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Intestinal failure in children

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https://www.readbyqxmd.com/read/29210814/caregiver-education-reduces-the-incidence-of-community-acquired-clabsis-in-the-pediatric-patient-with-intestinal-failure
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/29126506/surgical-care-of-the-pediatric-crohn-s-disease-patient
#10
Dylan Stewart
Despite the significant advances in the medical management of inflammatory bowel disease over the last decade, surgery continues to play a major role in the management of pediatric Crohn's disease (CD). While adult and pediatric Crohn's disease may share many clinical characteristics, pediatric Crohn's patients often have a more aggressive phenotype, and the operative care given by the pediatric surgeon to the newly diagnosed Crohn's patient is very different in nature to the surgical needs of adult patients after decades of disease progression...
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29113094/pediatric-chronic-intestinal-failure-in-italy-report-from-the-2016-survey-on-behalf-of-italian-society-for-gastroenterology-hepatology-and-nutrition-sigenp
#11
Antonella Diamanti, Teresa Capriati, Paolo Gandullia, Grazia Di Leo, Antonella Lezo, Laura Lacitignola, Maria Immacolata Spagnuolo, Simona Gatti, Lorenzo D'Antiga, Giovanna Verlato, Paola Roggero, Sergio Amarri, Maria Elisabetta Baldassarre, Francesco Cirillo, Domenica Elia, Renata Boldrini, Angelo Campanozzi, Carlo Catassi, Marina Aloi, Claudio Romano, Manila Candusso, Nicola Cecchi, Tommaso Bellini, Elaine Tyndall, Fabio Fusaro, Tamara Caldaro, Daniele Alberti, Piergiorgio Gamba, Mario Lima, Pietro Bagolan, Jean De Ville de Goyet, Luigi Dall'Oglio, Marco Spada, Francesca Grandi
BACKGROUND: Intestinal failure (IF) is the reduction in functioning gut mass below the minimal level necessary for adequate digestion and absorption of nutrients and fluids for weight maintenance in adults or for growth in children. There is a paucity of epidemiologic data on pediatric IF. The purpose of this study was to determine the prevalence, incidence, regional distribution and underlying diagnosis of pediatric chronic IF (CIF) requiring home parenteral nutrition (HPN) in Italy...
November 5, 2017: Nutrients
https://www.readbyqxmd.com/read/29110830/long-term-outcomes-of-pediatric-intestinal-failure
#12
Brenna S Fullerton, Charles R Hong, Tom Jaksic
Management of pediatric intestinal failure has evolved in recent decades, with improved survival since the advent of specialized multidisciplinary intestinal failure centers. Though sepsis and intestinal failure associated liver disease still contribute to mortality, we now have growing data on the long-term outcomes for this population. While intestinal adaptation and parenteral nutrition weaning is most rapid during the first year on parenteral support, achievement of enteral autonomy is possible even after many years as energy and protein requirements decline dramatically with age...
October 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29079315/a-comparison-of-lipid-minimization-strategies-in-children-with-intestinal-failure
#13
Jessica Gonzalez-Hernandez, Purvi Prajapati, Gerald Ogola, Van Nguyen, Nandini Channabasappa, Hannah G Piper
PURPOSE: The purpose of this study was to compare outcomes of lipid minimization with either Intralipid (IL) or Omegaven® in children with intestinal failure (IF) who developed intestinal failure-associated liver disease (IFALD) while receiving parenteral nutrition (PN). METHODS: A retrospective review of children with IF requiring PN who developed IFALD (direct bilirubin >2 mg/dL) while receiving IL (2009-2016) was performed. Clinical characteristics, nutritional, and laboratory values were compared between children treated with reduced IL or Omegaven®...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29077646/high-incidence-of-proteinuria-in-children-with-chronic-intestinal-failure-under-long-term-parenteral-nutrition
#14
Heiko Billing, Anna Traunspurger, Ekkehard Sturm, Andreas Busch
Long-term home parenteral nutrition (LTPN) in children with chronic intestinal failure (CIF) is associated with renal complications such as fluid and electrolyte imbalances, nephrocalcinosis, nephrolithiasis and chronic kidney disease (CKD). The etiology of CIF-associated nephropathy is multifactorial. The aim of this study was to evaluate renal involvement under LTPN. In this study 50 patients with CIF, median age 4.2 years (1.4 - 9.3, 23 female) were included. Kidney involvement was a frequent finding in this study...
October 27, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29066581/reducing-time-to-antibiotics-in-children-with-intestinal-failure-central-venous-line-and-fever
#15
Joel D Hudgins, Vera Goldberg, Gillian L Fell, Mark Puder, Matthew A Eisenberg
BACKGROUND: Children with intestinal failure (IF) on parenteral nutrition (PN) are at high risk for bacteremia, and delays in antibiotic administration have been associated with increased morbidity and mortality. We designed an emergency department (ED) quality improvement (QI) initiative to reduce time to administration of intravenous antibiotics in febrile children with IF on PN. METHODS: Our aim was to decrease the mean time for febrile children with IF on PN to receive intravenous antibiotics by 50% to <60 minutes over a 12-month period...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29063585/early-8-days-systemic-postnatal-corticosteroids-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#16
REVIEW
Lex W Doyle, Jeanie L Cheong, Richard A Ehrenkranz, Henry L Halliday
BACKGROUND: Bronchopulmonary dysplasia remains a major problem in neonatal intensive care units. Persistent inflammation in the lungs is the most likely underlying pathogenesis. Corticosteroids have been used to prevent or treat bronchopulmonary dysplasia because of their potent anti-inflammatory effects. OBJECTIVES: To examine the relative benefits and adverse effects of systemic postnatal corticosteroids commenced within the first seven days of life for preterm infants at risk of developing bronchopulmonary dysplasia...
October 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29062711/strongyloides-hyperinfection-syndrome-causing-fatal-meningitis-and-septicemia-by-citrobacter-koseri
#17
Felix Reyes, Navneet Singh, Nigar Anjuman-Khurram, Jihae Lee, Lillian Chow
Citrobacter koseri is a gram-negative bacillius that belongs to the Enterobacteriaceae family. It is an uncommon pathogen that typically causes meningitis and brain abscesses in children, however central nervous system (CNS) infections are rarely found in adults. We present a case of C. koseri meningitis in an immunocompetent adult secondary to intestinal micro-perforation caused by Strongyloides A 76-year-old man admitted for asthma exacerbation developed septic shock. A lumbar puncture revealed bacterial meningitis...
2017: IDCases
https://www.readbyqxmd.com/read/28987713/radiographic-measurement-of-intestinal-length-among-children-with-short-bowel-syndrome-retrospective-determination-remains-problematic
#18
Cristine S Velazco, Brenna S Fullerton, Joseph A Brazzo, Charles R Hong, Tom Jaksic, Carol E Barnewolt
PURPOSE: Small bowel length is the most reliable predictor of enteral independence in pediatric short bowel syndrome. Retrospectively measured bowel lengths on upper GI with small bowel follow-through (UGI/SBFT) were compared to operative measurements. METHODS: A pediatric radiologist and surgical trainees blinded to operative measurements retrospectively analyzed UGI/SBFT studies using the digital radiography curved measurement tool. Children with SBS and severe intestinal failure (parenteral nutrition >90days) at a multidisciplinary intestinal failure program 2002-2015 were included...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28964480/pediatric-intestinal-transplantation
#19
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
#20
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
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