 5 months and 4 years. Occurrence of the rotavirus infection almost exclusively during the winter season. Severe vomiting. Absence of gross blood in the stools. However, these signs did not form a safe basis for the clinical diagnosis of rotavirus gastroenteritis. One or more signs of upper respiratory illness were observed in 36% of the patients with rotavirus gastroenteritis and in 35% of those with non-rotavirus gastroenteritis. Consequently, the existence of a rotavirus syndrome is questioned. It is argued that upper respiratory illnesses in patients with rotavirus gastroenteritis could be due to a separate infection occurring coincidentally.

Acute Disease↗

PubMed2005

Risk of hypertension and reduced kidney function after acute gastroenteritis from bacteria-contaminated drinking water.

BACKGROUND: The long-term health consequences of acute bacterial gastroenteritis remain uncertain. We studied the risk of hypertension and reduced kidney function after an outbreak of acute gastroenteritis due to contamination of a regional drinking water supply with Escherichia coli O157:H7 and Campylobacter species. METHODS: A total of 1958 adults with no known history of hypertension or kidney disease before the outbreak participated in a long-term follow-up study. Of the participants, 675 had been asymptomatic during the outbreak, 909 had had moderate symptoms of acute self-limited gastroenteritis, and 374 had had severe symptoms that necessitated medical attention. The outcomes of interest were a diagnosis of hypertension or the presence of reduced kidney function and albuminuria during the follow-up period. RESULTS: After a mean follow-up of 3.7 years after the outbreak, hypertension was diagnosed in 27.0% of participants who had been asymptomatic during the outbreak and in 32.3% and 35.9% of those who had had moderate and severe symptoms of acute gastroenteritis respectively (trend p = 0.009). Compared with the asymptomatic participants, those with moderate and severe symptoms of gastroenteritis had an adjusted relative risk of hypertension of 1.15 (95% confidence interval [CI] 0.97-1.35) and 1.28 (95% CI 1.04-1.56) respectively. A similar graded association was seen for reduced kidney function, defined as the presence of an estimated glomerular filtration rate below 60 mL/min per 1.73 m2 (trend p = 0.03). No association was observed between gastroenteritis and the subsequent risk of albuminuria. INTERPRETATION: Acute bacterial gastroenteritis necessitating medical attention was associated with an increased risk of hypertension and reduced kidney function 4 years after infection. Maintaining safe drinking water remains essential to human health, as transient bacterial contaminations may have implications well beyond a period of acute self-limited illness.

Acute Disease↗

PubMed1997

[Gastroenteritis and acute respiratory infections among children up to 5 years old in an area of Southeastern Brazil, 1986-1987, II--Diarrhea].

INTRODUCTION: The decrease morbi-mortality gastroenteritis in is related to the factor responsible largely for the fall in infant mortality and mortality from communicable diseases in developing countries. Nevertheless, diarrhea is still a considerable public health problem in these countries, especially among children under 5 years old. OBJECTIVES: To describe some aspects of the of gastroenteritis epidemiology among children up to 5 years old, resident in areas of S. Paulo county. MATERIAL AND METHOD: A probabilistic sample of children up to 5 years old was studied (n = 468). The epidemiological survey was undertaken in five areas S. Paulo county (Brazil) from March 1986 to May 1987. Data were obtained through household interviews once a month over a year. RESULTS: During the follow-up 139 diarrhea episodes were registered, with a mean duration of 5.5 days. Twenty percent of the diarrhea events were followed by at least one other case in the household. The incidence of gastroenteritis was 2.78 episodes per 100 children/month. The highest incidence affected the children of up to 2 years of age. In 46.1% of the gastroenteritis episodes medical assistance was not sought, the children were treated by their mothers or not at all: 51.8% of the diarrhea events were attended to by the primary health care service, and only 2.1% were attended to by a hospital. No child died as a consequence of diarrhea. Of the therapeutical interventions used the most frequent were oral rehydration (25.2%) and oral rehydration with antibiotics (11.5%). Various socio-economic and personal background factors such as living conditions, water supply, sewarage, coverage; family income per capita and prior history of frequent gastroenteritis were associated with a higher incidence of gastroenteritis. DISCUSSION: The results seen to reflect the tendency of morbi-mortality by gastroenteritis to decrease in S. Paulo county during the 1980's when hospital treatment of diarrhea presented a considerable reduction. This tendency must be observed closely, because it will influence the changes to be mode in the kind of demand for medical care.

Acute Disease↗

PubMed2004

Estimation of annual incidence, age-specific incidence rate, and cumulative risk of rotavirus gastroenteritis among children in Japan.

Rotavirus gastroenteritis is a common childhood infection, but the exact morbidity of the disease is not well described in Japan. We aimed at estimating morbidity measures to determine the magnitude of rotavirus gastroenteritis. An estimate for acute infectious gastroenteritis of all causes, to which rotavirus gastroenteritis belongs, has been available since the enactment in 1999 of the Law concerning the Prevention of Infectious Diseases and Medical Care of Patients with Infectious Diseases. Using this estimate and another estimate for the detection proportion of rotavirus among outpatients with acute infectious gastroenteritis, we calculated the annual incidence, the age-specific annual incidence rate, and the cumulative risk by the age of 6 years for rotavirus gastroenteritis. The latter estimate was obtained by a meta-analysis of four independent studies previously performed in Japan. According to our estimates, approximately 800,000 children in Japan under the age of 6 years visit pediatric practices or the outpatient department of hospitals because of rotavirus gastroenteritis at a rate of 11 cases/100 persons/year, and one in two children will visit pediatricians before they go to primary school. Such pediatrician visits most frequently occur at the age of 1 year (27 cases/100 persons/year). Thus, the magnitude of the burden of rotavirus disease among Japanese children is substantial.

Age Distribution↗

PubMed2000

Immunohistochemical study on gastroenteric nervous system in trisomy 16 mice:an animal model of Down syndrome.

AIM:To study the development of gastroenteric nervous system in trisomy 16 mouse embryos.The gastroenteric nervous system in trisomy 16 mice and their normal littermates, serving as controls from embryonic days 13 to 18 (ED13-18) was identified by using primary antibody against protein gene product (PGP) 9.5.METHODS:Trisomy 16 mouse breeding and trisomy 16 mouse embryos were identified from their normal littermates by chromosome examination; PGP 9.5 immunohistochemical stainning.RESULTS:In normal littermates embryos, the precursor cells from the neural crest migrated into stomach and intestine at ED 13 and ED 14 respectively.Numerous nervous processes connected to each other and formed early nervous networks at ED 14 stomach and ED 15 intestine. Original ganglia in the muscular nervous plexus of the stomach appeared at ED15 with very simple arrangement. At ED 16 the early developed myenteric nervous plexuses were regularly found in the stomach and intestine respectively. In both stomach and intestine, the development of submucosal nervous plexuses were finished at ED17. However, the myenteric nervous plexus and the internal and external submucosal nervous plexuses were differentiated only in the stomach at ED 18.In comparison with the normal littermates, stomach and intestine nervous system developed much slower in trisomy 16 mice. Their immature neurons did not appear in the stomach and intestine until ED 14 and ED 15. Between ED 14 and ED 16, the gastroenteric nervous system was composed of only some scattered neurons with different distribution density and size. The development and differentiation of the gastroenteric nervous system were delayed and the myenteric nervous plexus did not appear until ED 18. There was no submucosal nervous plexus in all stomach and intestine specimens. A semiquantitative analysis and rank sum test of the data showed that the trisomy 16 mouse embryos were markedly retarded in the gastroenteric nervous development compared with their normal littermates.CONCLUSION:Trisomy 16 mice, as an animal model for Down syndrome, has abnormality not only in several systems and organs but also in gastroenteric innervation. This report describes for the first time that the development of the gastroenteric nervous system was not only delayed but also pathological.

Journal Article↗

PubMed2004

Surveillance of norovirus infection in a study of sporadic childhood gastroenteritis in South West England and South Wales, during one winter season (1999-2000).

Reverse transcriptase polymerase chain reaction (RT-PCR), electron microscopy (EM) and a genotype II specific antigen capture enzyme immunoassay (EIA), (Lordsdale strain) were used to establish the prevalence of Norwalk-like viruses (NLV) among sporadic cases of childhood gastroenteritis in South West England over a winter season. Samples of 3,172 stools from cases of gastroenteritis in children aged under 7 years sent to the Bristol Public Health Laboratory over the 1999/2000 winter 'season' were tested prospectively by EM, EIA and RT-PCR. The results from sporadic cases were compared with 1,360 samples from 285 outbreaks of gastroenteritis which were sent to the laboratory over the same period. In total NLV was established as the causal agent in 326 cases (10.3%) of sporadic gastroenteritis by one or more of the tests (EM 30 (0.9%), EIA 132 (4.2%) and RT-PCR 276 (8.7%)). The presence of other enteric viruses was established using EM and rotavirus EIA. Rotaviruses were the most common cause of viral gastroenteritis with 684 cases (21.6%). Other viruses detected included, adenovirus 124 cases (3.9%), astrovirus 97 cases (3.1%) and calicivirus in 7 cases (0.2%). NLV was the second most common viral agent indicating a significant role in cases of sporadic childhood gastroenteritis.

Caliciviridae Infections↗