60 research outputs found

    Post-Covid-19 Irritable Bowel Syndrome

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    Objectives The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalisation for SARS-CoV-2 infection. Design GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires. Results The study included 2183 hospitalised patients. The primary analysis included a total of 883 patients (614 patients with COVID-19 and 269 controls) due to the exclusion of patients with pre-existing gastrointestinal symptoms and/or surgery. At enrolment, gastrointestinal symptoms were more frequent among patients with COVID-19 than in the control group (59.3% vs 39.7%, p < 0.001). At the 12-month follow-up, constipation and hard stools were significantly more prevalent in controls than in patients with COVID-19 (16% vs 9.6%, p=0.019 and 17.7% vs 10.9%, p=0.011, respectively). Compared with controls, patients with COVID-19 reported higher rates of irritable bowel syndrome (IBS) according to Rome IV criteria: 0.5% versus 3.2%, p=0.045. Factors significantly associated with IBS diagnosis included history of allergies, chronic intake of proton pump inhibitors and presence of dyspnoea. At the 6-month follow-up, the rate of patients with COVID-19 fulfilling the criteria for depression was higher than among controls. Conclusion Compared with controls, hospitalised patients with COVID-19 had fewer problems of constipation and hard stools at 12 months after acute infection. Patients with COVID-19 had significantly higher rates of IBS than controls

    The fourth case of Veillonella parvula meningoencephalitis diagnosed by stereotactic brain biopsy

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    Introduction: Veillonella parvula is a small, nonfermentative anaerobic gram-negative coccus. Meningitidis due to V. parvula seen extremely rare. Here we want to report the fourth case with meningoencephalitis due to V. parvula and emphasize the significance of brain biopsy in encephalitis cases with unknown ethiology. Case report: A 64-year-old male admitted to the emergency room with a frontal and bitemporal headache. On physical examination, the patient was concious and oriented, his reaction time was prolonged. There was no focal neurological deficit, fever and meningeal signs. The magnetic resonance imaging scan showed hyperintensity on the T2-FLAR weighted sequences and diffusion restriction at the same place, concordant with encephalitis. On the third day of admission, oromandibular focal motor seizures were observed. Wecould not define any microbiological agent by analysis of cerebrospinal fluid. Stereotactic brain biopsy performed and the bacterial culture of the biopsy material grew V. parvula. Discussion: We reported the fourth V. parvula encephalitis case in the literature. The aim of this case report is to emphasize that brain biopsy should be considered in patients with encephalitis of unknown etiology. © 2014 Elsevier GmbH. All rights reserved

    Nitrofurantoin in the treatment of extended-spectrum ß-lactamase- producing Escherichia coli-related lower urinary tract infection

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    PubMed ID: 23063743The aim of this study was to evaluate the effect of nitrofurantoin (NFT) in the treatment of extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli-related lower urinary tract infection (LUTI). The hospital records of all patients aged &gt;18 years with dysuria or problems with frequency or urgency in passing urine, &gt;20 leukocytes/mm3 in urine microscopy and culture-proven ESBL-producing NFT-sensitive E. coli in the urine (&gt;105 CFU/mm3), no leukocytosis or fever and who were treated with NFT between January 2006 and May 2011 in our outpatient clinic or in the hospital were evaluated. All patients had received a NFT 50 mg capsule every 6 h for 14 days and had a control urine culture taken 7-9 days after therapy. Clinical success was defined as resolution of symptoms at the control visit, and microbiological success was defined as a sterile control urine culture. A total of 75 patients (mean ± standard deviation age, 54 ± 17 years; 45 females, 30 males, all but 14 with complicated LUTI) fulfilled the study inclusion criteria. Overall clinical and microbiological success rates were 69% (52/75) and 68% (51/75), respectively. Control urine culture performed 28-31 days after the end of therapy was available in 31/51 patients (61%) with microbiological success. Re-infection and relapse rates were 6.5% (2/31) and 3.2% (1/31), respectively. In conclusion, these results suggest that NFT may be an alternative in the treatment of ESBL-producing E. coli-related LUTI. This is the first study in which NFT was used in the treatment of LUTI due to ESBL-producing E. coli as well as in patients with complicated UTI. © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved

    Comparison of bronchoalveolar lavage and mini-bronchoalveolar lavage in the diagnosis of pneumonia in immunocompromised patients

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    PubMed ID: 21358222Background: Pneumonia is a major cause of morbidity and mortality in immunocompromised patients. Bronchoalveolar lavage (BAL) is commonly used to help diagnose and characterize pneumonia in these patients. Mini-BAL is a less-invasive, less-costly and less-cumbersome diagnostic tool than BAL. Objectives: In this study, we compared the diagnostic value of BAL and mini-BAL in the evaluation of pneumonia in immunocompromised patients with respiratory failure. Methods: Sixty-four respiratory samples were collected from 32 immunocompromised patients admitted to our respiratory intensive care unit with a clinical diagnosis of pneumonia and respiratory failure requiring invasive mechanical ventilation. A single BAL sample and a single mini-BAL sample were collected from each patient. Samples were examined for bacteriologic, mycologic, mycobacteriologic, and viral organisms. Results: The mean age of the patients was 56.0 ± 14.4 years. Of the 32 BAL samples, bacterial isolates were detected in 11 patients (34.4%) and on the other hand bacterial isolates were detected in 10 patients (31.3%) of the mini-BAL samples. Fungal isolates were detected in 11 patients (34.4%) from BAL samples and 13 patients (40.6%) from mini-BAL samples. Our analysis demonstrated a strong positive correlation between the results of BAL and mini-BAL testing (r = 0.850 and r = 0.821, respectively). Conclusion: In this study, we demonstrated a strong correlation between the isolation rates of bacteria and fungi in BAL and mini-BAL samples obtained from immunocompromised patients with pneumonia and respiratory failure. The data strongly support the use of mini-BAL sampling in such patients as a less-invasive, less-costly and simpler alternative to traditional BAL. Copyright © 2011 S. Karger AG, Basel

    Missed opportunities in HIV diagnosis: preliminary results

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    Missed opportunities in HIV diagnosis: preliminary results

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