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Complications of parenteral nutrition

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https://www.readbyqxmd.com/read/28646333/feeding-jejunostomy-associated-small-bowel-necrosis-after-elective-esophago-gastric-resection
#1
Omer S Al-Taan, Robert N Williams, James A Stephenson, Melanie Baker, S Murthy Nyasavajjala, David J Bowrey
BACKGROUND: Feeding jejunostomy has increasingly become a standard adjunctive procedure during major esophago-gastric resections. They provide nutritional support during the post-operative period as required. However, significant early complications have been reported, most notably small bowel necrosis. Literature reports have been restricted to case reports or series. This study aims to determine the frequency of this complication in a cohort of patients undergoing esophago-gastric resection, and identify any difference in the risk of this complication between patients undergoing esophagectomy and gastrectomy...
June 23, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28644219/an-uncommon-complication-of-laparoscopic-live-donor-nephrectomy
#2
Karen A Beer
Chylous ascites is an uncommon complication of laparoscopic live donor nephrectomy, occurring when milky chyle from the lymphatic system leaks into the peritoneal cavity. This can occur after trauma or be caused by obstruction of the lymphatic system. Treatment may include a fat-free diet, total parenteral nutrition, subcutaneous somatostatin, lymphangiography, and/or surgical closure of the leaking lymph vessel.
July 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28641304/hyperemesis-gravidarum-a-review-of-recent-literature
#3
Viktoriya London, Stephanie Grube, David M Sherer, Ovadia Abulafia
BACKGROUND: In the United States, hyperemesis gravidarum is the most common cause of hospitalization during the first half of pregnancy and is second only to preterm labor for hospitalizations in pregnancy overall. In approximately 0.3-3% of pregnancies, hyperemesis gravidarum is prevalent and this percentage varies on account of different diagnostic criteria and ethnic variation in study populations. Despite extensive research in this field, the mechanism of the disease is largely unknown...
June 23, 2017: Pharmacology
https://www.readbyqxmd.com/read/28629281/noninvasive-quantitative-assessment-of-hepatic-steatosis-by-proton-magnetic-resonance-spectroscopy-among-adult-patients-receiving-home-parenteral-nutrition
#4
Angelique Huijbers, Geert Wanten, Helena Maria Dekker, Marinette van der Graaf
BACKGROUND: Intestinal failure-associated liver disease is a frequent complication in patients with chronic intestinal failure (CIF), with steatosis as a dominant feature in adults. Proton magnetic resonance spectroscopy (1H-MRS) is a noninvasive method to quantify liver fat content (LFC). In this study, LFC was assessed with 1H-MRS, taking into account the possible accumulation of paramagnetic components of home parenteral nutrition (HPN) that may disturb these measurements. METHODS: LFC was measured in 15 adult CIF patients who had been receiving HPN for >6 months...
June 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28603716/optimizing-nutrition-in-preterm-low-birth-weight-infants-consensus-summary
#5
REVIEW
R Kishore Kumar, Atul Singhal, Umesh Vaidya, Saswata Banerjee, Fahmina Anwar, Shashidhar Rao
Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Appropriate nutrition is essential for the growth and development of preterm infants. Early administration of optimal nutrition to preterm birth survivors lowers the risk of adverse health outcomes and improves cognition in adulthood. A group of neonatologists, pediatricians, and nutrition experts convened to discuss and frame evidence-based recommendations for optimizing nutrition in preterm low birth weight (LBW) infants...
2017: Frontiers in Nutrition
https://www.readbyqxmd.com/read/28600659/a-meta-analysis-of-clinical-outcome-of-intestinal-transplantation-in-patients-with-total-intestinal-aganglionosis
#6
Hiroki Nakamura, Davina Henderson, Prem Puri
AIM OF THE STUDY: Total intestinal aganglionosis (TIA) occurs in less than 1% of patients with Hirschsprung disease (HD), and TIA is the most severe form of HD. Survival has improved with the advent of parenteral nutrition and intestinal transplantation (ITx). The field of ITx has rapidly progressed in the last two decades and has now become an established treatment for patients with intestinal failure. The purpose of this meta-analysis was to determine the clinical outcome of ITx in patients with TIA...
June 9, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28595432/challenges-and-successes-in-non-operative-management-of-high-grade-malignant-bowel-obstruction
#7
Sandhya K Mudumbi, Erica V Leonard, Keith M Swetz
Malignant bowel obstruction (MBO) occurs in between 3% and 15% of patients with cancer, and portends a poor mean survival of four weeks for patients who are not able to undergo operative intervention. Surgical interventions may be fraught with complications since these patients typically have compromised nutritional status and progressive metastatic disease burden, with tumor type and degree of aggressiveness affecting outcomes. MBO is a dynamic and difficult process to treat, with adequate pain control being limited by unpredictable enteral absorption and need for prolonged parenteral analgesia (given limited enteral access) with its inherent risks...
March 14, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28587182/preoperative-nutritional-conditioning-of-crohn-s-patients-systematic-review-of-current-evidence-and-practice
#8
Fabian Grass, Basile Pache, David Martin, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
Crohn's disease is an incurable and frequently progressive entity with major impact on affected patients. Up to half of patients require surgery in the first 10 years after diagnosis and over 75% of operated patients require at least one further surgery within lifetime. In order to minimize surgical risk, modifiable risk factors such as nutritional status need to be optimized. This systematic review on preoperative nutritional support in adult Crohn's patients between 1997 and 2017 aimed to provide an overview on target populations, screening modalities, routes of administration, and expected benefits...
June 1, 2017: Nutrients
https://www.readbyqxmd.com/read/28586591/celiac-crisis-a-rare-or-rarely-recognized-disease
#9
Nadia Waheed, Huma Arshad Cheema, Hassan Suleman, Zafar Fayyaz, Iqra Mushtaq, Muhammad, Almas Hashmi
OBJECTIVE: Celiac crisis is a serious life threatening complication of celiac disease characterized by profuse diarrhoea, severe dehydration and metabolic disturbances leading to neuromuscular weakness, cardiac arrhythmias and sudden death. It has been described as rare condition and not well documented in the literature. To improve awareness and facilitate diagnosis of this condition, we studied risk factors, pattern of presentation and management plans of celiac crisis. METHODS: It was a descriptive cross sectional study...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28585789/-management-protocol-in-gastroschisis
#10
V Villamil, M J Aranda García, J M Sánchez Morote, R Ruiz Pruneda, M Fernández Ibieta, A Sánchez Sánchez, I Martínez Castaño, J Rojas-Ticona, M C Giménez Aleixandre, J I Ruiz Jiménez
AIM: There are two classical managements in gastroschisis: primary or delayed closure. From 2007 on, a multidisciplinary approach protocol based in preterm caesarean delivery at 34-35th gestational age (in order to minimize peel injury) plus primary closure is followed in our institution. Prior to this, term delivery, either by caesarean section or not, was the rule. METHODS: Retrospective study of gastroschisis's patients before (1978-2006) and after (2007-2016) protocol approval...
January 25, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28584925/peripherally-inserted-central-catheters-are-associated-with-lower-risk-of-bloodstream-infection-compared-with-central-venous-catheters-in-paediatric-intensive-care-patients-a-propensity-adjusted-analysis
#11
Ricardo Silveira Yamaguchi, Danilo Teixeira Noritomi, Natalia Viu Degaspare, Gabriela Ortega Cisternas Muñoz, Ana Paula Matos Porto, Silvia Figueiredo Costa, Otavio T Ranzani
PURPOSE: Central line-associated bloodstream infection (CLABSI) is an important cause of complications in paediatric intensive care units (PICUs). Peripherally inserted central catheters (PICCs) could be an alternative to central venous catheters (CVCs) and the effect of PICCs compared with CVCs on CLABSI prevention is unknown in PICUs. Therefore, we aimed to evaluate whether PICCs were associated with a protective effect for CLABSI when compared to CVCs in critically ill children. METHODS: We have carried out a retrospective multicentre study in four PICUs in São Paulo, Brazil...
June 5, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28583886/risk-factors-and-clinical-outcomes-for-carbapenem-resistant-gram-negative-late-onset-sepsis-in-a-neonatal-intensive-care-unit
#12
Islam Nour, Heba Elsayed Eldegla, Nehad Nasef, Basma Shouman, Hesham Abdel-Hady, Abd Elazeez Shabaan
BACKGROUND: Gram-negative (GN), carbapenem-resistant (CR), late-onset sepsis (LOS) is a serious threat in the Neonatal Intensive Care Unit (NICU). OBJECTIVE: To assess the prevalence of CR-GN-LOS in NICU patients and to identify the risk factors and outcomes associated with its acquisition. METHODS: Neonates with carbapenem-sensitive (CS)-GN-LOS were compared with those with CR-GN-LOS in a 2-year observational study. RESULTS: A total of 158 patients had GN-LOS; 100 infants had CS-GN-LOS and 58 infants had CR-GN-LOS...
June 2, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28582806/prevalence-and-risk-factors-for-complications-in-adult-patients-with-short-bowel-syndrome-receiving-long-term-home-parenteral-nutrition
#13
Guohao Wu, Yi Jiang, Xiaoping Zhu, Dayong Jin, Yusong Han, Jun Han, Zhaohan Wu, Zhaoguang Wu
BACKGROUND AND OBJECTIVES: Short bowel syndrome (SBS) is a complicated and challenging disease where home parenteral nutrition (HPN) is widely used. The complications of long-term HPN-dependent in adult patients with SBS are poorly documented. This study was mainly aimed to assess the prevalence and risk factors of HPNassociated complications in adult patients with SBS, especially the catheter-related sepsis and HPN-associated liver/biliary disorders. METHODS AND STUDY DESIGN: 47 non-malignant adult patients with SBS who received HPN for more than 2 years in our clinical nutrition center were included...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28577653/nutritional-status-and-hyperglycemia-in-the-peritransplant-period-a-review-of-associations-with-parenteral-nutrition-and-clinical-outcomes
#14
Marina Verdi Schumacher, Gustavo Adolpho Moreira Faulhaber
Hematopoietic stem cell transplantation is an established treatment option for various hematological diseases. This therapy involves complex procedures and is associated with several systemic complications. Due to the toxic effects of the conditioning regimen used in allogeneic transplantations, patients frequently suffer from severe gastrointestinal complications and are unable to feed themselves properly. This complex clinical scenario often requires specialized nutritional support, and despite the increasing number of studies available, many questions remain regarding the best way to feed these patients...
April 2017: Revista Brasileira de Hematologia e Hemoterapia
https://www.readbyqxmd.com/read/28576435/-encapsulating-peritoneal-sclerosis
#15
Jean-Philippe Ryckelynck, Clémence Béchade, Nicolas Bouvier, Maxence Ficheux, Bruno Hurault de Ligny, Thierry Lobbedez
Encapsulating peritoneal sclerosis is a rare but devastating complication of long-term peritoneal dialysis with a high mortality rate. The incidence is between 0.5 and 2.5%, decreasing with time. PSE is defined as a clinical syndrome with signs of gastrointestinal obstruction, inflammation parameters, radiological and macroscopic changes. The duration of treatment and the cessation of peritoneal dialysis are the main risks. About 75% occured in patients on hemodialysis or after kidney transplantation. Morphological alterations are disappearance of mesothelial layer, submesothelial fibrosis, interstitial sclerosis and vasculopathy...
May 30, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28572561/follicular-b-cell-lymphoma-with-accompanying-ischemic-gastritis-completely-resolved-by-rituximab
#16
Anam Tariq, Neal Mehta, Kathryn Peroutka
BACKGROUND Follicular B cell lymphomas account for a significant portion of all newly diagnosed non-Hodgkin's lymphomas. While involvement can be varied, the most common extranodal presentation is within the gastrointestinal tract beyond the stomach. In addition, the stomach has a diffuse multivessel vascular supply, which decreases the likelihood of developing ischemic gastritis. CASE REPORT An 89-year-old woman with history of diabetes, deep venous thromboembolism, and hypertension was referred due to a newly diagnosed retroperitoneal mass...
June 2, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28553630/choice-of-allograft-in-patients-requiring-intestinal-transplantation-a-critical-review
#17
REVIEW
Genevieve Huard, Thomas Schiano, Jang Moon, Kishore Iyer
Intestinal transplantation (ITx) is indicated in patients with irreversible intestinal failure (IF) and life-threatening complications related to total parenteral nutrition (TPN). ITx can be classified into three main types. Isolated intestinal transplantation (IITx), that is, transplantation of the jejunoileum, is indicated in patients with preserved liver function. Combined liver-intestine transplantation (L-ITx), that is, transplantation of the liver and the jejunoileum, is indicated in patients with liver failure related to TPN...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28550876/neonatal-and-pediatric-esophageal-perforation
#18
Rebecca M Rentea, Shawn D St Peter
Esophageal perforation (EP) is a rare complication that is often iatrogenic in origin. In contrast with adult patients in whom surgical closure of the defect is preferred, nonoperative treatment has become a common therapeutic approach for EP in neonates and children. Principles of management pediatric EP includes rapid diagnosis, appropriate hemodynamic monitoring and support, antibiotic therapy, total parenteral nutrition, control of extraluminal contamination, and restoration of luminal integrity either through time or operative approaches...
April 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28549896/concordance-among-methods-of-nutritional-assessment-in-patients-included-on-the-waiting-list-for-liver-transplantation
#19
María Teresa García-Rodríguez, Beatriz López-Calviño, María Del Carmen Piñón-Villar, Alejandra Otero-Ferreiro, Francisco Suárez-López, Manuel Gómez-Gutiérrez, Sonia Pértega-Díaz, María Teresa Seoane-Pillado, Salvador Pita-Fernández
BACKGROUND: The aim of the present study was to determine the extent of malnutrition in patients waiting for a liver transplant. The agreement among the methods of nutritional assessment and their diagnostic validity were evaluated. METHODS: Patients on the waiting list for liver transplantation (n = 110) were studied. The variables were: body mass index, analytical parameters, liver disease etiology, and complications. Liver dysfunction was evaluated using the Child-Pugh Scale...
May 23, 2017: Journal of Epidemiology
https://www.readbyqxmd.com/read/28547740/biliary-duodenal-anastomosis-using-magnetic-compression-following-massive-resection-of-small-intestine-due-to-strangulated-ileus-after-living-donor-liver-transplantation-a-case-report
#20
Ryusuke Saito, Hiroyuki Tahara, Seiichi Shimizu, Masahiro Ohira, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Hideki Ohdan
BACKGROUND: Despite the improvements of surgical techniques and postoperative management of patients with liver transplantation, biliary complications are one of the most common and important adverse events. We present a first case of choledochoduodenostomy using magnetic compression following a massive resection of the small intestine due to strangulated ileus after living donor liver transplantation. CASE PRESENTATION: The 54-year-old female patient had end-stage liver disease, secondary to liver cirrhosis, due to primary sclerosing cholangitis with ulcerative colitis...
December 2017: Surgical Case Reports
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