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[PMID]: 29513802
[Au] Autor:Fontes CER; Abreu AP; Gasparim AZ
[Ad] Address:Laboratory of Experimental Surgery.
[Ti] Title:RADIOLOGICAL STUDY OF MEGACOLON IN TRYPANOSOMA CRUZI INFECTED RATS.
[So] Source:Arq Bras Cir Dig;31(1):e1341, 2018 Mar 01.
[Is] ISSN:2317-6326
[Cp] Country of publication:Brazil
[La] Language:eng; por
[Ab] Abstract:BACKGROUND: Researches on Chagas disease still use several animals and rats, due to size and susceptibility were preferred by many authors. AIM: To develop an experimental model of megacolon in rats inoculated with the strain Y of Trypanosoma cruzi. METHODS: Thirty male Wistar rats were distributed in three groups inoculated with different inoculants: Group A: 600000, Group B: 1000000 and Group C: 1500000 blood trypomastigotes of T. cruzi. Animals were sedated intramuscularly at zero inoculation time (T0) and 60 days after inoculation (T60), to perform the barium enema in order to evaluate the dilatation of the different segments of colon in a comparative study of the measurements obtained, using a digital caliper. Evidence of infection was performed by blood smear collected from the animal's tail 18 days after inoculation with observation of blood forms. RESULTS: Comparing the intestinal diameter of the inoculated animals with 60,0000 trypomastigotes in the T0 of infection with T60 days after the inoculation, significant dilatation was observed between the proximal, medial and distal segments (p<0.01), indicating the establishment of the megacolon model. In addition, comparing intestinal diameter between the different segments, with in the T0 of infection and the T60 after inoculation, significant alterations were observed (p<0.05). CONCLUSION: The proposed model was possible for in vivo studies of alterations due to infection by T. cruzi and functional alterations of the colon. In addition, the changes manifested in the colon are not directly proportional to the size of the inoculum, but to the time of infection that the animals were submitted, since the animals inoculated with 60,0000 blood forms were the ones which presented the most significant alterations.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process

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[PMID]: 29501836
[Au] Autor:McGuire E; Tiberi S; Ciesielczuk H; Melzer M
[Ad] Address:Division of Infection, Barts Health NHS Trust, London, United Kingdom. Electronic address: emma.mcguire@bartshealth.nhs.uk.
[Ti] Title:Shigellosis and toxic megacolon secondary to Shigella flexneri serotype 3a: the challenges of laboratory diagnosis.
[So] Source:Int J Infect Dis;, 2018 Mar 01.
[Is] ISSN:1878-3511
[Cp] Country of publication:Canada
[La] Language:eng
[Ab] Abstract:We present a rare case of Shigella flexneri bacteraemia and toxic megacolon, and discuss the challenges of conventional laboratory techniques versus molecular PCR platforms in differentiating between Shigella species and Escherichia coli.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180304
[Lr] Last revision date:180304
[St] Status:Publisher

  3 / 6729 MEDLINE  
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Martinelli, Patrícia Massara
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[PMID]: 29470711
[Au] Autor:Martins PR; Nascimento RD; Dos Santos AT; de Oliveira EC; Martinelli PM; d'Avila Reis D
[Ad] Address:Morphology Department, Federal University of Minas Gerais, Belo Horizonte, 31.270-901, Brazil.
[Ti] Title:Mast cell-nerve interaction in the colon of Trypanosoma cruzi-infected individuals with chagasic megacolon.
[So] Source:Parasitol Res;, 2018 Feb 22.
[Is] ISSN:1432-1955
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Chagas disease is an infection caused by the parasite Trypanosoma cruzi that affects millions of people worldwide and is endemic in Latin America. Megacolon is the most frequent complication of the digestive chronic form and happens due to lesions of the enteric nervous system. The neuronal lesions seem to initiate in the acute phase and persist during the chronic phase, albeit the mechanisms involved in this process are still debated. Among the cells of the immune system possibly involved in this pathological process is the mast cell (MC) due to its well-known role in the bi-directional communication between the immune and nervous systems. Using ultrastructural analysis, we found an increased number of degranulated MCs in close proximity to nerve fibers in infected patients when compared with uninfected controls. We also immunostained MCs for the two pro-inflammatory molecules tryptase and chymase, the first being also important in neuronal death. The number of MCs immunostained for tryptase or chymase was increased in patients with megacolon, whereas increased tryptase staining was additionally observed in patients without megacolon. Moreover, we detected the expression of the tryptase receptor PAR2 in neurons of the enteric nervous system, which correlated to the tryptase staining results. Altogether, the data presented herein point to the participation of MCs on the denervation process that occurs in the development of T. cruzi-induced megacolon.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:Publisher
[do] DOI:10.1007/s00436-018-5792-z

  4 / 6729 MEDLINE  
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[PMID]: 29273940
[Au] Autor:Simon A; Mock M; Graf N; von Müller L
[Ad] Address:Pediatric Oncology and Hematology, Saarland University Hospital, Saar, Homburg, Germany. Arne.Simon@uks.eu.
[Ti] Title:Investigation of Clostridium difficile ribotypes in symptomatic patients of a German pediatric oncology center.
[So] Source:Eur J Pediatr;177(3):403-408, 2018 Mar.
[Is] ISSN:1432-1076
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:In a German pediatric oncology unit, the attending physicians diagnosed 27 cases of Clostridium difficile-associated disease (CDI) from January 01, 2010 to October 31, 2013. This refers to a CDI incidence density of 2.0/1000 inpatient days. According to the hospital hygiene standard, symptomatic patients with CDI were kept in contact isolation. Most patients (median age 8.2 years) suffered from acute lymphoblastic leukemia; 88.9% were treated with broad-spectrum antibiotics during the preceding 4 weeks. 29.6% received intravenous morphine/metamizole and parenteral nutrition due to severe chemotherapy-induced mucositis. None of the patients experienced severe complications such as lower gastrointestinal tract bleeding, sepsis, or toxic megacolon. Genotyping of the isolates derived from symptomatic patients revealed many different ribotypes without detection of the hypervirulent 027 strain and did not point at hospital transmission as an important promoter of CDI in our unit. CONCLUSION: Under strict standard hygiene and contact isolation for symptomatic patients, genotyping of clinical isolates revealed that in pediatric cancer patients, CDI is not necessarily based on nosocomial transmission. The rate of CDI-related severe complications was low. What is Known: • Pediatric cancer patients face an increased risk of Clostridium difficile-associated disease due to immunosuppression, cancer chemotherapy, mucositis, and dysbiosis following intravenous broad-spectrum antimicrobial treatment. • C. difficile may be transmitted from patient to patient. What is New: • Under strict standard hygiene and contact isolation for symptomatic patients, genotyping of clinical isolates revealed that in pediatric cancer patients, CDI is not necessarily based on nosocomial transmission. • The rate of CDI-related severe complications was low.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:In-Process
[do] DOI:10.1007/s00431-017-3070-1

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[PMID]: 29459800
[Au] Autor:Borda Mederos LA; Kcam Mayorca EJ; Alarcon Aguilar P; Miranda Rosales LM
[Ad] Address:Servicio de Cirugía Colorectal, Hospital Nacional Guillermo Almenara. Lima, Perú; Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima, Perú.
[Ti] Title:Megacolon andino y vólvulo del sigmoides de la altura. Presentación de 418 casos entre 2008 - 2012 en el hospital C. Monge Puno, Perú. [Andean megacolon and sigmoid volvulus in the high altitude. Presentation of 418 cases between 2008 - 2012 at C. Monge Hospital, Puno, Peru].
[So] Source:Rev Gastroenterol Peru;37(4):317-322, 2017 Oct-Dec.
[Is] ISSN:1609-722X
[Cp] Country of publication:Peru
[La] Language:spa
[Ab] Abstract:OBJECTIVE: The present study describes the medical and surgical management of sigmoid volvulus due to Andean dolicomegacolon in a hospital at an altitude above 3000 m. MATERIAL AND METHODS: A descriptive, observational, crosssectional study of 418 patients diagnosed with sigmoid volvulus; Admitted initially due to intestinal obstruction, in the Hospital of Juliaca Carlos Monge. Puno-Perú, during the period 2008-2012. The data were processed through the SPSS software version 21. RESULTS: A total of 418 patients were enrolled, the mean age was 60 years, range 18-89 years, and the male/female ratio was 3.5/1. Nonsurgical management was done in 64 (15.4%), the treatment used was saline enema 20 cases (31%) and rectal catheter 44 (69%), recurrence was present in 27 patients (45%), who had surgery with primary anastomosis resection, of which the mortality corresponded to 8 patients (30%). Of the 354 patients undergoing emergency surgical management, 325 were submitted to sigmoidectomy with primary anastomosis (92%), while 29 had Hartmann's colostomy (8%), the morbidity for both procedures was 52 cases (14.7%), Mortality for both procedures was 45 cases (12.7%). CONCLUSIONS: In patients with sigmoid volvulus due to Andean megacolon the mean age was 60 years. The 15.4% had non-surgical management, the recurrence rate was 45%, and mortality 30%. Patients with surgical management was 84.7%, from this group; 92% had primary anastomosis resection and 8% Hartmann colostomy, morbidity was 14.7% and mortality was 12.7%.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:In-Process

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[PMID]: 29385992
[Au] Autor:Cuda T; Gunnarsson R; de Costa A
[Ad] Address:Cairns Clinical School, College of Medicine and Dentistry, James Cook University, 451 Draper Street, Cairns, QLD, 4870, Australia. tahleesa.cuda@gmail.com.
[Ti] Title:Symptoms and diagnostic criteria of acquired Megacolon - a systematic literature review.
[So] Source:BMC Gastroenterol;18(1):25, 2018 Jan 31.
[Is] ISSN:1471-230X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Acquired Megacolon (AMC) is a condition involving persistent dilatation and lengthening of the colon in the absence of organic disease. Diagnosis depends on subjective radiological, endoscopic or surgical findings in the context of a suggestive clinical presentation. This review sets out to investigate diagnostic criteria of AMC. METHODS: The literature was searched using the databases - PubMed, Medline via OvidSP, ClinicalKey, Informit and the Cochrane Library. Primary studies, published in English, with more than three patients were critically appraised based on study design, methodology and sample size. Exclusion criteria were studies with the following features: post-operative; megarectum-predominant; paediatric; organic megacolon; non-human; and failure to exclude organic causes. RESULTS: A review of 23 articles found constipation, abdominal pain, distension and gas distress were predominant symptoms. All ages and both sexes were affected, however, symptoms varied with age. Changes in anorectal manometry, histology and colonic transit are consistently reported. Studies involved varying patient numbers, demographics and data acquisition methods. CONCLUSIONS: Outcome data investigating the diagnosis of AMC must be interpreted in light of the limitations of the low-level evidence studies published to date. Proposed diagnostic criteria include: (1) the exclusion of organic disease; (2) a radiological sigmoid diameter of ~ 10 cm; (3) and constipation, distension, abdominal pain and/or gas distress. A proportion of patients with AMC may be currently misdiagnosed as having functional gastrointestinal disorders. Our conclusions are inevitably tentative, but will hopefully stimulate further research on this enigmatic condition.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180214
[Lr] Last revision date:180214
[St] Status:In-Process
[do] DOI:10.1186/s12876-018-0753-7

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[PMID]: 29350896
[Au] Autor:Milickovic M; Savic D; Stankovic N; Vukadin M; Bozic D
[Ti] Title:Transverse colon volvulus in neurologicaly imparied patient as an emergency surgical condition: A case report.
[So] Source:Vojnosanit Pregl;74(1):78-80, 2017 Jan.
[Is] ISSN:0042-8450
[Cp] Country of publication:Serbia
[La] Language:eng
[Ab] Abstract:Introduction: Transverse colon volvulus is an uncommon cause of bowel obstruction in general. Predisposing factors are mental retardation, dysmotility disorders, chronic constipation and congenital megacolon. Case report: We presented transverse colon volvulus in a 16-year-old boy with cerebral palsy. Chronic constipation in neurologicaly impaired patient was a risk factor predisposing to volvulus. The patient was admitted to the hospital with enormous abdominal distension and acute respiratory insufficiency. A boy was emergently taken to the operating room for exploratory laparotomy. During the surgery, a 360º clockwise volvulus of the transverse colon was found. After reduction of volvulus, an enormous transverse colon was resected and colostomy was formed. In the postoperative period, despite the good functioning of stoma and intraabdominal normotension, numerous and long lasting respiratory problems developed. The patient was discharged from our institution after 8 months. Conclusion: Though very rare in pediatric group, the possibility of a transverse colon volvulus must be considered in the differential diagnosis of acute large bowel obstruction.
[Mh] MeSH terms primary: Cerebral Palsy/complications
Colectomy
Colon, Transverse/surgery
Colonic Diseases/surgery
Colostomy
Intestinal Volvulus/surgery
[Mh] MeSH terms secundary: Adolescent
Cerebral Palsy/diagnosis
Cerebral Palsy/physiopathology
Colon, Transverse/diagnostic imaging
Colonic Diseases/complications
Colonic Diseases/diagnostic imaging
Emergencies
Humans
Intestinal Volvulus/complications
Intestinal Volvulus/diagnostic imaging
Length of Stay
Male
Postoperative Complications/etiology
Time Factors
Treatment Outcome
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[Js] Journal subset:IM
[Da] Date of entry for processing:180120
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150911015M

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[PMID]: 29186093
[Au] Autor:Polukhov RS
[Ad] Address:Azerbaijan Medical University, Baku, Azerbaijan Republic.
[Ti] Title:Operatsiia Rebeina pri vtorichnom megakolon u detei. [Rehbein procedure for secondary megacolon in children].
[So] Source:Khirurgiia (Mosk);(11):28-31, 2017.
[Is] ISSN:0023-1207
[Cp] Country of publication:Russia (Federation)
[La] Language:rus
[Ab] Abstract:AIM: To evaluate the results of Rehbein procedure with extraperitoneal colorectal anastomosis combined with complex conservative treatment in children with secondary megacolon due to chronic constipation. MATERIAL AND METHODS: We carried out surgical interventions in 78 children aged 7-12 years with chronic colostasis resistant to conservative treatment. All patients underwent clinical, laboratory and instrumental examination. All patients were divided into 3 groups depending on type of surgery: group I - colon resection followed by intraperitoneal colorectal anastomosis (28 patients), group II - open Rehbein procedure (29 patients), group III - laparoscopic Rehbein procedure (21 patients). RESULTS: Absence of dyspeptic disorders and enterocolitis in remote postoperative period in patients receiving comprehensive treatment enhanced with new additions is the cause of improved outcomes. Type of surgery should be individualized in view of anatomical colon changes and secondary pathological conditions. Some pathological symptoms observed at preoperative period may be recurrent in long-term postoperative period due to wrong selection of surgery. The risk of recurrent chronic constipation is high after colon resection followed by intraperitoneal colorectal anastomosis. CONCLUSION: Rehbein procedure may be preferred for management of secondary megarectum and megasigma. Laparoscopic technique reduces surgical trauma and requires less postoperative analgesia.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Process
[do] DOI:10.17116/hirurgia20171128-31

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[PMID]: 29413206
[Au] Autor:Frazer C; Hussey L; Bemker M
[Ad] Address:College of Health Sciences, School of Nursing, Walden University, 100 Washington Avenue South, Suite 900, Minneapolis, MN 55401, USA. Electronic address: christine.frazer@mail.waldenu.edu.
[Ti] Title:Gastrointestinal Motility Problems in Critically Ill Patients.
[So] Source:Crit Care Nurs Clin North Am;30(1):109-121, 2018 Mar.
[Is] ISSN:1558-3481
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Gastrointestinal (GI) motility problems are common complications in critical care patients. GI problems contribute to an increased risk of morbidity and mortality. Toxic megacolon (TM) is a type of acquired megacolon categorized as a medical emergency and includes severe inflammation affecting all layers of the colon wall. The high incidence of GI complications in critically ill patients requires the critical care nurse to provide close monitoring of patients at risk and an acute awareness of the causation, signs and symptoms, and treatment of various GI motility disorders, including gastroparesis, ileus, and TM.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180207
[Lr] Last revision date:180207
[St] Status:In-Process

  10 / 6729 MEDLINE  
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[PMID]: 29291715
[Au] Autor:Groß U; Brzuszkiewicz E; Gunka K; Starke J; Riedel T; Bunk B; Spröer C; Wetzel D; Poehlein A; Chibani C; Bohne W; Overmann J; Zimmermann O; Daniel R; Liesegang H
[Ad] Address:Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
[Ti] Title:Comparative genome and phenotypic analysis of three Clostridioides difficile strains isolated from a single patient provide insight into multiple infection of C. difficile.
[So] Source:BMC Genomics;19(1):1, 2018 01 02.
[Is] ISSN:1471-2164
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Clostridioides difficile infections (CDI) have emerged over the past decade causing symptoms that range from mild, antibiotic-associated diarrhea (AAD) to life-threatening toxic megacolon. In this study, we describe a multiple and isochronal (mixed) CDI caused by the isolates DSM 27638, DSM 27639 and DSM 27640 that already initially showed different morphotypes on solid media. RESULTS: The three isolates belonging to the ribotypes (RT) 012 (DSM 27639) and 027 (DSM 27638 and DSM 27640) were phenotypically characterized and high quality closed genome sequences were generated. The genomes were compared with seven reference strains including three strains of the RT 027, two of the RT 017, and one of the RT 078 as well as a multi-resistant RT 012 strain. The analysis of horizontal gene transfer events revealed gene acquisition incidents that sort the strains within the time line of the spread of their RTs within Germany. We could show as well that horizontal gene transfer between the members of different RTs occurred within this multiple infection. In addition, acquisition and exchange of virulence-related features including antibiotic resistance genes were observed. Analysis of the two genomes assigned to RT 027 revealed three single nucleotide polymorphisms (SNPs) and apparently a regional genome modification within the flagellar switch that regulates the fli operon. CONCLUSION: Our findings show that (i) evolutionary events based on horizontal gene transfer occur within an ongoing CDI and contribute to the adaptation of the species by the introduction of new genes into the genomes, (ii) within a multiple infection of a single patient the exchange of genetic material was responsible for a much higher genome variation than the observed SNPs.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1801
[Cu] Class update date: 180207
[Lr] Last revision date:180207
[St] Status:In-Process
[do] DOI:10.1186/s12864-017-4368-0


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