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https://www.readbyqxmd.com/read/28350645/the-use-of-bowel-protocols-in-critically-ill-adult-patients-a-systematic-review-and-meta-analysis
#1
Simon J W Oczkowski, Erick H Duan, Amy Groen, Dawn Warren, Deborah J Cook
OBJECTIVE: Constipation is common among critically ill patients and has been associated with adverse patient outcomes. Many ICUs have developed bowel protocols to treat constipation; however, their effect on clinical outcomes remains uncertain. We conducted a systematic review to determine the impact of bowel protocols in critically ill adults. DATA SOURCES: We searched MEDLINE, Embase, CINAHL, CENTRAL, ISRCTN, ClinicalTrials.gov, and conference abstracts until January 2016...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28346037/prognostic-significance-of-granulomas-in-children-with-crohn-s-disease
#2
Benjamin Rothschild, Firas Rinawi, Yonatan Herman, Osnat Nir, Raanan Shamir, Amit Assa
OBJECTIVES: Granulomas have long been considered the histological hallmark of Crohn's disease (CD). Currently, there is considerable dispute with regards to their prognostic implications. We aimed to determine the effect of granulomas on phenotypic features and disease's long-term outcomes in a large cohort of pediatric CD patients. MATERIALS AND METHODS: Medical records of pediatric CD patients diagnosed at the Schneider Children's Medical Center were reviewed retrospectively...
March 27, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28346031/chromogranin-a-cell-density-in-the-large-intestine-of-asian-and-european-patients-with-irritable-bowel-syndrome
#3
Magdy El-Salhy, Tanisa Patcharatrakul, Jan Gunnar Hatlebakk, Trygve Hausken, Odd Helge Gilja, Sutep Gonlachanvit
OBJECTIVE: Patients with irritable bowel syndrome (IBS) in Asia show distinctive differences from those in the western world. The gastrointestinal endocrine cells appear to play an important role in the pathophysiology of IBS. The present study aimed at studying the density of chromogranin A (CgA) cells in the large intestine of Thai and Norwegian IBS patients. METHODS: Thirty Thai IBS patients and 20 control subjects, and 47 Norwegian IBS patients and 20 control subjects were included...
March 27, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28344572/gut-colonization-by-methanogenic-archaea-is-associated-with-organic-dairy-consumption-in-children
#4
Jeroen A A van de Pol, Niels van Best, Catherine A Mbakwa, Carel Thijs, Paul H Savelkoul, Ilja C W Arts, Mathias W Hornef, Monique Mommers, John Penders
The gut microbiota represents a complex and diverse ecosystem with a profound impact on human health, promoting immune maturation, and host metabolism as well as colonization resistance. Important members that have often been disregarded are the methanogenic archaea. Methanogenic archaea reduce hydrogen levels via the production of methane, thereby stimulating food fermentation by saccharolytic bacteria. On the other hand, colonization by archaea has been suggested to promote a number of gastrointestinal and metabolic diseases such as colorectal cancer, inflammatory bowel disease, and obesity...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28342683/white-grape-juice-elicits-a-lower-breath-hydrogen-response-compared-with-apple-juice-in-healthy-human-subjects-a-randomized-controlled-trial
#5
Jennifer Erickson, Qi Wang, Joanne Slavin
BACKGROUND: Diets low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPS) are used to manage symptoms in individuals with irritable bowel syndrome. Although effective at reducing symptoms, the diet can be complex and restrictive. In addition, there are still large gaps in the literature and many foods with unclear effects in the gastrointestinal (GI) tract, like fruit juice. Although many fruits are allowable on a low-FODMAP diet, consumption of all fruit juice is generally cautioned due to the large fructose load contained in juice, regardless of the glucose concentration...
March 22, 2017: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/28340389/minilaparotomy-without-general-anesthesia-for-the-treatment-of-sigmoid-volvulus-in-high-risk-patients-a-case-series-of-4-patients
#6
Ernesto L Enrique, Kareem A Hamdy
BACKGROUND: Sigmoid volvulus (SV) is a common cause of large bowel obstruction worldwide. Presenting symptoms can be nonspecific and varied amongst the elderly population, making medical and surgical management challenging. This population is at markedly increase risk of complications and mortality with surgery under general anesthesia. In this case series, we describe 4 cases of sigmoid volvulus in octogenarians. GOALS: To demonstrate that sigmoid colectomy under local anesthesia, with or without intravenous conscious sedation, is feasible and can be done safely and with a low rate of converting to a general anesthetic...
March 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28335003/identification-of-genetic-variants-affecting-vitamin-d-receptor-binding-and-associations-with-autoimmune-disease
#7
Giuseppe Gallone, Wilfried Haerty, Giulio Disanto, Sreeram V Ramagopalan, Chris P Ponting, Antonio J Berlanga-Taylor
Large numbers of statistically significant associations between sentinel SNPs and case-control status have been replicated by genome-wide association studies. Nevertheless, few underlying molecular mechanisms of complex disease are currently known. We investigated whether variation in binding of a transcription factor, the vitamin D receptor (VDR) whose activating ligand vitamin D has been proposed as a modifiable factor in multiple disorders, could explain any of these associations. VDR modifies gene expression by binding DNA as a heterodimer with the Retinoid X receptor (RXR)...
March 9, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28334433/dietary-interventions-for-recurrent-abdominal-pain-in-childhood
#8
REVIEW
Tamsin V Newlove-Delgado, Alice E Martin, Rebecca A Abbott, Alison Bethel, Joanna Thompson-Coon, Rebecca Whear, Stuart Logan
BACKGROUND: This is an update of the original Cochrane review, last published in 2009 (Huertas-Ceballos 2009). Recurrent abdominal pain (RAP), including children with irritable bowel syndrome, is a common problem affecting between 4% and 25% of school-aged children. For the majority of such children, no organic cause for their pain can be found on physical examination or investigation. Many dietary inventions have been suggested to improve the symptoms of RAP. These may involve either excluding ingredients from the diet or adding supplements such as fibre or probiotics...
March 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28331902/cold-snare-polypectomy-for-non-pedunculated-colon-polyps-greater-than-1%C3%A2-cm
#9
Cyrus Piraka, Ahmed Saeed, Akbar K Waljee, Ajish Pillai, Ryan Stidham, B Joseph Elmunzer
Background and study aims Colonic polyps > 1 cm in size are commonly managed using hot polypectomy techniques. The most frequent adverse events (delayed bleeding, post-polypectomy syndrome, and perforation) are related to electrocautery-induced injury. We hypothesized that cold resection of large polyps may have similar efficacy and improved safety compared to hot polypectomy. Our aims were to evaluate efficacy and safety of piecemeal cold snare resection of colonic polyps > 1 cm. Patients and methods Patients undergoing lift and piecemeal cold snare polypectomy of non-pedunculated colon polyps > 1 cm from October 2013 to September 2015 were identified retrospectively...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28331018/strongyloides-hyperinfection-syndrome-in-an-immunocompetent-host-resulting-in-bandemia-and-death
#10
Aung Myint, Courtney Chapman, Isabel Almira-Suarez, Nupur Mehta
Strongyloides stercoralis infection is usually asymptomatic but can result in a hyperinfection syndrome, most commonly triggered by acquired or iatrogenic immunosuppression. Here, we present a case of a man aged 60 years originally from a strongyloides endemic area with a medical history of alcohol abuse who presents with strongyloides hyperinfection syndrome (SHS) complicated by partial small bowel obstruction, pulmonary haemorrhage, large bandemia without eosinophilia and cardiac arrest resulting in death...
March 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28330889/robust-microbiota-based-diagnostics-for-inflammatory-bowel-disease
#11
A Eck, E F J de Groot, T G J de Meij, M Welling, P H M Savelkoul, A E Budding
Strong evidence suggests that gut microbiota is altered in inflammatory bowel disease (IBD), indicating its potential role in non-invasive diagnostics. However, no clinical applications are currently used for routine patient care. The main obstacle to implementing a gut microbiota test for IBD is the lack of standardization, which leads to high inter-laboratory variations. We studied the between-hospital and between-platform batch effects and their effect on predictive accuracy for IBD.Fecal samples from 91 pediatric IBD patients and 58 healthy children were collected...
March 22, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28329069/giardiasis-and-subsequent-irritable-bowel-syndrome-a-longitudinal-cohort-study-using-health-insurance-data
#12
Jolene H Nakao, Sarah A Collier, Julia W Gargano
Background.: Giardia intestinalis is the most commonly reported human intestinal parasite in the United States. Increased incidence of chronic gastrointestinal complaints has been reported after some giardiasis outbreaks. We examined the relationship between giardiasis diagnosis and irritable bowel syndrome (IBS) diagnosis. Methods.: We used the 2006-2010 MarketScan commercial insurance database. Persons with at least 1 giardiasis diagnosis were individually matched on age group, sex, and enrollment length in months to 5 persons without a giardiasis diagnosis...
February 23, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28328258/value-of-mdct-and-clinical-and-laboratory-data-for-predicting-the-need-for-surgical-intervention-in-suspected-small-bowel-obstruction
#13
Andrew Scrima, Meghan G Lubner, Scott King, Joshua Pankratz, Gregory Kennedy, Perry J Pickhardt
OBJECTIVE: The purpose of this article is to assess the value of a large panel of clinical and MDCT variables in patients with suspected small-bowel obstruction (SBO) for predicting urgent surgical intervention (< 72 hours), bowel ischemia, and bowel resection. MATERIALS AND METHODS: MDCT studies performed at admission for 179 nonconsecutive adults (mean age, 55.8 years; 86 men and 93 women) with suspected SBO were retrospectively reviewed by three board-certified radiologists...
April 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28326568/early-response-predicts-a-sustained-response-to-eluxadoline-in-patients-with-irritable-bowel-syndrome-with-diarrhoea-in-two-phase-3-studies
#14
W D Chey, L S Dove, D A Andrae, P S Covington
BACKGROUND: The mixed μ- and κ-opioid receptor agonist and δ-opioid receptor antagonist, eluxadoline, is licensed in the USA for the treatment of irritable bowel syndrome with diarrhoea (IBS-D), based on the results of two large Phase 3 clinical trials. AIM: To understand the time course of treatment benefits with eluxadoline by comparing responder rates over the first month of treatment with responder rates over longer treatment intervals. METHODS: In this post hoc analysis of two Phase 3 studies, composite and adequate relief (AR) responder rates were calculated over month 1 and patients were stratified by their responder status...
March 22, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28323223/robotic-assisted-conservative-excision-of-retrocervical-rectal-deep-infiltrating-endometriosis-a-case-series
#15
Alfredo Ercoli, Emma Bassi, Stefania Ferrari, Daniela Surico, Anna Fagotti, Francesco Fanfani, Fiorenzo De Cicco, Nicola Surico, Giovanni Scambia
Deep infiltrating endometriosis (DIE) is a complex disease that impairs the quality of life and the fertility of women. Colorectal DIE accounts for 70% to 93% of all the intestinal endometriotic sites and frequently needs a surgical approach. However, the indications for the surgical management of this condition are still controversial. From March 2010 to June 2014, we scheduled 33 consecutive patients presenting with retrocervical-rectal DIE of any diameter not involving the mucosa nor producing rectal stenosis > 50% for laparoscopic robotic assisted nerve-sparing rectal nodulectomy (LRN)...
March 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28319601/effectiveness-of-double-balloon-enteroscopy-facilitated-polypectomy-in-paediatric-patients-with-peutz-jeghers-syndrome
#16
Dalia Belsha, Arun Urs, Thomas Attard, Mike Thomson
BACKGROUND: Sizable small-bowel (SB) polyps in Peutz-Jeghers syndrome (PJS) pose a high risk for intussusception, often necessitating laparotomy and intraoperative-enteroscopy (IOE). This series examines the effectiveness of double-balloon enteroscopy (DBE) facilitated polypectomy for pediatric patients with PJS. METHODS: Prospective analysis of collected data (6 years) on all patients with PJS referred for DBE-facilitated SB polypectomy at a pediatric tertiary-referral center...
March 17, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28316066/long-term-results-and-tolerability-of-tandem-peptide-receptor-radionuclide-therapy-with-90-y-177-lu-dotatate-in-neuroendocrine-tumors-with-respect-to-the-primary-location-a-10-year-study
#17
Jolanta Kunikowska, Dariusz Pawlak, Marianna I Bąk, Beata Kos-Kudła, Renata Mikołajczak, Leszek Królicki
INTRODUCTION: The peptide receptor radionuclide therapy (PRRT) with (90)Y and (177)Lu is a form of molecular targeted therapy for inoperable or disseminated neuroendocrine tumors (NET). AIM: The aim of the study was to evaluate clinical results and long-term side effects of tandem (90)Y /(177)Lu-DOTATATE therapy in patients with NET. Additionally, we evaluated clinical results with reference to the primary site. MATERIALS AND METHODS: 59 patients with disseminated NET were included in the study prospectively...
March 18, 2017: Annals of Nuclear Medicine
https://www.readbyqxmd.com/read/28315037/incidence-of-and-risk-factors-for-free-bowel-perforation-in-patients-with-crohn-s-disease
#18
Jong Wook Kim, Ho-Su Lee, Byong Duk Ye, Suk-Kyun Yang, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Kim
BACKGROUND: Incidence of and risk factors for intestinal free perforation (FP) in patients with Crohn's disease (CD) are not established. AIM: To establish rate of and risk factors for FP in a large cohort of CD patients. METHODS: Medical records of CD patients who visited Asan Medical Center from June 1989 to December 2012 were reviewed. After matching the FP patients to controls (1:4) by gender, year, and age at CD diagnosis, and disease location, their clinical characteristics were compared using conditional logistic regression analysis...
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28315032/novel-indications-for-fecal-microbial-transplantation-update-and-review-of-the-literature
#19
REVIEW
Nathaniel Aviv Cohen, Nitsan Maharshak
BACKGROUND AND AIMS: Fecal microbial transplantation (FMT) is an established successful treatment modality for recurrent Clostridium difficile infection (CDI). The safety profile and potential therapeutic advantages of FMT for diseases associated with dysbiosis and immune dysfunction have led to many publications, mainly case series, and while many studies and reviews have been published on the use of FMT for inflammatory bowel disease (IBD), its potential use for other disease conditions has not been thoroughly reviewed...
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28314199/unusual-ultrasound-appearance-of-small-bowel-intussusception-and-secondary-bowel-obstruction-in-a-child-with-peutz-jeghers-syndrome
#20
Lei Wu, Ramesh S Iyer, George T Drugas, A Luana Stanescu
Small bowel intussusception (SBI) in pediatric patients resolves spontaneously in the majority of cases. Pathologic small bowel intussusception with a lead point is rare in children. Ultrasound (US) is the preferred initial imaging study for the diagnosis of intussusception. We report a case of long-segment SBI and secondary bowel obstruction caused by a large hamartomatous polyp. This case emphasizes unique, atypical ultrasound findings that may be encountered in small bowel intussusception, with correlative radiographic, CT (computed tomography) and intra-operative findings...
March 9, 2017: Clinical Imaging
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