Epistemic_Statements  

CORD-19:065a6f1355d676bf50ffbda0267d2b8c34660cf4 JSONTXT 9 Projects

Annnotations TAB TSV DIC JSON TextAE-old TextAE

Id Subject Object Predicate Lexical cue
T1 289-475 Epistemic_statement denotes The frequency and volume of the excretions can be seen to increase within a highly variable range, starting with very slight diarrhea up to that which can put the patient's life at risk.
T2 796-928 Epistemic_statement denotes It is usually a symptom of gastrointestinal infection, which can be caused by a variety of bacterial, viral and parasitic organisms.
T3 1274-1478 Epistemic_statement denotes While carrying out studies epidemiologists can use other operative definitions adapted to the objectives of each study, taking into account the sensitivity and specificity of the definitions in each case.
T4 1479-1534 Epistemic_statement denotes From this three clinical syndromes can be described: a.
T5 1654-1861 Epistemic_statement denotes Main symptoms usually remain for less than 7 days (but can persist up to 2 weeks at most); it can be accompanied by vomiting and fever, but it also presents a greater problem, the possibility of dehydration.
T6 2421-2527 Epistemic_statement denotes c. Persistent diarrhea: With a duration of more than 14 days, it can start as acute diarrhea or dysentery.
T7 2528-2604 Epistemic_statement denotes It should not be confused with chronic diarrhea due to noninfectious causes.
T8 2605-2669 Epistemic_statement denotes It can produce noticeable weight loss and a risk of dehydration.
T9 2759-2988 Epistemic_statement denotes The consequent effects of diarrhea can be highly variable: from a slight and transitory condition that spontaneously resolves itself to its more severe incarnations where loss of water and electrolytes can be an important factor.
T10 2989-3134 Epistemic_statement denotes The resulting hypovolemic shock can cause renal failure, disorders in other organs, and in the most vulnerable patients it can prove to be fatal.
T11 3342-3611 Epistemic_statement denotes Among the defense mechanisms combating infectious agents, the following can be highlighted: gastric acid, gastrointestinal mucus, intestinal motility, bile salts, regular intestinal bacteria, macrophage cells, lymphocyte cells, and type IgA immunoglobulin in the mucus.
T12 3612-3922 Epistemic_statement denotes Additionally, there are genetic factors that can affect resistance to particular infections; for example, blood group 'O' individuals are at greater risk of suffering from cholera, whereas the socalled nonsecretory individuals, with certain FUT 2 gene mutations, are partially resistant to norovirus infection.
T13 3923-4172 Epistemic_statement denotes Other specific external circumstances such as the ingestion of alcohol or (nonvolatile) red wine could act as protective factors against infection by Salmonella when the ingestion of the microorganism and those kind of drinks is almost simultaneous.
T14 4234-4336 Epistemic_statement denotes Recently, a vaccine against rotavirus has been authorized, which is expected to show positive results.
T15 4501-4671 Epistemic_statement denotes However, this article discusses diarrhea as the principal effect of infections and poisoning by microorganisms, ingestion of animals, plants, or compound chemical toxins.
T16 4933-5068 Epistemic_statement denotes For example, in botulism or some marine biotoxins the essential factors are the neurological signs -diarrhea may or may not be present.
T17 5496-5671 Epistemic_statement denotes With as much respect to etiology as to the seriousness of the cases, somewhat different patterns have been found, according to whether the countries are industrialized or not.
T18 6016-6330 Epistemic_statement denotes Even when incidences of the infection do not display such great geographic differences, in the case of some viruses, the indicators in terms of its lethality are noticeably different; for example, rotavirus is very frequent in all types of countries, but its severity (mortality rate) is greater in poor countries.
T19 6873-7029 Epistemic_statement denotes The age of patients, the seriousness of the illness, and the capabilities of laboratories are factors that determine the scope of the etiological diagnosis.
T20 7130-7301 Epistemic_statement denotes Faced with a similar clinical profile, a child does not have the same probability as an adult of receiving an etiological diagnosis: in the child's case it is more likely.
T21 7662-7998 Epistemic_statement denotes However, epidemiological studies were performed in England and Holland at the end of 1990s and in the United States in 2001 and 2002, in which a thorough fecal examination of all patients was undertaken, independent of their age and the seriousness of their condition, including those patients who no longer showed symptoms of diarrhea.
T22 7999-8194 Epistemic_statement denotes In these studies, fecal examination was also carried out in healthy control subjects, so that the frequency in which specific microorganisms appeared could be compared with asymptomatic subjects.
T23 8195-8379 Epistemic_statement denotes Usually the etiological diagnosis of acute infectious (or toxic) diarrhea is obtained by fecal analysis: wet mount, coproculture, antigen detection, toxin detection, or other analyses.
T24 8380-8537 Epistemic_statement denotes Specialized laboratories can use more complex techniques that, generally, prove to be more sensitive and specific, but are also more expensive and difficult.
T25 8636-8938 Epistemic_statement denotes A negative result can be the consequence of the following reasons: diarrhea is not actually infectious, it is caused by an agent for which the laboratory has no data, there is a failure in the test sensitivity, the patient may have taken antibiotics, or there may have been problems in fecal transport.
T26 8939-9071 Epistemic_statement denotes Cases that have returned negative results are a mixture of etiologies, and for that reason further investigation makes little sense.
T27 9072-9263 Epistemic_statement denotes In the EDICS study (Study of Infectious Diarrhea in Castellón) of risk factors in infantile diarrhea, no risk factors were found associated to the cases with a negative fecal analysis result.
T28 9365-9513 Epistemic_statement denotes This indeed suggests that the group of negatives is a mixture of different etiological cases without common origin and with few shared risk factors.
T29 9709-9869 Epistemic_statement denotes Faced with an epidemiological case of diarrhea two questions arise: one, if the etiology is already known; two, if there are more cases related to the original.
T30 9870-9972 Epistemic_statement denotes These two elements are represented in Table 1 , where each cell signifies a distinct epidemic concern.
T31 10135-10222 Epistemic_statement denotes Certain microorganisms have a preference to appear fundamentally as one of these forms.
T32 10223-10356 Epistemic_statement denotes As such, Campylobacter or rotavirus constitutes the majority of sporadic cases, not excluding the possibility of producing outbreaks.
T33 10481-10693 Epistemic_statement denotes From the epidemiological point of view, it could be said that epidemic cases 'come' to the investigator as one, whereas the investigator 'goes' in search of the sporadic cases and reunites them for their studies.
T34 10870-11064 Epistemic_statement denotes This group of apparently sporadic cases (but which, in fact, are not sporadic) can only be detected by the existence of an exceptionally good monitoring system or by performing specific studies.
T35 11065-11471 Epistemic_statement denotes Steen Ettenberg and other collaborators performed a specific study on cases registered throughout Denmark in the 1990s and found that 13.3% of Salmonella enteritidis, 10.4% of Shigella sonnei, 5.6% of Salmonella serotype Typhimurium, 3.2% of Campylobacter, and 2.0% of Yersinia enterocolitica cases belonged to this type of clusters, which is a large majority unknown to epidemiological monitoring systems.
T36 12939-13102 Epistemic_statement denotes Following an outline inspired by the epidemic cases of Table 1 , three situations can be distinguished according to the characteristics of the affected population.
T37 13722-13896 Epistemic_statement denotes In the case of laboratory analysis, an epidemic is identified where some rare microorganism in unusually large numbers of people is detected in a fairly prolonged time frame.
T38 14664-14749 Epistemic_statement denotes Group B is related to diarrheas in adults and group C to slight diarrheas at any age.
T39 14750-14825 Epistemic_statement denotes Other serogroups are zoonotic and are possibly transmitted by some animals.
T40 14826-14919 Epistemic_statement denotes Rotavirus is the main etiological agent for serious diarrheas in children all over the world.
T41 15404-15547 Epistemic_statement denotes In nonindustrialized countries, hospitalizations are fewer because welfare services are less accessible; mortality rates, however, are greater.
T42 15548-15753 Epistemic_statement denotes Year 2006 saw the 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 August September Notification and control authorization of two new oral vaccines that promise to be effective: RotaTeq s and Rotarix s .
T43 15754-15844 Epistemic_statement denotes Previously known as 'Agent Norwalk,' this virus was identified by Albert Kapikian in 1972.
T44 15845-16050 Epistemic_statement denotes It is related to the Caliciviridae family, of which only norovirus and sapovirus cause diarrhea in humans -the former preferentially causing epidemic cases (outbreaks) and the latter causing sporadic ones.
T45 16590-16672 Epistemic_statement denotes On wood, metal, or plastic surfaces, the virus can survive for hours or even days.
T46 16673-16814 Epistemic_statement denotes It has been proven that transmission is possible through typical hand-to-surface contact, such as door handles, telephone receivers, or taps.
T47 16815-17023 Epistemic_statement denotes An experimental study found that contaminated fingers could transfer the virus to the clean surfaces they touch by up to seven times, and at least 14 people could be contaminated by touching the same surface.
T48 17024-17125 Epistemic_statement denotes Alternatively, it is known that certain subjects are genetically resistant to infection by norovirus.
T49 17317-17476 Epistemic_statement denotes However, recently it has been seen that nonsecretory subjects are not totally resistant, suggesting some norovirus strains use alternative routes of infection.
T50 17477-17560 Epistemic_statement denotes The characteristics of norovirus make it difficult to produce a vaccine against it.
T51 17735-17782 Epistemic_statement denotes Perhaps they have a limited epidemic potential.
T52 18194-18280 Epistemic_statement denotes The infectious capacity is high, perhaps very few viral particles can produce disease.
T53 18281-18363 Epistemic_statement denotes Epidemiological data suggest that immunity does not last and is serotype specific.
T54 18364-18424 Epistemic_statement denotes Few laboratories can diagnose the routine of this infection.
T55 18425-18533 Epistemic_statement denotes It is believed that the virus can be an important factor in hospital diarrheas as much as in external cases.
T56 18672-18801 Epistemic_statement denotes It is believed that the torovirus produces acute diarrhea in children and can also be an important factor in nosocomial diarrhea.
T57 19119-19208 Epistemic_statement denotes However, viral particles have been found several months after the symptoms first started.
T58 19357-19408 Epistemic_statement denotes It is a germ that grows little or nothing in foods.
T59 19409-19506 Epistemic_statement denotes This is the probable cause of its limited epidemic potential and the scarcity of known outbreaks.
T60 19507-19596 Epistemic_statement denotes Some relationships to the ingestion of milk or public drinking water have been described.
T61 19597-19746 Epistemic_statement denotes However, the majority of diagnosed cases are sporadic, essentially occurring in very small children and with little evidence of any seasonal pattern.
T62 19747-19905 Epistemic_statement denotes It is possible -as happens with other microorganisms -that this predominance of diagnosed cases in children may be the consequence of a diagnostical age bias.
T63 20389-20490 Epistemic_statement denotes Companion animals, if they have diarrhea when very young, can pose an infection risk to their owners.
T64 20654-20726 Epistemic_statement denotes Exposure to avian or bovine meat products has been related to infection.
T65 20727-20913 Epistemic_statement denotes Exposure is not necessarily by direct consumption; the presence of these products in home kitchens presents a risk factor, probably by cross-contamination due to poor hygienic practices.
T66 21466-21696 Epistemic_statement denotes In the nontyphoidal Salmonella group, there are more than 2500 serotypes that can cause gastroenteritis in humans, most common are S. enteritidis and S. typhimurium, although many others have been identified on numerous occasions.
T67 21948-22059 Epistemic_statement denotes Chickens and hens are principal reservoirs of S. enteritidis; however, pigs and cattle transmit S. typhimurium.
T68 22222-22261 Epistemic_statement denotes Hen eggshells can also be contaminated.
T69 22918-23012 Epistemic_statement denotes When investigating outbreaks, the possibility of secondary cases has to be taken into account.
T70 23013-23170 Epistemic_statement denotes It is not believed that there are chronic carriers as with S. typhi, but the feces of some patients can remain contagious for months, especially in children.
T71 23389-23528 Epistemic_statement denotes and some characteristics of the host can act as factors that greatly modify the incubation period and the severity of the clinical profile.
T72 23529-23614 Epistemic_statement denotes Symptoms can start from 6 h up to 3 days after the ingestion of contaminated produce.
T73 23749-23891 Epistemic_statement denotes It has been suggested, when faced with infection by S. ohio, that the simultaneous ingestion of alcohol (or red wine) has a protective effect.
T74 24299-24395 Epistemic_statement denotes In Asia, it seems that incidents of shigellosis maintain a presence but tend to be less serious.
T75 24396-24438 Epistemic_statement denotes Little is known about incidents in Africa.
T76 24689-24834 Epistemic_statement denotes Carriers can be asymptomatic for weeks, and with antibiotic treatment they could reduce the time needed for elimination of Shigella in the feces.
T77 24835-24902 Epistemic_statement denotes However, the appearance of antibiotic resistance has been observed.
T78 25152-25656 Epistemic_statement denotes The former (whose taxonomic classification has undergone important changes from its initial description in 1934 as Flavobacterium pseudomallei to the denomination Yersinia at the beginning of the 1960s) produces a diarrhea profile that includes abdominal pain and, sometimes, fever; the latter (whose first identification dates from many years earlier, in 1883) produces a clinical profile in which it is worth mentioning the symptoms of Mesenteric adenitis, which can sometimes simulate an appendicitis.
T79 25975-26112 Epistemic_statement denotes Changes in laboratory practice have been considered an explanation for observed increases in the 1980s and some geographical differences.
T80 26346-26466 Epistemic_statement denotes The Y. pseudotuberculosis species is less frequent and little knowledge exists regarding its mechanisms of transmission.
T81 26561-26667 Epistemic_statement denotes In these clusters no secondary cases were observed, suggesting the source was most probably environmental.
T82 26805-26882 Epistemic_statement denotes There is a possibility that some humans may be carriers of Y. enterocolitica.
T83 26883-27000 Epistemic_statement denotes Also, Yersinia, from these reservoirs, may contaminate foods or water, which will then infect those who consume them.
T84 27115-27302 Epistemic_statement denotes It is postulated that initially the infection is caused by waters contaminated by animal reservoirs, which indicates that the washing of fresh vegetables is a method to prevent infection.
T85 27303-27525 Epistemic_statement denotes But an outbreak that occurred in Finland in 1998 experimentally demonstrated the possibility of internal contamination of the lettuces, with the result that in such an eventuality external washing would have little effect.
T86 28366-28627 Epistemic_statement denotes Among the clinical characteristics of these infections, it is worth mentioning a serious complication of serotype O157:H7, hemolytic-uremic syndrome (HUS), which appears mainly in children, and can be exacerbated by taking antidiarrheal or antibiotic medicines.
T87 28628-28897 Epistemic_statement denotes This virulent stock of E. coli is transmitted mainly through ingestion of contaminated meat from bovine livestock, but it is also possible that there are other environmental routes of contagion by contact with surfaces or dust and sawdust in farms and zoological parks.
T88 28898-28976 Epistemic_statement denotes Recent studies suggest that EAEC can cause both traveler and chronic diarrhea.
T89 29092-29243 Epistemic_statement denotes This is a microorganism that can cause serious diarrhea, occasionally as pseudomembranous colitis, especially in hospitalized and debilitated patients.
T90 29604-29707 Epistemic_statement denotes The origin of diarrhea from microorganisms previously present in the same individual can be endogenous.
T91 29708-29932 Epistemic_statement denotes These microorganisms are stimulated when intestinal flora is altered as a result of taking antibiotics; this can happen for 4-9 days at the beginning of an antibiotic course and even later, up to 6 or 8 weeks after starting.
T92 29933-30019 Epistemic_statement denotes In these cases, it is difficult to speak of an incubation period in the classic sense.
T93 30020-30128 Epistemic_statement denotes There may also be exogenous contagion from environmental spores or C. difficile excreted by another patient.
T94 30274-30321 Epistemic_statement denotes It is rare that it produces communal outbreaks.
T95 30322-30390 Epistemic_statement denotes When it appears in an epidemic form it usually does so in hospitals.
T96 30391-30571 Epistemic_statement denotes According to what is known of its clinical and epidemiological characteristics, cholera only produces the V. cholerae serogroups O1 and O139, the latter confined to Southeast Asia.
T97 31410-31469 Epistemic_statement denotes Person-to-person transmission, if it exists, would be rare.
T98 31764-31906 Epistemic_statement denotes Patients with diarrhea dispose of the parasite in trophozoit form, a form with little infectious potential due to its environmental fragility.
T99 32306-32364 Epistemic_statement denotes Foods and water can also provide vehicles of transmission.
T100 32365-32431 Epistemic_statement denotes The reservoir is human and, perhaps, some animals such as beavers.
T101 32432-32470 Epistemic_statement denotes People can remain carriers for months.
T102 32471-32582 Epistemic_statement denotes Cryptosporidium parvum produces diarrhea in humans and can also affect systems other than the digestive system.
T103 32911-33073 Epistemic_statement denotes It is responsible for 57% of gastroenteritis outbreaks related to swimming venues in the EU, although hyperchlorination can inactivate cysts present in the water.
T104 33492-33578 Epistemic_statement denotes There is a very diverse range of agents that cause, or can cause, diarrhea (Table 3) .
T105 33712-33884 Epistemic_statement denotes Notable among the biotoxins is scombroid fish poisoning, which can take place after ingestion of certain scombroid fish (such as tuna and herring) in certain circumstances.
T106 33975-34105 Epistemic_statement denotes Ciguatoxin, tetrodotoxin, and gempilotoxin are marine biotoxins that can produce very serious digestive and neurological symptoms.
T107 34216-34284 Epistemic_statement denotes Among vegetables, mushroom poisoning can cause serious consequences.
T108 34285-34415 Epistemic_statement denotes Less well known is the diarrhea from Robinia pseudoacacia poisoning, which can be observed after chewing the bark of common trees.
T109 34839-35241 Epistemic_statement denotes The etiology of inflammatory bowel disease (IBD) is not known, but cohort studies carried out in the United Kingdom and Sweden indicate that previous bacterial intestinal infections by Salmonella, Campylobacter, or diarrheagenic E. coli and other agents of acute gastroenteritis double or triple the risk of suffering from some IBD variants, with incidences reaching almost 70 per 100 000 person-years.
T110 35242-35377 Epistemic_statement denotes Irritable bowel syndrome (IBS) can develop after infectious gastroenteritis by Campylobacter, Shigella, Salmonella, or E. coli O157:H7.
T111 35469-35623 Epistemic_statement denotes It is believed that age (young), sex (feminine), psychological profile, severity, and duration of gastroenteritis are all risk factors in contracting IBS.
T112 36089-36274 Epistemic_statement denotes Although the frequency of bacterial musculoskeletal symptoms after foodborne infection can reach up to 50% of affected patients, the incidences of ReA are positioned between 0% and 29%.
T113 36399-36425 Epistemic_statement denotes Perhaps there may be more.
T114 36541-36622 Epistemic_statement denotes The genetic marker HLA B27 would be associated more with severity than incidence.
T115 36765-36911 Epistemic_statement denotes Guillain-Barré syndrome (GBS) is an acute neuropathy of immune origin, which is associated with infections from Campylobacter and cytomegalovirus.
T116 37369-37564 Epistemic_statement denotes Autoimmune diseases (Graves' disease, autoimmune tiroiditis, Kawasiki disease, Sjogren syndrome, and psoriasis) have been related to previous intestinal infections by Staphylococcus and Yersinia.
T117 37565-37693 Epistemic_statement denotes The aftereffects of viral intestinal processes are less well known due to limitations of diagnosis in conventional laboratories.
T118 37807-37965 Epistemic_statement denotes Studies of stomach biopsies and the presence of enterovirus in skeletal muscles suggest the persistence of infection with viral replication in these patients.
T119 37966-38215 Epistemic_statement denotes Some cohort studies carried out in the United States suggest that children between 6 and 36 months of age infected by norovirus, sapovirus, or rotavirus are at greater risk of displaying persistent diarrhea in the 6 months following viral infection.
T120 38216-38404 Epistemic_statement denotes Cross-sectional epidemiological studies and prospective studies in children have suggested the importance of enteric viral infections in the development of autoimmune celiac disease (ACD).