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Short bowel syndrome in children

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https://www.readbyqxmd.com/read/28988213/management-of-pneumatosis-intestinalis-in-children-over-the-age-of-6-months-a-conservative-approach
#1
Leel Nellihela, Mohamed Mutalib, David Thompson, Kammermeier Jochen, Manasvi Upadhyaya
BACKGROUND: Pneumatosis intestinalis (PI) is an uncommon and poorly understood condition. Although it can be an incidental finding in asymptomatic individuals, it can also be secondary to life-threatening bowel ischaemia and sepsis. In premature infants, it is a pathognomonic sign of necrotising enterocolitis. There is no consensus regarding management and long-term outcome of children with PI. AIM: Review of our experience of PI in children beyond the early infantile period...
October 7, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28987713/radiographic-measurement-of-intestinal-length-among-children-with-short-bowel-syndrome-retrospective-determination-remains-problematic
#2
Cristine S Velazco, Brenna S Fullerton, Joseph A Brazzo, Charles R Hong, Tom Jaksic, Carol E Barnewolt
PURPOSE: Small bowel length is the most reliable predictor of enteral independence in pediatric short bowel syndrome. Retrospectively measured bowel lengths on upper GI with small bowel follow-through (UGI/SBFT) were compared to operative measurements. METHODS: A pediatric radiologist and surgical trainees blinded to operative measurements retrospectively analyzed UGI/SBFT studies using the digital radiography curved measurement tool. Children with SBS and severe intestinal failure (parenteral nutrition >90days) at a multidisciplinary intestinal failure program 2002-2015 were included...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28977131/use-of-warfarin-in-pediatrics-clinical-and-pharmacological-characteristics
#3
Bruna Bergmann Santos, Isabela Heineck, Giovanna Webster Negretto
OBJECTIVE: To describe how children respond to oral anticoagulation with warfarin, verifying the influence of age, clinical condition, route of administration of warfarin and use of total parenteral nutrition (TPN), as well as to describe risk factors for the occurrence of thrombotic events (TE) in childhood. METHODS: A retrospective descriptive study including all patients ≤18 years old for whom warfarin was prescribed in a university hospital. Patients were divided according to clinical condition, age, route of medication administration and use of TPN...
September 21, 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28953527/growth-trajectory-in-children-with-short-bowel-syndrome-during-the-first-two-years-of-life
#4
Cory M McLaughlin, Nandini Channabasappa, Jesse Pace, Hoa Nguyen, Hannah G Piper
OBJECTIVES: Infants with short bowel syndrome (SBS) require diligent nutritional support for adequate growth. Enteral independence is a primary goal, but must be balanced with ensuring sufficient nutrition. We aimed to describe growth trajectory in infants with SBS as function of nutritional intake during first two years of life. METHODS: Infants with SBS were reviewed (2008-2016). Z-scores for weight, height, and head circumference (HC), were recorded at birth, 3, 6, 12, 18, and 24 months...
September 26, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28937976/tissue-engineering-for-the-treatment-of-short-bowel-syndrome-in-children
#5
REVIEW
Laura Y Martin, Mitchell R Ladd, Adam Werts, Chhinder P Sodhi, John C March, David J Hackam
Short bowel syndrome is a major cause of morbidity and mortality in children. Despite decades of experience in the management of short bowel syndrome, current therapy is primarily supportive. Definitive treatment often requires intestinal transplantation, which is associated with significant morbidity and mortality. In order to develop novel approaches to the treatment of short bowel syndrome, we and others have focused on the development of an artificial intestine, by placing intestinal stem cells on a bioscaffold that has an absorptive surface resembling native intestine, and taking advantage of neovascularization to develop a blood supply...
September 22, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28920023/re-tubularization-of-highly-ischemic-anti-mesenteric-border-rehab-a-novel-bowel-preservation-technique-in-complex-gastroschisis
#6
Richard J Hendrickson, Ashwini S Poola, Katherine W Gonzalez, Joel Lim, Tolulope A Oyetunji
Complex gastroschisis with bowel necrosis poses an operative challenge. Surgeons must weigh the decision between resection versus preservation of ischemic bowel. As one of the leading causes of short bowel syndrome, aggressive resection in complicated gastroschisis subjects children to prolonged dependence on parenteral nutrition and its attendant complications. Herein, we describe a novel technique aimed towards bowel preservation in complex gastroschisis patients with severe bowel ischemia with the ultimate goal for enteral autonomy...
July 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28689603/small-bowel-dilation-in-children-with-short-bowel-syndrome-is-associated-with-mucosal-damage-bowel-derived-bloodstream-infections-and-hepatic-injury
#7
COMPARATIVE STUDY
Maria Hukkinen, Annika Mutanen, Mikko P Pakarinen
BACKGROUND: Liver disease occurs frequently in short bowel syndrome. Whether small bowel dilation in short bowel syndrome could influence the risk of liver injury through increased bacterial translocation remains unknown. Our aim was to analyze associations between small bowel dilation, mucosal damage, bloodstream infections, and liver injury in short bowel syndrome patients. METHODS: Among short bowel syndrome children (n = 50), maximal small bowel diameter was measured in contrast series and expressed as the ratio to the height of the fifth lumbar vertebra (small bowel diameter ratio), and correlated retrospectively to fecal calprotectin and plasma citrulline-respective markers of mucosal inflammation and mass-bloodstream infections, liver biochemistry, and liver histology...
September 2017: Surgery
https://www.readbyqxmd.com/read/28687683/substantial-harm-associated-with-failure-of-chronic-paediatric-central-venous-access-devices
#8
Amanda J Ullman, Tricia Kleidon, Marie Cooke, Claire M Rickard
Central venous access devices (CVADs) form an important component of modern paediatric healthcare, especially for children with chronic health conditions such as cancer or gastrointestinal disorders. However device failure and complications rates are high.Over 2½ years, a child requiring parenteral nutrition and associated vascular access dependency due to 'short gut syndrome' (intestinal failure secondary to gastroschisis and resultant significant bowel resection) had ten CVADs inserted, with ninesubsequently failing...
July 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28685192/venous-thrombosis-and-stenosis-after-peripherally-inserted-central-catheter-placement-in-children
#9
H Stella Shin, Alexander J Towbin, Bin Zhang, Neil D Johnson, Stuart L Goldstein
BACKGROUND: Peripherally inserted central catheters (PICCs) can lead to development of venous thrombosis and/or stenosis. The presence of venous thrombosis and/or stenosis may preclude children with chronic medical conditions from receiving lifesaving therapies, from hemodialysis in end-stage renal disease to total parenteral nutrition in short bowel syndrome. Several adult studies have found an association between PICCs and venous thrombosis and/or stenosis, but none has evaluated for this association in children...
July 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28625693/long-term-functional-outcomes-after-replacement-of-the-esophagus-in-pediatric-patients-a-systematic-literature-review
#10
REVIEW
Stefano Garritano, Tomoyuki Irino, Chiara Maria Scandavini, Andrianos Tsekrekos, Lars Lundell, Ioannis Rouvelas
BACKGROUND: The indications of esophageal replacement (ER) in pediatric patients include long gap esophageal atresia (LGEA), intractable post-corrosive esophageal strictures (PCES), and some rare esophageal diseases. Various conduits and procedures are currently used worldwide with a lack of consensus regarding the ideal substitute to replace the esophagus replacement. The short-term outcomes of these advanced procedures are well known; there are few data available describing long-term functional outcomes of these patients with long life expectancy...
September 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28610705/anastomotic-ulcers-in-short-bowel-syndrome-new-suggestions-from-a-multidisciplinary-approach
#11
Fabio Fusaro, Renato Tambucci, Erminia Romeo, Pietro Bagolan, Luigi Dall'Oglio, Stefano Ceccarelli, Paola Francalanci, Dominique Hermans, Andrea Pietrobattista, Antonella Diamanti, Filippo Torroni, Paola De Angelis
BACKGROUND AND AIMS: Anastomotic ulceration (AU) is a rare potential life-threatening complication that may occur after intestinal resection. The diagnosis is often delayed after a long-lasting history of refractory anemia. The pathogenesis remains unknown and there are no established therapies. The aim of the study was to analyze the medical history of children with short bowel syndrome (SBS) who were experiencing AU. METHODS: Records of SBS children were retrospectively reviewed...
June 3, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28521656/oral-feeding-difficulties-in-children-with-short-bowel-syndrome-a-narrative-review
#12
Judy Hopkins, Sharon A Cermak, Russell J Merritt
Children with short bowel syndrome (SBS) with associated intestinal failure may be unable to absorb sufficient nutrients to sustain life. Improvements in the medical management of SBS, including use of parenteral nutrition, has significantly increased life expectancy. Independence from parenteral nutrition further improves quality of life. However, children living with SBS often develop oral aversions and feeding difficulties. There is limited research and information on which to base interventions that will preserve and develop oral motor and feeding skills...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28510260/markers-of-enteral-adaptation-in-pediatric-short-bowel-syndrome
#13
Masahiro Chiba, Yutaka Sanada, Akira Toki
BACKGROUND: The aim of this study was to ascertain if prospective determination of specific gut hormones and growth factors could predict bowel adaptation in children with short bowel syndrome (SBS). METHODS: We studied independence from parenteral nutrition (PN) as the short-term result and discontinuation of enteral nutrition (EN) as the long-term result from a retrospective chart review of seven patients with SBS, who were managed in the absence of growth retardation...
May 16, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28462379/prolonged-absence-of-mechanoluminal-stimulation-in-human-intestine-alters-the-transcriptome-and-intestinal-stem-cell-niche
#14
Minna M Wieck, Christopher R Schlieve, Matthew E Thornton, Kathryn L Fowler, Mubina Isani, Christa N Grant, Ashley E Hilton, Xiaogang Hou, Brendan H Grubbs, Mark R Frey, Tracy C Grikscheit
BACKGROUND & AIMS: For patients with short-bowel syndrome, intestinal adaptation is required to achieve enteral independence. Although adaptation has been studied extensively in animal models, little is known about this process in human intestine. We hypothesized that analysis of matched specimens with and without luminal flow could identify new potential therapeutic pathways. METHODS: Fifteen paired human ileum samples were collected from children aged 2-20 months during ileostomy-reversal surgery after short-segment intestinal resection and diversion...
May 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28351520/toll-like-receptor-4-is-critical-for-the-development-of-resection-associated-hepatic-steatosis
#15
Lauren K Barron, James W Bao, Bola G Aladegbami, Jason J Colasanti, Jun Guo, Christopher R Erwin, Brad W Warner
BACKGROUND: A significant number of children with short bowel syndrome experience intestinal failure-associated liver disease. We recently demonstrated accelerated hepatic steatosis after 50% small bowel resection (SBR) in mice. Since SBR is associated with alterations in the gut microbiome, the purpose of this study was to determine whether TLR4 signaling is critical to the development of resection-associated hepatic steatosis. METHODS: Male C57BL6 (control) and TLR4-knockout (KO) mice underwent 50% proximal SBR...
June 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28343660/a-pilot-study-of-ultrasound-elastography-as-a-non-invasive-method-to-monitor-liver-disease-in-children-with-short-bowel-syndrome
#16
Daniel Lodwick, Molly Dienhart, Jennifer N Cooper, Bonita Fung, Joseph Lopez, Sally Smith, Patrick Warren, Jane Balint, Peter C Minneci
BACKGROUND: Our objective was to evaluate the accuracy of acoustic radiation force impulse (ARFI) elastography in determining extent of liver fibrosis in pediatric patients with short bowel syndrome (SBS). METHODS: This prospective cohort study included pediatric patients with SBS who underwent ultrasound with ARFI measurements of shear wave speed (SWS) and liver biopsy within 30days of each other between 12/2014-9/2015. The mean and median SWS were compared to the stage of fibrosis...
June 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28230078/unravelling-the-metabolic-impact-of-sbs-associated-microbial-dysbiosis-insights-from-the-piglet-short-bowel-syndrome-model
#17
Prue M Pereira-Fantini, Sean G Byars, James Pitt, Susan Lapthorne, Fiona Fouhy, Paul D Cotter, Julie E Bines
Liver disease is a major source of morbidity and mortality in children with short bowel syndrome (SBS). SBS-associated microbial dysbiosis has recently been implicated in the development of SBS-associated liver disease (SBS-ALD), however the pathological implications of this association have not been explored. In this study high-throughput sequencing of colonic content from the well-validated piglet SBS-ALD model was examined to determine alterations in microbial communities, and concurrent metabolic alterations identified in urine samples via targeted mass spectrometry approaches (GC-MS, LC-MS, FIA-MS) further uncovered impacts of microbial disturbance on metabolic outcomes in SBS-ALD...
February 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28194723/teduglutide-a-review-in-short-bowel-syndrome
#18
REVIEW
Esther S Kim, Susan J Keam
Subcutaneous teduglutide (Revestive(®)), a glucagon-like peptide-2 analogue that increases intestinal absorption, is approved in the EU for the treatment of short bowel syndrome (SBS) in patients aged ≥1 year who are stable following a period of postsurgical intestinal adaptation. In a phase III trial in adults with SBS intestinal failure (IF) dependent on parenteral support (PS), a significantly greater proportion of teduglutide 0.05 mg/kg/day than placebo recipients achieved a ≥20% reduction in weekly PS volume from baseline to week 20 and maintained it to week 24...
March 2017: Drugs
https://www.readbyqxmd.com/read/28190552/use-of-balloon-dilatation-for-management-of-postoperative-intestinal-strictures-in-children-with-short-bowel-syndrome
#19
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...
May 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28185632/risk-factors-and-outcomes-of-tapering-surgery-for-small-intestinal-dilatation-in-pediatric-short-bowel-syndrome
#20
Maria Hukkinen, Reetta Kivisaari, Antti Koivusalo, Mikko P Pakarinen
BACKGROUND: In remains unclear why in some short bowel syndrome (SBS) patients, the remaining small bowel (SB) dilates excessively leading to requirement of tapering surgery. METHODS: Among SBS children, we retrospectively analyzed risk factors for tapering surgery with logistic regression and compared the outcome of operated patients (n=16) to those managed conservatively (n=44) with Cox proportional hazards regression. RESULTS: SBS was caused by necrotizing enterocolitis (NEC) (n=31), SB atresia (SBA) (n=13), midgut volvulus (n=12), or gastroschisis (n=4)...
July 2017: Journal of Pediatric Surgery
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