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Gastrointestinal failure

Gudrun Aspelund, Elaa M Mahdi, David H Rothstein, Derek S Wakeman
Choledochal cysts (CDCs) and biliary atresia (BA) are rare pediatric hepatobiliary anomalies that require surgical intervention due to increased risk of malignancy and liver failure, respectively. The underlying disease and operative procedures place patients at risk for long-term complications, which may continue to affect them into adulthood. Lack of a transitional care model in the health care system potentiates the challenges they will face following aging out of their pediatric providers' care. We sought to elucidate the long-term complications and challenges patients with CDCs and BA face, review the current literature regarding transitioning care, and propose guidelines aiding adult providers in continued care and surveillance of these patients...
December 15, 2018: Journal of Gastroenterology and Hepatology
Hiroki Yukami, Tetsuji Terazawa, Masahiro Goto, Masahiko Aoki, Ken Asaishi, Toshifumi Yamaguchi, Shin Kuwakado, Takayuki Kii, Kazuhide Higuchi
AIM: Gastric cancer patients are normally treated with oral fluoropyrimidine and cisplatin or oxaliplatin; however, treating patients who also have a gastrointestinal obstruction is often difficult because of their poor oral intake. Instead, a modified (m)FOLFOX-6 regimen is administered, even to patients with gastrointestinal obstructions. The aim of this study was to assess the efficacy of mFOLFOX-6 for gastric cancer patients with a gastrointestinal obstruction. METHODS: Patients with a poor oral intake because of a gastrointestinal obstruction who received mFOLFOX-6 as systemic chemotherapy were retrospectively analyzed...
December 13, 2018: Asia-Pacific Journal of Clinical Oncology
Imed Ben Amor, Tarek Debs, Giorgio Dalmonte, Radwan Kassir, Patrick Baqué, Niccolo Petrucciani, Jean Gugenheim
BACKGROUND: Laparoscopic sleeve gastrectomy represents the most performed bariatric procedure in France. Staple line leak is the major short-term complication of the procedure. Patients with persistent fistula after sleeve gastrectomy, after failure of endoscopic and radiological treatment, are candidates for salvage surgery. Laparoscopic fistulo-jejunostomy (LRYFJ) represents a surgical option to treat persistent fistula post sleeve. METHODS: The case of a 46-year-old woman, with persistent fistula after sleeve gastrectomy, undergoing laparoscopic fistula-jejunostomy is presented...
December 13, 2018: Obesity Surgery
Darin Gopaul, Dilip Panjwani, Robert F Stephens, Michael Lock
Purpose To evaluate acute and late genitourinary (GU) and gastrointestinal (GI) toxicity and the biochemical control of pure hypofractionated radiotherapy (without acceleration) for the treatment of prostate cancer. Methods and materials This phase II prospective trial evaluated low-risk and intermediate-risk prostate cancer patients who received hypofractionated radiotherapy. Fifty-three patients with low-risk prostate cancer received 50 Gy in 15 fractions, 156 patients with intermediate-risk prostate cancer received 60 Gy in 20 fractions over eight weeks...
October 9, 2018: Curēus
Manisit Das, Leaf Huang
Gastrointestinal (GI) cancers like liver, pancreatic, colorectal, and gastric cancer remain some of the most difficult and aggressive cancers. Nanoparticles like liposomes had been approved in the clinic for cancer therapy dating as far back as in 1995. Over the years, liposomal formulations have come a long way, facing several roadblocks, and failures, and advanced by optimizing formulations and incorporating novel design approaches to navigate therapeutic delivery challenges. The first liposomal formulation for a gastrointestinal cancer drug was approved recently in 2015, setting the stage for further clinical developments of liposome-based delivery systems for therapies against GI malignancies...
December 12, 2018: Journal of Pharmacology and Experimental Therapeutics
Franziska Hanisch, Linda Toresson, Thomas Spillmann
Cobalamin is a member of the B-group of vitamins and a cofactor for metabolic processes like nucleic acid synthesis, amino acid synthesis, and the citric acid cycle. Mammals are unable to synthesize cobalamin and therefore rely on adequate food intake. Cobalamin absorption is a complex process in the stomach, duodenum, and ileum, requiring a functional exocrine pancreas. Thus, a great number of gastrointestinal diseases like chronic enteropathies, intestinal lymphoma, or exocrine pancreatic insufficiency can lead to hypocobalaminemia...
October 2018: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
Seham H M Hendawy
Gastrointestinal nematodes (GINs) of ruminants are prevalent and have major economic impacts worldwide. The insight studies of immune responses triggered against GINs are of great concern to understand interaction between host's immune system and parasite. T-helper 2 cytokines drive the effector cell mechanisms which include eosinophils and mast cells. The immune responses are controlled by Th2 secreted interleukins (IL); IL3, IL-4, IL-5, IL-9, IL-10 and IL-13. B-Cell immune response is incorporated in defense mechanisms developed against GINs specially immunoglobulins (Ig); IgA, IgE and IgG...
December 2018: Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology
J Müller-Engelmann, M Paparoupa, A Nierhaus, A Wittig, M Möller, R Gradaus, F Schuppert
Acute necrotizing esophagitis ("black esophagus") is defined as complete necrosis of the esophageal mucosa, which typically affects the entire circumference. We report a case of a healthy 62-year-old woman, who became hemodynamically unstable due to stress cardiomyopathy with acute right heart failure. Transfusion-dependent anemia occurred 24 h later and an upper gastrointestinal endoscopy revealed a black discoloured mucosa of the distal esophagus. After hemodynamic stabilization and treatment with proton pump inhibitors and sucralfate, complete healing of the esophageal mucosa was achieved...
December 10, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Shinichi Ito, Yutaka Tsutsumi, Ryo Kikuchi, Satomi Matsuoka, Norihiko Shimoyama
We report a case of a 60-year-old male who presented with fever and anasarca as well as hepatosplenomegaly, general lymphadenopathy, and disseminated intravascular coagulation (DIC), and was, therefore, admitted to our hospital. In addition, the patient suffered from respiratory failure and renal dysfunction and had pleural effusion and ascites. The pathological diagnosis from lymph node biopsy suggested multicentric Castleman's disease of the plasma cell type; however, the presence of high IL-6 levels, myelofibrosis, thrombocytopenia, anasarca, renal dysfunction, and hepatosplenomegaly led to a definitive diagnosis of TAFRO syndrome...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Maude Le Gall, Sophie Thenet, Doriane Aguanno, Anne-Charlotte Jarry, Laurent Genser, Lara Ribeiro-Parenti, Francisca Joly, Séverine Ledoux, André Bado, Johanne Le Beyec
The plasticity of a material corresponds to its capacity to change its feature under the effect of an external action. Intestinal plasticity could be defined as the ability of the intestine to modify its size or thickness and intestinal cells to modulate their absorption and secretion functions in response to external or internal cues/signals. This review will focus on intestinal adaptation mechanisms in response to diet and nutritional status. These physiological mechanisms allow a fine and rapid adaptation of the gut to promote absorption of ingested food, but they can also lead to obesity in response to overnutrition...
December 5, 2018: Nutrition Reviews
Chloe Q Wang, Thanh Tran, Beth Montera, Rachel Karlnoski, John Feldman, Michael H Albrink, Vic Velanovich
INTRODUCTION: Paraesophageal hernia repairs are prone to recurrence and mesh reinforcement is common. Both biologic and prosthetic meshes have been used. We report a comparison of a new type of biologically derived graft, Gentrix Surgical Urinary Bladder Matrix (UBM). METHODS: The medical records of 65 patients who underwent paraesophageal hernia repair (PEHR) were reviewed. Primary data points included demographics, first-time or recurrent hernia, operative approach, graft or primary repair, operative time, and postoperative complications...
December 3, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Kazuki Maesaka, Yoshiki Tsujii, Shinichiro Shinzaki, Shunsuke Yoshii, Yoshito Hayashi, Hideki Iijima, Kei Nakamoto, Tomohito Ohtani, Yasushi Sakata, Tetsuo Takehara
RATIONALE: Although esophageal compression due to cardiomegaly may be a risk factor of drug-induced esophageal injuries (DIEIs), the causal relationship between the two conditions has not been fully demonstrated. PATIENT CONCERNS: We present a case of a drug-induced esophageal ulcer caused by left atrial enlargement in a 44-year-old woman with end-stage hypertrophic cardiomyopathy. Upper gastrointestinal endoscopy showed a deep, circumferential ulcer in the middle thoracic esophagus...
November 2018: Medicine (Baltimore)
Ping Wang, Ying-Jian Zhang, Yi-Ran Li, Xiao-Yan Xia, Shu-Yan Lv
This study aims to investigate the gastrointestinal functions of patients with liver failure (LF) based on gastrointestinal dysfunction (GD) scores and serum gastrointestinal hormone levels.The GD in LF patients was scored using the gastrointestinal dysfunction scoring criteria. Serum gastrin (GAS), cholecystokinin (CCK), and motilin (MTL) levels were determined in LF patients. In addition, liver function and prothrombin activity were detected, and ultrasonography was performed.The GD score was significantly higher in the LF groups than in the control group...
November 2018: Medicine (Baltimore)
Tanyaporn Chantarojanasiri, Natsuyo Yamamoto, Yousuke Nakai, Tomotaka Saito, Kei Saito, Ryunosuke Hakuta, Kazunaga Ishigaki, Tsuyoshi Takeda, Rie Uchino, Naminatsu Takahara, Suguru Mizuno, Hirofumi Kogure, Saburo Matsubara, Minoru Tada, Hiroyuki Isayama, Kazuhiko Koike
Background and study aims  While endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collection (PFC) is recommended to be performed ≥ 4 weeks after onset of acute pancreatitis (AP), early (< 4 weeks) interventions are needed in some symptomatic cases. Despite feasibility of early percutaneous drainage, there have been few studies about early EUS-guided drainage of PFC. Patients and methods  Consecutive patients who received EUS-guided drainage (EUS-PCD) of infected or symptomatic PFC at the University of Tokyo were retrospectively studied...
December 2018: Endoscopy International Open
Ian Nora, Ravi Shridhar, Jamie Huston, Kenneth Meredith
Background: Accurate predictors of locally advanced and recurrence disease in patients with gastrointestinal cancer are currently lacking. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have emerged as possible markers for predicting recurrence in these patients. In this study, we sought to evaluate the utility of NLR and PLR in predicting the presence of regional nodal disease, metastasis and systemic recurrence in patients with gastrointestinal malignancies...
October 2018: Journal of Gastrointestinal Oncology
Jessica X Yu, Melissa Oliver, Jody Lin, Matthew Chang, Berkeley N Limketkai, Roy Soetikno, Jay Bhattacharya, Tonya Kaltenbach
BACKGROUND & AIMS: Use of direct-acting oral anticoagulants (DOACs) is increasing, but little is known about the associated risks in patients undergoing colonoscopy with polypectomy. We aimed to determine the risk of post-polypectomy complications in patients prescribed DOACs. METHODS: We performed a retrospective analysis using the Clinformatics Data Mart Database (a de-identified administrative database from a large national insurance provider) to identify adults who underwent colonoscopy with polypectomy or endoscopic mucosal resection (EMR) from January 1, 2011, through December 31, 2015...
November 29, 2018: Clinical Gastroenterology and Hepatology
Jun Won Kim, Do Young Kim, Kwang-Hyub Han, Jinsil Seong
BACKGROUND: To report the results of a phase I/II study of helical IMRT-based stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC). METHODS: Eligibility included Child-Turcotte-Pugh class A or B, ≤3 lesions, and cumulative tumor diameter ≤6 cm. Dose was escalated from 36 Gy to 60 Gy delivered in 4 fractions. Grade ≥3 gastrointestinal toxicities (CTCAE v3.0) or radiation-induced liver disease defined dose-limiting toxicity (DLT). RESULTS: Thirty-two patients were enrolled: seven in dose levels 1-2 (36-44 Gy) and 25 in levels 3-4 (42-60 Gy)...
November 17, 2018: Digestive and Liver Disease
A Marot, J V Barbosa, R Duran, P Deltenre, A Denys
PURPOSE: The purpose of this study was to evaluate the feasibility, safety, and efficacy of portal vein recanalization (PVR) and propose a new classification for better selecting candidates with portal vein occlusion (PVO) in whom PVR could be feasible. MATERIALS AND METHODS: The charts of 15 non-cirrhotic patients in whom stent placement using a trans-hepatic approach was attempted for the treatment of PVO with cavernous transformation were reviewed. There were 12 men and 5 women with a mean age of 47±12 years (range: 22-60 years)...
November 28, 2018: Diagnostic and Interventional Imaging
Stephanie A K Angarita, Sergio Duarte, Tara A Russell, Piotr Ruchala, Irmina A Elliott, Julian P Whitelegge, Ali Zarrinpar
BACKGROUND: Loss of intestinal barrier integrity plays a fundamental role in the pathogenesis of various gastrointestinal diseases and is implicated in the onset of sepsis and multiple organ failure. An array of methods to assess different aspects of intestinal barrier function suffers from lack of sensitivity, prolonged periods of specimen collection, or high expense. We have developed a technique to measure the concentration of the food dye FD&C Blue #1 from blood and sought to assess its utility in measuring intestinal barrier function in humans...
January 2019: Journal of Surgical Research
Liselotte C de Kloet, Sebastian E E Schagen, Anemone van den Berg, Agnes Clement-de Boers, Mieke E C A M Houdijk, Daniëlle C M van der Kaay
BACKGROUND: Growth failure can be a unique manifestation of untreated intestinal inflammation in children with inflammatory bowel disease (IBD). It can, however, be difficult to diagnose IBD in the absence of symptoms or in the presence of aspecific gastrointestinal symptoms. A delay in diagnosis is a risk factor for lower adult height. CASE DESCRIPTION: A 15--year-old boy was referred to a paediatric endocrinologist for growth failure and delayed puberty. Additional investigations were performed and he was diagnosed with Crohn's disease...
November 19, 2018: Nederlands Tijdschrift Voor Geneeskunde
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