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Neonatal jaundice is a common condition observed in newborns shortly after birth, making it one of the most frequent health concerns during the first two weeks of life. This study, conducted between May 2019 and July 2023, enrolled 300 full-term infants with bilirubin levels exceeding 15 mg/dL on the fourth day after birth. The infants were recruited and randomly assigned in equal numbers to one of three groups for further investigation. In addition to the control group, the other two groups of infants received probiotic supplementation administered twice daily, with each capsule delivering 5 × 10⁹ CFU of either Lactobacillus salivarius AP-32 or Bifidobacterium animalis subsp. lactis CP-9. Both probiotic groups significantly reduced the overall duration of phototherapy and accelerated the rate of bilirubin reduction compared to the control group. The AP-32 group experienced a significant reduction in hospitalization duration, staying seven hours less than the placebo group ( P  = 0.024). Analysis of gut microbiota revealed that the probiotic groups significantly enhanced microbial diversity in the intestines of neonates. The AP-32 group showed a significant increase in the abundance of L. salivarius , while the CP-9 group demonstrated a notable enhancement in the abundance of B. animalis . These findings suggest that integrating phototherapy with probiotic supplementation may enhance jaundice clearance increasing the abundance of beneficial gut bacteria, thereby facilitating the recovery of neonates.

A 37-year-old man was transferred to the hospital because of fever, myalgia, and hypoxemia. Evaluation revealed leukocytosis, acute kidney failure, and conjugated hyperbilirubinemia. A diagnosis was made.

Jaundice is a symptom of high blood bilirubin levels affecting about 80% of neonates. In neonates fed with breast milk, jaundice is particularly prevalent and severe, which is likely multifactorial. With the development of genomics and metagenomics, a deeper understanding of the neonatal gut microbiota has been achieved. We find there are accumulating evidence to indicate the importance of the gut microbiota in the mechanism of jaundice. In this paper, we present new comprehensive insight into the relationship between the microbiota and jaundice. In the new perspective, the gut is a crucial crossroad of bilirubin excretion, and bacteria colonizing the gut could play different roles in the excretion of bilirubin, including Escherichia coli as the main traffic jam causers, some Clostridium and Bacteroides strains as the traffic police, and most probiotic Bifidobacterium and Lactobacillus strains as bystanders with no effect or only a secondary indirect effect on the metabolism of bilirubin. This insight could explain why breast milk jaundice causes a longer duration of blood bilirubin and why most probiotics have limited effects on neonatal jaundice. With the encouragement of breastmilk feeding, our perspective could guide the development of new therapy methods to prevent this side effect of breastfeeding.

INTRODUCTION:Cholangiocarcinoma (CHOL), a malignant tumor of the biliary system, is particularly concerning because of its high malignancy and poor prognosis, often leading to obstructive jaundice. The advent of metagenomic next-generation sequencing technology has expanded diagnostic capabilities, including the identification of microbes within tumors and their potential role in cancer progression. The aims of this study were to explore the bacterial composition in bile from patients with obstructive jaundice of different etiologies and to investigate the association between bile microbiota and biochemical analytes, as well as their potential as biomarkers for diagnosis of obstructive jaundice diseases.METHODS:Bile samples from patients with obstructive jaundice admitted to Beijing Friendship Hospital were collected and subjected to 16S rRNA and metagenomic sequencing. The study included patients diagnosed with benign biliary stricture, gallstone, and CHOL. Clinical data and bile chemical components were analyzed. The potential functional roles of the identified microbiota were predicted using bioinformatics tools.RESULTS:The study enrolled 13 patients with benign biliary stricture, 19 with gallstones, and 10 with CHOL. Significant differences in bile chemical components and microbial diversity were observed among the groups. The bile microbiota was dominated by distinct phyla and genera across the groups, with Proteobacteria and Fusobacteriota enriched in benign biliary stricture, Firmicutes and Desulfobacterota in CHOL, and Synergistota in patients with gallstone. Functional analysis revealed differences in gene functions related to metabolism and other biological processes. A correlation between bile microbiota and biochemical markers was established, and the combination of differential microbiota showed potential as a diagnostic marker for obstructive jaundice of different etiologies.DISCUSSION:Bile microbiota varies significantly among patients with obstructive jaundice of different etiologies. The identified microbial signatures and their functional roles could serve as novel diagnostic markers and provide insights into the pathogenesis of biliary diseases.

Background This study aims to reveal the composition and features of the gut microbiota in neonatal hemolytic jaundice, potentially identifying biomarkers for the diagnosis of this condition. Methods A total of 62 neonates with hemolytic jaundice and 20 healthy neonates were ultimately enrolled in the study. Clinical data and fecal samples from these infants were collected separately. The composition and features of the gut microbiota were analyzed using 16S rRNA high-throughput sequencing technology. Alpha and Beta diversity analyses were conducted to elucidate the differences in gut microbiota composition. Additionally, LEfSe analysis was employed to identify differential microorganisms. Finally, PICRUSt2, metagenomeSeq, and BugBase software were utilized to investigate the phenotypic and functional differences in the gut microbiota. Results Beta diversity analysis revealed significant differences in the composition of gut microbiota. LEfSe analysis demonstrated a significant increase in the relative abundance of Enterobacter in neonatal hemolytic jaundice. Furthermore, METACYC metabolic pathway analysis based on PICRUSt2 indicated a notable elevation in liver-related metabolic pathways in neonatal hemolytic jaundice. The metabolic analysis of differential bacterial genera revealed that Enterobacter secretes a wide array of enzymes, including oxidases, oxidoreductases, transferases, hydrolases, isomerases, and lyases. Notably, these enzymes are responsible for altering the liver metabolic pathways in neonates with hemolytic jaundice. Conclusions Enterobacter is linked to multiple metabolic pathways in the liver via the secretion of numerous enzymes along the gut-liver axis metabolic pathway. This interaction indirectly reflects the metabolic status and disease progression in neonatal hemolytic jaundice. Consequently, Enterobacter may serve as a potential diagnostic marker of the gut microbiota for assessing liver metabolic disorders associated with hemolytic jaundice.

Background In spite of a local favorable environment, leptospirosis has never been described in Central African Republic so far mainly because of the weakness of diagnostic tests and differential diagnostic strategy for febrile jaundice cases negative for yellow fever virus. Here we bring a complementary insight to conclusions of Gadia CLB et al. regarding the presence of leptospirosis in Central African Republic in YFV-negative febrile icteric patients. Methods Our study included 497 individuals presenting with fever and jaundice but negative for yellow fever infection, retrospectively selected from the national surveillance biobank for yellow fever in Institut Pasteur de Bangui, Central African Republic. A combination of serological (ELISA, agglutination) and molecular biology techniques (quantitative real-time polymerase chain reaction) was used to identify Leptospira or the patient’s immune response to the bacteria. Statistical analyses were done using the non parametric Mann-Withney U test with a 5% statistical threshold. Results ELISA test results showed 46 positive serum samples while 445 were negative and 6 remains equivocal. In addition, the reference microscopic agglutination test for leptospirosis diagnostic confirmed that 7 out of 32 samples tested were positive. Unfortunately, all 497 serum samples tested for leptospirosis were negative using the molecular techniques. Conclusions Unlike Gadia et al., we confirmed that leptospirosis is circulating in Central African Republic and therefore may be responsible for some of the unexplained cases of febrile jaundice in the country. Thus, leptospirosis needs to be investigated to improve identification of aetiological pathogens. Our study also suggests a need to improve sample transportation and storage conditions.

Background Anthrax is a zoonotic occupational disease caused by Bacillus anthracis , a rod-shaped immobile aerobic gram-positive bacteria with spore. Anthrax occurs in humans randomly and with low frequency. Most cases of anthrax are acquired through contact with infected animals or contaminated animal products. This old disease became particularly important since 2001 that the biological spores were exploited in America. Depending on the transmission method of the disease, clinical manifestations occur in three classes: Cutaneous, respiratory, and gastrointestinal anthrax. The respiratory form is considered as the most fatal and a rare form of anthrax intending to show complicated and unusual manifestations. Case presentation In this case report a rare case of inhalation anthrax acquired naturally in southeast of Iran is presented. A blind 65-year-old man, living in a rural area, was admitted with respiratory infection, fever, dyspnea, loss of appetite, and myalgia. The patient was treated with outpatient antibiotics a week ago. After admission, the patient was again treated for pneumonia, but there was no improvement despite treatment and the patient was suffering from septicemia symptoms. Radiographic images showed wide mediastinum. Bacillus anthracis was isolated from blood and sputum culture and the results were confirmed by colony morphology, biochemical reactions and PCR. The treatment was changed to ciprofloxacin, clindamycin, and penicillin. On the second day of anthrax treatment, the patient was complicated with jaundice, elevation of liver enzymes, and a significant drop in hemoglobin, hematocrit, and platelet despite lack of obvious bleeding and was complicated with respiratory distress and sepsis and died a week after treatment. Conclusions We could discover no specific exposure associated with anthrax infection for this patient. However, due to being located in an endemic and enzootic area, it is proposed that the exposure occurred through contact with infected airborne dust or an unknown contaminated item. Despite many advances in preventing anthrax, still some rare cases of respiratory and complicated anthrax are emerging. With regard to the threat of bioterrorism, medical staff’s sensitivity to the clinical syndrome, methods of prophylaxis and treatment of anthrax must be raised. Fast diagnosis and successful treatment the lethal cases of this infection are of utmost important.

[LANGUAGE= \"English\"] BACKGROUNDObstructive jaundice is a common surgical issue caused by obstruction in the bile ducts, which can result from factors such as stones or cancers in the main bile duct. This study aimed to investigate the effects of carvacrol, a compound known for its strong antioxidant properties, on intestinal damage, liver damage, and bacterial translocation in an animal model of obstructive jaundice.METHODSThe study utilized six groups of six Wistar Albino rats each. Obstructive jaundice was induced in the rats through a surgical procedure, resulting in the enlargement of the common bile duct. Carvacrol was administered at a dose of 100 mg/kg to evaluate its therapeutic effects. Blood samples were collected for biochemical analysis, and tissue samples were obtained from the ileum and liver for histopathological examination. Additionally, samples from the spleen and mesenteric lymph nodes were collected for microbiological analysis.RESULTSThe findings revealed that carvacrol did not have a significant therapeutic effect on liver and bowel damage or on bacterial translocation in the rats with obstructive jaundice. Despite carvacrol's known antioxidant properties, it failed to show benefits in this experimental model.CONCLUSIONCarvacrol, while recognized for its antioxidant effects, did not demonstrate therapeutic efficacy in treating obstructive jaundice in rats. The study suggests that further research with a larger sample size may be necessary to potentially uncover positive effects and better understand carvacrol's potential role in managing obstructive jaundice.[LANGUAGE= \"Turkish\"] AMAÇObstrüktif sarılık, safra kanallarındaki tıkanmalardan kaynaklanan yaygın bir cerrahi sorundur ve bu tıkanmalar safra kesesindeki taşlar veya ana safra kanalı kanserleri gibi faktörlerden kaynaklanabilir. Bu çalışma, güçlü antioksidan özellikleri ile bilinen karvakrolün, obstrüktif sarılık modelinde bağırsak hasarı, karaciğer hasarı ve bakteriyel translokasyon üzerindeki etkilerini araştırmayı amaçlamıştır.GEREÇ VE YÖNTEMÇalışmada her biri altı Wistar Albino rat grubundan oluşan toplam altı grup kullanılmıştır. Obstrüktif sarılık, sıklıkla ortak safra kanalının genişlemesiyle sonuçlanan cerrahi bir prosedürle ratlarda indüklenmiştir. Karvakrol, terapötik etkilerini değerlendirmek için 100 mg/kg dozunda uygulanmıştır. Kan örnekleri biyokimyasal analiz için toplanmış, ileum ve karaciğerden doku örnekleri histopatolojik inceleme için elde edilmiştir. Ayrıca, dalak ve mezenterik lenf düğümlerinden mikrobiyolojik analiz için örnekler alınmıştır.BULGULARSonuçlar, karvakrolün, obstrüktif sarılığı olan ratlarda karaciğer ve bağırsak hasarı veya bakteriyel translokasyon üzerinde anlamlı bir terapötik etki göstermediğini ortaya koymuştur. Karvakrolün bilinen antioksidan özelliklerine rağmen, bu deneysel modelde fayda sağladığı gösterilmemiştir.SONUÇKarvakrol, antioksidan etkileriyle tanınmasına rağmen, ratlarda obstrüktif sarılığı tedavi etmede terapötik etkinlik göstermemiştir. Çalışma, daha büyük bir örneklem büyüklüğü ile yapılacak ileri araştırmaların, karvakrolün obstrüktif sarılığın yönetimindeki potansiyel rolünü daha iyi anlamak için gerekli olabileceğini önermektedir.

Neonatal jaundice is a common disease that affects up to 60% of newborns. Herein, we performed a comparative analysis of the gut microbiome in neonatal jaundice and non-neonatal jaundice infants (NJIs) and identified gut microbial alterations in neonatal jaundice pre- and post-treatment. We prospectively collected 232 fecal samples from 51 infants at five time points (0, 1, 3, 6, and 12 months). Finally, 114 samples from 6 NJIs and 19 non-NJI completed MiSeq sequencing and analysis. We characterized the gut microbiome and identified microbial differences and gene functions. Meconium microbial diversity from NJI was decreased compared with that from non-NJI. The genus Gemella was decreased in NJI versus non-NJI. Eleven predicted microbial functions, including fructose 1,6-bisphosphatase III and pyruvate carboxylase subunit B, decreased, while three functions, including acetyl-CoA acyltransferase, increased in NJI. After treatments, the microbial community presented significant alteration-based β diversity. The phyla Firmicutes and Actinobacteria were increased, while Proteobacteria and Fusobacteria were decreased. Microbial alterations were also analyzed between 6 recovered NJI and 19 non-NJI. The gut microbiota was unique in the meconium microbiome from NJI, implying that early gut microbiome intervention could be promising for the management of neonatal jaundice. Alterations of gut microbiota from NJI can be of great value to bolster evidence-based prevention against ‘bacterial dysbiosis’.

ObjectiveNeonatal jaundice is a common disease that affects up to 60% of newborns. Gut microbiota mediated the excretion of bilirubin from the human body. However, the relationship between early gut microbiome and development of neonatal jaundice is not fully understood. Here we sought to characterize meconium microbiome of newborns and to clarify its association with risk of neonatal jaundice.MethodsWe conducted a nested case–control study with 301 newborns providing meconium samples from 2014 to 2015. The main outcome was the development of neonatal jaundice at 42 day follow-up. 16S rRNA gene sequencing was performed to profile the meconium microbiome. LEfSe was employed to identify different features between control and case groups. Logistic regression was used to estimate the risk effect of early gut microbiome on neonatal jaundice.ResultsLogistic regression models suggested that higher ɑ-diversity was significantly associated with lower risk of jaundice in cesarean infants (OR 0.72, 95% CI 0.52–0.98), but not in infants born naturally. Higher relative abundance of Bifidobacterium pseudolongum in newborn meconium was significantly associated with lower risk of jaundice both in cesarean-born infants and in the total subjects (OR 0.24, 95% CI 0.07–0.68; OR 0.55, 95% CI 0.31–0.95, respectively). Spearman’s correlations showed that relative abundance of B. pseudolongum was significantly correlated with ɑ-diversity (P < 0.01).ConclusionPreventive and treatment methods implying early gut microbiome intervention could be promising for the management of neonatal jaundice.