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Thoracic nutrition

Zuhair Ahmed, Jessie A Elliott, Sinead King, Claire L Donohoe, Narayanasamy Ravi, John V Reynolds
BACKGROUND: Benign anastomotic strictures occur frequently after esophagectomy, and impact on postoperative recovery, nutritional status, and quality of life. This large cohort study explored the incidence of stricture after transthoracic (2- and 3-stage) and transhiatal resections with uniform single-layer sutured anastomotic technique, and aimed to identify independent risk factors. METHODS: Patients undergoing esophagectomy with gastric conduit reconstruction between February 2001 and October 2014 were studied prospectively...
October 24, 2016: World Journal of Surgery
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
Fei Chang, Dasheng Cheng, Mingyuan Qian, Wei Lu, Huatao Li, Hongtai Tang, Zhaofan Xia
BACKGROUND As patients with thoracic duct injuries often suffer from severe local soft tissue defects, integrated surgical treatment is needed to achieve damage repair and wound closure. However, thoracic duct chylous fistula is rare in burn patients, although it typically involves severe soft tissue damage in the neck or chest. CASE REPORT A 32-year-old male patient fell after accidentally contacting an electric current (380 V) and knocked over a barrel of sulfuric acid. The sulfuric acid continuously poured onto his left neck and chest, causing combined electrical and sulfuric acid burn injuries to his anterior and posterior torso, and various parts of his limbs (25% of his total body surface area)...
October 11, 2016: American Journal of Case Reports
Wenze Tian, Zhongwu Hu, Jian Ji, Dafu Xu, Zhenbing You, Wei Guo, Keping Xu
OBJECTIVE: To investigate the application of bundles of intervention in the treatment of esophageal carcinoma anastomotic leak. METHODS: From January 2014 to May 2015, 44 cases of esophageal carcinoma anastomotic fistula were treated by bundles of intervention (through the collection of a series of evidence-based treatment and care measures for the treatment of diseases) in Department of Thoracic Surgery, Huai'an First Hospital, Nanjing Medical University (bundles of intervention group), and 68 patients with esophageal carcinoma postoperative anastomotic leak from December 2013 to January 2012 receiving traditional therapy were selected as the control group...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Takahiro Toyokawa, Naoshi Kubo, Tatsuro Tamura, Katsunobu Sakurai, Ryosuke Amano, Hiroaki Tanaka, Kazuya Muguruma, Masakazu Yashiro, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: The purpose of this study was to investigate the impact of the Controlling Nutritional Status (CONUT) score on survival compared with the platelet to lymphocyte ratio (PLR), the neutrophil to lymphocyte ratio (NLR), and the Glasgow Prognostic Score (GPS) in patients with resectable thoracic esophageal squamous cell carcinoma (ESCC). METHODS: One hundred eighty-five consecutive patients who underwent subtotal esophagectomy with curative intent for resectable thoracic ESCC were retrospectively reviewed...
2016: BMC Cancer
Rakesh Kapoor, Anshuma Bansal, Shikhar Kumar, Ravi Teja Miriyala
BACKGROUND: The aim of this study is to identify the factors responsible for interruption of planned treatment in patients of carcinoma mid-thoracic esophagus and also discuss the strategies for improving treatment completion rates. MATERIALS AND METHODS: Patients with nonmetastatic mid-thoracic esophageal cancer who received treatment by multimodality approach using chemotherapy, radiation, and/or surgery were retrospectively analyzed. Factors influencing compliance with planned treatment completion were evaluated, and their significance was determined using multivariate Cox regression analysis...
July 2016: Indian Journal of Palliative Care
Conor T McCartney, Melissa N Weis, Gregg L Ruppel, Ravi P Nayak
BACKGROUND: Reversibility of obstructive lung disease is traditionally defined by changes in FEV1 or FVC in response to bronchodilators. These may not fully reflect changes due to a reduction in hyperinflation or air-trapping, which have important clinical implications. To date, only a handful of studies have examined bronchodilators' effect on lung volumes. The authors sought to better characterize the response of residual volume and total lung capacity to bronchodilators. METHODS: Responsiveness of residual volume and total lung capacity to bronchodilators was assessed with a retrospective analysis of pulmonary function tests of 965 subjects with obstructive lung disease as defined by the lower limit of normal based on National Health and Nutritional Examination Survey III prediction equations...
August 23, 2016: Respiratory Care
L Schweitzer, C Geisler, M Johannsen, C-C Glüer, M J Müller
BACKGROUND/OBJECTIVES: There are positive associations between pulmonary function (PF) and fat-free mass as well as muscle strength. Contrarily, negative associations were found with indirect measures of visceral adipose tissue (VAT). We aimed to differentiate between associations of body composition and PF by assessing mediating and moderating effects of physical capabilities. SUBJECTS/METHODS: Cross-sectional data were assessed among 40 healthy, free-living elderly (20 males) aged 65...
August 10, 2016: European Journal of Clinical Nutrition
Sushma Jonna, Leslie Chiang, Jingxia Liu, Maria B Carroll, Kellie Flood, Tanya M Wildes
PURPOSE: Survival in older adults with cancer varies given differences in functional status, comorbidities, and nutrition. Prediction of factors associated with mortality, especially in hospitalized patients, allows physicians to better inform their patients about prognosis during treatment decisions. Our objective was to analyze factors associated with survival in older adults with cancer following hospitalization. METHODS: Through a retrospective cohort study, we reviewed 803 patients who were admitted to Barnes-Jewish Hospital's Oncology Acute Care of Elders (OACE) unit from 2000 to 2008...
November 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
B Oyinkan Marquis, Patrick M Capone
Myelopathy is an inclusive term, referring to pathology leading to a neurologic deficit related to the spinal cord. The clinical diagnosis of myelopathy requires a detailed history and physical examination to define the clinical syndrome. Neuroimaging is indicated in most instances of new-onset myelopathy. It is indicated also when the worsening of a myelopathy is unexplained. Advances in neuroimaging have proved to play a vital role in diagnosis. Appropriate diagnosis and treatment are dependent upon an adequate imaging evaluation to establish the presence of mechanical stability, extrinsic spinal cord compression, or an intramedullary lesion...
2016: Handbook of Clinical Neurology
Argenis Herrera, Richard K Freeman
Esophageal stent placement was used primarily for the treatment of malignant strictures until the development of a new generation of biomaterials allowed the production of easily removable, occlusive stents in 2001. Since then, thoracic surgeons have gained experience using esophageal stents for the treatment of acute esophageal perforation. As part of a hybrid treatment strategy, including surgical drainage of infected spaces, enteral nutrition, and aggressive supportive care, esophageal stent placement has produced results that can exceed those of traditional surgical repair...
August 2016: Thoracic Surgery Clinics
Raphael Suy, Sarah Thomis, Inge Fourneau
The early history of lymphatic anatomy from Hippocrates (ca. 460-377 B.C.) to Eustachius (1510-1574). The presence of lymphatic vessels and lymph nodes was reported by ancient anatomists without any accurate knowledge of their true functions. Lymph nodes were described as spongy structures, spread over the whole body for the support of vulnerable body parts. Digestion was explained as being the resorption of clear chyle from digested food by the open endings of chyle vessels. The first insights into the place of lymphatic components within nutrition emanated from the medical school of Alexandria (fourth century B...
June 2, 2016: Acta Chirurgica Belgica
C McDonald, J Fraser, K Shekar, A Clarke, J Coombes, A Barnett, B Pearse, L Fung
BACKGROUND/OBJECTIVES: Post-operative atrial fibrillation (POAF) is a frequent complication of cardiac surgery. Oxidative stress and reduced antioxidant function have major roles in its development. Selenium is a key to normal antioxidant function, and levels are often low before cardiac surgery. This study investigated whether low preoperative selenium levels were associated with POAF in cardiac surgical patients. SUBJECTS/METHODS: Using the Society of Thoracic Surgeons (STS) Mortality risk score, 50 patients having primary coronary artery bypass grafts (CABG) surgery were divided into two groups: (i) low-risk group (STS ⩽0...
July 13, 2016: European Journal of Clinical Nutrition
Rabia Topan, Tim Ambrose, Mia Small, Elewys Lightman, Jeremy Nightingale, Simon M Gabe
Spinal infections are a rare yet serious metastatic complication of bacteremia among patients with long-term central venous catheters (CVCs) for which clinicians must remain vigilant. We performed a retrospective review of all cases of spinal infection occurring in the context of a CVC for long-term parenteral nutrition (PN) managed in our department between January 2010 and October 2013, a cohort of 310 patients over this time period. Six patients were identified (mean age, 65 years; 5 male). One hundred percent of patients presented with spinal pain (5/6 cervical, 1/6 thoracic)...
July 6, 2016: Nutrition in Clinical Practice
Armin Zittermann, Joachim Kuhn, Jana B Ernst, Tobias Becker, Julia Larisch, Jens Dreier, Cornelius Knabbe, Jochen Börgermann, Jan F Gummert
BACKGROUND: Vitamin D has immunomodulatory properties and seems to reduce the risk of infections. Whether low vitamin D concentrations are independent risk factors for nosocomial postoperative infections in surgical patients remains to be studied in detail. METHODS: In 3,340 consecutive cardiac surgical patients, we investigated the association of circulating 25-hydroxyvitamin D (25OHD; indicator of nutritional vitamin D status) and 1,25-dihydroxyvitamin D (1,25[OH]2D; active vitamin D hormone) with nosocomicial infections...
2016: PloS One
Bela Keshan, Bembem Thounaojam, Sanathoibi D Kh
Insulin and ecdysone signaling play a critical role on the growth and development of insects including Bombyx mori. Our previous study showed that Bombyx larvae reached critical weight for metamorphosis between day 3.5 and 4 of the fifth larval instar. The present study showed that the effect of insulin on the accumulation of glycogen in fat body of Bombyx larvae depends on the critical growth period. When larvae are in active growth period (before reaching critical weight), insulin caused increased accumulation of glycogen, while its treatment in larvae at terminal growth period (after critical period) resulted in an increased mobilization of glycogen...
June 14, 2016: General and Comparative Endocrinology
Mary E Huerter, Eric J Charles, Emily A Downs, Yinin Hu, Christine L Lau, James M Isbell, Timothy L McMurry, Benjamin D Kozower
BACKGROUND: The nutritional status of esophageal cancer patients during neoadjuvant therapy remains a challenging problem. The objective of this study was to determine whether routine enteral feeding tube placement improved nutritional status and perioperative outcomes for patients undergoing neoadjuvant therapy for esophageal cancer. METHODS: The Society of Thoracic Surgeons database was used to identify patients who underwent neoadjuvant therapy and esophagectomy at our institution between 2010 and 2014...
September 2016: Annals of Thoracic Surgery
Hyung Joo Park, Jae Jun Kim, Jae Kil Park, Seok Whan Moon
OBJECTIVES: Pectus excavatum is one of the most common congenital chest wall deformities, and is thought to be one of the musculoskeletal diseases. There have been few studies on the development of growth of patients with pectus excavatum. The objectives of the present study were to present the development of growth of patients with pectus excavatum and to investigate the effects of the Nuss procedure on the development of growth. METHODS: Data from 1371 patients who were treated for pectus excavatum (411 patients for only the Nuss procedure, 316 patients for only bar removal and 322 patients for both the Nuss procedure and the bar removal) at the Department of Thoracic and Cardiovascular Surgery in a single tertiary Korean Hospitals from March 2011 to December 2014 were assessed with respect to body measurements [height, weight and body mass index (BMI)]...
May 10, 2016: European Journal of Cardio-thoracic Surgery
Anindita Singha Roy, Amit Bandyopadhyay
During the month of Ramadan intermittent fasting (RIF), both dietary and sleep patterns are adversely affected to cope with the rituals of Ramadan. Literature suggests that sleep deprivation and alteration of dietary pattern and nutritional impairment affect the pulmonary structure and function. Pulmonary function during RIF was not explored earlier. The present study aimed to investigate the effects of RIF on pulmonary function tests (PFTs) in healthy young Muslim males. Fifty sedentary nonsmoking healthy young Muslim male individuals of 20 to 25 years of age without any history of pulmonary or other major diseases were recruited by simple random sampling from different parts of Kolkata, India...
April 22, 2016: American Journal of Men's Health
Jinsik Kim, Jee Won Chang, Su Wan Kim, Seogjae Lee
Bilateral chylothorax after transsternal total thymectomy is very rare, but can be a serious complication. Disruption of minor lymphatic channels in the anterior mediastinum which is remote from thoracic duct is considered to be the cause of chylothorax. We report the case of bilateral chylothorax followed by thymectomy which was treated with pleural drainage, total parenteral nutrition, and fasting without octreotide injection.
March 2016: Journal of Thoracic Disease
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