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Enteral nutrition in pancreatitis

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https://www.readbyqxmd.com/read/29019560/pancreatoduodenectomy-brazilian-practice-patterns
#1
Orlando Jorge M Torres, Eduardo de Souza M Fernandes, Rodrigo Rodrigues Vasques, Fabio Luís Waechter, Paulo Cezar G Amaral, Marcelo Bruno de Rezende, Roland Montenegro Costa, André Luís Montagnini
BACKGROUND: Pancreatoduodenectomy is a technically challenging surgical procedure with an incidence of postoperative complications ranging from 30% to 61%. The procedure requires a high level of experience, and to minimize surgery-related complications and mortality, a high-quality standard surgery is imperative. AIM: To understand the Brazilian practice patterns for pancreatoduodenectomy. METHOD: A questionnaire was designed to obtain an overview of the surgical practice in pancreatic cancer, specific training, and experience in pancreatoduodenectomy...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28906293/frequency-and-variables-associated-with-fasting-orders-in-inpatients-with-ulcerative-colitis-the-audit-of-diet-orders-ulcerative-colitis-adore-uc-study
#2
Zane R Gallinger, Amir Rumman, Kevin Pivovarov, Kyle J Fortinsky, A Hillary Steinhart, Adam V Weizman
INTRODUCTION: Current clinical practice guidelines suggest that patients with ulcerative colitis (UC) hospitalized because of a disease flare should be offered a normal diet, unless such a diet is not tolerated. Studies of hospitalized patients have demonstrated iatrogenic malnutrition from unjustified or inappropriate nil per os (NPO) or clear liquid diet (CLD) orders. In this study, we aim to characterize the burden of this problem in hospitalized patients with UC. METHODS: We conducted a retrospective cohort study of all patients with UC admitted to the gastroenterology service or the general internal medicine service at a tertiary, academic hospital between January 2009 and December 2014, with a length of stay between 2 and 30 days...
October 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28901335/enteral-versus-parenteral-nutrition-in-critically-ill-patients-with-severe-pancreatitis-a-meta-analysis
#3
REVIEW
H Yao, C He, L Deng, G Liao
Whether enteral nutrition (EN) is superior to parenteral nutrition (PN) in critically ill patients with severe acute pancreatitis remains unknown. The objective of this meta-analysis was to assess the effects of EN versus PN on clinical outcomes in a subgroup of pancreatitis patients. Relevant randomized controlled trials (RCTs) were searched in Scopus, PubMed and Web of Science from inception to August 2016. Ultimately, five RCTs including 348 patients were enrolled in this analysis. Compared with PN, EN was associated with a significant reduction in overall mortality (risk ratio (RR)=0...
September 13, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28870388/the-optimal-timing-of-enteral-nutrition-and-its-effect-on-the-prognosis-of-acute-pancreatitis-a-propensity-score-matched-cohort-study
#4
Meng Jin, Huimin Zhang, Bo Lu, Yi Li, Dong Wu, Jiaming Qian, Hong Yang
BACKGROUND: Early enteral nutrition (EN) can improve the prognosis of acute pancreatitis (AP), but the optimal initiation time is unknown. In this study, the optimal time of early EN was analyzed to disclose the application of early EN in AP. METHODS: Data of 104 patients with AP were prospectively collected. With secondary infection (infected pancreatic necrosis and extrapancreatic infection) as the primary outcome variable, receiver operating characteristic (ROC) curve was used to calculate the optimal cut-off time of early EN...
September 1, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28837512/the-management-of-acute-pancreatitis-in-the-pediatric-population-a-clinical-report-from-the-naspghan-pancreas-committee
#5
Maisam Abu-El-Haija, Soma Kumar, J Antonio Quiros, Keshawadhana Balakrishnan, Bradley Barth, Samuel Bitton, John F Eisses, Elsie Jazmin Foglio, Victor Fox, Denease Francis, A Jay Freeman, Tanja Gonska, Amit S Grover, Sohail Z Husain, Rakesh Kumar, Sameer Lapsia, Tom Lin, Quin Y Liu, Asim Maqbool, Zachary M Sellers, Flora Szabo, Aliye Uc, Steven L Werlin, Veronique D Morinville
BACKGROUND: While the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS: The NASPGHAN Pancreas committee performed a MEDLINE review using several pre-selected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed...
August 23, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28727476/options-for-addressing-exocrine-pancreatic-insufficiency-in-patients-receiving-enteral-nutrition-supplementation
#6
Steven D Freedman
Patients with exocrine pancreatic insufficiency (EPI) have suboptimal secretion of pancreatic digestive enzymes and experience a range of clinical symptoms related to the malabsorption of fat. In patients with EPI unable to meet their nutritional requirements, enteral nutrition (EN) support is used to augment nutritional status. In addition to protein and carbohydrate, EN formulas contain fats as a calorie source, as well as vitamins and minerals to help prevent nutritional deficiencies related to malabsorption...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28727475/guidance-for-supplemental-enteral-nutrition-across-patient-populations
#7
Douglas L Nguyen
Enteral nutrition is preferred over parenteral nutrition as a result of the greater safety of enteral nutrition therapy and comparative convenience. A wide variety of enteral nutrition products have been developed, including disease-specific products to help manage the nutritional needs of patients with kidney failure, liver failure, lung disease, diabetes, and other conditions. An assessment of each patient's nutritional needs and digestive function should be conducted prior to initiation of enteral nutrition therapy...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28713382/recent-advances-on-nutrition-in-treatment-of-acute-pancreatitis
#8
REVIEW
Li-Long Pan, Jiahong Li, Muhammad Shamoon, Madhav Bhatia, Jia Sun
Acute pancreatitis (AP) is a common abdominal acute inflammatory disorder and the leading cause of hospital admission for gastrointestinal disorders in many countries. Clinical manifestations of AP vary from self-limiting local inflammation to devastating systemic pathological conditions causing significant morbidity and mortality. To date, despite extensive efforts in translating promising experimental therapeutic targets in clinical trials, disease-specific effective remedy remains obscure, and supportive care has still been the primary treatment for this disease...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28678307/effect-of-early-enteral-nutrition-en-on-endotoxin-in-serum-and-intestinal-permeability-in-patients-with-severe-acute-pancreatitis
#9
Q-X Shen, G-X Xu, M-H Shen
OBJECTIVE: This work aimed at studying the effect of early enteral nutrition (EN) on serum endotoxin and intestinal permeability in patients with severe acute pancreatitis. PATIENTS AND METHODS: 70 cases of patients with severe acute pancreatitis were cured in our hospital from April 2015 to January 2016. Patients selected were randomly divided into two groups including a group of patients having parenteral nutrition (group PN) and that had enteral nutrition (group EN)...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28676052/comparison-of-different-feeding-regimes-after-pancreatoduodenectomy-a-retrospective-cohort-analysis
#10
Théophile Guilbaud, David Jérémie Birnbaum, Sandrine Loubière, Julien Bonnet, Sophie Chopinet, Emilie Grégoire, Stéphane Berdah, Jean Hardwigsen, Vincent Moutardier
BACKGROUND: Delayed gastric emptying (DGE) is the most frequent pancreatic specific complication (PSC) after pancreaticoduodenectomy (PD). Several gastric decompression systems exist to manage DGE. Patients with a pancreatic tumor require prolonged nutrition; however, controversies exist concerning nutrition protocol after PD. The aim of the study was to assess the safety and efficacy of nasogastric (NG), gastrostomy (GT), and gastrojejunostomy (GJ) tubes with different feeding systems on postoperative courses...
July 4, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28576773/distinct-roles-for-the-mtor-pathway-in-postnatal-morphogenesis-maturation-and-function-of-pancreatic-islets
#11
Katie L Sinagoga, William J Stone, Jacqueline V Schiesser, Jamie I Schweitzer, Leesa Sampson, Yi Zheng, James M Wells
While much is known about the molecular pathways that regulate embryonic development and adult homeostasis of the endocrine pancreas, little is known about what regulates early postnatal development and maturation of islets. Given that birth marks the first exposure to enteral nutrition, we investigated how nutrient-regulated signaling pathways influence postnatal islet development in mice. We performed loss-of-function studies of mechanistic target of rapamycin (mTOR), a highly conserved kinase within a nutrient-sensing pathway known to regulate cellular growth, morphogenesis and metabolism...
July 1, 2017: Development
https://www.readbyqxmd.com/read/28540837/enterovesical-fistula-after-enteric-conversion-of-a-bladder-drained-pancreatic-allograft-a-case-report
#12
Clifford Akateh, Amer Rajab, Mitchell Henry, Ashraf El-Hinnawi
Since the inception of pancreas transplant as a treatment for type 1 diabetes mellitus, there has been considerable debate about the best way to manage exocrine secretions and monitor patients for graft rejection. For patients who undergo bladder exocrine drainage of a pancreatic allograft, a bladder-to-enteric drainage conversion can serve as a rescue procedure in case of anastomotic leaks or other complications. However, this procedure is associated with its own complications, including a rarely described enterovesical fistula...
May 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28522901/transition-of-early-phase-treatment-for-acute-pancreatitis-an-analysis-of-nationwide-epidemiological-survey
#13
EDITORIAL
Shin Hamada, Atsushi Masamune, Tooru Shimosegawa
Treatment of acute pancreatitis (AP) is one of the critical challenges to the field of gastroenterology because of its high mortality rate and high medical costs associated with the treatment of severe cases. Early-phase treatments for AP have been optimized in Japan, and clinical guidelines have been provided. However, changes in early-phase treatments and the relationship between treatment strategy and clinical outcome remain unclear. Retrospective analysis of nationwide epidemiological data shows that time for AP diagnosis has shortened, and the amount of initial fluid resuscitation has increased over time, indicating the compliance with guidelines...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28510290/retrospective-evaluation-of-the-impact-of-early-enteral-nutrition-on-clinical-outcomes-in-dogs-with-pancreatitis-34-cases-2010-2013
#14
Jessica P Harris, Nolie K Parnell, Emily H Griffith, Korinn E Saker
OBJECTIVE: To evaluate the effect of early enteral nutritional therapy on time to return to voluntary intake, maximum food consumption, incidence of gastrointestinal intolerance (GI), and total hospitalization time for dogs with acute pancreatitis. DESIGN AND SETTING: Retrospective analysis of dogs with pancreatitis at a veterinary teaching hospital between 2010 and 2013. ANIMALS: Thirty-four client-owned dogs diagnosed with acute or acute-on-chronic pancreatitis...
July 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28487729/severity-treatment-and-outcome-of-acute-pancreatitis-in-thailand-the-first-comprehensive-review-using-revised-atlanta-classification
#15
Supot Pongprasobchai, Peeradon Vibhatavata, Piyaporn Apisarnthanarak
Background. Severity and outcome of acute pancreatitis (AP) in Thailand are unknown. Methods. A retrospective study of 250 patients with AP during 2011-2014 was performed. Severity, treatment, and outcome were evaluated. Severity was classified by revised Atlanta classification. Results. The mean age was 58 years and 56% were men. Etiologies were gallstones (45%), alcohol (16%), postendoscopic retrograde cholangiopancreatography (14%), and idiopathic (15%). Overall, 72%, 16%, and 12% of patients had mild, moderately severe, and severe AP, respectively...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28348985/current-concepts-in-the-management-of-acute-pancreatitis
#16
REVIEW
Gautham Srinivasan, L Venkatakrishnan, Swaminathan Sambandam, Gursharan Singh, Maninder Kaur, Krishnaveni Janarthan, B Joseph John
Guidelines for the management of acute pancreatitis (AP) are based on the Western experience, which may be difficult to extrapolate in India due to socioeconomic constraints. Hence, modifications based on the available resources and referral patterns should be introduced so as to ensure appropriate care. We reviewed the current literature on the management of AP available in English on Medline and proposed guidelines locally applicable. Patients of AP presenting with systemic inflammatory response syndrome are at risk of moderate-severe pancreatitis and hence, should be referred to a tertiary center early...
October 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28341116/management-and-outcomes-of-acute-pancreatitis-patients-over-the-last-decade-a-us-tertiary-center-experience
#17
Efstratios Koutroumpakis, Adam Slivka, Alessandro Furlan, Anil K Dasyam, Anwar Dudekula, Julia B Greer, David C Whitcomb, Dhiraj Yadav, Georgios I Papachristou
BACKGROUND/OBJECTIVES: Acute pancreatitis (AP) management remains largely supportive and can be challenging in patients with severe disease. This study aims to describe a ten-year US tertiary-center experience in managing AP patients. METHODS: Clinical management and outcomes of 400 prospectively enrolled AP patients stratified by the Revised Atlanta Classification were analyzed; trends in management between early (2004-2008) and late enrollment phase (2009-2014) were assessed...
January 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28289881/modified-biliary-enteric-anastomosis-for-congenital-choledochal-cyst-clinical-and-prognostic-analysis-of-91-cases
#18
Ji Chen, Bin Jiang, Jun Yi, Lei Huang, Xinmin Si
PURPOSE: To report our experience with a modified biliary-enteric anastomosis procedure for the surgical treatment of congenital choledochal cysts. METHODS: Between January 2009 and December 2013, 91 children (19 boys, 72 girls; ages, 6-145 months) with congenital choledochal cysts were treated with our modified surgical procedure in our hospital. Of these patients, 69 had type I cysts, and 22 had type IV B cysts. The main parameters analyzed mainly included the operative time, duration of bowel recovery, resumption of diet, postoperative hospital stay, liver-function tests, postoperative complications, and prognosis...
June 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28272344/nutritional-and-metabolic-derangements-in-pancreatic-cancer-and-pancreatic-resection
#19
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/28262916/vitamin-e-supplementation-in-people-with-cystic-fibrosis
#20
REVIEW
Peter O Okebukola, Sonal Kansra, Joanne Barrett
BACKGROUND: People with cystic fibrosis are at an increased risk of fat-soluble vitamin deficiency including vitamin E. Vitamin E deficiency can cause a host of conditions such as haemolytic anaemia, cerebellar ataxia and cognitive difficulties. Vitamin E supplementation is widely recommended in cystic fibrosis and aims to ameliorate this deficiency. This is an updated version of the review. OBJECTIVES: To determine the effects of any level of vitamin E supplementation on the frequency of vitamin E deficiency disorders in people with cystic fibrosis...
March 6, 2017: Cochrane Database of Systematic Reviews
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