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Travelers Diarrhea

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101. Seroepidemiology of norovirus-associated travelers' diarrhea. Full Text available with Trip Pro

Seroepidemiology of norovirus-associated travelers' diarrhea. Noroviruses (NoVs) are the most common cause of epidemic gastroenteritis, responsible for at least 50% of all gastroenteritis outbreaks worldwide and were recently identified as a leading cause of travelers' diarrhea (TD) in US and European travelers to Mexico, Guatemala, and India.Serum and diarrheic stool samples were collected from 75 US student travelers to Cuernavaca, Mexico, who developed TD. NoV RNA was detected in acute (...) infection was identified in 12 (16%; 9 GI-NoV and 3 GII-NoV) of 75 travelers by either RT-PCR or fourfold or more rise in antibody titer. Significantly more individuals had detectable preexisting IgA antibodies against HOV (62/75, 83%) than against NV (49/75, 65%) (p = 0.025) VLPs. A significant difference was observed between NV- and HOV-specific preexisting IgA antibody levels (p = 0.0037), IgG (p = 0.003), and BT50 (p = <0.0001). None of the NoV-infected TD travelers had BT50  > 200, a level that has

2014 Journal of Travel Medicine

102. Targeting of Rifamycin SV to the Colon for Treatment of Travelers' Diarrhea: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Study. Full Text available with Trip Pro

Targeting of Rifamycin SV to the Colon for Treatment of Travelers' Diarrhea: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Study. Rifamycin SV is under development for treatment of travelers' diarrhea (TD) in a new oral formulation, Rifamycin SV MMX (RIF-MMX; Santarus Inc., San Diego, CA, USA), which targets its delivery to the colon, making it a unique rifamycin drug.This was a randomized, double-blind, phase 3 study of adult travelers to Mexico or Guatemala experiencing acute (...) diarrhea. A total of 264 patients received RIF-MMX (2 × 200 mg twice daily for 3 days, n = 199) or placebo (n = 65) in a 3 : 1 ratio. The primary endpoint was the length of time between the administration of first dose of study drug and passage of the last unformed stool (TLUS; after which clinical cure was declared). Other endpoints included eradication of pathogens from the stools, pathogen minimum inhibitory concentration (MIC), and adverse events (AEs).TLUS was significantly shorter in the RIF-MMX

2014 Journal of Travel Medicine Controlled trial quality: predicted high

103. High number of diarrhoeal co-infections in travellers to Benin, West Africa. Full Text available with Trip Pro

High number of diarrhoeal co-infections in travellers to Benin, West Africa. Travellers' diarrhoea (TD) is the most frequent health problem among travellers to the tropics. Using routine techniques, the aetiology mostly remains unresolved, whereas modern molecular methods enable reducing the number of equivocal cases considerably. While many studies address the aetiology of TD in Asian, Central American and North African tourist resorts, only few focus on Western Africa.Stool samples from 45 (...) travellers travelling in Benin, West Africa, were analyzed by a new multiplex qPCR assay for Salmonella, Yersinia, Campylobacter, Vibrio cholerae, Shigella or enteroinvasive (EIEC), enterohaemorrhagic (EHEC), enterotoxigenic (ETEC), enteroaggregative (EAEC), and enteropathogenic Escherichia coli (EPEC).All 18 pre-travel samples proved negative for bacterial pathogens. Of the 39/45 (87%) travellers having had TD, EPEC was detected in post-travel samples in 30 (77%) cases, EAEC in 23 (59%), ETEC in 22 (56

2014 BMC Infectious Diseases

104. Aetiology of traveller's diarrhoea: Evaluation of a multiplex PCR tool to detect different enteropathogens. Full Text available with Trip Pro

Aetiology of traveller's diarrhoea: Evaluation of a multiplex PCR tool to detect different enteropathogens. Traveller's diarrhoea (TD) is the most common illness reported in international travellers. TD is caused by a wide range of pathogens, including bacteria, viruses and parasites. Multiplex PCR assays can be especially useful for studying the aetiology of TD. The first objective of this study was to evaluate the utility of the commercially available multiplex PCR (xTAG(®) Gastrointestinal (...) obtained by the GPP test and routine methods. The primary pathogens causing TD were Shigella (24.2%) followed by enterotoxigenic Escherichia coli (ETEC) (23.2%), enteroaggregative E. coli (14.7%) and Giardia (13.7%). Significant regional differences were observed for ETEC with 19.4% of TD cases acquired in Africa, 11.3% in Asia and none in South Central (SC) America (p 0.01), Giardia was found in 1.5% of cases among those who had travelled to Africa, 14.1% of those who had travelled to Asia and 3

2014 Clinical Microbiology and Infection

105. Extended-spectrum β-lactamase prevalence and virulence factor characterization of enterotoxigenic Escherichia coli responsible for acute diarrhea in Nepal from 2001 to 2016 Full Text available with Trip Pro

(ETEC) is a leading cause of both acute infant diarrhea and traveler's diarrhea in Nepal. The MDR prevalence and associated resistance mechanisms of ETEC isolates responsible for enteric infections in Nepal are largely unknown.A total of 265 ETEC isolates were obtained from acute diarrheal samples (263/265) or patient control samples (2/265) at traveler's clinics or regional hospitals in Nepal from 2001 to 2016. Isolates were screened for antibiotic resistance, to include extended spectrum beta (...) Extended-spectrum β-lactamase prevalence and virulence factor characterization of enterotoxigenic Escherichia coli responsible for acute diarrhea in Nepal from 2001 to 2016 Multidrug-resistant (MDR) Gram-negative bacterial species are an increasingly dangerous public health threat, and are now endemic in many areas of South Asia. However, there are a lack of comprehensive data from many countries in this region determining historic and current MDR prevalence. Enterotoxigenic Escherichia coli

2018 Antimicrobial resistance and infection control

106. Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea Full Text available with Trip Pro

is increasing, it is essential to restrict the use of antibiotics to prevent further resistance development. We aimed to investigate EAEC strains in adult Danish patients suffering from diarrhea and from healthy controls. We examined the antibiotic resistance in EAEC strains, the clinical response to antibiotic treatment in EAEC diarrheal cases, and the distribution of virulence genes in diarrheal cases. The EAEC strains were collected from patients suffering from diarrhea in a Danish multicenter study (...) in the adult Danish population was rare, in contrast to findings in healthy Danish children. The duration of diarrhea was not shortened by antibiotic treatment, specifically ciprofloxacin treatment, or by over-the-counter antidiarrheal drugs. Follow-up revealed no pathology in diarrheal patients apart from irritable bowel syndrome in two patients. A high number of patients suffered from long-term diarrhea, which was associated with the enterotoxin EAST-1 and a high virulence factor score. A high level

2018 Frontiers in cellular and infection microbiology

107. Cholera: under diagnosis and differentiation from other diarrhoeal diseases. Full Text available with Trip Pro

to shared pathology and symptoms with few reported cases in travellers from Northern Europe.A search of PubMed and Ovid Medline for publications on cholera diagnosis from 2010 through 2017 was conducted. Search terms included were cholera, Rapid Diagnostic Test (RDT), multiplex PCR and diagnosis of diarrhoea. Studies were included if they are published in English, French or Spanish.An increase of RDT study publications for diarrhoeal disease and attempted test validations were seen over the publication (...) in underdeveloped countries and in travellers to those areas. The wider applicability of RDTs may also represent an opportunity in the wider management of traveller's diarrhoea.

2018 Journal of Travel Medicine

108. TReatment of Irritable Bowel Syndrome With Diarrhoea Using Titrated ONdansetron Trial

provided by University of Leeds: Diarrhoea Additional relevant MeSH terms: Layout table for MeSH terms Syndrome Diarrhea Irritable Bowel Syndrome Disease Pathologic Processes Signs and Symptoms, Digestive Signs and Symptoms Colonic Diseases, Functional Colonic Diseases Intestinal Diseases Gastrointestinal Diseases Digestive System Diseases Ondansetron Antiemetics Autonomic Agents Peripheral Nervous System Agents Physiological Effects of Drugs Gastrointestinal Agents Antipruritics Dermatologic Agents (...) TReatment of Irritable Bowel Syndrome With Diarrhoea Using Titrated ONdansetron Trial TReatment of Irritable Bowel Syndrome With Diarrhoea Using Titrated ONdansetron Trial - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before

2018 Clinical Trials

109. Enterotoxigenic Escherichia coli Adhesin-Toxoid Multiepitope Fusion Antigen CFA/I/II/IV-3xSTaN12S-mnLTG192G/L211A-Derived Antibodies Inhibit Adherence of Seven Adhesins, Neutralize Enterotoxicity of LT and STa Toxins, and Protect Piglets against Diarrhea Full Text available with Trip Pro

Enterotoxigenic Escherichia coli Adhesin-Toxoid Multiepitope Fusion Antigen CFA/I/II/IV-3xSTaN12S-mnLTG192G/L211A-Derived Antibodies Inhibit Adherence of Seven Adhesins, Neutralize Enterotoxicity of LT and STa Toxins, and Protect Piglets against Diarrhea Enterotoxigenic Escherichia coli (ETEC) strains are a leading cause of children's diarrhea and travelers' diarrhea. Vaccines inducing antibodies to broadly inhibit bacterial adherence and to neutralize toxin enterotoxicity are expected (...) to be effective against ETEC-associated diarrhea. 6×His-tagged adhesin-toxoid fusion proteins were shown to induce neutralizing antibodies to several adhesins and LT and STa toxins (X. Ruan, D. A. Sack, W. Zhang, PLoS One 10:e0121623, 2015, https://doi.org/10.1371/journal.pone.0121623). However, antibodies derived from His-tagged CFA/I/II/IV-2xSTaA14Q-dmLT or CFA/I/II/IV-2xSTaN12S-dmLT protein were less effective in neutralizing STa enterotoxicity and were not evaluated in vivo for efficacy against ETEC

2018 Infection and immunity

110. Visualization-assisted binning of metagenome assemblies reveals potential new pathogenic profiles in idiopathic travelers’ diarrhea Full Text available with Trip Pro

Visualization-assisted binning of metagenome assemblies reveals potential new pathogenic profiles in idiopathic travelers’ diarrhea Travelers' diarrhea (TD) is often caused by enterotoxigenic Escherichia coli, enteroaggregative E. coli, other bacterial pathogens, Norovirus, and occasionally parasites. Nevertheless, standard diagnostic methods fail to identify pathogens in more than 40% of TD patients. It is predicted that new pathogens may be causative agents of the disease.We performed (...) a comprehensive amplicon and whole genome shotgun (WGS) metagenomic study of the fecal microbiomes from 23 TD patients and seven healthy travelers, all of which were negative for the known etiologic agents of TD based on standard microbiological and immunological assays. Abnormal and diverse taxonomic profiles in TD samples were revealed. WGS reads were assembled and the resulting contigs were visualized using multiple query types. A semi-manual workflow was applied to isolate independent genomes from

2018 Microbiome

111. Critical Role of Zinc in a New Murine Model of Enterotoxigenic Escherichia coli Diarrhea Full Text available with Trip Pro

Critical Role of Zinc in a New Murine Model of Enterotoxigenic Escherichia coli Diarrhea Enterotoxigenic Escherichia coli (ETEC) is a major cause of traveler's diarrhea as well as of endemic diarrhea and stunting in children in developing areas. However, a small-mammal model has been badly needed to better understand and assess mechanisms, vaccines, and interventions. We report a murine model of ETEC diarrhea, weight loss, and enteropathy and investigate the role of zinc in the outcomes. ETEC (...) strains producing heat-labile toxins (LT) and heat-stable toxins (ST) that were given to weaned C57BL/6 mice after antibiotic disruption of normal microbiota caused growth impairment, watery diarrhea, heavy stool shedding, and mild to moderate intestinal inflammation, the latter being worse with zinc deficiency. Zinc treatment promoted growth in zinc-deficient infected mice, and subinhibitory levels of zinc reduced expression of ETEC virulence genes cfa1, cexE, sta2, and degP but not of eltA in vitro

2018 Infection and immunity

112. Sodium butyrate and short chain fatty acids in prevention of travellers' diarrhoea: A randomized prospective study. (Abstract)

Sodium butyrate and short chain fatty acids in prevention of travellers' diarrhoea: A randomized prospective study. Travellers' diarrhoea (TD) remains a considerable concern among international travellers. Known methods of prevention include dietary precautions, administration of vaccines and antibiotic agents.To assess the efficacy of sodium butyrate (SB) and short-chain fatty acids (SCFA) in prevention of TD.67 adult patients planning to travel to subtropical countries were originally (...) ), was associated with a significant decrease in number of stools per day in travellers (1.9 vs. 4.2, p = 0.04), as well as a decrease in gastrointestinal symptoms including pain, bloating and nausea with fevers (0.7 vs. 1.4, p = 0.01). We recorded a trend towards decrease in diarrhoea related utilization of medical care in subjects from the study arm. There were no adverse effects noted regarding the use of SB and SCFA.Administration of SB with SCFA decreases occurrence of travellers' diarrhoea. It is safe

2013 Travel medicine and infectious disease Controlled trial quality: uncertain

113. Development and Accuracy of Quantitative Real-Time Polymerase Chain Reaction Assays for Detection and Quantification of Enterotoxigenic Escherichia coli (ETEC) Heat Labile and Heat Stable Toxin Genes in Travelers' Diarrhea Samples. Full Text available with Trip Pro

Development and Accuracy of Quantitative Real-Time Polymerase Chain Reaction Assays for Detection and Quantification of Enterotoxigenic Escherichia coli (ETEC) Heat Labile and Heat Stable Toxin Genes in Travelers' Diarrhea Samples. Enterotoxigenic Escherichia coli (ETEC), the leading bacterial pathogen of travelers' diarrhea, is routinely detected by an established DNA hybridization protocol that is neither sensitive nor quantitative. Quantitative real-time polymerase chain reaction (qPCR

2013 American Journal of Tropical Medicine & Hygiene

114. A Randomized, Double Blind, Placebo-Controlled Trial of an Oral Synbiotic (AKSB) for Prevention of Travelers' Diarrhea. Full Text available with Trip Pro

A Randomized, Double Blind, Placebo-Controlled Trial of an Oral Synbiotic (AKSB) for Prevention of Travelers' Diarrhea. Travelers' diarrhea (TD) is a significant problem for travelers. TD is treatable once it occurs, but few options for prevention exist. Probiotics have been studied for prevention or treatment of TD; however, very few combination probiotics have been studied. Therefore, the purpose of this study was to determine if prophylactic use of an oral synbiotic could reduce the risk (...) and 53.9% in the placebo (p = 0.8864). Among the subjects who experienced diarrhea (n = 107) there was no significant difference in the proportion of subjects that took antibiotics versus those that did not take antibiotics (35% vs 29%, p = 0.68). AKSB was safe with no difference in toxicity between the two arms.The prophylactic oral synbiotic was safe but did not reduce the risk of developing TD among travelers, nor did it decrease the duration of TD or the use of antibiotics when TD occurred.© 2013

2013 Journal of Travel Medicine Controlled trial quality: predicted high

115. Post-infectious sequelae of travelers' diarrhea. Full Text available with Trip Pro

Post-infectious sequelae of travelers' diarrhea. Travelers' diarrhea (TD) has generally been considered a self-limited disorder which resolves more quickly with expeditious and appropriate antibiotic therapy given bacteria are the most frequently identified cause. However, epidemiological, clinical, and basic science evidence identifying a number of chronic health conditions related to these infections has recently emerged which challenges this current paradigm. These include serious (...) and potentially disabling enteric and extra-intestinal long-term complications. Among these are rheumatologic, neurologic, gastrointestinal, renal, and endocrine disorders. This review aims to examine and summarize the current literature pertaining to three of these post-infectious disorders: reactive arthritis, Guillain-Barré syndrome, and post-infectious irritable bowel syndrome and the relationship of these conditions to diarrhea associated with travel as well as to diarrhea associated with gastroenteritis

2013 Journal of Travel Medicine

116. Effectiveness of rifaximin in prevention of diarrhoea in individuals travelling to south and southeast Asia: a randomised, double-blind, placebo-controlled, phase 3 trial. (Abstract)

Asia, where enteroinvasive and antibiotic-resistant bacteria cause a substantial proportion of diarrhoeal episodes. We aimed to assess the effectiveness of rifaximin in prevention of diarrhoea in individuals travelling to south and southeast Asia.We did this double-blind, placebo-controlled, single-centre, parallel-group, clinical trial in Tübingen, Germany, between Nov 12, 2009, and Sept 3, 2012. Individuals aged 18-64 years who were planning a 6-28 day journey to south and southeast Asia were (...) Effectiveness of rifaximin in prevention of diarrhoea in individuals travelling to south and southeast Asia: a randomised, double-blind, placebo-controlled, phase 3 trial. Travellers' diarrhoea causes substantial acute and long-term morbidity. Chemoprophylaxis with fluoroquinolones or rifaximin is effective in prevention of diarrhoea in individuals travelling to Latin America and Africa. Little evidence is available to support the protective effect of antimicrobial drugs in south and southeast

2013 Lancet infectious diseases Controlled trial quality: predicted high

117. A quantitative polymerase chain reaction assay for rapid detection of 9 pathogens directly from stools of travelers with diarrhea. (Abstract)

A quantitative polymerase chain reaction assay for rapid detection of 9 pathogens directly from stools of travelers with diarrhea. Every year, 80 million tourists traveling to tropical and subtropical areas contract traveler's diarrhea (TD). Forty percent to 80% of cases are caused by bacteria, yet clinical diagnostic tests are available to identify only a few of the strains that cause TD. We aimed to develop a quantitative polymerase chain reaction (qPCR) assay to identify all major pathogens (...) positive and negative stool samples. In addition, stool samples were collected from 96 returning travelers with TD. The findings were compared with those from routine diagnostic tests.The assay detected the bacterial strains with 100% sensitivity and specificity, compared with results from the reference tests. Of all stool samples collected from travelers with TD, EPEC was found in 47%, EAEC in 46%, ETEC in 22%, enterohemorrhagic E coli in 7%, Campylobacter in 6%, Shigella or enteroinvasive E coli in 2

2013 Clinical Gastroenterology and Hepatology

118. Development of an ERIC sequence typing scheme for Laribacter hongkongensis, an emerging pathogen associated with community-acquired gastroenteritis and traveller's diarrhoea. Full Text available with Trip Pro

Development of an ERIC sequence typing scheme for Laribacter hongkongensis, an emerging pathogen associated with community-acquired gastroenteritis and traveller's diarrhoea. Laribacter hongkongensis is a potential emerging pathogen, associated with community-acquired diarrhoea. For epidemiological purposes, different molecular typing methods, such as pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing, have been developed for this pathogen. However, these methods require

2013 Journal of Medical Microbiology

119. Travelers' diarrhea: Prevention, treatment, and post-trip evaluation. (Abstract)

Travelers' diarrhea: Prevention, treatment, and post-trip evaluation. 23957028 2013 11 04 2013 11 21 1533-7294 62 7 2013 Jul The Journal of family practice J Fam Pract Travelers' diarrhea: prevention, treatment, and post-trip evaluation. 356-61 Nair Dilip D Joan C. Edwards School of Medicine at Marshall University, Huntington, WV, USA. nair@marshall.edu eng Case Reports Journal Article United States J Fam Pract 7502590 0094-3509 0 Anti-Bacterial Agents 0 Antidiarrheals 6X9OC3H4II Loperamide (...) 83905-01-5 Azithromycin AIM IM J Fam Pract. 2013 Sep;62(9):464 Adult Anti-Bacterial Agents administration & dosage Antibiotic Prophylaxis Antidiarrheals therapeutic use Azithromycin administration & dosage Beverages Chemoprevention Diarrhea epidemiology microbiology prevention & control therapy Female Food Humans Loperamide therapeutic use Risk Factors Travel 2013 8 20 6 0 2013 8 21 6 0 2013 11 5 6 0 ppublish 23957028 jfp_6207g

2013 Journal of Family Practice

120. Tropical Travel Trouble 005 RUQ Pain and Jaundice

rates can be over 90% E. histolytica infection coincides with poor sanitation , poor hygiene, overcrowding, and poverty. It is also seen in immigrants, displaced people, and travelers visiting low and middle-income countries (although it is an uncommon cause of travellersdiarrhoea, 0.3% in one perspective study of German’s in the tropics). Q2. How does infection occur? Answer and interpretation Fecal-oral fashion by ingesting E. hystolytica cysts, cysts are the infective form and can survive (...) in the environment for weeks to months. The ingestion of one cyst is enough to cause disease. The cysts are resistant to stomach acid and pass into the small intestine. 4 active trophozoites emerge from one cyst (each cyst has 4 nuclei), mature and travel toward the colon. The trophozoites cause the invasive disease ultimately resulting in body diarrhoea (dysentery). These trophozoites invade the mucosa by killing epithelial cells and inflammatory cells, secrete proteinases, and possibly disrupt tight junctions

2018 Life in the Fast Lane Blog

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