Little data are available regarding the association of ancylostomiasis with overt gastrointestinal bleeding. This 6-year retrospective study describes the clinical and biological profiles of unexpectedly identified ancylostomiasis in a 4-month-old baby and four adults; they presented with melena and were referred for urgent diagnostic gastrointestinal endoscopy, which confirmed numerous small intestine injuries with surrounding blood pools caused by Ancylostoma duodenale worms. Gastric erosions were also encountered in one patient. Uniquely, worm biological activities were recorded live in vivo, including mucosal invasion through a vigorous, rapid piercing process, repeated bloodsucking habits, and gut appearance during the stages of feeding, digestion, and excretion in male and female worms. In conclusion, ancylostomiasis-induced melena may occur in all ages from infants to the elderly. Worm bloodfeeding occurs after quick mucosal piercing, with blood loss being aggravated by a repeated feeding behavior. After treatment is started, bleeding stops rapidly in response to anthelmintic therapy.

Little data are available regarding the association of ancylostomiasis with overt gastrointestinal bleeding. This 6-year retrospective study describes the clinical and biological profiles of unexpectedly identified ancylostomiasis in a 4-month-old baby and four adults; they presented with melena and were referred for urgent diagnostic gastrointestinal endoscopy, which confirmed numerous small intestine injuries with surrounding blood pools caused by Ancylostoma duodenale worms. Gastric erosions were also encountered in one patient. Uniquely, worm biological activities were recorded live in vivo, including mucosal invasion through a vigorous, rapid piercing process, repeated bloodsucking habits, and gut appearance during the stages of feeding, digestion, and excretion in male and female worms. In conclusion, ancylostomiasis-induced melena may occur in all ages from infants to the elderly. Worm bloodfeeding occurs after quick mucosal piercing, with blood loss being aggravated by a repeated feeding behavior. After treatment is started, bleeding stops rapidly in response to anthelmintic therapy.

Background: The principal sites of neonatal phototherapy (NNPT) action may localize not only in the skin but also in capillary circulation under the skin. Thus, the safety of phototherapy particularly in relation to hemodynamic control must be investigated. Since regional blood flow is affected by Endothelin-1 (ET) and nitric oxide (NO), it is important to study the effect of phototherapy on circulating levels of both of them and to use the changes of vital signs as markers for hemodynamic stability. Aim: This study aimed to evaluate the effect of phototherapy on blood ET and NO in hyperbilirubinemic newborn infants of different gestational ages with stable vital signs and to observe changes in vital signs in those newborn infants after 24 hours of phototherapy. Methods: This study included 50 newborn infants (29 37 weeks [preterm]; 21 ≥ 37 weeks [full term]) with stable vital signs who received phototherapy for high unconjugated bilirubin levels. Heart rate (HR), respiration rate (RR), mean arterial blood pressure (MABP), serum ET and NO levels were detected before phototherapy and subsequently monitored after 24 hours under phototherapy. Results: The present study revealed that after 24 hours of phototherapy there is a significant increase in NO and ET serum levels, NO:ET ratio, and HR and a significant decrease in MABP in both full term and preterm newborns. There is no significant change in RR in either preterm or full term newborns. Conclusions: Phototherapy can disturb the dynamic balance between NO and ET, leading to a more prominent effect of NO. This effect may be not harmful in newborns with stable vital signs, but harmful effect may occur in newborns with septicemia or decompensated vital signs. Careful observation of vital signs should be done in all newborns under the effect of phototherapy. Also the safety of continuous phototherapy for more than 24 hours in newborn infants with different gestational ages and different birth weights should be verified.

Background: The principal sites of neonatal phototherapy (NNPT) action may localize not only in the skin but also in capillary circulation under the skin. Thus, the safety of phototherapy particularly in relation to hemodynamic control must be investigated. Since regional blood flow is affected by Endothelin-1 (ET) and nitric oxide (NO), it is important to study the effect of phototherapy on circulating levels of both of them and to use the changes of vital signs as markers for hemodynamic stability. Aim: This study aimed to evaluate the effect of phototherapy on blood ET and NO in hyperbilirubinemic newborn infants of different gestational ages with stable vital signs and to observe changes in vital signs in those newborn infants after 24 hours of phototherapy. Methods: This study included 50 newborn infants (29 37 weeks [preterm]; 21 ≥ 37 weeks [full term]) with stable vital signs who received phototherapy for high unconjugated bilirubin levels. Heart rate (HR), respiration rate (RR), mean arterial blood pressure (MABP), serum ET and NO levels were detected before phototherapy and subsequently monitored after 24 hours under phototherapy. Results: The present study revealed that after 24 hours of phototherapy there is a significant increase in NO and ET serum levels, NO:ET ratio, and HR and a significant decrease in MABP in both full term and preterm newborns. There is no significant change in RR in either preterm or full term newborns. Conclusions: Phototherapy can disturb the dynamic balance between NO and ET, leading to a more prominent effect of NO. This effect may be not harmful in newborns with stable vital signs, but harmful effect may occur in newborns with septicemia or decompensated vital signs. Careful observation of vital signs should be done in all newborns under the effect of phototherapy. Also the safety of continuous phototherapy for more than 24 hours in newborn infants with different gestational ages and different birth weights should be verified.

Background: The principal sites of neonatal phototherapy (NNPT) action may localize not only in the skin but also in capillary circulation under the skin. Thus, the safety of phototherapy particularly in relation to hemodynamic control must be investigated. Since regional blood flow is affected by Endothelin-1 (ET) and nitric oxide (NO), it is important to study the effect of phototherapy on circulating levels of both of them and to use the changes of vital signs as markers for hemodynamic stability. Aim: This study aimed to evaluate the effect of phototherapy on blood ET and NO in hyperbilirubinemic newborn infants of different gestational ages with stable vital signs and to observe changes in vital signs in those newborn infants after 24 hours of phototherapy. Methods: This study included 50 newborn infants (29 37 weeks [preterm]; 21 ≥ 37 weeks [full term]) with stable vital signs who received phototherapy for high unconjugated bilirubin levels. Heart rate (HR), respiration rate (RR), mean arterial blood pressure (MABP), serum ET and NO levels were detected before phototherapy and subsequently monitored after 24 hours under phototherapy. Results: The present study revealed that after 24 hours of phototherapy there is a significant increase in NO and ET serum levels, NO:ET ratio, and HR and a significant decrease in MABP in both full term and preterm newborns. There is no significant change in RR in either preterm or full term newborns. Conclusions: Phototherapy can disturb the dynamic balance between NO and ET, leading to a more prominent effect of NO. This effect may be not harmful in newborns with stable vital signs, but harmful effect may occur in newborns with septicemia or decompensated vital signs. Careful observation of vital signs should be done in all newborns under the effect of phototherapy. Also the safety of continuous phototherapy for more than 24 hours in newborn infants with different gestational ages and different birth weights should be verified.

Background: The principal sites of neonatal phototherapy (NNPT) action may localize not only in the skin but also in capillary circulation under the skin. Thus, the safety of phototherapy particularly in relation to hemodynamic control must be investigated. Since regional blood flow is affected by Endothelin-1 (ET) and nitric oxide (NO), it is important to study the effect of phototherapy on circulating levels of both of them and to use the changes of vital signs as markers for hemodynamic stability. Aim: This study aimed to evaluate the effect of phototherapy on blood ET and NO in hyperbilirubinemic newborn infants of different gestational ages with stable vital signs and to observe changes in vital signs in those newborn infants after 24 hours of phototherapy. Methods: This study included 50 newborn infants (29 37 weeks [preterm]; 21 ≥ 37 weeks [full term]) with stable vital signs who received phototherapy for high unconjugated bilirubin levels. Heart rate (HR), respiration rate (RR), mean arterial blood pressure (MABP), serum ET and NO levels were detected before phototherapy and subsequently monitored after 24 hours under phototherapy. Results: The present study revealed that after 24 hours of phototherapy there is a significant increase in NO and ET serum levels, NO:ET ratio, and HR and a significant decrease in MABP in both full term and preterm newborns. There is no significant change in RR in either preterm or full term newborns. Conclusions: Phototherapy can disturb the dynamic balance between NO and ET, leading to a more prominent effect of NO. This effect may be not harmful in newborns with stable vital signs, but harmful effect may occur in newborns with septicemia or decompensated vital signs. Careful observation of vital signs should be done in all newborns under the effect of phototherapy. Also the safety of continuous phototherapy for more than 24 hours in newborn infants with different gestational ages and different birth weights should be verified.

Objective: Antibiotic-associated diarrhea constitutes 1 of the most frequent side effects of antimicrobial therapy with widely varying clinical presentations; however, little is known about its antibiotic-associated bloody diarrhea (AABD) form, particularly in very young children. The aim of this study was to describe the clinical, endoscopic, and histopathologic profiles of community-acquired AABD in infants. Patients and Methods: The study included 23 infants referred with bloody diarrhea that developed a few days after receiving antibiotics on an outpatient basis for watery diarrhea (18), respiratory tract infections (4), or urinary tract infection (1). Detailed clinical assessment, videosigmoidoscopy, and histopathologic examination of endoscopic biopsies were performed for all. Results: Clinically, on presentation, bloody diarrhea was acute in all except 1 patient with a prolonged course (for 25 days) and stopped in all 2 to 6 days after discontinuation of antibiotics. Fever and/or leukocytosis were present only in 8 (34.8%). Sigmoidoscopy revealed varying types of erythema (patchy, ring, diffuse) and ulcers (aphthoid, diffuse) in 18 and pseudomembranes in 5. Histopathologically, only 3 showed the characteristic mushroom-like pseudomembranes, whereas all of the other infants had nonspecific colitis. Conclusions: Community-acquired AABD is not uncommon in infants presenting with acute or chronic forms even without fever or leukocytosis. When suspected, discontinuation of antibiotics is a good policy if facilities for bacterial culture with cytotoxin assays are limited. The characteristic endoscopic or histopathologic pseudomembranes are encountered only in a small percentage (26%). Rational use of antibiotics should be adhered to particularly in cases of watery diarrhea that is mostly of viral origin.

Objective: Antibiotic-associated diarrhea constitutes 1 of the most frequent side effects of antimicrobial therapy with widely varying clinical presentations; however, little is known about its antibiotic-associated bloody diarrhea (AABD) form, particularly in very young children. The aim of this study was to describe the clinical, endoscopic, and histopathologic profiles of community-acquired AABD in infants. Patients and Methods: The study included 23 infants referred with bloody diarrhea that developed a few days after receiving antibiotics on an outpatient basis for watery diarrhea (18), respiratory tract infections (4), or urinary tract infection (1). Detailed clinical assessment, videosigmoidoscopy, and histopathologic examination of endoscopic biopsies were performed for all. Results: Clinically, on presentation, bloody diarrhea was acute in all except 1 patient with a prolonged course (for 25 days) and stopped in all 2 to 6 days after discontinuation of antibiotics. Fever and/or leukocytosis were present only in 8 (34.8%). Sigmoidoscopy revealed varying types of erythema (patchy, ring, diffuse) and ulcers (aphthoid, diffuse) in 18 and pseudomembranes in 5. Histopathologically, only 3 showed the characteristic mushroom-like pseudomembranes, whereas all of the other infants had nonspecific colitis. Conclusions: Community-acquired AABD is not uncommon in infants presenting with acute or chronic forms even without fever or leukocytosis. When suspected, discontinuation of antibiotics is a good policy if facilities for bacterial culture with cytotoxin assays are limited. The characteristic endoscopic or histopathologic pseudomembranes are encountered only in a small percentage (26%). Rational use of antibiotics should be adhered to particularly in cases of watery diarrhea that is mostly of viral origin.

Objective: Antibiotic-associated diarrhea constitutes 1 of the most frequent side effects of antimicrobial therapy with widely varying clinical presentations; however, little is known about its antibiotic-associated bloody diarrhea (AABD) form, particularly in very young children. The aim of this study was to describe the clinical, endoscopic, and histopathologic profiles of community-acquired AABD in infants. Patients and Methods: The study included 23 infants referred with bloody diarrhea that developed a few days after receiving antibiotics on an outpatient basis for watery diarrhea (18), respiratory tract infections (4), or urinary tract infection (1). Detailed clinical assessment, videosigmoidoscopy, and histopathologic examination of endoscopic biopsies were performed for all. Results: Clinically, on presentation, bloody diarrhea was acute in all except 1 patient with a prolonged course (for 25 days) and stopped in all 2 to 6 days after discontinuation of antibiotics. Fever and/or leukocytosis were present only in 8 (34.8%). Sigmoidoscopy revealed varying types of erythema (patchy, ring, diffuse) and ulcers (aphthoid, diffuse) in 18 and pseudomembranes in 5. Histopathologically, only 3 showed the characteristic mushroom-like pseudomembranes, whereas all of the other infants had nonspecific colitis. Conclusions: Community-acquired AABD is not uncommon in infants presenting with acute or chronic forms even without fever or leukocytosis. When suspected, discontinuation of antibiotics is a good policy if facilities for bacterial culture with cytotoxin assays are limited. The characteristic endoscopic or histopathologic pseudomembranes are encountered only in a small percentage (26%). Rational use of antibiotics should be adhered to particularly in cases of watery diarrhea that is mostly of viral origin.

Objective: Antibiotic-associated diarrhea constitutes 1 of the most frequent side effects of antimicrobial therapy with widely varying clinical presentations; however, little is known about its antibiotic-associated bloody diarrhea (AABD) form, particularly in very young children. The aim of this study was to describe the clinical, endoscopic, and histopathologic profiles of community-acquired AABD in infants. Patients and Methods: The study included 23 infants referred with bloody diarrhea that developed a few days after receiving antibiotics on an outpatient basis for watery diarrhea (18), respiratory tract infections (4), or urinary tract infection (1). Detailed clinical assessment, videosigmoidoscopy, and histopathologic examination of endoscopic biopsies were performed for all. Results: Clinically, on presentation, bloody diarrhea was acute in all except 1 patient with a prolonged course (for 25 days) and stopped in all 2 to 6 days after discontinuation of antibiotics. Fever and/or leukocytosis were present only in 8 (34.8%). Sigmoidoscopy revealed varying types of erythema (patchy, ring, diffuse) and ulcers (aphthoid, diffuse) in 18 and pseudomembranes in 5. Histopathologically, only 3 showed the characteristic mushroom-like pseudomembranes, whereas all of the other infants had nonspecific colitis. Conclusions: Community-acquired AABD is not uncommon in infants presenting with acute or chronic forms even without fever or leukocytosis. When suspected, discontinuation of antibiotics is a good policy if facilities for bacterial culture with cytotoxin assays are limited. The characteristic endoscopic or histopathologic pseudomembranes are encountered only in a small percentage (26%). Rational use of antibiotics should be adhered to particularly in cases of watery diarrhea that is mostly of viral origin.