THesis (M.C.T.M. (Clinical Tropical Medicine))--Mahidol University, 2003.

Thesis (M.C.T.M. (Clinical Tropical Medicine))--Mahidol University, 2003.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2008. / Title from title screen (site viewed Jan. 13, 2009). PDF text: vii, 268 p. : col. ill. ; 5 Mb. UMI publication number: AAT 3321565. Includes bibliographical references. Also available in microfilm and microfiche formats.

Thesis (M.S.)--University of Massachusetts Amherst, 2009. / Open access. Includes bibliographical references (p. 68-81).

Thesis--Auburn University, 2009. / Abstract. Vita. Includes bibliographical references (p. 75-84).

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Death from acute diarrhea has been reduced since 80Âs. However diarrhoeal diseases account for nearly 1.34 million deaths a year among children under-five years of age, making them the second most common cause of child deaths worldwide. As mortality acute diarrhea was reduced, persistent diarrhea (PD) has become a major enteric diseases infant collaborating to morbidity of affected populations. Small intestinal mucosa injury that becomes prolonged has been named as a central mechanism in the pathophysiology of PD. The protein malnutrition and infection by Escherichia coli enteroaggregative (EAEC) are strongly associated with development PD. The present study investigated the effect of supplementation of Alanyl-Glutamine on monolayer of intestinal cells in the absence of infection, evaluated some parameters of the injury caused by EAEC (strain 239-1) on the intestinal mucosa in vitro and modulation of such injury by Alanyl-Glutamine 10mM. The result show that effects of supplementation of Alanyl-Glutamine 10mM is no different from effects free glutamine 4mM. Compared to E. coli HS, EAEC infection reduced the number of migrating cells, increased the percentage of necrosis, decreased the proliferation and transcription-reverse from small GTPases (RhoA, Rac1 and Cdc42), within 6 hours of contact. The contact EAEC reduced transcription of IL-8 (6h and 0h), NF-κB (6h) and TLR5 (6h and 12h) and increased TNF-α expression. The treatment of infection with Ala-Gln 10mM altered the following parameters: reduced the percentage of necrosis, increase of cell migration, although it has not caused changes in the transcription of Rho GTPases genes, increased transcription IL-8, NF-κB (6h) e TLR5 (6h and 12h). Treatment with dipeptidio significantly reduced the secretion of TNF-α (12h) while increased protein expression of IL-6 (6 e 12h). In conclusion, found that glutamine deprivation decreases cellular response against the infectious stimulus. The EAEC appears to minimize the innate host immune defenses by reducing the transcription of NF-kB and TLR5 and limit the increased transcription of IL-8. The Ala-Gln seems to make the cell more reactive against injurious stimuli, increasing their responsiveness through increased transcriptional IL-8, NF-kB and TLR5. Moreover increased protein expression of IL-6 appears to be one of the mechanisms by which promotes Ala-Gln protective effect on the intestinal epithelial barrier. / A morte por diarreia aguda tem apresentado grande declÃnio desde a dÃcada de 80 em todas as regiÃes do mundo. Entretanto as doenÃas diarreicas ainda sÃo responsÃveis por 1,34 milhÃes de mortes infantis a cada ano e representam a segunda maior causa de mortalidade no grupo etÃrio com idade inferior a 5 anos. Com o declÃnio de mortalidade por casos de diarreia aguda a diarreia persistente (DP) se tornou uma das principais doenÃas entÃricas infantis contribuindo para morbidade das populaÃÃes afetadas. Uma lesÃo no intestino delgado que se torna prolongada tem sido colocada como elemento central da patofisiologia da DP. A desnutriÃÃo proteica e a infecÃÃo por Escherichia coli enteroagregativa (EAEC) estÃo fortemente associados ao desenvolvimento da DP. O presente estudo investigou o efeito da suplementaÃÃo de Alanil-Glutamina sobre monocamada de cÃlulas da mucosa intestinal na ausÃncia de infecÃÃes. Avaliou alguns parÃmetros da lesÃo promovida por EAEC (cepa 239-1) sobre a mucosa intestinal in vitro e a modulaÃÃo de tal dano pela Alanil-Glutamina 10Mm. Os resultados obtidos mostram que os efeitos da suplementaÃÃo de Ala-Gln 10mM nÃo diferem dos efeitos exibidos pela glutamina livre 4mM. Em relaÃÃo a cepa comensal E. coli HS, a infecÃÃo com EAEC reduziu de forma significativa a quantidade de cÃlulas em migraÃÃo, aumentou o percentil de necrose, diminuiu a proliferaÃÃo celular e reduziu significativamente a transcriÃÃo dos genes das pequenas GTPases (RhoA, Cdc42 e Rac1) apÃs 6h de contato com enterÃcitos. O contato com EAEC reduziu a transcriÃÃo de IL-8 (0h e 6h), NF-κB (6h) e TLR5 (6h e 12h) e aumentou a expressÃo proteica de TNF- α (12h). O tratamento da infecÃÃo com Ala-Gln 10mM alterou significativamente os seguintes parÃmetros: aumento da quantidade de cÃlulas em migraÃÃo embora nÃo tenha causado alteraÃÃo na transcriÃÃo dos genes da pequenas GTPases, reduÃÃo do percentual de necrose, aumento da proliferaÃÃo celular, aumento da transcriÃÃo IL-8, NF-κB (6h) e TLR5 (6h e 12h). O tratamento com o dipeptidio reduziu significativamente a secreÃÃo de TNF-α (12h) enquanto aumentou a expressÃo proteica de IL-6 (6 e 12h). Em conclusÃo, verificamos que a privaÃÃo de glutamina diminui a resposta celular frente ao estÃmulo infeccioso. A EAEC, por sua vez, parece minimizar as defesas imunes inatas hospedeiro ao reduzir a transcriÃÃo de NF-kB e TLR5 e limitar o aumento da transcriÃÃo de IL-8. A Ala-Gln parece tornar a cÃlula mais reativa frente aos estÃmulos lesivos, aumentando sua capacidade de resposta atravÃs do aumento transcricional de IL-8, NF-kB e TLR5. Por outro lado o aumento da expressÃo proteica de IL-6 parece ser um dos mecanismos pelas quais Ala-Gln promove efeito protetor sobre a barreira epitelial intestinal.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Diarrhea is the fourth leading cause of children under five worldwide. Recommendations for diarrhea treatment include oral rehydration therapy, continued feeding, zinc supplementation, and antibiotic use if indicated. The use of these therapies is lower than expected in developing countries. This study aims to determine how cultural beliefs impact the use of evidence-based approaches for diarrhea treatment, specifically in developing countries. A systematic review of primary research articles was done to assess knowledge of and attitudes towards evidence-based treatments, analyze care-seeking behaviors, and identify beliefs attached to treatment practices. Most cultural beliefs fall into the following themes: misconceptions about evidence-based treatments; feeding practices; home remedies and herbal medicines; inappropriate use of medications; and traditional healers and spiritual beliefs. The results show the possibility for working with traditional healers and the local population to gather more data about beliefs and practices. This information can be used to develop culturally sensitive treatment programs that can operate within the framework of local beliefs and practices.

Metagenomic analysis of diarrhea samples revealed the presence of numerous human enteric viruses and small circular Rep-encoding single-stranded DNA (CRESS-DNA) genomes. One such genome was related to smacoviruses, while eight others were related to genomes reported in the feces of different mammals. The tropism of these CRESS-DNA viruses remains unknown.

Idelalisib is an oral, phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitor, approved by FDA since July 2014 for the treatment of relapsed follicular B-cell non-Hodgkin lymphoma. Data from three phases of the study involving idelalisib demonstrate diarrhea (47%) to be the common adverse effect. The other side effects are pyrexia (28%), fatigue (30%), nausea (29%), cough (29%), pneumonia (25%), abdominal pain (26%) and rash (21%). The characteristic histological findings of idelalisib colitis include intraepithelial lymphocytosis, neutrophilic cryptitis and epithelial cell apoptosis within the crypts. Histological findings help differentiate among other causes of diarrhea and entero-colitis. We present a female patient with recurrent follicular lymphoma treated with idelalisib and presented with diarrhea. She was found to have entero-colitis and was treated successfully with drug discontinuation and prednisone.

1 Microbiology Laboratory, Charlotte Maxeke Johannesburg Academic Hospital, Department of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service and University of the Witwatersrand, Johannesburg / Background: Clostridium difficile is a common cause of healthcare-associated diarrhoea. Laboratory testing for C. difficile infection (CDI) remains an area of confusion as there is not a single accepted reference standard or a single best test. Aim: To analyse the impact of different diagnostic methods on reported CDI rates. In addition, CDI incidence rates at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) were determined. Method: Results of stool samples submitted for C. difficile testing at CMJAH from 1 January 2014 to 31 August 2017 were reviewed. From January 2014 to July 2016, samples were tested by polymerase chain reaction (PCR) or toxin immunoassay, and from August 2016 to August 2017 algorithm-based testing (glutamate dehydrogenase and toxin immunoassay followed by PCR) was performed. Results: A total of 4829 samples were submitted. For the first period, toxin immunoassay and PCR showed a positivity rate of 11.4% and 21.1%, respectively, with an overall positivity rate of 18.7% (95% CI: 15.6 – 21.9). For the second period, the positivity rate was 15.9% (95% CI: 11.3 – 17.7). This rate included samples that were GDH positive and either showed toxin production or had a positive Xpert® result. CDI incidence for the two periods was different, with an incidence rate of 8.8 and 6.1 per 10 000 patient-days for the first and second periods, respectively. Conclusion: The choice of laboratory testing method has a major impact on the diagnosis of CDI, and therefore on the reported rates of CDI. Standardisation of laboratory testing and incidence rate reporting is required in order to obtain robust and reliable data. / E.K. 2019