DIARRHOEA

Some Selected Abstracts:

1.

Baysan A, Lynch E.The use of ozone in dentistry and medicine. Prim Dent Care. 2005 Apr;12(2):47-52.

Department of Restorative Dentistry, GKT, King's College London, London SE1 9RT, UK. aylin.baysan@kcl.ac.uk

There is growing interest in the use of ozone in oral healthcare and the National Institute for Clinical Excellence (NICE) is at present reviewing the evidence for its effectiveness in the management of occlusal and plain surface caries. These are only two of the clinical problems for which ozone can, and has, been used; it has also been employed for a wide variety of other purposes in both dentistry and medicine. This pale blue-coloured gas plays an important role as a natural constituent in the higher layer of the Earth's atmosphere. There is growing evidence that it can be employed as a useful therapeutic agent. This paper reviews its therapeutic uses to date and suggests its possible future clinical applications. Consumer demands for this strong oxidant may increase as the general public becomes increasingly aware of its therapeutic capacity and the non-invasive manner in which it can be administered.

2.

Ciliberto H, Ciliberto M, Briend A, Ashorn P, Bier D, Manary M. Antioxidant supplementation for the prevention of kwashiorkor in Malawian children: randomised, double blind, placebo controlled trial. BMJ. 2005 May 14;330(7500):1109.

Department of Pediatrics, Washington University School of Medicine, St Louis Children's Hospital, One Children's Place, St Louis, MO 63110, USA.

OBJECTIVE: To evaluate the efficacy of antioxidant supplementation in preventing kwashiorkor in a population of Malawian children at high risk of developing kwashiorkor. DESIGN: Prospective, double blind, placebo controlled trial randomised by household. SETTING: 8 villages in rural southern Malawi. PARTICIPANTS: 2372 children in 2156 households aged 1-4 years were enrolled; 2332 completed the trial. INTERVENTION: Daily supplementation with an antioxidant powder containing riboflavin, vitamin E, selenium, and N-acetylcysteine in a dose that provided about three times the recommended dietary allowance of each nutrient or placebo for 20 weeks. MAIN OUTCOME MEASURES: The primary outcome was the incidence of oedema. Secondary outcomes were the rates of change for weight and length and the number of days of infectious symptoms. RESULTS: 62 children developed kwashiorkor (defined by the presence of oedema); 39/1184 (3.3%) were in the antioxidant group and 23/1188 (1.9%) were in the placebo group (relative risk 1.70, 95% confidence interval 0.98 to 2.42). The two groups did not differ in rates of weight or height gain. Children who received antioxidant supplementation did not experience less fever, cough, or diarrhoea. CONCLUSIONS: Antioxidant supplementation at the dose provided did not prevent the onset of kwashiorkor. This finding does not support the hypothesis that depletion of vitamin E, selenium, cysteine, or riboflavin has a role in the development of kwashiorkor.

3.

Morrow AL, Ruiz-Palacios GM, Jiang X, Newburg DS Human-milk glycans that inhibit pathogen binding protect breast-feeding infants against infectious diarrhea. J Nutr. 2005 May;135(5):1304-7

Center for Epidemiology and Biostatistics, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, OH, USA. ardythe.morrow@cchmc.org

Breast-feeding is a highly effective strategy for preventing morbidity and mortality in infancy. The human-milk glycans, which include oligosaccharides in their free and conjugated forms, constitute a major and an innate immunologic mechanism by which human milk protects breast-fed infants against infections. The glycans found in human milk function as soluble receptors that inhibit pathogens from adhering to their target receptors on the mucosal surface of the host gastrointestinal tract. The alpha1,2-linked fucosylated glycans, which require the secretor gene for expression in human milk, are the dominant glycan structure found in the milk of secretor mothers, who constitute the majority ( approximately 80%) of mothers worldwide. In vitro and in vivo binding studies have demonstrated that alpha1,2-linked fucosylated glycans inhibit binding by campylobacter, stable toxin of enterotoxigenic Escherichia coli, and major strains of caliciviruses to their target host cell receptors. Consistent with these findings, recently published epidemiologic data demonstrate that higher relative concentrations of alpha1,2-linked fucosylated glycans in human milk are associated with protection of breast-fed infants against diarrhea caused by campylobacter, caliciviruses, and stable toxin of enterotoxigenic E. coli, and moderate-to-severe diarrhea of all causes. These novel data open the potential for translational research to develop the human-milk glycans as a new class of antimicrobial agents that prevent infection by acting as pathogen anti-adhesion agents.

4.

Zerr DM, Blume HK, Berg AT, Del Beccaro MA, Gospe SM Jr, Allpress AL, Christakis DA.Nonfebrile illness seizures: a unique seizure category? Epilepsia. 2005 Jun;46(6):952-5.

Department of Pediatrics, University of Washington, Seattle, Washington 98105, USA. zerr@u.washington.edu

PURPOSE: To describe the clinical characteristics of children with a first-time nonfebrile seizure in the setting of mild illness and to test the hypothesis that these seizures are associated with illness characterized by diarrhea. METHODS: This retrospective cohort study was performed in a pediatric emergency department. Patients ages 6 months to 6 years who were evaluated with first-time seizures were eligible for inclusion. Subjects were divided into three groups on the basis of symptoms accompanying their seizure: febrile (temperature, >38.0 degrees C with seizure), unprovoked (no symptoms of illness), and nonfebrile illness (no fever at the time of seizure, but other symptoms of illness present). RESULTS: Of the 323 children with first-time seizures, 247 (76%) had febrile seizure, 37 (12%) had unprovoked seizures, and 39 (12%) had nonfebrile illness seizures. Children with nonfebrile illness seizures were more likely than children with febrile seizures to have diarrheal illnesses accompanying their seizure (44 vs. 16%; p=0.001). Frequency of cough, rhinorrhea, and rash did not differ significantly between children with febrile and nonfebrile illness seizures. Diagnostic testing for infectious etiologies was not performed frequently in either group. CONCLUSIONS: Nonfebrile illness seizures may represent a distinct group of seizures with unique epidemiology. Further study to define this seizure group better is warranted.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics: 

12586.   Anderson RP. Coeliac disease. Aust Fam Physician. 2005 Apr;34(4):239-42. Review.

12587.  Baker DE. Rationale for using serotonergic agents to treat irritable bowel syndrome. Am J Health Syst Pharm. 2005 Apr 1;62(7):700-11; quiz 712-3. Review.

12588.  Barta Z, Miltenyi Z, Toth L, Illes A. Hypokalemic myopathy in a patient with gluten-sensitive enteropathy and dermatitis herpetiformis Duhring: a case report. World J Gastroenterol. 2005 Apr 7;11(13):2039-40.

12589.  Chen MJ, Wang TE, Chang WH, Tsai SJ, Liao WS. Endoscopic findings in a patient with Henoch-Schonlein purpura. World J Gastroenterol. 2005 Apr 21;11(15):2354-6.

12590.  Ciliberto H, Ciliberto M, Briend A, Ashorn P, Bier D, Manary M. Antioxidant supplementation for the prevention of kwashiorkor in Malawian children: randomised, double blind, placebo controlled trial. BMJ. 2005 May 14;330(7500):1109.

12591.  Ciliberto MA, Sandige H, Ndekha MJ, Ashorn P, Briend A, Ciliberto HM, Manary MJ. Comparison of home-based therapy with ready-to-use therapeutic food with standard therapy in the treatment of malnourished Malawian children: a controlled, clinical effectiveness trial. Am J Clin Nutr. 2005 Apr;81(4):864-70.

12592.  Fasano A. Clinical presentation of celiac disease in the pediatric population. Gastroenterology. 2005 Apr;128(4 Suppl 1):S68-73. Review.

12593.  Gupte S, Gupte S, Ravinder Kumar. Antibiotic-induced diarrhoea. Pediat Today 2004; 7(4): 218-23.

12594.  Gustavsson P, Gerhardsson L. Intoxication from an accidentally ingested lead shot retained in the gastrointestinal tract. Environ Health Perspect. 2005 Apr;113(4):491-3.

12595.  Hegde MM, Ahluwalia NK. Rare presentation of a common illness. Campylobacter jejuni infection. Gut. 2005 Jun;54(6):758, 763.

12596.  Isbister GK, Kiernan MC. Neurotoxic marine poisoning. Lancet Neurol. 2005 Apr;4(4):219-28. Review.

12597.  Ito Y, Toda K, Hatakeyama H, Nakamura T, Kiyama S, Katagiri Y, Mimoto H, Onitsuka A, Mori H. Escherichia coli O157 infection mimicking acute appendicitis: usefulness of computed tomography for differential diagnosis. J Infect Chemother. 2005 Apr;11(2):93-6.

12598.  Kellermayer R, Siitonen HA, Hadzsiev K, Kestila M, Kosztolanyi G. A patient with Rothmund-Thomson syndrome and all features of RAPADILINO. Arch Dermatol. 2005 May;141(5):617-20.

12599.  Leeper NJ, Wener LS, Dhaliwal G, Saint S, Wachter RM. Clinical problem-solving. One surprise after another. N Engl J Med. 2005 Apr 7;352(14):1474-9.

12600. Olaogun AA, Ayandiran O, Olasode OA, Adebayo A, Omokhodion F.  Home management of childhood febrile illnesses in a rural community in Nigeria. Aust J Rural Health. 2005 Apr;13(2):97-101.

12601.  Otegbayo JA, Otegbeye FM, Rotimi O. Microscopic colitis syndrome--a review article. J Natl Med Assoc. 2005 May;97(5):678-82. Review.

12602.  Sher L, Arguedas A, Husseman M, Pichichero M, Hamed KA, Biswas D, Pierce P, Echols R. Randomized, investigator-blinded, multicenter, comparative study of gatifloxacin versus amoxicillin/clavulanate in recurrent otitis media and acute otitis media treatment failure in children. Pediatr Infect Dis J. 2005 Apr;24(4):301-8.

12603.  Sotiriadis A, Makrydimas G, Papatheodorou S, Ioannidis JP. Expectant, medical, or surgical management of first-trimester miscarriage: a meta-analysis. Obstet Gynecol. 2005 May;105(5 Pt 1):1104-13. Review.

12604.  Webb A, Starr M. Acute gastroenteritis in children. Aust Fam Physician. 2005 Apr;34(4):227-31. Review.

12605.   Zerr DM, Blume HK, Berg AT, Del Beccaro MA, Gospe SM Jr, Allpress AL, Christakis DA. Nonfebrile illness seizures: a unique seizure category? Epilepsia. 2005 Jun;46(6):952-5.

Pathogenesis:

12606.  Alderman J. Diarrhea in palliative care. J Palliat Med. 2005 Apr;8(2):449-50.

12607.  Diamond JA, Diamond WJ. Common functional bowel problems. What do homeopathy, Chinese medicine and nutrition have to offer? Adv Nurse Pract. 2005 May;13(5):31-4, 72. Review.

12608.   Fried M, Beglinger C, Bobalj NG, Minor N, Coello N, Michetti P; TegaSwiss Study Group. Tegaserod is safe, well tolerated and effective in the treatment of patients with non-diarrhoea irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2005 Apr;17(4):421-7.

12609.   Kass B. Traveller's diarrhoea. Aust Fam Physician. 2005 Apr;34(4):243-7. Review.

12610.   Kochli A, Tenenbaum-Rakover Y, Leshem M. Increased salt appetite in patients with congenital adrenal hyperplasia 21-hydroxylase deficiency. Am J Physiol Regul Integr Comp Physiol. 2005 Jun;288(6):R1673-81.

12611.  Kwan AC, Chau TN, Tong WL, Tsang OT, Tso EY, Chiu MC, Yu WC, Lai TS. Severe acute respiratory syndrome-related diarrhea. J Gastroenterol Hepatol. 2005 Apr;20(4):606-10.

12612.  Lynn RM, O'Brien SJ, Taylor CM, Adak GK, Chart H, Cheasty T, Coia JE, Gillespie IA, Locking ME, Reilly WJ, Smith HR, Waters A, Willshaw GA.  Childhood hemolytic uremic syndrome, United Kingdom and Ireland. Emerg Infect Dis. 2005 Apr;11(4):590-6.

12613.  Morrow AL, Ruiz-Palacios GM, Jiang X, Newburg DS. Human-milk glycans that inhibit pathogen binding protect breast-feeding infants against infectious diarrhea. J Nutr. 2005 May;135(5):1304-7.

12614.  O'Ryan M, Prado V, Pickering LK. A millennium update on pediatric diarrheal illness in the developing world. Semin Pediatr Infect Dis. 2005 Apr;16(2):125-36. Review.

12615.  Sarrell EM, Horev Z, Cohen Z, Cohen HA. Parents' and medical personnel's beliefs about infant teething. Patient Educ Couns. 2005 Apr;57(1):122-5.

12616.  Taylor CP, LaMont JT. Genetically engineered probiotics: a new twist on an old remedy. Gastroenterology. 2005 May;128(5):1509-12. Review.

Therapy:

12617.  Bajaj P, Sharma SS, Vijayarraghavan KS, Gawde AS, Baliga V, Desai A. Role of cilostazol in clinical practice: an overview. Indian Practitioner. 2005 Feb; 58(2): 85-98.

12618.  Baysan A, Lynch E. The use of ozone in dentistry and medicine. Prim Dent Care. 2005 Apr;12(2):47-52.

12619.  Thiagarajah JR, Verkman AS. New drug targets for cholera therapy. Trends Pharmacol Sci. 2005 Apr;26(4):172-5. Review.

12620.  Yates J. Traveler's diarrhea. Am Fam Physician. 2005 Jun 1;71(11):2095-100. Review.

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