12 results on '"Renata H Kukuruzovic"'
Search Results
2. Cochrane Review: Antibiotics for whooping cough (pertussis)
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Nigel Curtis, Sultan M Altunaiji, John Massie, and Renata H Kukuruzovic
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Bordetella pertussis ,Pediatrics ,medicine.medical_specialty ,biology ,business.industry ,medicine.drug_class ,Antibiotics ,Erythromycin ,General Medicine ,biology.organism_classification ,Azithromycin ,medicine.disease ,Trimethoprim ,Clarithromycin ,Relative risk ,Pediatrics, Perinatology and Child Health ,Medicine ,business ,Whooping cough ,medicine.drug - Abstract
Background Whooping cough is a highly contagious respiratory disease. Infants are at highest risk of severe disease and death. Erythromycin for 14 days is currently recommended for treatment and contact prophylaxis but its benefit is uncertain. Objectives To assess the risks and benefits of antibiotic treatment of and contact prophylaxis against whooping cough in children and adults. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL Issue 4, 2010), which contains the Cochrane Acute Respiratory Infections Group's Specialised Register, the Database of Abstracts of Reviews of Effects (DARE Issue 4, 2010), MEDLINE (1966 to January Week 1, 2011) and EMBASE (1974 to 18 January 2011). Selection criteria Randomised controlled trials (RCTs) and quasi-RCTs of antibiotics for treatment of and contact prophylaxis against whooping cough in children and adults. Data collection and analysis Three to four review authors independently extracted data and assessed the quality of each trial. Main results Thirteen trials with 2197 participants met the inclusion criteria: 11 trials investigated treatment regimens; two investigated prophylaxis regimens. The quality of the trials was variable. For eradicating Bordetella pertussis (B. pertussis) from the nasopharynx, short-term antibiotics (azithromycin for three to five days, or clarithromycin or erythromycin for seven days) were as effective as long-term (erythromycin for 10 to 14 days) (risk ratio (RR) 1.01; 95% confidence interval (CI) 0.98 to 1.04), but had fewer side effects (RR 0.66; 95% CI 0.52 to 0.83). Trimethoprim/sulphamethoxazole for seven days was also effective. Nor were there differences in clinical outcomes or microbiological relapse between short and long-term antibiotics. For preventing infection by treating contacts older than six months of age, antibiotics did not significantly improve clinical symptoms, nor the number of cases developing culture-positive B. pertussis. Side effects were reported with antibiotics and they varied from one antibiotic to another. Authors' conclusions Although antibiotics were effective in eliminating B. pertussis, they did not alter the subsequent clinical course of the illness. There is insufficient evidence to determine the benefits of prophylactic treatment of pertussis contacts. Plain Language Summary Antibiotics for whooping cough (pertussis) Whooping cough is a highly contagious disease caused by pertussis bacteria and may lead to death, particularly in infants less than 12 months of age. Although it can be prevented by routine vaccination, it still affects many people. Thirteen trials involving 2197 participants were included in this review. We found that several antibiotic treatments were equally effective in eliminating the bacteria infecting patients, but they did not alter the clinical outcome. There was insufficient evidence to decide whether there is benefit for treating healthy contacts. Side effects were reported with antibiotics and they varied from one antibiotic to another. The result of the review should be interpreted with caution since this review is based on a limited number of trials and some of these trials involved small numbers of participants.
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- 2012
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3. Dual sugar permeability testing in diarrheal disease
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April Bright, Antje M. Haase, Renata H. Kukuruzovic, David Brewster, and Kim Dunn
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Male ,medicine.medical_specialty ,Urine ,Urinalysis ,Rhamnose ,Gastroenterology ,Permeability ,Urine collection device ,Lactulose ,Internal medicine ,medicine ,Humans ,Ingestion ,Intestinal Mucosa ,Chromatography, High Pressure Liquid ,Blood Specimen Collection ,Intestinal permeability ,business.industry ,Infant ,Reproducibility of Results ,medicine.disease ,Confidence interval ,Gastroenteritis ,Surgery ,Diarrhea ,Intestinal Absorption ,Case-Control Studies ,Diarrhea, Infantile ,Pediatrics, Perinatology and Child Health ,Female ,Geometric mean ,medicine.symptom ,business ,medicine.drug - Abstract
Objective: To assess the validity of the use of a blood specimen for the sugar permeability test because of the high failure rate of 5-hour urine collection in young children with diarrhea. Study design: Simultaneous 5-hour urine collections and timed blood tests were taken after ingestion of an isotonic solution of lactulose (L) and L-rhamnose (R) in 24 children with acute gastroenteritis and 25 children without diarrhea in a control group. Sugars were measured with highperformance liquid chromatography, and the percent of recovered sugars was expressed as an L-R ratio. Results: With acute gastroenteritis the geometric mean L-R ratios (95% confidence intervals) were 12.4 (9.3 to 16.3) in urine and 9.4 (6.7 to 13.1) in blood compared with 6.7 (5.0 to 8.8) and 5.9 (4.4 to 7.8), respectively, in the control group. The level of agreement (kappa) among normal, intermediate, and high ratios for blood and urine was 0.71 (0.51 to 0.92). The failure rate of L-R tests was significantly reduced with a blood specimen (urine 37% vs blood 10%; P Conclusions: Intestinal permeability testing on a blood specimen is a valid alternative to urine collection in young children and has a significantly lower test failure rate. (J Pediatr 2000;136:232-7)
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- 2000
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4. Intestinal permeability and diarrhoeal disease in Aboriginal Australians
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K Dunn, Renata H. Kukuruzovic, A Haase, A Bright, and D R Brewster
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Diarrhea ,Male ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Hypokalemia ,Rhamnose ,Permeability ,Lactulose ,Gastrointestinal Agents ,Internal medicine ,Epidemiology ,Northern Territory ,medicine ,Humans ,Acidosis ,Intestinal permeability ,Dehydration ,business.industry ,Metabolic disorder ,Infant ,Original Articles ,medicine.disease ,Confidence interval ,Surgery ,Intestinal Absorption ,El Niño ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,business ,Complication ,medicine.drug - Abstract
BACKGROUND Northern Territory Aboriginal children hospitalised with acute gastroenteritis have high rates of acidosis, hypokalaemia, and dehydration. AIMS To determine whether Aboriginal children with and without diarrhoea have greater impairment in intestinal function than non-Aboriginal children, as assessed by increased permeability ratios. METHODS A descriptive study of 124 children (96 Aboriginal and 28 non-Aboriginal) hospitalised with and without diarrhoea. Intestinal permeability was assessed by the lactulose to rhamnose (L–R) ratio from a five hour urine collection. RESULTS In Aboriginal children, mean L–R ratios (95% confidence intervals) were 18.3 (17.1 to 19.6) with diarrhoea and 9.0 (7.3 to 11.0) without diarrhoea, and in non-Aboriginal children they were 5.9 (2.8 to 12.3) and 4.2 (3.3 to 5.2), respectively. In patients with diarrhoea, L–R ratios were significantly raised when accompanied by acidosis (mean, 22.8; 95% CI, 17.0 to 30.5), hypokalaemia (mean, 20.7; 95% CI, 15.4 to 27.9), and ⩾ 5% dehydration (mean, 24.3; 95% CI, 19.0 to 29.6) compared with none of these complications (mean, 7.0; 95% CI, 3.5 to 13.8). CONCLUSION The high incidence of acidosis, hypokalaemia, and dehydration in Aboriginal children admitted with diarrhoeal disease is related to underlying small intestinal mucosal damage.
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- 1999
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5. Hypnotherapy for treatment of irritable bowel syndrome
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Annette N. Webb, Susan M Sawyer, Anthony G. Catto-Smith, and Renata H Kukuruzovic
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Male ,Abdominal pain ,medicine.medical_specialty ,Constipation ,business.industry ,medicine.disease ,Placebo ,Irritable Bowel Syndrome ,Clinical trial ,Bloating ,Functional gastrointestinal disorder ,Quality of life ,medicine ,Physical therapy ,Humans ,Female ,Pharmacology (medical) ,medicine.symptom ,business ,Hypnosis ,Irritable bowel syndrome ,Randomized Controlled Trials as Topic - Abstract
Background Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder of unknown aetiology. Current pharmacological treatments have limited value. Hypnotherapy has been reported to have beneficial effects for IBS symptoms. Objectives To evaluate the efficacy of hypnotherapy for the treatment of irritable bowel syndrome. Search methods Published and unpublished randomised clinical trials and quasi-randomised clinical trials were identified through structured searches of MEDLINE (1966 to March 2006), EMBASE (1980 to March 2006), PsycINFO (1806 to March 2006), CINAHL (Cumulative Index to Nursing and Allied Health Literature, 1982 to March 2006), AMED (Allied and Complementary Medicine Database, 1985 to March 2006) and The Cochrane Central Register of Controlled trials. Conference proceedings from Digestive Disease Week (1980 to 2005) were also searched. Selection criteria Eligible studies included all randomised and quasi-randomised clinical studies comparing hypnotherapy for the treatment of irritable bowel syndrome with no treatment or another therapeutic intervention. Data collection and analysis All studies were evaluated for eligibility for inclusion. Included studies were assessed for quality and data were extracted independently by four authors. The primary outcome measure of interest was the overall bowel symptom severity score which combines abdominal pain, diarrhoea or constipation and bloating. Secondary outcomes included abdominal pain, diarrhoea, constipation, bloating, quality of life, patient's overall assessment of well-being, psychological measures as per validated questionnaires, and adverse events. Main results Four studies including a total of 147 patients met the inclusion criteria. Only one study compared hypnotherapy to an alternative therapy (psychotherapy and placebo pill), two studies compared hypnotherapy with waiting-list controls and the final study compared hypnotherapy to usual medical management. Data were not pooled for meta-analysis due to differences in outcome measures and study design. The therapeutic effect of hypnotherapy was found to be superior to that of a waiting list control or usual medical management, for abdominal pain and composite primary IBS symptoms, in the short term in patients who fail standard medical therapy. Harmful side-effects were not reported in any of the trials. However, the results of these studies should be interpreted with caution due to poor methodological quality and small size. Authors' conclusions The quality of the included trials was inadequate to allow any conclusion about the efficacy of hypnotherapy for irritable bowel syndrome. More research with high quality trials is needed.
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- 2007
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6. Antibiotics for whooping cough (pertussis)
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Nigel Curtis, John Massie, Sultan M Altunaiji, and Renata H Kukuruzovic
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Pediatrics ,medicine.medical_specialty ,Bordetella pertussis ,Erythromycin Estolate ,Whooping Cough ,Population ,Erythromycin ,Azithromycin ,Clarithromycin ,Trimethoprim, Sulfamethoxazole Drug Combination ,medicine ,Humans ,Pharmacology (medical) ,education ,Whooping cough ,Randomized Controlled Trials as Topic ,education.field_of_study ,biology ,business.industry ,Erythromycin Ethylsuccinate ,Infant ,medicine.disease ,biology.organism_classification ,Trimethoprim ,Anti-Bacterial Agents ,Contact Tracing ,business ,medicine.drug - Abstract
Background Whooping cough is a highly contagious disease. Infants are the population at highest risk of severe disease and death. Erythromycin for 14 days is recommended for treatment and contact prophylaxis but this regime is considered inconvenient and prolonged. The value of contact prophylaxis is uncertain. Objectives To study the benefits and risks of antibiotic treatment of and contact prophylaxis against whooping cough. Search strategy The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2004); MEDLINE (January 1966 to February 2004); EMBASE (January 1974 to August 2003); conference abstracts and reference lists of articles were searched. Study investigators and pharmaceutical companies were approached for additional information (published or unpublished studies). There were no constraints based on language or publication status. Selection criteria All randomised and quasi-randomised controlled trials of antibiotics for treatment of and contact prophylaxis against whooping cough were included in the systematic review. Data collection and analysis At least three reviewers independently extracted data and assessed the quality of each trial. Main results Twelve trials with 1,720 participants met the inclusion criteria. Ten trials investigated treatment regimens and two investigated prophylaxis regimens. The quality of the trials was variable. Results showed that short-term antibiotics (azithromycin for three days, clarithromycin for seven days, or erythromycin estolate for seven days) were equally effective with long-term antibiotic treatment (erythromycin estolate or erythromycin for 14 days) in the microbiological eradication of Bordetella pertussis (B. pertussis) from the nasopharynx. The relative risk (RR) was 1.02 (95% confidence interval (CI) 0.98 to 1.05). Side effects were fewer with short-term treatment (RR 0.66; 95% CI 0.52 to 0.83). There were no differences in clinical improvement or microbiological relapse between short and long-term treatment regimens. Contact prophylaxis (of contacts older than six months of age) with antibiotics did not significantly improve clinical symptoms or the number of cases that developed culture positive B. pertussis. Authors' conclusions Antibiotics are effective in eliminating B. pertussis from patients with the disease, rendering them non-infectious, but do not alter the subsequent clinical course of the illness. Effective regimens include: three days of azithromycin, seven days of clarithromycin, seven or 14 days of erythromycin estolate, and 14 days of erythromycin ethylsuccinate. Considering microbiological clearance and side effects, three days of azithromycin or seven days of clarithromycin are the best regimens. Seven days of trimethoprim/sulfamethoxazole also appeared to be effective for the eradication of B. pertussis from the nasopharynx and may serve as an alternative antibiotic treatment for patients who cannot tolerate a macrolide. There is insufficient evidence to determine the benefit of prophylactic treatment of pertussis contacts.
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- 2005
7. Non-surgical interventions for eosinophilic oesophagitis
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Renata H Kukuruzovic, Elizabeth J Elliott, Edward (Ted) V O'Loughlin, and Jonathan E Markowitz
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Adult ,Pediatrics ,medicine.medical_specialty ,Anti-Inflammatory Agents ,Cochrane Library ,Antibodies, Monoclonal, Humanized ,Placebo ,Esophageal candidiasis ,Eosinophilia ,medicine ,Esophagitis ,Humans ,Pharmacology (medical) ,Child ,Adverse effect ,Eosinophilic esophagitis ,Randomized Controlled Trials as Topic ,Fluticasone ,business.industry ,Antibodies, Monoclonal ,medicine.disease ,Androstadienes ,Prednisone ,business ,Mepolizumab ,medicine.drug - Abstract
BACKGROUND: People with eosinophilic esophagitis (EE) have clinical symptoms of esophageal disease, an elevated intraepithelial eosinophil count (15 in one or more high power field at endoscopy), consistent endoscopic findings and failure to respond to gastric acid suppressants. The cause of EE is unknown, however dietary, environmental and immunological factors may contribute. Current medical therapies include steroids, dietary manipulation, mast cell inhibitors, leukotriene receptor antagonists and immune modulators; however there is no universal approach to treatment. OBJECTIVES: To evaluate the benefits and harms of medical interventions for EE. SEARCH METHODS: We searched the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group trials register (The Cochrane Library Issue 1, 2009), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2009), MEDLINE (1966 to February 2009) and EMBASE (1980 to February 2009). SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing a medical or dietary intervention for EE with a placebo or with another medical intervention. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened the titles of abstracts. MAIN RESULTS: Three RCTs fulfilled inclusion criteria, two in children and one in adults. In one trial, topical fluticasone decreased vomiting more than placebo (67% versus (vs) 27%, P
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- 2004
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8. Hypotonic vs isotonic saline solutions for intravenous fluid management of acute infections
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Asish Mathur, Michael McGuigan, Trevor Duke, and Renata H Kukuruzovic
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medicine.medical_specialty ,Isotonic saline ,business.industry ,medicine.medical_treatment ,MEDLINE ,Sodium Chloride ,Infections ,Clinical research ,Intravenous fluid ,Anesthesia ,Acute Disease ,Medicine ,Tonicity ,Fluid Therapy ,Humans ,Pharmacology (medical) ,Isotonic Solutions ,business ,Intensive care medicine ,Adverse effect ,Saline - Abstract
Background Hypotonic saline (such as 0.18−0.3% NaCl with dextrose) is commonly used as maintenance fluid in the management of acute infections. In recent years there have been numerous reports of hypotonic saline solutions being associated with adverse outcomes. To reduce the rates of adverse outcomes, use of isotonic saline as maintenance fluid has been proposed. Objectives To assess adverse events and benefits associated with infusion of hypotonic saline compared with isotonic saline solutions in the management of acute infections. Search methods We searched MEDLINE, EMBASE, the Cochrane Controlled Trials Register, Current Controlled Trials and the Specialised Register of the Injuries Group. Selection criteria Randomised trials comparing hypotonic saline to isotonic saline in the management of acute infections. Data collection and analysis Three reviewers independently evaluated all potentially relevant articles, examined each study for possible inclusion and assessed the methodology quality using the Cochrane guidelines. Main results No trials met our inclusion criteria. Authors' conclusions Although there is ample evidence elsewhere that administration of large volumes of hypotonic fluids has led to severe hyponatraemia and adverse neurological outcomes in many patients with a variety of medical and surgical conditions, we found no randomised controlled trials investigating whether use of isotonic saline as maintenance fluid in those who require intravenous fluid would a be safer alternative. Careful research with adequate design and sample sizes is needed to evaluate the benefits and safety of using isotonic saline as maintenance fluid in a variety of acute clinical conditions.
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- 2004
9. Increased nitric oxide production in acute diarrhoea is associated with abnormal gut permeability, hypokalaemia and malnutrition in tropical Australian aboriginal children
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Nicholas M. Anstey, E. Gray, Renata H. Kukuruzovic, and David Brewster
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Diarrhea ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Nutritional Status ,Hypokalemia ,Nitric Oxide ,Gastroenterology ,Intestinal absorption ,Permeability ,Excretion ,chemistry.chemical_compound ,Internal medicine ,medicine ,Northern Territory ,Humans ,Nitrites ,Acidosis ,Creatinine ,Intestinal permeability ,Nitrates ,business.industry ,digestive, oral, and skin physiology ,Public Health, Environmental and Occupational Health ,Infant ,General Medicine ,medicine.disease ,Surgery ,Nutrition Disorders ,Malnutrition ,Infectious Diseases ,Logistic Models ,chemistry ,Intestinal Absorption ,Acute Disease ,Regression Analysis ,Parasitology ,medicine.symptom ,business - Abstract
Australian Aboriginal children hospitalized with diarrhoeal disease have severe manifestations with acidosis, hypokalaemia, osmotic diarrhoea and abnormal small bowel permeability. Nitric oxide (NO) production is increased in diarrhoeal disease, but its relationship to mucosal function and diarrhoeal complications is not known. We examined the relationship between NO production and complications of acute diarrhoea in Aboriginal and non-Aboriginal children between February 1998 and February 2000. We enrolled 318 children admitted to Royal Darwin Hospital into one of three groups: acute diarrhoea, non-diarrhoeal controls with no inflammatory illness, and non-diarrhoeal controls with inflammatory illness. Nitric oxide production was measured by urine nitrate-creatinine (NOx/Cr) excretion on a low nitrate diet. Small bowel intestinal permeability was measured by the lactulose-rhamnose (L/R) ratio on a timed blood specimen. The NOx/Cr ratios were markedly elevated in Aboriginal diarrhoeal cases (geometric mean [GM] = 1.23, 95% confidence interval [95% CI] 1.07-1.44), lowest in non-Aboriginal non-inflammatory controls (GM = 0.13, 95% CI 0.10-0.16) and intermediate in all other groups (GM = 0.35, 95% CI 0.28-0.43). Convalescent levels (day 5) in the Aboriginal diarrhoeal group (GM = 1.02, 95% CI 0.82-1.28) were slower to fall than L/R ratios. Multivariate analysis in the diarrhoeal group indicated that high NO production was associated with abnormal permeability, hypokalaemia and malnutrition, but not with the severity of diarrhoea, acidosis or osmotic diarrhoea. We concluded that increased NO production may contribute to impaired mucosal barrier function and hypokalaemia in acute gastroenteritis, which may be the cost of the known gut-protective and antimicrobial effects mediated by NO in acute intestinal inflammation.
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- 2003
10. Enteric pathogens, intestinal permeability and nitric oxide production in acute gastroenteritis
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David Brewster, Roy M. Robins-Browne, Nicholas M. Anstey, and Renata H. Kukuruzovic
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Microbiology (medical) ,Diarrhea ,Male ,Rotavirus ,Native Hawaiian or Other Pacific Islander ,Cryptosporidium ,medicine.disease_cause ,Nitric Oxide ,Intestinal absorption ,Microbiology ,Strongyloides stercoralis ,parasitic diseases ,Strongyloides ,medicine ,Animals ,Humans ,Intestinal Mucosa ,Child ,biology ,business.industry ,Australia ,Infant ,biology.organism_classification ,medicine.disease ,Gastroenteritis ,Intestines ,Infectious Diseases ,Cryptosporidium parvum ,Strongyloidiasis ,Intestinal Absorption ,Case-Control Studies ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Linear Models ,Female ,medicine.symptom ,business - Abstract
Background. Aboriginal children hospitalized with diarrheal disease in northern Australia have high rates of acidosis, hypokalemia and osmotic diarrhea, as well as abnormal small bowel permeability and elevated nitric oxide (NO) production. Methods. In a study of 291 diarrheal admissions and 84 controls, we examined the relationship of diarrheal severity outcomes with specific enteric pathogens. NO production was measured by urine nitrate plus nitrite excretion on a low nitrate diet, small bowel permeability by the lactulose:rhamnose ratio on a timed blood specimen and stool pathogens by standard microbiologic investigations and PCR. Results. The addition of diagnostic tests for diarrheagenic Escherichia coli to standard stool microbiologic testing increased the rate of specific diagnoses from 53% to 75%, but with multiple pathogens isolated from 34%. The most frequently isolated pathogens from diarrheal patients were enteroaggregative E. coli (28.9%), rotavirus (26.5%), enteropathogenic E. coli (17.2%), Salmonella spp. (10.7%), Cryptosporidium parvum (7.2%) and Strongyloides stercoralis (7.2%). High geometric mean permeability ratios (95% confidence intervals) occurred with rotavirus (19.6; 15.3 to 25.1), enteroaggregative E. coli (21.2; 15.3 to 29.3) and Cryptosporidium (23.0; 15.1 to 35.1) compared with 9.4 (6.8 to 13.1) for no pathogens. NO production was highest for Cryptosporidium (3.7; 2.3 to 6.1) compared with 0.6 (0.4 to 1.1) for no pathogens. Multiple regression analysis revealed significant associations (P < 0.001) for rotavirus with acidosis and osmotic diarrhea, for Strongyloides with wasting and hypokalemia and for Cryptosporidium with severe and prolonged diarrhea. Conclusions. Cryptosporidium, Strongyloides, rotavirus and enteroaggregative E. coli are important contributors to the severe manifestations of acute gastroenteritis in Australian Aboriginal children.
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- 2002
11. Antibiotics for cholangitis and/or cholecystitis
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Sunita Chauhan, Stuart Dorney, Elizabeth J Elliott, and Renata H Kukuruzovic
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medicine.medical_specialty ,business.industry ,medicine.drug_class ,Antibiotics ,Cholecystitis ,medicine ,Pharmacology (medical) ,medicine.disease ,Intensive care medicine ,business - Published
- 2002
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12. Short Bowel Syndrome, Intestinal Permeability and Glutamine
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Renata H. Kukuruzovic, Antje M. Haase, and David Brewster
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Glutamine ,medicine.medical_specialty ,Intestinal permeability ,business.industry ,Internal medicine ,Pediatrics, Perinatology and Child Health ,Gastroenterology ,medicine ,business ,Short bowel syndrome ,medicine.disease - Published
- 1998
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