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It has been commonly believed that children in developing countries pass stools that are very different from those of developed countries. A community based study on defecation frequency, stool weight, and consistency was conducted in a cohort of 300 Myanmar (Burmese) children aged 1 to 4 years. Most (80.3%) children opened their bowels daily and none passed more than three stools a day. The mean (SD) defecation frequency was 6.98 (1.94) times a week and total stool weight was 596 (221) g a week. The majority (61%) of children passed soft stools. At all ages, there was no significant difference in the defecation frequency, stool weight, and consistency between boys and girls, those on adult style diet and those partially weaned, and between age groups. [ABSTRACT FROM AUTHOR]

Dose-limiting toxicities remain a major barrier to drug development and therapy, revealing the limited predictive power of human genetics. Herein, we demonstrate the utility of a more comprehensive approach to studying drug toxicity through longitudinal study of the human gut microbiome during colorectal cancer (CRC) treatment (NCT04054908) coupled to cell culture and mouse experiments. 16S rRNA gene sequencing revealed significant shifts in gut microbial community structure during oral fluoropyrimidine treatment across multiple patient cohorts, in mouse small and large intestinal contents, and in patient-derived ex vivo communities. Metagenomic sequencing revealed marked shifts in pyrimidine-related gene abundance during oral fluoropyrimidine treatment, including enrichment of the preTA operon, which is sufficient for the inactivation of active metabolite 5-fluorouracil (5-FU). preTA + bacteria depleted 5-FU in gut microbiota grown ex vivo and the mouse distal gut. Germ-free and antibiotic-treated mice experienced increased fluoropyrimidine toxicity, which was rescued by colonization with the mouse gut microbiota, preTA + E. coli , or preTA -high CRC patient stool. Finally, preTA abundance was negatively associated with fluoropyrimidine toxicity in patients. Together, these data support a causal, clinically relevant interaction between a human gut bacterial operon and the dose-limiting side effects of cancer treatment. Our approach is generalizable to other drugs, including cancer immunotherapies, and provides valuable insights into host-microbiome interactions in the context of disease., Competing Interests: Competing interests: W.A.K. has received research funding (institution) from Pfizer; there is no direct overlap with the current study. P.J.T. is on the scientific advisory boards of Pendulum, Seed and SNIPRbiome; there is no direct overlap between the current study and these consulting duties. C.E.A served on the scientific advisory board of Pionyr Immunotherapeutics and has received research funding (institution) from Bristol Meyer Squibb, Erasca, Gossamer Bio, Guardant Health, Kura Oncology, Merck and Novartis; there is no direct overlap with the current study. E.V.B. is on the medical advisory board for Fight CRC; there is no direct overlap with the current study. All other authors declare no competing interests.

Purpose: To understand healthcare utilization by comparing hospital encounters among individuals with Spina Bifida and the general population and to identify the factors associated with utilization., Method: Using the Department of Health Care Access and Information database (1995-2017), individuals with Spina Bifida were identified and matched to controls by birth year. The primary outcome measures were the number of hospital encounters (stratified as ≤ 2 vs ≥ 3 encounters) and the time between the first and second encounters. Univariate, multivariate and sub-group analyses were performed to identify factors associated with ≥ 3 encounters., Results: When compared to controls, individuals with Spina Bifida had more ≥ 3 hospital encounters (69% vs 29%), spent more days in the hospital (58 days vs 13 days), and had a higher average charge per hospital stay ($433,537 vs $99,975) ( P < .001 for all). After adjusting for covariates, we found that having Spina Bifida was associated with increased hospital encounters compared to controls (OR = 3.95, 95% CI = 3.77, 4.14, P < .001). Individuals with Spina Bifida were found to have less time between their first and second encounters (2.5 vs 3.3 years, P < .001). Within the Spina Bifida population, sex, race, ethnicity, comorbidities, and non-private insurance were associated with ≥ 3 encounters., Conclusions: Spina Bifida is associated with more hospital encounters and fewer days between first and second encounters compared to the general population. These findings highlight factors driving increased utilization of resources thereby empowering providers to better support this vulnerable population.