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Intestinal failure in children

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https://www.readbyqxmd.com/read/29443401/pediatric-intestinal-failure-associated-liver-disease-challenges-in-identifying-clinically-relevant-biomarkers
#1
Kathleen M Gura, Andrew E Mulberg, Paul D Mitchell, John Yap, Clara Y Kim, Minjun Chen, Alexis Potemkin, Mark Puder
BACKGROUND: Intestinal failure-associated liver disease (IFALD) is complex and diagnosed by concurrent use of parenteral nutrition, clinical presentation, and alterations in hepatic biomarkers exclusive of other causes of liver disease. In comparison with individual measures, composite biomarkers may provide a more effective means for assessing disease progression and response to treatment than single parameters. Since IFALD is considered by some to be a type of drug-induced liver injury (DILI), those diagnostic criteria could potentially be used in this population...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29436350/a-longitudinal-study-of-household-water-sanitation-and-hygiene-characteristics-and-environmental-enteropathy-markers-in-children-less-than-24-months-in-iquitos-peru
#2
Natalie G Exum, Gwenyth O Lee, Maribel Paredes Olórtegui, Pablo Peñataro Yori, Mery Siguas Salas, Dixner Rengifo Trigoso, Josh Colston, Kellogg J Schwab, Benjamin J J McCormick, Margaret N Kosek
Poor child gut health, resulting from a lack of access to an improved toilet or clean water, has been proposed as a biological mechanism underlying child stunting and oral vaccine failure. Characteristics related to household sanitation, water use, and hygiene were measured among a birth cohort of 270 children from peri-urban Iquitos Peru. These children had monthly stool samples and urine samples at four time points and serum samples at (2-4) time points analyzed for biomarkers related to intestinal inflammation and permeability...
February 12, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29413210/escherichia-coli-complications-in-pediatric-critical-care
#3
REVIEW
Suzanne S Puentes, Michele Dunstan
Escherichia coli is a bacterium that is an important part of the intestinal tract; however, it has the potential to become pathogenic. Shiga toxin-producing E coli (STEC) is a leading cause of E coli infections and has led to outbreaks in North America. Transmission is through ingestion of contaminated food sources, and via infected humans and animals. Young children infected with STEC are at high risk for developing hemolytic uremic syndrome (HUS). HUS is a clinical syndrome characterized by macroangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29389822/management-of-intestinal-failure-in-middle-income-countries-for-children-and-adults
#4
Gabriel E Gondolesi, Francisco Pattín, Hamed Nikkoupur
PURPOSE OF REVIEW: Intestinal failure is a life-threatening medical condition that remains as a rare or orphan disease in most countries. The prevalence of intestinal failure and the therapeutic options available in middle-income countries (MIC) remain unclear. We aim to provide an overview on the current differences in management of intestinal failure patients in MIC from Latin America and Asia. RECENT FINDINGS: In order to fulfil the challenge, and after facing the difficulties of going over a topic with scarce available data, from countries with an extreme variety of social and economic problems, which are closely related to the treatment of intestinal failure patients, we have used both the existing publications and personal surveys to draft this document...
January 30, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29385236/strategies-to-reduce-catheter-related-bloodstream-infections-in-pediatric-patients-receiving-home-parenteral-nutrition-the-efficacy-of-taurolidine-citrate-prophylactic-locking
#5
Cecile Lambe, Catherine Poisson, Cecile Talbotec, Olivier Goulet
BACKGROUND: Catheter-related bloodstream infections (CRBSIs) remain a major issue in patients who are receiving home parenteral nutrition (HPN). The aim of this interventional study was to assess the impact of a new strategy using taurolidine-citrate (T-C) prophylactic locks on the CRBSI rate in children with intestinal failure who are receiving HPN. METHODS: The rate of CRBSIs was monitored every calendar year in a prospective cohort of 195 children with intestinal failure...
January 31, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29383732/a-new-concept-to-achieve-optimal-weight-gain-in-malnourished-infants-on-total-parenteral-nutrition
#6
Elie Abi Nader, Cécile Lambe, Cécile Talbotec, Liping Dong, Bénédicte Pigneur, Olivier Goulet
BACKGROUND: Infants with intestinal failure (IF) are at increased risk of malnutrition and require adapted nutrition support. Optimal weight gain during nutrition rehabilitation should occur at the velocity of statural age (adjusted to the 50th percentile of height) and not chronological age. The aim of this study was to assess the relationship between weight gain during catch-up growth, nonprotein energy intake (NPEI) provided by total parenteral nutrition (TPN), and resting energy expenditure (REE) in children with severe malnutrition due to IF...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29382923/effect-of-a-fish-oil-based-lipid-emulsion-on-intestinal-failure-associated-liver-disease-in-children
#7
Tian Zhang, Nan Wang, Weihui Yan, Lina Lu, Yijing Tao, Fang Li, Ying Wang, Wei Cai
BACKGROUND/OBJECTIVES: The aim of this study was to assess the effects of a fish oil-based lipid emulsion on intestinal failure-associated liver disease (IFALD) in children. SUBJECTS/METHODS: From January 2014 through June 2017, we enrolled 32 children with IF on long-term parenteral nutrition (PN). When the levels of any three of seven liver indicators (TBA, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase, gamma glutamyl transferase (γ-GT), total bilirubin (TB), or direct bilirubin (DB)) were two times higher than normal levels, we switched a 50:50 mix of soybean oil and medium-chain triglycerides (MCT) lipid emulsion (with an average dose of 1...
January 30, 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29341979/wilson-s-disease-in-children-a-position-paper-by-the-hepatology-committee-of-the-european-society-for-paediatric-gastroenterology-hepatology-and-nutrition
#8
Piotr Socha, Wojciech Janczyk, Anil Dhawan, Ulrich Baumann, Lorenzo D'Antiga, Stuart Tanner, Raffaele Iorio, Pietro Vajro, Roderick Houwen, Björn Fischler, Antal Dezsofi, Nedim Hadzic, Loreto Hierro, Jörg Jahnel, Valérie McLin, Valerio Nobili, Francoise Smets, Henkjan J Verkade, Dominique Debray
BACKGROUND: Clinical presentations of Wilson's disease (WD) in childhood ranges from asymptomatic liver disease to cirrhosis or acute liver failure, whereas neurological and psychiatric symptoms are rare. The basic diagnostic approach includes serum ceruloplasmin and 24-hour urinary copper excretion. Final diagnosis of WD can be established using a diagnostic scoring system based on symptoms, biochemical tests assessing copper metabolism, and molecular analysis of mutations in the ATP7B gene...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29338456/an-update-on-the-safety-of-nutraceuticals-and-effects-on-lipid-parameters
#9
Arrigo F G Cicero, Alessandro Colletti
Cardiovascular diseases (CVDs) are the leading cause of mortality and disability in developed countries, whereas a large portion of patients in primary prevention have uncontrolled level of CVD risk factors. Dietary supplementation with bioactive natural compounds with demonstrated lipid-lowering effects is currently supported by the international guidelines for CVD prevention and some international expert panels. Areas covered: This review provides insights on issues concerning the tolerability and safety of the most commonly used nutraceuticals with demonstrated lipid-lowering effect in humans...
January 16, 2018: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29334565/reversal-of-intestinal-failure-in-children-with-tufting-enteropathy-supported-with-parenteral-nutrition-at-home
#10
Iona Ashworth, Alexander Wilson, Samuel Aquilina, Raymond Parascandalo, Victor Mercieca, Jurgen Gerada, Sarah Macdonald, Venetia Simchowitz, Susan Hill
OBJECTIVES: To review long-term outcome of Intestinal Epithelial Dysplasia(IED)/tufting enteropathy(TE) patients treated with parenteral nutrition(PN) at home managed by an intestinal failure(IF) rehabilitation service METHODS:: Infants presenting from 1986-2010 with IF, and TE histology were retrospectively reviewed for up to 30 years. Data collected included: outcome, presentation, nutrition(parenteral/enteral), country of residence, race, EpCAM gene, growth, bone age, occupation. RESULTS: 13 patients (6 male) in Malta and the UK with TE histology were established on home PN...
January 13, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29243034/application-of-pyridostigmine-in-pediatric-gastrointestinal-motility-disorders-a-case-series
#11
Mhd Louai Manini, Michael Camilleri, Rayna Grothe, Carlo Di Lorenzo
BACKGROUND: Gastrointestinal (GI) motility disorders are common in children. Treatment is challenging with limited medical and surgical options. Pyridostigmine, an acetyl cholinesterase inhibitor, increases acetylcholine at the neuromuscular junction promoting intestinal contractions. Little is known about the role and dosing of pyridostigmine in pediatric GI motility disorders. METHODS: We present a case series of children with GI dysmotility managed with oral pyridostigmine...
December 14, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/29210814/caregiver-education-reduces-the-incidence-of-community-acquired-clabsis-in-the-pediatric-patient-with-intestinal-failure
#12
Barbie Drews, Michelle Macaluso, Hannah Piper, Nandini Channabasappa
Pediatric patients with intestinal failure often require central venous catheters for extended periods of time for parenteral nutrition, blood sampling, and medication administration, increasing morbidity, mortality, and costs. In 2007, we reported a central line-associated bloodstream infection rate of 7.0 per 1,000 catheter line-days in our pediatric patients with intestinal failure. On the basis of this high rate of catheter-associated infections, we developed and implemented a central line care curriculum for patients/family caregivers and home health nurses...
November 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/29206679/predicting-intestinal-adaptation-in-pediatric-intestinal-failure-a-retrospective-cohort-study
#13
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/29203343/wide-variation-in-organisation-and-clinical-practice-of-paediatric-intestinal-failure-teams-an-international-survey
#14
Esther Neelis, Barbara de Koning, Myriam van Winckel, Merit Tabbers, Susan Hill, Jessie Hulst
BACKGROUND & AIMS: We aimed to assess the current organisation and clinical practice of teams treating children with intestinal failure (IF) across Europe and compare the results with the current guideline. METHODS: A two-part online survey was sent to all the major European specialist IF services. The first part concerned general information about the team and patients monitored. The second part concerned important care topics such as vascular access and monitoring of complications...
November 22, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29187397/the-spirochete-brachyspira-pilosicoli-enteric-pathogen-of-animals-and-humans
#15
REVIEW
David J Hampson
Brachyspira pilosicoli is a slow-growing anaerobic spirochete that colonizes the large intestine. Colonization occurs commonly in pigs and adult chickens, causing colitis/typhlitis, diarrhea, poor growth rates, and reduced production. Colonization of humans also is common in some populations (individuals living in village and peri-urban settings in developing countries, recent immigrants from developing countries, homosexual males, and HIV-positive patients), but the spirochete rarely is investigated as a potential human enteric pathogen...
January 2018: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/29187063/nutrition-deficiencies-in-children-with-intestinal-failure-receiving-chronic-parenteral-nutrition
#16
Shweta S Namjoshi, Sarah Muradian, Hannah Bechtold, Laurie Reyen, Robert S Venick, Elizabeth A Marcus, Jorge H Vargas, Laura J Wozniak
BACKGROUND: Home parenteral nutrition (PN) is a lifesaving therapy for children with intestinal failure (IF). Our aims were to describe the prevalence of micronutrient deficiencies (vitamin D, zinc, copper, iron, selenium) in a diverse population of children with IF receiving PN and to identify and characterize risk factors associated with micronutrient deficiencies, including hematologic abnormalities. METHODS: Data were collected on 60 eligible patients through retrospective chart review between May 2012 and February 2015...
February 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29187040/parenteral-soybean-oil-induces-hepatosteatosis-despite-addition-of-fish-oil-in-a-mouse-model-of-intestinal-failure-associated-liver-disease
#17
Prathima Nandivada, Gillian L Fell, Amy H Pan, Vania Nose, Paul D Mitchell, Kathleen M Gura, Mark Puder
BACKGROUND: Replacement of parenteral soybean oil (SO) with fish oil (FO) is an effective therapy for intestinal failure-associated liver disease (IFALD) in children. However, practitioners remain concerned about the risk of essential fatty acid deficiency (EFAD) and sometimes treat IFALD with a combination of 50% SO and 50% FO emulsions. The purpose of this study was to determine if mixing 50% SO and 50% FO emulsions would prevent hepatosteatosis in a murine model of parenteral nutrition (PN)-induced hepatosteatosis...
February 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29150304/are-the-estrogenic-hormonal-effects-of-environmental-toxins-affecting-small-intestinal-bacterial-and-microfilaria-overgrowth
#18
Edward Lichten
The important role of microfilaria (worms) in human and animal disease remains an area of key disagreement between the naturopathic and allopathic physicians. While microfilaria infections are rampart in undeveloped countries, they rarely rise to identification as a cause of disease in Western countries. New research studies in the diagnosis and treatment of SIBO (Small Intestinal Bacterial Overgrowth) and (IBD) Inflammatory Bowel Diseases of ulcerative colitis, Crohn's Disease and microcytic colitis may make both sides equally correct...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29144272/body-composition-in-children-with-chronic-illness-accuracy-of-bedside-assessment-techniques
#19
Enid E Martinez, Craig D Smallwood, Nicolle L Quinn, Katelyn Ariagno, Lori J Bechard, Christopher P Duggan, Nilesh M Mehta
OBJECTIVE: To evaluate the accuracy of estimated fat mass and fat-free mass from bedside methods compared with reference methods in children with chronic illnesses. STUDY DESIGN: Fat mass and fat-free mass values were obtained by skinfold, bioelectrical impedance analysis (BIA), dual-energy x-ray absorptiometry (DXA), and deuterium dilution method in children with spinal muscular atrophy, intestinal failure, and post hematopoietic stem cell transplantation (HSCT)...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29129242/intestinal-failure-as-a-significant-risk-factor-for-renal-impairment-in-children
#20
Elisa Ylinen, Laura Merras-Salmio, Riikka Gunnar, Timo Jahnukainen, Mikko P Pakarinen
OBJECTIVE: Although impaired renal function has been a frequent finding among adults with intestinal failure (IF), the data on children is scarce. The aim of this study was to assess renal function in pediatric-onset IF. METHODS: Medical records of 70 patients (38 boys) with pediatric-onset IF due to either short bowel syndrome (n = 59) or primary motility disorder (n = 11) and a history of parenteral nutrition (PN) dependency for ≥1 mo were evaluated. Renal function at the most recent follow-up was studied using plasma creatinine, cystatin C, and urea concentrations and estimated glomerular filtration rate (eGFR)...
January 2018: Nutrition
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