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https://www.readbyqxmd.com/read/28190552/use-of-balloon-dilatation-for-management-of-postoperative-intestinal-strictures-in-children-with-short-bowel-syndrome
#1
Christina Belza, Kevin Fitzgerald, Joao Amaral, Karen Steinberg, Yaron Avitzur, Paul W Wales
PURPOSE: Children with short bowel syndrome (SBS) often require numerous operations to optimize intestinal function. Postoperative intestinal strictures are a complication that inhibits enteral feeding advancement and prolongs parenteral nutrition dependency, often requiring reoperation. Our objective was to review our experience with fluoroscopic balloon dilatation to treat intestinal strictures. METHODS: A retrospective cohort study of intestinal failure patients with SBS was completed...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28176790/architectural-and-functional-alterations-of-the-small-intestinal-mucosa-in-classical-whipple-s-disease
#2
H-J Epple, J Friebel, V Moos, H Troeger, S M Krug, K Allers, K Schinnerling, A Fromm, B Siegmund, M Fromm, J D Schulzke, T Schneider
Classical Whipple's disease (CWD) affects the gastrointestinal tract and rather elicits regulatory than inflammatory immune reactions. Mechanisms of malabsorption, diarrhea, and systemic immune activation are unknown. We here analyzed mucosal architecture, barrier function, and immune activation as potential diarrheal trigger in specimens from 52 CWD patients. Our data demonstrate villus atrophy and crypt hyperplasia associated with epithelial apoptosis and reduced alkaline phosphatase expression in the duodenum of CWD patients...
February 8, 2017: Mucosal Immunology
https://www.readbyqxmd.com/read/28166091/oral-polyphosphate-suppresses-bacterial-collagenase-production-and-prevents-anastomotic-leak-due-to-serratia-marcescens-and-pseudomonas-aeruginosa
#3
Sanjiv K Hyoju, Robin E Klabbers, Melissa Aaron, Monika A Krezalek, Alexander Zaborin, Mara Wiegerinck, Neil H Hyman, Olga Zaborina, Harry Van Goor, John C Alverdy
OBJECTIVE: The objective of this study was to determine the effect of polyphosphate on intestinal bacterial collagenase production and anastomotic leak in mice undergoing colon surgery. BACKGROUND: We have previously shown that anastomotic leak can be caused by intestinal pathogens that produce collagenase. Because bacteria harbor sensory systems to detect the extracellular concentration of phosphate which controls their virulence, we tested whether local phosphate administration in the form of polyphosphate could attenuate pathogen virulence and prevent leak without affecting bacterial growth...
February 3, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28153961/novel-insight-into-the-role-of-microbiota-in-colorectal-surgery
#4
REVIEW
Radu Bachmann, Daniel Leonard, Nathalie Delzenne, Alex Kartheuser, Patrice D Cani
Recent literature undeniably supports the idea that the microbiota has a strong influence on the healing process of an intestinal anastomosis. Understanding the mechanisms by which the bacterial community of the gut influences intestinal healing could open the door for new preventive and therapeutic approaches. Among the different mechanisms, data have shown that the production of specific reactive oxygen species (ROS) and the activation of specific formyl peptide receptors (FPRs) regulate intestinal wound healing...
February 2, 2017: Gut
https://www.readbyqxmd.com/read/28151501/-angioedema-and-the-role-of-bradykinins-new-treatments-and-implications-in-patients-with-heart-failure
#5
Marta Mansi, Maddalena Alessandra Wu, Andrea Zanichelli, Marco Cicardi
The definition of angioedema is an edema of subcutaneous and submucosal tissues due to increased vascular permeability and fluid extravasation. It can affect different areas, including extremities, genitals, upper airways and intestinal mucosa. The symptoms are disabling and this condition can be fatal if it involves the larynx. We can distinguish different forms of angioedema (hereditary and acquired) with different pathogenetic mechanisms, therefore responding to different treatments. Bradykinin-mediated angioedema (such as hereditary angioedema due to C1-inhibitor deficiency) does not respond to the standard therapy used for histamine-mediated angioedema...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28147352/pathogenesis-of-intestinal-fibrosis-in-inflammatory-bowel-disease-and-perspectives-for-therapeutic-implication
#6
REVIEW
Dominik Bettenworth, Florian Rieder
BACKGROUND: Intestinal fibrosis with stricture formation is a common feature of inflammatory bowel disease (IBD) and leads to a significantly impaired quality of life in affected patients, intestinal obstruction as well as to the need for surgical intervention. This constitutes a major treatment challenge. Key Messages: Fibrosis results from the response of gut tissue to the insult inflicted by chronic inflammation. Similarly to what occurs in other organs, the underlying fibrogenic mechanisms are complex and dynamic, involving multiple cell types, interrelated cellular events, and a large number of soluble factors...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28111222/intentional-omission-of-ureteral-stents-during-robotic-assisted-intracorporeal-uretero-enteric-anastomosis-is-it-safe-and-feasible
#7
Wei Phin Tan, Patrick Whelan, Leslie Deane
OBJECTIVE: To describe the surgical technique we use to perform a stentless intracorporeal uretero-enteric anastomosis and to determine the outcomes in this initial series. METHODS: We performed a retrospective review of a prospective database of all patients undergoing robotic assisted intracorporeal urinary diversion with stentless uretero-enteric anastomosis between March 2014 and July 2016. Diversions were performed either at the time of robotic assisted laparoscopic cystectomy for bladder cancer or urinary diversion for other indications...
January 19, 2017: Urology
https://www.readbyqxmd.com/read/28089636/influence-of-perioperative-nonsteroidal-anti-inflammatory-drugs-on-complications-after-gastrointestinal-surgery-a-meta-analysis
#8
REVIEW
Fang Peng, Shijiang Liu, Youli Hu, Min Yu, Jing Chen, Cunming Liu
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are a key part of multimodal perioperative analgesia. This study aimed to evaluate the influence of perioperative NSAIDs application on complications after gastrointestinal surgery by using meta-analysis. METHODS: A systematic review of published literature was conducted by searching computerized databases including PubMed, CBM, Springer, Chinese Academic Journals, and China Info since the databases were published until June 2015...
January 12, 2017: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/28080215/laparoscopy-assisted-duhamel-z-anastomosis-for-total-colonic-aganglionosis-outcome-assessed-by-fecal-continence-evaluation
#9
Go Miyano, Hiroki Nakamura, Shogo Seo, Ryo Sueyoshi, Manabu Okawada, Takashi Doi, Hiroyuki Koga, Geoffrey J Lane, Tadaharu Okazaki, Atsuyuki Yamataka
BACKGROUND: A Z-shaped colorectal side-to-side anastomosis was introduced to improve the Duhamel procedure by eliminating the rectal blind pouch. We retrospectively reviewed all total colonic aganglionosis patients treated by laparoscopy-assisted Duhamel-Z (LapDZ) between 2009 and 2014 focusing on annual fecal continence evaluation scores (CES) as an indicator of outcome. METHODS: LapDZ was performed conventionally. Postoperatively, defecation was regulated with medications and enemas according to our standard protocol...
January 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28000657/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#10
Morten Holt Thomsen, Henrik Ovesen, Jens Ravn Eriksen
INTRODUCTION: Incomplete specimens resulting in residual mesorectum in the patient and an increased risk of local recurrence remains a problem. We have introduced transanal-total mesorectal excision (Ta-TME) in our department to potentially overcome this problem due to more direct access to the lower pelvis in patients undergoing TME for rectal cancer and this article presents our initial experience with the new procedure. MATERIALS AND METHODS: Patients with a T1-T3 mid or low rectal cancer eligible for TME or intersphincteric abdominoperineal excision were selected for a combined transanal and transabdominal laparoscopic resection...
December 21, 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27993324/nontraumatic-chylothorax-diagnostic-algorithm-and-treatment-options
#11
REVIEW
Gregory Nadolski
Nontraumatic chylothorax is a relatively rare condition in which the intestinal lymph (chyle) leaks into the pleural cavity. Nontraumatic chylothorax is more difficult to treat than the more common traumatic chylothorax because the site of chylous leak may occur in less predictable locations. In the past, patients with nontraumatic chylothoraces were offered traditional fluoroscopically guided lymphangiography and thoracic duct embolization similar to traumatic chylothorax. However, the observation that thoracic duct embolization outcomes for nontraumatic chylothorax differed based on the imaging findings during lymphangiography has led to the development of a treatment algorithm, which incorporates noninvasive diagnostic studies, such as magnetic resonance lymphangiography...
December 2016: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/27966452/toxicity-assessment-of-hydrogen-peroxide-on-toll-like-receptor-system-apoptosis-and-mitochondrial-respiration-in-piglets-and-ipec-j2-cells
#12
Jie Yin, Miaomiao Wu, Yuying Li, Wenkai Ren, Hao Xiao, Shuai Chen, Chunyong Li, Bie Tan, Hengjia Ni, Xia Xiong, Yuzhe Zhang, Xingguo Huang, Rejun Fang, Tiejun Li, Yulong Yin
In this study, expressions of toll-like receptors (TLRs) and apoptosis-related genes in piglets and mitochondrial respiration in intestinal porcine epithelial cells were investigated after hydrogen peroxide (H2O2) exposure. The in vivo results showed that H2O2 influenced intestinal expressions of TLRs and apoptosis related genes. H2O2 treatment (5% and 10%) downregulated uncoupling protein 2 (UCP2) expression in the duodenum (P < 0.05), while low dosage of H2O2 significantly increased UCP2 expression in the jejunum (P < 0...
January 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/27931200/amoebic-liver-abscess-an-unusual-cause-for-a-right-iliac-fossa-mass-a-case-report
#13
Vithiya Ratnasamy, Kumanan Thirunavukarasu, Kannathasan Selvam, Murugananthan Arumugam
BACKGROUND: Amoebic liver abscess is the most common extra intestinal manifestation of amoebiasis in tropical countries. It usually presents with right hypochondrial pain, fever and anorexia. Amoebic liver abscess has gained clinical significance due to the wide variety of clinical presentations which can cause diagnostic dilemmas and high mortality in untreated cases. CASE PRESENTATION: We report a case of a 63-year-old male with a history of anorexia for 3 weeks, fever for 4 days and examination findings of tender hepatomegaly with a liver span of 15 cm in the mid clavicular line and a firm irregular mass in the right iliac fossa...
December 8, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27921277/surgery-for-acute-exacerbation-of-chronic-mesenteric-ischemia-a-case-report
#14
Shinji Abe, Tomoji Yamakawa, Hideaki Kawashima, Makoto Yoshida, Setsuji Takanashi, Motoya Kashiyama, Masahiro Ishigooka, Yasushige Shingu, Yoshiro Matsui
BACKGROUND: Chronic mesenteric ischemia (CMI) is a rare disease; however, symptomatic CMI has a risk of acute exacerbation without timely revascularization. CASE PRESENTATION: A 54-year-old man who had had postprandial pain for 6 months was admitted to our hospital because of vomiting and diarrhea. Although the celiac and superior mesenteric arteries were occluded at the proximal portion, contrast enhancement of the bowel wall was good in contrast-enhanced computed tomography (CECT)...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27904960/active-and-passive-involvement-of-claudins-in-the-pathophysiology-of-intestinal-inflammatory-diseases
#15
REVIEW
Christian Barmeyer, Michael Fromm, Jörg-Dieter Schulzke
Intestinal inflammatory diseases, four of which are discussed here, are associated with alterations of claudins. In ulcerative colitis, diarrhea and antigen entry into the mucosa occurs. Claudin-2 is upregulated but data on other claudins are still limited or vary (e.g., claudin-1 and -4). Apart from that, tight junction changes contribute to diarrhea via a leak flux mechanism, while protection against antigen entry disappears behind epithelial gross lesions (erosions) and apoptotic foci. Crohn's disease is additionally characterized by a claudin-5 and claudin-8 reduction which plays an active role in antigen uptake already before gross lesions appear...
January 2017: Pflügers Archiv: European Journal of Physiology
https://www.readbyqxmd.com/read/27899040/clinical-role-of-fluorescence-imaging-in-colorectal-surgery-a-review
#16
Ido Mizrahi, Steven D Wexner
Anastomotic leak (AL) after colorectal surgery is a devastating complication; decreased blood perfusion is an important risk factor. Surgeons rely on subjective measures to assess bowel perfusion. Fluorescence imaging (FI) with indocyanine green (ICG) provides a real-time objective assessment of intestinal perfusion. Areas covered: A PubMed search using the terms 'fluorescence imaging', 'indocyanine green', 'colon and rectal surgery' was undertaken. Sixteen articles between 2010 to present were identified. Main outcomes were leak rate reduction, change in surgical plan, and technical feasibility...
January 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27896159/intestinal-atresia-experience-at-a-busy-center-of-north-west-india
#17
Shilpi Gupta, Rahul Gupta, Soumyodhriti Ghosh, Arun Kumar Gupta, Arvind Shukla, Vinita Chaturvedi, Praveen Mathur
Objective: To evaluate the presentation, management, complications and outcome of intestinal atresia (IA) managed at our center over a period of 1 year. Materials and methods: Records of patients of IA admitted in our center from January 2015 to December 2015 were retrospectively analyzed. Demographic data, antenatal history, presenting complaints, location (duodenal, jejunoileal, colonic) of atresia, surgery performed and peri-operative complications were noted. Results: Total 78 cases of IA were included in the analyses...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27896157/congenital-neonatal-intestinal-obstruction-retrospective-analysis-at-tertiary-care-hospital
#18
Vijay Singh, Manish Pathak
BACKGROUND: The purpose of this study is to analyze the etiology, clinical presentation and outcome of neonatal intestinal obstruction at our institute. MATERIALS AND METHODS: The medical record of all the patients, presented with intestinal obstruction in neonatal period during 2014 and 2015 was reviewed retrospectively for etiology, clinical features, investigations, management, and outcome. RESULTS: Out of total 53 cases of neonatal intestinal obstruction, 27 were of intestinal atresia (9 cases (17%) were of duodenal atresia, 7 (13%) were of jejunal atresia and 8 (13%) were ileal atresias and 3 cases were found with colonic atresia); 7 were malrotation, 17 were Hirschsprung's disease (HD)...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27895400/esophagogastric-anastomosis-in-rats-improved-healing-by-bpc-157-and-l-arginine-aggravated-by-l-name
#19
Zeljko Djakovic, Ivka Djakovic, Vedran Cesarec, Goran Madzarac, Tomislav Becejac, Goran Zukanovic, Domagoj Drmic, Lovorka Batelja, Anita Zenko Sever, Danijela Kolenc, Alen Pajtak, Nikica Knez, Mladen Japjec, Kresimir Luetic, Dinko Stancic-Rokotov, Sven Seiwerth, Predrag Sikiric
AIM: To cure typically life-threatening esophagogastric anastomosis in rats, lacking anastomosis healing and sphincter function rescue, in particular. METHODS: Because we assume esophagogastric fistulas represent a particular NO-system disability, we attempt to identify the benefits of anti-ulcer stable gastric pentadecapeptide BPC 157, which was in trials for ulcerative colitis and currently for multiple sclerosis, in rats with esophagocutaneous fistulas. Previously, BPC 157 therapies have promoted the healing of intestinal anastomosis and fistulas, and esophagitis and gastric lesions, along with rescued sphincter function...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27858187/duodeno-duodenostomy-or-duodeno-jejunostomy-for-duodenal-atresia-is-one-repair-better-than-the-other
#20
Augusto Zani, Jung-Pin Benjamin Yeh, Sebastian K King, Priscilla P L Chiu, Paul W Wales
PURPOSE: The surgical management of neonates with duodenal atresia (DA) involves re-establishment of intestinal continuity, either by duodeno-duodenostomy (DD) or by duodeno-jejunostomy (DJ). Although the majority of pediatric surgeons perform DD repair preferentially, we aimed to analyze the outcome of DA neonates treated with either surgical technique. METHODS: Following ethical approval (REB:1000047737), we retrospectively reviewed the charts of all patients who underwent DA repair between 2004 and 2014...
February 2017: Pediatric Surgery International
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