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Hepatic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Ghassan M. Hammoud, Jamal A. Ibdah
Hepatitis E virus (HEV) is a positive-stranded RNA virus that belongs to the Hepeviridae family. The virus is transmitted via the fecal–oral route, commonly by contaminated water supplies. Vertical transmission of hepatitis E virus ranged between 33% and 50% (33,34). The virus is endemic in the Middle East, India, Southeast Asia, Central Asia, Central America, and South America. Hepatitis E is an acute disease that does not progresses to chronicity, although reports of chronic HEV have been described in liver transplant recipients (35,36). The clinical presentation is basically the same as that for HAV. HEV infection is known to cause severe hepatitis, fulminant liver failure, preterm labor, and increased mortality in pregnant women especially in their third trimester with reported maternal mortality rates as high as 20% to 31.1% (4,37). The incubation period is 3–8 weekes, with a mean of 40 days. Cholestatic hepatitis is common. Acute hepatitis E infection is diagnosed by detection of IgM anti-HEV or a rising titer of IgG anti-HEV. The treatment is supportive therapy. A proved effective vaccine against HEV is currently not available. There is no current evidence that HEV infection is transmitted in breast milk.
Surgery
Published in Seema Khan, Get Through, 2020
The single-celled protozoan causes gastrointestinal symptoms, in particular watery diarrhoea, flatulence, abdominal cramps and nausea. Giardiasis is spread via the faecal – oral route and most people become infected by drinking contaminated water.
The gastrointestinal system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Sharon J. White, Francis A. Carey
Amoebiasis affects the large intestine, and is the result of infection by the protozoan Entamoeba histolytica. It is more prevalent in the tropics than in temperate climates. Infection is by the faecal–oral route. Ingested as cysts, the organism is passed unharmed through the stomach, eventually reaching the large intestine where the cyst wall is dissolved, liberating active amoebae. These invade the mucosa by means of the release of a cytolytic enzyme. They cause characteristic undermining ‘flask-shaped’ ulcers (recognizable under the microscope), or they may cause a more diffuse colitis. Organisms can be recognized in faeces or the tissues, and often contain ingested red blood cells.
Epidemiological characteristics of acute hepatitis A, 2013–2016: a cross-sectional study in Morocco
Published in Infectious Diseases, 2023
Adnane Karami, Raouia El Fihry, Asmaa Haddaji, Fatima-Zahra Jadid, Imane Zaidane, Hajar Chihab, Ahd Ouladlahsen, Mohamed Tahiri, Pascal Pineau, Khadija Akarid, Soumaya Benjelloun, Sayeh Ezzikouri
Generally, Type-A hepatitis is a self-limiting and asymptomatic disease in children that resolves spontaneously but approximately 70% of infected adolescents and adults present an acute illness with evocative symptoms (jaundice, fever, etc…). This infection is generally transmitted through fecal-oral route with contaminated water or foodstuffs causing frequently community-wide outbreaks [3,4]. Occasionally, HAV is transmitted through close contact with an infected person. With improved sanitation and provision of HAV vaccination, areas or populations with historically intense HAV circulation underwent a decline in Type-A hepatitis endemicity [5]. Based on the different age-specific HAV seroprevalence profiles, the world can be divided into countries of high, intermediate, low, and very low HAV endemicity [6]. In countries of high endemicity, most people acquire HAV in their early childhood and are immune to the virus. In contrast, persons from low endemic areas are first exposed to HAV as adults during travels to or residence in endemic areas, or when engaged in risky behaviours including contact with infected persons, a situation frequently encountered for men who have sex with men (MSM), or illicit drugs users [7].
Gut-brain communication in COVID-19: molecular mechanisms, mediators, biomarkers, and therapeutics
Published in Expert Review of Clinical Immunology, 2022
Tameena Wais, Mehde Hasan, Vikrant Rai, Devendra K. Agrawal
Gut infection with SARS-CoV-2 and inflammation cause altered gut microbiota and increased anti-microbial agents in GIT. This causes altered expression of various mediators and increased secretion of zonulin which cause disrupted tight junction. All these events stimulate enteric nervous system and signals to central nervous system precipitating neurological sequalae. Most of the research relating to the treatment of SARS-CoV-2 focuses on treating symptoms and the respiratory route of entry. However, fecal-oral route of entry and GI pathogenesis has not been thoroughly investigated. The available literature suggests potential role of BOAT1 (SLC6A19), ACE2, TMRSS2, TMPRSS4, IFN-γ, IL-17A, zonulin, and altered gut microbiome in gut-brain axis and associated neurological sequalae. Thus, targeting these mediators and gut microbiome will be of therapeutic significance. The role of probiotics in the treatment of COVID-19 has been discussed in the literature but the role of targeting IL-17, TMRSS2, TMPRSS4, IFN-γ, and supplementing nicotinamide for the treatment of COVID-19 has not been investigated in-depth. Most of the available literature discussing the potential of targeting IL-17, TMRSS2, TMPRSS4, IFN-γ, and supplementing nicotinamide are review articles and thus well-designed clinical trials are warranted.
Positive RT-PCR in urine from an asymptomatic patient with novel coronavirus 2019 infection: a case report
Published in Infectious Diseases, 2020
Jian-guo Ren, Dong-yan Li, Chang-fei Wang, Jian-hua Wu, Ying Wang, Yu-jing Sun, Qian Zhang, Yao-yong Wang, Xin-jian Chang
Based on current epidemiological data, SARS-CoV-2 is mainly transmitted through droplets and close contact [3]. Although the virus has been isolated from faeces, there is no evidence that it can be transmitted via the faecal–oral route [4]. Previous studies have shown that MERS-CoV is transmitted via this route [14]. Our patient was positive for RT-PCR in urine when she was admitted to the hospital, suggesting that the patient might excrete the virus and could be a source of infection. Unfortunately, we could not attempt virus isolation from the urine of our patient or transport samples that may constitute a risk of transmission to another laboratory. We hope that our case report may inspire other researchers to study whether this coronavirus can be isolated from urine from asymptomatic patients and whether this could be a source of transmission. According to the latest COVID-19 diagnosis and treatment guidelines in China, the diagnosis is confirmed if the RT-PCR is positive. Compared with nasopharyngeal swabs and sputum specimens, faeces and urine sampling is more convenient, and the quantity and quality of specimens are easily ascertained. Such samples might increase the detection of asymptomatic patients.