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https://www.readbyqxmd.com/read/28622737/a-mnemonic-for-pharmacists-to-ensure-optimal-monitoring-and-safety-of-total-parenteral-nutrition-i-am-full
#1
Chris J Bohl, Ann Parks
OBJECTIVE: To present a guideline-derived mnemonic that provides a systematic monitoring process to increase pharmacists' confidence in total parenteral nutrition (TPN) monitoring and improve safety and efficacy of TPN use. DATA SOURCES: The American Society for Parenteral and Enteral Nutrition (ASPEN) guidelines were reviewed. Additional resources included a literature search of PubMed (1980 to May 2016) using the search terms: total parenteral nutrition, mnemonic, indications, allergy, macronutrients, micronutrients, fluid, comorbidities, labs, peripheral line, and central line...
July 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28622477/an-examination-of-factors-affecting-the-length-of-stay-in-a-palliative-care-center
#2
Metin Dincer, Kadriye Kahveci, Cihan Doger
BACKGROUND: With the increase in elderly population, life-threatening chronic diseases are increasing, simultaneously increasing the need for palliative care centers (PCCs). OBJECTIVES: To evaluate the factors affecting the length of stay (LOS) and discharge of patients from a PCC. METHODS: A retrospective scan was made of the records of patients followed up in the PCC between January 2013 and March 2016. A record was made of patient age, gender, diagnosis, conditions/comorbidities, Glasgow Coma Scale, Karnofsky Performance Scale, LOS, prognosis (exitus or surviving), percutaneous endoscopic gastrostomy (PEG), tracheostomy, mechanical ventilator, nutrition (total parenteral nutrition [TPN] or enteral nutrition), and the results of cultures taken during stay in PCCs (blood, tracheal aspirate, urine, rectal swab, wound)...
June 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28620494/endemic-goitre-and-hypothyroidism-in-an-adult-female-patient-dependent-on-total-parenteral-nutrition
#3
S Pearson, C Donnellan, L Turner, E Noble, K Seejore, R D Murray
We present the case of a thirty-year-old female patient who was referred to the endocrinology team with an enlarging goitre and biochemical hypothyroidism. She had been dependent on total parenteral nutrition for the previous six years as a result of intestinal failure thought to be caused by possible underlying mitochondrial disease. The patient also suffers from a Desmin myopathy, and at present, the exact aetiology behind her intestinal failure is not certain. The goitre was smooth and had been enlarging slowly over the previous few months...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28606477/n-3-polyunsaturated-fatty-acid-enriched-lipid-emulsion-improves-paneth-cell-function-via-the-il-22-stat3-pathway-in-a-mouse-model-of-total-parenteral-nutrition
#4
Jiwei Wang, Feng Tian, Huijun Zheng, Hao Tian, Peng Wang, Li Zhang, Xuejin Gao, Xinying Wang
Total parenteral nutrition (TPN) is a life-saving therapy for patients with gastrointestinal dysfunction or failure. Long-term TPN impairs gut barrier function and contributes to infections and poor clinical outcomes. However, the underlying mechanisms of TPN-related gut barrier damage has not been fully elucidated, and effective measures are still rare. Here, we compared the effects of a predominantly n-6 polyunsaturated fatty acids emulsion (PUFAs; Intralipid) and a lipid emulsion containing n-3 PUFAs (Intralipid plus Omegaven) on antimicrobial peptides produced by Paneth cells...
June 9, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28586591/celiac-crisis-a-rare-or-rarely-recognized-disease
#5
Nadia Waheed, Huma Arshad Cheema, Hassan Suleman, Zafar Fayyaz, Iqra Mushtaq, Muhammad, Almas Hashmi
OBJECTIVE: Celiac crisis is a serious life threatening complication of celiac disease characterized by profuse diarrhoea, severe dehydration and metabolic disturbances leading to neuromuscular weakness, cardiac arrhythmias and sudden death. It has been described as rare condition and not well documented in the literature. To improve awareness and facilitate diagnosis of this condition, we studied risk factors, pattern of presentation and management plans of celiac crisis. METHODS: It was a descriptive cross sectional study...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28583886/risk-factors-and-clinical-outcomes-for-carbapenem-resistant-gram-negative-late-onset-sepsis-in-a-neonatal-intensive-care-unit
#6
Islam Nour, Heba Elsayed Eldegla, Nehad Nasef, Basma Shouman, Hesham Abdel-Hady, Abd Elazeez Shabaan
BACKGROUND: Gram-negative (GN), carbapenem-resistant (CR), late-onset sepsis (LOS) is a serious threat in the Neonatal Intensive Care Unit (NICU). OBJECTIVE: To assess the prevalence of CR-GN-LOS in NICU patients and to identify the risk factors and outcomes associated with its acquisition. METHODS: Neonates with carbapenem-sensitive (CS)-GN-LOS were compared with those with CR-GN-LOS in a 2-year observational study. RESULTS: A total of 158 patients had GN-LOS; 100 infants had CS-GN-LOS and 58 infants had CR-GN-LOS...
June 2, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28559783/long-term-results-of-serial-transverse-enteroplasty-with-neovalve-creation-for-extreme-short-bowel-syndrome-report-of-two-cases
#7
REVIEW
Mireia Botey, Antonio Alastrué, Henrik Haetta, Jaume Fernández-Llamazares, Arantxa Clavell, Pau Moreno
OBJECTIVE: The aim of this article was to determine whether serial transverse enteroplasty (STEP) and the creation of a new ileocecal valve in extreme short bowel syndrome (SBS) cases (<45 cm) is effective in intestinal adaptation and improvement of nutritional parameters and serum citrulline levels. PATIENTS AND METHODS: We present 2 cases of SBS treated with STEP. Enterectomy was performed for massive intestinal ischemia secondary to a gastrointestinal stromal tumor in the first case and to catastrophic antiphospholipid syndrome in the second...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28553630/choice-of-allograft-in-patients-requiring-intestinal-transplantation-a-critical-review
#8
REVIEW
Genevieve Huard, Thomas Schiano, Jang Moon, Kishore Iyer
Intestinal transplantation (ITx) is indicated in patients with irreversible intestinal failure (IF) and life-threatening complications related to total parenteral nutrition (TPN). ITx can be classified into three main types. Isolated intestinal transplantation (IITx), that is, transplantation of the jejunoileum, is indicated in patients with preserved liver function. Combined liver-intestine transplantation (L-ITx), that is, transplantation of the liver and the jejunoileum, is indicated in patients with liver failure related to TPN...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28538646/defining-the-ge-junction-in-trauma-epidemiology-and-management-of-a-challenging-injury
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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