54-471: [REDACTED] Look up lanzo in Wiktionary, the free dictionary. Lanzo may refer to: Medicine [ edit ] Lansoprazole , a proton-pump inhibitor. Its Swedish brand name is "Lanzo" Geography [ edit ] Lanzo d'Intelvi , a frazione in the municipality of Alta Valle Intelvi , Province of Como, Lombardy, Italy Lanzo Torinese ,
108-430: A sensitivity of 63–99% and a specificity of 93–100%, depending on detection assays. Previously, experts recommended sending as many as three stool samples to rule out disease if initial tests are negative, but evidence suggests repeated testing during the same episode of diarrhea is of limited value and should be discouraged. C. difficile toxin should clear from the stool of somebody previously infected if treatment
162-436: A sensitivity of 86% and a specificity of 45%. In this study with a prevalence of positive cytotoxin assays of 14%, the positive predictive value was 18% and the negative predictive value was 94%. In children, the most prevalent symptom of a CDI is watery diarrhea with at least three bowel movements a day for two or more days, which may be accompanied by fever, loss of appetite, nausea, and/or abdominal pain. Those with
216-418: A greater risk of hip fractures and Clostridioides difficile -associated diarrhea . Lansoprazole interacts with several other drugs, either due to its nature or as a PPI. Lansoprazole possibly interacts with, among other drugs: It is a racemic 1:1 mixture of the enantiomers dexlansoprazole and levolansoprazole. Dexlansoprazole is an enantiomerically pure active ingredient of a commercial drug as
270-591: A municipality in the Province of Turin, Piedmont, Italy Monastero di Lanzo , a municipality in the Province of Turin, Piedmont, Italy Stura di Lanzo , a river in Piedmont, Italy See also [ edit ] Lanza , disambiguation page Lanze , a German municipality in Schleswig-Holstein Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with
324-409: A nursing home within the previous year are independent risk factors for increased colonization . Increasing rates of community-acquired CDI are associated with the use of medication to suppress gastric acid production: H2-receptor antagonists increased the risk 1.5-fold, and proton pump inhibitors by 1.7 with once-daily use and 2.4 with more than once-daily use. Increased risk in recurrent CDI
378-537: A result of suppression of healthy bacteria, via a loss of bacterial food source, prolonged use of an elemental diet increases the risk of developing C. difficile infection. Low serum albumin levels is a risk factor for the development of C. difficile infection and when infected for severe disease. The protective effects of serum albumin may be related to the capability of this protein to bind C. difficile toxin A and toxin B, thus impairing entry into enterocytes. Chronic kidney disease (CKD) has been identified as
432-507: A result of the enantiomeric shift . Lansoprazole's plasma elimination half-life (1.5 h) is not proportional to the duration of the drug's effects to the person (i.e., gastric acid suppression). Lansoprazole was originally synthesized at Takeda and was given the development name AG 1749. Takeda patented it in 1984 and the drug launched in 1991. In the United States, it was approved for medical use in 1995. Patent protection of
486-609: A risk factor in the development of a C. difficile infection. Patients with CKD have a higher risk of both initial and recurring infection, as well as a higher chance of severe infection, than those without CKD. Patients with Inflammatory Bowel Disease are also at higher risk for infection and a recent study suggests they may have intermittent C. difficile infection masked by IBD symptoms, and testing should be considered in patients with changes in disease activity. The use of systemic antibiotics, including broad-spectrum penicillins/cephalosporins, fluoroquinolones, and clindamycin, causes
540-444: A room after treatment is completed have been shown to reduce infection rates and to reduce risk of infection to others. The incidence of CDI was reduced by 53% or 42% through use of HPV. Ultraviolet cleaning devices, and housekeeping staff especially dedicated to disinfecting the rooms of people with C. difficile after discharge may be effective. Carrying C. difficile without symptoms is common. Treatment in those without symptoms
594-564: A severe infection also may develop serious inflammation of the colon and have little or no diarrhea. Infection with C. difficile bacteria is responsible for C. difficile diarrhea. Clostridia are anaerobic motile bacteria , ubiquitous in nature, and especially prevalent in soil. Under the microscope, they appear as long, irregular (often drumstick- or spindle-shaped) cells with a bulge at their terminal ends. Under gram staining , C. difficile cells are gram-positive and show optimum growth on blood agar at human body temperatures in
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#1732872371068648-466: A single person with CDI, are effective at prevention. This works by limiting the spread of C. difficile in the hospital setting. In addition, washing with soap and water will wash away the spores from contaminated hands, but alcohol-based hand rubs are ineffective. These precautions should remain in place among those in hospital for at least 2 days after the diarrhea has stopped. Bleach wipes containing 0.55% sodium hypochlorite have been shown to kill
702-529: A stool transplant, is roughly 85% to 90% effective in those for whom antibiotics have not worked. It involves infusion of the microbiota acquired from the feces of a healthy donor to reverse the bacterial imbalance responsible for the recurring nature of the infection. The procedure replenishes the normal colonic microbiota that had been wiped out by antibiotics, and re-establishes resistance to colonization by Clostridioides difficile . Side effects, at least initially, are few. Fecal microbiota, live (Rebyota)
756-418: Is able to detect C. difficile about 93% of the time and when positive is incorrectly positive about 3% of the time. This is more accurate than cytotoxigenic culture or cell cytotoxicity assay. Another benefit is that the result can be achieved within three hours. Drawbacks include a higher cost and the fact that the test only looks for the gene for the toxin and not the toxin itself. The latter means that if
810-465: Is also found with gastric acid repression use in observational studies, with a rate of 22.1%, compared to patients without gastric acid repression has a rate of 17.3% of recurrent CDI. People with a recent history of diarrheal illness are at increased risk of becoming colonized by C. difficile when exposed to spores, including laxative abuse and gastrointestinal pathogens. Disturbances that increase intestinal motility are thought to transiently elevate
864-426: Is associated most strongly with the use of these antibiotics: fluoroquinolones , cephalosporins , and clindamycin . Some research suggests the routine use of antibiotics in the raising of livestock is contributing to outbreaks of bacterial infections such as C. difficile . People are most often infected in hospitals , nursing homes , or other medical institutions, although infection outside medical settings
918-593: Is by stool culture or testing for the bacteria's DNA or toxins . If a person tests positive but has no symptoms, the condition is known as C. difficile colonization rather than an infection. Prevention efforts include terminal room cleaning in hospitals, limiting antibiotic use, and handwashing campaigns in hospitals. Alcohol based hand sanitizer does not appear effective. Discontinuation of antibiotics may result in resolution of symptoms within three days in about 20% of those infected. The antibiotics metronidazole , vancomycin , or fidaxomicin , will cure
972-424: Is controversial. In general, mild cases do not require specific treatment. Oral rehydration therapy is useful in treating dehydration associated with the diarrhea. Several different antibiotics are used for C. difficile , with the available agents being more or less equally effective. Vancomycin or fidaxomicin by mouth are the typically recommended for mild, moderate, and severe infections. They are also
1026-555: Is effective. Many hospitals only test for the prevalent toxin A. Strains that express only the B toxin are now present in many hospitals, however, so testing for both toxins should occur. Not testing for both may contribute to a delay in obtaining laboratory results, which is often the cause of prolonged illness and poor outcomes. Stool leukocyte measurements and stool lactoferrin levels also have been proposed as diagnostic tests, but may have limited diagnostic accuracy. Testing of stool samples by real-time polymerase chain reaction
1080-470: Is highly recommended, about 50% is considered inappropriate. This is consistent whether in the hospital, clinic, community, or academic setting. A decrease in CDI by limiting antibiotics or by limiting unnecessary prescriptions in general, both in an outbreak and non-outbreak setting has been demonstrated to be most strongly associated with reduced CDI. Further, reactions to medication may be severe: CDI infections were
1134-500: Is important to prevent the spread of C. difficile . Contact precautions are an important part of preventing the spread of C. difficile. C. difficile does not often occur in people who are not taking antibiotics so limiting use of antibiotics decreases the risk. The most effective method for preventing CDI is proper antibiotic prescribing. In the hospital setting, where CDI is most common, most people who develop CDI are exposed to antibiotics. Although proper antibiotic prescribing
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#17328723710681188-467: Is increasing. Individuals can develop the infection if they touch objects or surfaces that are contaminated with feces and then touch their mouth or mucous membranes. Healthcare workers could possibly spread the bacteria or contaminate surfaces through hand contact. The rate of C. difficile acquisition is estimated to be 13% in those with hospital stays of up to two weeks, and 50% with stays longer than four weeks. Long-term hospitalization or residence in
1242-568: Is of unclear safety. It works by blocking H /K -ATPase in the parietal cells of the stomach. Lansoprazole was patented in 1984 and came into medical use in 1992. It is available as a generic medication . In 2021, it was the 216th most commonly prescribed medication in the United States, with more than 1 million prescriptions. Lansoprazole is used for treatment of: There is no good evidence that it works better than other PPIs. Side effects of PPIs in general and lansoprazole in particular may include: PPIs may be associated with
1296-442: Is recommended as an alternative treatment only for C. difficile infections when the affected person is allergic to first-line treatments, is unable to tolerate them, or has financial difficulties preventing them from accessing them. In fulminant disease vancomycin by mouth and intravenous metronidazole are commonly used together. Medications used to slow or stop diarrhea , such as loperamide , may only be used after initiating
1350-419: Is the practical gold standard for studies investigating new CDI diagnostic techniques. Toxigenic culture, in which organisms are cultured on selective media and tested for toxin production, remains the gold standard and is the most sensitive and specific test, although it is slow and labor-intensive. Assessment of the A and B toxins by enzyme-linked immunosorbent assay ( ELISA ) for toxin A or B (or both) has
1404-498: The Infectious Diseases Society of America recommended against their use due to the risk of complications. Subsequent reviews, however, did not find an increase in adverse effects with treatment, and overall treatment appears safe and moderately effective in preventing C. difficile-associated diarrhea. One study in particular found that there does appear to be a "protective effect" of probiotics, specifically reducing
1458-525: The Rho family of GTPases . Toxin B (cytotoxin) induces actin depolymerization by a mechanism correlated with a decrease in the ADP-ribosylation of the low molecular mass GTP-binding Rho proteins. Another toxin, binary toxin , also has been described, but its role in disease is not fully understood. Antibiotic treatment of CDIs may be difficult, due both to antibiotic resistance and physiological factors of
1512-474: The spore -forming bacterium Clostridioides difficile . Symptoms include watery diarrhea , fever, nausea, and abdominal pain . It makes up about 20% of cases of antibiotic-associated diarrhea . Antibiotics can contribute to detrimental changes in gut microbiota ; specifically, they decrease short-chain fatty acid absorption which results in osmotic, or watery, diarrhea. Complications may include pseudomembranous colitis , toxic megacolon , perforation of
1566-436: The United States in 2011, resulting in 29,000 deaths. Global rates of disease increased between 2001 and 2016. C. difficile infections occur more often in women than men. The bacterium was discovered in 1935 and found to be disease-causing in 1978. Attributable costs for Clostridioides difficile infection in hospitalized adults range from $ 4500 to $ 15,000. In the United States, healthcare-associated infections increase
1620-917: The absence of oxygen . When stressed, the bacteria produce spores that are able to tolerate extreme conditions that the active bacteria cannot tolerate. C. difficile may colonize the human colon without symptom; approximately 2–5% of the adult population are carriers, although it varies considerably with demographics . The risk of colonization has been linked to a history of unrelated diarrheal illnesses (e.g. laxative abuse and food poisoning due to Salmonellosis or Vibrio cholerae infection). Pathogenic C. difficile strains produce multiple toxins . The most well-characterized are enterotoxin ( Clostridium difficile toxin A ) and cytotoxin ( Clostridium difficile toxin B ), both of which may produce diarrhea and inflammation in infected people, although their relative contributions have been debated. Toxins A and B are glucosyltransferases that target and inactivate
1674-511: The bacteria (spore formation, protective effects of the pseudomembrane). The emergence of a new and highly toxic strain of C. difficile that is resistant to fluoroquinolone antibiotics such as ciprofloxacin and levofloxacin , said to be causing geographically dispersed outbreaks in North America, was reported in 2005. The U.S. Centers for Disease Control and Prevention in Atlanta warned of
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1728-630: The brand name Prevacid among others, is a medication which reduces stomach acid . It is a proton pump inhibitor (PPI), used to treat peptic ulcer disease , gastroesophageal reflux disease , and Zollinger–Ellison syndrome . Its effectiveness is similar to that of other PPIs. It is taken by mouth . Onset is over a few hours and effects last up to a couple of days. Common side effects include constipation , abdominal pain , and nausea . Serious side effects may include osteoporosis , low blood magnesium , Clostridioides difficile infection , and pneumonia . Use in pregnancy and breastfeeding
1782-399: The colon , and sepsis . Clostridioides difficile infection is spread by bacterial spores found within feces . Surfaces may become contaminated with the spores with further spread occurring via the hands of healthcare workers. Risk factors for infection include antibiotic or proton pump inhibitor use, hospitalization, hypoalbuminemia, other health problems, and older age. Diagnosis
1836-434: The colon . In adults, a clinical prediction rule found the best signs to be significant diarrhea ("new onset of more than three partially formed or watery stools per 24-hour period"), recent antibiotic exposure, abdominal pain, fever (up to 40.5 °C or 105 °F), and a distinctive foul odor to the stool resembling horse manure. In a hospital population, prior antibiotic treatment plus diarrhea or abdominal pain had
1890-434: The concentration of available dietary sugars, allowing C. difficile to proliferate and gain a foothold in the gut. Although not all colonization events lead to disease, asymptomatic carriers remain colonized for years at a time. During this time, the abundance of C. difficile varies considerably day-to-day, causing periods of increased shedding that could substantially contribute to community-acquired infection rates. As
1944-510: The cost of care by US$ 1.5 billion each year. Although C. difficile is a common healthcare-associated infection, at most 30% of infections are transmitted within hospitals. The majority of infections are acquired outside of hospitals, where medications and a recent history of diarrheal illnesses (e.g. laxative abuse or food poisoning due to Salmonellosis ) are thought to drive the risk of colonization. Signs and symptoms of CDI range from mild diarrhea to severe life-threatening inflammation of
1998-514: The emergence of an epidemic strain with increased virulence, antibiotic resistance, or both. C. difficile is transmitted from person to person by the fecal-oral route . The organism forms heat-resistant spores that are not killed by alcohol-based hand cleansers or routine surface cleaning. Thus, these spores survive in clinical environments for long periods. Because of this, the bacteria may be cultured from almost any surface. Once spores are ingested, their acid-resistance allows them to pass through
2052-747: The first-line treatment for pregnant women, especially since metronidazole may cause birth defects. Typical vancomycin 125 mg is taken four times a day by mouth for 10 days. Fidaxomicin is taken at 200 mg twice daily for 10 days. It may also be given rectally if the person develops an ileus . Fidaxomicin is tolerated as well as vancomycin, and may have a lower risk of recurrence. Fidaxomicin has been found to be as effective as vancomycin in those with mild to moderate disease, and it may be better than vancomycin in those with severe disease. Fidaxomicin may be used in those who have recurrent infections and have not responded to other antibiotics. Metronidazole (500 mg 3 times daily for 10 days ) by mouth
2106-427: The gut, but is unlikely to cause pseudomembranous colitis. The colitis associated with severe infection is part of an inflammatory reaction, with the "pseudomembrane" formed by a viscous collection of inflammatory cells, fibrin , and necrotic cells. Prior to the advent of tests to detect C. difficile toxins, the diagnosis most often was made by colonoscopy or sigmoidoscopy . The appearance of "pseudomembranes" on
2160-399: The identification of the C. difficile strain type characterized as group BI by restriction endonuclease analysis, as North American pulse-field-type NAP1 by pulsed-field gel electrophoresis and as ribotype 027; the differing terminology reflects the predominant techniques used for epidemiological typing. This strain is referred to as C. difficile BI/NAP1/027. C. difficile colitis
2214-418: The infection. Retesting after treatment, as long as the symptoms have resolved, is not recommended, as a person may often remain colonized. Recurrences have been reported in up to 25% of people. Some tentative evidence indicates fecal microbiota transplantation and probiotics may decrease the risk of recurrence. C. difficile infections occur in all areas of the world. About 453,000 cases occurred in
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2268-448: The lansoprazole molecule expired on 10 November 2009, and generic formulations became available under many brand names in many countries. Some formulations may not be available in generic form. Since 2009, lansoprazole has been available over the counter (OTC) in the U.S. as Prevacid 24HR and as Lansoprazole 24HR. In Australia, it is marketed by Pfizer as Zoton. In vitro experiments have shown that lansoprazole binds to
2322-477: The most common contributor to adverse drug events seen in U.S. hospitals in 2011. In some regions of the UK, reduced used of fluoroquinolone antibiotics seems to lead to reduced rates of CDI. Some evidence indicates probiotics may be useful to prevent infection and recurrence. Treatment with Saccharomyces boulardii in those who are not immunocompromised with C. difficile also may be useful. Initially, in 2010,
2376-475: The mucosa of the colon or rectum is highly suggestive, but not diagnostic of the condition. The pseudomembranes are composed of an exudate made of inflammatory debris, white blood cells . Although colonoscopy and sigmoidoscopy are still employed, now stool testing for the presence of C. difficile toxins is frequently the first-line diagnostic approach. Usually, only two toxins are tested for—toxin A and toxin B—but
2430-488: The normal microbiota of the bowel to be altered. In particular, when the antibiotic kills off other competing bacteria in the intestine, any bacteria remaining will have less competition for space and nutrients. The net effect is to permit more extensive growth than normal of certain bacteria. C. difficile is one such type of bacterium. In addition to proliferating in the bowel, C. difficile also produces toxins . Without either toxin A or toxin B, C. difficile may colonize
2484-400: The organism produces several others. This test is not 100% accurate, with a considerable false-negative rate even with repeat testing. CDI may be classified in non-severe CDI, severe CDI and fulminant CDI depending on creatinine and white blood count parameters. C. difficile toxins have a cytopathic effect in cell culture, and neutralization of any effect observed with specific antisera
2538-425: The pathogenic form of tau protein . As of 2015 laboratory studies were underway on analogs of lansoprazole to explore their use as potential PET imaging agents for diagnosing tauopathies including Alzheimer's disease . Clostridioides difficile infection Clostridioides difficile infection ( CDI or C-diff ), also known as Clostridium difficile infection , is a symptomatic infection due to
2592-445: The risk of antibiotic-associated diarrhea (AAD) by 51% in 3,631 outpatients, but it is important to note that the types of infections in the subjects were not specified. Yogurt, tablets, dietary supplements are just a few examples of probiotics available for people. Rigorous infection protocols are required to minimize this risk of transmission. Infection control measures, such as wearing gloves and noncritical medical devices used for
2646-509: The spores and prevent transmission. Installing lidded toilets and closing the lid prior to flushing also reduces the risk of contamination. Those who have CDIs should be in rooms with other people with CDIs or by themselves when in hospital. Common hospital disinfectants are ineffective against C. difficile spores, and may promote spore formation, but various oxidants (e.g 1% sodium hypochlorite solution) rapidly destroy spores. Hydrogen peroxide vapor (HPV) systems used to sterilize
2700-452: The stomach unscathed. Upon exposure to bile acids , they germinate and multiply into vegetative cells in the colon. The presence of the bile acid deoxycholic acid in the intestinal environment can promote induction of C. difficle biofilm formation. People without a history of gastrointestinal disturbances due to antibiotic use or diarrheal illness are less likely to become colonized by C. difficile . In 2005, molecular analysis led to
2754-411: The test is used without confirmation, overdiagnosis may occur. Repeat testing may be misleading, and testing specimens more than once every seven days in people without new symptoms is highly unlikely to yield useful information. The screening specificity is relatively low because of the high number of false positive cases from asymptomatic infection. Self containment by housing people in private rooms
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#17328723710682808-507: The title Lanzo . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=Lanzo&oldid=1166105730 " Categories : Disambiguation pages Place name disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Lansoprazole Lansoprazole , sold under
2862-497: The treatment. Cholestyramine , an ion-exchange resin , is effective in binding both toxin A and B, slowing bowel motility, and helping prevent dehydration. Cholestyramine is recommended with vancomycin. A last-resort treatment in those who are immunosuppressed is intravenous immunoglobulin . Monoclonal antibodies against C. difficile toxin A and C. difficile toxin B are approved to prevent recurrence of C. difficile infection including bezlotoxumab . Evidence to support
2916-506: The use of probiotics in the treatment of active disease is insufficient. Researchers have recently begun taking a mechanical approach to fecal-derived products. It is known that certain microbes with 7α-dehydroxylase activity can metabolize primary to secondary bile acids, which inhibit C. difficile. Thus, incorporating such microbes into therapeutic products such as probiotics may be protective, although more pre-clinical investigations are needed. Fecal microbiota transplant , also known as
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