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Intestinal failure in adult

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https://www.readbyqxmd.com/read/29778510/assessment-of-intestinal-failure-associated-liver-disease-according-to-different-diagnostic-criteria
#1
Anna Simona Sasdelli, Federica Agostini, Caterina Pazzeschi, Mariacristina Guidetti, Simon Lal, Loris Pironi
BACKGROUND & AIMS: Intestinal failure associated liver disease (IFALD) has been defined using numerous criteria; however the clinical relevance of these criteria has never been compared. We therefore aimed to evaluate the prevalence, incidence, evolution of IFALD diagnosed by different criteria and to assess any clinical features that may be associated with its occurrence. METHODS: A cross sectional (CS) and retrospective study were carried out on adults on home parenteral nutrition (HPN) for chronic intestinal failure (CIF) managed at a single center...
May 8, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29755909/malrotation-of-the-gut-in-adults-an-often-forgotten-entity
#2
Sushant Bhatia, Sudhir Jain, Chandra B Singh, Lovenish Bains, Rohit Kaushik, Nishant S Gowda
Malrotation of the gut is a common paediatric condition that usually presents in the first month of life. However, presentation in adults is rare, and as a diagnostic dilemma quite often surprises the surgeon intraoperatively. If this condition is not timely recognized, it may result in disastrous consequences, such as gangrene of the small gut. We present the case of a 21-year-old male who presented to the emergency room with recurrent episodes of colicky abdominal pain and bilious vomiting. Contrast-enhanced computerized tomography (CT) revealed malrotation of the gut...
March 12, 2018: Curēus
https://www.readbyqxmd.com/read/29754190/allergic-and-immunologic-perspectives-of-inflammatory-bowel-disease
#3
REVIEW
Kofi Clarke, Jayakrishna Chintanaboina
Inflammatory bowel disease (IBD) is a chronic immune-mediated inflammatory condition primarily involving the gastrointestinal tract. It includes Crohn's disease (CD), ulcerative colitis (UC), and a less common phenotype-indeterminate colitis. It is thought to result from a complex interplay of environmental, microbial, and host factors including genetic factors, although the exact mechanism is not known. Dietary factors have been shown to play a role in the pathogenesis of IBD and can potentially alter the intestinal microbiota as well as disrupt the immune function in the gut...
May 12, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29745058/post-transplant-lymphoproliferative-disorder-in-pediatric-intestinal-transplant-recipients-a-literature-review
#4
REVIEW
Kaitlin Stanley, Erika Friehling, Sarangarajan Ranganathan, George Mazariegos, Linda M McAllister-Lucas, Rakesh Sindhi
Intestinal transplantation is a successful treatment for children with intestinal failure, but has many potential complications. PTLD, a clinically and histologically diverse malignancy, occurs frequently after intestinal transplantation and can be fatal. The management of this disease is particularly challenging. The rejection-prone intestinal allograft requires high levels of immunosuppression, a precondition for PTLD. While EBV infection clearly plays a role in disease pathogenesis, the relatively naïve immune system of children is another likely contributor...
May 10, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29735028/adult-intestinal-transplantation
#5
REVIEW
Cal S Matsumoto, Sukanya Subramanian, Thomas M Fishbein
Adult intestinal transplantation differs significantly from pediatric intestinal transplantation. While indications have remained largely consistent since 2000, indications for adults have expanded over the last two decades to include motility disorders and desmoid tumors. Graft type in adult recipients depends on the distinct anatomic characteristics of the adult recipient. Colonic inclusion, while initially speculated to portend unfavorable outcomes due to complex host-bacterial interactions has increased over the past two decades with superior graft survival and improved patient quality of life...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29722835/catheter-related-bloodstream-infections-in-patients-with-intestinal-failure-receiving-home-parenteral-support-risks-related-to-a-catheter-salvage-strategy
#6
Siri Tribler, Christopher F Brandt, Kristian A Fuglsang, Michael Staun, Per Broebech, Claus E Moser, Thomas Scheike, Palle B Jeppesen
Background: In intestinal failure (IF) patients receiving home parenteral support (HPS), catheter-related bloodstream infections (CRBSIs) frequently result in replacement of their tunneled central venous catheters (CVCs), which may lead to future loss of central venous access. Objective: This observational study investigated the consequences of a catheter-salvage strategy related to CRBSIs. Design: All CRBSIs from 2002 to 2016 in the Copenhagen IF and microbiological databases were retrospectively analyzed...
May 1, 2018: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29605021/diazoxide-reduces-local-and-remote-organ-damage-in-a-rat-model-of-intestinal-ischemia-reperfusion
#7
Saulo Fernandes de Mattos Dourado, Denise Frediani Barbeiro, Marcia Kiyomi Koike, Hermes Vieira Barbeiro, Fabiano Pinheiro da Silva, Marcel Cerqueira César Machado
BACKGROUND: Intestinal ischemia reperfusion is a common clinical condition that causes functional impairment. Once tight junctions are damaged, barrier function is compromised, and the intestines become a source for entry of bacterial and inflammatory mediators into the circulation, leading to systemic inflammatory response syndrome, multiple organ failure, and death. It is possible that diazoxide could protect the intestines against ischemia reperfusion. The aim of this study is to determine whether diazoxide can provide protection in a rat model of intestinal ischemia reperfusion...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29576346/patients-experiences-with-home-parenteral-nutrition-a-grounded-theory-study
#8
Christina Wong, Beverley Lucas, Diana Wood
BACKGROUND & AIMS: Parenteral nutrition (PN) provides nourishment and hydration as an intravenous infusion to patients with intestinal failure (IF). The aim of the study is to generate theory that explains the experiences of adult patients living with home parenteral nutrition (HPN) and complex medication regimens. METHODS: A grounded theory methodology was used to explore the experiences of twelve patients receiving HPN. A semi-structured interview was conducted and recorded in each participant's home setting...
April 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29552791/survival-and-nutritional-factors-on-home-parenteral-nutrition-hpn-our-initial-experience
#9
John Spiliotis, Nikolaos Kopanakis, Anastasia Prodromidou, Alexis Terras, Anastasia Polichronaki, Christina Koutikova, Anna Gogou, Christina Sidera, Elias Efstathiou
PURPOSE: Home parenteral nutrition (HPN) has been proposed as the treatment of choice in patients suffering from intestinal failure (IF) and has been claimed to improve survival and quality of life either in patients with benign disorders or even in those with malignancies. The purpose of the present analysis was to report characteristics and outcomes of adult patients with IF receiving HPN in Greece. METHODS: Patients that received HPN between 2011 and 2017 were included in this retrospective analysis...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29534292/prevalence-evolution-and-risk-factors-for-advanced-liver-fibrosis-in-adults-undergoing-intestinal-transplantation
#10
Geneviève Huard, M Isabel Fiel, Jang Moon, Kishore Iyer, Thomas D Schiano
INTRODUCTION: Intestinal failure-associated liver disease (IFALD) occurs commonly in intestinal transplant (ITx) candidates receiving parenteral nutrition (PN). The aim of this study is to establish the prevalence and risk factors for advanced liver fibrosis in adults at the time of ITx. METHODS: Retrospective chart review of all ITx was performed in adults between January 2000 and May 2014. Advanced liver fibrosis was defined as stage 3 or stage 4 fibrosis. RESULTS: Fifty-three patients met the inclusion criteria...
March 13, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29528830/imaging-of-intestinal-and-multivisceral-transplantation
#11
Mitchell A Rees, Nikhil B Amesur, Ruy J Cruz, Amir A Borhani, Kareem M Abu-Elmagd, Guilherme Costa, Anil K Dasyam
Intestinal transplantation has evolved from its experimental origins in the mid-20th century to its status today as an established treatment option for patients with end-stage intestinal failure who cannot be sustained with total parenteral nutrition. The most common source of intestinal failure in both adults and children is short-bowel syndrome, but a host of other disease processes can lead to this common end-point. The development of intestinal transplantation has presented multiple hurdles for the transplant community, including technical challenges, immunologic pitfalls, and infectious complications...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29505151/single-center-experience-with-the-use-of-teduglutide-in-adult-patients-with-short-bowel-syndrome
#12
Kwai Lam, Lauren Schwartz, Jennifer Batisti, Kishore R Iyer
BACKGROUND: Teduglutide is a glucagon-like peptide 2 (GLP-2) analog that has been approved for the treatment of adult short bowel syndrome (SBS)-associated intestinal failure (IF; SBS-IF). Teduglutide increases villus height and crypt depth in the small bowel mucosa, promoting nutrition absorption and enteral independence from parenteral nutrition (PN). We aim to report our single-center experience with teduglutide in adult patients with SBS to provide real-world context to its use. METHOD: We conducted a retrospective analysis on patients managed within our tertiary-level intestinal rehabilitation program to identify patients with SBS-IF treated with teduglutide from 2009-2015...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29505150/home-parenteral-nutrition-in-adult-patients-with-chronic-intestinal-failure-catheter-related-complications-over-4-decades-at-the-main-danish-tertiary-referral-center
#13
Christopher Filtenborg Brandt, Siri Tribler, Mark Hvistendahl, Rahim M Naimi, Per Brøbech, Michael Staun, Palle Bekker Jeppesen
BACKGROUND/AIMS: Catheter-related complications (CRCs) cause mortality and morbidity in patients dependent on parenteral support at home (HPN) due to intestinal failure (IF). This study describes the incidences of CRCs in an adult IF cohort over 40 years. It illustrates the evolution and consequences of CRCs, their association to demographic characteristics, and potential risk factors in an effort to provide the rationale for preventive precautions to the relevant patients with IF at risk...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29503733/clinicopathological-and-immunological-characteristics-and-outcome-of-concomitant-coeliac-disease-and-non-alcoholic-fatty-liver-disease-in-adults-a-large-prospective-longitudinal-study
#14
Sanaa Kamal, Khaled K Aldossari, Dhalia Ghoraba, Sara Mahmoud Abdelhakam, Amgad H Kamal, Mohamad Bedewi, Leila Nabegh, Khaled Bahnasy, Tamer Hafez
Objective: Concomitant non-alcoholic fatty liver disease (NAFLD) and coeliac disease (CD) have not been adequately studied. This study investigated the frequency of CD among NAFLD patients and the clinicopathological and immunological patterns and outcome of concomitant NAFLD and CD. Design: This prospective longitudinal study screened patients with NAFLD for CD (tissue transglutaminase antibodies (TTGA); anti-TTGA and antiendomysial antibodies (EMA)). Patients with concomitant NAFLD and CD and patients with either NAFLD or CD were enrolled and followed...
2018: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/29485752/development-of-consensus-on-models-of-care-in-adults-with-intestinal-failure-using-a-modified-delphi-approach
#15
Sharon Carey, Michelle Kalachov, Lynn Jones, Cherry Koh
BACKGROUND AND AIM: The aims of this study were to establish consensus on service delivery models for management of Type III intestinal failure (IF) and home parenteral nutrition (HPN) within the Australian health-care system and to identify barriers and enablers in moving towards this ideal model. METHODS: A modified Delphi methodology was utilized to survey experts working in Type III IF HPN. The panel comprised physicians, dietitians, nurses, and pharmacists from 18 of the 20 adult Type III IF HPN centres across Australia...
February 27, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29481379/impact-of-psychiatric-comorbidities-on-short-term-outcomes-following-intervention-for-lumbar-degenerative-disc-disease
#16
Piyush Kalakoti, Daniel M Sciubba, Andrew J Pugely, Matthew J McGirt, Kanika Sharma, Devi P Patra, Kevin Phan, Karthik Madhavan, Richard P Menger, Christina Notarianni, Bharat Guthikonda, Anil Nanda, Hai Sun
STUDY DESIGN: Retrospective, observational cohort study. OBJECTIVE: To investigate the impact of psychiatric diseases on short-term outcomes in patients undergoing fusion surgery for LDDD. SUMMARY OF BACKGROUND DATA: Limited literature exists on the prevalence and impact of psychiatric comorbidities on outcomes in patients undergoing surgery for lumbar degenerative disc disease (LDDD). METHODS: Adult patients (>18 years) registered in the Nationwide Inpatient Sample (NIS) database (2002-2011) and undergoing an elective spine fusion for LDDD that met inclusion criteria formed the study population...
February 23, 2018: Spine
https://www.readbyqxmd.com/read/29479440/liver-inclusive-intestinal-transplantation-results-in-decreased-alloimmune-mediated-rejection-but-increased-infection
#17
Guosheng Wu, Ruy J Cruz
Background and aims: A co-transplanted liver allograft has been thought to protect other organs from rejection-mediated injury; however, detailed analyses of co-transplanted liver on intestinal allograft outcomes have not been conducted to date. The aim of the study was to compare immune-mediated injury, causes of graft failure and clinical outcomes between recipients who underwent either a liver-inclusive intestinal transplant (LITx) or liver-exclusive intestinal transplant (LETx). Methods: Between May 2000 and May 2010, 212 adult patients undergoing LITx ( n  =76) and LETx ( n  =136) were included...
February 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29443401/pediatric-intestinal-failure-associated-liver-disease-challenges-in-identifying-clinically-relevant-biomarkers
#18
Kathleen M Gura, Andrew E Mulberg, Paul D Mitchell, John Yap, Clara Y Kim, Minjun Chen, Alexis Potemkin, Mark Puder
BACKGROUND: Intestinal failure-associated liver disease (IFALD) is complex and diagnosed by concurrent use of parenteral nutrition, clinical presentation, and alterations in hepatic biomarkers exclusive of other causes of liver disease. In comparison with individual measures, composite biomarkers may provide a more effective means for assessing disease progression and response to treatment than single parameters. Since IFALD is considered by some to be a type of drug-induced liver injury (DILI), those diagnostic criteria could potentially be used in this population...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29443394/catheter-related-bloodstream-infections-in-adults-receiving-home-parenteral-nutrition-substantial-differences-in-incidence-comparing-a-strict-microbiological-to-a-clinically-based-diagnosis
#19
Siri Tribler, Christopher F Brandt, Mark Hvistendahl, Michael Staun, Per Brøbech, Claus E Moser, Palle B Jeppesen
BACKGROUND: A common complication in patients receiving home parenteral nutrition (HPN) is catheter-related bloodstream infections (CRBSIs). The CRBSI incidence has been advocated as an outcome parameter assessing the quality of care. This study aimed to illustrate how the use of different CRBSI definitions affects the reported incidence. MATERIALS AND METHODS: In an observational study based on the Copenhagen intestinal failure database, all clinically reported CRBSIs from 2002-2013 were compared with data from the affiliated microbiological database according to recommended CRBSI criteria...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29436744/long-term-use-of-mixed-oil-lipid-emulsion-in-adult-home-parenteral-nutrition-patients-a-case-series
#20
Manpreet S Mundi, Megan T McMahon, Jennifer J Carnell, Ryan T Hurt
BACKGROUND: Despite providing significant benefits, home parenteral nutrition (HPN) can be associated with complications such as infections, intestinal failure-associated liver disease, and metabolic abnormalities. Soybean oil (SO)-based intravenous lipid emulsion (ILE) has been noted to contribute to some of these complications, leading to the development of alternative sources of ILE. Mixed-oil (MO) ILE has recently been approved for use in adults with short-term studies revealing a benefit over SO ILE...
February 13, 2018: Nutrition in Clinical Practice
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