Methodology and application of Escherichia coli F4 and F18 encoding infection models in post-weaning pigs

The enterotoxigenic Escherichia coli (ETEC) expressing F4 and F18 fimbriae are the two main pathogens associated with post-weaning diarrhea (PWD) in piglets.The growing global concern regarding antimicrobial resistance (AMR) has encouraged research into the development of nutritional and feeding strategies as well as vaccination protocols in order to counteract the PWD due to ETEC.A valid approach to researching effective strategies is to implement piglet in vivo challenge models with ETEC infection.Thus,the proper application and standardization of ETEC F4 and F18 challenge models represent an urgent priority.The current review provides an overview regarding the current piglet ETEC F4 and F18 challenge models;it highlights the key points for setting the challenge protocols and the most important indicators which should be included in research studies to verify the effectiveness of the ETEC challenge.Based on the current review,it is recommended that the setting of the model correctly assesses the choice and preconditioning of pigs,and the timing and dosage of the ETEC inoculation.Furthermore,the evaluation of the ETEC challenge response should include both clinical parameters (such as the occurrence of diarrhea,rectal temperature and bacterial fecal shedding) and biomarkers for the specific expression of ETEC F4/F18 (such as antibody production,specific F4/F18 immunoglobulins (lgs),ETEC F4/F18 fecal enumeration and analysis of the F4/F18 receptors expression in the intestinal brush borders).On the basis of the review,the piglets' response upon F4 or F18 inoculation differed in terms of the timing and intensity of the diarrhea development,on ETEC fecal shedding and in the piglets' immunological antibody response.This information was considered to be relevant to correctly define the experimental protocol,the data recording and the sample collections.Appropriate challenge settings and evaluation of the response parameters will allow future research studies to comply with the replacement,reduction and refinement (3R) approach,and to be able to evaluate the efficiency of a given feeding,nutritional or vaccination intervention in order to combat ETEC infection.

Sow performance in response to natural betaine fed during lactation and post-weaning during summer and non-summer months

Background: Two studies were conducted to evaluate the effects of dietary natural betaine on sow reproductive performance during summer(Exp. 1) and non-summer months(Exp. 2). Treatments were designed as a 2 × 2 factorial arrangement with factors including dietary betaine(0 or 0.2%) and period of supplementation(lactation or post-weaning until 35 days post-insemination). In Exp. 1, 322 and 327 sows and in Exp. 2, 300 and 327 sows representing young(parity 1 and 2) and mature(parity 3 to 6) sows, respectively, were used.Results: In Exp. 1, supplementation of betaine during lactation increased sow body weight losses(-11.95 vs.-14.63 kg;P = 0.024), reduced feed intake(4.12 vs. 4.28 kg/d;P = 0.052), and tended to reduce percentage of no-value pigs(P = 0.071). Betaine fed post-weaning reduced weaning-to-estrus interval(5.75 vs. 6.68 days;P = 0.054) and farrowing rate(86.74% vs. 91.36%;P = 0.060), regardless of parity group. Post-hoc analysis with sows clustered into 3 parity groups(1, 2 and 3, and 4+) indicated that betaine fed in lactation to parity 4+ sows(P = 0.026) and betaine fed post-weaning to parity 1 sows increased the number of pigs born in the subsequent cycle(P ≤ 0.05). In Exp. 2, betaine fed during lactation tended to reduce the weaning-to-estrus interval(6.64 vs. 7.50 days;P = 0.077) and farrowing rate(88.23% vs.83.54%;P = 0.089), regardless of parity group. Feeding betaine post-weaning reduced number of pigs born(13.00 vs.13.64;P = 0.04) and pigs born alive(12.30 vs. 12.82;P = 0.075), regardless of parity group.Conclusions: Using 0.2% betaine during the non-summer months did not benefit sow performance. During the summer, betaine supplementation in lactation increased subsequent litter size in parity 4+ sows. Betaine fed during the post-weaning period reduced the wean-to-estrus interval and farrowing rate, increased total number of pigs born for parity 1 sows and reduced total number of pigs born to parity 4+ sows. Further research is needed to determine if the detrimental effects on feed intake and farrowing rate may be correlated and depend on dietary betaine level.

Tannic acid prevents post-weaning diarrhea by improving intestinal barrier integrity and function in weaned piglets

Background:Tannic acid(TA)is potential to reduce diarrhea in weaning pigs,but knowledge about the influence of TA on intestinal barrier integrity and function is still scarce.This experiment was conducted to investigate the effects of dietary TA supplementation on growth performance,diarrhea rate,intestinal barrier integrity and function of weaned pigs.Methods:A total of 108 crossbred(Duroc×Landrace×Yorkshire)piglets,with an initial average body weight of 6.60±0.27 kg,were allotted to 3 groups(6 pigs/pen and 6 replicates/group)in a randomized complete block design according to their gender and body weight.Piglets were fed the basal diet with 0(control,CON),0.2%and 1.0%TA,respectively.The trial lasted for 28 d.Results:Compared with the CON group,dietary 0.2%and 1.0%TA supplementation didn’t affect ADFI,ADG and F:G(P>0.05),but reduced diarrhea rate,diarrhea index and diarrhea score of piglets(P<0.05),reduced diamine oxidase(DAO)activity and D-lactic acid concentration in serum(P<0.01).The higher occludin expression and localization were observed in the duodenum,jejunum and ileum after supplementation with 0.2%or 1.0%TA(P<0.05).Adding 0.2%TA to diet significantly decreased crypt depth,increased villus height/crypt depth ratio in the duodenum(P<0.05),and dietary 1.0%TA tended to decrease crypt depth(P<0.10)and significantly decreased villus height(P<0.05)of the ileum.Moreover,lower malondialdehyde content in the ileum was detected in the pigs fed 1.0%TA(P<0.05).In the duodenum,both 0.2%and 1.0%TA groups had higher occludin(OCLN)mRNA and 0.2%TA group had higher zonula occludens-2(ZO-2)level(P<0.05).Meanwhile,dietary 1.0%TA supplementation tended to up-regulate OCLN mRNA levels in the jejunum(P<0.10)and 0.2%TA supplementation tended to up-regulate zonula occludens-1(ZO-1)mRNA levels in the ileum(P<0.10).Conclusion:In conclusion,dietary supplementation of 0.2%or 1.0%TA could effectively alleviate postweaning diarrhea without altering growth performance in weaned piglets,which might be achieved by improving intestinal barrier integrity and function.

Household Survey on Access to Medicines Used for the Treatment of Diarrhoea in Musoma Municipal Council, Tanzania

Background: Access to medicines is part of the human right to health. According to WHO, access to medicine is measured by how easily households obtain medicines for acute and chronic conditions including diarrhoea through household surveys. Diarrhoea is among the top ten leading causes of death. Anti-diarrhoea medicines save lives but, should be available and obtainable to do so. The objectives of this study were to determine anti-diarrhoea medicines used by households, their sources and factors affecting their accessibility in Musoma Municipal. Methods: A cross-section survey was conducted in Musoma Municipal Council, Mara, Tanzania. The lottery method of simple random sampling was used to select three wards and pick three streets from each ward. The study population was 255 household heads from households selected by systematic random sampling from each street. A structured questionnaire was used to obtain information from household heads. Results and Discussion: Males (51.8%) had more diarrhoea illnesses than females (48.2%). Distinctive household heads (52.6%) had primary education. The majority, (79.1%) of all diarrhoea patients were recommended/prescribed anti-diarrhoea medicines. Of those whom anti-diarrhoea medicines were prescribed/recommended, 63.5% adhered to the prescriber’s/dispenser’s instructions and obtained and used anti-diarrhoea medicines. The most frequent source of anti-diarrhoea medicines was ADDO (38%). Widely used anti-diarrhoea medicines were antimicrobials (77.5%) followed by ORS (17.5%). Reasons not to seek or obtain anti-diarrhoea medicines were;Patient started feeling better (56.3%), Alternative treatment (26%), Financial reasons (10%), Decided medicines weren’t needed (3.5%), Distance from source (2.2%), Reactions to medicine (1%). Utilization of primary health care services was only 21.5%. Under-fives were mostly prescribed with antimicrobials (62.5%) than ORS (31.2%) and Zinc (6.3%) in mild to moderate dehydration contrary to Standard treatment guidelines (STG) in Tanzania. Conclusion: Anti-diarrhoea medicines are moderately easily obtainable in Musoma Municipal (50% of all diarrhoea patients obtained medicines). Alternative treatment (26%) and financial reasons (10%) were vivid factors hindering access. Treatment of diarrhoea in under-five years old is not adhered to in Musoma Municipal (use of 62.5% of antimicrobials and only 31.2% of ORS in mild diarrhoea cases).

Diagnosis and treatment of post-cholecystectomy diarrhoea

The incidence of cholecystitis is relatively high in developed countries and may usually be attributed to gallstones,the treatment for which involves complete surgical removal of the gallbladder(cholecystectomy).Bile acids produced following cholecystectomy continue to flow into the duodenum but are poorly absorbed by the colon.Excessive bile acids in the colon stimulate mucosal secretion of water and electrolytes leading,in severe cases,to diarrhoea.Bile acid diarrhoea(BAD)is difficult to diagnose,requiring a comprehensive medical history and physical examination in combination with laboratory evaluation.The current work reviews the diagnosis and treatment of BAD following chole-cystectomy.

Effectiveness of traditional Chinese medicine in treating AIDS related diarrhoea:a meta-analysis

Background:To evaluate the efficacy of traditional Chinese medicine(TCM)in treating Acquired Immune Deficiency Syndrome(AIDS)related diarrhoea.Methods:Chinese and English databases(CBM,CNKI,Wanfang Database,PubMed,Web of Science,Cochrane Library)were searched up to November 2021.Studies that compared TCM with western medicine were included.RevMan 5.4,Stata 17,and Grading of Recommendations Assessment Development and Evaluation system were used for data analyses.The inclusion and exclusion criteria,quality assessment process,and potential biases were specified.Result:24 randomized controlled trial with a total of 1,766 participants of TCM compared with western medicine were included,12 of which reported random assignment methods.Meta-analyses showed that,TCM was more effective than western medicine in treating AIDS-related diarrhoea[RR=1.32,95%CI(1.26,1.39),P<0.01],internal treatment of TCM[RR=1.37,95%CI(1.28,1.46),P<0.01],external treatment of TCM[RR=1.27,95%CI(1.17,1.39)],internal and external treatment of TCM[RR=1.21,95%CI(1.07,1.37),P<0.01],Shenlingbaizhu Powder/Pill[RR=1.25,95%CI(1.13,1.39),P<0.01],Xielikang Capsules[RR=1.57,95%CI(1.33,1.84),P<0.01],Jianpizhixie Recipe[RR=1.31,95%CI(1.05,1.65),P<0.01],Moxibustion[RR=1.19,95%CI(1.07,1.32),P<0.01],Ginger Moxibustion[RR=1.24,95%CI(1.04,1.47),P<0.01],when compared to using western medicine alone and with significant differences.Conclusion:Shenlingbaizhu Powder/Pill,Xielikang Capsules,Jianpizhixie Recipe,Moxibustion and Ginger Moxibustion had certain advantages in improving the effective rate of AIDS-related diarrhoea,they needed to be further validated by high quality clinical trials.

犊牛腹泻的病因及中草药治疗研究进展

犊牛腹泻是影响犊牛生长发育的主要疾病之一。造成犊牛腹泻的因素有细菌、病毒、寄生虫性腹泻及非感染因素。细菌性腹泻是犊牛临床常见的腹泻原因之一,其发生机制主要是细菌进入肠道后大量增殖,破坏肠道菌群的平衡,进而对犊牛的肠黏膜屏障造成严重破坏。中草药具有调节机体肠道菌群、增强免疫功能、降低犊牛腹泻率等作用。文章对犊牛腹泻的病因及其中草药治疗研究进展进行综述,为中草药临床治疗犊牛腹泻的应用提供参考。

《重订古今名医临证金鉴·腹泻便秘卷》论治泄泻用药规律分析

目的:通过探讨古今名医治疗泄泻的用药规律,为临床用药提供借鉴。方法:收集整理《重订古今名医临证金鉴·腹泻便秘卷》中古今名医治疗泄泻的有效处方,共纳入49位医家治疗泄泻的处方204首,将处方所涉及的单味中药录入Excel 2022软件建立用药数据库,应用SPSS Modeler 18.0统计学软件提供的Apriori算法进行单味药物频次分析、关联分析,应用SPSS Statistics 27.0统计学软件进行聚类分析,通过多角度挖掘治疗泄泻的用药规律与特征。结果:共纳入49位名医治疗泄泻的处方204首,涉及药物230味,用药频次1731次,用药频次高达30次以上的中药有甘草、白术、茯苓、白芍、陈皮、木香等12味。关联规则按支持度≥10%、置信度≥80%,获得“茯苓+甘草→白术”“陈皮+茯苓→白术”“白芍+茯苓→白术”等11个核心药对;聚类分析得到5个组合。结论:通过药物频次分析、关联分析等方法研究古今名医治疗泄泻的用药规律与特征,为临床治疗泄泻用药提供了参考与借鉴。

酵母肽和枯草肽对断奶仔猪生长性能、腹泻率和肠道健康的影响

【目的】旨在研究酵母肽和枯草肽对断奶仔猪生长性能、腹泻率和肠道健康的影响,为抗菌肽在仔猪养殖中的合理利用提供参考依据。【方法】生长试验选取21日龄“杜×长×大”三元杂健康断奶仔猪200头,随机分为5组,每组5个重复,每个重复8头。分别饲喂基础日粮、基础日粮+300 mg/kg酵母肽、基础日粮+500 mg/kg酵母肽、基础日粮+300 mg/kg枯草肽和基础日粮+300 mg/kg酵母肽+300 mg/kg枯草肽,预饲期7 d,正式试验28 d。诱导腹泻试验选取28日龄“杜×长×大”三元杂健康断奶仔猪30头,随机分成3组,每组10头。分别饲喂基础日粮、基础日粮+300 mg/kg酵母肽和基础日粮+500 mg/kg酵母肽,预饲期7 d,正式试验8 d,前3 d用未经氯化消毒井水拌料饲喂诱导腹泻,后5 d用氯化消毒井水拌料饲喂。【结果】(1)生长试验中日粮添加不同剂量酵母肽和枯草肽对断奶仔猪的生长性能无显著影响(P>0.05),但诱导腹泻试验中,酵母肽成剂量依赖性降低仔猪腹泻率;(2)添加500 mg/kg酵母肽显著提高仔猪血液中谷胱甘肽过氧化物酶(GSH-PX)的活力;(3)添加枯草肽300 mg/kg显著提高空肠绒毛高度和绒/隐比(P<0.05)和空肠紧密连接蛋白Claudin-1的mRNA表达量(P<0.05)。(4)添加300 mg/kg酵母肽+300 mg/kg枯草肽能显著降低血液中白介素-1β(IL-1β)的含量(P<0.05),提高空肠绒毛高度和隐窝深度(P<0.05),同时显著升高Coverage指数(P<0.05),Simpson指数有升高的趋势(0.05<P<0.1)。【结论】饲料中添加500 mg/kg的酵母肽能够有效预防仔猪腹泻的发生,提高免疫球蛋白水平,抗氧化能力。单独添加300 mg/kg枯草肽或混合添加300 mg/kg酵母肽和300 mg/kg枯草肽可以增加肠道吸收和屏障功能,降低肠道炎症,改善肠道微生物的多样性。

ICU老年有创机械通气患者早期肠内营养喂养不耐受现状及影响因素分析

目的:调查ICU老年有创机械通气患者喂养不耐受的现状并探究其影响因素,为识别喂养不耐受高危人群提供理论依据。方法:本研究选取实施肠内营养支持治疗的老年有创机械通气患者202例作为研究对象。采用一般情况资料调查表、肠内营养不耐受状况调查表进行持续5 d的数据收集,采用二元Logistic回归方程进行多因素分析。结果:二元Logistic回归结果显示,鼻饲速度>40 mL·h^(-1)(OR=5.826)、使用血管活性药物(OR=2.581)、呼吸末正压增高(OR=0.821)、低血清白蛋白(OR=1.050)是老年有创机械通气患者喂养不耐受的危险因素,床头抬高≥30°(OR=0.339)、使用可溶性膳食纤维(0R=0.325)是老年有创机械通气患者喂养不耐受的保护因素,差异具有统计学意义(P<0.05)。结论:鼻饲速度、血管活性药物、呼吸末正压、血清白蛋白、床头抬高≥30°、使用可溶性膳食纤维是老年有创机械通气患者喂养不耐受的影响因素,临床工作中应关注以上因素以预测患者喂养不耐受的发生,保证患者营养供给,改善患者预后。

Effects of early postnatal gastric and colonic microbiota transplantation on piglet gut health

Background Diarrhea is a major cause of reduced growth and mortality in piglets during the suckling and weaning periods and poses a major threat to the global pig industry.Diarrhea and gut dysbiosis may in part be prevented via improved early postnatal microbial colonization of the gut.To secure better postnatal gut colonization,we hypothesized that transplantation of colonic or gastric content from healthy donors to newborn recipients would prevent diarrhea in the recipients in the post-weaning period.Our objective was to examine the impact of transplanting colonic or gastric content on health and growth parameters and paraclinical parameters in recipient single-housed piglets exposed to a weaning transition and challenged with enterotoxigenic Escherichia coli(ETEC).Methods Seventy-two 1-day-old piglets were randomized to four groups:colonic microbiota transplantation(CMT,n=18),colonic content filtrate transplantation(CcFT,n=18),gastric microbiota transplantation(GMT,n=18),or saline(CON,n=18).Inoculations were given on d 2 and 3 of life,and all piglets were milk-fed until weaning(d 20)and shortly after challenged with ETEC(d 24).We assessed growth,diarrhea prevalence,ETEC concentration,organ weight,blood parameters,small intestinal morphology and histology,gut mucosal function,and microbiota composition and diversity.Results Episodes of diarrhea were seen in all groups during both the milk-and the solid-feeding phase,possibly due to stress associated with single housing.However,CcFT showed lower diarrhea prevalence on d 27,28,and 29 compared to CON(all P<0.05).CcFT also showed a lower ETEC prevalence on d 27(P<0.05).CMT showed a higher alpha diversity and a difference in beta diversity compared to CON(P<0.05).Growth and other paraclinical endpoints were similar across groups.Conclusion In conclusion,only CcFT reduced ETEC-related post-weaning diarrhea.However,the protective effect was marginal,suggesting that higher doses,more effective modalities of administration,longer treatment periods,and better donor quality should be explored by future research to optimize the protective effects of transplantation.

基于“脾主困”思想论治小儿泄泻

小儿泄泻与诸滞困脾关系密切。滞分虚实,虚滞为中土脏虚所生,实滞为寒食湿热及无形中气壅滞,多有虚实夹杂。小儿脾常不足,滞邪困脾,脾失运化,气机枢转反作,清阳不升,携未化谷液合污而下,发为泄泻。临证中,当以“解湿运脾,行滞调气”为治疗原则,善用醒脾运脾,辛温辛平轻清味药以复脾之生理,审证求因,行诸滞,使运化有节,升降有度。

复方谷氨酰胺肠溶胶囊联合双歧杆菌四联活菌片治疗肠道菌群失调相关性腹泻的疗效

目的观察复方谷氨酰胺肠溶胶囊联合双歧杆菌四联活菌片治疗肠道菌群失调相关性腹泻的疗效。方法选取2022年中国人民解放军陆军第七十三集团军医院收治的肠道菌群失调相关性腹泻患者100例,按双色球法分为双歧杆菌组(n=50)与联合治疗组(n=50)。双歧杆菌组给予双歧杆菌四联活菌片治疗,联合治疗组在双歧杆菌组基础上联合复方谷氨酰胺肠溶胶囊治疗,2组均治疗30 d。比较2组临床疗效,治疗前与治疗30 d后真菌感染、细菌计数减少、杆球比例倒置情况及世界卫生组织生存质量测定量表简表(WHOQOL-BREF)(生理、心理、社会关系、环境)评分、症状(腹胀、排便急迫感、腹痛、腹泻)积分,不良反应。结果联合治疗组总有效率高于双歧杆菌组(96.00%vs.82.00%,χ^(2)=5.005,P=0.025)。治疗30 d后,2组真菌感染、细菌计数减少、杆球比例倒置者占比低于治疗前,且联合治疗组低于双歧杆菌组(P<0.01);2组生理、心理、社会关系、环境评分高于治疗前,且联合治疗组高于双歧杆菌组(P<0.01);2组腹胀、排便急迫感、腹痛、腹泻积分低于治疗前,且联合治疗组低于双歧杆菌组(P<0.01)。双歧杆菌组不良反应总发生率为6.00%,与联合治疗组的2.00%比较,差异无统计学意义(χ^(2)=0.260,P=0.610)。结论复方谷氨酰胺肠溶胶囊联合双歧杆菌四联活菌片治疗肠道菌群失调相关性腹泻可提高临床疗效,改善患者肠道微生物环境,减轻临床症状,提高患者的生活质量,且安全性较高。

Potential antibacterial activity of berberine against multi drug resistant enterovirulent Escherichia coli isolated from yaks(Poephagus grunniens) with haemorrhagic diarrhoea

Objective:To evaluate the antimicrobial efficacy of berberine,a plant alkaloid.Methods:Five multi-drug resistant（MDR） STEC/EPEC and five MDR ETEC isolates from yaks with haemorrhagic diarrhoea were selected for the study.Antibacterial activity of berberine was evaluated by broth dilution and disc diffusion methods.The binding kinetics of berberine to DNA and protein was also enumerated.Results:For both categories of enterovirulent Escherichia coli（E.roli） isolates, berberine displayed the antibaclerial effect in a dose dependent manner.The MIC50 of berberine chloride for STEC/EPEC isolates varied from 2.07μM to 3.6μM with a mean of（2.95±0.33）μM where as for ETEC strains it varied from 1.75 to 1.96μM with a mean of（1.87±0.03）μM. Berberine bind more tightly with double helix DNA with Bmax and Kd of（24.68±2.62） and（357.8±57.8）,respectively.Berberine reacted with protein in comparatively loose manner with Bmax and Kd of（18.9±3.83） and 【286.2±113.6),respectively.Conclusions:The results indicate clearly that berberine may serve as a good antibacterial against multi drug resistant E.coli.

Potential of Zimbabwean commercial probiotic products and strains of Lactobacillus plantarum as prophylaxis and therapy against diarrhoea caused by Escherichia coli in children

Objective: To evaluate the potential of commercial fermented products sold in the country,and strains of Lactobacillus plantarum(L,plantarum)as prophylaxis and therapy against diarrhoea in children,Methods: The antimicrobial potential of cultures of lactobacilli enriched from 4 Zimbabwean commercial food/beverage products: Dairibord Lacto sour milk(DLSM),Probrand sour milk(PSM),Kefalos Vuka cheese(KVC) and Chibuku opaque beer(COB); and four strains of L,plantarum obtained from Balkan traditional cheeses against clinical strains of Escherichia coli(E,coli) was assayed using the well diffusion method,Three commercial paediatric antidiarrhoeal drug products: Biogaia(BG),Prolife(PL) and Probio Junior(PJ) and a mutant strain of E,coli [strain 11105(ATCC)- a vitamin B-12 auxotroph and penicillin G acylase-producing strain] were used as controls,An agar diffusion assay and a competitive exclusion assay were carried out on Mueller Hinton agar,Results: Crude cultures of putative lactobacillus strains obtained from Zimbabwean dairy products(Probrand sour milk,Kefalos Vuka vuka cheese and Chibuku opaque beer) had significantly higher antimicrobial activities against clinical strains of E,coli than strains of L,plantarum isolated from Balkan cheeses(CLP1,CLP2 or CLP3) and crude microbial cultures from commercial paediatric probiotic products(BG,PJ and PL) of a culture of Lactobacillus rhamnosus LGG(P<0.05),Conclusions: The putative Lactobacilli from four commercial Zimbabwean dairy products(Probrand sour milk,Kefalos Vuka vuka cheese and Chibuku opaque beer),and three strains of L,plantarum from Balkan cheeses(CLP1,CLP2 or CLP3) exhibited high antibacterial activities that can be harnessed to control paediatric diarrhoea that is caused by pathogenic strains of E,coli,Studies to characterise the probiotic potential of the live cultures in the products and the new strains of L,plantarum are underway.

Role of a probiotic (Saccharomyces boulardii) in management and prevention of diarrhoea

瞄准：估计酵母属 boulardii 的功效和安全(S。boulardii ) 在在减少腹泻的事件的频率在的尖锐水的腹泻和它的角色随后二个月。方法：从 2 瞬间的孩子到 12 岁，在 S 根据包括标准和随机的 ised 与尖锐腹泻被选择。boulardii 组(与 ORS，营养的支持和 S 一起对待。boulardii， 250 mg 出价) 并且在控制组(仅仅与 ORS 和营养的支持一起对待) 。直接疗法阶段是 5 d，每个孩子以后被跟随二个月。象药的安全一样的凳子的频率和一致性在每访问上被估计。二个组的比较以痢疾的事件的数字被做在随后二个月。结果：在每个组有五十个病人。象吝啬的年龄和凳子的平均频率那样的基线特征在 S 是可比较的。boulardii 和控制在试用在包括的时候组织。由 d 3 它分别地并且由 d 每 d 归结为 2.7 和 4.2 张凳子 6 它归结为 1.6 (S。boulardii 组) 并且 3.3 (控制组) 。腹泻的持续时间是在 S 的 3.6 d。而它是在控制组的 4.8 d， boulardii 组织(P = 0.001 ) 。在下列二个月内， S。有的 boulardii 组一显著地， 0.54 个事件的低频率作为与在控制的 1.08 个事件相比组织。这药很好被接受并且容忍。在治疗时期期间没有副作用的报告。结论：S。boulardii 显著地减少尖锐腹泻的频率和持续时间。凳子的一致性也改善。这药是容忍得好的。

Anti-Colorectal Cancer Chemotherapy-Induced Diarrhoea: Current Treatments and Side-Effects

Chemotherapy-induced diarrhoea (CID) is a common side-effect experienced by patients being treated with a variety of antineoplastic agents. Approximately 80% of patients undergoing chemotherapeutic treatment for colorectal and other gastrointestinal cancers present with CID;moreover, about 5% of early deaths associated with combination anti-cancer chemotherapy are due to CID. Chronic post-treatment diarrhoea amongst cancer survivors can persist for more than 10 years greatly effecting long-term quality of life. Gastrointestinal toxicities such as diarrhoea and vomiting are amongst the primary contributors to dose reductions and delays throughout anti-cancer treatment, presenting a significant hurdle in clinical management of anti-cancer regimes and often result in sub-optimum treatment. However, little is known about pathophysiological mechanisms underlying CID. This work provides a review of chemotherapy-induced diarrhoea, current management guidelines, and shortcomings of current treatments as well as emerging and already existing anti-diarrhoeal treatments potentially suitable for CID.

Prevalence of Diarrhoea and Associated Factors among Under-Five Children in Jigjiga District, Somali Region, Eastern Ethiopia

Background: Diarrheal disease is a major cause of morbidity and mortality among children in many developing countries, including Ethiopia and is a leading cause of morbidity in Pastoralist Ethiopian-Somali region. Diarrheal disease is not purely medical, but huge part of this should be traced back to the social, economic, environmental and behavioural aspects of the family. Determining these interactions is relevant to prevent and control diarrhoea. Objective: The objective of this study was to measure the prevalence of diarrhoea and describe associated factors relating to diarrheal disease among under-five children in Jigjiga district. Methods: A cross-sectional study was conducted in Jigjiga district from June 12 to 26 in 2014 using a structured and pretested questionnaire. A total of 1807 primary care takers were interviewed. Proportionate to size allocation was done and simple random selection was used to select sample units. Diarrheal morbidity occurred in the under-five children in the past 14 days were registered to determine prevalence. Data were entered using Epi Info version 3.5.3 and analysed in SPSS version 20. Odds ratio with 95% CI in a multivariate logistic regression was employed to control confounding factors. Results: The findings of this study showed that the overall two-week period prevalence of diarrhoea in under-five children was 27.3%: 95% CI (26.9%, 27.4%). Education of the primary caretaker, occupation of the father, birth order of the child, maternal diarrhoea, and hand washing during critical times, water source, type of water storage container, latrine availability, frequency of household solid waste water disposal, availability of liquid waste water drainage system and the type of the kitchen floor material showed as independent predictors of under-five child hood diarrhoea. Conclusion: This study revealed that diarrhoea morbidity was relatively high among children under-five years of age residing in Somali region. Efforts to reduce childhood diarrhoea should focus mainly on water, sanitation and hygiene interventions including health education.

Focus on acute diarrhoeal disease

Diarrhoea is an alteration of normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Diarrhoea needs to be classif ied according to the trends over time (acute or chronic) and to the characteristics of the stools (watery, fatty, inflammatory). Secretory diarrhoeas, mostly acute and of viral aetiology in more than 70% of cases, are by far the most important subtype of diarrhoeas in terms of frequency, incidence and mortality (over 2.5 million deaths/year in developing countries). Natural and synthetic opiates such as morphine, codeine, and loperamide which react with endogenous opiates (enkephalins, beta-endorphins, dynorphins) mainly act on intestinal motility and slow down transit. An antidiarrhoeal drug developed in recent years, racecadotril, acts as an enkephalinase inhibitor. Clinical studies have shown that it is just as effective as loperamide in resolving acute diarrhoea but with greater reduction in pain and abdominal distension. Some studies have explored the prevalence of diarrhoea in old age. An epidemiological study carried out in Italy by 133 General Practitioners on 5515 elderly outpatients reported a prevalence of diarrhoea, def ined according to the Rome criteria, of 9.1%. Infectious diseases (19%) and drug use (16%) were the most common causes of diarrhoea in old age. Regardless of the cause, the treatment of elderly patients with diarrhoea must include rehydration and nutritional support. Every year, more than 50 million tourists travel from industrialized countries to places where hygiene levels are poor. At least 75% of those travelling for short periods mention health problems, and in particular traveller's diarrhoea.

Global research on Clostridium difficile-associated diarrhoea:A visualized study

BACKGROUND Clostridioides(Clostridium)difficile(C.difficile)is still the most common cause of healthcare-associated diarrhoea and is increasing in prevalence as a communityacquired infection.In addition,the emergence of antibiotic resistance in C.difficile can increase the likelihood of the disease developing and/or spreading.AIM To provide an up-to-date picture of the trends in publications related to C.difficile infection,together with specific insights into hot-button issues in this field.METHODS Publications on C.difficile infections in the field of microbiology between 2001 and 2020 were identified from the Scopus database and Reference Citation Analysis.Bibliometric indicators were determined,including the number and type of publications,countries,affiliations,funding agencies,journals and citation patterns.VOSviewer was used to determine research areas and hot-button issues by identifying recurring terms with a high relative occurrence in the title and abstract.RESULTS A total of 8127 documents on‘C.difficile-associated diarrhoea’published between 2001 and 2020 were retrieved from the Scopus database.In the last decade,there has been a significant almost fourfold increase in the number of published papers on this topic.The United States was among the countries(44.11%)with the most publications,and the most involved institution was the University of Leeds in the United Kingdom(2.50%).Three clusters of research were identified and included‘illness spectrum and severity,as well as the signs,symptoms and clinical pathogenesis of C.difficile’;‘laboratory diagnosis and characterization of C.difficile’and‘risk factors for C.difficile infection’.CONCLUSION This study contains the most up-to-date and comprehensive data ever compiled in this field.More international research and cross-institutional collaborations are needed to address more global C.difficile concerns and to benefit from greater sharing of expertise,which will result in higher quality or more effective studies in the future.Promising research avenues in the near future may draw the attention of relevant scientists and funding organizations and open up novel C.difficile infection–based diagnosis and treatment approaches.