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Parenteral nutrition

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https://www.readbyqxmd.com/read/28220407/favourable-outcome-in-two-pregnancies-in-a-patient-with-3-hydroxy-3-methylglutaryl-coa-lyase-deficiency
#1
David Santosa, Markus G Donner, Stephan Vom Dahl, Markus Fleisch, Thomas Hoehn, Ertan Mayatepek, Katrin Heldt, Tim Niehues, Dieter Häussinger
In patients with 3-hydroxy-3-methylglutaryl(HMG)-CoA lyase deficiency (OMIM 246450), five pregnancies have been described worldwide, which were either terminated or resulted in severe metabolic sequelae during pregnancy or delivery. Here, we report on a patient with HMG-CoA lyase deficiency, who underwent two uncomplicated pregnancies. The 19-year-old patient was admitted because of recurrent vomiting and nausea. Diagnostics revealed pregnancy at week 8 of gestation. Metabolic analyses revealed normal lactate and blood glucose levels and normal acid-base status...
February 21, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28214850/olive-oil-supplemented-lipid-emulsion-induces-celf1-expression-and-promotes-apoptosis-in-caco-2-cells
#2
Jun-Kai Yan, Jie Zhu, Zi-Zhen Gong, Jie Wen, Yong-Tao Xiao, Wei Cai, Tian Zhang
BACKGROUND AND AIMS: Parenterally-administered lipid emulsion (LE) is a key cause of enterocyte apoptosis under total parenteral nutrition, yet the pathogenesis has not been fully understood. CUGBP, Elav-like family member 1 (CELF1) has been recently identified as a crucial modulator of apoptosis, and thus this study sought to investigate its role in the LE-induced apoptosis in vitro. METHODS: Caco-2 cells were used as an in vitro model. The cells were treated with varying LEs derived from soybean oil, olive oil or fish oil, and changes in the apoptosis and CELF1 expression were assessed...
February 8, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28214831/p38-mapk-pharmacological-inhibitor-sb203580-alleviates-total-parenteral-nutrition-induced-loss-of-intestinal-barrier-function-but-promotes-hepatocyte-lipoapoptosis
#3
Yong-Tao Xiao, Wei-Hui Yan, Yi Cao, Jun-Kai Yan, Wei Cai
BACKGROUND & AIMS: Our previous studies have provided evidence that p38 mitogen-activated protein kinase (MAPK) is involved in total parenteral nutrition (TPN)-associated complications, but its exact effects and mechanisms have not been fully understood. This study aimed to evaluate the roles of p38 MAPK inhibitor SB203580 in the TPN-induced loss of intestinal barrier function and liver disease. METHODS: A rodent model of TPN was used to analyze the roles of SB203580 in TPN-associated complications...
February 8, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28214097/impact-of-an-enhanced-recovery-after-surgery-programme-in-radical-cystectomy-a-cohort-comparative-study
#4
R Casans-Francés, A T Roberto-Alcácer, A C García-Lecina, M L Ferrer-Ferrer, J Subirá-Ríos, J Guillén-Antón
OBJECTIVE: To evaluate the results of the implementation of an enhanced recovery program (ERAS) for open approach radical cystectomy compared to the historical cohort of the same hospital. MATERIAL AND METHODS: A retrospective analysis of 138 consecutive patients who underwent radical cystectomy with Bricker or Studer ileal derivation (97 historical vs. 41 ERAS). Overall complication rate, Clavien-Dindo stage>2 complications, mortality, hospital and critical care length of stay and readmission rates, as well as need for reoperation, nasogastric intubation, transfusion or parenteral nutrition were compared...
February 14, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28209419/a-safety-and-pharmacokinetic-dosing-study-of-glucagon-like-peptide-2-in-infants-with-intestinal-failure
#5
David L Sigalet, Mary E Brindle, Dana Boctor, Bryan Dicken, Viona Lam, Lily Sia Lu, Elaine de Heuvel, Bolette Hartmann, Jens J Holst
BACKGROUND & AIMS: Glucagon-like peptide 2 (GLP-2) analogues are approved for adults with intestinal failure (IF), but no studies have included infants. This study examined the pharmacokinetics (PK), safety, and nutritional effects of GLP-2 in infants with IF. METHODS: With parental consent (Health Canada Protocol:150,979), parenteral nutrition (PN)-dependent infants were treated with 5-20-μg/kg/day GLP-2 for 3days (phase 1), and if tolerated continued for 42days (phase 2)...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28203330/risk-factors-for-health-care-associated-bloodstream-infections-in-a-neonatal-intensive-care-unit
#6
Sabahattin Ertugrul, Fesih Aktar, Ilyas Yolbas, Ahmet Yilmaz, Bilal Elbey, Ahmet Yildirim, Kamil Yilmaz, Recep Tekin
BACKGROUND: Healthcare-associated bloodstream infections (HCA-BSI) are a major cause of morbidity and mortality in neonatal intensive care units (NICUs). OBJECTIVES: We aimed to determine the causative organisms and risk factors of HCA-BSIs in NICUs. METHODS: This study was performed between January 2011 and December 2014 in the neonatal intensive care unit of Dicle university, Turkey. The study consisted of 126 patients (infected group) with positive blood culture and 126 randomly selected patients (uninfected control group) with negative blood culture after four days of hospitalization...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28201847/the-differentiation-of-intestinal-failure-associated-liver-disease-from-nonalcoholic-fatty-liver-and-nonalcoholic-steatohepatitis
#7
Alan L Buchman, Bita V Naini, Bert Spilker
Intestinal failure-associated liver disease (IFALD), formerly known as parenteral nutrition-associated liver disease has often been listed in textbooks as an example of nonalcoholic fatty liver disease (NAFLD). However, the etiology, pathophysiology, epidemiology, histology, and progression differ substantially between the conditions defined as NAFLD and the disease, IFALD. Therefore, IFALD should not be defined or considered as a type or a cause of nonalcoholic fatty liver or nonalcoholic steatohepatitis, but rather as a distinct disease...
February 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/28194286/central-venous-catheter-related-bloodstream-infection-with-kocuria-kristinae-in-a-patient-with-propionic-acidemia
#8
Masato Kimura, Eichiro Kawai, Hisao Yaoita, Natsuko Ichinoi, Osamu Sakamoto, Shigeo Kure
Kocuria kristinae is a catalase-positive, coagulase-negative, Gram-positive coccus found in the environment and in normal skin and mucosa in humans; however, it is rarely isolated from clinical specimens and is considered a nonpathogenic bacterium. We describe a case of catheter-related bacteremia due to K. kristinae in a young adult with propionic acidemia undergoing periodic hemodialysis. The patient had a central venous catheter implanted for total parenteral nutrition approximately 6 months prior to the onset of symptoms because of repeated acute pancreatitis...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28191783/concise-review-the-potential-use-of-intestinal-stem-cells-to-treat-patients-with-intestinal-failure
#9
Sung Noh Hong, James C Y Dunn, Matthias Stelzner, Martín G Martín
Intestinal failure is a rare life-threatening condition that results in the inability to maintain normal growth and hydration status by enteral nutrition alone. Although parenteral nutrition and whole organ allogeneic transplantation have improved the survival of these patients, current therapies are associated with a high risk for morbidity and mortality. Development of methods to propagate adult human intestinal stem cells (ISCs) and pluripotent stem cells raises the possibility of using stem cell-based therapy for patients with monogenic and polygenic forms of intestinal failure...
February 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28190552/use-of-balloon-dilatation-for-management-of-postoperative-intestinal-strictures-in-children-with-short-bowel-syndrome
#10
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/28188037/determinants-of-outcomes-in-patients-with-simple-gastroschisis
#11
Fouad Youssef, Jean-Martin Laberge, Pramod Puligandla, Sherif Emil
PURPOSE: We analyzed the determinants of outcomes in simple gastroschisis (GS) not complicated by intestinal atresia, perforation, or necrosis. METHODS: All simple GS patients enrolled in a national prospective registry from 2005 to 2013 were studied. Patients below the median for total parenteral nutrition (TPN) duration (26days) and hospital stay (34days) were compared to those above. Univariate and multivariate logistic and linear regression analyses were employed using maternal, patient, postnatal, and treatment variables...
January 28, 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
#12
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)...
January 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28185508/infusion-therapy
#13
Erin Dean
Essential facts Many patients admitted to hospital or receiving care in other settings, including their own homes, are recipients of one or more infusion therapies. Total parenteral nutrition, chemotherapy, parenteral antimicrobial therapy, pain relief and other infusion therapies are increasingly delivered in community settings. While the move away from hospital helps meet patients' lifestyles and clinical needs, it can have implications for patient care and safety.
February 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28181921/feed-induced-dystonias-in-children-with-severe-central-nervous-system-disorders
#14
Santosh Mordekar, Manjula Velayudhan, David I Campbell
Dystonias can arise from any painful stimuli in neurologically disabled children. Classically, feed induced dystonias from mediastinal pain due to severe gastroesophageal reflux disease are described as Sandifer's spasm. We report a case series of 12 severely neurologically impaired children with enteral feed induced dystonias. Intestinal dysmotility was demonstrated in several. Improvements are seen with jejunal feeds or gut rest with Total Parenteral Nutrition. Use of parenteral nutrition in children with severe neurodisability requires thorough discussion with patient groups and commissioners to give clinicians guidelines to standardise care...
February 8, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28179737/updates-in-nutrition-support-for-critically-ill-adult-patients
#15
Diana Wells Mulherin, Sarah V Cogle
Specialized nutrition support is often employed in critically ill patients who are unable to maintain volitional intake. The Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recently updated guidelines for the provision of nutrition support in critically ill patients. The purpose of this review is to summarize key changes from the previous guidelines as they relate to recently published literature, which will aid the hospital pharmacist in optimizing nutrition support therapies in the critical care setting...
January 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28174650/copper-deficiency-related-bone-marrow-changes-secondary-to-long-term-total-parenteral-nutrition
#16
Thein Hlaing Oo, Shimin Hu
Total parenteral nutrition can be complicated by the marrow sea-blue histiocytes as well as copper deficiency-related bone marrow changes. Cytoplasmic vacuoles in the erythroid and myeloid precursors raise the possibility of copper deficiency anemia. If the diagnosis is delayed, the clinical course can be complicated by neurologic deficits.
February 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28169021/supplemental-parenteral-nutrition-in-intensive-care-patients-a-cost-saving-strategy
#17
Lorenzo Pradelli, Séverine Graf, Claude Pichard, Mette M Berger
BACKGROUND & AIMS: The Swiss supplemental parenteral nutrition (SPN) study demonstrated that optimised energy provision combining enteral nutrition (EN) and SPN reduces nosocomial infections in critically ill adults who fail to achieve targeted energy delivery with EN alone. To assess the economic impact of this strategy, we performed a cost-effectiveness analysis using data from the SPN study. METHODS: Multivariable regression analyses were performed to characterise the relationships between SPN, cumulative energy deficit, nosocomial infection, and resource consumption...
January 25, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28168988/a-comparison-of-broviac-%C3%A2-and-peripherally-inserted-central-catheters-in-children-with-intestinal-failure
#18
Carolina Blotte, Jennifer Styers, Hong Zhu, Nandini Channabasappa, Hannah G Piper
PURPOSE: Central venous catheters (CVCs) are a source of morbidity for children with intestinal failure (IF). Complications include infection, breakage, occlusion, and venous thrombosis. Broviacs® have traditionally been preferred, but peripherally inserted central catheters (PICCs) are gaining popularity. This study compares complications between Broviacs® and PICCs in children with IF. METHODS: After IRB approval, children with IF receiving parenteral nutrition (2012-2016) were reviewed...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28168985/predicting-time-to-full-enteral-nutrition-in-children-after-significant-bowel-resection
#19
Jessica Gonzalez-Hernandez, Purvi Prajapati, Gerald Ogola, Nandini Channabasappa, Barbara Drews, Hannah G Piper
PURPOSE: Parenteral nutrition (PN) contributes to considerable morbidity in children after significant bowel resection. This study evaluates the utility of clinical variables in predicting time to independence from PN. METHODS: After IRB approval, a retrospective review (1999-2012) of 71 children who were on PN for >6weeks after intestinal resection and successfully weaned was performed. Clinical characteristics were evaluated to determine the relationship to time to full enteral nutrition...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#20
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
February 6, 2017: Intensive Care Medicine
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