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https://www.readbyqxmd.com/read/28538646/defining-the-ge-junction-in-trauma-epidemiology-and-management-of-a-challenging-injury
#1
Morgan Schellenberg, Kenji Inaba, James M Bardes, Daniel OʼBrien, Lydia Lam, Elizabeth Benjamin, Daniel Grabo, Demetrios Demetriades
INTRODUCTION: Injuries to the gastroesophageal (GE) junction are infrequently encountered because of the high mortality of associated injuries. Consequently, there is a paucity of literature on the patient demographics and treatment options. The aim of this study was to examine the epidemiology, surgical management, and outcomes of these rare injuries. METHODS: Patients presenting to LAC+USC Medical Center (01/2008-08/2016) with traumatic esophageal or gastric injury (ICD-9 and -10 codes) were extracted from the trauma registry...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28534331/-application-of-bowel-plication-combined-with-early-enteral-nutrition-in-the-enhanced-recovery-after-surgery-for-neonates-with-jejunal-atresia
#2
Huan Chen, Qiming Geng, Changgui Lu, Weiwei Jiang, Jie Zhang, Xiaofeng Lyu, Wei Li, Hongxing Li, Weibing Tang
OBJECTIVE: To evaluate the efficacy of bowel plication combined with early enteral nutrition (EEN) in the enhanced recovery after surgery(ERAS) of jejunal atresia (JA) neonates. METHODS: Between January 2005 and January 2014, 58 neonates with JA underwent surgical treatment in Children's Hospital of Nanjing Medical University. Their clinical data, including operation procedures, ages, birth weight, concomitant diseases, age at surgery, hospital stay, total parenteral nutrition (TPN), postoperative intestinal function recovery (the time to the first oral feeding and the time to oral feeding volume reaching 150 ml·kg(-1)·d(-1)), complications and reoperation, were retrospectively analyzed...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28531775/a-protocol-for-sustained-reduction-of-total-parenteral-nutrition-and-cost-savings-by-improvement-of-nutritional-care-in-hospitals
#3
Rian van Schaik, Kurt Van den Abeele, Glenn Melsens, Peter Schepens, Truus Lanssens, Bernadette Vlaemynck, Maria Devisch, Theo A Niewold
BACKGROUND AND AIMS: Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14)...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28515508/evaluating-sterility-of-single-dose-vials-on-an-automated-compounding-device
#4
Hannah M Hutchinson, Brian E Sayre, Terrence Prettyman, Erica King
Background: Current guidelines for sterile compounding require that single dose vials of pharmaceuticals must be discarded after 6 hours when accessed in an ISO Class 5 environment. At this time, no studies have evaluated the sterility of single dose vials at any time after opening. Objective: The purpose of this study is to evaluate the sterility of single dose vials attached to an automated compounding device for up to 24 hours and accessed and maintained within a cleanroom environment. Methods: This is a prospective, observational study evaluating the sterility of 32 pooled samples of manufactured single dose injectable drugs attached to an automated compounding device for up to 24 hours and maintained within an ISO Class 5 environment in an ISO Class 7 buffer area...
April 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28503510/a-case-report-of-the-nutrition-support-for-a-patient-with-hellp-syndrome
#5
Seo Eun Yeon, Sun Jung Kim, Ju Hee Kim, Hae-Yun Chung, Se Hee Na, Song Mi Lee
A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria...
April 2017: Clinical Nutrition Research
https://www.readbyqxmd.com/read/28499656/outcome-of-a-step-up-treatment-strategy-for-chyle-leakage-after-esophagectomy
#6
Teun J Weijs, Jelle P Ruurda, Maria E Broekhuizen, Tom C L Bracco Gartner, Richard van Hillegersberg
BACKGROUND: Thoracic chyle leakage is a major complication of esophagectomy. In this study our treatment strategy for chyle leakage was evaluated and its risk factors were identified. METHODS: According to the Esophagectomy Complications Consensus Group recommendations, chyle leakage was classified as follows: I, enteric dietary modifications; II, total parenteral nutrition (TPN); and III, interventional or surgical therapy. It was graded as A, less than 1,000 mL per day; or B, more than 1,000 mL per day...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28489215/negative-pressure-therapy-for-the-treatment-of-complex-wounds
#7
Renan Victor Kümpel Schmidt Lima, Pedro Soler Coltro, Jayme Adriano Farina
The objective of this study is to evaluate the effectiveness of negative pressure therapy (NPT) in the treatment of complex wounds, with emphasis on its mechanisms of action and main therapeutic indications. We searched the Pubmed / Medline database for articles published from 1997 to 2016, and selected the most relevant ones. The mechanisms of action of NPT involveboth physical effects, such as increased perfusion, control of edema and exudate, reduction of wound dimensions and bacterial clearance, and biological ones, such as the stimulation of granulation tissue formation, microdeformations and reduction of Inflammatory response...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28483165/variability-in-outcomes-after-gastroschisis-closure-across-u-s-children-s-hospitals
#8
Dani O Gonzalez, Jennifer N Cooper, Shawn D St Peter, Peter C Minneci, Katherine J Deans
BACKGROUND: In patients undergoing gastroschisis closure, the effects of timing of closure and patient and hospital-level characteristics on length of stay (LOS) and time to enteral autonomy are unknown. STUDY DESIGN: Using the Pediatric Health Information System, we compared neonates who underwent early (within 1day of birth) versus delayed (>1day after birth) gastroschisis closure from 2005 to 2013. We evaluated the relationship between time to closure and both LOS and days on total parenteral nutrition (TPN)...
April 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28474354/aggravated-nausea-and-vomiting-induced-by-fat-emulsion-for-hyperemesis-gravidarum-a-case-report
#9
B Zhao, M Li, C Ren, X Y Liu, D Mei
WHAT IS KNOWN AND OBJECTIVE: Total parental nutrition (TPN) for hyperemesis gravidarum (HG) is generally effective and well-tolerated. We report a case of aggravated nausea and vomiting caused by fat emulsion. CASE DESCRIPTION: A 40-year-old pregnant woman through IVF was admitted to the hospital at 11-week gestation and diagnosed with HG. During TPN treatment, the patient suffered from aggravated nausea and vomiting. We identified fat emulsion as the most likely culprit using challenge, dechallenge and rechallenge...
May 5, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28462383/interdependency-of-egf-and-glp-2-signaling-in-attenuating-mucosal-atrophy-in-a-mouse-model-of-parenteral-nutrition
#10
Yongjia Feng, Farok R Demehri, Weidong Xiao, Yu-Hwai Tsai, Jennifer C Jones, Constance D Brindley, David W Threadgill, Jens J Holst, Bolette Hartmann, Terrence A Barrett, Daniel H Teitelbaum, Peter J Dempsey
BACKGROUND & AIMS: Total parenteral nutrition (TPN), a crucial treatment for patients who cannot receive enteral nutrition, is associated with mucosal atrophy, barrier dysfunction, and infectious complications. Glucagon-like peptide-2 (GLP-2) and epidermal growth factor (EGF) improve intestinal epithelial cell (IEC) responses and attenuate mucosal atrophy in several TPN models. However, it remains unclear whether these 2 factors use distinct or overlapping signaling pathways to improve IEC responses...
May 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28447222/feeding-strategies-in-pediatric-cancer-patients-with-gastrointestinal-mucositis-a-multicenter-prospective-observational-study-and-international-survey
#11
Nicoline S S Kuiken, Edmond H H M Rings, Marry M van den Heuvel-Eibrink, Marianne D van de Wetering, Wim J E Tissing
INTRODUCTION: Currently, there is no adequate prevention or treatment for both oral and gastrointestinal mucositis induced by chemotherapy and/or radiotherapy. Supportive care of symptoms plays a primary role during mucositis in the pediatric clinical setting. We aimed to get insight in the currently used feeding strategies in clinical practice in pediatric cancer patients with chemotherapy-induced mucositis. METHODS: A prospective observational study was performed to identify feeding strategies after chemotherapy courses causing mucositis in almost all patients at the University Medical Center Groningen (UMCG), the Academic Medical Center Amsterdam (AMC), and the Princess Maxima Center Utrecht (PMC)...
April 26, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28405877/revision-roux-en-y-gastric-bypass-to-biliopancreatic-long-limb-gastric-bypass-for-inadequate-weight-response-case-series-and-analysis
#12
Henry Buchwald, Danette M Oien
BACKGROUND: The long-limb Roux-en-Y gastric bypass (LLRYGB) was introduced in 1987 as a salvage operation for inadequate weight loss after a standard Roux-en-Y gastric bypass (RYGB). METHODS: We report on 53 consecutive patients (44 females) with conversion of a failed RYGB to a LLRYGB performed by a single surgeon between 2002 and 2014. No patient had an ascertainable anatomic abnormality to explain his/her weight regain. LLRYGB revision consisted of a 75-cm to 100-cm alimentary Roux limb and a 75-cm to 100-cm common channel; after 2011, in suitable patients, the Roux limb was lengthened to greater than 250 cm...
April 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28390165/default-mode-and-task-positive-networks-connectivity-during-the-n-back-task-in-remitted-depressed-patients-with-or-without-emotional-residual-symptoms
#13
Pauline Delaveau, Tiago Arruda Sanchez, Ricardo Steffen, Karine Deschet, Maritza Jabourian, Vincent Perlbarg, Emerson Leandro Gasparetto, Stéphanie Dubal, Jorge Costa E Silva, Philippe Fossati
Clinical remission of depression may be associated with emotional residual symptoms. We studied the association of emotional blunting, rumination with neural networks dynamics in remitted depressed patients and cognitive performance during an N-Back task. Twenty-six outpatients in remission of depression (Hamilton Depressive rating scale score <7) performed an N-Back task during fMRI assessment. All patients had been treated by paroxetine for a minimum of 4 months. Two subgroups of patients [Nonemotionally blunted (NEB) = 14 and emotionally blunted (EB) = 12] were determined...
April 8, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28361844/new-mutations-of-epcam-gene-for-tufting-enteropathy-in-saudi-arabia
#14
Shaden AlMahamed, Abdelhai Hammo
BACKGROUND/AIM: Tufting enteropathy (TE) is a rare cause of congenital intractable diarrhea in children. It often results in an irreversible intestinal failure and total parenteral nutrition (TPN) dependency; eventually, intestinal transplantation may be necessary. Data on TE from the Middle East are scarce; therefore, our aim of conducting this study was to clarify the clinical, histopathologic, and molecular features of TE in Saudi children. PATIENTS AND METHODS: This was a retrospective chart review of four children with TE who presented between January 2011 and December 2013 to King Fahad Specialist Hospital-Dammam (KFSH-D)...
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28357482/immunoassay-quantification-of-human-insulin-added-to-ternary-parenteral-nutrition-containers-comparison-of-two-methods
#15
Héloïse Henry, Damien Lannoy, Nicolas Simon, David Seguy, Michèle D'Herbomez, Christine Barthélémy, Bertrand Décaudin, Thierry Dine, Pascal Odou
Adding insulin directly into infusion bags seems to be a useful method for controlling hyperglycemia in patients under ternary parenteral nutrition (TPN). Its efficacy is assessed by glycemic monitoring but few data are available on insulin stability in this situation. Among the various methods for quantifying insulin levels in human serum, the immunoassay ones seemed potentially appropriate for a TPN admixture containing high lipid concentrations. We sought to identify and validate which of two immunoassay methods was the better to quantify human insulin and consequently be adapted to studying its stability in a TPN admixture...
March 29, 2017: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/28353418/factors-associated-with-the-development-of-tertiary-peritonitis-in-critically-ill-patients
#16
Josep Ballus, Juan C Lopez-Delgado, Joan Sabater-Riera, Xose L Perez-Fernandez, Antoni J Betbese, Joan A Roncal
BACKGROUND: Critically ill surgical patients remain at a high risk of adverse outcomes as a result of secondary peritonitis (SP). The risk is even higher if tertiary peritonitis (TP) develops. Factors related to the development of TP, however, are scarce in the literature. The main aim of our study was to identify factors associated with the development of TP in patients with SP in the intensive care unit (ICU), and also to report differences in microbiologic patterns and antibiotic therapy in patients with the two conditions...
March 29, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28342580/evidence-based-management-of-chylothorax-in-infants
#17
Joseph T Church, Alexis G Antunez, Ashley Dean, Niki Matusko, Kristopher B Deatrick, Mohammad A Attar, Samir K Gadepalli
PURPOSE: Management guidelines for infants with chylothorax lack substantial evidence. We sought to identify variables that impact outcomes in these patients in order to develop an evidence-based management algorithm. METHODS: We retrospectively reviewed the medical records of all infants diagnosed with chylothorax from June 2005 to December 2014 at our institution. Data collected included demographics, chest tube output (CTO), medical and dietary interventions, surgical procedures, and absolute lymphocyte count (ALC)...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28332879/iodine-content-of-enteral-and-parenteral-nutrition-solutions
#18
Devina L Willard, Lorraine S Young, Xuemei He, Lewis E Braverman, Elizabeth N Pearce
BACKGROUND: Iodine is essential for thyroid hormone synthesis, and iodine deficiency may result in thyroid disorders including goiter and hypothyroidism. Patients on long-term enteral nutrition (EN) or parenteral nutrition (PN) may be at risk for micronutrient deficiencies. The recommended daily allowance for iodine intake is 150 μg for nonpregnant adults. However, there is no current consensus among scientific societies regarding the quantity of iodine to be added in adult EN and PN formulations...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28330584/central-line-associated-sepsis-in-children-receiving-parenteral-nutrition-in-oman
#19
Tawfiq T Al Lawati, Adawaiya Al Jamie, Nasra Al Mufarraji
Parenteral Nutrition (PN) is used when gut fails to provide complete nutrition. Central line Associate Blood Stream Infection (CLABSI) a major complication of this therapy. The objective of the study was to report the incidence of CLABSI and associated mortality in children receiving PN in the Royal Hospital and study the indication and duration of PN use. All children from the age of 0-48 months who received TPN outside NICU from the period between 1/1/2011 till 31/12/2014 were included. Data were retrieved from the hospital electronic data base...
March 16, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28272344/nutritional-and-metabolic-derangements-in-pancreatic-cancer-and-pancreatic-resection
#20
REVIEW
Taylor M Gilliland, Nicole Villafane-Ferriol, Kevin P Shah, Rohan M Shah, Hop S Tran Cao, Nader N Massarweh, Eric J Silberfein, Eugene A Choi, Cary Hsu, Amy L McElhany, Omar Barakat, William Fisher, George Van Buren
Pancreatic cancer is an aggressive malignancy with a poor prognosis. The disease and its treatment can cause significant nutritional impairments that often adversely impact patient quality of life (QOL). The pancreas has both exocrine and endocrine functions and, in the setting of cancer, both systems may be affected. Pancreatic exocrine insufficiency (PEI) manifests as weight loss and steatorrhea, while endocrine insufficiency may result in diabetes mellitus. Surgical resection, a central component of pancreatic cancer treatment, may induce or exacerbate these dysfunctions...
March 7, 2017: Nutrients
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