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Intestinal failure

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https://www.readbyqxmd.com/read/28813225/pediatric-intestinal-failure
#1
Christopher P Duggan, Tom Jaksic
New England Journal of Medicine, Volume 377, Issue 7, Page 666-675, August 2017.
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28808520/gallstone-ileus-dilemma-in-the-management
#2
Girish D Bakhshi, Rajesh G Chincholkar, Jasmine R Agarwal, Madhukar R Gupta, Prachiti S Gokhe, Amogh R Nadkarni
Gallstone ileus is a mechanical intestinal obstruction caused due to impaction of a large gallstone within the bowel. The ideal treatment of gallstone ileus remains controversial, with the main dilemma being between a one-stage and a two-stage surgical procedure. A 69-year old male patient presented with gallstone ileus. A one-stage procedure with enterolithotomy and primary closure of duodenal fistula was done. His immediate postoperative recovery was uneventful, but after 3 weeks of surgery, he developed respiratory complications and expired of multi-organ failure...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28805088/the-current-therapeutic-options-for-crohn-s-disease-from-medical-therapy-to-intestinal-transplantation
#3
Augusto Lauro, Francesco D'Amico, Gabriel Gondolesi
Crohn's disease (CD) has an annual incidence per 100.000 person-year of 20.2 in North America and 12.7 in Europe, and the purpose of this review is to evaluate its medical management, from diagnosis to transplant. Pharmacologic manipulation with nutritional care aims to achieve and maintain remission, but more than half of patients will undergo an intestinal resection, very often repeated over time. They could experience short bowel syndrome (SBS) requiring total parenteral nutrition (TPN). Intestinal transplantation (ITx) represents an alternative in case of irreversible intestinal failure (IF) with life-threatening TPN complications...
August 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28804659/fatal-systemic-vasoconstriction-in-a-case-of-metastatic-small-intestinal-net
#4
Stenzel Jochen, Noe Sebastian, Holzapfel Konstantin, Erlmeier Franziska, Eyer Florian
An increased release of serotonin secreted by ileal NETs is thought to be the major factor causing the carcinoid syndrome. However, in acutely arising carcinoid crisis also other vasoactive factors may lead to hazardous fluctuations in blood pressure and bronchial constriction. In rare cases, systemic vasoconstriction can be observed, probably caused by catecholamines or similar acting substances. Here, we report a fatal case of fulminant systemic vasoconstriction possibly caused by catecholamines in a patient with metastasized ileal NET...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28803860/intestinal-permeability-changes-systemic-endotoxemia-inflammatory-serum-markers-and-sepsis-after-whipple-s-operation-for-carcinoma-of-the-pancreas-head
#5
Mario Schietroma, Beatrice Pessia, Francesco Carlei, Gianfranco Amicucci
POURPOSE: The aim was to evaluate the relationship between failure of gut barrier function, inflammatory markers and septic complications after pancreatoduodenectomy for pancreatic adenocarcinoma. METHODOLOGY: 44 patients were enrolled in this prospective observational clinical study and underwent curative open pancreatoduodenectomy for adenocarcinoma of the head of the pancreas. All patients underwent assessment of intestinal permeability using the lactulose/manitol excretions ratios (L/M ratio), endotoxemia, IL-1β, IL-6, CRP, and elastase levels before surgery and on postoperative days 1, 3 and 7...
July 29, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28801969/anesthetic-management-for-intestinal-transplantation-a-decade-of-experience
#6
Jeron Zerillo, Sang Kim, Bryan Hill, David Shapiro, Hung-Mo Lin, Alyssa Burnham, Jang Moon, Kishore Iyer, Samuel DeMaria
BACKGROUND: Intestinal transplantation (ITx) is the definitive therapy for patients suffering from intestinal failure. Previous published reports suggest that these cases should be managed peri-operatively with the same intensive monitors and techniques as in liver transplantation. METHODS: We retrospectively reviewed the anesthetic management of sixty-seven isolated intestinal, intestinal-pancreas and intestinal-kidney transplants over the previous decade (2005-2015) in our tertiary care institution...
August 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28801782/common-pediatric-medical-emergencies-in-office-practice
#7
Bharat Mehra, Suresh Gupta
General Practitioners frequently see children with medical conditions that may evolve into an emergency if not promptly attended to. The most common emergencies encountered in pediatric office practice are respiratory distress, dehydration, anaphylaxis, seizures and trauma. Assessment of children is sometimes difficult as the signs and symptoms might be subtle and not markedly expressed. Also, normal value of vital signs vary with age, thus their interpretation requires discrete knowledge of age appropriate values...
August 12, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28793993/taurolidine-citrate-heparin-lock-reduces-catheter-related-bloodstream-infections-in-intestinal-failure-patients-dependent-on-home-parenteral-support-a-randomized-placebo-controlled-trial
#8
Siri Tribler, Christopher F Brandt, Anne H Petersen, Jørgen H Petersen, Kristian A Fuglsang, Michael Staun, Per Broebech, Claus E Moser, Palle B Jeppesen
Background: In patients with intestinal failure who are receiving home parenteral support (HPS), catheter-related bloodstream infections (CRBSIs) inflict health impairment and high costs.Objective: This study investigates the efficacy and safety of the antimicrobial catheter lock solution, taurolidine-citrate-heparin, compared with heparin 100 IE/mL on CRBSI occurrence.Design: Forty-one high-risk patients receiving HPS followed in a tertiary HPS unit were randomly assigned in a double-blinded, placebo-controlled trial...
August 9, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28792647/ultrashort-bowel-is-an-independent-risk-factor-for-liver-fibrosis-in-adults-with-home-parenteral-nutrition
#9
Dominique Cazals-Hatem, Lore Billiauws, Pierre-Emmanuel Rautou, Vanessa Bondjemah, Nicolas Pote, 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 (HPN) for intestinal failure and its impact on survival. METHODS: We retrospectively analyzed 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/28776498/methylprednisolone-prevents-bacterial-translocation-in-thioacetamide-induced-liver-failure-in-rats
#10
Murat Muhsin Muhip Harputluoğlu, İsmail Temel, Ulvi Demirel, Yüksel Seçkin, Murat Aladağ, Barış Otlu, Neşe Karadağ, Fatma Özyalın, Nilay Aydoğan, Engin Burak Selçuk
BACKGROUND/AIMS: Steroids have been shown to prevent intestinal oxidative stress. We investigated the effects of methylprednisolone on intestinal oxidative damage and bacterial translocation in thioacetamide-induced liver failure in rats. MATERIALS AND METHODS: Group 1 (n=8) was the control group. In group 2 (n=8), the thioacetamide group, rats received 300 mg/kg intraperitoneal thioacetamide daily for 2 days. In group 3 (n=8), the thioacetamide+methylprednisolone group, treatment with methylprednisolone (30 mg/kg intraperitoneal) was commenced 48 h before the first dose of thioacetamide...
August 4, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28772054/heart-failure-is-associated-with-depletion-of-core-intestinal-microbiota
#11
Mark Luedde, Thorben Winkler, Femke-Anouska Heinsen, Malte C Rühlemann, Martina E Spehlmann, Amer Bajrovic, Wolfgang Lieb, Andre Franke, Stephan J Ott, Norbert Frey
AIMS: In spite of current medical treatment approaches, mortality of chronic heart failure (HF) remains high and novel treatment modalities are thus urgently needed. A recent theory proposes a possible impact of the intestinal microbiome on the incidence and clinical course of heart failure. This study sought to systematically investigate, if there are specific changes of the intestinal microbiome in heart failure patients. METHODS AND RESULTS: The intestinal microbiome of 20 patients with heart failure with reduced ejection fraction due to ischemic or dilated cardiomyopathy was investigated by applying high-throughput sequencing of the bacterial 16S rRNA gene...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28770824/acute-liver-failure-enhances-oral-plasma-exposure-of-zidovudine-in-rats-by-downregulation-of-hepatic-ugt2b7-and-intestinal-p-gp
#12
Fan Wang, Ming-Xing Miao, Bin-Bin Sun, Zhong-Jian Wang, Xian-Ge Tang, Yang Chen, Kai-Jing Zhao, Xiao-Dong Liu, Li Liu
HIV infection is often associated with liver failure, which alters the pharmacokinetics of many drugs. In this study we investigated whether acute liver failure (ALF) altered the pharmacokinetics of the first-line anti-HIV agent zidovudine (AZT), a P-gp/BCRP substrate, in rats. ALF was induced in rats by injecting thioacetamide (TAA, 300 mg·kg(-1)·d(-1), ip) for 2 days. On the second day after the last injection of TAA, the pharmacokinetics of AZT was investigated following both oral (20 mg/kg) and intravenous (10 mg/kg) administration...
August 3, 2017: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/28768655/the-use-of-metabolic-balance-studies-in-the-objective-discrimination-between-intestinal-insufficiency-and-intestinal-failure
#13
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...
August 2, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28768258/septic-complications-after-resection-for-middle-or-low-rectal-cancer-role-of-gut-barrier-function-and-inflammatory-serum-markers
#14
Mario Schietroma, Beatrice Pessia, Sara Colozzi, Francesco Carlei, Marco Clementi, Gianfranco Amicucci, Stefano Guadagni
BACKGROUND: The focus of this study was to understand the relationship between the failure of gut barrier function, inflammatory markers and septic complications after resection for extraperitoneal rectal cancer. METHODS: One hundred seven patients were enrolled into this prospective observational study and underwent open colorectal resection for extraperitoneal cancer. All patients underwent an assessment of intestinal permeability (L/M ratio), endotoxemia, interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP) and elastase levels before surgery and on postoperative days 1, 3, and 7...
August 3, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28767319/systematic-review-and-meta-analysis-of-the-utilization-of-ethanol-locks-in-pediatric-patients-with-intestinal-failure
#15
Riad Rahhal, Maisam A Abu-El-Haija, Lin Fei, Dawn Ebach, Sarah Orkin, Elizabeth Kiscaden, Conrad R Cole
BACKGROUND: Intestinal failure is a chronic condition related to loss of bowel length and/or function, resulting in dependence on central venous catheters for fluids and nutrition. Catheter use can be associated with significant complications, including catheter-related bloodstream infections (CRBSIs), which can lead to loss of vascular access, advancing intestinal failure associated-liver disease and death. Our objective was to evaluate the effectiveness and safety of ethanol locks as compared with standard heparin locks in pediatric intestinal failure...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28766556/antigen-specific-regulatory-t-cell-responses-to-intestinal-microbiota
#16
REVIEW
E V Russler-Germain, S Rengarajan, C-S Hsieh
The mammalian gastrointestinal tract can harbor both beneficial commensal bacteria important for host health, but also pathogenic bacteria capable of intestinal damage. It is therefore important that the host immune system mount the appropriate immune response to these divergent groups of bacteria-promoting tolerance in response to commensal bacteria and sterilizing immunity in response to pathogenic bacteria. Failure to induce tolerance to commensal bacteria may underlie immune-mediated diseases such as human inflammatory bowel disease...
August 2, 2017: Mucosal Immunology
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
#17
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/28751427/unremitting-watery-diarrhoea-in-early-childhood-period
#18
Palittiya Sintusek, Thanita Thammarakcharoen, Shanop Shuangshoti, Boosba Vivatvakin
Chronic watery diarrhoea can be a presentation of gastrointestinal disease itself or a less-evident systemic disease. A 17-month-old boy presented with intractable diarrhoea, failure to gain weight, refractory tachycardia and severe hypertension. The ability to recognise and make a quick diagnosis of secretory type of diarrhoea dictated the outcome of patients with this ailment. Catecholamine hypersecretion was considered with the additional clues of refractory tachycardia and hypertension, a well-recognised phenomenon of neuroblastic tumours...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28750860/impaired-barrier-function-and-autoantibody-generation-in-malnutrition-enteropathy-in-zambia
#19
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/28738853/host-gene-microbiome-interactions-molecular-mechanisms-in-inflammatory-bowel-disease
#20
Hiutung Chu
Recent studies have identified links between host genetic variants and microbial recognition of the microbiome. Defects in host-microbiome interactions in individuals harboring inflammatory bowel disease risk alleles may result in imbalances of the microbial community, impaired pathogen clearance, and failure to sense beneficial commensal microbes. These findings highlight the importance of maintaining bi-directional communication at the mucosal interface during intestinal homeostasis.
July 24, 2017: Genome Medicine
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