DOCSLIB.ORG

Guía De Práctica Clínica Ibero-Latinoamericana Sobre El Manejo De La Gastroenteritis Aguda En Menores De 5 Años

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Guía De Práctica Clínica Ibero-Latinoamericana Sobre El Manejo De La Gastroenteritis Aguda En Menores De 5 Años ISSN 1695-4033 Volumen 80|Extraordinario 1|Marzo 2014 Guía de práctica clínica ibero-latinoamericana sobre el manejo de la gastroenteritis aguda en menores de 5 años 00 Portada_01.indd 1 24/03/14 14:14 Volumen 80|Extraordinario 1|Marzo 2014 Guía de práctica clínica ibero-latinoamericana sobre el manejo de la gastroenteritis aguda en menores de 5 años 1 Guía de práctica clínica ibero-latinoamericana sobre el manejo de la gastroenteritis aguda en menores de 5 años: enfoque, alcances y diseño P. Gutiérrez-Castrellón, E. Salazar-Lindo, I. Polanco Allué y Grupo Ibero- Latinoamericano sobre el Manejo de la Diarrea Aguda (GILA) 5 Guía práctica clínica ibero-latinoamericana sobre el manejo de la gastroenteritis aguda en menores de 5 años: diagnóstico y criterios de atención médica I. Polanco Allué, E. Salazar-Lindo, P. Gutiérrez-Castrellón y Grupo Ibero- Latinoamericano sobre el Manejo de la Diarrea Aguda (GILA) 9 Guía práctica clínica ibero-latinoamericana sobre el manejo de la gastroenteritis aguda en menores de 5 años: esquemas de hidratación y alimentación P. Gutiérrez-Castrellón, E. Salazar-Lindo, I. Polanco Allué y Grupo Ibero- Latinoamericano sobre el Manejo de la Diarrea Aguda (GILA) 15 Guía de práctica clínica ibero-latinoamericana sobre el manejo de la gastroenteritis aguda en menores de 5 años: tratamiento farmacológico E. Salazar-Lindo, I. Polanco Allué, P. Gutiérrez-Castrellón y Grupo Ibero- Latinoamericano sobre el Manejo de la Diarrea Aguda (GILA) 23 Anexo 1. Grupo Ibero-Latinoamericano sobre el Manejo de la Diarrea Aguda (GILA) 24 Anexo 2. Evaluación GRADE de las intervenciones en el tratamiento de la gastroenteritis aguda en niños menores de 5 años Elsevier y sus asociados no asumen responsabilidad alguna por cualquier lesión y/o daño sufridos por personas o bienes en cuestiones de responsabilidad de productos, negligencia o cualquier otra, ni por uso o aplicación de métodos, productos, instrucciones o ideas contenidos en el presente material. Dados los rápidos avances que se producen en las ciencias médicas, en particular, debe realizarse una verificación independiente de los diagnósticos y las posologías de los fármacos. 00 Sumario_01.indd 1 24/03/14 14:14 An Pediatr (Barc). 2014;80(Supl 1):1-4 www.elsevier.es/anpediatr Guía de práctica clínica ibero-latinoamericana sobre el manejo de la gastroenteritis aguda en menores de 5 años: enfoque, alcances y diseño Pedro Gutiérrez-Castrellóna,*, Eduardo Salazar-Lindob, Isabel Polanco Alluéc y Grupo Ibero-Latinoamericano sobre el Manejo de la Diarrea Aguda (GILA)✶ aUnidad de Investigación Traslacional, Subdirección de Investigación Biomédica, Hospital General Dr. Manuel Gea González, Ministerio de Salud, México bLaboratorio Gastrolab, Perú cCatedrática de Pediatría, Facultad de Medicina, UAM. Jefe del Servicio de Gastroenterología y Nutrición, Hospital Infantil Universitario La Paz, Madrid, España Justificación para el desarrollo de la guía feccionado tras realizar un análisis de la evidencia científica publicada sobre los distintos abordajes terapéuticos de La gastroenteritis aguda (GEA) es muy frecuente en niños GEA, matizados considerando las diferencias en cuanto a menores de 5 años y contribuye de forma importante a un eficiencia preventiva y terapéutica de los sistemas de salud, aumento de la mortalidad y morbilidad1,2. Gracias a un pro- tradiciones, cultura, uso y aceptación de diferentes opcio- grama para el control de la GEA, promovido en especial por nes de tratamiento existentes en cada uno de los países la Organización Mundial de la Salud (OMS) y centrado funda- ibero-latinoamericanos. Se ofrece como herramienta para mentalmente en implementar la solución de rehidratación estandarizar el manejo de la GEA en niños en esta región. oral (SRO) a nivel comunitario y en el entrenamiento de pro- fesionales de la salud, los índices de mortalidad asociados a la GEA descendieron en todo el mundo el 75% entre 1980 y Componentes de la guía 2008, pero siguen siendo muy elevados y se han mantenido en los últimos años3. A pesar del gran avance que significa la En una primera parte de esta nueva versión se analizan las hidratación oral como herramienta para el tratamiento o últimas aportaciones referentes a la evaluación y el diag- prevención de la deshidratación en la GEA, existen otros nóstico de la GEA en niños menores de 5 años. Para su en- aspectos del protocolo clínico de esta enfermedad que ne- samblado se realizó una revisión de la literatura científica cesitan ser igualmente atendidos. El enfoque diagnóstico en la que se han adoptado, en general, las definiciones y inicial, las decisiones sobre si el tratamiento diagnóstico- recomendaciones publicadas por las guías realizadas por la terapéutico puede ser ambulatorio o debe ser hospitalario, European Society for Pediatric Gastroenterology, Hepato- el protocolo dietético, el rol de los fármacos y las posibles logy and Nutrition y la European Society of Pediatric Infec- medidas de prevención son otros aspectos sobre los que el tious Diseases (ESPGHAN/ESPID)1, así como otras actualiza- médico necesita guía y orientación. ciones publicadas recientemente5-10. Se incluyen, asimismo, La presente guía es la actualización de la primera versión como aspectos relevantes los criterios de solicitud de aten- de la Guía de práctica clínica ibero-latinoamericana (GPC- ción médica, la evaluación de la presencia de deshidrata- ILA), publicada en 20094 y, al igual que la primera versión, ción, los criterios de gravedad y la necesidad de hospitaliza- está estructurada en varias partes que se han elaborado a ción. La parte final de la guía se centra en el abordaje partir de las últimas guías publicadas y que abordan terapéutico y se ha fundamentado en el análisis detallado, primordialmente los aspectos diagnósticos y que se han con- riguroso y sistematizado de la evidencia científica publicada *Autor para correspondencia. Correo electrónico: [email protected] (P. Gutiérrez-Castrellón). ✶ Los miembros del Grupo Ibero-Latinoamericano sobre el Manejo de la Diarrea Aguda (GILA) se relacionan en el anexo 1. 1695-4033/© 2014 Asociación Española de Pediatría. Publicado por Elsevier España, S.L. Todos los derechos reservados. 01 Guia práctica 01.indd 1 24/03/14 14:17 2 Gutiérrez-Castrellón P et al en el periodo comprendido entre mayo de 2008 y noviembre comparación y outcome [PICO, por sus siglas en inglés]). Te- de 2012. Para su desarrollo se contó con expertos en las niendo como fundamento las preguntas relevantes, se esta- áreas de gastroenterología pediátrica, urgencias pediátri- blecieron protocolos de búsqueda de evidencia a través de cas, metodología de la investigación, análisis de la eviden- estrategias validadas y publicadas11-15 utilizando los térmi- cia, pediatría general y economía de la salud. Para el en- nos «MesH: soluciones, terapia de fluidos, rehidratación samblado de las estrategias de búsqueda, identificación de oral, fórmula infantil, alimentación infantil, alimentación la evidencia, evaluación de la calidad y gradación de la especializada, nutrición especial, tratamientos dietéticos, misma se contó con instituciones profesionales dedicadas prebióticos, probióticos, simbióticos». Se incluyeron tam- específicamente a la implementación de esta metodología. bién los términos específicos para cada una de las medica- Una vez establecidas las recomendaciones basadas en la ciones a revisar (racecadotrilo, antieméticos, ondansetrón, evidencia, se enviaron para su análisis a cada uno de los loperamida, esmectita [diosmectita], vitamina A, zinc, bis- expertos regionales de Latinoamérica, España y Portugal muto, crofelemer). Se utilizaron los términos en castellano para, así, recoger los comentarios basados en su experien- o inglés según las bases de datos correspondientes. Las bús- cia. Por último, se recogieron las observaciones y se armoni- quedas se limitaron de igual manera en todas las bases de zaron para constituir el documento final. datos, cuando estas lo permitían, a los siguientes términos: estudios en humanos, niños (de 0 a 5 años), guías de prác- tica clínica, metaanálisis, ensayos aleatorizados controlados Alcances de la guía con grupos placebo, conferencias para el desarrollo de con- senso y ensayos controlados del National Institute of Health El objetivo final del desarrollo de esta GPC-ILA-II fue elabo- (NIH, EE.UU.). Se realizaron las búsquedas en Medline (Pub- rar un documento que pudiera apoyar, en la toma eficiente med de mayo de 2008 a noviembre de 2012), EMBASE (de de decisiones sobre la salud, a todos los profesionales invo- mayo de 2008 a noviembre de 2012), The Cochrane Library, lucrados en la atención integral del niño con GEA (médicos Cochrane Iberoamericana, Centro para Revisiones y Disemi- generales, pediatras, médicos de familia, pediatras de ur- nación (CRD-DARE) y en las bases de datos latinoamericanas gencias, gastroenterólogos pediatras, residentes de las es- Latin American and Caribbean Health Sciences Literature pecialidades referidas, internos de pregrado, pasantes en (LILACS de mayo de 2008 a noviembre de 2012) y Scientific servicio social, personal de enfermería y promotores de sa- Electronic Library Online (Scielo, de mayo de 2008 a no- lud comunitaria). De igual forma, esta GPC-ILA pretende viembre de 2012). La calidad de las investigaciones publica- orientar a las autoridades administrativas y gerenciales de das identificadas fue evaluada mediante el instrumento los diferentes niveles de atención hospitalaria y ambulatoria GRADE y solo fueron incluidas aquellas que obtuvieron pun- para
Load more

Recommended publications
  • ESPGHAN/European Society for Pediatric Infectious Diseases
    CLINICAL GUIDELINES European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases Evidence-Based Guidelines for the Management of Acute Gastroenteritis in Children in Europe: Update 2014 ÃAlfredo Guarino (Coordinator), yShai Ashkenazi, zDominique Gendrel, ÃAndrea Lo Vecchio, yRaanan Shamir, and §Hania Szajewska ABSTRACT Results: Gastroenteritis severity is linked to etiology, and rotavirus is the most Objectives: These guidelines update and extend evidence-based indications severe infectious agent and is frequently associated with dehydration. for the management of children with acute gastroenteritis in Europe. Dehydration reflects severity and should be monitored by established score Methods: The guideline development group formulated questions, systems. Investigations are generally not needed. Oral rehydration with identified data, and formulated recommendations. The latter were graded hypoosmolar solution is the major treatment and should start as soon as with the Muir Gray system and, in parallel, with the Grading of possible. Breast-feeding should not be interrupted. Regular feeding should Recommendations, Assessment, Development and Evaluations system. continue with no dietary changes including milk. Data suggest that in the hospital setting, in non–breast-fed infants and young children, lactose-free feeds can be considered in the management of gastroenteritis. Active therapy Received March 17, 2014; accepted March 19, 2014. may reduce the duration and severity of diarrhea. Effective interventions From the ÃDepartment of Translational Medical Science, Section of include administration of specific probiotics such as Lactobacillus GG or Pediatrics, University of Naples Federico II, Naples, Italy, the Saccharomyces boulardii, diosmectite or racecadotril. Anti-infectious drugs ySchneider Children’s Medical Center, Tel-Aviv University, Tel-Aviv, should be given in exceptional cases.
    [Show full text]
  • List of Union Reference Dates A
    Active substance name (INN) EU DLP BfArM / BAH DLP yearly PSUR 6-month-PSUR yearly PSUR bis DLP (List of Union PSUR Submission Reference Dates and Frequency (List of Union Frequency of Reference Dates and submission of Periodic Frequency of submission of Safety Update Reports, Periodic Safety Update 30 Nov. 2012) Reports, 30 Nov.
    [Show full text]
  • Diosmectite for Chemotherapy-Induced Diarrhea
    Edinburgh Research Explorer Chemotherapy-induced diarrhoea in dogs and its management with smectite Citation for published version: Fournier, Q, Serra, JC, Williams, C & Bavcar, S 2021, 'Chemotherapy-induced diarrhoea in dogs and its management with smectite: results of a monocentric open-label randomized clinical trial ', Veterinary and Comparative Oncology, vol. 19, no. 1, pp. 25-33. https://doi.org/10.1111/vco.12631 Digital Object Identifier (DOI): 10.1111/vco.12631 Link: Link to publication record in Edinburgh Research Explorer Document Version: Peer reviewed version Published In: Veterinary and Comparative Oncology General rights Copyright for the publications made accessible via the Edinburgh Research Explorer is retained by the author(s) and / or other copyright owners and it is a condition of accessing these publications that users recognise and abide by the legal requirements associated with these rights. Take down policy The University of Edinburgh has made every reasonable effort to ensure that Edinburgh Research Explorer content complies with UK legislation. If you believe that the public display of this file breaches copyright please contact [email protected] providing details, and we will remove access to the work immediately and investigate your claim. Download date: 27. Sep. 2021 1 1 Chemotherapy-induced diarrhea in dogs and its management with 2 smectite: results of a monocentric open-label randomized clinical trial 3 Word count: 3810 4 Number of figures and tables: 2 tables, 3 figures 5 Data availability statement: The data that support the findings of this study are available 6 from the corresponding author upon reasonable request. 2 7 Abstract 8 Chemotherapy-induced diarrhea (CID) is a frequent chemotherapy adverse event in dogs.
    [Show full text]
  • An Approach to Acute and Chronic Diarrhoea
    Leader in digital CPD Earn 3 for Southern African Gastroenterology healthcare professionals free CEUs An approach to acute and chronic diarrhoea Learning objectives You will learn: • The causes of and risk factors for acute and chronic diarrhoea • How to screen and diagnose acute and chronic diarrhoea • The general principles of treating diarrhoea, with a focus on anti-diarrhoeal agents used adjunctively to oral rehydration and, if necessary, antimicrobials. Introduction In the healthy adult, diarrhoea is often viewed as a ‘nuisance’ disease. However, serious complications including severe dehydration and renal failure can occur and may necessitate admission to hospital. Elderly people and those in long-term care have an increased risk of death as a consequence of diarrhoea. Diarrhoea is reported to cause more deaths, an estimated 2.5 million annually, than any other condition Oral rehydration in children under five years of age living in resource-poor countries. In South Africa, therapy is central to diarrhoea accounts for 19% of deaths of children under five years of age; dehydration 1-3 the management of is the key factor in these deaths. acute diarrhoea, being Diarrhoea is classified as acute (short-term, less than 7 days), prolonged (a form of sufficient in most acute diarrhoea lasting more than 7 days), or chronic (long-term, more than 2 weeks patients to prevent in children or 4 weeks in adults). It is also classified as mild, moderate, or severe, complications due to with dehydration reflecting severity of symptoms. Oral rehydration
    [Show full text]
  • Review Article Role of Antidiarrhoeal Drugs As Adjunctive Therapies for Acute Diarrhoea in Children
    Hindawi Publishing Corporation International Journal of Pediatrics Volume 2013, Article ID 612403, 14 pages http://dx.doi.org/10.1155/2013/612403 Review Article Role of Antidiarrhoeal Drugs as Adjunctive Therapies for Acute Diarrhoea in Children Christophe Faure Division of Gastroenterology, Department of Pediatrics, CHU Sainte-Justine, Montreal, QC, Canada H3T 1C5 Correspondence should be addressed to Christophe Faure; [email protected] Received 25 October 2012; Revised 2 January 2013; Accepted 2 January 2013 Academic Editor: Catherine Bollard Copyright © 2013 Christophe Faure. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Acute diarrhoea is a leading cause of child mortality in developing countries. Principal pathogens include Escherichia coli, rotaviruses, and noroviruses. 90% of diarrhoeal deaths are attributable to inadequate sanitation. Acute diarrhoea is the second leading cause of overall childhood mortality and accounts for 18% of deaths among children under five. In 2004 an estimated 1.5 million children died from diarrhoea, with 80% of deaths occurring before the age of two. Treatment goals are to prevent dehydration and nutritional damage and to reduce duration and severity of diarrhoeal episodes. The recommended therapeutic regimen is to provide oral rehydration solutions (ORS) and to continue feeding. Although ORS effectively mitigates dehydration, it has no effect on the duration, severity, or frequency of diarrhoeal episodes. Adjuvant therapy with micronutrients, probiotics, or antidiarrhoeal agents may thus be useful. The WHO recommends the use of zinc tablets in association with ORS.The ESPGHAN/ESPID treatment guidelines consider the use of racecadotril, diosmectite, or probiotics as possible adjunctive therapy to ORS.
    [Show full text]
  • Efficacy of Dioctahedral Smectite in Treating Patients Of
    doi:10.1111/j.1440-1746.2007.04895.x GASTROENTEROLOGY Efficacy of dioctahedral smectite in treating patients of diarrhea-predominant irritable bowel syndrome Full-Young Chang, Ching-Liang Lu, Chih-Yen Chen and Jiing-Chyuan Luo Division of Gastroenterology, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan Key words Abstract abdominal bloating, diosmectite, functional gastrointestinal disorder, irritable bowel Background and Aim: Dioctahedral smectite (DS) is natural adsorbent clay useful in syndrome, Rome criteria. treating acute diarrhea. The aim of this study was to determine DS efficacy on patients with diarrhea-predominant irritable bowel syndrome (D-IBS in a phase III-, 8-week- Accepted for publication 23 November 2006. randomized, double-blind, placebo-controlled trial. Methods: The 104 patients who met the D-IBS Rome II criteria were randomized to Correspondence receive either DS (n = 52) or placebo (n = 52) treatment for 8 weeks (three sachets daily). Dr Full-Young Chang, Division of The primary efficacy endpoint was the changes of the visual analog scale (VAS) score of Gastroenterology, Taipei Veterans General IBS overall disorder and pain/discomfort-related symptoms after treatment on days 28 and Hospital, 201 Shih-Pai Road, Section 2, Taipei, 56, respectively. Other outcome measures included improvement of bowel movement Taiwan 11217. Email: [email protected] disorders. The therapeutic global response was assessed by the patients and investigators at each visit, as was drug safety. Results: Both treatments diminished overall disorder at each visit (P < 0.01), with respect to primary efficacy. This effect was further observed in DS-treated patients on day 56 (P = 0.0167).
    [Show full text]
  • BMJ Open Is Committed to Open Peer Review. As Part of This Commitment We Make the Peer Review History of Every Article We Publish Publicly Available
    BMJ Open: first published as 10.1136/bmjopen-2017-019186 on 20 March 2019. Downloaded from BMJ Open is committed to open peer review. As part of this commitment we make the peer review history of every article we publish publicly available. When an article is published we post the peer reviewers’ comments and the authors’ responses online. We also post the versions of the paper that were used during peer review. These are the versions that the peer review comments apply to. The versions of the paper that follow are the versions that were submitted during the peer review process. They are not the versions of record or the final published versions. They should not be cited or distributed as the published version of this manuscript. BMJ Open is an open access journal and the full, final, typeset and author-corrected version of record of the manuscript is available on our site with no access controls, subscription charges or pay-per-view fees (http://bmjopen.bmj.com). If you have any questions on BMJ Open’s open peer review process please email [email protected] http://bmjopen.bmj.com/ on September 29, 2021 by guest. Protected copyright. BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019186 on 20 March 2019. Downloaded from Potentially inappropriate prescriptions and omissions in pediatrics: detection by POPI (Pediatrics: Omission of Prescription and Inappropriate prescription) in the emergency unit and in the ambulatory setting. ForJournal: peerBMJ Open review only Manuscript ID bmjopen-2017-019186 Article Type: Research Date
    [Show full text]
  • Lactose Intolerance and Health: Evidence Report/Technology Assessment, No
    Evidence Report/Technology Assessment Number 192 Lactose Intolerance and Health Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Contract No. HHSA 290-2007-10064-I Prepared by: Minnesota Evidence-based Practice Center, Minneapolis, MN Investigators Timothy J. Wilt, M.D., M.P.H. Aasma Shaukat, M.D., M.P.H. Tatyana Shamliyan, M.D., M.S. Brent C. Taylor, Ph.D., M.P.H. Roderick MacDonald, M.S. James Tacklind, B.S. Indulis Rutks, B.S. Sarah Jane Schwarzenberg, M.D. Robert L. Kane, M.D. Michael Levitt, M.D. AHRQ Publication No. 10-E004 February 2010 This report is based on research conducted by the Minnesota Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA 290-2007-10064-I). The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment. This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies.
    [Show full text]
  • Smecta®) in the Symptomatic Treatment of Acute Diarrhoea in Adults
    IPSEN GROUP F-FR-00250-105 CONFIDENTIAL PROTOCOL: FINAL (WITH AMENDMENT NO. 4): 07 JANUARY 2019 PAGE 1/89 PROTOCOL TITLE: EFFICACY OF DIOSMECTITE (SMECTA®) IN THE SYMPTOMATIC TREATMENT OF ACUTE DIARRHOEA IN ADULTS. A MULTICENTRE, RANDOMISED, DOUBLE BLIND, PLACEBO-CONTROLLED, PARALLEL GROUPS STUDY STUDY PROTOCOL STUDY number: F-FR-00250-105 (Diosmectite- BN 00250) EudraCT number: n° 2015-001138-10 Final Version (with Amendment No. 4): 07 January 2019 Sponsor’s Medically Responsible Person: Study Sponsor: PPD Ipsen Pharma SAS PPD 65 quai Georges Gorse Ipsen Pharma SAS 92100 Boulogne-Billancourt, France 65 quai Georges Gorse Tel: PPD 92100 Boulogne-Billancourt, France Fax: PPD Tel: PPD Fax: PPD Monitoring Office: and/or CRO Co-ordinating Investigator: PPD PPD PPD Délégation à la Recherche Ipsen Pharma SAS Centre Hospitalier Régional Universitaire 65 quai Georges Gorse de Lille 92100 Boulogne-Billancourt, France 2, avenue Oscar Lambret, Tel: PPD 59037 Lille, France Cedex Fax: PPD Tel: PPD Fax: PPD Pharmacovigilance/Emergency Contact: PPD Ipsen Innovation, ZI de Courtaboeuf - 5 avenue du Canada - 91940 Les Ulis - France Tel: PPD Tel: PPD – PPD For SAEs reporting: Fax: PPD Email: PPD Persons supplied with this information must understand that it is strictly confidential. Information contained herein cannot be disclosed, submitted for publication or used for any purpose other than that contemplated herein without the sponsor’s prior written authorisation. IPSEN GROUP F-FR-00250-105 CONFIDENTIAL PROTOCOL: FINAL (WITH AMENDMENT NO. 4): 07 JANUARY 2019 PAGE 2/89 INVESTIGATOR’S AGREEMENT Investigator Agreement and Signature: I have read and agree to Protocol F-FR-00250-105 entitled Efficacy of the diosmectite (Smecta®) in the symptomatic treatment of acute diarrhoea in adults.
    [Show full text]
  • A Transgenic Probiotic Secreting a Parasite Immunomodulator for Site-Directed Treatment of Gut Inflammation
    © The American Society of Gene & Cell Therapy original article original article Transgenic Probiotic Inhibits Gut Inflammation © The American Society of Gene & Cell Therapy A Transgenic Probiotic Secreting a Parasite Immunomodulator for Site-Directed Treatment of Gut Inflammation Rose A Whelan1, Sebastian Rausch1, Friederike Ebner1, Dorothee Günzel2, Jan F Richter2,3, Nina A Hering4, Jörg-Dieter Schulzke4, Anja A Kühl5, Ahmed Keles2, Pawel Janczyk6, Karsten Nöckler6, Lothar H Wieler7 and Susanne Hartmann1 1Center for Infection Medicine, Institute of Immunology, Freie Universität Berlin, Berlin, Germany; 2Institute of Clinical Physiology, Charité- University Medicine Berlin, Berlin, Germany; 3Current address: Institute for Anatomy II, Friedrich-Schiller-University, Jena, Germany; 4Department of Gastroenterology, Division of Nutritional Medicine, Charité-University Medicine Berlin, Berlin, Germany; 5Department of Internal Medicine, Rheumatology and Clinical Immunology/Research Center ImmunoSciences (RCIS), Charité-University Medicine Berlin, Berlin, Germany; 6Unit for Molecular Diagnostics, Genetics and Pathogen Characterisation, Department of Biological Safety Federal Institute for Risk Assessment, Berlin, Germany; 7Institute for Microbiology and Animal Health, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany New treatment strategies for inflammatory bowel disease INTRODUCTION are needed and parasitic nematode infections or appli- Parasitic worms modulate host immune responses in order to cation of helminth
    [Show full text]
  • The Impact of Antibiotic Treatment on Diarrhea and Growth in Early Childhood
    ARE OUR FAVORITE DRUGS KILLING THE WRONG BUGS? THE IMPACT OF ANTIBIOTIC TREATMENT ON DIARRHEA AND GROWTH IN EARLY CHILDHOOD Elizabeth Tacket Rogawski A dissertation submitted to the faculty of the University of North Carolina at Chapel Hill in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Epidemiology. Chapel Hill 2015 Approved by: Daniel J. Westreich Steven R. Meshnick Sylvia Becker-Dreps Linda S. Adair Robert S. Sandler © 2015 Elizabeth Tacket Rogawski ALL RIGHTS RESERVED ii ABSTRACT Elizabeth Tacket Rogawski: Are our favorite drugs killing the wrong bugs? The impact of antibiotic treatment on diarrhea and growth in early childhood (Under the direction of Daniel J. Westreich) Diarrhea is a recurring illness in childhood that is associated with malnutrition, stunted growth, and cognitive impairment. Children with diarrhea and other common childhood illnesses are frequently treated with antibiotics, often against recommendations. Antibiotic exposures early in life may increase susceptibility to infections and affect child growth through modifications of the gastrointestinal microbiota. We assessed the impact of antibiotic treatment on diarrheal risk and growth in a birth cohort from 2009 to 2013 of 497 children from semi- urban slums of Vellore, India. We estimated the effect of antibiotic treatment for diarrhea on the timing of a subsequent episode using inverse probability of exposure-weighted Kaplan-Meier curves. We also estimated the effect of any early life antibiotic exposure on rates of diarrhea using negative binomial regression. Based on these results, we used the parametric g-formula to model the impact of hypothetical interventions to prevent unnecessary antibiotic exposures.
    [Show full text]
  • Farmak-Jsc-1544688257.Pdf
    ATC groups A Alimentary tract and metabolism B Blood and blood forming organs C Cardiovascular system D Dermatologicals G Genito-urinary system and sex hormones H Systemic hormonal preparations, excluding sex hormones and insulins J Anti-infectives for systemic use L Antineoplastic and immunomodulating agents M Musculo-skeletal system N Nervous system P Antiparasitic products, insecticides and repellents R Respiratory system S Sensory organs V Contrast products ATC Farmak name INN Dosage form Measure, pack Dossier type Note groups Bean pericarp extract, blueberry A Arfa Solid form capsules Food supplement leaves extract Taurine, bean pericarp extract, A Arfa Combi Solid form capsules Food supplement blueberry leaves extract A Asparcam-Farmak Asparginat K-Mg Sterile in ampoules solution for inj. 5ml, 10ml, 20ml CTD powder for oral suspension 3g in A Apsorbin Diosmectite Solid form Food supplement new sachet A Antral Antral Solid form coated tablets 100mg, 200mg CTD A Esonexa Esomeprazole Solid form enterosoluble tablets 20mg, 40mg CTD new oromucosal spray 3 mg/ml 15 ml, 30 A Zipelor Forte Benzydamine Oral liquid form CTD ml A Calcium gluconate Calcium gluconate Sterile in ampoules solution for inj. 100mg/ml 5ml, 10ml EU CTD A Diaformin Metformin Solid form tablets 500mg, 850mg, 1000 mg CTD A Diaglizid Gliclazide Solid form tablets 80mg CTD tablets with modified release 30mg, A Diaglizid MR Gliclazide Solid form CTD 60mg A Diagnol Macrogol Solid form pulvis for oral solution, package 64g CTD A Dialipon Thioctic acid Sterile in ampoules solution for inf. 3% 10ml, 20ml CTD A Dialipon Thioctic acid Solid form capsules 300mg CTD A Dialipon Turbo Thioctic acid Sterile in vials solution for inf.
    [Show full text]