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Gastrointestinal failure

Shlomi Rayman, Michael Goldenshluger, Orly Goitein, Joseph Dux, Nasser Sakran, Asnat Raziel, David Goitein
BACKGROUND: Failure or complications following laparoscopic adjustable gastric banding (LAGB) may necessitate band removal and conversional surgery. Band position and band-induced chronic vomiting create ideal conditions for de novo hiatal hernia (HH) formation. HH presence impedes and complicates conversional surgery by obscuring crucial anatomical landmarks and hindering precise gastric sleeve or pouch formation. The aim of this study was to evaluate the incidence of a HH in patients with an LAGB undergoing conversion compared to patients undergoing primary bariatric surgery (BS)...
October 19, 2018: Surgical Endoscopy
Do Hoon Kim, Gwang Ha Kim, Chang Min Cho, Chang Hwan Park, Soo-Young Na, Tae Hyeon Kim, Yu Kyung Cho, Ji Hyun Kim, Dong-Wan Seo
BACKGROUND: Endoscopic ultrasonography-guided fine-needle biopsy (EUS-FNB) may facilitate tissue acquisition for a definitive diagnosis of gastrointestinal subepithelial tumors (SETs). This study aimed to determine the diagnostic yield of EUS-FNB using a novel 20-gauge ProCore needle with a coiled sheath in tissue sampling of gastrointestinal SETs. METHODS: Between July 2016 and February 2017, 39 patients with gastrointestinal SETs were prospectively recruited from six university hospitals in Korea...
October 19, 2018: BMC Gastroenterology
Prisca Da Lozzo, Andrea Magnolato, Irene Del Rizzo, Fabio Sirchia, Irene Bruno, Egidio Barbi
Hereditary fructose intolerance is an autosomal recessive disorder of fructose metabolism caused by catalytic deficiency of aldolase B enzyme [1]. The disease is typically expressed when fructose- and sucrose-containing foods are first introduced in the diet; acute manifestations include nausea, vomiting, abdominal distress, and symptomatic hypoglycemia [1,2]. Chronic fructose ingestion eventually leads to poor feeding, growth retardation and gradual liver and/or renal failure [3,4]. Some patients may remain undiagnosed until adulthood because of a self-protective avoidance of sweet tasting food that prevents the development of acute toxicity from fructose containing food; however, these subjects may suffer intermittent symptoms throughout life, leading to potentially serious misdiagnosis [4]...
October 13, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Ali Yurtseven, Mümine Türksoylu, Pınar Yazıcı, Bülent Karapınar, Eylem Ulaş Saz
Yurtseven A, Türksoylu M, Yazıcı P, Karapınar B, Saz EU. A `glue sniffer` teenager with anuric renal failure and hepatitis. Turk J Pediatr 2018; 60: 206-209. `Inhalant abuse` is a common form of volatile drug abuse throughout the world especially in developing countries. This substance mainly contains toluene. Acute toluene inhalation produces a biphasic response with an initial central nervous system (CNS) excitation followed by CNS depression as well as various metabolic alterations. Chronic inhalational abuse is associated with muscular weakness, gastrointestinal symptoms, renal and hepatic injury...
2018: Turkish Journal of Pediatrics
Marijana Rincic Antulov, Runar B Båtevik
Angiotensin-converting enzyme inhibitors (ACEI) are widely used to treat hypertension and congestive heart failure. A rare side effect of ACEI therapy is angioedema, which in very rare cases may present as gastrointestinal angioedema (GA). A 45-year-old female presented with suddenly occurring diffuse abdominal pain. Imaging studies revealed small bowel wall edema. The patient had been on ACEI therapy for the last 6 months. The therapy was withdrawn, and the patient recovered quickly. There is no specific diagnostic test to confirm ACEI-induced GA, but symptoms usually regress completely after therapy discontinuation...
September 2018: Case Reports in Gastroenterology
Michael John Renouf, Youn Hee Cho, Joseph B McPhee
Inflammatory bowel diseases are becoming increasingly common throughout the world, both in developed countries and increasingly in rapidly developing countries. Multiple lines of evidence point to a role for the microbial composition of the gastrointestinal tract in the etiology of IBD, but to date, attempts to define a specific microbial cause for IBD have proved unsuccessful. Microbial 16S rRNA profiling shows that IBD patients have elevated levels of Enterobacteriaceae, in particular Escherichia coli, and reduced levels of Faecalibacterium prausnitzii...
October 12, 2018: Inflammatory Bowel Diseases
Milena Armacki, Anna Katharina Trugenberger, Ann K Ellwanger, Tim Eiseler, Christiane Schwerdt, Lucas Bettac, Dominik Langgartner, Ninel Azoitei, Rebecca Halbgebauer, Rüdiger Groß, Tabea Barth, André Lechel, Benjamin M Walter, Johann M Kraus, Christoph Wiegreffe, Johannes Grimm, Annika Scheffold, Marlon R Schneider, Kenneth Peuker, Sebastian Zeißig, Stefan Britsch, Stefan Rose-John, Sabine Vettorazzi, Eckhart Wolf, Andrea Tannapfel, Konrad Steinestel, Stefan O Reber, Paul Walther, Hans A Kestler, Peter Radermacher, Thomas Fe Barth, Markus Huber-Lang, Alexander Kleger, Thomas Seufferlein
Dysregulated intestinal epithelial apoptosis initiates gut injury, alters the intestinal barrier, and can facilitate bacterial translocation leading to a systemic inflammatory response syndrome (SIRS) and/or multi-organ dysfunction syndrome (MODS). A variety of gastrointestinal disorders, including inflammatory bowel disease, have been linked to intestinal apoptosis. Similarly, intestinal hyperpermeability and gut failure occur in critically ill patients, putting the gut at the center of SIRS pathology. Regulation of apoptosis and immune-modulatory functions have been ascribed to Thirty-eight-negative kinase 1 (TNK1), whose activity is regulated merely by expression...
October 15, 2018: Journal of Clinical Investigation
Kiran Gordhanbhai Piparva, Gaurav Jansari, Anil P Singh
Background: The emergence of drug-resistant mycobacteria becomes a significant public health problem globally creating an obstacle to effective tuberculosis (TB) control. Gujarat, Maharashtra, and Andhra Pradesh DRS survey estimated that the proportion of multidrug-resistant TB (MDR-TB) is 2.1% (in new TB cases) and 15% (in previously treated cases). Programmatic management of MDR-TB implemented under Revised National Tuberculosis Control Programme in India in 2007. Objectives: The objective of this study is to evaluate treatment outcome and adverse drug reactions (ADRs) of category IV...
October 2018: Perspectives in Clinical Research
Xavier M Keutgen, Erik Schadde, Rodney F Pommier, Thorvardur R Halfdanarson, James R Howe, Electron Kebebew
Over 50% of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have stage IV disease at presentation and the most likely organ to be affected by metastases is the liver. Hepatic involvement and hepatic tumor burden is a key prognostic factor affecting survival of these patients and 80% eventually die of liver failure due to tumor dissemination within the liver. This commentary explores the efficacy and limitations of systemic treatments in patients with GEP-NETs and liver metastases. Landmark randomized trials using systemic therapies including sandostatin (PROMID), lanreotide (CLARINET), everolimus (RADIANT 3 and 4), sunitinib and Peptide Receptor Radionuclide Therapy (NETTER-1) have not shown efficacy in reducing liver tumor burden in patients with stage IV GEP-NETs with liver metastases as outlined in this review...
October 11, 2018: Seminars in Oncology
Kazuhiro Nishiyama, Kimiya Aono, Yasuyuki Fujimoto, Mitsuru Kuwamura, Toshiya Okada, Hayato Tokumoto, Takeshi Izawa, Ryoichi Okano, Hidemitsu Nakajima, Tadayoshi Takeuchi, Yasu-Taka Azuma
Organ-organ crosstalk is involved in homeostasis. Gastrointestinal symptoms are common in patients with renal failure. The aim of this study was to elucidate the relationship between gastrointestinal motility and gastrointestinal symptoms in chronic kidney disease. We performed studies in C57BL/6 mice with chronic kidney disease after 5/6 nephrectomy. Gastrointestinal motility was evaluated by assessing the ex vivo responses of ileum and distal colon strips to electrical field stimulation. Feces were collected from mice, and the composition of the gut microbiota was analyzed using 16S ribosomal RNA sequencing...
October 14, 2018: Journal of Cellular Physiology
Anita J Campbell, Christopher C Blyth, Christopher J Hewison, Yu-Ping Chen, Leanne Gough, Zoy Goff, Asha C Bowen
AIM: Bacteraemia episodes were assessed to calculate a hospital-wide central line-associated blood stream infection (CLABSI) rate per 1000 catheter-days. Secondary objectives were to describe risk factors, microbiology and outcomes of children with CLABSI. METHODS: A retrospective study was conducted at an Australian tertiary paediatric hospital in children <18 years who had blood culture sampling during the 2-year period, 2014-2015. All blood culture results were extracted from the hospital's laboratory information system...
October 13, 2018: Journal of Paediatrics and Child Health
Chiara Gasteiger, Rebekah Sherriff, Alan Fraser, Meike C Shedden-Mora, Keith J Petrie, Anna S Serlachius
OBJECTIVE: Failure to effectively reassure patients can lead to patients becoming distressed and seeking further medical care. Whilst existing studies have identified that patients' psychological and demographic characteristics can impact patient reassurance, little research has explored specific predictors of patient reassurance following a colonoscopy. This study investigates demographic and psychological predictors of patient reassurance after receiving normal test results following a colonoscopy...
November 2018: Journal of Psychosomatic Research
Jennifer J Chung, Robert Stetson, Jonathan Gordon, Carol W Chen, Ann C Gaffey, J Eduardo Rame, Michael Acker, Pavan Atluri
OBJECTIVE: This study aims to identify the major components of left ventricular assist device (LVAD) -related costs in a population on long term mechanical circulatory support to gain insight into opportunities for improvements in quality, safety, and efficiency of care for end stage heart failure patients. METHODS: This was a single institution, retrospective cost analysis of patients who received a Heartmate II or HeartWare LVAD between November 2005 - October 2015...
October 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
Peter Novak
Autonomic complaints are frequently encountered in clinical practice. They can be due to primary autonomic disorders or secondary to other medical conditions. Primary autonomic disorders can be categorized as orthostatic intolerance syndromes and small fiber neuropathies, the latter are associated with autonomic failure, pain, or their combinations. The review outlines orthostatic intolerance syndromes (neurally mediated syncope, orthostatic hypotension, postural tachycardia syndrome, inappropriate sinus tachycardia, orthostatic cerebral hypoperfusion syndrome and hypocapnic cerebral hypoperfusion) and small fiber neuropathies (sensory/autonomic/mixed, acute/subacute/chronic, idiopathic/secondary, inflammatory and non-inflammatory)...
October 8, 2018: American Journal of Medicine
Sheridan M Hoy
Sodium zirconium cyclosilicate (Lokelma™) [hereafter referred to as SZC] is a non-absorbed, non-polymer zirconium silicate compound that preferentially exchanges hydrogen and sodium for potassium and ammonium ions in the gastrointestinal tract (GIT), thereby increasing faecal potassium excretion and lowering serum potassium levels. It is available as a powder for oral suspension (in water) and is approved in the EU and the USA for the treatment of hyperkalaemia in adults. In two multinational, phase III studies in adults with hyperkalaemia, SZC 10 g three times daily lowered serum potassium levels to within the normal range (3...
October 10, 2018: Drugs
Masayuki Saijo
Severe fever with thrombocytopenia syndrome (SFTS) was first reported in 2011 as an emerging virus infection caused by a novel Phlebovirus in the Bunyaviridae family [SFTS virus (SFTSV)]. In addition, it was reported to be endemic to Hubei, Henan, Shandong, and Heilongjiang provinces in China. The primary symptoms of SFTS are gastrointestinal symptoms such as fever, general fatigue, nausea, vomiting, and diarrhea. The total blood cell counts in patients with SFTS reveal thrombocytopenia and leukopenia. A woman in her 50s died due to multiorgan failure, intestinal hemorrhage, and hemophagocytosis in the autumn of 2012...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Mohsin Hamid, Waqas Ullah, Mamoon Ur Rashid, Waseem Amjad, Maryam Mukhtar, Abu Hurairah
The barium swallow is an important radiological investigation used for the diagnosis of upper gastrointestinal anatomical disorders like esophageal cancer, diverticulum, achalasia, foreign body, among others. Generally, it is believed to be a safe technique with rare complications, but few cases of barium sulfate aspiration have been reported in the literature with multiple complications. We are reporting a case of an elderly male who underwent esophagogram for the workup of chronic dysphagia, aspirated barium sulfate, and went into respiratory failure and circulatory shock several hours later...
January 2018: Journal of Investigative Medicine High Impact Case Reports
Vritika Batura, Aleixo M Muise
PURPOSE OF REVIEW: To summarize the current understanding and recent advances on the genetic aetiology in the pathogenesis of very early onset inflammatory bowel disease (VEO-IBD). RECENT FINDINGS: IBD is a chronic disorder of the gastrointestinal tract whose manifestation is a result of complex interactions between genetics, environment, immune system and microbial flora. Over 230 IBD risk loci have been reported in genome wide association studies but the genetic contribution of the majority of these loci in the manifestation of IBD is very low...
October 6, 2018: Current Opinion in Allergy and Clinical Immunology
Saman Setareh-Shenas, Felix Thomas, Robert M Cole, Alejandro Lemor, Eyal Herzog, Francisco Arabia, Jaime Moriguchi
Ventricular assist device (VAD) implantation has improved quality of life and short-term survival for advanced heart failure patients. There are limited data from single-center studies addressing the characteristics and etiologies of 30 day readmissions after VAD implant. We used the Nationwide Readmissions Database (NRD) 2014 to identify insertion of implantable heart assist system during index admission. Primary and secondary outcomes were 30 day readmissions and leading etiologies, respectively. We analyzed 1,481 patients who received VAD during the primary admission of whom 1,315 patients survived to hospital discharge (mortality rate 11...
October 3, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Nicholas Nacca, Rachel Schult, Robert Loflin, Adam Weltler, Rachel Gorodetsky, Sherri Kacinko, Jeffery Moran, Alex Krotulski, Timothy Wiegand
BACKGROUND: Synthetic cannabinoid intoxication has become difficult to diagnose and manage in the United States, in part due to varying clinical effects within this heterogeneous group of compounds. CASE REPORT: A 38-year-old man was admitted with altered mental status and bradycardia. He demonstrated progressive encephalopathy, seizure activity, second-degree atrioventricular block type I, respiratory failure, hypotension, hypothermia, and hypoglycemia. A computed tomography scan of the abdomen and pelvis revealed multiple packages in the patient's stomach and rectum...
October 5, 2018: Journal of Emergency Medicine
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