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Nutritional intravenous therapy

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https://www.readbyqxmd.com/read/27922234/long-term-azithromycin-therapy-in-patients-with-cystic-fibrosis
#1
Nagehan Emiralioğlu, Zeynelabidin Öztürk, Ebru Yalçın, Deniz Doğru, Uğur Özçelik, Nural Kiper
Inflammation is a central contributor to the pathogenesis of cystic fibrosis (CF) pulmonary disease; so limiting the excessive production of inflammatory mediators represents a major therapeutic strategy for slowing the decline in lung function and improving survival. The macrolide antibiotic azithromycin (AZM) has anti-inflammatory properties and immunomodulatory effects that may be beneficial in CF. The aim of this study was to document the long term use of AZM effect on pulmonary function, nutritional status and number of pulmonary exacerbations in patients with CF...
2016: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27911464/two-successful-insertions-of-peripherally-inserted-central-catheter-in-a-super-elderly-patient-with-bilateral-pacemaker-placement
#2
Wenyan Sun, Yufen Ma, Bing Liu, Ruibing Ge, Kai Wang, Qi Song
Peripherally inserted central catheters (PICCs) have been placed through the peripheral veins, and the best location for the tip of the PICCs is the lower third of the superior vena cava (SVC) and cavo-atrial junction. PICCs are commonly used in intravenous administration, parenteral nutrition therapy, chemotherapy, as well as in critical care units. The success rates in venipuncture are enhanced when ultrasonographic guides are used by the bedside PICC teams. There have been few reports of PICCs placed in super elderly patients with permanent cardiac pacemakers...
December 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27900630/current-delivery-of-hyperthermic-intraperitoneal-chemotherapy-with-cytoreductive-surgery-cs-hipec-and-perioperative-practices-an-international-survey-of-high-volume-surgeons
#3
Allison H Maciver, Eisar Al-Sukhni, Jesus Esquivel, Joseph J Skitzki, John M Kane, Valerie A Francescutti
BACKGROUND: Cytoreductive surgery and heated intraperitoneal chemotherapy (CS/HIPEC) is performed for selected indications at a limited number of specialized centers worldwide. Currently there is no standardized approach to the perioperative care process. We sought to capture current practices in the perioperative management of patients who undergo CS/HIPEC at high-volume centers. METHODS: Surgeon members of the American Society of Peritoneal Surface Malignancies working at high-volume CS/HIPEC centers (>10 cases/year) were invited to complete an online survey...
November 29, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27897734/how-to-insert-a-peripheral-cannula
#4
Sally Jane Shaw
Rationale and key points This article aims to assist practitioners to undertake the safe and effective insertion of a peripheral cannula. It provides information on best practice related to peripheral cannulation with an open-ported safety cannula. The same principles for practice apply to non-ported open safety cannulae. » Peripheral cannulation enables venous access, the administration of intravenous medication, infusion therapy and total parenteral nutrition. It also enables blood samples to be obtained...
November 16, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27891260/intravenous-vitamin-c-administered-as-adjunctive-therapy-for-recurrent-acute-respiratory-distress-syndrome
#5
Amit Bharara, Catherine Grossman, Daniel Grinnan, Aamer Syed, Bernard Fisher, Christine DeWilde, Ramesh Natarajan, Alpha A Berry Fowler
This case report summarizes the first use of intravenous vitamin C employed as an adjunctive interventional agent in the therapy of recurrent acute respiratory distress syndrome (ARDS). The two episodes of ARDS occurred in a young female patient with Cronkhite-Canada syndrome, a rare, sporadically occurring, noninherited disorder that is characterized by extensive gastrointestinal polyposis and malabsorption. Prior to the episodes of sepsis, the patient was receiving nutrition via chronic hyperalimentation administered through a long-standing central venous catheter...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27828934/review-of-intravenous-lipid-emulsion-therapy
#6
Jeffery W Spray
Intravenous fat emulsion (IVFE) is an important source of calories and essential fatty acids for patients receiving parenteral nutrition (PN). Administered as an individual infusion or combined with PN, the fats provided by IVFE are vital for cellular structural function and metabolism. The affinity of some medications to lipids has led to the use of IVFE as a treatment for any lipophilic drug overdose. This article will explain the available formulations of IVFE, administration, and maintenance issues, as well as the risks and benefits for various applications...
November 2016: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/27741183/guillain-barr%C3%A3-syndrome-in-pregnancy
#7
Luis D Pacheco, Antonio F Saad, Gary D V Hankins, Giuseppe Chiosi, George Saade
Guillain-Barré syndrome has been reported in pregnancy and is a potentially lethal condition. It affects the nervous system with acute onset of symmetric ascending weakness and may result in frank respiratory failure and autonomic dysfunction. Most patients recall symptoms of a respiratory or gastrointestinal illness in the weeks preceding the onset of weakness. Recent evidence suggests a potential role of the Zika virus as a trigger for the syndrome. The diagnosis of Guillain-Barré is clinical. Supportive measures include venous thromboembolism prophylaxis, aggressive physical therapy, pressure ulcer prevention, enteral nutrition, and respiratory support...
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27727026/best-practice-for-perioperative-management-of-patients-with-cytoreductive-surgery-and-hipec
#8
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27659099/aortic-elastic-properties-in-preschool-children-born-preterm
#9
Irena Odri Komazec, Anna Posod, Martin Schwienbacher, Maria Resch, Ulrike Pupp Peglow, Stefan Kiechl, Daniela Baumgartner, Ursula Kiechl-Kohlendorfer
OBJECTIVE: Preterm birth predisposes to the development of cardiovascular diseases in adulthood. The aim of this study was to characterize elastic properties of the aorta at preschool age and test the hypothesis that prematurity is associated with decreased aortic distensibility and increased stiffness, both of which are predictors of increased cardiovascular risk. APPROACH AND RESULTS: In an observational study of 76 five- to seven-year-old children born at a gestational age <32 weeks and 79 term-born controls, elastic parameters of the ascending and descending abdominal aorta were determined noninvasively by means of M mode echocardiographic tracings and calculated using computerized wall contour analysis...
September 22, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/27646053/mutism-caused-by-severe-demyelination-in-a-patient-with-marchiafava-bignami-disease
#10
Raman Mehrzad, Michael G Ho
BACKGROUND: Marchiafava-Bignami (MB) disease is a rare disorder that causes primary degeneration of the corpus callosum. It is associated with chronic alcohol consumption caused by either a toxic or nutritional etiology. CASE REPORT: We report a case of a 54-year-old woman who presented to our emergency department with complete mutism caused by MB disease that completely resolved with intravenous thiamine and dextrose therapy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians frequently encounter patients with alcohol abuse and its complications...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27642056/espen-guidelines-on-definitions-and-terminology-of-clinical-nutrition
#11
T Cederholm, R Barazzoni, P Austin, P Ballmer, G Biolo, S C Bischoff, C Compher, I Correia, T Higashiguchi, M Holst, G L Jensen, A Malone, M Muscaritoli, I Nyulasi, M Pirlich, E Rothenberg, K Schindler, S M Schneider, M A E de van der Schueren, C Sieber, L Valentini, J C Yu, A Van Gossum, P Singer
BACKGROUND: A lack of agreement on definitions and terminology used for nutrition-related concepts and procedures limits the development of clinical nutrition practice and research. OBJECTIVE: This initiative aimed to reach a consensus for terminology for core nutritional concepts and procedures. METHODS: The European Society of Clinical Nutrition and Metabolism (ESPEN) appointed a consensus group of clinical scientists to perform a modified Delphi process that encompassed e-mail communication, face-to-face meetings, in-group ballots and an electronic ESPEN membership Delphi round...
September 14, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27637335/the-impact-of-an-omega-3-fatty-acid-rich-lipid-emulsion-on-fatty-acid-profiles-in-critically-ill-septic-patients
#12
Thomas C Hall, Dilraj K Bilku, Christopher P Neal, Jill Cooke, Helena L Fisk, Philip C Calder, Ashley R Dennison
BACKGROUND: Death from sepsis in the intensive therapy unit (ITU) is frequently preceded by the development of multiple organ failure as a result of uncontrolled inflammation. Treatment with omega-3 (n-3) fatty acids (FAs), principally eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has been demonstrated to attenuate the effects of uncontrolled inflammation and may be clinically beneficial in reducing mortality from organ dysfunction. Fish oil (FO) is a source of EPA and DHA...
September 2016: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/27580687/acute-severe-ulcerative-colitis-from-pathophysiology-to-clinical-management
#13
Pieter Hindryckx, Vipul Jairath, Geert D'Haens
Ulcerative colitis is a common chronic inflammatory disease of the colon and rectum, resulting from a dysregulated immune response towards intraluminal antigens in a genetically predisposed host. The disease has a varying extent and severity. Approximately 20% of patients with ulcerative colitis experience a severe flare during the course of their disease, requiring hospitalization. Acute severe ulcerative colitis (ASUC) is potentially a life-threatening condition that requires early recognition, hospitalization, correction of body fluids and electrolytes, and nutritional support if needed...
November 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27574883/favorable-outcomes-of-preterm-infants-with-pnald-treated-with-iv-fish-oil-based-lipid-emulsion
#14
Michael Sorrell, Alvaro Moreira, Kay Green, Rachel Jacobs, Robin Tragus, Laura Keller, Amy Quinn, Donald McCurnin, Alice Gong, Abeer El Sakka, Naveen Mittal, Cynthia Blanco
OBJECTIVES: To study the acute and long-term outcomes of preterm infants treated with an intravenous (IV) fish oil-based lipid emulsion (FishLE) for parenteral nutrition-associated liver disease (PNALD). METHODS: Preterm infants 14 days to 24 months of age with anatomic short gut or severe intestinal dysmotility, serum direct bilirubin ≥4 mg/dL, and requiring >60% calories from PN were eligible. Enrolled infants received 1 g/kg/day of FishLE until resolution of direct hyperbilirubinemia or return of enteral nutrition...
August 27, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27564079/efficiency-of-a-combination-of-pharmacological-treatment-and-nondrug-interventions-in-childhood-narcolepsy
#15
Ayşe Kacar Bayram, Hüseyin Per, Sevda Ismailoğullari, Mehmet Canpolat, Hakan Gumus, Murat Aksu
Objective Narcolepsy is a chronic sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic and/or hypnopompic hallucinations, and sleep paralysis. It is one of the most important causes of excessive daytime sleepiness in the pediatric population. The aim of this study is to present the clinical and laboratory findings, and treatment results of pediatric patients with narcolepsy. Materials and Methods We studied five unrelated consecutive children with narcolepsy, focusing on clinical and laboratory features, the therapy and outcome over the 33-month follow-up period...
December 2016: Neuropediatrics
https://www.readbyqxmd.com/read/27540247/application-of-pharmaceutical-knowledge-to-the-unconventional-use-of-a-rarely-used-anaesthetic-agent
#16
Caroline Cole
CASE SUMMARY: A 6 yr old 45 kg child with severe Cushinoid features was admitted to PICU with probable hypertensive encephalopathy. She presented with increasing headaches, vomiting and seizures becoming unresponsive with a GCS of 3. She was profoundly hypertensive and her cortisol levels were significantly elevated (>2000 nmol/L). Rapid reduction in cortisol levels was required to stabilise her condition prior to surgery. Etomidate is the only readily available intravenous preparation which reliably suppresses adrenocortical function...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27540245/opinions-of-users-of-pharmacy-service-provided-to-picu
#17
Rhian Isaac, Astrid Gerrard, Kevin Bazaz
BACKGROUND: Pressures to open pharmacy services 7 days a week, with no financial input for these extra resources, has knock on effects that may dilute accessibility to clinical pharmacists in specialist areas. AIMS: The aim of this survey was to assess opinions of the users of the current pharmacy services to PICU and the planned extended hours provision. METHOD: An e-survey was sent to PIC Consultants, Advanced Nurse Practitioners, and Senior Nursing Staff following a six month period of increased clinical pharmacists time allocation to PIC...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27539619/effect-of-pulmonary-exacerbations-treated-with-oral-antibiotics-on-clinical-outcomes-in-cystic-fibrosis
#18
Sanja Stanojevic, Alexandra McDonald, Valerie Waters, Sarah MacDonald, Eric Horton, Elizabeth Tullis, Felix Ratjen
BACKGROUND: Despite extensive knowledge regarding the effect of pulmonary exacerbations treated with intravenous antibiotics on clinical outcomes in cystic fibrosis (CF), there is little known about the role of milder pulmonary exacerbations treated with oral antibiotics (oPEx). METHODS: This was a retrospective cohort study of patients with CF followed at the Hospital for Sick Children and St. Michael's Hospital from 2009 to 2014. We evaluated the effect of oPEx on short-term clinical outcomes as the proportion of oPEx events in which 100% or 90% of baseline FEV1% predicted was recovered at the end of treatment...
August 18, 2016: Thorax
https://www.readbyqxmd.com/read/27433811/safety-and-efficacy-of-teduglutide-gattex-in-patients-with-crohn-s-disease-and-need-for-parenteral-support-due-to-short-bowel-syndrome-associated-intestinal-failure
#19
Bharati Kochar, Millie D Long, Edward Shelton, Lorraine Young, Francis A Farraye, Vijay Yajnik, Hans Herfarth
BACKGROUND: Teduglutide is a GLP-2 analogue indicated for treatment of adults with short bowel syndrome (SBS). Because of the rarity of SBS, real-world safety or efficacy data are not available in patients with Crohn's disease (CD) and SBS treated with teduglutide. AIM: To evaluate teduglutide's safety and efficacy in CD patients with SBS. METHODS: We conducted a retrospective cohort study at 3 tertiary centers in the United States between 2012 and 2014...
July 18, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27429564/one-center-s-guide-to-outpatient-management-of-pediatric-cystic-fibrosis-acute-pulmonary-exacerbation
#20
Corinne A Muirhead, Jillian N Sanford, Benjamin G McCullar, Dawn Nolt, Kelvin D MacDonald
Cystic fibrosis (CF) is a chronic disorder characterized by acute pulmonary exacerbations that comprise increased cough, chest congestion, increased mucus production, shortness of breath, weight loss, and fatigue. Typically, severe episodes are treated in the inpatient setting and include intravenous antimicrobials, airway clearance therapy, and nutritional support. Children with less-severe findings can often be managed as outpatients with oral antimicrobials and increased airway clearance therapy at home without visiting the specialty CF center to begin treatment...
2016: Clinical Medicine Insights. Pediatrics
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