• 제목/요약/키워드: Clinical diarrhea

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Evaluation of virulence reversion of an attenuated porcine epidemic diarrhea vaccine strain by serial passages in suckling piglets

  • Da-Jeong Kim;Seung-Chai Kim;Hwan-Ju Kim;Gyeong-Seo Park;Sang Chul Kang;Won-Il Kim
    • Korean Journal of Veterinary Service
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    • v.46 no.3
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    • pp.193-202
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    • 2023
  • Porcine epidemic diarrhea is an infectious intestinal disease caused by the porcine epidemic diarrhea virus (PEDV). Especially, when suckling piglets are infected, the mortality rate is close to 100%. PEDV is classified into G1 and G2 types based on genetic differences. The G2 type PEDV outbreak in the United States in 2013 was highly pathogenic and contagious, and it has spread worldwide and caused continuous economic losses. Most commercial vaccines used are G1 type vaccines, and existing vaccines do not fully protect piglets due to genetic differences. In this study, we evaluated the safety of the newly developed G2 type attenuated HSGP vaccine strain by inoculating it into piglets and testing whether the vaccine virus spreads to the non-vaccinated, negative pigs and whether the vaccine reverts to its virulence during serial passage experiments. Each experiment lasted for 7 days for each passage, and fecal viral titers, clinical symptoms, and weight gain were measured daily. After the experiment, necropsy was performed to measure intestinal virus titer and pathological evaluation. As a result of the first passage, no transmission of the vaccine virus to negative pigs co-housed with vaccinated pigs was observed. In addition, after four consecutive passage experiments, the clinical symptoms and small intestine lesions were gradually alleviated, and no virus was detected in the feces in the fourth passage experiment. Therefore, it was concluded that the vaccine was safe without virulence reversion in accordance with the guidelines of the current licensing authority. However, further studies are needed on the genetic changes and biological characteristics of the mutant virus that occur during successive passages of the attenuated vaccine since the replication and clinical symptoms of the virus increased until the third passage during successive passages of the vaccine virus. Based on this study, it was concluded that virulence reversion and safety evaluation of attenuated vaccines through serial passage in target animals can be useful to evaluate the safety of attenuated viruses.

Capsule Endoscopy in Refractory Diarrhea-Predominant Irritable Bowel Syndrome and Functional Abdominal Pain

  • Valero, Manuel;Bravo-Velez, Gladys;Oleas, Roberto;Puga-Tejada, Miguel;Soria-Alcivar, Miguel;Escobar, Haydee Alvarado;Baquerizo-Burgos, Jorge;Pitanga-Lukashok, Hannah;Robles-Medranda, Carlos
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.570-575
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    • 2018
  • Background/Aims: Capsule endoscopy is a diagnostic method for evaluating the small bowel lumen and can detect undiagnosed lesions. The aim of this study was to evaluate the diagnostic yield and clinical impact of capsule endoscopy in patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain. Methods: This study involved a retrospective analysis of prospectively collected data, maintained in a database. Patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain within the period of March 2012 to March 2014 were included. Capsule endoscopy was used to detect small bowel pathologies in both groups. Results: Sixty-five patients (53.8% female) fulfilled the inclusion criteria and had a mean (${\pm}$standard deviation) age of $50.9{\pm}15.9$ years. Clinically significant lesions were detected via capsule endoscopy in 32.5% of the patients in the abdominal pain group and 54.5% of the patients in the diarrhea group. Overall, 48% of patients had small bowel pathologies detected during the capsule endoscopy study. Inflammatory lesions and villous atrophy were the most frequent lesions identified in 16.9% and 15.3% of patients in the abdominal pain and the diarrhea groups, respectively. Conclusions: Routine use of capsule endoscopy in patients with irritable bowel syndrome should not be recommended. However, in patients with refractory conditions, capsule endoscopy may identify abnormalities.

A clinical case study of Irritable bowel syndrome patient with chronic diarrhea (만성설사를 주소로 한 과민성 대장증후군 환자의 치험례)

  • Kim, Kyung-sok;Lee, Sang-yong;Kim, Jae-hoon;Kwon, Do-ick
    • Journal of Sasang Constitutional Medicine
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    • v.13 no.3
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    • pp.134-139
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    • 2001
  • The irritable bowel syndrome(IBS) is the most common gastrointestinal disorder in clinical practice and is characterized by abdominal pain associated with a chronic disturbance of defecation. It is important to discriminate IBS from organic bowel disease. Based on clinical and epidemiologic studies, specific symptom criteria for IBS have been developed. The subject is a 29 year old man who has abdominal pain, chronic diarrhea, general weakness, dizziness, insomnia and has been diagnosed as irritable bowel syndrome. We classified this as Shaoyangin Mangyin(少陽人 亡陰證) and prescribed Hyeongbangjiwhangtang(荊防地黃湯) in accordance with the principle of pyoeumganggi(表陰降氣). In the result, we had the improvement of his symptoms.

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Effect of Saccharomyces boulardii CNCM-I 3799 and Bacillus subtilis CU-1 on Acute Watery Diarrhea: A Randomized Double-Blind Placebo-Controlled Study in Indian Children

  • Ghosh, Apurba;Sundaram, Balasubramaniam;Bhattacharya, Piyali;Mohanty, Nimain;Dheivamani, Nirmala;Mane, Sushant;Acharyya, Bhaswati;Kamale, Vijay;Poddar, Sumon;Khobragade, Akash;Thomas, Winston;Prabhudesai, Sumant;Choudhary, Ankita;Mitra, Monjori
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.5
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    • pp.423-431
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    • 2021
  • Purpose: To assess the effect of combination probiotic Saccharomyces boulardii CNCM-I 3799 and Bacillus subtilis CU-1 in outpatient management of acute watery diarrhea in children. Methods: A randomized double-blind placebo-controlled study was conducted in 180 participants aged six months to five years with acute mild to moderate diarrhea. All were enrolled from six centers across India and centrally randomized to receive S. boulardii CNCM-I 3799 and B. subtilis CU-1 or a placebo along with oral rehydration salts and zinc supplementation. Each participant was followed up for three months to assess recurrence of diarrhea. Results: The mean duration of diarrhea in the probiotic and placebo groups were 54.16 hours and 59.48 hours, respectively. The difference in the duration of diarrhea in those administered with probiotic or placebo within 24 hours of diarrhea onset was 25.21 hours. Furthermore, the difference in duration of diarrhea was 13.84 hours (p<0.05) for participants who were administered with probiotics within 48 hours. There were no significant differences in the stool frequencies between the two arms. After three months, 15% in the probiotic group and 18.5% in the placebo group reported episodes of diarrhea. The mean duration of diarrhea was considerably lower in the probiotic group, 31.02 hours versus 48 hours in placebo (p=0.017). Conclusion: S. boulardii CNCM-I 3799 and B. subtilis CU-1 combination was effective in reducing the duration of diarrhea when administered within 48 hours of diarrhea onset. Similarly, it reduced recurrence of diarrhea and its intensity in the subsequent three months.

A Case Report of Antibiotic-associated Diarrhea Treated with Traditional Korean Medicine (항생제 투여중 발생한 설사 환자 치험 1례)

  • Seo, Yoon-jeong;Park, Sung-woon;Choi, Hyun-jeong;Lew, Jae-hwan
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.172-179
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    • 2017
  • Objectives: The aim of this clinical study is to describe the case of a patient with antibiotic-associated diarrhea, which was improved by treatment with herbal medicine. Methods: The antibiotic-associated diarrhea improved following treatment with Boikyangwi-tang and Opae-san for two months. During this period, western medicine, including antibiotics, was also administered. To evaluate the effect of the treatment, the Bristol Stool Form Scale was used. Results: During the treatment, the Bristol Stool Form Scale changed from type 7 to type 5. Conclusion: The results suggest that traditional Korean medicine may be an effective treatment for antibiotic-associated diarrhea.

Congenital Chloride Diarrhea in Dizygotic Twins

  • Seo, Kyung Ah;Lee, Na Mi;Kim, Gwang Jun;Yun, Sin Weon;Chae, Soo Ahn;Lim, In Seok;Choi, Eung Sang;Yoo, Byoung Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.3
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    • pp.195-199
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    • 2013
  • Congenital chloride diarrhea (CLD) is a rare inherited autosomal recessive disorder. Mutations of the solute carrier family 26 member 3 gene cause profuse, chloride ion rich diarrhea, which results in hypochloremia, hyponatremia and metabolic alkalosis with dehydration. If a fetal ultrasound shows bowel dilatation suggestive of bowel obstruction, or if a neonate shows persistent diarrhea and metabolic alkalosis, CLD should be considered in the differential diagnosis. The severity of CLD varies, but early detection and early therapy can prevent complications including growth failure. We report a case of dizygotic twins affected by CLD who had been born to non-consanguineous parents. Both of them showed growth failure, but one of the twins experienced worse clinical course. He showed developmental delay, along with dehydration and severe electrolyte imbalance. He was diagnosed with CLD first at 6-month age, and then the other one was also diagnosed with CLD.

A clinical study of the treatment prescribed Hwalsuckgosamtang(滑石苦蔘湯) for the acute diarrhea (급성설사(急性泄瀉)를 활석고삼탕(滑石苦蔘湯)으로 치료(治療)한 증례(症例))

  • Park, Eun-kyung;Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.385-389
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    • 1999
  • Acute diarrhea is fastly progressing and its most symptom are caused by virus. It usually continue within 3 weeks. And also it company fever, chilling sign, anorexia and vomitting. Mostly, it is getting better by basic treatment but must be cautious about progressing to dehydration, sepsis or other complications. In this study, it is experienced that acute diarrhea patient, got sick by food, became better by treating in the point of Sasang Medicine. 75 years old male patient having abdominal pain with aqueous diarrhea (about 10th a day before admission), chilling sign, general weakness was classed as Soyangin having Shinhanbocktongmangeumjeung(身寒腹痛亡陰證). I prescribed Hwalsuckgosamtang(滑石苦蔘湯) by Peueumganggy(表陰降氣) therapy and his symptom was getting better. So report it.

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Diagnosis of Clostridium difficile infection in patients with hospital-acquired diarrhea

  • Ibrahim Afifi, Salwa Selim;Gomaa, Fatma Alzahraa M.;Fathi, Lamia Fouad;Rasslan, Fatma Salah;Hamdy, Ahmed Mohamed
    • Korean Journal of Microbiology
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    • v.54 no.3
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    • pp.214-221
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    • 2018
  • Clostridium difficile infection (CDI) is a rapidly emerging infection that may have devastating consequences. Prompt and accurate diagnosis is crucial for management and control. The aim of this study was to determine the incidence of C. difficile associated diarrhea among hospitalized patients, and to compare different diagnostic laboratory methods for detection of toxin producing strains in clinical specimens. The study was conducted at a university hospital in Cairo during the period from May 2013 till June 2015. Subjects were under antibiotic therapy and presented with hospital-acquired diarrhea. Four hundred and sixty-five stool specimens were processed by different microbiological methods. C. difficile was recovered in culture in 51 of stool specimens. Of these, 86.3% to 98% were positive for toxin production by 2 different methods. This study showed that antibiotic intake is the major risk factor for development of hospital-acquired diarrhea. We evaluated different microbiological methods for diagnosis of C. difficile. We recommend the use of toxigenic culture as a gold standard for microbiological diagnosis of C. difficile.

A Case Study of a Taeeumin Patient with Chronic Diarrhea treated with Cheongsimyeonja-tanggamibang (삼차신경통 태음인 환자의 만성 설사 치험례)

  • Kwon, Mi Hye;Jang, Halim;Lee, Hyeri;Lee, Eui Ju
    • Journal of Sasang Constitutional Medicine
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    • v.33 no.4
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    • pp.43-56
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    • 2021
  • Objectives This study was aimed to report a significant improvement of chronic diarrhea patient, diagnosed as 'Taeeum type liver heat-lung dryness pattern' based on Sasang medicine. Methods The patient had treatment with Sasang constitutional medicine. The treatment was executed three times everyday from August 27th to September 3rd and two times everyday from September 3rd to September 16th of 2021. Clinical improvement was evaluated with Bristol stool form scale, the degree of abdominal discomfort and nausea compared to the day of hospitalization and the number of defecations and nocturia per day. Results The symptoms of diarrhea, abdominal discomfort and nausea were improved. The number of night urination was decreased from 3-4 times to once a night. Conclusion After the treatment with Sasang constitutional medicine, diarrhea, abdominal discomfort, nausea and the general condition of the patient also improved.