Loperamide have negative effects from rebound constipation. If a suspicion exists of diarrhea associated with organisms that can penetrate the intestinal walls, such as or "Salmonella", loperamide is contraindicated as a primary treatment. Loperamide treatment is not used in symptomatic "C. difficile" infections, as it increases the risk of toxin retention and precipitation of toxic megacolon. Loperamide should be administered with caution to people with liver failure due to reduced first-pass metabolism. Additionally, caution should be used when treating people with advanced HIV, as cases of both viral and bacterial toxic megacolon have been reported. If abdominal distension is noted, therapy
What Is to Be Done? belonged to this bourgeois intelligentsia. Lars T. Lih, a McGill University course lecturer, has suggested that Lenin's pamphlet has been widely misinterpreted partly by mistranslations of key terms used by Lenin. Lih says that those historians and textbooks that misinterpret the pamphlet follow "three mutually reinforcing strands": Lih argues that "even if we examine the controversial passages in "What is to be Done?" we misunderstand them if we are not alive to the meanings of the words used. Some of these have been translated in such a way as to confuse or even to draw readers to the opposite of