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At least 163 records · Page 9Linked to original sources
PubMed1999

Low endogenous prostaglandin E2 predisposes to relapsing inflammation in experimental rat enterocolitis.

Intramural injection of peptidoglycan-polysaccharide (PG-PS) induces acute enterocolitis that spontaneously relapses in Lewis but not Fischer rats. Interleukin-1 (IL-1) and tumor-necrosis factor-alpha (TNF-alpha) induce prostaglandin E2 (PGE2) secretion, which inhibits secretion of these cytokines by macrophages, suggesting an inhibitory feedback mechanism. We postulate that Lewis rat susceptibility to relapse is due to an imbalance between protective prostaglandins and cytokines. Female Fischer and Lewis rats were injected with PG-PS (37.5 microg/g) or human serum albumin intramurally. Tissue IL-1alpha and PGE2 immunoreactivities and myeloperoxidase (MPO) activity were determined. Relapsing rats had lower PGE2 and PGE2:IL-1alpha ratios than nonrelapsing rats (P < 0.05). In Fischer rats, 2 mg/kg/day indomethacin potentiated cecal MPO and IL-1alpha concentrations above PG-PS alone (P < 0.05). Misoprostol treatment blocked PG-PS-induced IL-1alpha and MPO and inhibited the potentiating effect of indomethacin on MPO and IL-1alpha (P < 0.05). In conclusion, increased endogenous PG may be protective against relapsing inflammation in PG-PS induced enterocolitis, at least partially via inhibition of proinflammatory cytokines. An imbalance between protective prostaglandins and proinflammatory cytokines may be involved in the pathogenesis of chronic relapsing inflammation in genetically susceptible hosts.

Animals↗
PubMedDate not supplied

Continuous high-energy low-flow-rate enteral support: a panoramic review of 1000 cases.

One thousand intensive care digestive surgical cases are reviewed concerning continuous low-flow-rate enteral support (CLFRES), using Nutripompe: 607 males and 393 females, average age 51 years. The average duration of CLFRES is 21.5 days +/- 13, range 4 to 180 days. CLFRES was used postoperatively in 76 per cent, preoperatively in 10 per cent, and pre- and postoperatively in 14 per cent of cases, respectively. The enteral support route was 63 per cent nasogastric, 20 per cent gastrostomy and 17 per cent jejunostomy. Five hundred and ten patients required extensive digestive surgery with temporary exclusions. More than 100 patients with either temporary enterostomies or enterocutaneous fistulas have had continuous reinstillation of digestive chyme (CRDC) associated with their intensive care unit treatment management. CRDC in the lower end of an enterostomy has shown a specific retrograde inhibitory effect on the upper digestive secretions, particularly on the intestinal secretions during pathologies associated with one or several interruptions of the continuity of the gastrointestinal tract. This technique and its physiological implications were discussed. The principal pathologies in this important study group are: severe digestive fistulas, 24 per cent; acute diffuse peritonitis, 18 per cent; acute enterocolitis, 14 per cent; digestive tumours, 35 per cent; and acute necrotizing haemorrhagic pancreatitis, 9 per cent. A comparative analysis of nutritional energy nitrogen requirement was presented in view of the cancer, the septic, and the non-cancer non-septic patient groups. Enteral support nutritional solutions were primarily mixed non-degraded food, 70 per cent, and semi-elemental diets, 30 per cent. Certain pathology groups required variations in protein and lipid percentage. An up-to-date evaluation of nutritive formulas based on small peptides in normal and small bowel postoperative patients was discussed. Four CLFRES administration programmes were discussed: normal gastrointestinal tract, 38 per cent; abnormal gastrointestinal tract, 44 per cent; pancreatitis, 11 per cent; short bowel, 7 per cent. Nutrition evolution parameters (clinical), were: weight gain curve (minimum 10 days), local regional healing, biological positive changes in protein metabolism, nitrogen balance, lipid metabolism and glucose regulation. Impact on complications such as thrombosis, embolism and haemorrhage were discussed. Clinical and biological results using CLFRES were most satisfactory in more than 90 per cent of patients.

Adolescent↗
PubMed2004

Serum cytokines in differentiating between viral and bacterial enterocolitis.

It is difficult to distinguish clinically between bacterial and viral causes of enterocolitis. The aim of the study was to investigate if serum cytokines can distinguish bacterial from viral enterocolitis. We prospectively enrolled 147 paediatric in-patients with acute enterocolitis. Blood was taken for leucocyte count, CRP, ESR, IL-6, IL-8, IFN-alpha and TNF-alpha on the day of admission. A pathogen was identified in 115 of the 147 children, 72 of whom had a bacterial pathogen (bacterial group) and 43 rotavirus (viral group). Mean values of the serum markers IL-6, IL-8 and CRP were significantly higher in the bacterial group. Receiver-operating characteristic curves demonstrated that a cut-off of 15 pg/ml for IL-6 had a sensitivity of 0.75 and a specificity of 0.91 for bacterial diarrhoea. Comparable values for CRP at a cut-off of 13 mg/L demonstrated a sensitivity of 0.54 and a specificity of 0.72. Values for IL-8 at a cut-off of 80 pg/ml had a sensitivity of 0.46 and a specificity of 0.71. Despite the small sample size, our data suggest that serum IL-6, IL-8 and CRP are significantly elevated in children with bacterial enterocolitis. IL-6 has a higher sensitivity, specificity and positive predictive value than IL-8 and CRP. Determination of serum cytokines might be a useful way of differentiating viral from bacterial gastro-enteritis.

Bacterial Infections↗
PubMed1981

[Clinical evaluation of 6059-S therapy in children (author's transl)].

A new semisynthetic 1-oxa-beta-lactam derivative, 6059-S, was evaluated for its safety and efficacy in children. Twenty-five patients were treated with 10 to 274 mg/kg per day of 6059-S by intravenous administrations. The diagnosis of the patients were acute pharyngitis (2), acute bronchitis (2), pneumonia (4), pertussis (4), acute enterocolitis (2), recurrent urinary tract infection (2), suspected septicemia (3), and acute purulent meningitis (1); and the remaining 5 patients were considered to have nonbacterial infections. The pathogens recovered were Streptococcus pneumoniae (1), Haemophilus influenzae (4), Haemophilus parainfluenzae (1), Enterobacter cloacae (1), Enterobacter aerogenes (1), Proteus morganii (1), Psuedomonas aeruginosa (2) and Salmonella typhimurium (1). All the patients of bacterial infections were cured after the 6059-S therapy. However, Pseudomonas aeruginosa and Salmonella typhimurium were not eradicated after the 6059-S therapy, and the rate of bacterial disappearance was 75%. Diarrhea (3), precordial pain (2, only in cases with high-dose therapy), transient elevation of GOT and GPT (2), and transient eosinophilia (2) were found to be associated with the 6059-S therapy. However, no severe adverse reactions were encountered. Half life of the serum 6059-S level was 1.34 +/- 0.16 hours. CSF concentrations in a case with Haemophilus influenzae meningitis ranged 4.0 to 9.7 mcg/ml after an intravenous injection of 34.3 to 75 mg/kg of 6059-S. From the present study, 6059-S appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections. It remains to be further determined whether 6059-S is superior to ABPC in the treatment of Haemophilus influenzae meningitis.

Adolescent↗
PubMed1990

Hemodynamic and permeability characteristics of acute experimental necrotizing enterocolitis.

We examined the local hemodynamic response of intestinal loops during acute necrotizing enterocolitis (NEC) in anesthetized rabbits. NEC was induced in ileal loops by transmural injection of a solution containing casein (10 mg/ml) and calcium gluconate (50 mg/ml) acidified to pH 4.0 with propionic or acetic acid. Control loops received casein only (pH 5.0). Mucosal damage was quantified by the blood-to-lumen movement of [51Cr]EDTA, fluid shifts into the lumen, and histology. Mean arterial pressure and loop blood flow were steady over the 3-hr period, loop fluid volume decreased, and there was no evidence of necrosis or epithelial damage. In loops receiving acidified casein and calcium gluconate, there was an immediate dramatic increase in loop blood flow that returned to baseline by 50 min. In addition, loop fluid volume was dramatically increased, necrosis was noted in the form of blunting and loss of villi, and sevenfold increase in [51Cr]EDTA permeability was evident. Administration of CV 1808 (30 mg/kg/hr), a selective adenosine2 agonist, which maintained and elevated loop blood flow throughout the 3 hr protocol, failed to alter the changes in loop fluid volume or prevent necrosis. Histamine levels in loop fluid levels were significantly elevated 20-30 min after NEC induction when compared to saline controls, indicating an early activation of mucosal defenses with this luminal insult. Thus, this model of NEC is characterized by a transient, acute hyperemia, increased intestinal permeability, and histamine release. As mucosal damage was independent of ischemia and could not be prevented by vasodilatory therapy, this model supports the clinical findings that NEC is correlated with luminal factors related to feeding and independent of cardiovascular stress.

Acid-Base Imbalance↗
PubMedDate not supplied

Neutropenic enterocolitis in children with acute lymphoblastic leukemia.

Neutropenic enterocolitis is an acute, life-threatening inflammation of the small and large bowel, often seen in children with malignancies during periods of prolonged or severe neutropenia. During the period 1990-1995, 180 children were treated at the authors' center for acute lymphoblastic leukemia using a standard chemotherapy protocol. Among them, 11 children (6.1%) aged 4 to 12 years, were diagnosed clinically to have neutropenic enterocolitis. Eight had severe neutropenia (absolute neutrophil count < 10(8)/L and 5 had prolonged neutropenia (> 7 days duration). The symptoms included diffuse abdominal pain (10 children), oral mucositis (7), hematochezia (7), diarrhea (6), hematemesis (5), and right lower quadrant tenderness (4). Three children had radiological evidence of free intraperitoneal gas and an additional 3 children were found on surgical exploration to have cecal perforation. Laparotomy was performed on 8 children (73%), 4 of whom survived. Among the 3 children managed conservatively, 1 died awaiting surgical exploration, while the other 2 did well. The overall survival was 55%. The authors recommend an approach to management that respects the heterogeneity of the disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

[Acute primary ulcer of the small intestine. Present concepts (author's transl)].

Acute primary ulcer of the small intestine is an exceptional occurrence. Diagnosis is established only after a complication occurs. In most instances, this complication is perforation of the gut. Acute primary ulcer of the small intestine is accurately defined by specific histologic criteria. It can be unequivocally distinguished from the many other causes of spontaneous perforation of the small intestine. Experimental studies, although numerous, have not improved understanding of pathophysiology. Nosologic classification remains unclear. Many features are similar to those encountered in acute peptic ulcer but stress is usually absent. Other features resemble those of transient necrotizing enterocolitis ; acute primary ulcer of the small intestine may be a very localized form of this latter condition. Ischemia seems to be the most significant factor. However, for an ulcer and finally perforation to occur, ischemia must probably be associated with a number of other factors.

Acute Disease↗
PubMed2004

[Surgery for neutropenic enterocolitis, a complication in acute lymphoblastic leukemia].

Neutropenic enterocolitis (NE) is an unusual acute complication of neutropenia, associated with leukemia and lymphoma. It has been observed mainly in the first phase of therapy when drugs are used in maximally tolerated dose. This is a case report of neutropenic enterocolitis in a patient with acute lymphoblast leukemia who received prednisone, vincristine, daunorubicin and L-asparaginase, with perforation of cecal and terminal ileum. Perforation and defect intestine wall was excised and sutured directly in two layers. Protective proximal loop ileostomy was performed at that time.

Adolescent↗
PubMedDate not supplied

Culture of colonoscopically obtained biopsy specimens in acute infectious colitis.

To investigate the value of colonoscopy in the diagnosis of acute infectious colitis, we prospectively cultured both feces and biopsy specimens obtained during colonoscopy of patients who, because of clinical features such as the acute onset of abdominal pain and diarrhea, were suspected of having the disease. Of the 20 patients who participated in the study, some causative micro-organism was identified in 13 (Campylobacter in 6 patients, Salmonella in 5 patients, and Yersinia in 2 patients), but not in the remaining 7. In addition, biopsy specimens were more sensitive for culture (positive for Campylobacter in 4 patients, Salmonella in 5 patients, and Yersinia in 1 patient) than were feces samples (positive for Campylobacter in 2 patients and for Yersinia and Salmonella in 1 patient each) (50% versus 20%, p = 0.048). These findings suggest that cultures of biopsy specimens obtained during colonoscopy may be diagnostic in sporadic cases of acute enterocolitis caused by bacteria.

Acute Disease↗
PubMed1982

[Enteral yersiniosis--a serious disease? Current knowledge of clinical aspects, diagnosis and therapy].

Enteral yersiniosis is caused either by Y. enterocolitica 0-group I (syn. serotype 0:3) and 0-group V (syn. serotype 0:9) or Y. pseudotuberculosis type I-VI. The clinical symptoms are mostly like enteritis, enterocolitis, acute abdomen, mesenteric lymphadenitis, or ileitis terminalis. Post-infection reactions are possible like septicemia, arthritis and erythema nodosum. Only cultural and serological examinations confirm the diagnosis of enteral yersiniosis. In the judgement of serological results it is necessary to consider the cross-reactions of Y. enterocolitica 0-group V to Brucella abortus, Brucella melitensis and Brucella suis and also to the antigenic community of Y. pseudotuberculosis type II respectively IV to Salmonella group B respectively D. With exception of septicemia, it is not necessary to treat enteral yersiniosis with antibiotics.

Abdomen, Acute↗
PubMed1986

Staphylococcus epidermidis-associated enterocolitis.

Nineteen infants (mean +/- SD gestational age 30 +/- 2 weeks, birth weight 1.28 +/- 0.53 kg) with Staphylococcus epidermidis bacteremia were found on retrospective chart review to have had signs and symptoms of acute enterocolitis. This S. epidermidis-associated enterocolitis constituted 37% of the 51 cases of enterocolitis and 23% of the 81 cases of S. epidermidis sepsis during the study period. S. epidermidis-associated enterocolitis was relatively mild compared with other forms of enterocolitis. Although abdominal radiographs showed markedly abnormal bowel gas patterns with distended bowel loops and bowel wall edema, only one infant had pneumatosis intestinalis and none had portal venous or free intraperitoneal gas. Only three infants had neutropenia, and five had thrombocytopenia. None of these infants required surgical intervention. Although bloody stools often persisted for weeks, none of the neonates had prolonged feeding intolerance or development of a stricture. We conclude that S. epidermidis infection is commonly associated with a mild form of enterocolitis in the neonate and that this association should be considered when selecting antibiotics for therapy.

Enterocolitis↗
PubMedDate not supplied

Psoas abscess with osteomyelitis in a patient undergoing long-term hemodialysis.

We describe a 69-year-old male patient on maintenance hemodialysis for 24 years who developed a fatal left psoas abscess with osteomyelitis at the hip joint following acute enterocolitis. He had systemic beta(2)-microglobulin amyloid deposition in colon epithelium and psoas muscle. Cultures from abscess fluid and femoral bone marrow yielded Bacteroides fragilis. To our knowledge, this is the first case on hemodialysis having a psoas abscess following acute gastrointestinal infection. This rare case suggested that a secondary psoas abscess could be one of the occult infections in patients undergoing long-term maintenance hemodialysis.

Aged↗
PubMed1991

Rheumatic symptoms following an outbreak of campylobacter enteritis: a five year follow up.

Eighty six of 106 (81%) guests attending a party were followed up after an outbreak of Campylobacter jejuni enterocolitis. Acute diarrhoeal illness was reported in 35 subjects (33%), of whom seven showed acute rheumatic symptoms either alone or with other symptoms of infection with C jejuni. The antibody response to C jejuni corresponded well with the intensity of the disease. In the early phase of the gastrointestinal disease the patients with acute rheumatic symptoms displayed significantly higher IgM antibody levels in serum samples than the other patients in this study. Levels of antibodies to C jejuni were increased in serum samples from 31 patients (29%) without symptoms of infection with C jejuni. At a follow up after five and a half years, four of these patients suffered from chronic rheumatic disorders. One HLA-B27 positive woman developed reactive arthritis with a relapse seven years later. The remaining 20 subjects (19%) remained healthy and their antibody tests and stool cultures were negative for C jejuni. It is concluded that C jejuni enterocolitis is significantly associated with rheumatic symptoms in the early phase and may also cause chronic rheumatic disorders.

Acute Disease↗
PubMedDate not supplied

[Acute non-obstructive necrotizing enterocolitis in adults].

Acute non-obstructive necrotizing enterocolitis in adults is characterized by pathological features: it is an intestinal necrosis beginning in the mucosa, without obstruction of the mesenteric vessels. The disease occurs in a variety of circumstances which may be roughly divided into infections and fall in proximal or distal mesenteric flow rate, the infectious and circulatory mechanisms often coexisting. Little information on the diagnosis is provided by clinical and paraclinical data. Management is medical and/or surgical; it includes alleviation of the symptoms in intensive care unit, attempts at producing local vasodilation whenever possible and resection of the intestinal segment affected. In many cases the diagnosis is made at exploratory laparotomy. The prognosis is poor; it depends on the patient's age, on the extent of the lesions which sometimes require wide intestinal resections, and on the time to diagnosis.

Anti-Bacterial Agents↗
PubMed1989

[Isolation of Campylobacter jejuni and Campylobacter coli from children with acute intestinal diseases].

In this work the data obtained in the examination of 338 children with diarrhea, aged 5 days to 14 years, are presented. The methods used for the collection of samples and their storage till the moment of inoculation are described. The possibility of using the microscopic examination of Campylobacter-containing native feces is shown. The work resulted in the isolation of 85 C. jejuni and C. coli strains. As shown in this work, the isolation of Campylobacter depended on the age of children and the season. The etiological importance of Campylobacter for the development of acute enterocolitis and gastroenteritis in 10% of the children under examination is suggested.

Acute Disease↗
PubMed1988

Enterocolitis in cattle associated with Yersinia pseudotuberculosis infection.

A syndrome in cattle of diarrhoea and death associated with enteric Yersinia pseudotuberculosis infection is described. Outbreaks occurred during winter and early spring in adult cattle grazing pastures waterlogged by recent flooding or persistent heavy rain. Antibiotic therapy was effective early in the course of the syndrome. At necropsy there was severe acute enterocolitis, and bacteria consistent with Y. pseudotuberculosis were observed in the lesions. This organism could usually be isolated from the intestines of affected animals but was recovered less often from other organs. Representative isolates were identified as Y. pseudotuberculosis serotype III. The association of this syndrome with waterlogged pastures and low temperatures suggests that these conditions favour transmission of Y. pseudotuberculosis infection in cattle. The role of Y. pseudotuberculosis as primary pathogen requires confirmation.

Abomasum↗
PubMed1984

Nonspecificity of barium enema findings in acute appendicitis.

Barium enema examination is a well known and useful adjunctive technique for the diagnosis of acute appendicitis when its clinical presentation is atypical. The combination of a mass effect on the cecum and nonfilling of the appendix have been considered virtually pathognomonic radiographic findings. These appearances on barium enema examination may also be encountered in patients with small-bowel obstruction, acute enterocolitis, pelvic hemorrhage and adhesions, and pelvic inflammatory disease. In three of five cases, these radiographic findings contributed to the decision to perform laparotomy, at which a histologically normal appendix was removed. The value of the barium enema examination in suspected but atypical acute appendicitis must be tempered by the recognition that occasionally other diseases with acute presentations produce similar findings.

Acute Disease↗