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delayed gastric emptying

William L Hasler, Laura A Wilson, Linda A Nguyen, William J Snape, Thomas L Abell, Kenneth L Koch, Richard W McCallum, Pankaj J Pasricha, Irene Sarosiek, Gianrico Farrugia, Madhusudan Grover, Linda A Lee, Laura Miriel, James Tonascia, Frank A Hamilton, Henry P Parkman
BACKGROUND & AIMS: Many patients with gastroparesis are prescribed opioids for pain control, but indications for opioid prescription and relations of opioid use to gastroparesis manifestations are undefined. We characterized associations of use of potent vs weaker opioids and presentations of diabetic and idiopathic gastroparesis. METHODS: We collected data on symptoms, gastric emptying, quality of life, and healthcare resource use from 583 patients with gastroparesis (more than 10% 4 hr scintigraphic retention) from the NIDDK Gastroparesis Consortium, from January 2007 through November 2016...
October 13, 2018: Clinical Gastroenterology and Hepatology
Felix J Hüttner, Pascal Probst, Hannes G Kenngott, Phillip Knebel, Thilo Hackert, Alexis Ulrich, Markus W Büchler, Markus K Diener
BACKGROUND: Postoperative pancreatic fistula (POPF) remains a frequent problem especially after distal pancreatectomy. The application of 2-octyl cyanoacrylate showed promising results in the reduction of POPF after pancreatoduodenectomy prompting an expansion of this technique to distal pancreatectomy. Thus, the objective of the current study was to assess safety, feasibility and preliminary efficacy of an intraoperative 2-octyl cyanoacrylate application after distal pancreatectomy. METHODS: Between April 2015 and June 2016 adult patients scheduled for elective distal pancreatectomy were considered eligible for the study...
2018: PloS One
Amber M Milan, Alison J Hodgkinson, Sarah M Mitchell, Utpal K Prodhan, Colin G Prosser, Elizabeth A Carpenter, Karl Fraser, David Cameron-Smith
Fortified milk drinks are predominantly manufactured from bovine (cow) sources. Alternative formulations include those prepared with hydrolysed bovine milk proteins or from alternate bovidae species, such as caprine (goat) milk. Currently, there is little data on protein digestive and metabolic responses following ingestion of fortified milk drinks. To examine the digestive and metabolic responses to commercially-available fortified milks, young adults ( n = 15 males: 15 females), in a randomised sequence, ingested isonitrogenous quantities of whole cow-protein (WC), whole goat-protein (WG), or partially-hydrolysed whey cow-protein (HC), commercial fortified milks...
October 12, 2018: Nutrients
J-H Liou, Y-M Liu, C-H Chen
BACKGROUND: Diabetes mellitus (DM) is the major cause of end-stage renal disease (ESRD) in Taiwan. Despite the use of steroids and/or calcineurin inhibitors (CNIs) in renal transplantation (RTx), additional challenges occur when a patient displays persisting metabolic disease, carries on an unhealthy lifestyle, or experiences genetic effects. Although RTx recipients could get better glycemic control by oral anti-diabetic drugs (OADs) or several insulin agents, they still need more than two kinds of medication...
October 2018: Transplantation Proceedings
Danny J Avalos, Irene Sarosiek, Priyadarshini Loganathan, Richard W McCallum
Diabetic gastroparesis (DMGP) is a condition of delayed gastric emptying after gastric outlet obstruction has been excluded. Symptoms of nausea, vomiting, early satiety, bloating, and abdominal pain are associated with DMGP. Uncontrolled symptoms can lead to overall poor quality of life and financial burdens on the healthcare system. A combination of antiemetics and prokinetics is used in symptom control; metoclopramide is the main prokinetic available for clinical use and is the only U.S. Food and Drug Administration-approved agent in the United States...
2018: Clinical and Experimental Gastroenterology
Michael J Moss, J Ashton Fisher, Tara A Kenny, Allison C Palmer, John A Thompson, Hannah Wolfer, Robert G Hendrickson
BACKGROUND: Salicylates are usually rapidly absorbed and quickly measurable in serum. An undetectable serum salicylate concentration ([ASA]) may occur early after ingestion and may be interpreted as evidence of non-exposure and not repeated. Although cases of delayed salicylate detection are reported rarely, the risk factors associated with this phenomenon are not known. RESEARCH QUESTION: What factors are associated with an early undetectable [ASA] in salicylate poisoning? METHODS: Records from a single regional poison center were searched from 2002 to 2016 for cases of salicylate toxicity treated with bicarbonate and [ASA] > 30 mg/dL...
October 11, 2018: Clinical Toxicology
Aida Cristina Rahy-Martín, Francisco Cruz-Benavides, Mar Sánchez-Lauro, Álvaro Rodríguez-Méndez, Íñigo San Miguel, Pedro Lara, Joaquín Marchena-Gómez
INTRODUCTION: The application of intraoperative radiation therapy to the tumor bed after resection of pancreatic cancer has been shown to be beneficial in the local control of the disease. The objective of this study was to evaluate the preliminary outcomes after the application of a single intraoperative dose to the tumor bed with a new intraoperative radiotherapy device (Intrabeam® ) in terms of viability, safety and short-term results. METHODS: We studied 5 patients who underwent pancreaticoduodenectomy for resectable pancreatic cancer in which a radiotherapy boost (5Gy) was intraoperatively applied to the tumoral bed using the portable Intrabeam® device, a low-energy point-source X-ray...
October 2018: Cirugía Española
Adam M Deane, Marianne J Chapman, Annika Reintam Blaser, Stephen A McClave, Anton Emmanuel
Gastrointestinal dysmotility causes delayed gastric emptying, enteral feed intolerance, and functional obstruction of the small and large intestine, the latter functional obstructions being frequently termed ileus and Ogilvie syndrome, respectively. In addition to meticulous supportive care, drug therapy may be appropriate in certain situations. There is, however, considerable variation among individuals regarding what gastric residual volume identifies gastric dysmotility and would encourage use of a promotility drug...
October 7, 2018: Nutrition in Clinical Practice
Yunxiao Lyu, Ting Li, Bin Wang, Yunxiao Cheng, Sicong Zhao
BACKGROUND: One of the most clinically significant current discussions is the optimal pancreaticojejunostomy (PJ) technique for pancreaticoduodenectomy (PD). We performed a meta-analysis to compare duct-to-mucosa and invagination techniques for pancreatic anastomosis after PD. METHODS: A systematic search of PubMed, Embase, Web of Science, the Cochrane Central Library, and up to June 1, 2018 was performed. Randomized controlled trials (RCTs) comparing duct-to-mucosa versus invagination PJ were included...
October 2018: Medicine (Baltimore)
Chathura Bb Ratnayake, Benjamin Pt Loveday, Shailesh V Shrikhande, John A Windsor, Sanjay Pandanaboyana
BACKGROUND: Morphometric analysis of sarcopenia has garnered interest due to its putative role in predicting outcomes following surgery for a variety of pathologies, including resection for pancreatic disease. However, there are no standard recommendations on whether sarcopenia is a clinically relevant predictor of outcomes in this setting. The aim of this study was to review the prognostic impact of preoperatively diagnosed sarcopenia on postoperative outcomes following pancreatic resection...
September 27, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Javier Herrera Cabezón, Pablo Sánchez Acedo, Antonio Tarifa Castilla, Cruz Zazpe Ripa
INTRODUCTION: delayed gastric emptying (DGE) is the most common complication after pancreaticoduodenectomy (PD) and it occurs in 50% of cases. OBJECTIVES: the endpoint was to determine if there were any differences in the incidence of DGE between Roux-en-Y gastrojejunostomy (ReY) and Billroth II gastrojejunostomy (BII) in PD with pancreaticogastrostomy (PG). METHODS: this was a case-control prospective randomized study of all PD cases between 2013 and 2016...
October 4, 2018: Revista Española de Enfermedades Digestivas
Bryan Zoll, Huaqing Zhao, Michael A Edwards, Roman Petrov, Ron Schey, Henry P Parkman
BACKGROUND: Gastroparesis (GP) is characterized by delayed gastric emptying with symptoms of nausea, vomiting, early satiety, postprandial fullness, and abdominal pain. Various surgical options exist to treat GP not responding to medical treatments (refractory GP), including gastric electric stimulation (GES), gastrectomy (GTx), and pyloric interventions (PI), whereas the outcomes of these procedures have been published; few comparison studies exist. METHODS: PubMed literature review for articles from September 1988 to October 2017 was performed for prospective and retrospective analyses reporting >5 patients...
November 2018: Journal of Surgical Research
Hsien-Hao Huang, Yu-Chi Lee, Chih-Yen Chen
This review analyzed the published studies on the effects of thermal injury on gastrointestinal motility and mucosal damage. Our strategy was to integrate all available evidence to provide a complete review on the prokinetic properties of variable reagents and the potential clinical treatment of mucosal damage and gastrointestinal dysmotility after thermal injury. We classified the studies into two major groups: studies on gastrointestinal dysmotility and studies on mucosal damage. We also subclassified the studies into 3 parts: stomach, small intestine, and colon...
September 21, 2018: Neuropeptides
Jan L Madsen, Morten Damgaard, Stefan Fuglsang, Carsten Dirksen, Jens J Holst, Jesper Graff
In young individuals, oral free fatty acid delays gastric emptying, promotes gut hormone release, and reduces energy intake more than an isocaloric load of triglyceride does. The objective of this study was to compare the effects of the free fatty acid oleic acid (OA) and the triglyceride olive oil (OO) on gastrointestinal motility, gut hormone secretion, and energy intake in older and middle-aged healthy volunteers. In a double-blind, randomized, cross-over, study 10 older (age 83.0 ± 3.4 (mean ± SD) years) and 10 middle-aged (age 43...
September 25, 2018: Appetite
Haruaki Murakami, Shiying Li, Robert Foreman, Jieyun Yin, Toshihiro Hirai, Jiande D Z Chen
INTRODUCTION: Postoperative ileus (POI) is a heavy burden for healthcare industries and reduces the postoperative quality of life. The aim of this study was to investigate the effects and mechanisms of the intraoperative vagus nerve stimulation (iVNS) on gastrointestinal motility in a rodent model of POI. METHODS: For control group (control, n = 8), electrodes were placed on the chest wall for recording the electrocardiogram and on the stomach and small intestine for measuring gastric slow waves (GSWs) and small intestinal slow waves (SSWs)...
September 27, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Ashley Thomas, Bruno de Souza Ribeiro, Miguel Malespin, Silvio W de Melo
PURPOSE OF REVIEW: Gastroparesis (GP) is a disorder of gastrointestinal motility which leads to delayed gastric emptying in the absence of mechanical obstruction. Treatment is limited as many patients are refractory to dietary modification and the use prokinetic medications carry significant adverse risks. These limitations necessitate more research into experimental therapies. The purpose of this article is to summarize the known information and guidelines on the diagnosis and management of GP and to review the latest literature on experimental treatments...
September 26, 2018: Current Treatment Options in Gastroenterology
Yunxiao Lyu, Yunxiao Cheng, Bin Wang, Yueming Xu, Weibing Du
BACKGROUND: This systematic review and meta-analysis were performed to summarize available evidence comparing totally minimally invasive pancreaticoduodenectomy (TMIPD) versus open pancreaticoduodenectomy (OPD) Materials and Methods: We searched PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and for comparative cohort studies published from January 1990 through April 2018 comparing TMIPD versus OPD. Outcomes evaluated were postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), postoperative hemorrhage, wound infection, estimated blood loss, transfusion rate, retrieved lymph nodes (RLNs), R0 rate, reoperation rate, length of hospital stay, and mortality...
September 25, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Yi Liu, Sunjuan Zhang, Feng Ye, Jieyun Yin, Shiying Li, Jiande D Z Chen
BACKGROUND: Chemotherapy-associated dyspepsia syndrome (CADS) is among the most intensive side effects and critical concerns for patients with cancer. To investigate the effects and mechanisms of chronic electroacupuncture (EA) at ST36 on chemotherapy-associated dyspeptic symptoms (CADS) in rats. METHODS: Cisplatin (8 mg/kg, ip) was given once to establish CADS model. EA or sham-EA treatment was then performed one hour daily for 21 days. KEY RESULTS: (a) EA treatment decreased kaolin intake within 24 hours (1...
September 23, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Jody A Porter, Karen E MacKenzie, Brian A Darlow, Ross Butler, Andrew S Day
AIM: Delayed gastric emptying (GE) has been demonstrated in adults with type 1 diabetes mellitus (T1DM). Little is known about GE in children with T1DM. Most methods to measure GE are invasive, that is, scintigraphy, or are only indirectly related to GE, that is, electrogastrography. Carbon-13 breath testing is a non-invasive, very low-risk procedure that accurately correlates with GE time. This was a pilot study to determine the feasibility of using carbon-13 breath testing to measure GE in children with T1DM and healthy controls...
September 17, 2018: Journal of Paediatrics and Child Health
Mehmet Bülbül, Osman Sinen, V Nimet İzgüt-Uysal, Gökhan Akkoyunlu, Saffet Öztürk, Fatma Uysal
Exposure to stress induces gastrointestinal (GI) dysmotility. In rodents, acute restraint stress (ARS) inhibits gastric emptying (GE) and intestinal transit (IT) via central and peripheral corticotropin-releasing factor (CRF)-mediated pathways. Peripherally administered apelin-13 was shown to inhibit GI motor functions; moreover, stress-induced upregulation of gastric apelin content was demonstrated in rats suggesting that peripheral apelin may mediate stress-induced alterations in GI motility. We investigated the role of endogenous peripheral apelin in stress-induced GI dysfunction...
September 17, 2018: Clinical and Experimental Pharmacology & Physiology
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