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Intestinal failure in adult

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https://www.readbyqxmd.com/read/29129242/intestinal-failure-as-a-significant-risk-factor-for-renal-impairment-in-children
#1
Elisa Ylinen, Laura Merras-Salmio, Riikka Gunnar, Timo Jahnukainen, Mikko P Pakarinen
OBJECTIVE: Although impaired renal function has been a frequent finding among adults with intestinal failure (IF), the data on children is scarce. The aim of this study was to assess renal function in pediatric-onset IF. METHODS: Medical records of 70 patients (38 boys) with pediatric-onset IF due to either short bowel syndrome (n = 59) or primary motility disorder (n = 11) and a history of parenteral nutrition (PN) dependency for ≥1 mo were evaluated. Renal function at the most recent follow-up was studied using plasma creatinine, cystatin C, and urea concentrations and estimated glomerular filtration rate (eGFR)...
January 2018: Nutrition
https://www.readbyqxmd.com/read/29126506/surgical-care-of-the-pediatric-crohn-s-disease-patient
#2
Dylan Stewart
Despite the significant advances in the medical management of inflammatory bowel disease over the last decade, surgery continues to play a major role in the management of pediatric Crohn's disease (CD). While adult and pediatric Crohn's disease may share many clinical characteristics, pediatric Crohn's patients often have a more aggressive phenotype, and the operative care given by the pediatric surgeon to the newly diagnosed Crohn's patient is very different in nature to the surgical needs of adult patients after decades of disease progression...
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29113094/pediatric-chronic-intestinal-failure-in-italy-report-from-the-2016-survey-on-behalf-of-italian-society-for-gastroenterology-hepatology-and-nutrition-sigenp
#3
Antonella Diamanti, Teresa Capriati, Paolo Gandullia, Grazia Di Leo, Antonella Lezo, Laura Lacitignola, Maria Immacolata Spagnuolo, Simona Gatti, Lorenzo D'Antiga, Giovanna Verlato, Paola Roggero, Sergio Amarri, Maria Elisabetta Baldassarre, Francesco Cirillo, Domenica Elia, Renata Boldrini, Angelo Campanozzi, Carlo Catassi, Marina Aloi, Claudio Romano, Manila Candusso, Nicola Cecchi, Tommaso Bellini, Elaine Tyndall, Fabio Fusaro, Tamara Caldaro, Daniele Alberti, Piergiorgio Gamba, Mario Lima, Pietro Bagolan, Jean De Ville de Goyet, Luigi Dall'Oglio, Marco Spada, Francesca Grandi
BACKGROUND: Intestinal failure (IF) is the reduction in functioning gut mass below the minimal level necessary for adequate digestion and absorption of nutrients and fluids for weight maintenance in adults or for growth in children. There is a paucity of epidemiologic data on pediatric IF. The purpose of this study was to determine the prevalence, incidence, regional distribution and underlying diagnosis of pediatric chronic IF (CIF) requiring home parenteral nutrition (HPN) in Italy...
November 5, 2017: Nutrients
https://www.readbyqxmd.com/read/29096949/effect-of-tight-control-management-on-crohn-s-disease-calm-a-multicentre-randomised-controlled-phase-3-trial
#4
Jean-Frederic Colombel, Remo Panaccione, Peter Bossuyt, Milan Lukas, Filip Baert, Tomas Vaňásek, Ahmet Danalioglu, Gottfried Novacek, Alessandro Armuzzi, Xavier Hébuterne, Simon Travis, Silvio Danese, Walter Reinisch, William J Sandborn, Paul Rutgeerts, Daniel Hommes, Stefan Schreiber, Ezequiel Neimark, Bidan Huang, Qian Zhou, Paloma Mendez, Joel Petersson, Kori Wallace, Anne M Robinson, Roopal B Thakkar, Geert D'Haens
BACKGROUND: Biomarkers of intestinal inflammation, such as faecal calprotectin and C-reactive protein, have been recommended for monitoring patients with Crohn's disease, but whether their use in treatment decisions improves outcomes is unknown. We aimed to compare endoscopic and clinical outcomes in patients with moderate to severe Crohn's disease who were managed with a tight control algorithm, using clinical symptoms and biomarkers, versus patients managed with a clinical management algorithm...
October 30, 2017: Lancet
https://www.readbyqxmd.com/read/29062711/strongyloides-hyperinfection-syndrome-causing-fatal-meningitis-and-septicemia-by-citrobacter-koseri
#5
Felix Reyes, Navneet Singh, Nigar Anjuman-Khurram, Jihae Lee, Lillian Chow
Citrobacter koseri is a gram-negative bacillius that belongs to the Enterobacteriaceae family. It is an uncommon pathogen that typically causes meningitis and brain abscesses in children, however central nervous system (CNS) infections are rarely found in adults. We present a case of C. koseri meningitis in an immunocompetent adult secondary to intestinal micro-perforation caused by Strongyloides A 76-year-old man admitted for asthma exacerbation developed septic shock. A lumbar puncture revealed bacterial meningitis...
2017: IDCases
https://www.readbyqxmd.com/read/29046259/assessing-the-impact-of-quality-improvement-measures-on-catheter-related-blood-stream-infections-and-catheter-salvage-experience-from-a-national-intestinal-failure-unit
#6
A Bond, A Teubner, M Taylor, C Cawley, A Abraham, M Dibb, P R Chadwick, M Soop, G Carlson, S Lal
BACKGROUND & AIMS: Prevention of catheter related blood stream infections (CRBSI) and salvage of infected central venous catheters (CVC) are vital to maintaining long term venous access in patients needing home parenteral nutrition (HPN). It remains unclear as to whether patients are best trained for catheter care at home or in hospital or whether CRBSIs are lower if the patient self-cares for the CVC. Furthermore, there is minimal data on the longer term outcome following salvage of infected catheter and limited consensus on agreed protocols for catheter salvage...
October 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28987256/liver-disease-in-patients-on-total-parenteral-nutrition
#7
REVIEW
Arnab Mitra, Joseph Ahn
Parenteral nutrition-associated liver disease (PNALD) spectrum ranges from liver enzyme abnormalities to steatosis to fibrosis, and, eventually, cirrhosis from total parenteral nutrition (TPN). The pathophysiology is postulated to be multifactorial. Diagnosis in adults is primarily by exclusion, eliminating other causes of chronic liver disease or cirrhosis, and other factors seen in critically ill or postoperative patients on TPN. Principal treatment is avoiding TPN. If this is not feasible, research supports fish oil-based lipid emulsions in TPN formulations to reduce risk and progression of PNALD...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28982740/phase-ii-evaluation-of-anti-madcam-antibody-pf-00547659-in-the-treatment-of-crohn-s-disease-report-of-the-opera-study
#8
William J Sandborn, Scott D Lee, Dino Tarabar, Edouard Louis, Maria Klopocka, Jochen Klaus, Walter Reinisch, Xavier Hébuterne, Dong-Il Park, Stefan Schreiber, Satyaprakash Nayak, Alaa Ahmad, Anindita Banerjee, Lisa S Brown, Fabio Cataldi, Kenneth J Gorelick, John B Cheng, Mina Hassan-Zahraee, Robert Clare, Geert R D'Haens
OBJECTIVE: This phase II, randomised, double-blind, placebo-controlled clinical trial was designed to evaluate the efficacy and safety of PF-00547659, a fully human monoclonal antibody that binds to human mucosal addressin cell adhesion molecule (MAdCAM) to selectively reduce lymphocyte homing to the intestinal tract, in patients with moderate-to-severe Crohn's disease (CD). DESIGN: Eligible adults were aged 18-75 years, with active moderate-to-severe CD (Crohn's Disease Activity Index (CDAI) 220-450), a history of failure or intolerance to antitumour necrosis factor and/or immunosuppressive agents, high-sensitivity C reactive protein >3...
October 5, 2017: Gut
https://www.readbyqxmd.com/read/28936879/parenteral-therapy-and-complications-in-patients-with-intestinal-failure-in-a-regional-unit
#9
Ruben Lorentsen, Lars Kristian Munck, Signe Wildt
OBJECTIVE: To describe a cohort of patients with intestinal failure (IF) and tunnelled catheters in a regional IF unit, treatment and catheter-related complication rates, and to compare the quality of care with previously published results from specialised IF centres in Denmark. METHODS: A retrospective chart review of an adult IF patient cohort receiving parenteral therapy through tunnelled catheters in a regional IF unit from 2005 to 2014. Demographics, indication, type and frequency of parenteral therapy, dwell time, cause of removal and complications were recorded...
September 22, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28934206/estimating-the-prevalence-and-intensity-of-schistosoma-mansoni-infection-among-rural-communities-in-western-tanzania-the-influence-of-sampling-strategy-and-statistical-approach
#10
Jared S Bakuza, Matthew J Denwood, Gamba Nkwengulila, Barbara K Mable
BACKGROUND: Schistosoma mansoni is a parasite of major public health importance in developing countries, where it causes a neglected tropical disease known as intestinal schistosomiasis. However, the distribution of the parasite within many endemic regions is currently unknown, which hinders effective control. The purpose of this study was to characterize the prevalence and intensity of infection of S. mansoni in a remote area of western Tanzania. METHODOLOGY/PRINCIPAL FINDINGS: Stool samples were collected from 192 children and 147 adults residing in Gombe National Park and four nearby villages...
September 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28876684/differences-in-microbiome-in-rat-models-of-cardiovascular-disease
#11
A Thiba, C A Umar, S Myende, E Nweke, K Rumbold, G Candy
BACKGROUND: Recent studies have underscored the important role the gut metagenome in various human diseases, including diabetes and obesity. Hypertension is a major risk factor for cardiovascular disease, stroke, and heart and kidney failure, and affects approximately 25% of the world's adult population. The cause of essential hypertension remains unknown. Patients given antibiotics show blood pressure changes and transfer of gut bacteria from hypertensive to normal WKY rats resulted in the latter developing hypertension...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28839904/uk-practice-in-the-prevention-of-central-venous-catheter-associated-thrombosis-in-adults-on-home-parenteral-nutrition
#12
L Macdougall, J Hanley, C Mountford, N P Thompson
BACKGROUND: Maintaining central access is imperative for the delivery of home parenteral nutrition (HPN) in those with intestinal failure. Methods to reduce central venous catheter infection are well recognised; however, the prevention of line thrombosis is less well studied. METHODS: This paper reviews the current evidence and reports a survey of current practice within the UK. Using an electronic survey, respondents were asked to detail their use of anticoagulation in different patient groups and the type of anticoagulation used...
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28839442/gut-barrier-failure-biomarkers-are-associated-with-poor-disease-outcome-in-patients-with-primary-sclerosing-cholangitis
#13
Tamas Tornai, Eszter Palyu, Zsuzsanna Vitalis, Istvan Tornai, David Tornai, Peter Antal-Szalmas, Gary L Norman, Zakera Shums, Gabor Veres, Antal Dezsofi, Gabriella Par, Alajos Par, Peter Orosz, Ferenc Szalay, Peter Laszlo Lakatos, Maria Papp
AIM: To assess the prevalence of a panel of serologic markers that reflect gut barrier dysfunction in a mixed cohort of pediatric and adult primary sclerosing cholangitis (PSC) patients. METHODS: Sera of 67 PSC patients [median age (range): 32 (5-79) years, concomitant IBD: 67% and cirrhosis: 20%] were assayed for the presence of antibodies against to F-actin (AAA IgA/IgG) and gliadin (AGA IgA/IgG)] and for serum level of intestinal fatty acid-binding protein (I-FABP) by ELISA...
August 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28792647/ultra-short-bowel-is-an-independent-risk-factor-for-liver-fibrosis-in-adults-with-home-parenteral-nutrition
#14
Dominique Cazals-Hatem, Lore Billiauws, Pierre-Emmanuel Rautou, Vanessa Bondjemah, Nicolas Poté, Olivier Corcos, Valérie Paradis, Francisca Joly
BACKGROUND & AIMS: Intestinal failure-associated liver disease is rare in adults and risk factors are unclear. The aim of this study was to determine risk factors of liver fibrosis in adults receiving home parenteral nutrition for intestinal failure and its impact on survival. METHODS: We retrospectively analysed patients with irreversible intestinal failure who underwent a liver biopsy between 2000 and 2013. Significant liver fibrosis was defined as ≥F2 according to NASH-CRN score...
August 9, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28768655/the-use-of-metabolic-balance-studies-in-the-objective-discrimination-between-intestinal-insufficiency-and-intestinal-failure
#15
COMPARATIVE STUDY
August P Prahm, Christopher F Brandt, Carsten Askov-Hansen, Per B Mortensen, Palle B Jeppesen
Background: In research settings that use metabolic balance studies (MBSs) of stable adult patients with short bowel syndrome, intestinal failure (IF) and dependence on parenteral support (PS) have been defined objectively as energy absorption <84% of calculated basal metabolic rate (BMR), wet weight (WW) absorption <23 g · kg body weight(-1) · d(-1), or both. Objective: This study aimed to explore and validate these borderlines in the clinical setting.Design: Intestinal absorption was measured from April 2003 to March 2015 in 175 consecutive patients with intestinal insufficiency (INS) in 96-h MBSs...
September 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28758360/essential-roles-of-thyroid-hormone-regulated-hyaluronan-cd44-signaling-in-adult-stem-cell-development-during-xenopus-laevis-intestinal-remodeling
#16
Takashi Hasebe, Kenta Fujimoto, Mitsuko Kajita, Atsuko Ishizuya-Oka
In the amphibian intestine during metamorphosis, thyroid hormone (TH) induces some larval epithelial cells to dedifferentiate into stem cells, which generate the adult epithelium analogous to the mammalian intestinal epithelium. We have previously shown that the canonical Wnt signaling pathway is involved in adult epithelial development in the Xenopus laevis intestine. To understand the function of this pathway more precisely, we here focused on CD44, a major Wnt target, which has been identified as a TH response gene in the X...
July 31, 2017: Stem Cells
https://www.readbyqxmd.com/read/28750860/impaired-barrier-function-and-autoantibody-generation-in-malnutrition-enteropathy-in-zambia
#17
Beatrice Amadi, Ellen Besa, Kanekwa Zyambo, Patrick Kaonga, John Louis-Auguste, Kanta Chandwe, Phillip I Tarr, Donna M Denno, James P Nataro, William Faubion, Anne Sailer, Sunil Yeruva, Tricia Brantner, Joseph Murray, Andrew J Prendergast, Jerrold R Turner, Paul Kelly
Intestinal damage in malnutrition constitutes a threat to the survival of many thousands of children globally. We studied children in Lusaka, Zambia, with severe acute malnutrition (SAM) and persistent diarrhea using endoscopy, biopsy and analysis of markers and protective proteins in blood and intestinal secretions. We carried out parallel investigations in apparently healthy adults, and analyzed biomarkers only in apparently healthy children. Villus height and crypt depth did not differ in children with SAM and adult controls, but epithelial surface was reduced in children with SAM (median 445, interquartile range (IQR) 388, 562μm per 100μm muscularis mucosae) compared to adults (578, IQR 465,709; P=0...
August 2017: EBioMedicine
https://www.readbyqxmd.com/read/28729836/an-overview-of-herbal-products-and-secondary-metabolites-used-for-management-of-type-two-diabetes
#18
REVIEW
Ajda Ota, Nataša P Ulrih
Diabetes mellitus is a common effect of uncontrolled high blood sugar and it is associated with long-term damage, dysfunction, and failure of various organs. In the adult population, the global prevalence of diabetes has nearly doubled since 1980. Without effective prevention and management programs, the continuing significant rise in diabetes will have grave consequences on the health and lifespan of the world population, and also on the world economy. Supplements can be used to correct nutritional deficiencies or to maintain an adequate intake of certain nutrients...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28701261/five-year-survival-and-causes-of-death-in-patients-on-home-parenteral-nutrition-for-severe-chronic-and-benign-intestinal-failure
#19
Francisca Joly, Janet Baxter, Michael Staun, Darlene G Kelly, Yi Lisa Hwa, Olivier Corcos, Antonella De Francesco, Federica Agostini, Stanislaw Klek, Lidia Santarpia, Franco Contaldo, Cora Jonker, Geert Wanten, Luisa Chicharro, Rosa Burgos, Andre Van Gossum, Cristina Cuerda, Nuria Virgili, Loris Pironi
BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions and underlying disease are known predictors of HPN dependency and overall survival. Although the cause of death on HPN is mostly related to underlying disease in these patients, the relationship between mortality and duration of HPN use remains unclear...
June 19, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28686309/absence-of-calcitriol-causes-increased-lactational-bone-loss-and-lower-milk-calcium-but-does-not-impair-post-lactation-bone-recovery-in-cyp27b1-null-mice
#20
Brittany R Gillies, Brittany A Ryan, Brett A Tonkin, Ingrid J Poulton, Yue Ma, Beth J Kirby, René St-Arnaud, Natalie A Sims, Christopher S Kovacs
We hypothesized that adaptation to calcium supply demands of pregnancy and lactation do not require calcitriol. Adult Cyp27b1 null mice lack calcitriol and have hypocalcemia, hypophosphatemia, and rickets. We studied wild-type (WT) and null sister pairs raised on a calcium-, phosphorus-, and lactose-enriched "rescue" diet that prevents hypocalcemia and rickets. Bone mineral content (BMC) increased >30% in pregnant nulls, declined 30% during lactation, and increased 30% by 4 weeks post-weaning. WT showed less marked changes...
July 7, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
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