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https://www.readbyqxmd.com/read/28526379/the-polish-intestinal-failure-centres-consensus-on-the-use-of-teduglutide-for-the-treatment-of-short-bowel-syndrome
#1
Stanisław Klek, Marek Kunecki, Jacek Sobocki, Konrad Matysiak, Katarzyna Karwowska, Krystyna Urbanowicz
OBJECTIVE: Teduglutide is an active, glucagon-like peptide (GLP)-2 analog with proven clinical efficacy regarding intestinal adaptation in patients with short bowel syndrome (SBS). There are two factors that preclude its reimbursement, and thereby, its availability: its cost (reaching ∼$300,000/y)-which significantly exceeds the cost of home parenteral nutrition (HPN) in most countries-and the lack of clear guidelines. The aim of this study was to create evidence-based working criteria for the use of teduglutide that could be used in clinical settings...
June 2017: Nutrition
https://www.readbyqxmd.com/read/28521656/oral-feeding-difficulties-in-children-with-short-bowel-syndrome-a-narrative-review
#2
Judy Hopkins, Sharon A Cermak, Russell J Merritt
Children with short bowel syndrome (SBS) with associated intestinal failure may be unable to absorb sufficient nutrients to sustain life. Improvements in the medical management of SBS, including use of parenteral nutrition, has significantly increased life expectancy. Independence from parenteral nutrition further improves quality of life. However, children living with SBS often develop oral aversions and feeding difficulties. There is limited research and information on which to base interventions that will preserve and develop oral motor and feeding skills...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28521607/intravenous-fish-oil-and-pediatric-intestinal-failure-associated-liver-disease-changes-in-plasma-phytosterols-cytokines-and-bile-acids-and-erythrocyte-fatty-acids
#3
Kara L Calkins, Andrea DeBarber, Robert D Steiner, Martiniano J Flores, Tristan R Grogan, Susanne M Henning, Laurie Reyen, Robert S Venick
BACKGROUND: Soybean oil (SO) emulsions are associated with intestinal failure-associated liver disease (IFALD); fish oil (FO) emulsions are used to treat IFALD. SO and FO differ with respect to their fatty acid and phytosterol content. In children with IFALD whose SO was replaced with FO, we aimed to (1) quantify changes in erythrocyte fatty acids and plasma phytosterols, cytokines, and bile acids and (2) correlate these changes with direct bilirubin (DB). DESIGN: This study enrolled IFALD children who received 6 months of FO...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28502441/intestinal-transplant-in-children
#4
REVIEW
Nidhi Rawal, Nada Yazigi
The past decade has seen major advances in the field of transplantation; it is the treatment of choice for many with intestinal failure. One-year mortality from pediatric intestinal transplantation has significantly declined, from 30% to 10% to 15% nationally, mainly due to a multidisciplinary approach in transplant centers. Pediatric age carries special considerations along the spectrum of care that continue to cause challenges but also offers growth opportunities. Pediatric intestinal transplantation indications and timing are changing as a result of new developments in diagnostic and treatment tools...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28501098/alterations-in-intestinal-microbiota-relate-to-intestinal-failure-associated-liver-disease-and-central-line-infections
#5
Panliang Wang, Ying Wang, Lina Lu, Weihui Yan, Yijing Tao, Kejun Zhou, Jie Jia, Wei Cai
BACKGROUND: The gut microbiota plays a vital role in modulating the metabolic and immune functions of the intestines. We aimed to analyze the dysbiosis of microbiota in infants with short bowel syndrome (SBS) with different complications. PROCEDURE: We included 26 fecal samples from 18 infants with SBS during parenteral nutrition. The samples were categorized into three groups: asymptomatic, parenteral nutrition-associated liver disease (PNALD), and central line-associated bloodstream infection (CLABSI)...
May 3, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28483328/clinical-classification-of-adult-patients-with-chronic-intestinal-failure-due-to-benign-disease-an-international-multicenter-cross-sectional-survey
#6
Loris Pironi, Denise Konrad, Chrisoffer Brandt, Francisca Joly, Geert Wanten, Federica Agostini, Cecile Chambrier, Umberto Aimasso, Sarah Zeraschi, Darlene Kelly, Kinga Szczepanek, Amelia Jukes, Simona Di Caro, Miriam Theilla, Marek Kunecki, Joanne Daniels, Mireille Serlie, Florian Poullenot, Jian Wu, Sheldon C Cooper, Henrik H Rasmussen, Charlene Compher, David Seguy, Adriana Crivelli, Maria C Pagano, Sarah-Jane Hughes, Francesco W Guglielmi, Nada Rotovnik Kozjek, Stéphane M Schneider, Lyn Gillanders, Lars Ellegard, Ronan Thibault, Przemysław Matras, Anna Zmarzly, Konrad Matysiak, Andrè Van Gossum, Alastair Forbes, Nicola Wyer, Marina Taus, Nuria M Virgili, Margie O'Callaghan, Brooke Chapman, Emma Osland, Cristina Cuerda, Peter Sahin, Lynn Jones, Andre D W Lee, Valentino Bertasi, Paolo Orlandoni, Ferenc Izbéki, Corrado Spaggiari, Marta Bueno Díez, Maryana Doitchinova-Simeonova, Carmen Garde, Aurora E Serralde-Zúñiga, Gabriel Olveira, Zeljko Krznaric, Laszlo Czako, Gintautas Kekstas, Alejandro Sanz-Paris, Estrella Petrina Jáuregui, Ana Zugasti Murillo, Eszter Schafer, Jann Arends, José P Suárez-Llanos, Jon Shaffer, Simon Lal
BACKGROUND & AIMS: The aim of the study was to evaluate the applicability of the ESPEN 16-category clinical classification of chronic intestinal failure, based on patients' intravenous supplementation (IVS) requirements for energy and fluids, and to evaluate factors associated with those requirements. METHODS: ESPEN members were invited to participate through ESPEN Council representatives. Participating centers enrolled adult patients requiring home parenteral nutrition for chronic intestinal failure on March 1st 2015...
April 19, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28481229/parenteral-nutrition-and-intestinal-failure
#7
REVIEW
Barbara Bielawska, Johane P Allard
Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN...
May 6, 2017: Nutrients
https://www.readbyqxmd.com/read/28481070/-negative-pressure-system-in-the-treatment-of-enterocutaneous-fistulas-in-the-pediatric-population
#8
V Núñez Cerezo, M I Romo Muñoz, M V Amesty Morello, A Vilanova Sánchez, M Dore Reyes, M Gómez Cervantes, A M Andrés Moreno, E Martínez-Ojinaga Nodal, L Martínez Martínez, M López Santamaría
AIM OF THE STUDY: The management of children with enterocutaneous fistulas (EF) along with large abdominal wall defects secondary to multiple surgical interventions can be difficult and sometimes lead to intestinal failure (IF). The aim of this study is to present the results of negative pressure systems and their properties (edema reduction angiogenesis promotion and granulation tissue formation) in children with enterocutaneous fistulas (EF) and their prognosis. MATERIALS AND METHODS: A retrospective analysis of children with refractory, high output EF treated with NPS between 2008-2014...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28462382/gata4-is-sufficient-to-establish-jejunal-versus-ileal-identity-in-the-small-intestine
#9
Cayla A Thompson, Kevin Wojta, Kirthi Pulakanti, Sridhar Rao, Paul Dawson, Michele A Battle
BACKGROUND & AIMS: Patterning of the small intestinal epithelium along its cephalocaudal axis establishes three functionally distinct regions: duodenum, jejunum, and ileum. Efficient nutrient assimilation and growth depend on the proper spatial patterning of specialized digestive and absorptive functions performed by duodenal, jejunal, and ileal enterocytes. When enterocyte function is disrupted by disease or injury, intestinal failure can occur. One approach to alleviate intestinal failure would be to restore lost enterocyte functions...
May 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28462379/prolonged-absence-of-mechanoluminal-stimulation-in-human-intestine-alters-the-transcriptome-and-intestinal-stem-cell-niche
#10
Minna M Wieck, Christopher R Schlieve, Matthew E Thornton, Kathryn L Fowler, Mubina Isani, Christa N Grant, Ashley E Hilton, Xiaogang Hou, Brendan H Grubbs, Mark R Frey, Tracy C Grikscheit
BACKGROUND & AIMS: For patients with short-bowel syndrome, intestinal adaptation is required to achieve enteral independence. Although adaptation has been studied extensively in animal models, little is known about this process in human intestine. We hypothesized that analysis of matched specimens with and without luminal flow could identify new potential therapeutic pathways. METHODS: Fifteen paired human ileum samples were collected from children aged 2-20 months during ileostomy-reversal surgery after short-segment intestinal resection and diversion...
May 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28446383/development-and-validation-of-the-parenteral-nutrition-impact-questionnaire-pniq-a-patient-centric-outcome-measure-for-home-parenteral-nutrition
#11
Jeanette Wilburn, Stephen P McKenna, Alice Heaney, Matthew Rouse, Michael Taylor, Alison Culkin, Simon Gabe, Sorrel Burden, Simon Lal
BACKGROUND & AIMS: Patients with Type 3 Intestinal Failure (IF) who need Home Parenteral Nutrition (HPN) face several clinical, psychological and social problems. The study was designed to produce and test the first patient-centric measure for HPN ('PNIQ: Parenteral Nutrition Impact Questionnaire'). The new measure focused on the extent to which patients were able to fulfil their human needs. METHODS: Questionnaire content was derived from the analysis of transcripts of interviews conducted with UK HPN patients...
April 12, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28445795/a-novel-approach-to-calculating-small-intestine-length-based-on-magnetic-resonance-enterography
#12
Nicole A Wilson, Hyung-Soon Park, Kyoung Soub Lee, Lauren K Barron, Brad W Warner
BACKGROUND: Bowel length is an important factor in the management of patients with intestinal failure and short bowel syndrome (SBS). However, it is difficult to accurately measure the length of the small intestine. Our purpose was to demonstrate the feasibility of a dedicated software algorithm for calculating small intestine length based on magnetic resonance enterography (MRE) images. STUDY DESIGN: A custom algorithm for image thresholding, wall-identification, segmentation, and path extraction was designed and implemented...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28441092/self-evaluation-of-quality-of-life-among-patients-receiving-home-parenteral-nutrition-a-validation-study
#13
Miriam Theilla, Ilya Kagan, Karina Chernov, Jonathan Cohen, Ilya Kagan, Pierre Singer
BACKGROUND: Home parenteral nutrition (HPN) can increase survival and quality of life (QOL) in cases of chronic intestinal failure. The present study compares a gold standard-a validated QOL assessment by Baxter et al (hereafter, HPN-QOL)-with a shorter questionnaire for QOL evaluation (hereafter, New QOL). MATERIALS AND METHODS: Both questionnaires were completed by 58 patients attending the nutrition clinic of the Rabin Medical Center (Israel). A z score was used to equate means and variances...
April 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28437326/favorable-outcomes-of-preterm-infants-with-parenteral-nutrition-associated-liver-disease-treated-with-intravenous-fish-oil-based-lipid-emulsion
#14
Michael Sorrell, Alvaro Moreira, Kay Green, Rachel Jacob, Robin Tragus, Laura Keller, Amy Quinn, Donald McCurnin, Alice Gong, Abeer El Sakka, Naveen Mittal, Cynthia Blanco
OBJECTIVES: The aim of the study was to determine the acute and long-term outcomes of preterm infants treated with an intravenous fish oil-based lipid emulsion (FishLE) for parenteral nutrition-associated liver disease (PNALD). METHODS: Preterm infants 14 days to 24 months of age with anatomic short gut or severe intestinal dysmotility, serum direct bilirubin ≥4 mg/dL, and requiring >60% calories from parenteral nutrition were eligible. Enrolled infants received 1 g · kg · day of FishLE until resolution of direct hyperbilirubinemia or return of enteral nutrition...
May 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28437160/meeting-report-of-the-xiv-international-small-bowel-transplant-symposium-summary-of-presentations-workshops-and-debates-from-a-comprehensive-meeting-on-intestinal-failure-rehabilitation-and-transplantation-buenos-aires-argentina-june-10-13-2015
#15
Gabriel E Gondolesi, Adriana Fernandez, Karolina M Burghardt, Scott Nowakowski, Stuart S Kaufman, Andreas Pascher, Diana Florescu, Phillip Ruiz, Rodrigo Vianna, Sara Clarke, Mihai Oltean, Martin Rumbo, George Mazariegos, Debra L Sudan, Douglas G Farmer
The 2015 meeting of the Intestinal Transplant Association was held in Buenos Aires, Argentina. This was the 14th International Small Bowel Transplant Symposium, and it was the first meeting organized as a joint venture of the Transplantation Society, the Intestinal Transplant Association, and the Argentinean Transplant Society (Sociedad Argentina de Trasplantes). Innovative aspects of the classic meeting format included workshops sessions, debates, and multicenter studies. This report highlights the most prominent scientific contributions and results of the first such symposium in a Latin American country...
April 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28433363/the-molecular-impact-of-omega-3-fatty-acids-on-hepatic-pro-inflammatory-cytokine-signaling
#16
George J Ventro, Yingkui Yang, Min Chen, Carroll M Harmon
PURPOSE: Parenteral nutrition associated liver disease (PNALD) develops in a subset of children receiving parenteral nutrition for intestinal failure. Omegaven™ is an omega-3 fatty acid (Ω3FA) lipid emulsion high in docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) that can lessen PNALD. Inflammatory cytokines (IL-1, TNF-α, TGF-β) are elevated in PNALD and can decrease paraoxonase 1 protein expression (PON1). We sought to determine the effect of Omegaven™, EPA, and DHA on inflammatory cytokines TNF-α, IL-1, and TGF-β via ERK1/2 and p-Smad2/3 signaling pathways as well as the changes in intracellular PON1 protein expression as a potential mechanism explaining the protective effects of Omegaven™ and Ω3FA...
March 18, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28425133/fecal-microbiota-signatures-of-adult-patients-with-different-types-of-short-bowel-syndrome
#17
Yuhua Huang, Feilong Guo, Yousheng Li, Jian Wang, Jieshou Li
BACKGROUND AND AIM: Short bowel syndrome (SBS) is a common cause of intestinal failure and can be divided into three types depending on intestinal anatomy. Gut dysbiosis has been observed in pediatric SBS patients and is associated with impaired outcome. Little is known about the changes in gut microbiota of adult SBS patients. Therefore, we aim to characterize the fecal microbiota of adult patients with different types of SBS. METHODS: Fifteen fecal samples from healthy controls and adult patients with type II or type III SBS were collected (five in each group)...
April 19, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28401057/intestinal-hypoganglionosis-leading-to-intestinal-failure-and-the-compassionate-use-of-omegaven%C3%A2
#18
Racha Khalaf, Sara Karjoo, Paul Danielson, Michael Wilsey, Fauzia Shakeel
Intestinal hypoganglionosis is a rare innervation disorder that provides numerous nutritional, medical and surgical challenges. In this case report, we present a case of a newborn with intestinal hypoganglionosis leading to intestinal failure and intestinal failure-associated liver disease who responded to Omegaven™, a fat emulsion comprised of omega-3 fatty acids. Omegaven™ has been shown to be beneficial in the management of cholestatic liver injury. Clinical success with Omegaven™ was seen in this patient with a clear decrease in aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and complete resolution of cholestasis with a direct bilirubin of zero within two weeks of initiation of Omegaven™...
March 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28394957/-intestinal-failure-due-to-short-bowel-syndrome-impact-of-a-multidisciplinary-intestinal-rehabilitation-program
#19
María Elena Molina, Felipe Bellolio, Julieta Klaassen, Javier Gómez, Constanza Villalón, Juan Francisco Guerra, Álvaro Zúñiga
BACKGROUND: In patients suffering intestinal failure due to short bowel, the goal of an Intestinal Rehabilitation Program is to optimize and tailor all aspects of clinical management, and eventually, wean patients off lifelong parenteral nutrition. AIM: To report the results of our program in patients suffering intestinal failure. PATIENTS AND METHODS: A registry of all patients referred to the Intestinal Failure unit between January 2009 and December 2015 was constructed...
November 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28379928/impact-of-multidisciplinary-teams-for-management-of-intestinal-failure-in-children
#20
Christina Belza, Paul W Wales
PURPOSE OF REVIEW: To review the recent literature related to the impact of an intestinal rehabilitation program (IRP) on the management of intestinal failure in children. RECENT FINDINGS: As publication of a systematic review of pediatric IRPs in 2013, there have been four publications further describing the impact of IRPs in children with intestinal failure. The results continue to support an improvement in survival and enteral autonomy, and a decrease in complications related to liver dysfunction, central venous catheters, and transplantation...
June 2017: Current Opinion in Pediatrics
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