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Parenteral nutrition in pancreatitis

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https://www.readbyqxmd.com/read/28273241/pancreatic-necrosis-and-gas-in-the-retroperitoneum-treatment-with-antibiotics-alone
#1
Roberto Rasslan, Fernando da Costa Ferreira Novo, Marcelo Cristiano Rocha, Alberto Bitran, Manoel de Souza Rocha, Celso de Oliveira Bernini, Samir Rasslan, Edivaldo Massazo Utiyama
OBJECTIVE: To present our experience in the management of patients with infected pancreatic necrosis without drainage. METHODS: The records of patients with pancreatic necrosis admitted to our facility from 2011 to 2015 were retrospectively reviewed. RESULTS: We identified 61 patients with pancreatic necrosis. Six patients with pancreatic necrosis and gas in the retroperitoneum were treated exclusively with clinical support without any type of drainage...
February 1, 2017: Clinics
https://www.readbyqxmd.com/read/28272344/nutritional-and-metabolic-derangements-in-pancreatic-cancer-and-pancreatic-resection
#2
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
https://www.readbyqxmd.com/read/28194286/central-venous-catheter-related-bloodstream-infection-with-kocuria-kristinae-in-a-patient-with-propionic-acidemia
#3
Masato Kimura, Eichiro Kawai, Hisao Yaoita, Natsuko Ichinoi, Osamu Sakamoto, Shigeo Kure
Kocuria kristinae is a catalase-positive, coagulase-negative, Gram-positive coccus found in the environment and in normal skin and mucosa in humans; however, it is rarely isolated from clinical specimens and is considered a nonpathogenic bacterium. We describe a case of catheter-related bacteremia due to K. kristinae in a young adult with propionic acidemia undergoing periodic hemodialysis. The patient had a central venous catheter implanted for total parenteral nutrition approximately 6 months prior to the onset of symptoms because of repeated acute pancreatitis...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#4
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
March 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28141617/nutritional-management-of-acute-pancreatitis
#5
Kumar Krishnan
PURPOSE OF REVIEW: Acute pancreatitis is one of the most common causes for hospitalization related to a gastrointestinal disorder. It carries significant morbidity, and when severe, significant mortality. Multiple interventions have been studied to treat pancreatitis. Of all these interventions, none is more important or impactful than nutrition. RECENT FINDINGS: High-quality evidence along with society guidelines have recommended the use of enteral nutrition over parenteral nutrition in patients with pancreatitis...
March 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28088773/epidemiology-and-outcome-of-acute-pancreatitis-in-end-stage-renal-disease-dialysis-patients-a-10-year-national-cohort-study
#6
Hung-Jui Chen, Jhi-Joung Wang, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Chih-Chiang Chien
BACKGROUND: The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. METHODS: We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27994337/management-of-graft-duodenal-leak-in-simultaneous-pancreas-kidney-transplant-a-case-report-from-india-and-review-of-literature
#7
REVIEW
Sunil Kumar, Sarbpreet Singh, Deepesh Benjamin Kenwar, Manish Rathi, Sanjay Bhadada, Ashish Sharma, Vikas Gupta, Anil Bhansali, Anupam Lal, Mukut Minz
Pancreatic transplantation is currently the only effective cure for Type 1 diabetes mellitus. It allows long-term glycemic control without exogenous insulin and amelioration of secondary diabetic complications. In India, pancreas transplant has not yet established with only a single successful transplant reported so far in the literature. We report a 24-year-old Type 1 diabetic patient with renal failure who underwent a simultaneous pancreas kidney transplant. On postoperative day 15, he had leak from the graft duodenal stump for which a tube duodenostomy and proximal diversion enterostomy was done...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27920476/self-expanding-metal-stents-for-the-palliation-of-malignant-gastric-outlet-obstruction-in-patients-with-peritoneal-carcinomatosis
#8
Christoph Rademacher, Matthias Bechtler, Steffen Schneider, Bettina Hartmann, Johannes Striegel, Ralf Jakobs
AIM: To evaluate the efficacy of self-expanding metal stents (SEMS) for the palliation of malignant gastric outlet obstruction in patients with and without peritoneal carcinomatosis (PC). METHODS: We performed a retrospective analysis of 62 patients who underwent SEMS placement for treatment of malignant gastroduodenal obstruction at our hospital over a six-year period. Stents were deployed through the scope under combined fluoroscopic and endoscopic guidance. Technical success was defined as successful stent placement and expansion...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27847836/obstructive-acute-pancreatitis-secondary-to-peg-tube-migration
#9
Douglas F Taylor, Ryan Cho, Allan Cho, Viet Nguyen, Abhijit Sunnapwar, Craig Womeldorph
Percutaneous gastrostomy is a well-established method of providing enteral nutrition to patients incapable of oral intake, or for whom oral intake is insufficient to meet metabolic needs. In comparison to total parenteral nutrition, enteral feeding is advantageous in that it helps maintain gut mucosal integrity, which decreases the risk of bacterial translocation through the gastrointestinal tract. Complications include bleeding, aspiration, internal organ injury, perforation, periostomal leaks, tube dislodgement, and occlusion...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27775778/the-role-of-glutamine-supplemented-total-parenteral-nutrition-tpn-in-severe-acute-pancreatitis
#10
X Liu, X F Sun, Q X Ge
OBJECTIVE: To evaluate the role of glutamine-supplemented total parenteral nutrition (TPN) in severe acute pancreatitis. PATIENTS AND METHODS: Forty-seven patients with severe acute pancreatitis were admitted to Huaihe Hospital, China, over a period of one year (July 2013 to June 2014) were randomly divided into two therapeutic groups. Patients in group 1 (24 patients in total) and group 2 (23 patient in total) were treated with glutamine-supplemented TPN and standard TPN respectively...
October 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27731565/mediastinal-pseudocyst-in-acute-on-chronic-pancreatitis
#11
Sushil Kumar Mishra, Pawan Kumar Jain, Sukhdev Gupta
Pseudocyst is a common complication of Acute and chronic pancreatitis. However, its extension into the mediastinum is a rare entity. We present a case of 52 years male with acute on chronic pancreatitis (alcohol related) who presented with dysphagia and dyspnoea and was found to have a pancreatic pseudocyst extending upto the neck. Ultrasound fails to pick up mediastinal pseudocysts and requires additional imaging modalities - CT and MRI. Management of Mediastinal pseudocyst depends upon underlying etiology, ductal anatomy, size of the pseudocyst, and availability of expertise...
March 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27692778/definition-and-classification-of-chyle-leak-after-pancreatic-operation-a-consensus-statement-by-the-international-study-group-on-pancreatic-surgery
#12
Marc G Besselink, L Bengt van Rijssen, Claudio Bassi, Christos Dervenis, Marco Montorsi, Mustapha Adham, Horacio J Asbun, Maximillian Bockhorn, Oliver Strobel, Markus W Büchler, Olivier R Busch, Richard M Charnley, Kevin C Conlon, Laureano Fernández-Cruz, Abe Fingerhut, Helmut Friess, Jakob R Izbicki, Keith D Lillemoe, John P Neoptolemos, Michael G Sarr, Shailesh V Shrikhande, Robert Sitarz, Charles M Vollmer, Charles J Yeo, Werner Hartwig, Christopher L Wolfgang, Dirk J Gouma
BACKGROUND: Recent literature suggests that chyle leak may complicate up to 10% of pancreatic resections. Treatment depends on its severity, which may include chylous ascites. No international consensus definition or grading system of chyle leak currently is available. METHODS: The International Study Group on Pancreatic Surgery, an international panel of pancreatic surgeons working in well-known, high-volume centers, reviewed the literature and worked together to establish a consensus on the definition and classification of chyle leak after pancreatic operation...
February 2017: Surgery
https://www.readbyqxmd.com/read/27528694/a-randomized-trial-on-the-efficacy-of-prophylactic-active-drainage-in-prevention-of-complications-after-pancreaticoduodenectomy
#13
H Jiang, N Liu, M Zhang, L Lu, R Dou, L Qu
BACKGROUND AND AIMS: This randomized controlled trial was conducted to examine whether prophylactic active drainage decreases morbidity associated with pancreati-coduodenectomy. MATERIAL AND METHODS: A prospective, randomized controlled trial was conducted between April 2010 and May 2015 when 160 consecutive patients following elective pancreaticoduodenectomy were randomized intraoperatively to either prophylactic active drainage group or conventional passive drainage group...
August 15, 2016: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/27442698/-intramural-duodenal-hematoma-and-acute-pancreatitis-as-a-complication-of-diagnostic-biopsy-of-a-duodenal-6-year-old-boy
#14
Elżbieta Krzesiek, Barbara Iwańczak, Urszula Zaleska-Dorobisz, Dariusz Patkowski
Hematoma duodenum is a very rare complication of diagnostic endoscopy of the upper gastrointestinal tract when biopsy of the duodenum is performed (average frequency is estimated as 1:1,250 biopsies). Most often, it affects children and young adults without any risk factors. Symptoms result from obstruction of the duodenum and compression of the adjacent structures. Conservative treatment, which consists of parenteral nutrition and aspiration of gastric contents until the absorption of hematoma and patency of the gastrointestinal tract returns, is preferred...
April 2016: Developmental Period Medicine
https://www.readbyqxmd.com/read/27435303/parenteral-fish-oil-and-liver-function-tests-in-hospitalized-adult-patients-receiving-parenteral-nutrition-a-propensity-score-matched-analysis
#15
J M Llop-Talaveron, M B Badia-Tahull, E Leiva-Badosa, J M Ramon-Torrel
BACKGROUND & AIMS: Intravenous fat emulsions are associated with liver disease and there is some evidence that the administration of intravenous fish oil (FO) may be useful in reversing it. The aim of our study was to assess whether there are differences in the changes of liver function tests (LFTs) in hospitalized adult patients with parenteral nutrition (PN) with FO and vegetal lipids vs patients without FO. The secondary aim was to study the relationship between impaired LFT and FO...
July 5, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27433811/safety-and-efficacy-of-teduglutide-gattex-in-patients-with-crohn-s-disease-and-need-for-parenteral-support-due-to-short-bowel-syndrome-associated-intestinal-failure
#16
Bharati Kochar, Millie D Long, Edward Shelton, Lorraine Young, Francis A Farraye, Vijay Yajnik, Hans Herfarth
BACKGROUND: Teduglutide is a GLP-2 analogue indicated for treatment of adults with short bowel syndrome (SBS). Because of the rarity of SBS, real-world safety or efficacy data are not available in patients with Crohn's disease (CD) and SBS treated with teduglutide. AIM: To evaluate teduglutide's safety and efficacy in CD patients with SBS. METHODS: We conducted a retrospective cohort study at 3 tertiary centers in the United States between 2012 and 2014...
July 18, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27429039/early-enteral-versus-total-parenteral-nutrition-in-patients-undergoing-pancreaticoduodenectomy-a-randomized-multicenter-controlled-trial-nutri-dpc
#17
Julie Perinel, Christophe Mariette, Bertrand Dousset, Igor Sielezneff, Alain Gainant, Jean-Yves Mabrut, Sylvie Bin-Dorel, Michel El Bechwaty, Dominique Delaunay, Lorraine Bernard, Alain Sauvanet, Marc Pocard, Emmanuel Buc, Mustapha Adham
OBJECTIVES: The aim of this study was to compare nasojejunal early enteral nutrition (NJEEN) with total parenteral nutrition (TPN), after pancreaticoduodenectomy (PD), in terms of postoperative complications. BACKGROUND: Current nutritional guidelines recommend the use of enteral over parenteral nutrition in patients undergoing gastrointestinal surgery. However, the NJEEN remains controversial in patients undergoing PD. METHODS: Multicenter, randomized, controlled trial was conducted between 2011 and 2014...
November 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27403414/nutrition-in-pancreatic-cancer-a-review
#18
REVIEW
Simone Gärtner, Janine Krüger, Ali A Aghdassi, Antje Steveling, Peter Simon, Markus M Lerch, Julia Mayerle
BACKGROUND: Pancreatic cancer is the fourth leading cause of cancer-related mortality in both genders. More than 80% of patients suffer from significant weight loss at diagnosis and over time develop severe cachexia. Early nutritional support is therefore essential. SUMMARY: This review evaluates the different nutritional therapies, such as enteral nutrition, parenteral nutrition and special nutritional supplements, on nutritional status, quality of life and survival...
May 2016: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/27314259/the-gut-in-trauma
#19
Jayshil J Patel, Martin D Rosenthal, Keith R Miller, Robert G Martindale
PURPOSE OF REVIEW: The purpose of this review is to describe established and emerging mechanisms of gut injury and dysfunction in trauma, describe emerging strategies to improve gut dysfunction, detail the effect of trauma on the gut microbiome, and describe the gut-brain connection in traumatic brain injury. RECENT FINDINGS: Newer data suggest intraluminal contents, pancreatic enzymes, and hepatobiliary factors disrupt the intestinal mucosal layer. These mechanisms serve to perpetuate the inflammatory response leading to multiple organ dysfunction syndrome (MODS)...
August 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27312764/novel-endovascular-technique-for-removal-of-adherent-picc
#20
Julie Le, Areg Grigorian, Samuel Chen, Isabella J Kuo, Roy M Fujitani, Nii-Kabu Kabutey
INTRODUCTION: Peripherally inserted central catheters (PICCs) are a popular alternative to central venous lines. PICCs can provide reliable long-term access for intravenous fluids, antibiotics and total parenteral nutrition. Multiple factors can contribute to difficult PICC removal including adherent fibrin and thrombus formation around the catheter. We discuss a novel endovascular retrieval technique to remove tightly adherent PICCs. CASE PRESENTATION: A 42-year-old male with history of chronic pancreatitis requiring intravenous pain medications, presented with right upper extremity single lumen PICC that could not be removed by standard techniques...
November 2, 2016: Journal of Vascular Access
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