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PubMed1989

[Enteral nutrition in clinical practice. Pathophysiologic basis of the effective use of enteral nutrition].

Enteral nutrition by means of a thin tube is a significant enrichment of methods of nutritional support of patients in a catabolic state and those suffering from malnutrition. For the rational use of this method it is important to have reliable knowledge of physiological and pathophysiological processes in the course of digestion and absorption of nutrients, metabolism of energy substrates and to know the technique of enteral nutrition. The submitted brief review provides basic information on the problem.

Dietary Carbohydrates↗

PubMedDate not supplied

Role of splenectomy in prevention of hemorrhagic enteritis and death from hemorrhagic enteritis virus in turkeys.

Hemorrhagic diarrhea, gross hemorrhagic enteritis, and death caused by intravenous virus injection of hemorrhagic enteritis virus (HEV) were prevented in otherwise susceptible turkey poults by surgical splenectomy. The splenectomized poults produced anti-HEV antibodies, which indicated that splenectomy did not completely prevent replication of the virus. These results indicate that the spleen is necessary for the development of the intestinal lesions of this disease. The role of a toxic factor in this disease is discussed.

Animals↗

PubMed1995

[Deep cystic enteritis in Peutz-Jeghers syndrome (pseudoinfiltrating lesions in a patient with enteric polyps)].

We report a case of enteritis cystica profunda observed in a patient who, owing to both his personal and familial history, had been diagnosed and suffering from Peutz-Jeghers syndrome. The patient was operated because of a clinical picture of intestinal invagination. Together with hamartomatous polyps, anatomopathological study of the segment of the small intestine removed revealed the presence of lesions typical of Enteritis cystica profunda consisting in the presence of benign encysted glands and pools of mucous in the deep layers of the intestinal wall. The main characteristics of this interesting and rare entity are briefly commented.

Adult↗

PubMed2003

Pyrodictium cannulae enter the periplasmic space but do not enter the cytoplasm, as revealed by cryo-electron tomography.

The hyperthermophilic archaeon Pyrodictium grows in the form of a macroscopically visible network. It consists of cells entrapped in an extracellular matrix of hollow tubules, the "cannulae." Here, we present the three-dimensional structure of a single cell in conjunction with two extracellular cannulae, as determined by cryo-electron microscopy. To achieve this, the information from two independent tilt series of the same specimen was combined, with the specimen rotated in the second series. In the three-dimensional tomographic reconstruction, we were able to trace the two cannulae in their full length, in particular, also inside the cell. One cannula enters the periplasmic space, while the other cannula contacts the surface of the cell, the S-layer. This indicates that the cannulae interconnect individual cells with each other on the level of their periplasmic space; we do not, however, have evidence that they enter the cytoplasm of the cells. The implications of these data for possible functions of the cannulae are discussed.

Cryoelectron Microscopy↗

PubMed1986

Zuelzer-Wilson's syndrome and absence of the enteric nervous system. Two rare forms of anomalies of the enteric nervous system with identical clinical symptoms.

47 children have been treated in Basel for aganglionosis (Hirschsprung's disease) during the last 25 years. Six children presented severe vomiting and an ileus as leading symptoms instead of chronic constipation, the classical leading symptom of Hirschsprung's disease. Clinical, radiological and intraoperative findings were virtually identical in these 6 patients. However, enzyme histochemical and immunocytochemical investigations disclosed an aganglionosis of the entire colon (Zuelzer-Wilson's disease) in 3 patients, absence of the enteric nervous system in the small and large intestine in 2 patients, and a combination of both in 1 patient. In contrast to children suffering from aganglionosis of the entire colon, the chance of survival for patients with an absence of the enteric nervous system is extremely small. It is therefore necessary in presence of severe vomiting and an ileus to take intraoperative biopsies from the large and the small intestine. The precise diagnosis can be made only by using enzyme histochemical and immunocytochemical techniques.

Cholinergic Fibers↗

PubMed1988

Role of enteric adenoviruses and rotaviruses in mild and severe acute enteritis.

The role of enteric-type adenoviruses and rotaviruses in mild and severe acute gastroenteritis was investigated among children younger than 5 years of age seeking treatment at an urban hospital (UH) and at a rural health center (RHC) in India. There were 330 children at the UH and 340 at the RHC; 319 and 315 age matched nondiarrheal children served as controls for the respective groups. Rotavirus was detected in 15.2% of 330 cases and 1.9% of 319 controls at the UH (P less than 0.001) and in 16.5% of 340 cases and 2.9% of 315 controls at the RHC (P less than 0.001). RV excretion was 3- to 5-fold more common in severe compared with mild diarrhea at the UH and at the RHC (P less than 0.001). The detection rate for enteric-type adenoviruses was similar in patients and controls, respectively, at the UH (0.9%; 2.5%) and RHC (3.8%; 2.5%). At the RHC adenovirus types other than 40 and 41 were excreted by 8.8% of the patients and by only 1.0% of the controls (P less than 0.001). It is possible that the diarrheagenic role of adenoviruses may not be restricted to types 40 and 41.

Adenoviruses, Human↗

PubMed1994

A Single-Dose Bioavailability Study of Pamidronate Disodium after Oral Administration as Encapsulated Enteric-Coated Pellets, Enteric-Coated Tablets, and a Solution to Patients with Postmenopausal Osteoporosis.

This was a pilot, single-center, single-dose, open-label, randomized three-way crossover study comparing the relative bioavailability of pamidronate disodium after oral doses of the drug administered as four capsules, each containing 75 mg enteric-coated pellets, two 150-mg enteric-coated tablets and 300 mg in solution (reference standard) in patients with postmenopausal osteoporosis. Results from seven patients are reported; five subjects completed all three phases of the study---one received solution and pellets, and another one received pellets and tablets. The onset of urinary excretion (an indicator of relative onset of oral absorption) of pamidronate disodium occurred in the first 2 h in all (except one) patients for solution and pellets, whereas the onset of urinary excretion for the tablets was prolonged and more variable. The extent of absorption was estimated in terms of percent of administered dose excreted in urine up to 72 h after dosing. The extend of absorption was highest after the pellets (mean plus minus S.D., 0.37 plus minus 0.27%), followed by the solution (0.20 plus minus 0.16%). The extent of absorption after the tablets (0.09 plus minus 0.10%) was the lowest and most variable. The poorer and more variable bioavailability of the tablets may be explained by the longer and more variable residence time of the tablets in the stomach.

Journal Article↗

PubMed1968

A new plating medium for the isolation of enteric pathogens. I. hektoen enteric agar.

A new agar plating medium for the isolation of enteric pathogens is described. This medium contains greater quantities of peptone to offset the inhibitory effects of bile salts. Additional carbohydrates and larger quantities of those previously used have also been incorporated into the medium to differentiate pathogens from some of the slow lactose fermenters. The use of an indicator system never used before in a differential plating medium opens new possibilities for improvement over traditional and newer selective media. Known strains from the various genera of Enterobacteriaceae have been tested for colonial differentiation as well as for possible inhibitory effects. The results show the medium to be highly selective for the shigellae as well as for other enteric pathogens.

Agar↗

PubMed2000

Schistosoma mansoni infection causing diffuse enteric inflammation and damage of the enteric nervous system in the mouse small intestine.

Schistosomiasis mansoni is a major health problem, mainly occurring in developing countries. A large proportion of infected individuals suffers from motility-related gastrointestinal problems. In the present study, the diffuse inflammatory response in the small bowel wall, as compared to the egg-induced granulomatous inflammation, was investigated. For this purpose, OF1 mice infected with Schistosoma mansoni 8-16 weeks prior to the experiment, and uninfected control mice were studied. The ileum showed both a diffuse mucosal inflammation as well as a granulomatous reaction. The diffuse mucosal inflammation caused an increase in the thickness of the mucosa, with blunting of the villi. A significant, transient increase of thickness of the muscularis propria after 12 weeks of infection was noted. There was an infection-related mast cell infiltrate in the muscularis propria, consisting of formalin fixation-insensitive connective tissue mast cells. Ganglionitis of the myenteric plexus was noted. Rarely, ganglia of the myenteric plexus contained apoptotic cells. A general pharmacological set of experiments showed a significant increase in intestinal contractility, both to exogenously administered, as well as to endogenously released neurotransmitters. Our results demonstrate that S. mansoni infection in the mouse ileum leads to diffuse specific enteric inflammation that is associated with an enhanced response to contractile agents.

Animals↗

PubMed1982

Aspirin--a national survey V: Determination of aspirin and impurities in enteric coated tablets and suppository formulations and in vitro dissolution of enteric coated tablets.

The results of a national survey on the quality of enteric coated aspirin tablets and aspirin suppositories are presented. The tablets were analyzed for strength, salicylic acid content, in vitro dissolution rate, and related aspirin impurities. The suppositories were analyzed for strength and salicylic acid content. The methods of analysis and validation of data are also presented.

Aspirin↗

PubMed1998

The 1996 Nestlé International Clinical Nutrition Award for Enteral Nutrition. "Enteral versus parenteral nutrition: effects on gastrointestinal function and metabolism": background.

Nutrition therapy for the critically ill patient is today an integral part of the treatment concept in intensive care medicine. Parenteral and enteral artificial nutrition are expensive, cost-intensive treatment procedures that are certainly not risk-free. For both ethical and economic reasons, the indications and principles of artificial nutrition must always be adapted to the latest knowledge.

Awards and Prizes↗

PubMed2002

[The current status of infectious enteritis in Japan--reports of the "Research Group for Infectious Enteric Diseases, Japan" in the last 5 years (1996-2000)].

The patients or carriers with infectious enteritis admitted to the Hospitals for infectious diseases in the last 5 years (1996-2000) were studied. The total number of cases admitted in each year were 969, 1,113, 981, 637 and 573 respectively. A total of 1,527 Shigella spp. strains including 1,078 strains from overseas travelers' cases were isolated. The isolates of Salmonella spp. excluding S. Typhi and S. Paratyphi A were 562 in number. A total of 61 Vibrio cholerae O1 strains including 44 strains from overseas travelers was isolated. These V. cholerae O1 strains were all of El Tor type. Entamoeba histolytica, Giardia lamblia, Cryptosporidium parvum and Isospora belli were detected in 225, 46, 3 and 3 cases respectively. Abdominal pain, nausea and vomiting were frequently observed in the cases caused by Vibrio parahaemolyticus. The highest body temperature and the highest frequency of bowel movements were revealed in the cases caused by Salmonella spp. Bloody stool was observed in 55.3% of the cases due to Escherichia coli, in 40.5% of the cases due to Campylobacter spp. and in 24.1% of cases due to Shigella spp. As for shigellosis and salmonellosis, the clinical symptoms were more serious in the domestic cases than those in travelers. OFLX-resistant strains accounted for 1.7% of Shigella spp. isolates. No strains of Salmonella spp. were resistant to OFLX. The incidence of drug-resistant isolates of Campylobacter jejuni were 26.0% for OFLX and 2.5% for EM.

Drug Resistance, Bacterial↗

PubMed1980

Fine-bore enteral feeding: a simple alternative to intravenous feeding: Enteral Nutrition Group of the Royal Adelaide Hospital.

Malnutrition may affect up to 50% of patients in most large hospitals and is associated with increased morbidity and mortality. Parenteral nutrition has been available for over ten years but suffers some major disadvantages in cost and patient risk. Many patients requiring nutritional support can be fed through the gastrointestinal tract, and our experience with fine-bore enteral feeding has shown it can be administered comfortably, safely and cheaply to patients with a wide variety of diseases. Details are given of locally available formulae and methods of administration, and a summary is presented of one year's experience in this method at the Royal Adelaide Hospital.

Enteral Nutrition↗

PubMedDate not supplied

Mortality patterns associated with poult enteritis mortality syndrome (PEMS) and coronaviral enteritis in turkey flocks raised in PEMS-affected regions.

Poult enteritis mortality syndrome (PEMS) is an economically devastating disease. To date, many questions about the syndrome remain unanswered, including its cause, transmission of causative agent(s), and control methods. Turkey coronavirus (TCV) infection has been associated with some outbreaks of PEMS, with areas having a higher prevalence of TCV infection also experiencing an increased incidence of PEMS. This study was designed to establish mortality patterns for flocks experiencing excess mortality and TCV infection in PEMS-affected regions and to delineate the possible role of TCV in PEMS-affected flocks. Fifty-four commercial turkey flocks on farms in areas with and without a history of TCV infection were monitored for weekly mortality and for antibodies to TCV. Flocks were chosen on the basis of placement dates and were monitored from day of placement until processing. All flocks were tested for TCV by an indirect fluorescent antibody assay. PEMS status was determined with the use of the clinical definition of mortality greater than 2% during any 3-wk period from 2 wk of age through the end of brooding due to unknown cause. Of the 54 flocks, 24 remained healthy, 23 experienced PEMS, and 7 tested positive for TCV but did not experience PEMS. Ten flocks experienced PEMS and tested positive for TCV, whereas 13 flocks experienced PEMS and did not test positive for TCV. Four health status groups were evident: healthy, PEMS positive, TCV positive, and PEMS + TCV positive. Distinct mortality patterns were seen for each of the four health status groups. Whereas TCV was associated with PEMS in 43% of PEMS cases, 13 cases (57%) of PEMS did not involve TCV. Additionally, 7 out of 17 cases of TCV (41%) did not experience excess mortality (PEMS) at any time during brooding of the flock. The results of this study indicate that TCV can be associated with PEMS but is neither necessary nor sufficient to cause PEMS.

Animals↗

PubMedDate not supplied

Hemorrhagic enteritis of turkeys in California: serologic study of hemorrhagic enteritis virus antibody with an enzyme-linked immunosorbent assay.

The incidence of hemorrhagic enteritis (HE) infection in California turkeys was studied by testing 2220 turkey blood samples from 173 flocks for HE virus (HEV) antibody by the enzyme-linked immunosorbent assay (ELISA). Maternal antibody was detected at 1 day of age in all flocks tested, and it vanished after 3 weeks. Acquired HEV antibody appeared at 8 to 10 weeks, and 100% of the meat and breeder turkey flocks were positive after 11 weeks of age. HEV infection occurred earlier in the meat flocks than in the breeder flocks, and it also occurred earlier during summer than during the fall and winter months.

Animals↗

PubMed1983

Aortic graft-enteric and paraprosthetic-enteric fistulas.

Gastrointestinal hemorrhage is often a late manifestation of an aortoenteric fistula. Warning symptoms may include back or abdominal pain, fever, anemia, hematochezia, or melena. This entity results from erosion of the gastrointestinal tract by an adjacent vascular prosthesis. A paraprosthetic-enteric fistula represents a step in the formation of a true aortoenteric communication. Aggressive diagnostic studies, including endoscopy, aortography, barium contrast, computerized axial tomography, and radionuclide scanning, may allow earlier diagnosis and correction than have occurred in the past. Treatment should include graft excision, closure of the bowel defect, appropriate antibiotic therapy, and extraanatomic revascularization if collateral flow is not adequate. Our experience with 21 patients has illustrated the high mortality rate (74 percent) when operative treatment is delayed until massive hemorrhage occurs.

Aged↗

PubMed1993

Diarrhoeal disease: current concepts and future challenges. Rapid detection of enteric infections by measurement of enteric pathogen-specific antibody secreting cells in peripheral blood.

Enteric infections and diarrhoeal disease are important causes of morbidity and mortality. Infections are often difficult to diagnose, especially when access to sophisticated laboratory facilities is limited. In an attempt to develop a rapid method of diagnosis, which might not require an advanced laboratory, advantage was taken of the observation that precursors of lymphocytes secreting immunoglobulin A (IgA), generated in response to mucosal stimulation with an antigen, are transiently present in peripheral blood. Detection of cells in peripheral blood bearing IgA specific for a pathogenic microbe should indicate current infection. This hypothesis was tested using peripheral blood mononuclear cells collected from volunteers who were clinically 'normal', had experimentally induced shigellosis, had naturally acquired shigellosis, or had naturally acquired typhoid fever. The method was sensitive for detection of Salmonella typhi infection and less sensitive for detection of Shigella infection. The antibody secreting cell procedure has good potential as a rapid, simple diagnostic procedure if applied during the acute phase of infection.

Adult↗

PubMed1993

Bioavailable level and source of cysteine determine protein quality of a commercial enteral product: adequacy of tryptophan but deficiency of cysteine for rats fed an enteral product prepared fresh or stored beyond shelf life.

Young rats were used in bioassays designed to assess the protein quality and tryptophan as well as cystine adequacy of the enteral product TwoCal-HN that was either freshly prepared or had been stored (nonrefrigerated) in a warehouse for 10 mo (i.e., beyond shelf life). Based upon supplementation studies, cystine was observed to be the first-limiting amino acid in both fresh and expired TwoCal-HN, and tryptophan was not second limiting. Protein efficiency ratio (PER) of expired, but not fresh, TwoCal-HN was lower than that of the casein control diet, but with cystine supplementation, PER of the TwoCal-HN products was equal to or greater than the PER of the casein control. With a diet containing 10 g protein/100 g that also contained energy-furnishing ingredients simulating TwoCal-HN, maximal growth enhancement occurred with a supplement of 1 g cystine/kg diet. Both glutathione and N-acetyl-L-cysteine were observed to be equivalent to an isomolar level of L-cystine in stimulating growth. Using a chemically defined amino acid diet that was singly deficient in tryptophan, bioavailability of tryptophan was determined for casein, fresh TwoCal-HN, expired TwoCal-HN and D-tryptophan. Slope-ratio bioefficacy values relative to L-tryptophan (weight gain regressed on supplemental tryptophan intake) indicated that none of the experimental sources of tryptophan had bioavailabilities different from 100%. The results indicated that tryptophan did not deteriorate, as measured analytically or biologically, as a result of storing TwoCal-HN beyond shelf life.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗