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"Intestinal rehabilitation"

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https://www.readbyqxmd.com/read/29754463/intestinal-failure-the-evolving-demographic-and-patient-outcomes-on-home-parenteral-nutrition
#1
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/29746341/screening-endoscopy-contributes-to-relevant-modifications-of-therapeutic-regimen-in-children-with-intestinal-failure
#2
Andreas Busch, Ekkehard Sturm
OBJECTIVE: The role of endoscopy in the diagnostic work-up of children with intestinal failure (IF) is not well defined. It is unclear whether endoscopies should be performed as a screening procedure or only upon manifestation of symptoms. The aim of this study is to evaluate, whether performing screening endoscopy contributes to clinical management in children with IF. METHODS: Comparative retrospective case-series study in children with IF (mean age 70,4 months ± 58,4 months) presenting for diagnostic work-up in a single intestinal rehabilitation center...
May 9, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29702489/what-s-new-in-short-bowel-syndrome
#3
Lore Billiauws, Olivier Corcos, Francisca Joly
PURPOSE OF REVIEW: Short bowel syndrome (SBS) is a rare disease but with many complications due to intestinal failure, parenteral nutrition and underlying disease. A better prevention, comprehension and treatment could improve the outcome of these patients. RECENT FINDINGS: Recent studies have been published on acute intestinal failure, first cause of SBS, and gives us strategy to avoid extended intestinal resection and thus SBS. There has been progress in the comprehension of intestinal adaptation, characterized by improvements in intestinal absorption, changes on hormonal secretion, development of a hyperphagia and dysbiosis of the gut microbiota...
April 26, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29701873/children-with-intestinal-failure-undergoing-intestinal-rehabilitation-are-at-risk-for-essential-fatty-acid-deficiency
#4
Riikka Gunnar, Mirka Lumia, Mikko Pakarinen, Laura Merras-Salmio
BACKGROUND: Essential fatty acid (EFA) status may be compromised during the intestinal failure (IF) rehabilitation. Parenteral lipid restriction is used to treat intestinal failure associated liver disease (IFALD), while the enteral fatty acid (FA) absorption remains limited. We analyzed the FA status among pediatric IF and intestinal insufficiency patients. METHODS: We evaluated 49 patients aged 0-18 years attending our nationwide IF referral center. Their serum FA fractions were determined and examined against previous nutrition, parenteral lipid emulsion, and intestinal anatomy data...
April 27, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29602547/ostomy-in-continuity-a-novel-approach-for-the-management-of-children-with-complex-short-bowel-syndrome
#5
Sona Sehgal, Anthony D Sandler, A Alfred Chahine, Parvati Mohan, Clarivet Torres
INTRODUCTION: Despite medical and surgical management, a subset of children with short bowel syndrome (SBS) who have discrepancy between proximal small bowel and distal colon have persistent feeding intolerance. We propose the use of an Ostomy in Continuity (OIC) (Bishop-Koop or Santulli) as a salvage procedure to decompress the proximal bowel while still maintaining maximal intestinal length, in these patients. METHODS: A retrospective chart review of 104 SBS patients identified sixteen patients who underwent an OIC...
March 4, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29505151/single-center-experience-with-the-use-of-teduglutide-in-adult-patients-with-short-bowel-syndrome
#6
Kwai Lam, Lauren Schwartz, Jennifer Batisti, Kishore R Iyer
BACKGROUND: Teduglutide is a glucagon-like peptide 2 (GLP-2) analog that has been approved for the treatment of adult short bowel syndrome (SBS)-associated intestinal failure (IF; SBS-IF). Teduglutide increases villus height and crypt depth in the small bowel mucosa, promoting nutrition absorption and enteral independence from parenteral nutrition (PN). We aim to report our single-center experience with teduglutide in adult patients with SBS to provide real-world context to its use. METHOD: We conducted a retrospective analysis on patients managed within our tertiary-level intestinal rehabilitation program to identify patients with SBS-IF treated with teduglutide from 2009-2015...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29498797/visceral-transplantation-in-patients-with-intestinal-failure-associated-liver-disease-evolving-indications-graft-selection-and-outcomes
#7
REVIEW
Jason S Hawksworth, Chirag S Desai, Khalid M Khan, Stuart S Kaufman, Nada Yazigi, Raffaele Girlanda, Alexander Kroemer, Thomas M Fishbein, Cal S Matsumoto
Intestinal failure (IF)-associated liver disease (IFALD) is widely recognized as a lethal complication of long-term parenteral nutrition. The pathophysiology of IFALD is poorly understood but appears to be multifactorial and related to the inflammatory state in the patient with IF. Visceral transplant for IFALD includes variants of intestine, liver, or combined liver-intestine allografts. Graft selection for an individual patient depends on the etiology of IF, abdominal and vascular anatomy, severity of IFALD, and potential for intestinal rehabilitation...
March 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29478887/long-term-outcomes-of-intestinal-rehabilitation-in-children-with-neonatal-very-short-bowel-syndrome-parenteral-nutrition-or-intestinal-transplantation
#8
Lorenzo Norsa, Solene Artru, Cecile Lambe, Cecile Talbotec, Benedicte Pigneur, Frank Ruemmele, Virginie Colomb, Carmen Capito, Christophe Chardot, Florence Lacaille, Olivier Goulet
BACKGROUND & AIMS: Intestinal rehabilitation is the preferred treatment for children with short bowel syndrome (SBS) whatever the residual bowel length, and depends on the accurate management of long-term parenteral nutrition (PN). If nutritional failure develops, intestinal transplantation (ITx) should be discussed and may be life-saving. This study aimed to evaluate survival, PN dependency and nutritional status in children with neonatal very SBS on PN or after ITx, in order to define indications and timing of both treatments...
February 15, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29429053/program-of-gastrointestinal-rehabilitation-and-early-postoperative-enteral-nutrition-a-prospective-study
#9
Frank Daniel Martos-Benítez, Anarelys Gutiérrez-Noyola, Andrés Soto-García, Iraida González-Martínez, Ilionanys Betancourt-Plaza
Nutritional depletion is commonly observed in patients undergoing surgical treatment for a gastrointestinal malignancy. An appropriate nutritional intervention could be associated with improved postoperative outcomes. The study was aimed to determine the effect of a program of gastrointestinal rehabilitation and early postoperative enteral nutrition upon complications and clinical outcomes in patients who experienced gastrointestinal surgery for cancer. This is a prospective study (2013 January-2015 December) of 465 consecutive patients submitted to gastrointestinal surgery for cancer and admitted to an Oncological Intensive Care Unit...
March 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29406449/long-term-results-of-surgery-for-bowel-lengthening-how-many-transplants-are-avoided-for-which-patients
#10
Francisco Hernandez, Ane M Andres, Manuel Lopez-Santamaria
PURPOSE OF REVIEW: One of the biggest successes of intestinal rehabilitation programs is that more patients achieve enteral autonomy without transplantation. Many factors are responsible of this accomplishment including new parenteral formulas, better catheter management, surgical management, and the experience of the teams. The purpose of this review is to analyze recent published papers regarding intestinal lengthening procedures trying to find out how many transplantations are avoided and for which patients...
April 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29206679/predicting-intestinal-adaptation-in-pediatric-intestinal-failure-a-retrospective-cohort-study
#11
Christina Belza, Kevin Fitzgerald, Nicole de Silva, Yaron Avitzur, Karen Steinberg, Glenda Courtney-Martin, Paul W Wales
OBJECTIVE: The primary goal in intestinal failure (IF) is adaptation and enteral autonomy (EA). Our goals were to determine the proportion of patients treated for IF by an established intestinal rehabilitation program who achieved EA and to assess the predictors of EA. BACKGROUND: There have been considerable advancements in the management of IF over the last 15 years, children with short bowel syndrome with a reduction in mortality. Several studies have discussed variables that may influence the ability to attain EA; however, majority were written when mortality rates were considerably higher compared with the current contemporary experience...
December 4, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29182898/reconnection-surgery-in-adult-post-operative-short-bowel-syndrome-100-cm-is-colonic-continuity-sufficient-to-achieve-enteral-autonomy-without-autologous-gastrointestinal-reconstruction-report-from-a-single-center-and-systematic-review-of-literature
#12
A Lauro, R Cirocchi, N Cautero, A Dazzi, D Pironi, F M Di Matteo, A Santoro, L Pironi, A D Pinna
A systematic bibliographic research concerning patients operated on for SBS was performed: inclusion criteria were adult age, reconnection surgery and SBS < 100 cm. Autologous gastrointestinal reconstruction represented an exclusion criteria. The outcomes of interest were the rate of total parenteral nutrition (TPN) independence and the length of follow-up (minimum 1 year) after surgery. We reviewed our experience from 2003 to 2013 with minimum 1-year follow-up, dealing with reconnection surgery in 13 adults affected by < 100 cm SBS after massive small bowel resection: autologous gastrointestinal reconstruction was not feasible...
July 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29161210/index-use-of-smoflipid-in-a-tertiary-intestinal-rehabilitation-and-transplantation-program
#13
Kwai Lam, Thomas Schiano, Maria Isabel Fiel, Kishore Iyer
Long-term parenteral nutrition (PN) may be complicated by PN-associated liver disease (PNALD), and some studies suggest an association between the use of soy-based fat emulsions and PNALD development. Patients' liver function typically improves and PNALD resolves after reducing or stopping a soy-based fat emulsion, and thus lipid minimization has been the primary strategy for managing PNALD in many intestinal rehabilitation programs. However, fat emulsions often cannot be stopped entirely, leading some patients to develop PNALD even after lipid reduction strategies have been implemented...
November 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29130223/-metabolic-changes-in-patients-with-short-bowel-syndrome-and-the-nutritional-support-therapy
#14
Guohao Wu
Patients with short bowel syndrome suffer from fluid and electrolyte imbalance and malabsorption due to poor nutrient processing capability of the residual intestine. Nutritional support therapy has been considered as one of the important treatments for short bowel syndrome. For patients with short bowel syndrome, a deep understanding of metabolic changes, and then rational application of nutritional support therapy and intestinal rehabilitation program can save many patients' lives, improve quality of life, and even achieve independence from parenteral nutrition, and return to a normal life...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28964480/pediatric-intestinal-transplantation
#15
REVIEW
Kyle A Soltys, Geoff Bond, Rakesh Sindhi, Sara K Rassmussen, Armando Ganoza, Ajai Khanna, George Mazariegos
The field of intestinal transplantation has experienced dramatic growth since the first reported cases 3 decades ago. Improvements in operative technique, donor assessment and immunosuppressive protocols have afforded children who suffer from life-threatening complications of intestinal failure a chance at long-term survival. As experience has grown, newer diseases, with more systemic manifestations have arisen as potential indications for transplant. After discussing the historical developments of intestinal transplant as a backdrop, this review focuses on the specific pre-operative indications for transplant as well as the great success that intestinal rehabilitation has witnessed over the past decade...
August 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28943136/the-extent-of-intestinal-failure-associated-liver-disease-in-patients-referred-for-intestinal-rehabilitation-is-associated-with-increased-mortality-an-analysis-of-the-pediatric-intestinal-failure-consortium-database
#16
Patrick J Javid, Assaf P Oron, Christopher Duggan, Robert H Squires, Simon P Horslen
BACKGROUND: The advent of regional multidisciplinary intestinal rehabilitation programs has been associated with improved survival in pediatric intestinal failure. Yet, the optimal timing of referral for intestinal rehabilitation remains unknown. We hypothesized that the degree of intestinal failure-associated liver disease (IFALD) at initiation of intestinal rehabilitation would be associated with overall outcome. METHODS: The multicenter, retrospective Pediatric Intestinal Failure Consortium (PIFCon) database was used to identify all subjects with baseline bilirubin data...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28866623/epidemiology-management-and-outcome-of-ultrashort-bowel-syndrome-in-infancy
#17
REVIEW
Akshay Batra, Simon Charlie Keys, Mark John Johnson, Robert A Wheeler, Robert Mark Beattie
Ultrashort bowel syndrome (USBS) is a group of heterogeneous disorders where the length of small bowel is less than 10 cm or 10% of expected for the age. It is caused by massive loss of the gut which in the neonatal period can be a result of vanishing gastroschisis or surgical resection following mid-gut volvulus, jejunoileal atresia and/or extensive necrotising enterocolitis. The exact prevalence of USBS is not known although there is a clear trend towards increasing numbers because of increased incidence and improved survival...
November 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28838002/pediatric-intestinal-rehabilitation-and-transplantation-registry-initial-report-from-a-european-collaborative-registry
#18
Giorgia Totonelli, Roberto Tambucci, Alessandro Boscarelli, Dominique Hermans, Luigi Dall'Oglio, Antonella Diamanti, Aloys du Bois d'Aische, Mikko Pakarinen, Raymond Reding, Francesco Morini, Pietro Bagolan, Fabio Fusaro
INTRODUCTION:  Short bowel syndrome (SBS) is the main cause of intestinal failure (IF) in the pediatric population. To promote the standardization of care of these patients, the registry of Pediatric Intestinal Rehabilitation and Transplantation (PIRAT) has been established. The aim of this study is to describe patients with IF using PIRAT database. MATERIALS AND METHODS:  Data from two tertiary care European referral Centers registered in PIRAT (https://www...
February 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28837507/intestinal-rehabilitation-programs-in-the-management-of-pediatric-intestinal-failure-and-short-bowel-syndrome
#19
Russell J Merritt, Valeria Cohran, Bram P Raphael, Timothy Sentongo, Diana Volpert, Brad W Warner, Praveen S Goday
Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation...
November 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28731841/survey-of-nutrition-management-practices-in-centers-for-pediatric-intestinal-rehabilitation
#20
Anita M Nucci, Kipp Ellsworth, Austin Michalski, Emily Nagel, Jackie Wessel
BACKGROUND: Nutrition management of pediatric intestinal failure (IF) requires interdisciplinary coordination of parenteral nutrition (PN) and enteral nutrition (EN) support. Nutrition strategies used by specialists in pediatric intestinal rehabilitation to promote gut adaptation and manage complications have not been previously summarized. METHODS: A practice survey was distributed to members of the dietitian subgroup of the American Society for Parenteral and Enteral Nutrition Pediatric Intestinal Failure Section...
July 1, 2017: Nutrition in Clinical Practice
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