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Intestinal failure

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https://www.readbyqxmd.com/read/29779158/diffusion-weighted-magnetic-resonance-enterography-for-prediction-of-response-to-tumor-necrosis-factor-inhibitors-in-stricturing-crohn-s-disease
#1
Marianne M Amitai, Eyal Klang, Asaf Levartovsky, Noa Rozendorn, Shelly Soffer, Gadeer Ali Taha, Bella Ungar, Tomer Greener, Shomron Ben-Horin, Rami Eliakim, Uri Kopylov
BACKGROUND AND AIMS: Distinguishing between fibrotic and inflammatory strictures in Crohn's disease (CD) is still challenging. The capacity of diffusion-weighted (DWI) magnetic resonance (MRE) to identify intestinal fibrosis was recently demonstrated; however, the therapeutic implications of this association have never been evaluated. The aim of the current study was to identify imaging features, including DWI, which can predict response to anti-inflammatory treatment in patients with stricturing CD...
May 19, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29778510/assessment-of-intestinal-failure-associated-liver-disease-according-to-different-diagnostic-criteria
#2
Anna Simona Sasdelli, Federica Agostini, Caterina Pazzeschi, Mariacristina Guidetti, Simon Lal, Loris Pironi
BACKGROUND & AIMS: Intestinal failure associated liver disease (IFALD) has been defined using numerous criteria; however the clinical relevance of these criteria has never been compared. We therefore aimed to evaluate the prevalence, incidence, evolution of IFALD diagnosed by different criteria and to assess any clinical features that may be associated with its occurrence. METHODS: A cross sectional (CS) and retrospective study were carried out on adults on home parenteral nutrition (HPN) for chronic intestinal failure (CIF) managed at a single center...
May 8, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29778436/enhanced-central-venous-catheter-bundle-for-pediatric-parenteral-dependent-intestinal-failure
#3
Jennifer A Ormsby, Bola Bukoye, Debra Lajoie, Herminia Shermont, Lisa Martin, Kierrah Leger, Judy Mahoney, Gail Potter-Bynoe, Jane Carpenter, Al Ozonoff, Grace M Lee
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) cause substantial morbidity and increase antimicrobial use and length of stay among hospitalized children in the United States. CLABSI occurs more frequently among high-risk pediatric patients, such as those with intestinal failure (IF) who are parenteral nutrition (PN) dependent. Following an increase in CLABSI rates, a quality improvement (QI) initiative was implemented. METHODS: Using QI methodology, an enhanced central venous catheter (CVC) maintenance bundle was developed and implemented on 2 units for pediatric PN-dependent patients with IF...
May 16, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29777706/n-3-polyunsaturated-fatty-acids-ameliorate-hepatic-steatosis-via-the-ppar-%C3%AE-cpt-1%C3%AE-pathway-in-a-mouse-model-of-parenteral-nutrition
#4
Feng Tian, Jiwei Wang, Haifeng Sun, Jianbo Yang, Peng Wang, Songlin Wan, Xuejin Gao, Li Zhang, Jieshou Li, Xinying Wang
Parenteral nutrition (PN) is one of the basic therapies for patients with intestinal failure; however, hepatic steatosis associated with PN limits the long-term use of PN. N-3 polyunsaturated fatty acids (PUFAs) have been used to improve clinical outcomes of patients receiving PN; however, the mechanisms by which n-3 PUFAs ameliorate hepatic steatosis remain unclear. In the present study, C57BL/6J mice were randomly assigned to three treatment groups, namely, enteral nutrition (EN), n-3 PUFAs, and n-6 PUFAs...
May 16, 2018: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#5
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29777267/improved-prognosis-and-low-failure-rate-with-anticoagulation-as-first-line-therapy-in-mesenteric-venous-thrombosis
#6
S Salim, M Zarrouk, J Elf, A Gottsäter, O Ekberg, S Acosta
BACKGROUND: Monotherapy with anticoagulation has been considered as first-line therapy in patients with mesenteric venous thrombosis (MVT). The aim of this study was to evaluate outcome, prognostic factors, and failure rate of anticoagulation as monotherapy, and to identify when bowel resection was needed. METHODS: Retrospective study of consecutive patients with MVT diagnosed between 2000 and 2015. RESULTS: The overall incidence rate of MVT was 1...
May 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29776790/-modern-treatment-of-mesenteric-ischemia
#7
Alexandre Nuzzo, Audrey Huguet, Olivier Corcos
Acute mesenteric ischemia is a highly morbid affliction which requires urgent care. Acute mesenteric ischemia consists in an ischemia injury of the small bowel, secondary to vascular insufficiency, either occlusive (thrombosis, embolism, arterial, venous) or non-occlusive (low flow or vasospasm). Given that the superior mesenteric artery supplies the small bowel as well as the right part of the colon, any ischemic process involving the right colon should be considered an acute mesenteric ischemia until proven otherwise...
May 15, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29770706/intestinal-transplants-review-of-normal-imaging-appearance-and-complications
#8
Bashir Hakim, Daniel T Myers, Todd R Williams, Shunji Nagai, John Bonnett
Intestinal transplant (IT) is one of the least common forms of organ transplant but is increasing both in volume of cases and number of centers performing intestinal transplants, with the busiest centers in North America and Europe. IT can be performed in isolation or as part of a multivisceral transplant (MVT). Intestinal failure either in the form of short gut syndrome or functional bowel problems is the primary indication for IT. The normal post-surgical anatomy can be variable due to both recipient anatomy in regard to amount of residual bowel and status of native vasculature as well as whether the transplant is isolated or part of an multivisceral transplant...
May 17, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29762383/starch-tolerance-and-the-short-bowel
#9
Jan de Laffolie, Hassan Y Naim, Silvia Rudloff, Klaus-Peter Zimmer
Short bowel syndrome with intestinal failure is a rare disease with a massive impairment in quality of life, requiring a multidisciplinary team approach to medical, surgical, and nutritional therapy. Current pharmacological and surgical therapeutic options are limited; an important cornerstone is enteral and parenteral nutrition. The changed physiology of carbohydrate digestion plays a major role in the adaptation process and can be a target for specific enteral nutrition interventions. An important prognostic factor is the preservation of at least portions of the colon in continuity with small bowel...
June 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29761915/reduction-of-parenteral-nutrition-and-hydration-support-and-safety-with-long-term-teduglutide-treatment-in-patients-with-short-bowel-syndrome-associated-intestinal-failure-steps-3-study
#10
Douglas L Seidner, Ken Fujioka, Joseph I Boullata, Kishore Iyer, Hak-Myung Lee, Thomas R Ziegler
BACKGROUND: Patients with intestinal failure associated with short bowel syndrome (SBS-IF) require parenteral support (PS) to maintain fluid balance or nutrition. Teduglutide (TED) reduced PS requirements in patients with SBS-IF in the randomized, placebo (PBO)-controlled STEPS study (NCT00798967) and its 2-year, open-label extension, STEPS-2 (NCT00930644). METHODS: STEPS-3 (NCT01560403), a 1-year, open-label extension study in patients with SBS-IF who completed STEPS-2, further monitored the safety and efficacy of TED (0...
May 15, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29761676/planned-re-laparotomy-in-a-non-trauma-setting-a-single-center-experience
#11
Yehuda Hershkovitz, Itamar Ashkenazi, Zahar Shapira, Oded Zmora, Igor Jeroukhimov
BACKGROUND: Damage control laparotomy (DCL) is the widely accepted procedure of choice in management of severely injured trauma patient. It has been implemented in non-trauma-related surgical pathology in the last decade. OBJECTIVES: To evaluate our experience with planned re-laparotomy (PRL) in non-trauma patients and compare it to other reports. METHODS: Charts of all patients admitted to Assaf Harofeh Medical Center who underwent PRL for non-trauma-related abdominal pathology during a 6 year period were reviewed...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29755909/malrotation-of-the-gut-in-adults-an-often-forgotten-entity
#12
Sushant Bhatia, Sudhir Jain, Chandra B Singh, Lovenish Bains, Rohit Kaushik, Nishant S Gowda
Malrotation of the gut is a common paediatric condition that usually presents in the first month of life. However, presentation in adults is rare, and as a diagnostic dilemma quite often surprises the surgeon intraoperatively. If this condition is not timely recognized, it may result in disastrous consequences, such as gangrene of the small gut. We present the case of a 21-year-old male who presented to the emergency room with recurrent episodes of colicky abdominal pain and bilious vomiting. Contrast-enhanced computerized tomography (CT) revealed malrotation of the gut...
March 12, 2018: Curēus
https://www.readbyqxmd.com/read/29754868/attitudes-surrounding-the-management-of-neonates-with-severe-necrotizing-enterocolitis
#13
Gillian C Pet, Ryan M McAdams, Lilah Melzer, Assaf P Oron, Simon P Horslen, Adam Goldin, Patrick J Javid
OBJECTIVES: To assess providers' recommendations as to comfort care versus medical and surgical management in clinical scenarios of newborns with severe bowel loss and to assess how a variety of factors influence providers' decision making. STUDY DESIGN: We conducted a survey of pediatric surgeons and neonatologists via the American Pediatric Surgical Association and American Academy of Pediatrics Section of Neonatal-Perinatal Medicine. We examined how respondents' recommendations were affected by a variety of patient and provider factors...
May 10, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29754463/intestinal-failure-the-evolving-demographic-and-patient-outcomes-on-home-parenteral-nutrition
#14
Sarah Kate Brown, Natalie Davies, Enda Smyth, Nicky Heather, Caroline Cole, Simon Charles Keys, Robert Mark Beattie, Akshay Batra
AIM: We performed this study to examine and understand the evolving demographics and changing outcomes of intestinal failure, and its implications for healthcare delivery. METHOD: We conducted a retrospective analysis of outcome data of children on home Parenteral Nutrition (HPN), over a 15 year period. RESULTS: 31 patients received HPN, 15 for short bowel syndrome (SBS), 8 neuromuscular disease (NMD) and 8 for other causes. The HPN prevalence increased from 1...
May 13, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29754190/allergic-and-immunologic-perspectives-of-inflammatory-bowel-disease
#15
REVIEW
Kofi Clarke, Jayakrishna Chintanaboina
Inflammatory bowel disease (IBD) is a chronic immune-mediated inflammatory condition primarily involving the gastrointestinal tract. It includes Crohn's disease (CD), ulcerative colitis (UC), and a less common phenotype-indeterminate colitis. It is thought to result from a complex interplay of environmental, microbial, and host factors including genetic factors, although the exact mechanism is not known. Dietary factors have been shown to play a role in the pathogenesis of IBD and can potentially alter the intestinal microbiota as well as disrupt the immune function in the gut...
May 12, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29753801/a-comparative-study-between-2-different-grafts-used-as-patches-after-plaque-incision-and-inflatable-penile-prosthesis-implantation-for-end-stage-peyronie-s-disease
#16
Marco Falcone, Mirko Preto, Carlo Ceruti, Massimiliano Timpano, Giulio Garaffa, Omidreza Sedigh, Mattia Sibona, Marco Oderda, Paolo Gontero, Luigi Rolle
BACKGROUND: Although many grafts have been used for plaque incision with grafting (PIG) and penile prosthesis (PP) implantation, there is no evidence that favors 1 specific graft over another. AIM: To compare fibrin-coated collagen fleece (TachoSil; Baxter International, Deerfield, IL, USA) with porcine small intestinal submucosa (SIS; Cook Biotech, West Lafayette, IN, USA) as grafts. METHODS: From January 2007 to January 2015, 60 non-randomized consecutive patients affected by end-stage Peyronie disease underwent PIG and PP implantation (AMS 700CX; Boston Scientific, Marlborough, MA, USA)...
May 9, 2018: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29752972/urologic-phenotype-and-patterns-of-care-in-patients-with-megacystis-microcolon-intestinal-hypoperistalsis-syndrome-presenting-to-a-major-pediatric-transplantation-center
#17
Lee A Hugar, Rajeev Chaudhry, Thomas W Fuller, Glenn M Cannon, Francis X Schneck, Michael C Ost, Heidi A Stephany
OBJECTIVES: To describe the phenotype, referral pattern, and trends of urologic management for children with megacystis microcolon intestinal hypoperistalsis syndrome. METHODS: We performed a retrospective review of all patients with megacystis microcolon intestinal hypoperistalsis syndrome treated at a large tertiary children's medical center over a 14-year period. Our primary outcomes included the rate of urology referral, urodynamic characteristics of bladder function, and the proportion of patients managed with clean intermittent catheterization...
May 9, 2018: Urology
https://www.readbyqxmd.com/read/29752866/a-requirement-for-septins-and-the-autophagy-receptor-p62-in-the-proliferation-of-intracellular-shigella
#18
Damián Lobato-Márquez, Sina Krokowski, Andrea Sirianni, Gerald Larrouy-Maumus, Serge Mostowy
Shigella flexneri, a Gram-negative enteroinvasive pathogen, causes inflammatory destruction of the human intestinal epithelium. During infection of epithelial cells, Shigella escape from the phagosome to the cytosol, where they reroute host cell glycolysis to obtain nutrients for proliferation. Septins, a poorly understood component of the cytoskeleton, can entrap cytosolic Shigella targeted to autophagy in cage-like structures to restrict bacterial proliferation. Although bacterial entrapment by septin caging has been the subject of intense investigation, the role of septins and the autophagy machinery in the proliferation of non-caged Shigella is mostly unknown...
May 12, 2018: Cytoskeleton
https://www.readbyqxmd.com/read/29752823/prenatal-diagnosis-of-megacystis-microcolon-intestinal-hypoperistalsis-syndrome-by-biochemical-analysis-of-fetal-urine
#19
Jonathan Rosenblatt, Sophie Dreux, Emmanuel Spaggiari, Cécile Morin, Bichr Allaf, Anne Sylvie Valat, Danny Halim, Jean-François Oury, Françoise Muller
OBJECTIVES: To determine a model of fetal urine biochemical markers to differentiate megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) from other megacystis. METHOD: Retrospective study of biochemical analysis of fetal urine in patients who presented prenatally with megacystis. We studied β2-microglobulin, sodium, calcium, and phosphorus. Twenty-six patients subsequently diagnosed with MMIHS were compared with two control groups: one of end-stage renal failure (ESRF, 64 fetuses) and the second of "good" postnatal renal function (control group, 64 fetuses)...
May 12, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29750290/neonatal-intestinal-obstruction-syndrome
#20
Manuel Gil Vargas, Mariana L Miguel-Sardaneta, Michelle Rosas-Téllez, Dayana Pereira-Reyes, Jaime M Justo-Janeiro
Neonatal intestinal obstruction is caused by an anatomical abnormality that produces bowel movement failure. Intestinal obstruction presents with three classic clinical signs: vomiting, abdominal distention, and failure to pass meconium. Intestinal obstruction is one of the most common causes for admitting a pediatric patient to the pediatric surgery unit in his or her first weeks of postnatal life. Congenital obstruction of the digestive tract in neonates is a common problem, with the most frequent cause being anorectal malformations (41%), followed by esophageal obstruction (24%), and duodenal obstruction (20%)...
May 1, 2018: Pediatric Annals
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