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Travelers Diarrhea

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121. Tropical Travel Trouble 009 Humongous HIV Extravaganza

: a randomised clinical trial. JAMA 2000; 283:1167–74. Rollins NC, et al . Exclusive breastfeeding, diarrhoeal morbidity and all-cause mortality in infants of HIV-infected and HIV uninfected mothers: an intervention cohort study in KwaZulu Natal, South Africa. PLoS One 2013; 8:e81307. UK Guideline for the use of HIV Following Sexual Exposure (PEPSE) 2015. WHO – – guidelines 2016 update. WHO – – guidelines 2016 WHO – – guidelines July 2015 CLINICAL CASES Tropical Travel Trouble Peer Reviewer • Dr McBride ID (...) Tropical Travel Trouble 009 Humongous HIV Extravaganza Humongous HIV Extravaganza • LITFL • Tropical Traveler Clinical Cases Emergency medicine and critical care medical education blog Search LITFL ... | | | Humongous HIV Extravaganza , last update March 1, 2019 aka 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease

2018 Life in the Fast Lane Blog

122. Got diarrhea? The latest trend in fashionable nonsense is “raw water”

Got diarrhea? The latest trend in fashionable nonsense is “raw water” Got diarrhea? The latest trend in fashionable nonsense is "raw water" - RESPECTFUL INSOLENCE March 27, 2019 March 25, 2019 March 22, 2019 March 20, 2019 March 19, 2019 March 18, 2019 Denice Walter on squirrelelite on Derek Freyberg on RJ on RJ on RJ on RJ on rs on Christine Rose on Nancie on on Search and explore Browse "A statement of fact cannot be insolent." The miscellaneous ramblings of a surgeon/scientist on medicine (...) , quackery, science, and pseudoscience (and anything else that interests him). Got diarrhea? The latest trend in fashionable nonsense is “raw water” As an old year fades into its final days and a new year approaches, I always wonder what new quackery will make an appearance in the new year. I know, of course, that all the old quackeries, cancer quackery, antivaccine pseudoscience, homeopathy, naturopathy, reflexology, and the huge number of other variations on self-deception will still be there. I also

2018 Respectful Insolence

123. French Travelers' Knowledge of Risk of Acquiring ESBL-PE

Posted: November 13, 2017 Last Update Posted: November 13, 2017 Last Verified: November 2017 Layout table for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Keywords provided by CHU de Reims: Multidrug-resistant Enterobacteriaceae acquisition travellers' diarrhoea international travel (...) French Travelers' Knowledge of Risk of Acquiring ESBL-PE French Travelers' Knowledge of Risk of Acquiring ESBL-PE - 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 adding more. French Travelers' Knowledge of Risk

2017 Clinical Trials

124. Medical and psychological problems faced by young Australian gap year travellers. Full Text available with Trip Pro

( n = 14; 41.2%), and diarrhoea/food poisoning ( n = 13; 38.2%). Three participants (3.4%) were admitted to hospital; for a muscle injury, head injury and skin infection after getting a tribal tattoo.Psychological stressors were common, but most did not seek help. Some medical problems encountered during their placement may have been preventable with improved pre-departure preparation.Gap year, pre-departure, preparation.© International Society of Travel Medicine, 2017. Published by Oxford (...) Medical and psychological problems faced by young Australian gap year travellers. Gap year travellers can potentially be exposed to many infectious diseases and other travel-related health problems including injuries and psychological problems. Currently, there is little information on health and wellbeing of this particular group of travellers.Participants were recruited from an organization that specialized in organising international gap year placements. Gap year travellers were asked

2017 Journal of Travel Medicine

125. Seronegative Adult Autoimmune Enteropathy in a Male Traveler Full Text available with Trip Pro

Seronegative Adult Autoimmune Enteropathy in a Male Traveler Autoimmune enteropathy (AIE) is rare but damaging. The lack of consistent objective findings makes diagnosis a challenge. A 45-year-old male developed noninfectious diarrhea with significant weight loss and electrolyte abnormalities. Computed tomography delineated enteritis. Colonoscopy and esophagogastroduodenoscopy showed villous atrophy, chronic inflammation, and ulceration of the terminal ileum and cecum. Pathology showed (...) cryptitis with apoptosis and abscesses throughout the small and large bowel and absent goblet cells. Steroids rapidly improved symptoms. Anti-enterocyte antibody serologies were negative. Management can be challenging, and, in this case, the patient initially improved with budesonide and infliximab but required alternative anti-tumor necrosis factor therapy after relapsing. This is an unusual presentation of seronegative AIE, which should be considered in cases of persistent severe diarrhea.

2017 ACG case reports journal

126. Travellers returning ill from the tropics – a descriptive retrospective study Full Text available with Trip Pro

of presenting symptoms and diseases in ill returning travellers and to correlate them to the areas visited and the duration and purpose of travel. The main symptoms during travel were diarrhoea (n = 200, 56 %) and fever (n = 124, 34 %). Travellers not visiting friends and relatives but with close contact to the local population were at more than two-fold increased risk of diarrhoea (Odds Ratio [OR] 2.5; 95 % confidence interval [CI] 1.1-6.0, p = 0.03) and fever (OR 2.4; 95 % CI 1.1-5.3; p = 0.02) compared (...) to tourist travellers. Travellers visiting friends and relatives (VFR) were not at increased risk for diarrhoea (OR 0.6; 95 % CI 0.3-1.3; p = 0.17), or fever (OR 1.5; 95 % CI 0.7-3.4; p = 0.28). Thirty-two percent of all travellers (n = 115) were diagnosed with a specific pathogen. Malaria (6 %), giardiasis (6 %) and amebiasis (4 %) were the most frequently detected pathogens. The odds of malaria as a cause of the presenting illness was lower among travellers reporting pre-travel advice. Specific

2016 Tropical diseases, travel medicine and vaccines

127. Health problems and health care seeking behavior among adult backpackers while traveling in Thailand Full Text available with Trip Pro

reported at least health problem during travel. Most of them (79.1 %) had single episode of illness. Of this, diarrhea was the most common health problem (30.4 %), followed by abdominal pain (14.3 %), skin problems (8.9 %), respiratory problems (8.9 %), accident-associated injury (7.1 %), and febrile illness (7.1 %). One third of backpackers with health problems spontaneously recovered without any treatment, while nearly a quarter treated themselves with standby medication, and one in five had to buy (...) Health problems and health care seeking behavior among adult backpackers while traveling in Thailand Health problems among travelers in developing countries are not uncommon. Little is known about the occurrence of health problems and their impacts among backpackers in Thailand. The objective of this study was to assess the health problems and the health seeking behavior among adult backpackers who visited Thailand.This was a cross-sectional questionnaire-based study. Data were collected from

2016 Tropical diseases, travel medicine and vaccines

128. Acute Liver Failure in a Patient Travelling From Asia: The Other Face of the Coin of Infectious Disease Full Text available with Trip Pro

Acute Liver Failure in a Patient Travelling From Asia: The Other Face of the Coin of Infectious Disease We present a case of a 63-year-old male who had travelled from South India to United Kingdom (UK) visiting relatives. He had developed episodes of diarrhea, vomiting and fevers while travelling and on assessment in hospital, mild abdominal distension was noted with rapid deterioration to hypovolemic shock. Initial blood test showed a low platelet count with deranged liver function tests (LFTs

2017 Gastroenterology research

129. Antibiotic susceptibility profiles among Campylobacter isolates obtained from international travelers between 2007 and 2014 Full Text available with Trip Pro

Antibiotic susceptibility profiles among Campylobacter isolates obtained from international travelers between 2007 and 2014 Campylobacter infection is a common cause of diarrhea among international travelers. We studied antibiotic resistance patterns among Campylobacter isolates obtained from international travelers according to travel destination. Three collections of isolates obtained from international travelers between 2007 and 2014 (Institute of Tropical Medicine, the "Laboratoire (...) Hospitalier Universitaire de Bruxelles "and the Belgian National Reference Centre for Campylobacter) were used. Isolates were tested for minimal inhibitory concentration (MIC) values (E-test macromethod) for fluoroquinolones, macrolides, tetracyclines, amoxicillin-clavulanic acid, and meropenem. Single isolates from 261 travelers were available; median (IQR) age was 25.4 (4-42) years, 85.8% were symptomatic (information for 224 patients available). Overall resistance to ciprofloxacin was 60.9%, ranging

2017 European Journal of Clinical Microbiology & Infectious Diseases

130. Non-inferiority Trials of the Quality of Nurse Consultation Versus a Medical Consultation in Travel Medicine.

to the individual prevention of the traveler's Malaria, diarrhea and sexually transmitted infections. [ Time Frame: At day 1 ] Evaluated by a post-consultation memorization survey Secondary Outcome Measures : Quality score of the support consultation evaluating the memorization of Information by travelers. [ Time Frame: At day 1 ] Evaluated by memorisation survey Level of satisfaction of travelers [ Time Frame: At day 1 ] The level of satisfaction will be assessed by a visual scale. The relevance of the choice (...) Non-inferiority Trials of the Quality of Nurse Consultation Versus a Medical Consultation in Travel Medicine. Non-inferiority Trials of the Quality of Nurse Consultation Versus a Medical Consultation in Travel Medicine. - 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

2017 Clinical Trials

131. A Pilot Study Assessing Intestinal Microbiota Diversification and Changes After Travel to South(East) Asia From the US

. Multiple organisms have been implicated as causes of travelers' diarrhea, but bacteria account for 80-90% of cases. There is mounting evidence that the integrity of the intestinal microbiome may be a strong modulator of diarrheal disease, and that intestinal infections and other factors, including stress, antibiotic exposure, and diet may disrupt the diversity and overall composition of the microbiome. Dysbiosis, a state of altered microbiota diversity, may be less resistant to the acquisition (...) to South or Southeast Asia, regions where rates of travelers' diarrhea and intestinal colonization with antimicrobial resistant bacteria are highest. To measure the diversity change of the intestinal microbiota, participants will complete a questionnaire and provide a stool specimen at three different time points: prior to traveling, two weeks after returning from traveling, and 14 weeks after returning from traveling. Condition or disease Intervention/treatment Dysbiosis Other: Screening Criteria

2017 Clinical Trials

132. Colonization Factors in Enterotoxigenic Escherichia coli Strains in Travelers to Mexico, Guatemala, and India Compared with Children in Houston, Texas. Full Text available with Trip Pro

Colonization Factors in Enterotoxigenic Escherichia coli Strains in Travelers to Mexico, Guatemala, and India Compared with Children in Houston, Texas. Enterotoxigenic Escherichia coli (ETEC) can be attributed to around 200 million diarrheal episodes and 380,000 deaths in the developing regions. Travelers' diarrhea occurs in 15-40% of travelers to developing regions with ETEC being the most important etiologic agent. This study aims to describe the distribution of enterotoxins and colonization (...) factor (CF) profiles of ETEC isolates from stool samples of adult travelers acquiring diarrhea in Mexico, Guatemala, and India and a group of children with acute diarrhea in Houston, TX, between 2007 and 2012. The heat-labile/heat-stable (LT/ST) enterotoxins and CFs from 252 patients were determined using polymerase chain reaction assay. Among the 252 ETEC isolates, 15% were LT-only, 58% were ST-only, and 28% produced both LT and ST. The distribution of LT-only (12-15%) and ST-only (55-56%) isolates

2017 American Journal of Tropical Medicine & Hygiene

133. Travel-acquired ESBL-producing Enterobacteriaceae: impact of colonization at individual and community level. Full Text available with Trip Pro

on travel-acquired ESBL-PE. The acquisition rates reveal that 2070% of visitors to (sub)tropical regions get colonized by ESBL-PE. The main risk factors predisposing to colonization during travel are destination, travelers diarrhea, and antibiotic use.While most of those colonized remain asymptomatic, acquisition of ESBL-PE may have consequences both at individual and community level. We discuss current efforts to restrict the spread.© International Society of Travel Medicine, 2017. Published by Oxford (...) Travel-acquired ESBL-producing Enterobacteriaceae: impact of colonization at individual and community level. Antibiotic resistance is a rapidly increasing global emergency that calls for action from all of society. Intestinal multidrugresistant (MDR) bacteria have spread worldwide with extended-spectrum beta-lactamase (ESBL) -producing Enterobacteriaceae (ESBL-PE) as the most prevalent type. The millions of travelers annually visiting regions with poor hygiene contribute substantially

2017 Journal of Travel Medicine

134. Clostridium difficile infection in returning travellers. Full Text available with Trip Pro

(31%), Central/South America or the Caribbean (30%) and Africa (24%). Our site survey revealed substantial heterogeneity of testing approaches between sites; the most commonly used test was the C. difficile toxin gene PCR.CDI is encountered in returning international travellers, although there is considerable variability in testing practices. These data underscore the importance of awareness of C. difficile as a potential cause of travel-associated diarrhoea.© International Society of Travel (...) Clostridium difficile infection in returning travellers. There is increasing recognition of the contribution of community-acquired cases to the global burden of Clostridium difficile infection (CDI). The epidemiology of CDI among international travellers is poorly understood, and factors associated with international travel, such as antibiotic use and changes in gut microbiota, could potentially put travellers at higher risk.We summarized demographic, travel-associated and geographic

2017 Journal of Travel Medicine

135. Acute Diarrhea in Adults and Children: A Global Perspective

is reserved for prescription only in residents’ diarrhea or for inclusion in travel kits (add loperamide). Where feasible, families in localities with a high prevalence of diarrheal diseases should be encouraged to store a few ORS packets and zinc tablets if there are children under the age of five in the family for initiating home therapy as soon as diarrhea starts. Home-made oral fluid recipe Preparing 1 L of oral fluid using salt, sugar and water at home. The ingredients to be mixed are: • One level (...) Linking the main symptoms to the causes of acute diarrhea— enterohemorrhagic E. coli (EHEC) 7 Table 4 Clinical features of infection with selected diarrheal pathogens 8 Table 5 Medical assessment in diarrhea 8 Table 6 Assessment of dehydration using the “Dhaka method” 9 Table 7 Patient history details and causes of acute diarrhea 10 Table 8 Incubation period and likely causes of diarrhea 10 Table 9 Patient details and bacterial testing to consider 10 Table 10 Prognostic factors in children 11 Table 11

2012 World Gastroenterology Organisation

136. Travelers' health problems and behavior: prospective study with post-travel follow-up. Full Text available with Trip Pro

population consisted of 460 subjects, 79 % of whom reported illness during travel or on arrival: 69 % had travelers' diarrhea (TD), 17 % skin problems, 17 % fever, 12 % vomiting, 8 % respiratory tract infection, 4 % urinary tract infection, 2 % ear infection, 4 % gastrointestinal complaints other than TD or vomiting, and 4 % other symptoms. Of all subjects, 10 % consulted a doctor and 0.7 % were hospitalized; 18 % took antimicrobials, with TD as the most common indication (64 %). Ongoing symptoms were (...) Travelers' health problems and behavior: prospective study with post-travel follow-up. The annual number of international tourist arrivals has recently exceeded one billion, yet surprisingly few studies have characterized travelers' behavior, illness, and risk factors in a prospective setting. Particularly scarce are surveys of data spanning travel, return, and follow-up of the same cohort. This study examines behavior and illness among travelers while abroad, after return home, and at follow

2016 BMC Infectious Diseases

137. Travel Medicine and Vaccines for HIV-Infected Travelers Full Text available with Trip Pro

to vaccination. Available data indicate that immunization during antiretroviral therapy restores vaccine immunogenicity, improves the rate and persistence of immune responses, and reduces risk of vaccine-related adverse events, although vaccine responses often are suboptimal. Major issues for travelers to the developing world are vaccine-preventable illnesses (hepatitis A virus, yellow fever, and typhoid fever), traveler's diarrhea, and malaria. This article summarizes a presentation by D. Scott Smith, MD (...) Travel Medicine and Vaccines for HIV-Infected Travelers For the purposes of vaccination, persons with asymptomatic HIV infection and CD4+ cell counts of 200/μL to 500/μL are considered to have limited immune deficits and are generally candidates for immunization. HIVinfected persons with CD4+ cell counts less than 200/μL or history of an AIDS-defining illness should not receive live-attenuated viral or bacterial vaccines because of the risk of serious systemic disease and suboptimal response

2016 Topics in antiviral medicine

138. Prevention of Diarrheal Disease Due to Infection With Enterotoxigenic E. Coli (ETEC)

. Prior travelling participants will be vaccinated with two doses of vaccine or placebo. Vaccine Preventable Outcome will be identified and then characterized as to incidence, duration, severity and frequency of Moderate or Severe Travellers diarrhea. Health related information and assessments will be recorded during the travel. Condition or disease Intervention/treatment Phase Diarrhea Biological: E. coli ETVAX Other: Placebo Phase 2 Detailed Description: This is a Phase II b, double-blind (...) gets Travelers Diarrhea (TD) episodes for collection of study specific stool samples and health related information and assessments. If more than one diarrhea episode occurs, 48 diarrhea and symptom (TD defined symptoms) free hours must have passed between the episodes for the new episode to be counted as a separate one. One or two days prior to departure from the Grand Popo site, all participants will have a final review of their HC1s. Health Card ( HC2) will be given. After 1-6 days back

2017 Clinical Trials

139. The global problem of childhood diarrhoeal diseases: emerging strategies in prevention and management Full Text available with Trip Pro

been conducted in high-income settings. Trials of antimicrobials have also been primarily conducted in high-income settings or in travellers from high-income settings. Bloody diarrhoea has been shown to be a poor marker of potentially treatable bacterial enteritis, and rising antimicrobial resistance has also made empiric antimicrobial therapy more challenging in many settings. Novel effective and sustainable interventions and diagnostic strategies are clearly needed to help improve case management (...) The global problem of childhood diarrhoeal diseases: emerging strategies in prevention and management Acute diarrhoeal diseases remain a leading cause of global morbidity and mortality particularly among young children in resource-limited countries. Recent large studies utilizing case-control design, prospective sampling and more sensitive and broad diagnostic techniques have shed light on particular pathogens of importance and highlighted the previously under recognized impact

2017 Therapeutic advances in infectious disease

140. Strategies to Improve Management of Acute Watery Diarrhea during a Military Deployment: A Cost Effectiveness Analysis. Full Text available with Trip Pro

Strategies to Improve Management of Acute Watery Diarrhea during a Military Deployment: A Cost Effectiveness Analysis. To inform policy and decision makers, a cost-effectiveness model was developed to predict the cost-effectiveness of implementing two hypothetical management strategies separately and concurrently on the mitigation of deployment-associated travelers' diarrhea (TD) burden. The first management strategy aimed to increase the likelihood that a deployed service member with TD

2017 American Journal of Tropical Medicine & Hygiene

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